Jay Rockefeller

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise today in order to recognize Stone & Thomas, an outstanding business, for its continuous service to its customers and to the State of West Virginia. Stone & Thomas has been known for its commitment to customer service since 1847. That is 16 years longer than West Virginia has been a State. This year, Stone & Thomas celebrated 150 years in business, and its longevity is a testament to the quality of service and merchandise which they are committed to. Mr. President, since its founding in 1847 by Jacob Thomas and Elijah Stone, this remarkable business has been owned and operated by five generations of the same family. Currently, Stone & Thomas is run by W.S. Jones, the president, chief executive officer and the great-great- grandson of Elijah Stone. Mr. Jones, like the four generations before him, has continued the creed of outstanding service which Mr. Stone and Mr. Thomas pledged themselves to. Furthermore, Mr. Jones, like those before him, has continued to improve and expand upon an already exceptional business. All told, Stone & Thomas has employed, and continues to employ, thousands of citizens of West Virginia. They are presently responsible for over 1,500 jobs in my State, as well as several hundred jobs in Ohio, Kentucky, and Virginia. And just this week, Mr. President, they celebrated the opening of another customer-friendly store in Charleston, WV, which is expected to bring work to 70 more West Virginians. Mr. President, Stone & Thomas has accomplished so much during its 150 years in business. Because of its diligent efforts to satisfy the customer it has grown to become West Virginia's largest independent retailer, as well as one of the top 100 in the Nation. Because of their outstanding commitment to customer service; because of their longstanding record as a fair, honest, and friendly business; and because of their superior contributions to the economies of West Virginia and three other States, I pay special tribute to Stone & Thomas.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am pleased and proud to be joined by two of my distinguished colleagues, Senator Conrad Burns and Senator Byron Dorgan, in introducing today the Railroad Shipper Protection Act of 1997. This legislation is the result of many months of effort to develop constructive and pragmatic proposals for addressing the increasingly serious problems faced by shippers in need of affordable access to railroad service in every region of the country. As a bipartisan team committed to achieving urgently needed results in the coming year, we offer this bill with the hope that it will generate the interest, input, and support needed to help shippers obtain fair treatment and true competitive access from railroads across the country. I commend both Senators Burns and Dorgan for their leadership and constant attention to these issues, which can be complex and yet affect numerous communities, key industries, and workers nationwide. This legislation deals with issues of longstanding concern to me. Because of the importance of the relationship between the Nation's railroads and the shippers and communities that they serve, especially in my State of West Virginia, I have made a special effort throughout my tenure in the Senate to promote a rail transportation system that is fair and economically sound for all parties. Of all of the things that have troubled me about that system over the years, none is more troubling than the plight of captive rail shippers--businesses and communities that are dependent on a single railroad for freight transportation service. West Virginia has more than its fair share of captive shippers. Many of our coal fields, most of our chemical manufacturers, and one of our finest steel manufacturing facilities--and the largest single employer in our State--all are captive to a single railroad for shipments to domestic and foreign markets. The result is that West Virginia businesses too often suffer from unreasonable freight rates and inadequate transportation service. Today, two events are conspiring to create additional captive rail shippers--and worsen the competitive position of existing captive rail shippers--in West Virginia and across the Nation. First, our national freight rail system continues to concentrate into fewer and fewer major railroads. Since Congress deregulated the railroads in 1980, the number of major Class I railroads has declined from 43 to 5--and will drop to 4 if the division of Conrail is approved. For a long time the fears expressed by shippers, and by those of us in Congress who are dedicated to protecting shippers, have fallen on deaf ears. In the past several months, however, the entire Nation has witnessed the far-reaching economic impact of a merger gone awry. The 1996 merger of Union Pacific and Southern Pacific has made dramatic headlines as service is disrupted, trains pile up, shipments are lost, and ultimately facilities and jobs are put in jeopardy. The chemical industry alone has had to grapple with service disruptions costing an average of $35 to $60 million per month through the summer and into the fall. The UP-SP service crisis has caught my attention in part because the effects are so far-reaching that a number of West Virginia shippers have asked for my help, and in part because I now face a major merger in my own backyard with the proposal to divide Conrail between CSX and Norfolk Southern. The UP-SP situation is expected to improve in the coming months, following implementation of a comprehensive service recovery plan and unprecedented intervention by the Surface Transportation Board, but the UP-SP story has only reinforced my belief that concentration of the Nation's railroads is an ominous development for many shippers and for States like West Virginia. Railroad concentration is reducing transportation options and worsening the competitive position of captive shippers. Second, the Surface Transportation Board, established in 1995 to succeed the Interstate Commerce Commission, is understaffed and underfunded, and is not adequately promoting rail competition and protecting captive shippers. As I feared at the time it was passed, the effect of the ICC Termination Act has been to reduce our national commitment to a strong and effective regulatory body to protect rail shippers. Rather than being vigilant in protecting captive shippers from railroad abuses, the STB has instead been consumed with reviewing major railroad mergers, conducting annual revenue adequacy determinations which serve no purpose, and making matters worse for shippers by deciding in December 1996 that railroads may render captive a shipper that is otherwise positioned to enjoy competitive service by refusing to quote a rate on a bottleneck segment. Mr. President, just as the railroad industry has become more and more concentrated, the regulatory agency charged with protecting captive railroad customers has become less and less able to do its job. Some may wonder how the STB, which is directly charged with protecting against unreasonable rates and promoting competition, came to make such an anticompetitive and antishipper decision as that set forth in the 1996 bottleneck cases, and I think the answer illustrates well the need for Congress to correct the current imbalance between railroads and their customers. The answer lies in the confusing instructions that were given to the STB in the ICC Termination Act, and previously in the Staggers Rail Act of 1980 and the Railroad Revitalization and Regulatory Reform Act of 1976. In these statutes Congress directed the STB and its predecessor, the ICC, to promote our national rail transportation system ``by allowing rail carriers to earn adequate revenues'' (49 U.S.C. 10101(3)) and by making ``an adequate and continuing effort to assist those carriers in attaining revenue levels'' that allow them ``to attract and retain capital in amounts adequate to provide a sound transportation system in the United States'' (49 U.S.C. 10704(a)(2)). Congress has further directed the STB to make an annual determination of each railroad's revenue adequacy--a determination that finds most class I railroads to be revenue inadequate, contrary to the view of Wall Street and industry observers about the financial strength of individual railroads and the industry as a whole. As is evident in reading the Board's bottleneck decision, the perceived revenue inadequacy of the major railroads, and the belief that protecting revenue adequacy is the preeminent responsibility of the agency, formed the basis of the STB's agreement with the railroads that they should have the right to prevent rail-to-rail competition even where competition is physically possible. At this point in the evolution of the railroad industry, such an approach is not only inequitable, it is harmful to our national economy. Today, I join with my colleagues in proposing legislation to clarify the policy of the U.S. Government with regard to railroad competition and to restore the intended balance between railroads and shippers in the laws governing their relationship and the oversight role of the STB. This bill would accomplish five major objectives: First, making clear that it is the policy of the U.S. Government to promote rail competition and protect captive shippers; second, reducing the regulatory burden on captive shippers by simplifying the market dominance test; third, overturning the bottleneck decision by requiring railroads to quote a rate on any available segment of service; fourth, eliminating the ``revenue adequacy'' test, which serves no practical purpose and perpetuates the erroneous view that railroads are in dire financial straits; and fifth, requiring the STB to open its process more widely in order to meet the needs of small shippers. It is our intention to pursue this legislation in the context of the STB's reauthorization next year. I am firmly committed to ensuring that the Board is reauthorized in a timely way and is provided with the funds it needs to perform its mission as the primary oversight agency for the Nation's railroads, but I want to make clear that I will not support continuation of the status quo in the relationship between railroads and shippers. The legislation I introduce today will begin to afford rail-to-rail competition and captive shipper protection the priority they deserve in our national transportation policy. It is an important first-step, and I look forward to working with Senator Burns, Senator Dorgan, and others over the course of the next several months to expand upon the shipper protections we propose today. I invite our colleagues to join us in this effort, and genuinely seek constructive input and assistance to achieve needed solutions. Mr. President, I ask unanimous consent that a copy of the bill be printed in its entirety in the Record.