Jack Reed

Mr. REED

Mr. REED. Mr. President, I rise today to introduce the Parental Accountability, Recruitment, and Education National Training (PARENT) Act of 1999, which seeks to increase parental involvement in the educational lives of their children. Mr. President, research, experience, and reason tell us that providing parents with opportunities to play active roles in their children's schools empowers them to help their children excel. When parents are actively involved in their child's education, not only do their own children go further, but their child's school also improves to the benefit of all students. And, as I have witnessed in Rhode Island, and I am sure my colleagues can attest to this in their home states, our best schools are not simply those with the finest teachers and principals, but those which strive to engage parents in the education of their children. A recent National PTA survey revealed that 91% of parents recognize the importance of involvement in their children's schools. Unfortunately, even as we extol the virtue of parental involvement, we must recognize that reality falls far short of the goal. The National PTA survey also found that roughly half the parents surveyed felt they were inadequately informed about ways in which they could participate in schools, or even gain access to basic information about their children's studies and their children's teachers. There are also other obstacles to greater parental involvement, such as working parents who find it difficult to get to schools and be involved or parents who have had negative schooling experiences and are wary of entering schools to participate in their children's education. With 73% of parents favoring a federal effort to help schools get parents more involved with their children's education, the upcoming reauthorization of the Elementary and Secondary Education Act (ESEA) provides an opportunity to help bring schools and parents together, and to ensure parents have the tools to meaningfully and effectively get involved in their children's education. While the ESEA currently contains parental involvement provisions, they mainly apply to Title I schools and students, and have not been fully implemented. That is why I am pleased to be joined by Senators Murray, Kennedy, Harkin, and Bingaman and Representative Lynn Woolsey in the other body in introducing the PARENT Act. This legislation would amend the Elementary and Secondary Education Act (ESEA) to bolster existing and add new parental involvement provisions. The PARENT Act requires that all schools implement effective, research-based parental involvement best practices. It also seeks to improve parental access to information about their children's education and the school's parental involvement policies; ensure that professional development activities provide training to teachers and administrators on how to foster relationships with parents and encourage parental involvement; utilize technology to expand efforts to connect schools and teachers with parents; and promote parental involvement in drug and violence prevention programs. In addition, the PARENT Act requires any state seeking funding under ESEA to describe, implement, and evaluate parental involvement policies and practices. To succeed in the endeavor of increasing parental involvement, we must depend on parents, teachers, and school administrators throughout the country to work collaboratively to implement effective programs. However, federal leadership is needed to provide schools, teachers, and parents with the tools adequate to this task. Mr. President, the bottom line of federal support for education is to increase student achievement. Parental involvement is an essential component to ensuring that our students succeed. This legislation is strongly supported by the National PTA, and I urge my colleagues to join Senators Murray, Kennedy, Harkin, Bingaman, and me in supporting the PARENT Act, and working for its inclusion in the ESEA reauthorization. Mr. President, I ask unanimous consent that the text of this legislation be printed in the Record. The being no objection, bill was ordered to be printed in the Record, as follows:

Mr. REED

Mr. REED. I ask unanimous consent that a fellow in my office, Ms. Barbara Murray, be granted floor privileges during the pendency of my discussion on the child care quality incentive bill.

Mr. REED. Mr. President, I suggest the absence of a quorum.

Mr. REED

Mr. REED. Mr. President, I rise to talk about a crisis that is affecting the families of this country. That crisis is the child care system, the ability to obtain safe, affordable, high-quality child care. Today there are an estimated 13 million children, 6 million of them infants and toddlers, who require some form of day care. For working families, the price of this day care is exceedingly difficult to meet each and every day. Full-day child care ranges from $4,000 to $10,000 a year. For some low-income families, that represents 25 percent of their income. This is a huge obligation. We have, I fear and believe, the responsibility to ensure that we can help these families meet this obligation to protect their children. Not only is this necessary simply for the custodial protection and care of children, it is necessary for their enhancement, their advancement, for their intellectual development. We have discovered over the last several years, because of all the research that is being done at the National Institutes of Health, and other places, the crucial role of the early development of children in their ultimate intellectual and social development as adults. We know if we have good, nurturing care in the early days of life, this care will lead to better cognitive performance later on. It will increase classroom success. It will lead to more fully developed individuals who can cope with the challenges of this next century that is just upon us. So our investment in child care is not simply something that is altruistic--something we want to do because it is for the kids and for working families--it is in the best interests of this country in order to provide for the citizens of this country of the next century. We know also, as we look around, that one of the problems in child care, I say to Senators, is that because of the low reimbursement rates that the child care centers receive from the States, that they are not able to retain good employees and that they are not able to train the employees they can retain--particularly in this booming economy we see today. So what you have in so many child care centers is a situation where they cannot retain their employees, they cannot attract the very best employees, they do not have the resources to fully develop the potential for these employees, and as a result, ultimately, children suffer. In fact, there have been numerous studies. The one that I found most disturbing is one where four States were studied in the United States, and it was found that in those States only one out of seven child care centers provided care that promoted the healthy development of the child. Even more shocking, one in eight of these child care centers actually provided care that threatened the health of the child. We have to do something about it. Prior to welfare reform, there was a law on the books that said the State, when they were subsidizing day care for low-income parents, had to at least try to achieve the 75th percentile in terms of their reimbursement rate. What that means is that they had to have a reimbursement rate that could at least meet the cost of 75 out of 100 of the centers in their particular State. That has gone by the wayside. But in order to keep quality in our child care system, we have to get to reimbursement rates that will, in fact, provide the resources for child care centers to have quality, enhancing care to benefit the children of this country. What has also been abandoned in the last several years is even the attempt by the States to go ahead and do surveys of the market so they know what it costs different child care centers to provide care and know what it costs for the parents to send their children to day-care centers. Having abandoned these market surveys, essentially there is no connection between their subsidy rate and, in fact, the cost of day care. So working families who receive these subsidies--and there are more and more families who are receiving subsidies as we move welfare recipients to work--have no correlation between what they are getting and essentially what the cost of child care is in the real world. What I have done, along with some of my colleagues, is introduce legislation that would, in fact, give the States an incentive, first to do their market surveys, to find out the cost of day care in their communities, and then to strive to meet those market rates. I have been very pleased to be joined by Senators Chris Dodd and Ted Kennedy, who are leaders in the field of improving child care in this country, together with Senators Feinstein, Inouye, and Murray in introducing the Child Care Quality Incentive Act. Essentially, this legislation would establish a new mandatory pool of funding, $300 million each year over the next 5 years, as part of the Child Care Development Block Grant Program. This funding would be an incentive for States to first conduct a market survey and then to make significant movement towards raising their subsidy rates to that market rate. In so doing, we can directly contribute to the bottom line of these child care centers. They, in turn, can retain personnel, train their personnel, and create a more enhancing environment for the development of children. This, I think, is a goal we should have. Increased reimbursement rates also expand the number of choices parents have in finding quality child care. We will also, I hope, at the same time try to increase the overall scope of the child development block grants. One of the consequences of simply increasing funding for the child care development block grant, is many States will not increase the subsidy they pay for children; they will simply try to enroll more children. This puts centers in a very cruel dilemma because the more children they have at that far- below-market rate the greater the economic pressure on the centers. The program I am presenting today with my colleagues would do what child care providers have argued must be done, and that is to give them additional resources so they can, in fact, improve the quality of day care--not simply the number of children in day care but the quality of day care. If we do these things we are going to be in a strong position to face the challenges ahead. One of the greatest challenges for working families is the cost of day care for their children. I have been very pleased to note that this legislation has been endorsed by the USA Child Care, the Children's Defense Fund, Catholic Charities of the United States, the Child Welfare League of America, the YMCA of the United States, the National Association of Child Care Resource and Referral Agencies, the National Head Start Association, the National Child Care Association and a host of other agencies and organizations throughout the country. They recognize, as I do, and as my colleagues who are introducing this legislation do, that we can talk a lot about child care, we can emphasize how important it is to families, we can stress the importance to our economy and to our long-run future in this country, but until we put real resources to work, we will not be able to meet the real needs of families. These needs grow each day. I urge strong support for this legislation. Again, I thank and commend my colleagues who have joined me in this effort: Senators Dodd, Kennedy, Feinstein, Inouye, and Murray, and encourage others to join us. I believe if we make this investment in quality child care, we will be making one of the most important investments we can make in the future of this country and in the individual future of families throughout the United States. I thank my colleagues for joining me, and I ask unanimous consent to have printed in the Record a copy of the legislation.

