Jim Jeffords

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, it gives me great pleasure to join my colleagues today in introducing the Ryan White Comprehensive AIDS Resources and Emergency Act Amendments of 2000; a measure that will reauthorize a national program of providing primary health care services for people living with HIV and AIDS. I especially want to commend Senators Hatch and Kennedy for the leadership they have provided since the inauguration of the legislation establishing the Ryan White programs over a decade ago. I also want to commend Senator Frist whose medical expertise played a critical role in key provisions of the bill and continues to be an invaluable resource to our efforts on the range of health issues that come before the Senate. Finally, I want to acknowledge Senator Enzi's recognition of the growing burden that AIDS and HIV is having on rural communities throughout the country and the need to address those gaps in services. Since its inception in 1990, the Ryan White program has enjoyed broad bipartisan support. When I looked back to the last time the Ryan White CARE Act was reauthorized in 1996, I was heartened to see that the measure had garnered a vote of 97 to 3 on its final passage. I urge my colleagues to examine this bill we are introducing today and to join me in working toward its passage. With this reauthorization, we mark the ten years through which the Ryan White CARE Act has provided needed health care and support services to HIV positive people around the country. Titles I and II have provided much needed relief to cities and states hardest hit by this disease, while Titles III and IV have had a direct role in providing healthcare services to underserved communities. Ryan White program dollars provide the foundation of care so necessary in fighting this epidemic. Fortunately, we have experienced significant success over the last decade, and especially over the last five years. The General Accounting Office recently released a report that found that CARE Act funds are reaching the infected groups that have generally been found to be underserved, including the poor, the uninsured, women, and ethnic minorities. In fact, these groups form a majority of CARE Act clients and are being served by the CARE Act in higher proportions than their representation in the AIDS population. The GAO also found that CARE Act funds support a wide array of primary care and support services, including the provision of powerful therapeutic regimens for people with HIV/AIDS that have dramatically reduced AIDS diagnoses and deaths. Mr. President, there have also been successes in the reduction of HIV/AIDS among women, infants and children. During the last reauthorization, Congressman Coburn and our colleague, Senator Frist, focused our attention on the needs of women living with HIV/AIDS and the problems associated with perinatal transmission of HIV. Since then, the CARE Act has helped to dramatically reduce mother-to-child transmission through more effective outreach, counseling, and voluntary testing of mothers at risk for HIV infection. Between 1993 and 1998, perinatal-acquired AIDS cases declined 74% in the U.S. In this bill, I have continued to support efforts to reach women in need of care for their HIV disease and have included provisions to ensure that women, infants and children receive resources in accordance with the prevalence of the infection among them. Another key success has been the AIDS Drug Assistance Program. New therapies and improved systems of care have led to impressive reductions in the AIDS death rate and the number of new AIDS cases. From 1996 to 1998, deaths from AIDS dropped 54% while new AIDS cases have been reduced by 27%. However, these treatments are very expensive, do not provide a cure, and do not work for everyone. Much has occurred to change the course of the AIDS epidemic since the last reauthorization. A whole new class of therapeutic drugs called anti-retrovirals have been developed and people are living longer and the rate of increase of the number of new AIDS cases has begun to level off. AIDS, HIV, the people it infects and families that it has affected are not in the news today as often as they have been in the past. But for too many of us, this lack of bad news has created a false sense of complacency. The epidemic of HIV continues to grow, to infect whole new groups of people, and to expand both within our urban areas and beyond to our rural communities. While the rate of decline in new AIDS cases and AIDS deaths is leveling off, HIV infection rates continue to rise in many areas; becoming increasingly prevalent in rural and underserved urban areas; and also among women, youth, and minority communities. Local and state healthcare systems face an increasing burden of disease, despite our success in treating and caring for people living with HIV and AIDS. Unfortunately, rural and underserved urban areas are often unable to address the complex medical and support services needs of people with HIV infection. The bill being introduced today was developed on a bipartisan basis, working with other Committee Members, community stakeholders and elected officials at the state and local levels from whom we sought input to ensure that we addressed the most important problems facing communities of people with HIV infection. Earlier this month, I held a hearing before the Committee on Health, Education, Labor, and Pensions to learn whether the program has been successful and whether it needed to be changed. We received testimony from Ryan White's mother, Jeanne White, from Surgeon General David Satcher, from a person living with AIDS, as well as state and local officials familiar with the importance of this program. I especially want to commend Dr. Chris Grace of Vermont who testified as to the particular challenges of providing care to people living with HIV/AIDS in rural, and sometimes remote, parts of the country. It was clear from our witnesses' statements that, despite the successes, challenges remain. To address these challenges, we have developed a bill that will improve access to care in underserved urban and rural areas. My bill will double the minimum base funding available to states through the CARE Act to assist them in developing systems of care for people struggling with HIV and AIDS. The bill also includes a new supplemental state grant that will target assistance to rural and underserved areas to help them address the increasing number of people with HIV/AIDS living outside of urban areas that receive assistance under Title I of the Act. Furthermore, these areas will be given preference for direct care grants and we have strengthened the AIDS Drug Assistance Program to supplement those states struggling to provide lifesaving drugs to their HIV/AIDS patients. We have not changed the unique flexibility of CARE Act programs; it remains primarily a system of grants to State and local jurisdictions. States and EMAs will still decide how to best prioritize and address the healthcare needs of their HIV-positive citizens. Today, there are few people who can say they have not been touched by this epidemic. Recently, I had the opportunity to visit with Jeanne White. We talked about the impact of this disease; about the loved ones it has taken, and the damage to the lives of those it has left behind-- about the infected, and about the affected. We talked about her son Ryan, and about my good friend David Curtis of Burlington, Vermont, who testified before my committee in 1995, but who passed away just last year. As an advocate of the program and as a person living with AIDS, David helped me to understand the terrible impact of this disease. Ryan White and David and countless others, worked long and hard to ensure that all people affected by AIDS could receive both the care and compassion they deserve. The AIDS epidemic, despite our success in developing treatments and providing systems of care, is still ravaging communities in this country. This program remains as vital to the public health of this nation as it was in 1990 and in 1996. As the AIDS epidemic reaches into rural areas and into underserved urban communities across the country, this legislation being introduced today will allow us to adapt our care systems to meet the most urgent needs in the communities hardest hit by the epidemic. I intend to see this bill become law this year so that the people struggling to overcome the challenges of HIV and AIDS continue to benefit from high quality medical care and access to lifesaving drugs. We have made incredible progress in the fight against HIV/AIDS and I want to be sure that every person in America that needs our assistance, benefits from our tremendous advances. Mr. President I ask unanimous consent that the text of this measure be printed in the Record.