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am pleased and proud to be joined by two of my distinguished colleagues, Senator Conrad Burns and Senator Byron Dorgan, in introducing today the Railroad Shipper Protection Act of 1997. This legislation is the result of many months of effort to develop constructive and pragmatic proposals for addressing the increasingly serious problems faced by shippers in need of affordable access to railroad service in every region of the country. As a bipartisan team committed to achieving urgently needed results in the coming year, we offer this bill with the hope that it will generate the interest, input, and support needed to help shippers obtain fair treatment and true competitive access from railroads across the country. I commend both Senators Burns and Dorgan for their leadership and constant attention to these issues, which can be complex and yet affect numerous communities, key industries, and workers nationwide. This legislation deals with issues of longstanding concern to me. Because of the importance of the relationship between the Nation's railroads and the shippers and communities that they serve, especially in my State of West Virginia, I have made a special effort throughout my tenure in the Senate to promote a rail transportation system that is fair and economically sound for all parties. Of all of the things that have troubled me about that system over the years, none is more troubling than the plight of captive rail shippers--businesses and communities that are dependent on a single railroad for freight transportation service. West Virginia has more than its fair share of captive shippers. Many of our coal fields, most of our chemical manufacturers, and one of our finest steel manufacturing facilities--and the largest single employer in our State--all are captive to a single railroad for shipments to domestic and foreign markets. The result is that West Virginia businesses too often suffer from unreasonable freight rates and inadequate transportation service. Today, two events are conspiring to create additional captive rail shippers--and worsen the competitive position of existing captive rail shippers--in West Virginia and across the Nation. First, our national freight rail system continues to concentrate into fewer and fewer major railroads. Since Congress deregulated the railroads in 1980, the number of major Class I railroads has declined from 43 to 5--and will drop to 4 if the division of Conrail is approved. For a long time the fears expressed by shippers, and by those of us in Congress who are dedicated to protecting shippers, have fallen on deaf ears. In the past several months, however, the entire Nation has witnessed the far-reaching economic impact of a merger gone awry. The 1996 merger of Union Pacific and Southern Pacific has made dramatic headlines as service is disrupted, trains pile up, shipments are lost, and ultimately facilities and jobs are put in jeopardy. The chemical industry alone has had to grapple with service disruptions costing an average of $35 to $60 million per month through the summer and into the fall. The UP-SP service crisis has caught my attention in part because the effects are so far-reaching that a number of West Virginia shippers have asked for my help, and in part because I now face a major merger in my own backyard with the proposal to divide Conrail between CSX and Norfolk Southern. The UP-SP situation is expected to improve in the coming months, following implementation of a comprehensive service recovery plan and unprecedented intervention by the Surface Transportation Board, but the UP-SP story has only reinforced my belief that concentration of the Nation's railroads is an ominous development for many shippers and for States like West Virginia. Railroad concentration is reducing transportation options and worsening the competitive position of captive shippers. Second, the Surface Transportation Board, established in 1995 to succeed the Interstate Commerce Commission, is understaffed and underfunded, and is not adequately promoting rail competition and protecting captive shippers. As I feared at the time it was passed, the effect of the ICC Termination Act has been to reduce our national commitment to a strong and effective regulatory body to protect rail shippers. Rather than being vigilant in protecting captive shippers from railroad abuses, the STB has instead been consumed with reviewing major railroad mergers, conducting annual revenue adequacy determinations which serve no purpose, and making matters worse for shippers by deciding in December 1996 that railroads may render captive a shipper that is otherwise positioned to enjoy competitive service by refusing to quote a rate on a bottleneck segment. Mr. President, just as the railroad industry has become more and more concentrated, the regulatory agency charged with protecting captive railroad customers has become less and less able to do its job. Some may wonder how the STB, which is directly charged with protecting against unreasonable rates and promoting competition, came to make such an anticompetitive and antishipper decision as that set forth in the 1996 bottleneck cases, and I think the answer illustrates well the need for Congress to correct the current imbalance between railroads and their customers. The answer lies in the confusing instructions that were given to the STB in the ICC Termination Act, and previously in the Staggers Rail Act of 1980 and the Railroad Revitalization and Regulatory Reform Act of 1976. In these statutes Congress directed the STB and its predecessor, the ICC, to promote our national rail transportation system ``by allowing rail carriers to earn adequate revenues'' (49 U.S.C. 10101(3)) and by making ``an adequate and continuing effort to assist those carriers in attaining revenue levels'' that allow them ``to attract and retain capital in amounts adequate to provide a sound transportation system in the United States'' (49 U.S.C. 10704(a)(2)). Congress has further directed the STB to make an annual determination of each railroad's revenue adequacy--a determination that finds most class I railroads to be revenue inadequate, contrary to the view of Wall Street and industry observers about the financial strength of individual railroads and the industry as a whole. As is evident in reading the Board's bottleneck decision, the perceived revenue inadequacy of the major railroads, and the belief that protecting revenue adequacy is the preeminent responsibility of the agency, formed the basis of the STB's agreement with the railroads that they should have the right to prevent rail-to-rail competition even where competition is physically possible. At this point in the evolution of the railroad industry, such an approach is not only inequitable, it is harmful to our national economy. Today, I join with my colleagues in proposing legislation to clarify the policy of the U.S. Government with regard to railroad competition and to restore the intended balance between railroads and shippers in the laws governing their relationship and the oversight role of the STB. This bill would accomplish five major objectives: First, making clear that it is the policy of the U.S. Government to promote rail competition and protect captive shippers; second, reducing the regulatory burden on captive shippers by simplifying the market dominance test; third, overturning the bottleneck decision by requiring railroads to quote a rate on any available segment of service; fourth, eliminating the ``revenue adequacy'' test, which serves no practical purpose and perpetuates the erroneous view that railroads are in dire financial straits; and fifth, requiring the STB to open its process more widely in order to meet the needs of small shippers. It is our intention to pursue this legislation in the context of the STB's reauthorization next year. I am firmly committed to ensuring that the Board is reauthorized in a timely way and is provided with the funds it needs to perform its mission as the primary oversight agency for the Nation's railroads, but I want to make clear that I will not support continuation of the status quo in the relationship between railroads and shippers. The legislation I introduce today will begin to afford rail-to-rail competition and captive shipper protection the priority they deserve in our national transportation policy. It is an important first-step, and I look forward to working with Senator Burns, Senator Dorgan, and others over the course of the next several months to expand upon the shipper protections we propose today. I invite our colleagues to join us in this effort, and genuinely seek constructive input and assistance to achieve needed solutions. Mr. President, I ask unanimous consent that a copy of the bill be printed in its entirety in the Record.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I feel very strongly that we should give the President fast-track authority before we adjourn. He needs fast-track authority. We are not saying what is going to be in the trade bill that comes after the fast-track authority. It is extremely important to remember that fast-track authority is something every President has had since 1974. There is absolutely nothing new in it. The idea that we would withhold from the President fast-track authority on the notion that only the Congress can negotiate trade agreements--Lord help us when it comes to the point where the Congress has to negotiate trade agreements. There are some trade agreements where we can put our imprimatur on that trade agreement, for example: NAFTA, which I voted against; GATT, which I voted for; Chile, which would be upcoming; or others. But let's understand that in virtually all cases the President could go ahead and negotiate, his people at the U.S. Trade Representative's office could go ahead and negotiate trade agreements, and what the Congress thinks or does not think does not really apply. We would, obviously, watch that, and in the Finance Committee we watch trade very closely. The whole notion of withholding from the President of the United States, in a highly visible action, withholding fast-track authority from the President of the United States, doing that in the Senate or in the House or both, is absolutely unthinkable in terms of good judgment, as far as I'm concerned. I can tell you in my own State of West Virginia which is not exactly located on either the Atlantic or Pacific Ocean, that trade and exports are a tremendous part of our economy. We have tens of thousands of people who are working exclusively because of international trade. We need to be increasing that. We need to be opening up new markets not only as the State of West Virginia but also as a nation. There are about 11.5 million jobs in this country right now which are exclusively related to international trade. We ought to be pursuing that. One of the people that I work with was talking with somebody from the U.S. Trade Representative's office the other day and that person had just come back from a certain part of the world--I think, South America--and said that other countries are going ahead and making agreements and cutting deals on trade and that they are bypassing the United States because we are withholding fast-track authority. It is expired. It doesn't exist. We have to reauthorize it. We need to reauthorize it. Somehow, also, the idea that the United States exists all by ourselves in this world doesn't make sense anymore, much less the U.S. Senate being able to sit and determine what will happen in the world. I think the history of the last week and what has happened with the stock markets has shown that transactions are international, they are instantaneous, they are electronic, they depend enormously upon each country taking the maximum advantage of the comparative advantage which it has in terms of goods which it produces. The United States has an enormous comparative advantage. Not to take full advantage of that doesn't make any sense to me. Actually, it might interest some people to know that West Virginia, which is not thought of as an internationally related State, in fact, is. In terms of the proportion of the jobs in our State which are related to products which are exported internationally, only three or, maximum, four other States export more of what they produce proportionately than does the State of West Virginia. So here is a State in the middle of the Appalachian mountains--not just because of coal, not just because of steel, but because of many things--we are highly dependent on the international trade environment. Mr. President, I remember several years ago when fast track was still in existence. We had two votes. One was on something called NAFTA; the other was on something called GATT. We could have done neither of those unless we had first made sure that the President had fast-track authority, which he did. I happen to think NAFTA was a bad deal for the State of West Virginia and I think I have been proved correct. I would definitely vote again as I did then, which was to vote negatively. On the other hand, GATT was tremendously important to the State of West Virginia. As somebody who is interested in trade, I went to Geneva to work with some of the international trade folks where the GATT, the General Agreement on Tariff and Trade, was being negotiated. I