Mr. REED

Mr. REED. Mr. President, I rise to talk about a crisis that is affecting the families of this country. That crisis is the child care system, the ability to obtain safe, affordable, high-quality child care. Today there are an estimated 13 million children, 6 million of them infants and toddlers, who require some form of day care. For working families, the price of this day care is exceedingly difficult to meet each and every day. Full-day child care ranges from $4,000 to $10,000 a year. For some low-income families, that represents 25 percent of their income. This is a huge obligation. We have, I fear and believe, the responsibility to ensure that we can help these families meet this obligation to protect their children. Not only is this necessary simply for the custodial protection and care of children, it is necessary for their enhancement, their advancement, for their intellectual development. We have discovered over the last several years, because of all the research that is being done at the National Institutes of Health, and other places, the crucial role of the early development of children in their ultimate intellectual and social development as adults. We know if we have good, nurturing care in the early days of life, this care will lead to better cognitive performance later on. It will increase classroom success. It will lead to more fully developed individuals who can cope with the challenges of this next century that is just upon us. So our investment in child care is not simply something that is altruistic--something we want to do because it is for the kids and for working families--it is in the best interests of this country in order to provide for the citizens of this country of the next century. We know also, as we look around, that one of the problems in child care, I say to Senators, is that because of the low reimbursement rates that the child care centers receive from the States, that they are not able to retain good employees and that they are not able to train the employees they can retain--particularly in this booming economy we see today. So what you have in so many child care centers is a situation where they cannot retain their employees, they cannot attract the very best employees, they do not have the resources to fully develop the potential for these employees, and as a result, ultimately, children suffer. In fact, there have been numerous studies. The one that I found most disturbing is one where four States were studied in the United States, and it was found that in those States only one out of seven child care centers provided care that promoted the healthy development of the child. Even more shocking, one in eight of these child care centers actually provided care that threatened the health of the child. We have to do something about it. Prior to welfare reform, there was a law on the books that said the State, when they were subsidizing day care for low-income parents, had to at least try to achieve the 75th percentile in terms of their reimbursement rate. What that means is that they had to have a reimbursement rate that could at least meet the cost of 75 out of 100 of the centers in their particular State. That has gone by the wayside. But in order to keep quality in our child care system, we have to get to reimbursement rates that will, in fact, provide the resources for child care centers to have quality, enhancing care to benefit the children of this country. What has also been abandoned in the last several years is even the attempt by the States to go ahead and do surveys of the market so they know what it costs different child care centers to provide care and know what it costs for the parents to send their children to day-care centers. Having abandoned these market surveys, essentially there is no connection between their subsidy rate and, in fact, the cost of day care. So working families who receive these subsidies--and there are more and more families who are receiving subsidies as we move welfare recipients to work--have no correlation between what they are getting and essentially what the cost of child care is in the real world. What I have done, along with some of my colleagues, is introduce legislation that would, in fact, give the States an incentive, first to do their market surveys, to find out the cost of day care in their communities, and then to strive to meet those market rates. I have been very pleased to be joined by Senators Chris Dodd and Ted Kennedy, who are leaders in the field of improving child care in this country, together with Senators Feinstein, Inouye, and Murray in introducing the Child Care Quality Incentive Act. Essentially, this legislation would establish a new mandatory pool of funding, $300 million each year over the next 5 years, as part of the Child Care Development Block Grant Program. This funding would be an incentive for States to first conduct a market survey and then to make significant movement towards raising their subsidy rates to that market rate. In so doing, we can directly contribute to the bottom line of these child care centers. They, in turn, can retain personnel, train their personnel, and create a more enhancing environment for the development of children. This, I think, is a goal we should have. Increased reimbursement rates also expand the number of choices parents have in finding quality child care. We will also, I hope, at the same time try to increase the overall scope of the child development block grants. One of the consequences of simply increasing funding for the child care development block grant, is many States will not increase the subsidy they pay for children; they will simply try to enroll more children. This puts centers in a very cruel dilemma because the more children they have at that far- below-market rate the greater the economic pressure on the centers. The program I am presenting today with my colleagues would do what child care providers have argued must be done, and that is to give them additional resources so they can, in fact, improve the quality of day care--not simply the number of children in day care but the quality of day care. If we do these things we are going to be in a strong position to face the challenges ahead. One of the greatest challenges for working families is the cost of day care for their children. I have been very pleased to note that this legislation has been endorsed by the USA Child Care, the Children's Defense Fund, Catholic Charities of the United States, the Child Welfare League of America, the YMCA of the United States, the National Association of Child Care Resource and Referral Agencies, the National Head Start Association, the National Child Care Association and a host of other agencies and organizations throughout the country. They recognize, as I do, and as my colleagues who are introducing this legislation do, that we can talk a lot about child care, we can emphasize how important it is to families, we can stress the importance to our economy and to our long-run future in this country, but until we put real resources to work, we will not be able to meet the real needs of families. These needs grow each day. I urge strong support for this legislation. Again, I thank and commend my colleagues who have joined me in this effort: Senators Dodd, Kennedy, Feinstein, Inouye, and Murray, and encourage others to join us. I believe if we make this investment in quality child care, we will be making one of the most important investments we can make in the future of this country and in the individual future of families throughout the United States. I thank my colleagues for joining me, and I ask unanimous consent to have printed in the Record a copy of the legislation.