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I ask unanimous consent to proceed as in morning business for a period not to exceed 5 minutes.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am delighted to be here today to introduce the Worker Economic Opportunity Act. Having worked with colleagues from both sides of the aisle and the Department of Labor, I am extremely proud of this collaborative effort which has resulted in this legislation which will encourage employers to provide equity ownership opportunities to their hourly employees. In the last 10 years, we have witnessed tremendous change in the structure of our Nation's economy in large part due to the birth of the internet and e-commerce. The vitality of our economy is a tribute to the creative and entrepreneurial genius of thousands of individual business people and the indispensable contribution of the American workforce. As legislators during this exciting time, we are challenged to maintain an environment that will foster the continued growth of our economy. We must work to ensure that our laws are in sync with the changing environment. However, many of the laws and policies governing our workplace have fallen out of sync with the information age and there has been particular resistance to changing our labor laws. As Chairman of the Senate Committee with jurisdiction over workplace issues, I believe it is time to examine and modify these laws to meet the rapidly involving needs of the American workforce. The Fair Labor Standards Act (FLSA), for example, was enacted in the late 1930s, to establish basic standards for wages and overtime pay. While the principles behind the FLSA have not changed, its rigid provisions make it difficult for employers to accommodate the needs of today's workforce. Most recently, we discovered that the FLSA actually operates to deter employers from offering stock option programs to hourly employees. While stock option programs are most prevalent in the high tech industry, increasingly employers across the whole spectrum of American industry have begun to offer stock option programs to all of their employees. Broad-based stock option programs prove valuable to both employers and employees. For employers, stock options programs have become a key tool for employee recruitment, motivation and retention. Employees seek out companies offering these programs because they enable workers to become owners and reap the benefits of their company's growth. When I heard about the FLSA's application to stock options, I became very concerned about its impact on our workforce. I was pleased to discover that Senators' McConnell, Dodd, and Enzi shared similar concerns and that the Department of Labor also recognized that we had a problem on our hands that would require a legislative solution. Together we have crafted the Worker Economic Opportunity Act which will create a new exemption under the Fair Labor Standards Act for stock options, stock appreciation rights and employee stock purchase plans.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am delighted to be here today to introduce the Worker Economic Opportunity Act. Having worked with colleagues from both sides of the aisle and the Department of Labor, I am extremely proud of this collaborative effort which has resulted in this legislation which will encourage employers to provide equity ownership opportunities to their hourly employees. In the last 10 years, we have witnessed tremendous change in the structure of our Nation's economy in large part due to the birth of the internet and e-commerce. The vitality of our economy is a tribute to the creative and entrepreneurial genius of thousands of individual business people and the indispensable contribution of the American workforce. As legislators during this exciting time, we are challenged to maintain an environment that will foster the continued growth of our economy. We must work to ensure that our laws are in sync with the changing environment. However, many of the laws and policies governing our workplace have fallen out of sync with the information age and there has been particular resistance to changing our labor laws. As Chairman of the Senate Committee with jurisdiction over workplace issues, I believe it is time to examine and modify these laws to meet the rapidly involving needs of the American workforce. The Fair Labor Standards Act (FLSA), for example, was enacted in the late 1930s, to establish basic standards for wages and overtime pay. While the principles behind the FLSA have not changed, its rigid provisions make it difficult for employers to accommodate the needs of today's workforce. Most recently, we discovered that the FLSA actually operates to deter employers from offering stock option programs to hourly employees. While stock option programs are most prevalent in the high tech industry, increasingly employers across the whole spectrum of American industry have begun to offer stock option programs to all of their employees. Broad-based stock option programs prove valuable to both employers and employees. For employers, stock options programs have become a key tool for employee recruitment, motivation and retention. Employees seek out companies offering these programs because they enable workers to become owners and reap the benefits of their company's growth. When I heard about the FLSA's application to stock options, I became very concerned about its impact on our workforce. I was pleased to discover that Senators' McConnell, Dodd, and Enzi shared similar concerns and that the Department of Labor also recognized that we had a problem on our hands that would require a legislative solution. Together we have crafted the Worker Economic Opportunity Act which will create a new exemption under the Fair Labor Standards Act for stock options, stock appreciation rights and employee stock purchase plans.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to discuss my thoughts on a constitutional amendment to ban flag burning and other acts of desecration. As a veteran of 30 years in the United States Navy and United States Naval Reserve, I know the pride members of the Armed Forces have in seeing the United States flag wherever they may be in the world. I share the great respect most Vermonters and Americans have for this symbol. I personally abhor the notion that anyone would choose to desecrate or burn the flag as a form of self-expression. Members of the Armed Services place their lives at risk to defend the rights guaranteed by the United States Constitution, including the First Amendment freedom of speech. It is disrespectful of these past and present sacrifices to desecrate this symbol. It seems highly ironic to me that an individual would desecrate the symbol of the country that provides freedoms such as the first amendment freedom of speech. However, in my opinion the first amendment means nothing if it is not strong enough to protect the rights of those who express unpopular ideas or choose a distasteful means of this expression. I have given this issue a great deal of thought. I must continue to oppose this amendment since I do not think that a valid constitutional amendment, one that does not infringe on the first amendment, can be crafted. The first amendment right of freedom of speech is not an absolute right though as we have in the past recognized the legitimacy of some limits on free speech. I do not think, however, that we should open the Bill of Rights to amendment for the first time in our history unless our basic values as a nation are seriously threatened. In this case, in recent years there have not been a significant number of incidents of this misbehavior. In my view, a few flag desecrations or burnings around the Nation by media-seeking malcontents does not meet this high standard and I therefore cannot support the adoption of this amendment.