worked on antidumping. That is central to West Virginia's steel industry. I worked on countervailing duties. That is central to America's trading interests. Also, circumvention. Most people don't know what circumvention is. Here is a good example. Sony television used to make all of its television sets in Japan, and then export them to Mexico with everything done but the front piece glass--not the tube that actually radiates the pictures but the front piece of glass. That would be added on in Mexico and then would be exported into the United States from Mexico, counting as a Mexican import. That is circumvention for the purposes of trade law. In the GATT we were able to stop that. So Sony had to build a plant in America, hiring 1,000 American workers, to do what they had previously done in an entirely different fashion. Trade law is important. Section 337 has everything to do with intellectual property protection. It is the future of our information technology that is at stake. So we could not even have negotiated the GATT agreement without fast track. I'm saying that the President of the United States and his team of negotiators ought to have the right to negotiate a critical trade agreement as they choose, but then we would have the right to either approve it or disapprove it according to how we felt. I think that is a perfectly reasonable relationship. The Congress, in a sense, we up or down the trade agreement, but we don't down the process through which the administration can get into the trade agreement. We don't simply say, ``fast track you are not going to have,'' so you can't begin to negotiate a trade agreement. I think that is totally counter to the purposes of international trade and frankly to the interests of my own State. So I hope that in the Senate and these coming days as we debate this issue that we would give the President of the United States the fast-track authority which President Reagan had, which President Ford had, which President Carter had, which President Bush had, and which President Bill Clinton ought to be able to have. I yield the floor and I suggest the absence of a quorum.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am extremely pleased to be introducing the Advance Planning and Compassionate Care Act of 1997 with my colleague from Maine, Senator Collins. I have already had the great pleasure of working with Senator Collins on legislation earlier this year to improve the portability of Medigap insurance policies. We were successful in getting a good portion of that legislation enacted this year, so I am very pleased to have another opportunity to work with Senator Collins on another set of issues that are so important to millions of Medicare beneficiaries and the rest of America. We introduce this legislation to ask Congress to take action that responds directly and humanely to the needs of elderly and others during some of their most difficult and often traumatic time of their lives. The United States deserves to be extremely proud of the medical advances and efforts that have extended our people's life expectancy and our ability to overcome disease and medical setbacks. But we need to take some additional, tangible steps to also make progress in the practices and care that affect our citizens when they ultimately face death or the real possibility of death. Our bill provides some of those steps. While this is a difficult area to discuss, it is a very real area for Americans year in and year out. This is legislation designed to respond to pressing needs of patients, their family members, and their health care providers, and I hope that Congress will adopt these steps in the next year. In view of the debate this year on physician assisted suicide and from my own personal experiences, I have spent considerable time delving into the concerns and dilemmas that face patients, their family members, and their physicians when confronted with death or the possibility of dying. In almost all such difficult situations, people are not thinking about physician-assisted suicide. The needs and dilemmas that confront them have much more to do with the kind of care and information that they need, often desperately. The legislation we are introducing today builds on bipartisan legislation enacted in 1990, called the Patient Self-Determination Act. That legislation was championed by my former colleague from Missouri, Senator Danforth. I held a subcommittee hearing on Senator Danforth's legislation and it became very clear that the lack of a national policy on advance directives was not acceptable. As a result of that bill, hospitals, skilled nursing facilities, home health agencies, hospice programs, and HMO's participating in the Medicaid and Medicare programs must provide every adult receiving medical care with written information concerning patient involvement in their own treatment decisions. The health care institutions must also document in the medical record whether the patient has an advance directive. In addition, States were required to write description of their State laws concerning advance directives. Mr. President, at the time of that bill's enactment, we realized that it was only the first step toward increasing public awareness and addressing some very difficult issues related to end-of-life care. As a result of that legislation, a growing number of Americans do have advance directives. But recent studies have found that the majority of Americans have not discussed end-of-life issues with their families or their physicians and have not relayed their treatment preferences either verbally or in writing. There is also an increasing awareness that physicians and many other health care providers are uncomfortable addressing end-of-life issues and are even apparently unwilling to respect their patient's preferences in some cases. Another complicating factor is the great variation that exists among State laws, and the lack of a legal requirement that an advance directive written in one State be respected in another State. Mr. President, the legislation we are introducing today focuses on the need to improve end-of-life care for Medicare beneficiaries. It addresses the need to develop models of compassionate care and quality measures for end-of-life care in the Medicare Program, and it will encourage individuals to have more open communication with family members and health care providers concerning their preferences for end- of-life care. The first section of the Advance Planning and Compassionate Care Act strengthens the previously enacted Patient Self Determination Act in the following ways. First, it requires that every Medicare beneficiary have the opportunity to discuss health care decisionmaking issues with an appropriately trained professional, when he or she makes a request. This measure would help make sure that patients and their families have the ability to discuss and address concerns and issues relating to their care, including end-of-life care, with a trained professional. Many health care institutions already have teams of providers to address difficult health care decisions and some even mediate among patients, families, and providers. In smaller institutions, social workers, chaplains, nurses, or other trained professional could be made available for consultation. Second, our bill requires that a person's advance directive be placed in a prominent part of the medical record. Often advance directives can not even be found in the medical record, making it more difficult for providers to respect patients' wishes. It is essential that an individual's advance directive be readily available and visible to anyone involved in their health care. Third, it will assure that an advance directive valid in one State will be valid in another State. At present, portability of advance directives from State to State is not assured. Such portability can only be guaranteed through Federal legislation. The second part of our bill directs the Secretary of Health and Human Services to advise Congress on an approach to adopting the provisions of the Uniform Health Care Decisions Act for Medicare beneficiaries. The Uniform Health Care Decisions Act was developed by the Uniform Law Commissioners, a group with representation from all States that has been in existence for over 100 years. The Uniform Health Care Decisions Act includes all the important components of model advance directive legislation. A great deal of legal effort went into its development, with input by all the States and approval by the American Bar Association. Medicare beneficiaries deserve a uniform approach to advance directives, especially since many move from one State to another while in the Medicare Program. The tremendous variation in State laws that currently exists only adds to the confusion of health care professionals and their patients. Just this month, a study done by Dr. Jack Wennberg at Dartmouth University documented the tremendous variation that exists in the medical care that Medicare beneficiaries receive in the last few months of their lives. This sort of analysis highlights that patient preferences have little to do with the sort of care patients receive in their final months of life. Where you live determines the sort of medical care you will receive more so than what you might prefer. The third part of this legislation would encourage the development of models for end-of-life care for Medicare beneficiaries who do not qualify for the Medicare hospice benefit but still have chronic, debilitating and ultimately fatal illnesses. The tremendous advances in medicine and medical technology over the past 30 to 50 years have resulted in a greatly lengthened life expectancy for Americans, as well as vastly improved functioning and quality of life for the elderly and those with chronic disease. Many of these advances have been made possible by federally financed health care programs, such as the Medicare Program that assures access to high quality health care for all elderly Americans. Medicare has also funded much of the development of technology and a highly skilled physician workforce through support of medical education and academic medical centers. These advances have also created major dilemmas in addressing terminal or potentially terminal disease, as well as a sense of loss of control by many with terminal illness. I believe it is time for Medicare to help seniors have access to compassionate, supportive, and pain free care during prolonged illnesses and at the end of life. As we begin to discuss restructuring the Medicare Program for the long term, this will be one of my primary goals. Our legislation instructs the Department of Health and Human Services to develop appropriate quality measures and models of care for persons with chronic, debilitating disease, including the very frail elderly who will comprise an increasing number of Medicare beneficiaries. Our bill also sets up a consumer hotline that can provide the American public with information on the legal, medical, and ethical issues related to advance directives and medical decisionmaking. Mr. President, I am learning more and more about the importance of educating health care providers and the public that chronic, debilitating, terminal disease need not be associated with pain, major discomfort, and loss of control. We can control pain and treat depression, as well as the other causes of suffering during the dying process. We must now apply this knowledge to assure all Americans appropriate end-of-life care. And to make sure that Medicare beneficiaries are able to receive the most effective medicine to control their pain, Medicare's coverage rules would be expanded under our bill to include coverage for self-administered pain medications. Under current law, Medicare generally does not pay for any outpatient prescription drugs. The only pain medication paid for by the Medicare Program are those drugs that are administered by a portable pump. The pump is covered by Medicare as durable medical equipment and the drugs used with that pump are also covered. Our bill would expand coverage to include self-administered pain medications, for example oral drugs or transdermal patches. These alternatives are as effective in pain relief and, most obviously, a much more comfortable way for patients to receive their pain medication. Mr. President, much also needs to be done to assure that all health care providers have the appropriate training to use what is already known about supportive care. The public must be educated and empowered to discuss these issues with family members as well as their own physicians so that each individual's wishes can be respected. More research is needed to develop appropriate measures of quality end-of- life care and incorporate these measures into medical practice in all health care settings. And finally, appropriate financial incentives must be present within Medicare, especially, to allow the elderly and disabled their choice of appropriate care at the end of life. Medicare's coverage policy should not be the sole determinate of the route that pain medication is administered. To conclude, I am proud to offer this legislation with Senator Collins. We hope consideration of this bill will be an opportunity to take notice of the many constructive steps that can be taken to address the needs of patients and family members grappling with great pain and medical difficulties. During this time when physician assisted suicide obtains so many headlines, we are eager to call on Congress to turn to the alternative ways of providing help and relief to seniors and other Americans who only are interested in such alternatives. I ask unanimous consent that a summary and a copy of the bill be printed in its entirety in the Record.