Mr. REED

Mr. REED. Mr. President, I rise today to pay tribute to His Holiness Karekin I, Catholicos of the Armenian Orthodox Church. His Holiness passed away on June 29, 1999 at the Holy See of Etcmiadzin, Armenia. In 1997, I had the opportunity to meet personally with His Holiness, the supreme patriarch of the Armenian Church, in Yerevan. I was moved by his devotion to his church and the love and compassion he had for all people. His Holiness Karekin I was not only respected and loved by Armenian people throughout the world, but his wisdom, compassion and courage was renowned in international religious circles. Throughout his life, His Holiness traveled to many countries, including the United States and my home state of Rhode Island, to strengthen and reconfirm the faith of the Armenian community. He was truly an inspiration to all who knew him. His Holiness dedicated more than fifty years to his faith, and his devotion raised him rapidly to the highest ranks of the Church. He was born in the village of Kessab, Syria in 1932 and was ordained as a priest in the Church's celibate order in 1949 after his graduation from the Armenian Church Seminary in Antilias, Lebanon. His Holiness was recognized as an exceptional scholar and sent to Oxford University for theological studies. After completing his studies, he returned to Antilias to serve as Dean of the seminary. His Holiness was recognized for his leadership skills by being asked to lead church dioceses in Iran and the United States. In 1977, he was elected Catholicos of the Catholicosate of Cilicia, based in Lebanon. The people of Armenia elected Karekin I Supreme Catholicos of the Armenian people in 1995. Karekin I was the first Catholicos in centuries to reign within an independent Armenian state. His Holiness worked tirelessly for the spiritual revival of the Armenian Orthodox Church in Armenia. His Holiness also decentralized the infrastructure of the church in Armenia by adding new diocese throughout the country, and he restored churches and monasteries which had been closed during the era of Soviet rule. The Armenian people throughout the world are mourning the death of His Holiness, and Armenia will be paying tribute to his extraordinary life by holding a period of national mourning through August 8. I urge my colleagues to join with the Armenian community in remembering the legacy of hope, courage, and compassion left by His Holiness Karekin I.

Mr. REED

Mr. REED. Mr. President, I note that the banking committee is meeting at this time, and objection to that meeting has been made for the Record.

Mr. REED. Mr. President, we are at a historic juncture. In the 1980's, we faced massive deficits and growing debts. In sum, Congress debated red ink. On the edge of the millennium, we are debating the question of what to do with about $1 trillion in anticipated budget surpluses. Why are we here debating a surplus? We are here because of the tough choice we made in the past: a choice to use fiscal discipline. We started down the road of deficit reduction with the 1993 budget package, which passed without a single Republican vote. In fact, some members on the other side of the aisle claimed the bill would lead to economic collapse. However, because of the courageous stand we took then, we have gone from a $290 billion deficit in 1992 to an estimated $70 billion surplus in 1999. But we did more than reduce the deficit and restore fiscal discipline, we spurred tremendous economic growth and unprecedented economic expansion. For the sake of perspective, I would like to list the following facts: we have seen 3.5% annual growth since 1993, 18.9 million new jobs, 4.3% unemployment, and the median family income grow by more than $3,500 since 1993. This is good news, and we cannot afford to squander it. The days of red ink as far as the eye can see are gone. Instead, based on various budget projections, we can suppose that there will be a total surplus of approximately $3 trillion over the next ten years. More than $2 billion of that total comes from Social Security payroll taxes and must absolutely be set aside to preserve Social Security for current and future beneficiaries. Social Security is a promise to those Americans who worked and fought to make this nation great, and it is a program that must be preserved. The Office of Management and Budget and the Congressional Budget Office both project that the remaining non-Social Security surplus totals roughly $965 billion. But these are merely projections, dependent upon the performance and vagaries of the economy. And, I would caution that the Office and Management and Budget and the Congressional Budget Office have a history of predictions that fall far short of the mark. Indeed, Mr. President, because of changes in the economy between April and July of 1999, the Congressional Budget Office revised its ten year projections, adding $300 billion to the surplus. Imagine--a swing of $300 billion in three months. But how are we generating the surplus, or more accurately, why is the Congressional Budget Office predicting a budget surplus? Quite simply, the vast bulk of the non-Social Security surplus, nearly $600 billion of it, comes from the continuation of arbitrary spending caps established in the 1997 Balanced Budget Act. When we passed that legislation, we still had a deficit, but many of us realized then that if these budget caps were maintained beyond the period they were required to balance the budget, they would prevent us from meeting our long-term obligations for education, health care, and the environment. The American people cannot afford, as my colleagues on the other side of the aisle have asked of them, to retain these caps for the next 10 years. We cannot afford $600 billion in cuts to Pell Grants, Head Start, the Special Supplemental Nutrition Program for Women Infants and Children, Brownfield cleanup, Community Policing, Veterans benefits, and the National Institutes of Health, to name a few essential initiatives. Let me emphasize that the $600 billion figure is not for new, outlandish investments. Rather, that figure represents the resources we need to maintain current levels of funding. Make no mistake, these are cuts, not ``reductions in the rate of growth'', but real cuts. Moreover, if we adopt the Republican $800 billion tax cut plan and if we fund the President's plan to meet the military's personnel and equipment needs, as the Republican leadership has said it will do, non- defense domestic spending will be cut by a whopping 38% in 2009. Under this scenario, 375,000 children will not get Head Start services, 1.4 million veterans will lose medical care, and 6.5 million poor students will lose Title I education aid. Simply put, the $800 billion tax cut before us today crowds out every priority we know must be met in the future. Mr. President, the most serious shortfall of the Republican tax bill is that it disposes of the entire surplus without making any provisions to shore up Medicare. By using all of the projected surplus for tax cuts, we leave ourselves severely restricted in the options we will have in the future. Actuarial reports from the Medicare Trustees project that, under current economic conditions, we will have to contend with the inevitable fact that the Medicare program will be insolvent by 2015. Regrettably, by allocating the entire federal budget surplus for tax cuts, we will be forced to make radical changes to the program, either in the form of dramatic benefit reductions, large increases in premiums, or tax increases. In addition, the Republican tax cut plan completely ignores the impending burdens of a retiring baby boom generation. The truth is that by 2030, there will be about 70 million Americans 65 years or older, more than twice their number in 1996. In terms of the total population, seniors will grow from 13% to 20% between 1999 and 2030. In spite of these imminent demographic challenges, the Republican tax cut bill is structured in a way that tax breaks would explode during their second ten years. As the baby boom generation retirements occur, the cost of the tax cuts would explode to $2 trillion. Prudence dictates that we should take the opportunity the surplus presents to make meaningful changes to the Medicare program. I believe that we should be looking at the possibility of adding a prescription drug benefit as well as additional preventive benefits to the basic package of health care benefits. For elderly Rhode Islanders the cost of prescription drugs is a major concern and a major expense. Unfortunately, Medicare does not cover this expense nor does the COLA for Social Security accurately represent the medical expenditures of today's seniors. While consideration of these matters should be made in the context of overall structural reform, we must ensure that there are adequate resources to guarantee a basic benefit package upon which Medicare beneficiaries continue to rely. Sadly, the Republican tax bill saps these resources before the debate can even begin. The massive size of the Republican tax plan threatens to unravel the many years of fiscal austerity that have brought us to this important juncture. Their unrealistic and dangerous proposal sacrifices the future for short-term gratification. Mr. President, these are good times in our nation. More Americans are employed. More Americans own a home. Crime is down. Productivity is up, and inflation is low. Working families in Rhode Island expect us to be responsible and prepare for the future. They want us to preserve Medicare, but the Republicans say ``no''. They want us to invest in education, but the Republicans say ``no''. They want us to care for our veterans, but the Republicans say ``no''. They want us to address the shameful fact that 1 out of every 5 children in America lives in poverty, but the Republicans say ``no''. Mr. President, saying ``no'' to the needs of the American people is not an acceptable legacy for this Congress. On the edge of the Millennium, we should not put politics ahead of what is fair and responsible. Let's build for the future.