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am here today to introduce the Homebound Clarification Act of 2000. This important bill has been crafted to protect Medicare beneficiaries from a growing problem that is impeding access to vital home care services. I want to recognize my cosponsors, Senator Reed of Rhode Island and Senator Leahy, for their continued effort and dedication to protecting access to home health care. Federally funded home health care is an often quiet but invaluable part of life for America's seniors. Medical treatment can often mean being subjected to a strange and unfamiliar environment. For our nation's elderly, who may have special needs, this inconvenience can be more severe and detrimental to successful recovery. Home health care means that people recovering from surgery can go home sooner--it means that someone recovering from an accident can get physical therapy in their home, it means our seniors can stay at home, and out of nursing homes. The sooner you can return patients to their homes, the sooner they can recover. The familiar environment of the home, family, and friends is more nurturing to recovering patients than the often stressful and unfamiliar surroundings of a hospital. Home health is also a great avenue for education. It empowers families to assist in the care of their loved ones. It is smart policy from human and financial standpoints. But there are some seniors who are being denied access to this smart policy. An individual must be considered ``homebound'' to qualify for Medicare reimbursement for home health. Though an individual is not required to be bed-ridden, the condition of the individual should include ``a normal inability to leave the home.'' Under the current definition, an individual is ``homebound'' if ``leaving the home requires a considerable and taxing effort by the individual, and that absences of the individual from home are infrequent and of short duration, or are attributable to the need to receive medical treatment.'' The definition allows for ``infrequent'' or ``short duration,'' recognizing that short excursions may be a part of a successful recovery process, but leaves it up to fiscal intermediaries to interpret exactly what number is frequent and how short an absence must be. Interpretation of this definition has varied widely. Sadly, there is a ready supply of disturbing examples of the overzealous and arbitrary interpretation of the definition. Many seniors have found themselves virtual prisoners in their homes, threatened with loss of coverage if they attend adult day care, weekly religious services, or even visit family members in the hospital. This makes no sense because all of these activities are steps on the road to successful and healthy recovery. Often, health professionals want patients to get outside for fresh air or exercise, as part of their care plan. This helps fight off depression. Seniors deserve a more consistent standard to depend upon, rather than a completely arbitrary number of absences from the home. In April 1999, Secretary of Health and Human Services Donna Shalala sent a report to Congress on the homebound definition. The report identifies the wide variety in interpretation of the definition and the absurdity of some coverage determinations that follow. While the Administration unfortunately stopped short of taking action themselves, Shalala did propose that a clarification of the definition is needed to improve uniformity of determination. The Homebound Clarification Act states that eligibility of an individual depends on the condition of the patient, how ``taxing'' it is for the patient to leave home. It strikes the clause that states: ``that absences of the individual from home are infrequent or of relatively short duration, or are attributable to the need to receive medical treatment.'' This is consistent with the intent of Congress and the Administration. This will not open the door to wider coverage of home health, but rather protect coverage for those who need it. We ask that seniors put their trust in the Medicare program. We are responsible for making sure that the Medicare program lives up to its promise and that home health will be available to those who need it. Once again, I would like to thank my cosponsors, Senators Reed and Leahy for their work. We look forward to working with the rest of Congress to turn this legislation into law.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am here today to introduce the Homebound Clarification Act of 2000. This important bill has been crafted to protect Medicare beneficiaries from a growing problem that is impeding access to vital home care services. I want to recognize my cosponsors, Senator Reed of Rhode Island and Senator Leahy, for their continued effort and dedication to protecting access to home health care. Federally funded home health care is an often quiet but invaluable part of life for America's seniors. Medical treatment can often mean being subjected to a strange and unfamiliar environment. For our nation's elderly, who may have special needs, this inconvenience can be more severe and detrimental to successful recovery. Home health care means that people recovering from surgery can go home sooner--it means that someone recovering from an accident can get physical therapy in their home, it means our seniors can stay at home, and out of nursing homes. The sooner you can return patients to their homes, the sooner they can recover. The familiar environment of the home, family, and friends is more nurturing to recovering patients than the often stressful and unfamiliar surroundings of a hospital. Home health is also a great avenue for education. It empowers families to assist in the care of their loved ones. It is smart policy from human and financial standpoints. But there are some seniors who are being denied access to this smart policy. An individual must be considered ``homebound'' to qualify for Medicare reimbursement for home health. Though an individual is not required to be bed-ridden, the condition of the individual should include ``a normal inability to leave the home.'' Under the current definition, an individual is ``homebound'' if ``leaving the home requires a considerable and taxing effort by the individual, and that absences of the individual from home are infrequent and of short duration, or are attributable to the need to receive medical treatment.'' The definition allows for ``infrequent'' or ``short duration,'' recognizing that short excursions may be a part of a successful recovery process, but leaves it up to fiscal intermediaries to interpret exactly what number is frequent and how short an absence must be. Interpretation of this definition has varied widely. Sadly, there is a ready supply of disturbing examples of the overzealous and arbitrary interpretation of the definition. Many seniors have found themselves virtual prisoners in their homes, threatened with loss of coverage if they attend adult day care, weekly religious services, or even visit family members in the hospital. This makes no sense because all of these activities are steps on the road to successful and healthy recovery. Often, health professionals want patients to get outside for fresh air or exercise, as part of their care plan. This helps fight off depression. Seniors deserve a more consistent standard to depend upon, rather than a completely arbitrary number of absences from the home. In April 1999, Secretary of Health and Human Services Donna Shalala sent a report to Congress on the homebound definition. The report identifies the wide variety in interpretation of the definition and the absurdity of some coverage determinations that follow. While the Administration unfortunately stopped short of taking action themselves, Shalala did propose that a clarification of the definition is needed to improve uniformity of determination. The Homebound Clarification Act states that eligibility of an individual depends on the condition of the patient, how ``taxing'' it is for the patient to leave home. It strikes the clause that states: ``that absences of the individual from home are infrequent or of relatively short duration, or are attributable to the need to receive medical treatment.'' This is consistent with the intent of Congress and the Administration. This will not open the door to wider coverage of home health, but rather protect coverage for those who need it. We ask that seniors put their trust in the Medicare program. We are responsible for making sure that the Medicare program lives up to its promise and that home health will be available to those who need it. Once again, I would like to thank my cosponsors, Senators Reed and Leahy for their work. We look forward to working with the rest of Congress to turn this legislation into law.