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am extremely pleased to be introducing the Advance Planning and Compassionate Care Act of 1997 with my colleague from Maine, Senator Collins. I have already had the great pleasure of working with Senator Collins on legislation earlier this year to improve the portability of Medigap insurance policies. We were successful in getting a good portion of that legislation enacted this year, so I am very pleased to have another opportunity to work with Senator Collins on another set of issues that are so important to millions of Medicare beneficiaries and the rest of America. We introduce this legislation to ask Congress to take action that responds directly and humanely to the needs of elderly and others during some of their most difficult and often traumatic time of their lives. The United States deserves to be extremely proud of the medical advances and efforts that have extended our people's life expectancy and our ability to overcome disease and medical setbacks. But we need to take some additional, tangible steps to also make progress in the practices and care that affect our citizens when they ultimately face death or the real possibility of death. Our bill provides some of those steps. While this is a difficult area to discuss, it is a very real area for Americans year in and year out. This is legislation designed to respond to pressing needs of patients, their family members, and their health care providers, and I hope that Congress will adopt these steps in the next year. In view of the debate this year on physician assisted suicide and from my own personal experiences, I have spent considerable time delving into the concerns and dilemmas that face patients, their family members, and their physicians when confronted with death or the possibility of dying. In almost all such difficult situations, people are not thinking about physician-assisted suicide. The needs and dilemmas that confront them have much more to do with the kind of care and information that they need, often desperately. The legislation we are introducing today builds on bipartisan legislation enacted in 1990, called the Patient Self-Determination Act. That legislation was championed by my former colleague from Missouri, Senator Danforth. I held a subcommittee hearing on Senator Danforth's legislation and it became very clear that the lack of a national policy on advance directives was not acceptable. As a result of that bill, hospitals, skilled nursing facilities, home health agencies, hospice programs, and HMO's participating in the Medicaid and Medicare programs must provide every adult receiving medical care with written information concerning patient involvement in their own treatment decisions. The health care institutions must also document in the medical record whether the patient has an advance directive. In addition, States were required to write description of their State laws concerning advance directives. Mr. President, at the time of that bill's enactment, we realized that it was only the first step toward increasing public awareness and addressing some very difficult issues related to end-of-life care. As a result of that legislation, a growing number of Americans do have advance directives. But recent studies have found that the majority of Americans have not discussed end-of-life issues with their families or their physicians and have not relayed their treatment preferences either verbally or in writing. There is also an increasing awareness that physicians and many other health care providers are uncomfortable addressing end-of-life issues and are even apparently unwilling to respect their patient's preferences in some cases. Another complicating factor is the great variation that exists among State laws, and the lack of a legal requirement that an advance directive written in one State be respected in another State. Mr. President, the legislation we are introducing today focuses on the need to improve end-of-life care for Medicare beneficiaries. It addresses the need to develop models of compassionate care and quality measures for end-of-life care in the Medicare Program, and it will encourage individuals to have more open communication with family members and health care providers concerning their preferences for end- of-life care. The first section of the Advance Planning and Compassionate Care Act strengthens the previously enacted Patient Self Determination Act in the following ways. First, it requires that every Medicare beneficiary have the opportunity to discuss health care decisionmaking issues with an appropriately trained professional, when he or she makes a request. This measure would help make sure that patients and their families have the ability to discuss and address concerns and issues relating to their care, including end-of-life care, with a trained professional. Many health care institutions already have teams of providers to address difficult health care decisions and some even mediate among patients, families, and providers. In smaller institutions, social workers, chaplains, nurses, or other trained professional could be made available for consultation. Second, our bill requires that a person's advance directive be placed in a prominent part of the medical record. Often advance directives can not even be found in the medical record, making it more difficult for providers to respect patients' wishes. It is essential that an individual's advance directive be readily available and visible to anyone involved in their health care. Third, it will assure that an advance directive valid in one State will be valid in another State. At present, portability of advance directives from State to State is not assured. Such portability can only be guaranteed through Federal legislation. The second part of our bill directs the Secretary of Health and Human Services to advise Congress on an approach to adopting the provisions of the Uniform Health Care Decisions Act for Medicare beneficiaries. The Uniform Health Care Decisions Act was developed by the Uniform Law Commissioners, a group with representation from all States that has been in existence for over 100 years. The Uniform Health Care Decisions Act includes all the important components of model advance directive legislation. A great deal of legal effort went into its development, with input by all the States and approval by the American Bar Association. Medicare beneficiaries deserve a uniform approach to advance directives, especially since many move from one State to another while in the Medicare Program. The tremendous variation in State laws that currently exists only adds to the confusion of health care professionals and their patients. Just this month, a study done by Dr. Jack Wennberg at Dartmouth University documented the tremendous variation that exists in the medical care that Medicare beneficiaries receive in the last few months of their lives. This sort of analysis highlights that patient preferences have little to do with the sort of care patients receive in their final months of life. Where you live determines the sort of medical care you will receive more so than what you might prefer. The third part of this legislation would encourage the development of models for end-of-life care for Medicare beneficiaries who do not qualify for the Medicare hospice benefit but still have chronic, debilitating and ultimately fatal illnesses. The tremendous advances in medicine and medical technology over the past 30 to 50 years have resulted in a greatly lengthened life expectancy for Americans, as well as vastly improved functioning and quality of life for the elderly and those with chronic disease. Many of these advances have been made possible by federally financed health care programs, such as the Medicare Program that assures access to high quality health care for all elderly Americans. Medicare has also funded much of the development of technology and a highly skilled physician workforce through support of medical education and academic medical centers. These advances have also created major dilemmas in addressing terminal or potentially terminal disease, as well as a sense of loss of control by many with terminal illness. I believe it is time for Medicare to help seniors have access to compassionate, supportive, and pain free care during prolonged illnesses and at the end of life. As we begin to discuss restructuring the Medicare Program for the long term, this will be one of my primary goals. Our legislation instructs the Department of Health and Human Services to develop appropriate quality measures and models of care for persons with chronic, debilitating disease, including the very frail elderly who will comprise an increasing number of Medicare beneficiaries. Our bill also sets up a consumer hotline that can provide the American public with information on the legal, medical, and ethical issues related to advance directives and medical decisionmaking. Mr. President, I am learning more and more about the importance of educating health care providers and the public that chronic, debilitating, terminal disease need not be associated with pain, major discomfort, and loss of control. We can control pain and treat depression, as well as the other causes of suffering during the dying process. We must now apply this knowledge to assure all Americans appropriate end-of-life care. And to make sure that Medicare beneficiaries are able to receive the most effective medicine to control their pain, Medicare's coverage rules would be expanded under our bill to include coverage for self-administered pain medications. Under current law, Medicare generally does not pay for any outpatient prescription drugs. The only pain medication paid for by the Medicare Program are those drugs that are administered by a portable pump. The pump is covered by Medicare as durable medical equipment and the drugs used with that pump are also covered. Our bill would expand coverage to include self-administered pain medications, for example oral drugs or transdermal patches. These alternatives are as effective in pain relief and, most obviously, a much more comfortable way for patients to receive their pain medication. Mr. President, much also needs to be done to assure that all health care providers have the appropriate training to use what is already known about supportive care. The public must be educated and empowered to discuss these issues with family members as well as their own physicians so that each individual's wishes can be respected. More research is needed to develop appropriate measures of quality end-of- life care and incorporate these measures into medical practice in all health care settings. And finally, appropriate financial incentives must be present within Medicare, especially, to allow the elderly and disabled their choice of appropriate care at the end of life. Medicare's coverage policy should not be the sole determinate of the route that pain medication is administered. To conclude, I am proud to offer this legislation with Senator Collins. We hope consideration of this bill will be an opportunity to take notice of the many constructive steps that can be taken to address the needs of patients and family members grappling with great pain and medical difficulties. During this time when physician assisted suicide obtains so many headlines, we are eager to call on Congress to turn to the alternative ways of providing help and relief to seniors and other Americans who only are interested in such alternatives. I ask unanimous consent that a summary and a copy of the bill be printed in its entirety in the Record.