Mr. REED. Mr. President, I am proud to join Senator Rockefeller in proposing a prudent, fiscally responsible tax cut alternative. Like many, we are skeptical with the underlying assumption that there will be nearly a trillion dollar surplus. Indeed, the numbers show that much of the surplus is generated under the assumption that Congress will significantly slash investments in education, veterans, and defense below the level needed to keep pace with inflation. Such cuts in key investments are not what the American people want. Moreover, the current majority has already exceeded last year's spending limit by $35 billion in the first 10 months of this fiscal year. The real surplus from our current economic growth is closer to $112 billion when one eliminates the unrealistic, rosy scenarios painted by the Republican's $800 billion tax bill. Mr. President, our great economic growth has presented us with an opportunity to do many things. Sensible, modest, and targeted tax cuts for working families is part of that mix along with domestic investments and Medicare reform. In that spirit of balancing priorities, I supported the proposal of Sen. Moynihan to provide $290 billion in targeted tax relief, while extending the life of Medicare and preserving funding for our most pressing domestic needs. That proposal was realistic and based on sound footings. But, we should not enact an $800 billion tax cut based on mere projections; which slashes domestic investments; and which does nothing to preserve Medicare. Our $112 billion tax cut proposal is tied to a realistic review of the actual unencumbered surplus. This is the judgement of many outside experts including former Congressional Budget Office Director Robert Reischauer. Using this figure we can still provide marriage penalty relief, education tax credits, preserve Medicare, and meet the expectations of America's families. That is why Senators Rockefeller, Leahy, and I have put forth this proposal. Mr. President, my hope is that our colleagues on the side of the aisle will take a moment to review the real surplus numbers and join us in our effort.

Mr. REED. Mr. President, I oppose this amendment on procedural grounds. This is a highly complex subject. It is a subject that I am sure will be debated extensively as we consider the Elementary and Secondary Education Act. But in principle also I think it is inappropriate to divert these resources to private education when we have so many unmet needs in public education. I believe also that if we adopt the underlying tax bill there will be even less resources to devote to public education and it will exacerbate the demands that we already must meet with respect to public education. There is a difference between private schools and public schools. Private schools can exclude children. Public schools must educate every child in America. I believe our obligation and commitment is to public education, and this amendment will defeat that. I also note that the pending amendment is not germane. Therefore, I raise a point of order that the amendment violates Section 305(b)(2) of the Congressional Budget Act of 1974.

Mr. REED

Mr. REED. Thank you, Mr. President. I thank the Senator from New Mexico for yielding the time but also for his farsightedness. He recognizes, as the American people recognize, that the key to our future is investing in education. His amendment would precisely do that. It would sustain our education investment at least at the rate of inflation. We are here debating what to do with a surplus. This debate is a direct result of some very difficult choices we made starting in 1993 and continuing for the last several years. We now have before us a supposed $3 trillion surplus. But we all recognize and agree that $2 trillion of that is the Social Security account. We are in various ways recognizing that we don't want to disturb those accounts. So we are really talking about roughly $1 trillion, or $965 billion. As the Senator from Massachusetts so eloquently pointed out and so accurately pointed out, within that surplus we have already made significant commitments. One of the problems with the proposals that have been made by the Republicans--the almost $800 billion tax cut, or the $500 billion tax cut--is that the assumptions they are using have to be seriously questioned. They are theoretical assumptions, first, that we will enjoy the same kind of economic growth over the next 10 years that we have enjoyed recently. As Chairman Greenspan pointed out in his appearance both before the Senate Banking Committee and the comparable committee in the other body, the business cycle has not been repealed. We will run into, particularly over a 10-year time span, situations in which projections do not provide the resources that we think of today. But the second assumption and the one that is of critical importance to Senator Bingaman's amendment is the unrealistic assumption that we will continue these caps on discretionary spending as we have proposed in the 1997 balanced budget amendment. These discretionary caps are already constraining what we do. In fact, we have already violated these caps. As the Senator from Massachusetts suggested, we will probably in October somehow formally or informally avoid these caps. But the premise of this supposed trillion-dollar surplus is that we will live within these caps. You can see from Senator Bingaman's presentation that if we do not do our investment, education will collapse. We will find ourselves underinvesting in education as we have in so many other programs. The reality is, as was suggested before, that if we, in fact, simply fund the President's proposal by the year 2009, we will be spending 38 percent in domestic discretionary spending. There is no way that we can do that. Frankly, the political reality is that there is no way we will do that. We have to recognize that we will be investing in these programs. We have to recognize, as Senator Bingaman has said, that one of our first priorities is to continue to invest in education. Looking at these Republican proposals, I am reminded of what happened in the early 1980s. George Bush, when he was campaigning against President Reagan, described his economics as ``voodoo economics.'' It turned out to be that way. The supply side theories of cutting taxes will stimulate the economy, pay for themselves, and lead to surpluses proved dangerously in error during the 1980s. Perhaps what we are talking about today when we look at these Republican proposals is ``de ja voodoo economics.'' The theory is that we will return to the same kind of deficits, the same kind of economic instability that plagued us through the late 1980s and into the early 1990s until we did take some difficult votes in 1993. What Senator Bingaman is saying is let's recognize the reality. Let's recognize that we have to fund educational programs at least at the level of inflation. If we do that, we will have to invest at least about $132 billion. That is what we should be doing. If we don't do that, we are going to lose out tremendously in the title I programs--a Federal program that provides assistance and support for low-income students. Frankly, we understand the crisis in urban and rural education that this money is so effective in dealing with. Without it, urban systems and rural systems would be situated even worse. Without it, we would be fostering and contributing to two separate and terribly unequal societies. We have to keep our commitment to these young people. We would also lose opportunities to reform education, for professional development programs, for opportunities to have smaller class sizes, for opportunities to go ahead and fix crumbling school buildings throughout the country. We would do something that all Members say we would never want to do, and that is renege once again on our commitment to special education. I don't know how many times I have been on the floor listening particularly to my colleagues on the other side who have been talking about how we have to put more money into IDEA, the Individuals with Disability Education Act, how we have imposed programs on localities promising robust spending, and we have never delivered. If we have not delivered on IDEA yet, if these tax proposals pass, we will never have a chance to deliver on our contribution to local school systems. When we move to the area of higher education and Pell grants, work- study programs, the new LEAP program, which is an outgrowth of the State Student Center Grant Program, all of these provide opportunities for Americans to educate themselves beyond high school. We all recognize that might be the most critical issue we face as a nation-- educating our citizens to enable them to assume challenging roles in the next century. Yet we dramatically cut these programs, denying opportunities to thousands and thousands of Americans. We say to them again: This is not the land of opportunity; this is the land of advantage and affluence. Anyone lucky enough to pay for college with their own resources can go but don't look to the Government to provide the kind of help provided in the last several years. All of these cuts lead Members to ask a very simple question for the working families of Rhode Island, for the working families of New Mexico, for the working families across this country, when they lose the Pell grants or see the urban school systems getting less and less support and local property taxes going up: are they better off with whatever tax cut they receive than these proposed programs? I think not. One other aspect of the Republican proposal is a terribly distorted benefit that goes to the very wealthy at the expense of middle- and low-income America. Our constituents know education is the most important aspect facing our society. They want Congress to continue to support families. They want precisely what the Bingaman education amendment does. I believe if we listen to those people who sent us here, they will say vote for this amendment. They will say reject this deja voodoo economics that is underlying the proposals by the majority party. In fact, I hope we respond to that clarion call from our constituents. I commend and thank the Senator from New Mexico for his efforts and for his time. I yield the floor.