Mr. JEFFORDS

Mr. JEFFORDS. Hunger in this time of prosperity should not be tolerated by people of any party affiliation. The American people overwhelmingly support hunger relief efforts, and many of them volunteer their time and resources to help in their communities. I'm encouraged that the groundwork for modest hunger relief has been laid entirely in a bipartisan spirit, and should continue this way through passage of legislation that the experts on the Agriculture Committee have perfected. I join my colleagues from both sides of the aisle in inviting the Budget Committee to preserve this spirit as it reserves $2.5 billion over five years for hunger relief legislation. This will produce a significant bipartisan, moderate accomplishment this session for people in obvious need.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am very pleased to join my colleagues, Senators Grassley, Kennedy and Harkin in introducing the Family Opportunity Act of 2000. We are taking the right step, the logical step, and a much needed step. The last bill signed into law in the 20th Century was the Work Incentives Improvement Act. Through it, we extended health care coverage to adults with disabilities who work, by allowing them to buy- in to Medicaid coverage regardless of their income. Tomorrow, we set out to help children with disabilities by introducing the Family Opportunity Act. This legislation will create a similar Medicaid buy-in option for families of children with disabilities. When a child is born, it is a time for joy, hope, and dreams. If the child has a serious medical condition that may lead to a significant disability, or if the child is born with a disability, these feelings are often put on hold. Instead, the families of these children must concentrate on some basic facts, facts that may be a matter of life and death. These facts will shape the quality of life that the family can offer the child. The family will have to answer some important questions. First, do they have health insurance? If so, does the insurance cover the cost of the specialized services that their child needs? Families who answer `NO' to these questions are overwhelmed and fearful, and their vision of the future is filled with uncertainty. Every day, children in America are born with severe disabilities that require specialized health care services. Too often, the parents of these children do not have health care coverage or their coverage does not cover the needed services. These families do not have many options. Their child can receive health care coverage only if the family is poor, or if the family gives the child up to the state. We have all heard heart wrenching stories, but none are more traumatic than these. The Family Opportunity Act of 2000 is a solution to this tragic problem. Children without health insurance will now be covered. Those children with disabilities whose health insurance does not cover the services they need, will also be covered. Children with significant disabilities will no longer be denied the health care coverage they need, regardless of their family's income. Their families will, however, be expected to contribute to the cost of coverage. In addition, these families will have access to assistance from a Family Health Information Center. This service will provide families with information about their options and will help them exercise these options. Their children will receive the care they need and deserve. Data from the Social Security Administration indicates that in December 1999 there were 1,080 Vermont children with disabilities eligible for Medicaid. That means that the families of these children are poor. Some of these families have chosen to keep their income under the prescribed limits in law, so that they can access health care through Medicaid for their child with a disability. These families cannot access health care coverage for their children through the private sector. With the Family Opportunity Act everyone wins. Through Medicaid, children with disabilities will receive the health care services they desperately need. Through the Family Health Information Centers, their families will be provided with the right information at the right time. Families will be able to make key medical decisions that will maximize the quality of life for their children with disabilities. And, the federal and state governments will have a cost-effective program to help children and families in need. The Family Opportunity Act of 2000 will make time for joy, hope, and dreams, for families of children with special needs. This is a good start to the 21st Century.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am very pleased to join my colleagues, Senators Grassley, Kennedy and Harkin in introducing the Family Opportunity Act of 2000. We are taking the right step, the logical step, and a much needed step. The last bill signed into law in the 20th Century was the Work Incentives Improvement Act. Through it, we extended health care coverage to adults with disabilities who work, by allowing them to buy- in to Medicaid coverage regardless of their income. Tomorrow, we set out to help children with disabilities by introducing the Family Opportunity Act. This legislation will create a similar Medicaid buy-in option for families of children with disabilities. When a child is born, it is a time for joy, hope, and dreams. If the child has a serious medical condition that may lead to a significant disability, or if the child is born with a disability, these feelings are often put on hold. Instead, the families of these children must concentrate on some basic facts, facts that may be a matter of life and death. These facts will shape the quality of life that the family can offer the child. The family will have to answer some important questions. First, do they have health insurance? If so, does the insurance cover the cost of the specialized services that their child needs? Families who answer `NO' to these questions are overwhelmed and fearful, and their vision of the future is filled with uncertainty. Every day, children in America are born with severe disabilities that require specialized health care services. Too often, the parents of these children do not have health care coverage or their coverage does not cover the needed services. These families do not have many options. Their child can receive health care coverage only if the family is poor, or if the family gives the child up to the state. We have all heard heart wrenching stories, but none are more traumatic than these. The Family Opportunity Act of 2000 is a solution to this tragic problem. Children without health insurance will now be covered. Those children with disabilities whose health insurance does not cover the services they need, will also be covered. Children with significant disabilities will no longer be denied the health care coverage they need, regardless of their family's income. Their families will, however, be expected to contribute to the cost of coverage. In addition, these families will have access to assistance from a Family Health Information Center. This service will provide families with information about their options and will help them exercise these options. Their children will receive the care they need and deserve. Data from the Social Security Administration indicates that in December 1999 there were 1,080 Vermont children with disabilities eligible for Medicaid. That means that the families of these children are poor. Some of these families have chosen to keep their income under the prescribed limits in law, so that they can access health care through Medicaid for their child with a disability. These families cannot access health care coverage for their children through the private sector. With the Family Opportunity Act everyone wins. Through Medicaid, children with disabilities will receive the health care services they desperately need. Through the Family Health Information Centers, their families will be provided with the right information at the right time. Families will be able to make key medical decisions that will maximize the quality of life for their children with disabilities. And, the federal and state governments will have a cost-effective program to help children and families in need. The Family Opportunity Act of 2000 will make time for joy, hope, and dreams, for families of children with special needs. This is a good start to the 21st Century.