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise today to join my colleagues Senator Frist, Senator Hollings, Senator Burns in introducing legislation to reauthorize the programs of the Technology Administration for fiscal years 1998 and 1999. This bill reauthorizes the Office of Science and Technology Policy as well as the NIST labs and facilities about the President's budget request. It also funds the Advanced Technology Program at $198 million and the Manufacturing Extension Program at $111 million. It is noteworthy that after several hearings on ATP, and after assessing Secretary of Commerce Daley's detailed review of the program, we are now putting forward a bill that continues to authorize this important form of investment in America's economic competitiveness. As I, along with many others in this Chamber, have stated before, this program supports American industry's own efforts to develop new, cutting-edge technologies which create the new industries and jobs of the 21st century. Let me remind my colleagues that ATP does not, and I repeat, does not fund the development of commercial products. Instead, this program provides matching funds to both individual companies and joint ventures for pre-product research on high-risk technologies which have the potential to place U.S. industry as the leader in new industrial areas. This high-risk, high-reward strategy has already led to the creation of new U.S. industries based on information transfer, biotechnology, and new materials synthesis. In spite of the merits of this program ATP has been criticized by some Members for the past 4 years of the program's 6 years of existence. This year Secretary Daley undertook a 60-day review to assess the ATP's performance and evaluate these criticisms. The Department of Commerce solicited comments from more than 3,500 interested parties and took into account comments provided by both critics and supporters of the program. fact, Senators Lieberman, Domenici, Frist and I joined together and provided one of the 80-plus comments the Department received. I would like to take a moment and commend Secretary Daley for the job he did in undertaking this review. As we all know, there is not a department or program that can't be improved. And as a long time and avid supporter of ATP I believe, that after 6 years of operation, experience would suggest that there should be some areas that can be improved. This review has done just that. The recommendations that Secretary Daley has put forth further strengthens a strong and productive program. I agree with his suggestion to place more emphasis on small and medium-size single applicants, joint- ventures, and consortia. This bill adopts that recommendation by amending the National Institute of Standards and Technology Act to define a large business as one with gross annual revenues in excess of $2.5 billion and prohibits such businesses from participating in ATP programs as single applicants. In addition, I was pleased to see the added emphasis by the Secretary on the need for an EPSCoT program, based on the EPSCoR model, which would enhance technology development in the 18 States that have traditionally been under-represented in Federal R&D funding. EPSCoT would provide the opportunity for States which have been able to build infrastructure capable of supporting high-tech research to use this infrastructure to its maximum advantage. Studies have shown that strengthening the competitive performance of research laboratories, usually universities, in an underdeveloped area, which is the purpose of EPSCoR, is often not sufficient to establish new, high-tech companies. EPSCoT seeks to assist in technology transfer to the local economy by encouraging links between universities, local businesses, and local and State governments. Unlike ATP, which focuses on the national economic interest in research and development, EPSCoT focuses on allowing under-represented States the opportunity to participate in the technological revolution that is sweeping the global economy. In order to help the success of the program, Governors, business leaders and researchers were consulted about the importance of technology transfer for economic development. This bill provides statutory language to implement the Secretary's proposal of creating the EPSCoT program. Secretary Daley's review could not have been done at a better time. After 6 years of existence, a thorough and complete review of the process has shown that is it competently managed, produces positive results and has been working to achieve it's stated objectives. The proposals set forth in this review strengthen a very strong program that is one of the cornerstones to the Nation's long-term economic prosperity. The bill we are introducing today provides the necessary changes to existing law to implement many of the recommendations. I encourage my colleagues to support this bill.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise today to join my colleagues Senator Frist, Senator Hollings, Senator Burns in introducing legislation to reauthorize the programs of the Technology Administration for fiscal years 1998 and 1999. This bill reauthorizes the Office of Science and Technology Policy as well as the NIST labs and facilities about the President's budget request. It also funds the Advanced Technology Program at $198 million and the Manufacturing Extension Program at $111 million. It is noteworthy that after several hearings on ATP, and after assessing Secretary of Commerce Daley's detailed review of the program, we are now putting forward a bill that continues to authorize this important form of investment in America's economic competitiveness. As I, along with many others in this Chamber, have stated before, this program supports American industry's own efforts to develop new, cutting-edge technologies which create the new industries and jobs of the 21st century. Let me remind my colleagues that ATP does not, and I repeat, does not fund the development of commercial products. Instead, this program provides matching funds to both individual companies and joint ventures for pre-product research on high-risk technologies which have the potential to place U.S. industry as the leader in new industrial areas. This high-risk, high-reward strategy has already led to the creation of new U.S. industries based on information transfer, biotechnology, and new materials synthesis. In spite of the merits of this program ATP has been criticized by some Members for the past 4 years of the program's 6 years of existence. This year Secretary Daley undertook a 60-day review to assess the ATP's performance and evaluate these criticisms. The Department of Commerce solicited comments from more than 3,500 interested parties and took into account comments provided by both critics and supporters of the program. fact, Senators Lieberman, Domenici, Frist and I joined together and provided one of the 80-plus comments the Department received. I would like to take a moment and commend Secretary Daley for the job he did in undertaking this review. As we all know, there is not a department or program that can't be improved. And as a long time and avid supporter of ATP I believe, that after 6 years of operation, experience would suggest that there should be some areas that can be improved. This review has done just that. The recommendations that Secretary Daley has put forth further strengthens a strong and productive program. I agree with his suggestion to place more emphasis on small and medium-size single applicants, joint- ventures, and consortia. This bill adopts that recommendation by amending the National Institute of Standards and Technology Act to define a large business as one with gross annual revenues in excess of $2.5 billion and prohibits such businesses from participating in ATP programs as single applicants. In addition, I was pleased to see the added emphasis by the Secretary on the need for an EPSCoT program, based on the EPSCoR model, which would enhance technology development in the 18 States that have traditionally been under-represented in Federal R&D funding. EPSCoT would provide the opportunity for States which have been able to build infrastructure capable of supporting high-tech research to use this infrastructure to its maximum advantage. Studies have shown that strengthening the competitive performance of research laboratories, usually universities, in an underdeveloped area, which is the purpose of EPSCoR, is often not sufficient to establish new, high-tech companies. EPSCoT seeks to assist in technology transfer to the local economy by encouraging links between universities, local businesses, and local and State governments. Unlike ATP, which focuses on the national economic interest in research and development, EPSCoT focuses on allowing under-represented States the opportunity to participate in the technological revolution that is sweeping the global economy. In order to help the success of the program, Governors, business leaders and researchers were consulted about the importance of technology transfer for economic development. This bill provides statutory language to implement the Secretary's proposal of creating the EPSCoT program. Secretary Daley's review could not have been done at a better time. After 6 years of existence, a thorough and complete review of the process has shown that is it competently managed, produces positive results and has been working to achieve it's stated objectives. The proposals set forth in this review strengthen a very strong program that is one of the cornerstones to the Nation's long-term economic prosperity. The bill we are introducing today provides the necessary changes to existing law to implement many of the recommendations. I encourage my colleagues to support this bill.