Mr. REED

Mr. REED. Mr. President, I, too, wish to join Senator Chafee in paying tribute to the Very Reverend Abdulahad Gabriel Doumato on the occasion of his fiftieth anniversary as leader of the parish of Saint Ephraim's Syrian Orthodox Church in Rhode Island. A proud and patriotic ``American'', Father Doumato loves his adopted country and is happiest when helping the new immigrants within his flock assimilate into American society. Mr. President, Father Doumato is responsible for sponsoring hundreds of new citizens to our great nation, granting them the opportunity to live the American dream. He has educated these families--including those of six of his brothers and sisters--about our system of government and the privilege, opportunity, and responsibility of American citizenship. Father Doumato is often heard telling his parishioners, ``There is no country like the United States. It truly is the land of opportunity and you should thank God for the opportunity you have to live in this great land.'' A good shepherd, Father Doumato has been a shining example to his family and his flock. The Doumatos are a sizable and considerable clan in Rhode Island--the extended family numbers over 120 persons. We cannot imagine that there has been a single elected official in the Blackstone Valley area, or across the State, that has not come into contact with a member of the family. Indeed, father Doumato's children, grandchildren, nephews and nieces have been industrious citizens and have served our country in numerous positions of distinction, including as officers in the Armed Forces, diplomats, university educators, U.S. Senate aides and senior advisors, engineers, and leaders in law, the arts, medicine, commerce and industry. He and his family have richly contributed to the betterment of our community in Rhode Island. Mr. President, in closing, I would also like to wish Reverend Doumato and his wife, Victoria, a happy and healthy 57th Anniversary, which they will celebrate later this year. May his children and grandchildren--along with his parishioners-- continue to benefit from his wisdom!

Mr. REED

Mr. REED. Mr. President, I rise today to introduce the Professional Development Reform Act to strengthen and improve professional development for teachers and administrators. I have long worked to improve the quality of teaching in America's classrooms for the simple reason that well-trained and well-prepared teachers are central to improving the academic performance and achievement of students. Last Congress, I introduced the TEACH Act to reform the way our prospective teachers are trained. The TEACH Act sought to foster partnerships among teacher colleges, schools of arts and sciences, and elementary and secondary schools. Such partnerships were a central recommendation of the National Commission on Teaching and America's Future to reform teacher training, and I was pleased that my legislation was included in the renewed teacher training title of the Higher Education Act Amendments of 1998. As Congress turns to the reauthorization of the Elementary and Secondary Education Act, the focus shifts to new teachers and teachers already in the classroom. Mr. President, the legislation I introduce today would reform professional development, which too often consists of fragmented, one- shot workshops, at which teachers passively listen to experts and are isolated from the practice of teaching. We don't expect students to learn their ``ABCs'' after one day of lessons, and we shouldn't expect a one-day professional development workshop to yield the desired result. Research shows that such professional development fails to improve or even impact teaching practice. Moreover, a recent survey of teachers found that professional development is too short term and lacks intensity. In 1998, participation in professional development programs typically lasted from 1 to 8 hours--the equivalent of only a day or less. As a consequence, only about 1 in 5 teachers felt very well prepared for addressing the needs of students with limited English proficiency, those from culturally diverse backgrounds, and those with disabilities, or integrating educational technology into the curriculum. Instead, research shows that effective professional development approaches are sustained, intensive activities that focus on deepening teachers knowledge of content; allow teachers to work collaboratively; provide opportunities for teachers to practice and reflect upon their teaching; are aligned with standards and embedded in the daily work of the school; and involve parents and other community members. Such high-quality professional development improves student achievement. Indeed, a 1998 study in California found that the more teachers were engaged in ongoing, curriculum-centered professional development, holding school conditions and student characteristics constant, the higher their students' mathematics achievement on the state's assessment. Community School District 2 in New York City is one district which has seen its investment in sustained, intensive professional development pay off with increases in student achievement. Professional development in District 2 is delivered in schools and classrooms and focused on system-wide instructional improvement, with intensive activities such as observation of exemplary teachers and classrooms both inside and outside the district, supervised practice, peer networks, and offsite training opportunities. Unfortunately, a recent national evaluation of the Eisenhower Professional Development program found that the majority of professional development activities in the six districts studied did not follow such a sustained and intensive approach. And, in a recent article in the Providence Journal, some teachers noted that professional development for them has revolved around sitting and listening to experts talk about standards, rather than working closely with teachers and students to refine new methods of teaching those standards. Unlike the bill passed last week in the other body which would do little to address these issues or change professional development, my legislation would create a new formula program for professional development that is sustained, collaborative, content-centered, embedded in the daily work of the school, and aligned with standards and school reform efforts. To achieve this enhanced professional development, the legislation funds the following activities: mentoring; peer observation and coaching; curriculum-based content training; dedicated time for collaborative lesson planning; opportunities for teachers to visit other classrooms to model effective teaching practice; training on integrating technology into the curriculum, addressing the specific needs of diverse students, and involving parents; professional development networks to provide a forum for interaction and exchange of information among teachers and administrators; and release time and compensation for mentors and substitute teachers to make these activities possible. The Professional Development Reform Act also requires partnerships between elementary and secondary schools and institutions of higher education for providing training opportunities, including advanced content area courses and training to address teacher shortages. In fact, preliminary U.S. Department of Education data show that the Eisenhower Professional Development activities sponsored by institutions of higher education are most effective. My legislation will also provide funding for skills and leadership training for principals and superintendents, as well as mentors. Indeed, ensuring that our principals have the training and support to serve as instructional leaders is critical, as is ensuring that mentors have the skills necessary to help our newest teachers and other teachers who need assistance in the classroom. Funding is targeted to Title I schools with the highest percentages of students living in poverty, where improvements in professional development are needed most. My legislation does not eliminate the Eisenhower program, but it does require that Eisenhower and other federal, state, and local professional development funds be coordinated and used in the manner described in our bill--on professional development activities that research shows works. In addition, the Professional Development Reform Act offers resources but it demands results. Strong accountability provisions require that school districts and schools which receive funding actually improve student performance and increase participation in sustained professional development in three years in order to secure additional funding. In sum, my legislation seeks to ensure that new teachers have the support they need to be successful teachers, that all teachers have access to high quality professional development regardless of the content areas they teach, and that the professional development does not isolate teachers, but rather is part of a coordinated and comprehensive strategy aligned with standards. Not only does the research bear this out as the way to improve teaching practice and student learning, but education leaders in my home state of Rhode Island, as well as witnesses at a recent Health, Education, Labor, and Pensions Committee hearing stressed the importance of this type of professional development. Mr. President, the time for action is now as schools must hire an estimated 2.2 million new teachers over the next decade due to increasing enrollments, the retirement of approximately half of our current teaching force, and high attrition rates. Ensuring that teachers have the training, assistance, and support to increase student achievement and sustain them throughout their careers is a great challenge. But we must meet and overcome this challenge if we are to reform education and prepare our children for the 21st Century. The Professional Development Reform Act, by increasing our professional development investment and focusing it on the kind of activities and opportunities for teachers and administrators that research shows is effective, is critical to this effort. I urge my colleagues to join me in this essential endeavor by cosponsoring this legislation and working for its inclusion in the reauthorization of the Elementary and Secondary Education Act. Mr. President, I ask unanimous consent that the text of this legislation be printed in the Record.