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to support elimination of the Social Security earnings test for individuals who have attained Social Security retirement age--currently age 65. Currently, if these retirees work, their Social Security benefits are reduced $1 for every $3 of earnings above $17,000 per year. This is an unfair result for many older Americans who are receiving Social Security benefits after a lifetime of work but who must continue to work to supplement their retirement income. In my own state of Vermont, many people work beyond age 65. They should not have to give up a portion of their hard-earned Social Security benefit because they need to take a job. The earnings test can also be a problem for employers. Older workers are often in demand by employers because of their expertise and an overall tight labor market. The reduction in Social Security benefits can be a barrier to older workers reentering the workforce. The earnings test presents a special problem for small business owners receiving Social Security benefits. Small business owners are subject to both the dollar earnings test and a self-employment test that can involve an extensive audit to establish their level of earnings. Eliminating the earnings test will also eliminate the need for these audits. And removing the incentive for older small business owners to retire could mean continued employment opportunities in their businesses for other older workers. There has been an earnings test for Social Security benefits since the Social Security Act was passed in 1935, during the Great Depression. The earnings test originally was a way to encourage older workers to retire, to free up jobs for younger workers. The earnings test has always been unpopular, especially with those age 65 and older. In response, Congress has changed the earnings test provisions several times over the years--increasing the amount a benefit recipient can earn without a benefit reduction. The earnings limit for those age 65 and older currently is $17,000 and rises to $25,000 in 2001 and to $30,000 beginning in 2002. It provides a higher earnings limit and smaller reduction for older benefit recipients--$1 for each $3 of annual earnings over $17,000 for those age 65-69, compared to $1 for each $2 of earnings over $10,080 for those age 62- 64--and lowering the age at which an individual can work without suffering a benefit reduction to age 70 from age 72. It is time now to further lower that age to the Social Security retirement age, so that once a worker reaches that age--currently 65--the worker's Social Security benefit will not be reduced, no matter how much the worker earns. We have before us legislation to eliminate the earnings test for individuals at Social Security retirement age. I have cosponsored Senator Ashcroft's bill, S. 2074, and we have the House-passed bill, H.R. 5. These bills would free the approximately 800,000 Social Security benefit recipients currently ages 65 through 69 from the current law that reduces, and in some cases eliminates, their Social Security benefits if they work and earn above the earnings test. I urge my colleagues to act quickly to make this legislative change for older working Americans.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am pleased to join Senators Rockefeller and Hutchison in the introduction of the Recognition of Physician Assistants in the Department of Veterans Affairs Act of 2000. This legislation will establish a position of advisor on physician assistants within the office of the Undersecretary of Health for Veterans Affairs. Physician assistant are very valuable members of the VA health care delivery team. But unlike most components of the team, physician assistants have no representative within the VA's Office of the Undersecretary for Health. As the largest employer of physician assistants in the country, the VA will be establishing important precedents as the role of physician assistants evolves over the coming decade. Physician assistants must be part of the discussion and represented at the level where key health care delivery decisions are made. An advisory position would be established by this legislation to inform the Undersecretary for Health on such matters as optimal utilization of physician assistants by the VA, the advisability of establishing clinical privileges and practice areas, the development of appropriate educational requirements and certification criteria, and other matters. This representation is critically important at this time. As the VA moves toward Medicare Subvention and the requisite billing expertise, questions will continually arise surrounding the role of physician assistants. There must be consistent input on these matters directly from physician assistants. I urge my colleagues to carefully consider this legislation and I hope it is quickly enacted into law.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am pleased to join Senators Rockefeller and Hutchison in the introduction of the Recognition of Physician Assistants in the Department of Veterans Affairs Act of 2000. This legislation will establish a position of advisor on physician assistants within the office of the Undersecretary of Health for Veterans Affairs. Physician assistant are very valuable members of the VA health care delivery team. But unlike most components of the team, physician assistants have no representative within the VA's Office of the Undersecretary for Health. As the largest employer of physician assistants in the country, the VA will be establishing important precedents as the role of physician assistants evolves over the coming decade. Physician assistants must be part of the discussion and represented at the level where key health care delivery decisions are made. An advisory position would be established by this legislation to inform the Undersecretary for Health on such matters as optimal utilization of physician assistants by the VA, the advisability of establishing clinical privileges and practice areas, the development of appropriate educational requirements and certification criteria, and other matters. This representation is critically important at this time. As the VA moves toward Medicare Subvention and the requisite billing expertise, questions will continually arise surrounding the role of physician assistants. There must be consistent input on these matters directly from physician assistants. I urge my colleagues to carefully consider this legislation and I hope it is quickly enacted into law.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, for the Committee on Health, Education, Labor, and Pensions, I report favorably nomination lists which were printed in the Records of the dates indicated, and ask unanimous consent, to save the expense of reprinting on the Executive Calendar, that these nominations lie at the Secretary's desk for the information of Senators.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today in support of the legislation that is being introduced by my friend and colleague from Missouri, Senator Bond. As Chairman of the Committee on Health, Education, Labor, and Pensions and a member of the Congressional Coalition on Adoption, I have been a long-standing supporter of legislation to make adoption easier. This bill does exactly that by requiring federal agencies to reimburse their employees up to $2,000 for all qualified expenses associated with the adoption of a child. Both this bill and its House companion, introduced by Representatives Tom Bliley and James Oberstar last August, have gathered the support of a bipartisan group of legislators and numerous groups in the adoption community. Currently, many private sector businesses provide financial assistance to employees who wish to adopt a child. These businesses understand that adoption can be a very time-consuming, exhausting, and expensive process for parents. Relieving the financial burden on their employees will not only help encourage adoption, but also produce a happier and more productive work force. The legislation being introduced today provides a benefit for our own hard-working federal employees. In the process, it brings the federal government up to par with those private-sector businesses that already provide financial assistance to employees adopting a child. Even further, it establishes a leadership role for the federal government in this area. This hopefully will encourage even more businesses to assist their employees financially should they wish to adopt a child. I am proud to stand today with several of my colleagues as co- sponsors of the Federal Employees Adoption Assistance Act of 2000. I hope the Senate will proceed quickly to pass this legislation. It makes sense, both for the approximately 110,000 children currently awaiting adoption in the United States, and for those federal employees who are willing and able to provide a home for them.