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am proud to introduce today the Persian Gulf War Veterans Act of 1997, legislation which establishes a clear framework for the compensation and health care needs of Persian Gulf war veterans. This bill implements the recommendation of the Presidential Advisory Committee on Gulf War Veterans' Illnesses to create a permanent statutory authority for the compensation of ill gulf war veterans. It builds upon the system of scientific review and determinations for presumptive compensation that currently exists for veterans exposed to agent orange during the Vietnam war. As ranking member of the Committee on Veterans' Affairs, I have witnessed firsthand the struggles of many of our Nation's gulf war veterans. The Persian Gulf war will undoubtedly go down in history as one of our country's most decisive military victories. Despite our fears of potentially huge troop injuries and losses, the careful planning and strategy of our military leaders paid off. The ground war lasted only four days, and the casualties we experienced, while deeply regrettable, were fortunately few. But as with any war, the human costs of the gulf war have been high, and the casualties have continued long after the battle was over. Many of the men and women who served in the gulf have suffered chronic, debilitating health problems. Unnecessarily compounding their pain has been their difficulty in getting the government they served to acknowledge their problems and provide the appropriate care and benefits they deserve. This legislation will go a long way to address some of these concerns. We can't wait the 20 years we waited after the Vietnam war to assess the effects of agent orange, or the 40 years we waited after World War II to concede the problems of radiation-exposed veterans. We must learn from the lessons of the past and act now. We have already waited too long. For the past 6 years, we have looked to the leaders of the Department of Defense and the Department of Veterans Affairs for a resolution of these difficult issues. While they have made some progress, I think we can all agree there is much more to be done. This legislation will require VA to enlist the National Academy of Sciences--an independent, nonprofit, scientific organization--to review and evaluate the research regarding links between illnesses and exposure to toxic agents and wartime hazards. Based on the findings of the NAS, VA will then determine whether a diagnosed or undiagnosed illness found to be associated with gulf war service warrants a presumption of service connection for compensation purposes. This will provide an ongoing scientific basis and nonpolitical framework for the VA to use in compensating Persian Gulf war veterans.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am proud to introduce today the Persian Gulf War Veterans Act of 1997, legislation which establishes a clear framework for the compensation and health care needs of Persian Gulf war veterans. This bill implements the recommendation of the Presidential Advisory Committee on Gulf War Veterans' Illnesses to create a permanent statutory authority for the compensation of ill gulf war veterans. It builds upon the system of scientific review and determinations for presumptive compensation that currently exists for veterans exposed to agent orange during the Vietnam war. As ranking member of the Committee on Veterans' Affairs, I have witnessed firsthand the struggles of many of our Nation's gulf war veterans. The Persian Gulf war will undoubtedly go down in history as one of our country's most decisive military victories. Despite our fears of potentially huge troop injuries and losses, the careful planning and strategy of our military leaders paid off. The ground war lasted only four days, and the casualties we experienced, while deeply regrettable, were fortunately few. But as with any war, the human costs of the gulf war have been high, and the casualties have continued long after the battle was over. Many of the men and women who served in the gulf have suffered chronic, debilitating health problems. Unnecessarily compounding their pain has been their difficulty in getting the government they served to acknowledge their problems and provide the appropriate care and benefits they deserve. This legislation will go a long way to address some of these concerns. We can't wait the 20 years we waited after the Vietnam war to assess the effects of agent orange, or the 40 years we waited after World War II to concede the problems of radiation-exposed veterans. We must learn from the lessons of the past and act now. We have already waited too long. For the past 6 years, we have looked to the leaders of the Department of Defense and the Department of Veterans Affairs for a resolution of these difficult issues. While they have made some progress, I think we can all agree there is much more to be done. This legislation will require VA to enlist the National Academy of Sciences--an independent, nonprofit, scientific organization--to review and evaluate the research regarding links between illnesses and exposure to toxic agents and wartime hazards. Based on the findings of the NAS, VA will then determine whether a diagnosed or undiagnosed illness found to be associated with gulf war service warrants a presumption of service connection for compensation purposes. This will provide an ongoing scientific basis and nonpolitical framework for the VA to use in compensating Persian Gulf war veterans.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am pleased to join my colleague and friend, Senator Snowe, in introducing the Child Support Performance Improvement Act of 1997. I have long been impressed with Senator Snowe's commitment to the health, safety, and well-being of children, and I believe that this legislation will go far to improve the financial security of thousands of American children. As a country, our most fundamental measure of success is how well we treat our children. We have a responsibility as Members of Congress and as a community to do our utmost to make sure that American children live happy, healthy, and stable lives. At the same time, we must acknowledge that much of the responsibility in ensuring children's happiness and security falls squarely at the feet of their parents. Sadly, many parents neglect their emotional and financial responsibilities, maintaining that because they are no longer living in the same house as their children, they no longer have to support them. It is estimated that each year, $15 to $25 billion in child support go uncollected. One study reported that four out of five parents have attempted to shirk their court-ordered child support responsibilities at one time or another. In many of these cases, families, already fragile from the absence of one parent, are forced to turn to welfare as the only reliable source of monetary support. In 1975, Congress created the Child Support Enforcement Program to help stop this disturbing pattern. The goal of that program was and still remains to reduce public welfare expenditures by forcing absent parents to provide child support as a regular and reliable source of income for their children. As part of this goal, the Federal Government provides incentive payments to encourage State child support agencies to enforce child support collections as efficiently and effectively as possible. Unfortunately, in the past several years, these incentives have become disincentives; handsomely rewarding even the most poorly performing States with the most dismal collection rates. Last year, the welfare reform bill took a positive step by commissioning a task force composed of child support experts from the Department of Health and Human Services and State child support agencies to come up with a new set of incentives that would put State agencies back on the road to efficient collections. The Child Support Performance Improvement Act of 1997 incorporates the consensus findings of this working group. For the first time, the new incentive structure takes into account, not just a State's cost effectiveness in collecting child support, but that State's overall success is establishing paternity and child support orders as well as collecting current and back child support. The bill also requires the Secretary of HHS to create and implement a sixth incentive: a medical support incentive. As we are all aware, health care is an essential part of any financial package provided for a child. For the first time, this bill requires the implementation of a medical incentive which will require States to seek medical and health coverage as part of the overall child support order. All children deserve comprehensive health coverage, and there is no reason it should be a public expenditure when a child's parent is perfectly able to pay for it. The Child Support Performance Improvement Act of 1997 also takes an important step in requiring States to pay families back first. The bill ensures that States will not be allowed to count toward incentive payments the collection of arrearages that are not first returned to former welfare families who need such payments to remain financially independent. While the overall incentive structure rewards the States for good performance, the families first provision keeps the States from receiving a double bonus--allowing them to keep arrearages to reimburse themselves and then getting an incentive payment for it. Finally, the bill adds tough but reasonable data requirements to make sure child support incentive payments are based on complete and reliable data from the States. States that do not have accurate data on their child support collections and on other aspects of child support enforcement should not be qualified to receive incentives. This provision will encourage States to make their collection systems even more efficient and, in turn, this will mean millions of additional dollars being directed to the children who need it. The Child Support Performance Improvement Act of 1997 is the first vital step in assuring that the States have the most efficient and effective ways possible of collecting child support from parents who have the responsibility to care for their children. Increasing child support collections will not only save Federal and State Governments and taxpayers billions of dollars each year in public expenditures, it will accomplish the most important goal of all: improving the financial stability and general well-being of thousands of American children. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record. There being, no objection the bill was ordered to be printed in the Record, as follows:

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I am pleased to join my colleague and friend, Senator Snowe, in introducing the Child Support Performance Improvement Act of 1997. I have long been impressed with Senator Snowe's commitment to the health, safety, and well-being of children, and I believe that this legislation will go far to improve the financial security of thousands of American children. As a country, our most fundamental measure of success is how well we treat our children. We have a responsibility as Members of Congress and as a community to do our utmost to make sure that American children live happy, healthy, and stable lives. At the same time, we must acknowledge that much of the responsibility in ensuring children's happiness and security falls squarely at the feet of their parents. Sadly, many parents neglect their emotional and financial responsibilities, maintaining that because they are no longer living in the same house as their children, they no longer have to support them. It is estimated that each year, $15 to $25 billion in child support go uncollected. One study reported that four out of five parents have attempted to shirk their court-ordered child support responsibilities at one time or another. In many of these cases, families, already fragile from the absence of one parent, are forced to turn to welfare as the only reliable source of monetary support. In 1975, Congress created the Child Support Enforcement Program to help stop this disturbing pattern. The goal of that program was and still remains to reduce public welfare expenditures by forcing absent parents to provide child support as a regular and reliable source of income for their children. As part of this goal, the Federal Government provides incentive payments to encourage State child support agencies to enforce child support collections as efficiently and effectively as possible. Unfortunately, in the past several years, these incentives have become disincentives; handsomely rewarding even the most poorly performing States with the most dismal collection rates. Last year, the welfare reform bill took a positive step by commissioning a task force composed of child support experts from the Department of Health and Human Services and State child support agencies to come up with a new set of incentives that would put State agencies back on the road to efficient collections. The Child Support Performance Improvement Act of 1997 incorporates the consensus findings of this working group. For the first time, the new incentive structure takes into account, not just a State's cost effectiveness in