Mr. REED

Mr. REED. Mr. President, I rise today to introduce the Professional Development Reform Act to strengthen and improve professional development for teachers and administrators. I have long worked to improve the quality of teaching in America's classrooms for the simple reason that well-trained and well-prepared teachers are central to improving the academic performance and achievement of students. Last Congress, I introduced the TEACH Act to reform the way our prospective teachers are trained. The TEACH Act sought to foster partnerships among teacher colleges, schools of arts and sciences, and elementary and secondary schools. Such partnerships were a central recommendation of the National Commission on Teaching and America's Future to reform teacher training, and I was pleased that my legislation was included in the renewed teacher training title of the Higher Education Act Amendments of 1998. As Congress turns to the reauthorization of the Elementary and Secondary Education Act, the focus shifts to new teachers and teachers already in the classroom. Mr. President, the legislation I introduce today would reform professional development, which too often consists of fragmented, one- shot workshops, at which teachers passively listen to experts and are isolated from the practice of teaching. We don't expect students to learn their ``ABCs'' after one day of lessons, and we shouldn't expect a one-day professional development workshop to yield the desired result. Research shows that such professional development fails to improve or even impact teaching practice. Moreover, a recent survey of teachers found that professional development is too short term and lacks intensity. In 1998, participation in professional development programs typically lasted from 1 to 8 hours--the equivalent of only a day or less. As a consequence, only about 1 in 5 teachers felt very well prepared for addressing the needs of students with limited English proficiency, those from culturally diverse backgrounds, and those with disabilities, or integrating educational technology into the curriculum. Instead, research shows that effective professional development approaches are sustained, intensive activities that focus on deepening teachers knowledge of content; allow teachers to work collaboratively; provide opportunities for teachers to practice and reflect upon their teaching; are aligned with standards and embedded in the daily work of the school; and involve parents and other community members. Such high-quality professional development improves student achievement. Indeed, a 1998 study in California found that the more teachers were engaged in ongoing, curriculum-centered professional development, holding school conditions and student characteristics constant, the higher their students' mathematics achievement on the state's assessment. Community School District 2 in New York City is one district which has seen its investment in sustained, intensive professional development pay off with increases in student achievement. Professional development in District 2 is delivered in schools and classrooms and focused on system-wide instructional improvement, with intensive activities such as observation of exemplary teachers and classrooms both inside and outside the district, supervised practice, peer networks, and offsite training opportunities. Unfortunately, a recent national evaluation of the Eisenhower Professional Development program found that the majority of professional development activities in the six districts studied did not follow such a sustained and intensive approach. And, in a recent article in the Providence Journal, some teachers noted that professional development for them has revolved around sitting and listening to experts talk about standards, rather than working closely with teachers and students to refine new methods of teaching those standards. Unlike the bill passed last week in the other body which would do little to address these issues or change professional development, my legislation would create a new formula program for professional development that is sustained, collaborative, content-centered, embedded in the daily work of the school, and aligned with standards and school reform efforts. To achieve this enhanced professional development, the legislation funds the following activities: mentoring; peer observation and coaching; curriculum-based content training; dedicated time for collaborative lesson planning; opportunities for teachers to visit other classrooms to model effective teaching practice; training on integrating technology into the curriculum, addressing the specific needs of diverse students, and involving parents; professional development networks to provide a forum for interaction and exchange of information among teachers and administrators; and release time and compensation for mentors and substitute teachers to make these activities possible. The Professional Development Reform Act also requires partnerships between elementary and secondary schools and institutions of higher education for providing training opportunities, including advanced content area courses and training to address teacher shortages. In fact, preliminary U.S. Department of Education data show that the Eisenhower Professional Development activities sponsored by institutions of higher education are most effective. My legislation will also provide funding for skills and leadership training for principals and superintendents, as well as mentors. Indeed, ensuring that our principals have the training and support to serve as instructional leaders is critical, as is ensuring that mentors have the skills necessary to help our newest teachers and other teachers who need assistance in the classroom. Funding is targeted to Title I schools with the highest percentages of students living in poverty, where improvements in professional development are needed most. My legislation does not eliminate the Eisenhower program, but it does require that Eisenhower and other federal, state, and local professional development funds be coordinated and used in the manner described in our bill--on professional development activities that research shows works. In addition, the Professional Development Reform Act offers resources but it demands results. Strong accountability provisions require that school districts and schools which receive funding actually improve student performance and increase participation in sustained professional development in three years in order to secure additional funding. In sum, my legislation seeks to ensure that new teachers have the support they need to be successful teachers, that all teachers have access to high quality professional development regardless of the content areas they teach, and that the professional development does not isolate teachers, but rather is part of a coordinated and comprehensive strategy aligned with standards. Not only does the research bear this out as the way to improve teaching practice and student learning, but education leaders in my home state of Rhode Island, as well as witnesses at a recent Health, Education, Labor, and Pensions Committee hearing stressed the importance of this type of professional development. Mr. President, the time for action is now as schools must hire an estimated 2.2 million new teachers over the next decade due to increasing enrollments, the retirement of approximately half of our current teaching force, and high attrition rates. Ensuring that teachers have the training, assistance, and support to increase student achievement and sustain them throughout their careers is a great challenge. But we must meet and overcome this challenge if we are to reform education and prepare our children for the 21st Century. The Professional Development Reform Act, by increasing our professional development investment and focusing it on the kind of activities and opportunities for teachers and administrators that research shows is effective, is critical to this effort. I urge my colleagues to join me in this essential endeavor by cosponsoring this legislation and working for its inclusion in the reauthorization of the Elementary and Secondary Education Act. Mr. President, I ask unanimous consent that the text of this legislation be printed in the Record.