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today in support of the legislation that is being introduced by my friend and colleague from Missouri, Senator Bond. As Chairman of the Committee on Health, Education, Labor, and Pensions and a member of the Congressional Coalition on Adoption, I have been a long-standing supporter of legislation to make adoption easier. This bill does exactly that by requiring federal agencies to reimburse their employees up to $2,000 for all qualified expenses associated with the adoption of a child. Both this bill and its House companion, introduced by Representatives Tom Bliley and James Oberstar last August, have gathered the support of a bipartisan group of legislators and numerous groups in the adoption community. Currently, many private sector businesses provide financial assistance to employees who wish to adopt a child. These businesses understand that adoption can be a very time-consuming, exhausting, and expensive process for parents. Relieving the financial burden on their employees will not only help encourage adoption, but also produce a happier and more productive work force. The legislation being introduced today provides a benefit for our own hard-working federal employees. In the process, it brings the federal government up to par with those private-sector businesses that already provide financial assistance to employees adopting a child. Even further, it establishes a leadership role for the federal government in this area. This hopefully will encourage even more businesses to assist their employees financially should they wish to adopt a child. I am proud to stand today with several of my colleagues as co- sponsors of the Federal Employees Adoption Assistance Act of 2000. I hope the Senate will proceed quickly to pass this legislation. It makes sense, both for the approximately 110,000 children currently awaiting adoption in the United States, and for those federal employees who are willing and able to provide a home for them.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I am pleased to join Senator Graham today in introducing the Medicare Wellness Act of 2000. Our nation's rapidly growing senior population and the ongoing search for cost-effective health care have led to the development of this important bipartisan legislation. The goal of the Medicare Wellness Act is to increase access to preventive health services, improve the quality of life for America's seniors, and increase the cost- effectiveness of the Medicare program. Congress created the Medicare program in 1965 to provide health insurance for Americans age 65 and over. From the outset, the program has focused on coverage for hospital services needed for an unexpected or intensive illness. In recent years, however, a great escalation in program expenditures and an increase in knowledge about the value of preventive care have forced policy makers to re-evaluate the current Medicare benefit package. The Medicare Wellness Act adds to the Medicare program those benefits recommended by the Institute of Medicine and the U.S. Preventive Services Task Force. These include: screening for hypertension, counseling for tobacco cessation, screening for glaucoma, counseling for hormone replacement therapy, screening for vision and hearing loss, cholesterol screening, expanded screening and counseling for osteoporosis, and nutrition therapy counseling. These services address the most prominent risk facing Medicare beneficiaries. In 1997, Congress added several new preventive benefits to the Medicare program through the Balanced Budget Act. These benefits included annual mammography, diabetes self-management, prostate cancer screening, pelvic examinations, and colorectal cancer screening. Congress's next logical step is to incorporate the nine new screening and counseling benefits in the Medicare Wellness Act. If these symptoms are addressed regularly, beneficiaries will have a head start on fighting the conditions they lead to, such as diabetes, lung cancer, heart disease, blindness, osteoporosis, and many others. Research suggests that insurance coverage encourages the use of preventive and other health care services. The Medicare Wellness Act also eliminates the cost-sharing requirement for new and current preventive benefits in the program. Because screening services are directed at people without symptoms, this will further encourage the use of services by reducing the cost barrier to care. Increased use of screening services will mean that problems will be caught earlier, which will permit more successful treatment. This will save the Medicare program money because it is cheaper to screen for an illness and treat its early diagnosis than to pay for drastic hospital procedures at a later date. However, financial access is not the only barrier to the use of preventive care services. Other barriers include low levels of education of information for beneficiaries. That is why the Medicare Wellness Act instructs the Secretary of Health and Human Services to coordinate with the Centers for Disease Control and Prevention and the Health Care Financing Administration to establish a Risk Appraisal and Education Program within Medicare. This program will target both current beneficiaries and individuals with high risk factors below the age of 65. Outreach to these groups will offer questions regarding major behaviorial risk factors, including the lack of proper nutrition, the use of alcohol, the lack of regular exercise, the use of tobacco, and depression. State of the art software, case managers, and nurse hotlines will then identify what conditions beneficiaries are at risk for, based on their individual responses to the questions, then refer them to preventive screening services in their area and inform them of actions they can take to lead a healthier life. The Medicare Wellness Act also establishes the Healthy Seniors Promotion Program. This program will bring together all the agencies within the Department of Health and Human Services that address the medical, social and behavorial issues affecting the elderly to increase knowledge about and utilization of prevention services among the elderly, and develop better ways to prevent or delay the onset of age- related disease or disability. Mr. President, now is the time for Medicare to catch up with current health science. We need a Medicare program that will serve the health care needs of America's seniors by utilizing up-to-date knowledge of healthy aging. Effective health care must address the whole health of an individual. A lifestyle that includes proper exercise and nutrition, and access to regular disease screening ensures attention to the whole individual, not just a solitary body part. It is time we reaffirm our commitment to provide our nation's seniors with quality health care. It is my hope that my colleagues in Congress will examine this legislation and realize the inadequately of the current package of preventive benefits in the Medicare program. We have the opportunity to transform Medicare from an out-dated sickness program to a modern wellness program. I want to thank Senator Bob Graham and all the other cosponsors of the Medicare Wellness Act who are supporting this bold step towards successful Medicare reform.