collecting child support, but that State's overall success is establishing paternity and child support orders as well as collecting current and back child support. The bill also requires the Secretary of HHS to create and implement a sixth incentive: a medical support incentive. As we are all aware, health care is an essential part of any financial package provided for a child. For the first time, this bill requires the implementation of a medical incentive which will require States to seek medical and health coverage as part of the overall child support order. All children deserve comprehensive health coverage, and there is no reason it should be a public expenditure when a child's parent is perfectly able to pay for it. The Child Support Performance Improvement Act of 1997 also takes an important step in requiring States to pay families back first. The bill ensures that States will not be allowed to count toward incentive payments the collection of arrearages that are not first returned to former welfare families who need such payments to remain financially independent. While the overall incentive structure rewards the States for good performance, the families first provision keeps the States from receiving a double bonus--allowing them to keep arrearages to reimburse themselves and then getting an incentive payment for it. Finally, the bill adds tough but reasonable data requirements to make sure child support incentive payments are based on complete and reliable data from the States. States that do not have accurate data on their child support collections and on other aspects of child support enforcement should not be qualified to receive incentives. This provision will encourage States to make their collection systems even more efficient and, in turn, this will mean millions of additional dollars being directed to the children who need it. The Child Support Performance Improvement Act of 1997 is the first vital step in assuring that the States have the most efficient and effective ways possible of collecting child support from parents who have the responsibility to care for their children. Increasing child support collections will not only save Federal and State Governments and taxpayers billions of dollars each year in public expenditures, it will accomplish the most important goal of all: improving the financial stability and general well-being of thousands of American children. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record. There being, no objection the bill was ordered to be printed in the Record, as follows:

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, today I recognize a growing group of concerned citizens in West Virginia working to educate the public about their concerns over the costs of what they refer to as ``lawsuit abuse.'' In many areas of West Virginia, local supporters of Citizens Against Lawsuit Abuse have given their time on a volunteer basis to speak out about an issue that has statewide and national implications. The costs of lawsuits can include higher costs for consumer products, higher medical expenses, higher taxes, and fewer jobs, due to lost business expansion and forgone product development. At the same time, the legal system must provide avenues for recourse and justice. Together, leaders and citizens must try to achieve consensus in ensuring that our system is balanced and fair to all. Citizens Against Lawsuit Abuse has a straightforward goal. They want to help the public prevent unnecessary lawsuits. When West Virginians see a problem, we work to make people aware of it, and we try to make it right. CALA members are citizens who believe they see harm to our society brought on by certain unnecessary lawsuits and excessive awards that can cripple a small business or strip an individual of his or her life savings. CALA supporters emphasize that they want to make sure that persons with a real need for the civil justice system have access to the courts. Public opinion surveys in our state have shown that a majority of responsible citizens want their legal system to be more fair, more effective, and more sensible, to serve everyone's interests. These nonprofit CALA groups have raised local funds to run educational media announcements and are speaking to local organizations and citizen groups across the State to raise public awareness of the issue that they call ``lawsuit abuse.'' Supporters of CALA also encourage that citizens do their part by serving on juries when they are called. To help encourage the youth of West Virginia to become responsible citizens when they reach adulthood, CALA groups have offered scholarship grants to students through an essay contest on the subject of importance of jury service. While the local groups have thousands of supporters, there are few individuals who should be recognized for their ongoing leadership and for dedicating countless volunteer hours in the past year. These individuals are Cuz Blake of Bridgeport, chairman and founding member of CALA of Northern West Virginia, and Robert Mauk of Huntington, chairman and founding member of CALA of Southern West Virginia. Many others have given their time and energy to these public watchdog groups as well, persons such as Sid Davis of Charleston who, despite having to take time off recently for health reasons, has returned to his volunteer position as an officer of CALA of Southern West Virginia. Citizens Against Lawsuit Abuse groups have declared September 21 through September 27, 1997, to be Lawsuit Abuse Awareness Week in West Virginia. I commend all of the individuals who are involved in Citizens Against Lawsuit Abuse for their involvement in civic affairs and their efforts to promote constructive action in a policy area they care about. As someone who has been a leader for a balanced, responsible form of product liability reform, I continue to hope for the kind of education, dialogue, and consensus-building clearly needed to address problems in our legal system that hurt consumers, victims, and the private sector. I encourage CALA to continue raising these issues and promoting solutions that ensure justice and improve the legal system. West Virginia and the country as a whole need informed, educated, and dedicated citizens to help elected officials address serious issues and achieve proper reforms when necessary.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise today to join my colleagues, Senator Frist, Senator McCain, and Senator Hollings in introducing legislation to reauthorize the programs of the U.S. Fire Administration [USFA]. I just want to say a few quick words about this program. The USFA has a tough and rewarding mission. As I am sure my colleagues have noted, the statistics relating to fires in this country are staggering: Approximately 4,500 people die annually, and over 30,000 people are injured. In West Virginia, there were over 9,000 fires in 1995 causing 28 fatalities and 160 injuries. The fact is, Mr. President, these numbers would be worse if it were not for the brave men and women firefighters who put their lives on the line to save and protect others. I want to take this moment to commend the 1.2 million members of the Nation's fire service of whom 80 percent are volunteers. In 1995, 163 firefighters were injured in West Virginia in the line of duty. They deserve the best training, assistance, and technology available to do their job. The USFA provides these invaluable services to these men and women in an effort to ensure their safety, their health, and to improve their ability to fight fires with the best available technology. If there is a Federal program that is worth its value in dollars, it is this one--an ounce of prevention is clearly worth a pound of cure. In addition to the services the USFA provides firefighters, I want to commend this agency for its education and awareness programs, particularly those that target young children, and for their use of the Internet. Children start over 100,000 fires a year from just playing. The USFA has developed an interactive homepage and guide for parents clearly demonstrating their awareness of today's tools needed to reach today's youth. In closing, Mr. President, I would like to thank my colleague, the chairman of the Science Subcommittee, Senator Frist, for his efforts to move legislation in a bipartisan manner. This bill is a fine example of his efforts to work with Members of both parties to move good legislation that benefits the public as a whole. I encourage my colleagues to support this bill.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I rise today to join my colleagues, Senator Frist, Senator McCain, and Senator Hollings in introducing legislation to reauthorize the programs of the U.S. Fire Administration [USFA]. I just want to say a few quick words about this program. The USFA has a tough and rewarding mission. As I am sure my colleagues have noted, the statistics relating to fires in this country are staggering: Approximately 4,500 people die annually, and over 30,000 people are injured. In West Virginia, there were over 9,000 fires in 1995 causing 28 fatalities and 160 injuries. The fact is, Mr. President, these numbers would be worse if it were not for the brave men and women firefighters who put their lives on the line to save and protect others. I want to take this moment to commend the 1.2 million members of the Nation's fire service of whom 80 percent are volunteers. In 1995, 163 firefighters were injured in West Virginia in the line of duty. They deserve the best training, assistance, and technology available to do their job. The USFA provides these invaluable services to these men and women in an effort to ensure their safety, their health, and to improve their ability to fight fires with the best available technology. If there is a Federal program that is worth its value in dollars, it is this one--an ounce of prevention is clearly worth a pound of cure. In addition to the services the USFA provides firefighters, I want to commend this agency for its education and awareness programs, particularly those that target young children, and for their use of the Internet. Children start over 100,000 fires a year from just playing. The USFA has developed an interactive homepage and guide for parents clearly demonstrating their awareness of today's tools needed to reach today's youth. In closing, Mr. President, I would like to thank my colleague, the chairman of the Science Subcommittee, Senator Frist, for his efforts to move legislation in a bipartisan manner. This bill is a fine example of his efforts to work with Members of both parties to move good legislation that benefits the public as a whole. I encourage my colleagues to support this bill.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I thank the Chairman. In that light, I inquire whether he would have any objection if the Department were to shift up to $500,000 to continue the Coal Mine Methane Program.

Mr. ROCKEFELLER. Mr. President, I completely agree with the comments of my senior Senator. I would note that three of the five teams under contracts to the Department of Energy are working on projects in our State of West Virginia. I understand that the other two are located in Alabama and Ohio. These five projects offer great promise compared to conventional greenhouse gas mitigation efforts. A single, small coal mine methane project designed to produce 10 megawatts of electricity is expected to operate at a profit. That same project would unequivocally produce collateral greenhouse gas mitigation benefits equal to the carbon sequestered by approximately 14 million trees. In sharp contrast to the profit generated by the coal mine methane project, tree planting would come at a cost conservatively estimated at $18 million. So, DOE's methane capture program makes dollars and sense. This program is relatively small in terms of Federal cost but can leverage significant private sector investment and may generate considerable economic and environmental benefits for Americans living in the Appalachian coal regions. I hope that we may reconsider the recommendation on this particular program.