Mr. REED

Mr. REED. Mr. President, I rise today to acknowledge Mrs. Pearl Salotto of Warwick, Rhode Island for her dedicated work in establishing the ``Respect for Living Things Day'' in the state of Rhode Island. Mrs. Salotto has established a number of programs in Rhode Island including the D.J. Pet Assisted Therapy University Certificate Program, the D.J. Pet Assisted Therapy High School Program, and the D.J. Respect for Living Things Elementary School Program. Mr. President, I ask that Mrs. Salotto's op-ed on July 21st, 1999 in the Providence Journal be printed in the Record. The article follows: [The Providence Journal] The Best Way To Remember DJ, Therapy Dog (By Pearl Salotto) DJ, dog of joy, recently passed away peacefully within the loving arms of her family. The smiling face of this big white dog had become synonymous with professional Pet Assisted Therapy (PAT), locally and nationally, because of her enthusiasm for life and her unconditional love, because of the countless people of all ages whose lives she touched, because of the many programs as well as social-reform initiatives that she inspired, because of the many dreams that she helped turn into reality. Anyone who recognizes that pets and people are good for each other can turn this moment of sadness into a celebration of DJ's life and commit to carrying on her legacy, recognizing that she did more than her part in bringing about a healthier, friendlier, and more peaceful world simply by being herself. DJ showed me, at a New York nursing home in 1998, how residents could find a renewed joy of life through her loving touch and thus inspired not only my university program but also my vision that all universities should have PAT degree programs so that ultimately all facilities could have professional PAT as part of their treatment team. DJ showed me, in my granddaughter's first-grade classroom in New York in 1991, how a dog's strolling up and down aisles and interacting with children could open up their hearts and minds to their responsibilities to pets, people and themselves. DJ showed all of us the profound and life-changing impact that her freely given love could have on Feinstein High School students, giving them the ``heart-opening'' opportunity to learn of the positive impact that animals can have in all of our lives through their one-of-a-kind PAT curriculum and the subsequent follow-up opportunity to share their love with others through PAT Service Learning. DJ showed me from the first day of our experiences together that the bond between the therapy pet and the professional is the ethical foundation of this profession, protecting the pet in the field and providing the example from which all else flows. DJ and DJ-inspired programs have led to schoolchildren writing and singing songs about respecting animals, other people and themselves, Rhode Island Health Department guidelines for pet therapy, an official state commission, annual DJ Respect for Living Things Days on her birthday, May 8, several Rhode Island agencies having professional PAT programs, the integration of PAT with Service Learning and Windwalker Humane Coalition for Professional Pet Assisted Therapy, among other programs. Won't you join my children and grandchildren, friends and colleagues, elementary school students of Central Falls, Woonsocket, Providence and Feinstein High School students, and students of all ages who knew and loved DJ, in doing all in our power through all our words and deeds to help this magical profession earn its rightful place in health care, education, social services, and society as a whole, spearheaded over the past 13 years by the smiling face and extended paw of a big white dog named DJ?

Mr. REED

Mr. REED. I thank my colleague from Oregon. Let me reaffirm what my colleague said. This whole concept of ombudsman and consumer assistance centers is designed to allow the consumer in the first few hours, or even minutes, when they encounter problems in the health care system, to get advice and assistance. This is not a theoretical concept. It works already in several States. California has a model program around the Sacramento area. People have benefited from this. This is what we want to see in every State in the country. Again, if we cannot be sensitive enough to recognize the need for consumer assistance early in the process, then I believe we are failing the American public miserably. I hope we can embrace, support, and adopt this amendment, particularly this provision with respect to the ombudsman consumer assistance program. I yield back my time.

Mr. REED. I thank the Chair. Mr. President, I rise this evening with great regret, regret that we have not done what we should have done to protect the children of America who are in a managed care plan. The bill before us that we will vote upon is a litany of missed opportunities and missed statements with respect to the status of children in managed care. For example, access to pediatricians. They are classified as specialists, so they cannot be automatically the primary care provider to children. Frankly, most Americans believe that is exactly who they are. Second, there is no guaranteed access to pediatric specialists. We have language in this Republican proposal that talks about age- appropriate specialists. That is language written by HMO lawyers to ensure that they can magically transform an adult specialist, who might have seen a child at 1 year or 2 years, into an age-appropriate specialist, just as they do today. We have a situation in which we have not provided for expedited internal and external appeals based upon developmental needs of a child. Children are different from adults. They have conditions for which an adult could wait months and months and months for adequate care, but in a child they become critical because the child's development is critical. These are shortcomings that will leave the children of America shortchanged. We can and must do more. We could have done more, and we could have given all the individuals in managed care the right at least to go to consumer assistance centers, ombudsman programs, so they could have their questions resolved, and we pushed that aside. Frankly, the greatest disappointment I have is that we heard a lot of discussion this evening and the last few days about the cost of this bill. We could give all these protections to children, every item in the Democratic proposal, and the cost would be negligible, because one of the good news issues is that children are generally healthy. But for those chronically ill children, it would have made all the difference in the world. Today is not the day we are helping the children of America in managed care, but I hope we will some day, and that day will come, and it must come. I yield the floor.

Mr. REED. Mr. President, I rise in strong support of this amendment. There are many very important provisions, but I want to focus on one provision, and that is the creation at the State level of ombudsman programs or consumer assistance centers. I have been working on this provision, along with Senators Wyden and Wellstone. We introduced separate legislation, and today, as part of this amendment, we are considering this very valuable and very important opportunity to empower consumers of health care services in this country. One of the persistent themes we have heard throughout this debate is how do we give consumers more leverage in the system against these huge HMOs, against what appears to be illogical, indifferent decisions about the health of themselves and their families. We rejected some proposals which I believe we should have embraced. For example, we just defeated an opportunity to give people a chance, in extremist, to go to court if necessary. This is something that has been adopted in Texas and is working very well. If we cannot do any of those things, then I think we must do at least this; and that is, to give the States the incentive to develop consumer assistance centers so individual health care consumers--patients--when they have frustrating denials, have someplace to turn. We all know, because we all listen to our constituents, that every day there are complaints about the inability to get straight answers from their HMO, of the inability to get coverage, the inability to get what you paid for. Where do they turn? Too many Americans cannot turn anywhere today. If we pass this amendment, we will give them a chance to turn to a consumer assistance center. I will briefly outline the provisions of the legislation. We provide incentives to four States to set up consumer assistance centers. These centers will operate as a source of information. They can give direct assistance in terms of advice or assistance to someone who is in a health care plan who has a question about their coverage. They will operate a 1-800 hotline. They will be able to make referrals to appropriate public and private agencies. They will not be involved in any type of litigation. This is not an attempt to provide an opportunity to recruit litigants. This is a consumer assistance center concept. I hope also that these centers will educate consumers about their rights. This is something that has been promoted by many different organizations. The President's health care advisory commission in 1997 pointed out this is efficiency and every State, every region should have these types of centers. We have similar centers with respect to aging and long-term care ombudsman programs working very well. Several States--Vermont, Kentucky, Georgia, and Virginia--have adopted these programs because they want to give a voice and give some type of power to their consumers in health care. Florida and Massachusetts have programs they are trying to get up and running, and just a few weeks ago on this floor in response to profound concerns we have about the military managed care program, the TriCare program, we adopted legislation that would set in motion the creation of an ombudsman program for military personnel. It is not a controversial idea. We passed this idea with overwhelming support. This is something we can do. This is something we should do, and, frankly, if we rejected all the remedies we are proposing to give to consumers, we have to adopt at least this one. We have to give an incentive to States for working through not-for-profit agencies to set up these consumer assistance programs. Frankly, this is something that is long overdue, noncontroversial, and it should be done. I see the Senator from Oregon, who has been a stalwart on this issue, is standing. He might have a comment.