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to introduce the Summer Fill and Fuel Budgeting Act of 2000. This winter's fuel crisis will be etched on the memories of New Englanders for many years to come. Price spikes and low inventories have hit Vermonters hard. Schools closed down, oil dealers were driven out of business, and many low income families were forced to choose between heating their homes and purchasing necessary food and prescription medications. The region's Senators have focused with a single-mindedness on the seriousness of the situation and the dire need to ensure that it is never repeated. There have been many letters written, emergency funds released, meetings held, and legislative initiatives discussed. Today after weeks of diligent research and careful analysis, I am introducing the Summer Fill and Fuel Budgeting Act of 2000. Senators Joe Lieberman, John Kerry, Ted Kennedy, and Patrick Leahy are joining me as original co- sponsors. The legislation is a critical long term education initiative. Its purpose is to educate our constituents about the benefits of filling their propane, kerosene and heating oil tanks in the summer and entering into annual fuel budget contracts. The legislation authorizes $25 million for Fiscal Year 2001, and such sums in each fiscal year thereafter, for the states to use to develop education and outreach programs to encourage consumers to fill their fuel storage facilities during the summer months. It also promotes the use of budget plans, price cap arrangements, fixed-price contracts and other advantageous financial arrangements to help avoid severe seasonal price increases for and supply shortages of propane, kerosene, and heating oil. I believe that we must work with retailers and consumers to implement these types of proactive measures to ensure that our fuel supply, as well as the health and safety of millions of Americans, is not subject to the whims of foreign oil producing countries. I invite other Senators, concerned about the influence that major oil producing countries have on our economy and national security, to join me in cosponsoring this legislation.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, I rise today to introduce the Summer Fill and Fuel Budgeting Act of 2000. This winter's fuel crisis will be etched on the memories of New Englanders for many years to come. Price spikes and low inventories have hit Vermonters hard. Schools closed down, oil dealers were driven out of business, and many low income families were forced to choose between heating their homes and purchasing necessary food and prescription medications. The region's Senators have focused with a single-mindedness on the seriousness of the situation and the dire need to ensure that it is never repeated. There have been many letters written, emergency funds released, meetings held, and legislative initiatives discussed. Today after weeks of diligent research and careful analysis, I am introducing the Summer Fill and Fuel Budgeting Act of 2000. Senators Joe Lieberman, John Kerry, Ted Kennedy, and Patrick Leahy are joining me as original co- sponsors. The legislation is a critical long term education initiative. Its purpose is to educate our constituents about the benefits of filling their propane, kerosene and heating oil tanks in the summer and entering into annual fuel budget contracts. The legislation authorizes $25 million for Fiscal Year 2001, and such sums in each fiscal year thereafter, for the states to use to develop education and outreach programs to encourage consumers to fill their fuel storage facilities during the summer months. It also promotes the use of budget plans, price cap arrangements, fixed-price contracts and other advantageous financial arrangements to help avoid severe seasonal price increases for and supply shortages of propane, kerosene, and heating oil. I believe that we must work with retailers and consumers to implement these types of proactive measures to ensure that our fuel supply, as well as the health and safety of millions of Americans, is not subject to the whims of foreign oil producing countries. I invite other Senators, concerned about the influence that major oil producing countries have on our economy and national security, to join me in cosponsoring this legislation.

Mr. JEFFORDS

Mr. JEFFORDS. Will the Senator yield?

Mr. JEFFORDS. I will be very brief.

Mr. JEFFORDS. Mr. President, I thank the Senator for the changes made in the take title provisions. I have discussed it with my Governor, and now I can say that we no longer have an objection to the bill. The Governor hopes it passes with the changes that were made. So I wanted to let everybody know that I am in favor of the bill, and I appreciate the changes that were made. I yield the floor.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, today I am introducing a bill to reduce the marriage penalty built into the Earned Income Tax Credit--the EITC. It appears that Congress may well act to address the marriage penalty this year. Eliminating the marriage penalty is a worthwhile goal. A marriage license shouldn't come with a higher tax bill from Uncle Sam. As we consider this issue, however, I want to make sure that low-income taxpayers are not left out of the debate. In terms of dollars, the EITC marriage penalty may be relatively small, but for workers trying to raise children on low wages it represents a significant loss of income, and it may well deter couples from marrying. Though our nation's economy continues to thrive, many Americans still struggle to make ends meet. Working families across the nation hover above the poverty level, striving to stay off welfare and yearning to provide a decent life for their children. We can and must do more to help these families. And we can do it through the tax code in a manner that is proven and fair, using the earned income tax credit. The EITC is a refundable tax credit specifically targeted to help low-income workers and their families. In my state of Vermont, with soaring housing costs and spiking fuel costs, the EITC has proven effective in supplementing the income of working families. By some estimates, the EITC has moved more than two million children out of poverty. One recent report calls it the most effective safety net program for children in working poor families. In 1999, the EITC provided low-income working families with two children a subsidy of roughly 40 cents for every dollar of income. But after income reaches a certain point, the EITC is gradually phased out. Unfortunately, a marriage penalty is built into the EITC. This marriage penalty exists because a married couple's combined earnings put them at a higher point in the EITC phase-out range than where one or both of them would have been if they had remained single. If, for example, one minimum wage earner marries another minimum wage earner with two children, the couple's EITC would be over $1,300 less than the combined EITC they would have received if they hadn't gotten married. For working families that subsist on the minimum wage, this is a significant loss--more than half of their combined wages for a month. To reduce the EITC marriage penalty, the bill I'm introducing will extend the point at which the EITC begins to phase out. This is the approach I advocated, and which was subsequently adopted in last year's tax bill. It is also the approach adopted in the bill passed by the Ways and Means Committee. The difference between my bill and these other bills is the amount by which the beginning point of the phase-out range would be extended. The other bills proposed to extend it by $2,000. I propose to extend it by $3,500; this would provide significantly more marriage penalty relief. My back-of-the-envelope calculations indicate that my bill would eliminate about half of the marriage penalties built into the EITC. I do not have a cost estimate for this bill. For the Ways and Means marriage penalty bill, the Joint Committee on Taxation estimated that a $2,000 extension of the beginning point of the EITC phase-out would cost $11 billion over 10 years. This is a relatively small part of a bill whose overall 10-year cost is $182 billion. Last year, the conferees on the tax bill initially chose not to include help for EITC taxpayers in the marriage penalty provisions. I threatened to vote against the bill, probably depriving it of a majority in the Senate. The conference was reopened, and relief of the EITC marriage penalty was included in the final bill. I think that shows how strongly I feel about this issue. I'm glad that the House has looked out for low-income taxpayers in its marriage penalty bill. Still, I think we can do better.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, today I am introducing a bill to reduce the marriage penalty built into the Earned Income Tax Credit--the EITC. It appears that Congress may well act to address the marriage penalty this year. Eliminating the marriage penalty is a worthwhile goal. A marriage license shouldn't come with a higher tax bill from Uncle Sam. As we consider this issue, however, I want to make sure that low-income taxpayers are not left out of the debate. In terms of dollars, the EITC marriage penalty may be relatively small, but for workers trying to raise children on low wages it represents a significant loss of income, and it may well deter couples from marrying. Though our nation's economy continues to thrive, many Americans still struggle to make ends meet. Working families across the nation hover above the poverty level, striving to stay off welfare and yearning to provide a decent life for their children. We can and must do more to help these families. And we can do it through the tax code in a manner that is proven and fair, using the earned income tax credit. The EITC is a refundable tax credit specifically targeted to help low-income workers and their families. In my state of Vermont, with soaring housing costs and spiking fuel costs, the EITC has proven effective in supplementing the income of working families. By some estimates, the EITC has moved more than two million children out of poverty. One recent report calls it the most effective safety net program for children in working poor families. In 1999, the EITC provided low-income working families with two children a subsidy of roughly 40 cents for every dollar of income. But after income reaches a certain point, the EITC is gradually phased out. Unfortunately, a marriage penalty is built into the EITC. This marriage penalty exists because a married couple's combined earnings put them at a higher point in the EITC phase-out range than where one or both of them would have been if they had remained single. If, for example, one minimum wage earner marries another minimum wage earner with two children, the couple's EITC would be over $1,300 less than the combined EITC they would have received if they hadn't gotten married. For working families that subsist on the minimum wage, this is a significant loss--more than half of their combined wages for a month. To reduce the EITC marriage penalty, the bill I'm introducing will extend the point at which the EITC begins to phase out. This is the approach I advocated, and which was subsequently adopted in last year's tax bill. It is also the approach adopted in the bill passed by the Ways and Means Committee. The difference between my bill and these other bills is the amount by which the beginning point of the phase-out range would be extended. The other bills proposed to extend it by $2,000. I propose to extend it by $3,500; this would provide significantly more marriage penalty relief. My back-of-the-envelope calculations indicate that my bill would eliminate about half of the marriage penalties built into the EITC. I do not have a cost estimate for this bill. For the Ways and Means marriage penalty bill, the Joint Committee on Taxation estimated that a $2,000 extension of the beginning point of the EITC phase-out would cost $11 billion over 10 years. This is a relatively small part of a bill whose overall 10-year cost is $182 billion. Last year, the conferees on the tax bill initially chose not to include help for EITC taxpayers in the marriage penalty provisions. I threatened to vote against the bill, probably depriving it of a majority in the Senate. The conference was reopened, and relief of the EITC marriage penalty was included in the final bill. I think that shows how strongly I feel about this issue. I'm glad that the House has looked out for low-income taxpayers in its marriage penalty bill. Still, I think we can do better.

Mr. JEFFORDS

Mr. JEFFORDS. Mr. President, the federal investment in the area of education technology has been and continues to be critical in ensuring that schools in all of our states not only have technological capacity but are able to effectively integrate technology into the curriculum for the benefit of all children. The federal government has shown extraordinary leadership in this area through the funding it provides through the E-rate, the Technology Innovations Challenge Grant and Literacy Challenge Fund programs, to name a few. Still, making technology integral to and effective in the learning process is not something that can be done by the federal government alone. To be successful, it will require creating strong and committed partnerships of schools, teachers, institutions of higher education, local and state governments and of course the business community. There are many businesses that are leading by doing--creating partnerships for the educational benefit of kids. They are investing time and resources in our nation's schools to help make technology a positive and powerful educational tool. Intel is one such company. The Intel Teach to the Future program brings together expertise and resources from leading high-tech companies to improve technology use in the classroom. This comprehensive teacher development initiative has been designed to address the barriers teachers face in effectively applying computer technology to enhance student learning. In spite of the potential for technology to improve education, only 20% of today's 3.17 million teachers feel prepared to use technology in the classroom. Barriers to success include: lack of access to adequate equipment; lack of training on specific software tools; lack of training on tools to evaluate how, when and where technology should be applied to teach specific subject matter; and finally, lack of an evaluative process that measures success and provides for continuous improvement. Intel has learned from its own and others' experiences and partnered with leaders in the computer industry to deliver a program that can tackle these barriers head-on. The Teach to the Future program provides a flexible, modular curriculum delivered by teachers for teachers. The training incorporates the use of the Internet, web page design and multimedia software. Every participant is guaranteed access in their classrooms to the hardware and software necessary to put their training into practice. The training of a cadre of local master teachers ensures the knowledge and expertise remains within the school district and provides for ongoing support. Key elements of the Teach to the Future program include hands-on, face-to-face learning. The curriculum is based on the award-winning Intel ACE Project, authored by the Institute for Computer Technology. It has been delivered to some 3,200 teachers in nine communities over the last two years in cooperation with Microsoft Corporation and Hewlett-Packard Company. Responses from Intel ACE participants show that 98% of the participants found the training to be valuable; 97% developed new skills and knowledge and 94% felt the training would benefit their students. A follow-up study with teachers who participated in the training in 1998 found that more than 84% felt the use of computers had improved their instruction and more than 80% felt their students' learning was enhanced. I heard a great deal about the program that Intel sponsored in Washington, DC and was excited to learn of what a positive impact it had on students and teachers there. Intel will develop online communities via its web site to support the Regional Training Agencies, Master Teacher and teacher participants. Some of the areas will facilitate administration of the program itself such as registration and evaluation; other services include case studies, a lesson plan database, and chat capability. In its first three years the program will reach 100,000 teachers in the United States. Giving teachers the tools, know-how and confidence to apply technology effectively in the classroom will have a big payoff in improving educational opportunities for our nation's young people. I applaud Intel and its partners as well as all the other businesses for their commitment to education in the 21st century.