Mr. REED

Mr. REED. I ask unanimous consent for an additional minute

Mr. REED. Mr. President, I will discuss several issues that are central to the debate we are having on managed care in the Patients' Bill of Rights. First, I was very disappointed that the Senate rejected Senator Kennedy's amendment which would have extended the protections of the Patients' Bill of Rights to all privately insured Americans. Those in favor of much more limited coverage, very much restricted coverage, argue that the cost in the Democratic alternative would cause many Americans to lose their health insurance through increased premiums. They argue, as we have heard time and time again, that premiums would rise and that employers would drop coverage. When you actually talk to many employers, particularly those in small businesses who are represented by the American Small Business Alliance, for example, they tell quite a different story. They talk about a situation in which they have already seen premiums rise, but they get very little for what they pay for. For example, Mr. Brian McCarthy, President of McCarthy Flowers and Cabs, from Scranton, PA, had this to say. His words: Workers who spend time out sick or are consumed in battles with their health plan wreak havoc on the bottom line. That lost productivity costs my business a lot more than the modest premium increases that may result from this legislation. He went on to add: The Patients' Bill of Rights is about giving people the care they need and deserve, and it clearly gives small businesses a better deal for their health care dollar. That is not the voice of a Senator, but of a small businessperson who has seen the effects of managed care on his own bottom line. Another small business owner, Mr. Tom Reed, who owns Lake Motors in Eagle Lake, TX, said: My premiums go up now and I get nothing, or sometimes even less coverage. The Patients' Bill of Rights at least will give me something tangible, bringing me better value for the health care money I spend. Those are the words of businesspeople who are struggling with the issues. They are in favor of this legislation because they want to get what they have been paying a lot for, and that is quality health care. They will only get that with the Democratic Patients' Bill of Rights. There have been studies that have supported these anecdotal comments. The Kaiser-Harvard Program on Health Policy surveyed small business executives from the small business sector, and they found that 88 percent support independent appeals such as those that are in the Democratic alternative; 75 percent support the right to see a specialist without prior approval; 61 percent favor giving people the right to sue their health plan; and fewer than 1 percent suggested that they might drop coverage if rates increased. These are small business executives. This is compelling and persuasive evidence that, in order to be responsive to the needs of small businesses throughout the country, it is imperative that we pass the Democratic alternative. There is another aspect of this legislation which deserves discussion, and that is the fact that health care plans, HMOs, are immune from liability because of what is apparently a loophole in the ERISA law. A physician can be sued for malpractice, a physician can be sued for making misjudgments, but an insurance company, often working through nonphysicians, administrators, and reviewers, are immune from such suits. This aspect of accountability is critical to making sure that we have rights that are enforceable and that actually produce tangible results throughout the country. In another survey, the Kaiser Family Foundation found that 73 percent of those surveyed believe that patients should be able to hold their managed care plans accountable through the courts. This is not to suggest that anyone is encouraging a mass exodus to the courthouse. In fact, there is quite a bit of experience that suggests this probably will not happen. In Texas, in May of 1997, bipartisan legislation was passed making it the first State where managed care organizations can be sued for medical malpractice. Like the Democratic plan, the Texas liability law is closely tied to tough, independent external review processes. In fact, you cannot take advantage of the right to sue until you have been through this independent review process. Despite all the warnings about a flurry of lawsuits--the same thing we are hearing today--this has not been the experience in Texas. Neither has the State experienced increased premiums. What has happened is that both sides now are claiming success. HMOs are saying: Look, this is working. And consumers are saying: This is helping us out. In fact, according to Texas State Senator David Sibley----

Mr. REED. I was not aware of that. But I think experience is showing that it would have been an error because the law is working very well. We have a rare historic opportunity to do something to help the American people. It has been done already by the great State of Texas in many respects, but we can do much more, and we shall do much better. I would like to see the same type of protections that are available to the good people of Texas afforded to everyone in this great country. I thank the Chair and yield the floor.

Mr. REED

Mr. REED. Thank you, Mr. President.

Mr. REED

Mr. REED. I thank the Chair.

Mr. REED. Further parliamentary inquiry. Would that carry us past the 10 o'clock hour?

Mr. REED

Mr. REED. Thank you, Mr. President. I rise in strong support of the Bingaman amendment and the Harkin amendment and all my colleagues who are supporting it. This amendment is particularly responsive to the needs of children in the health care system. That is why it has been endorsed by the Children's Defense Fund. We find when we look at the access to pediatric specialists that children don't have that kind of adequate access. As a result, they are the ones who will suffer the most, I believe, if we do not have strong, explicit language giving the right to access to pediatric specialists. There was a survey done in 1992 by Pediatrics magazine. This survey indicated that of the pediatricians who were asked, 35 percent represented that they thought their patients' health outcome was severely upset by denial of access to a pediatric specialist. They found that this practice was all too common. For children, in particular with chronic illnesses, they must seek specialists. It must be clear. It must not be some type of very ambiguous language, as we find in the Republican version of the legislation. Let me suggest another area when it comes to children where access to specialists is difficult. I have a letter from Paul L. Schnur, who is president of the American Society of Plastic and Reconstructive Surgeons. He points out that approximately 7 percent of American children are born with pediatric deformities and congenital defects such as birthmarks, cleft lips, cleft palates, absent external ears, and even more profound facial deformities. Yet, even in these compelling circumstances, he reports that it is very difficult to get a referral from a managed care plan to a specialist, and it is probably even more difficult to get a referral to a pediatric specialist. Of the surgeons who indicated they had trouble getting referrals, 74 percent had patients denied coverage for initial procedures and 53 percent had patients denied coverage for subsequent procedures. What you see is, access to specialists is difficult for children. Access for pediatric specialists is extraordinarily difficult for children. And unless we do something about this, we are going to find the situation where children will again and again be shortchanged by the managed care system. The Republicans have said, listen, we have some in here who say it is ``age specific.'' We have a great deal of respect and esteem for our colleague from Tennessee, who is a physician. I suspect if he were making these decisions about referrals to specialists, he would be sensitive to ``age specificity.'' But that is not who makes these referral decisions. It is attorneys, reviewers, bureaucrats, and technicians. And, frankly, when they see ``age specific,'' they are going to say: Well, you know, we don't have a pediatric specialist on our panel. But that is OK, because we can find somebody who perhaps saw a child in the last year or two, and that is ``age specific'' enough for us. This whole approach is an invitation, once again, to the HMO to make up the rules and then make those rules work against the interests of their patients, and particularly I am concerned that they will work against the interests of children. There has been some various research done about managed care plans throughout the country. But I received some firsthand information from a doctor in Los Angeles who is conducting a very interesting program. It is Dr. Craig Jones. He is at the UCLA Medical School. He has developed a ``Breathmobile program.'' This program goes right to the schools in Los Angeles, and they deal with the No. 1 environmental illness affecting children, and that is chronic asthma. Dr. Jones has treated lots of children. He has had a great outcome. But they collected data. The startling thing about their data is that a child in managed care gets the same kind of treatment for severe asthma as a child without any insurance. If they look at the numbers, there is no difference, because a child in managed care doesn't get the referral to a pulmonary specialist or a respiratory specialist. They get--like every other child who shows up in the emergency room--a little bag with an inhaler, and some medicine, and are told to go home. We can do better, and we must do better. But we will not do better until health care plans are required to make references to specialists and, in the particular case of children, pediatric specialists. I have said this over and over again, but it still remains true. There is a difference between an adult oncologist and a pediatric oncologist. I don't think anyone in this body would dispute that. One other final point, if I may make it, is that when you go around and look at how physicians are categorized and how specialists are categorized, you are not going to find an ``age appropriate'' specialty. You are not going to find someone who says, I am qualified ``age appropriate.'' They are pediatricians, neurologists, and a whole host of people who have special qualifications. We have to work with those categories and not some vague, disingenuous category which will be severely distorted by the insurance companies. I urge passage of the Bingaman amendment.