Mr. ROCKEFELLER. Mr. President, I thank the manager of the bill for his consideration and support of this matter.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, abused and neglected children are among the most vulnerable and poorly protected members of American society. Too many of these children are left to wander aimlessly through the foster care system--a system which, from the outset, was never designed or intended to be a permanent home. We can no longer continue to sentence these foster children to endless waits--a legal limbo in which they no longer feel welcome in their biological families but are unable to be adopted into new and loving homes. Despite the thousands of dedicated foster parents and child welfare workers who strive daily to effectively address the many needs of abused and neglected children in an overloaded system, we know that nothing can replace a permanent and loving home made by adults who can be counted on without condition or limitation. Acknowledging our collective obligation to allow no child to fall between the cracks, I am proud to join together with Senator John Chafee and my other colleagues in a truly extraordinary bipartisan effort to introduce the Promotion of Adoption Safety and Support for Abused and Neglected Children Act [PASS]. Under Senator Chafee's committed leadership on children's issues, this bipartisan group has worked extremely hard to forge an effective compromise--a compromise which offers concrete, practical strategies to provide permanency in lives of foster children and to ensure that health and safety are built into every level of America's abuse and neglect system. Central to this entire effort was also Senator Larry Craig, who brought focus and determination to the sometimes difficult bipartisan negotiations. I would like to take this opportunity to extend my most sincere thanks to my other colleagues, Senators Jeffords, DeWine, Coats, Bond, Landrieu, and Levin for making possible this outstanding example of bipartisan teamwork. The Promotion of Adoption Safety and Support for Abused and Neglected Children Act will fundamentally shift the focus of the foster care system by insisting that a child's health, safety, and opportunity to find a permanent home should be the paramount concern when a State makes any decision concerning the well-being of abused and neglected children. As a comprehensive package based on bipartisan consensus, PASS will accelerate and improve the response to these concerns, promote safe adoptions, and restore safety and permanency to the lives of abused and neglected children. The main objective of this bill is to move abused and neglected children into adoptive or other permanent homes and to do so more quickly and more safely than ever before. Right now, many foster care children are forced to wait years before being adopted--even in cases where loving families are ready and willing to adopt them. Some children lose their chance for adoption altogether. While PASS preserves the requirement to reunify families where appropriate, it does not require States to use reasonable efforts to reunify families that have been irreparably broken by abandonment, torture, physical abuse, sexual abuse, murder, manslaughter, and sexual assault. The PASS Act maintains the delicate balance in protecting the rights of parents and families while placing primary focus where it should be: on the health and safety of child. PASS encourages adoptions by rewarding States financial incentives for facilitating adoption for all foster children--especially those with special needs which, sadly, make them more difficult to place. For those situations where children cannot go home again, PASS requires States to use reasonable efforts to place them into safe adoptive homes or into the permanent care of loving relatives. In addition, PASS cuts by one-third the time that an abused and neglected child must wait in order to be placed in such adoptive homes. In response to a candid and focused look at today's foster care crisis, the bill also seeks to rescue children from the legal limbo of the current system by requiring States to take the necessary legal steps to free for adoption those children who have been forced to linger in the system for a year or more. PASS also prevents further abuse of children in the foster care system by requiring criminal records checks for all foster and adoptive parents. PASS is about helping the individual child but, equally as importantly, fixing the system. It is always the right time to focus on the needs of children-- especially those unfortunate enough to find themselves in the sometimes dysfunctional labyrinth of the abuse and neglect system. Unfortunately, however, reform has never been more necessary. President Clinton's ``Adoption 2002 Report'' found that there are currently half a million children in temporary foster care placements. One hundred thousand of those children should be adopted, but less than half of that number are legally eligible to become part of an adoptive family. In my home State of West Virginia alone, referrals to Child Protective Services are expected to rise to an all-time high of 17,000 this year. Foster care placements have jumped from 2,900 children in January 1996 to 3,113 children in January 1997. These staggering figures reveal a foster care crisis of unprecedented proportions. PASS is the first step in a vital, ongoing effort to put children at the very top of our national agenda. It is time that we provide all children with their most profound wish: to live in a safe and loving home with caretakers who treat them with respect and dignity. If we are unable to address this most fundamental need, these children will not be able to grow, learn, and provide a secure place for their own families. It is unthinkable to deny abused and neglected children such vital opportunities.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, abused and neglected children are among the most vulnerable and poorly protected members of American society. Too many of these children are left to wander aimlessly through the foster care system--a system which, from the outset, was never designed or intended to be a permanent home. We can no longer continue to sentence these foster children to endless waits--a legal limbo in which they no longer feel welcome in their biological families but are unable to be adopted into new and loving homes. Despite the thousands of dedicated foster parents and child welfare workers who strive daily to effectively address the many needs of abused and neglected children in an overloaded system, we know that nothing can replace a permanent and loving home made by adults who can be counted on without condition or limitation. Acknowledging our collective obligation to allow no child to fall between the cracks, I am proud to join together with Senator John Chafee and my other colleagues in a truly extraordinary bipartisan effort to introduce the Promotion of Adoption Safety and Support for Abused and Neglected Children Act [PASS]. Under Senator Chafee's committed leadership on children's issues, this bipartisan group has worked extremely hard to forge an effective compromise--a compromise which offers concrete, practical strategies to provide permanency in lives of foster children and to ensure that health and safety are built into every level of America's abuse and neglect system. Central to this entire effort was also Senator Larry Craig, who brought focus and determination to the sometimes difficult bipartisan negotiations. I would like to take this opportunity to extend my most sincere thanks to my other colleagues, Senators Jeffords, DeWine, Coats, Bond, Landrieu, and Levin for making possible this outstanding example of bipartisan teamwork. The Promotion of Adoption Safety and Support for Abused and Neglected Children Act will fundamentally shift the focus of the foster care system by insisting that a child's health, safety, and opportunity to find a permanent home should be the paramount concern when a State makes any decision concerning the well-being of abused and neglected children. As a comprehensive package based on bipartisan consensus, PASS will accelerate and improve the response to these concerns, promote safe adoptions, and restore safety and permanency to the lives of abused and neglected children. The main objective of this bill is to move abused and neglected children into adoptive or other permanent homes and to do so more quickly and more safely than ever before. Right now, many foster care children are forced to wait years before being adopted--even in cases where loving families are ready and willing to adopt them. Some children lose their chance for adoption altogether. While PASS preserves the requirement to reunify families where appropriate, it does not require States to use reasonable efforts to reunify families that have been irreparably broken by abandonment, torture, physical abuse, sexual abuse, murder, manslaughter, and sexual assault. The PASS Act maintains the delicate balance in protecting the rights of parents and families while placing primary focus where it should be: on the health and safety of child. PASS encourages adoptions by rewarding States financial incentives for facilitating adoption for all foster children--especially those with special needs which, sadly, make them more difficult to place. For those situations where children cannot go home again, PASS requires States to use reasonable efforts to place them into safe adoptive homes or into the permanent care of loving relatives. In addition, PASS cuts by one-third the time that an abused and neglected child must wait in order to be placed in such adoptive homes. In response to a candid and focused look at today's foster care crisis, the bill also seeks to rescue children from the legal limbo of the current system by requiring States to take the necessary legal steps to free for adoption those children who have been forced to linger in the system for a year or more. PASS also prevents further abuse of children in the foster care system by requiring criminal records checks for all foster and adoptive parents. PASS is about helping the individual child but, equally as importantly, fixing the system. It is always the right time to focus on the needs of children-- especially those unfortunate enough to find themselves in the sometimes dysfunctional labyrinth of the abuse and neglect system. Unfortunately, however, reform has never been more necessary. President Clinton's ``Adoption 2002 Report'' found that there are currently half a million children in temporary foster care placements. One hundred thousand of those children should be adopted, but less than half of that number are legally eligible to become part of an adoptive family. In my home State of West Virginia alone, referrals to Child Protective Services are expected to rise to an all-time high of 17,000 this year. Foster care placements have jumped from 2,900 children in January 1996 to 3,113 children in January 1997. These staggering figures reveal a foster care crisis of unprecedented proportions. PASS is the first step in a vital, ongoing effort to put children at the very top of our national agenda. It is time that we provide all children with their most profound wish: to live in a safe and loving home with caretakers who treat them with respect and dignity. If we are unable to address this most fundamental need, these children will not be able to grow, learn, and provide a secure place for their own families. It is unthinkable to deny abused and neglected children such vital opportunities.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. In response to the Senator, I wholly agree with what he said, by trying to make two points. One is that when we were first contemplating this children's health insurance bill and the whole key concept of maybe getting as much as $24 billion, or even perhaps more than that, it was sort of understood that first we were going to insure 5 million children of the families that had the least resources to buy health insurance, and then we would move on to those who had a little bit more resources but still would not be able to afford buying health insurance from the private market for their children. We were talking about 10 million children. There was a lot of opposition to insuring 10 million children. It wasn't 40 million Americans, but it was 10 million children. Then even with the $24 billion that was applied to the program we are now faced with the prospect of maybe only being able to cover 3.6 million children, leaving, therefore, many of the 10 million uncovered. I think the Senator is also correct when he says this in no way precludes--I said that in my remarks earlier--the State of Washington, which has clearly moved out ahead of others, from, once the ink is dry, once we have seen a little bit more about how this works out, to be able to come back based on the ability of this particular State and others to be able to do more. But at this point, I am very, very nervous given, frankly, the rather capacious nature of the Governors in trying to bring this money to them, having to put in fairly strict guidelines about what could be spent on health care services as opposed to health interests, which regrettably are different things. I really want to see the program work, and I think we need to give it a chance to work and then come back. And I will be the first to support the State of Washington and others that have done more than other States. But let us take this incredibly, frankly, put-together program and let it work before we open more doors.

Mr. ROCKEFELLER. Of course.

Mr. ROCKEFELLER. Mr. President, will the Senator from Washington yield? I am not asking him to yield, but I simply would like to reply to what it was that he said. The last thing in the world that I want the Senator from Washington, or anybody else, to think is we have ours, let others take care of their own. First, I think the Senator from the State of Washington knows that is not the kind of legislator I am, in the first place. And, second, this is not about we have ours, and let others take care of their own. This is a question of trying to keep stitched together an extremely fragile program about which there was enormous controversy. Enormous heat was generated. I was actually almost surprised when it passed not only in the Congress but was signed by the President. I would simply say that I understand that the UC agreement on this bill prevents Senators from offering similar amendments on this bill. But as a Senator who is on the Senate Finance Committee, the Governors were always asking for more ways to do things, new ways to get money, more flexibility. The list of demands kept growing. Yes, I will fight for the children of West Virginia. But what I am thinking about here really is holding this program together, giving it a chance to work, not precluding the idea of the Senators from the State of Washington being able to introduce this kind of amendment a year or so from now, but simply let us get the children's health program implemented. Let us have a chance to see how it is going before we start exempting this situation and then that situation. I hope that will be cleared by the parties.

Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. ROCKEFELLER. Mr. President, it is very unusual for me to come to the floor to oppose an amendment by my two very distinguished colleagues from the State of Washington, Senator Gorton and Senator Murray. I respect them both immensely. I have worked with them both closely. In offering this amendment, I understand what it is they are trying to do. There are many who look at States like Oregon and the State of Washington and Wisconsin and Minnesota and say these are truly progressive States, their governments are doing things which other State governments ought to be doing. Philosophically, therefore, it would be natural for them to come to the floor to ask for some kind of exemption with respect to the children's health care bill. I come to the floor as somebody who has worked for a very long time on health care, and who has worked virtually full time on this children's health insurance bill. This legislation is a huge accomplishment in terms of this Congress and the President. The children's health initiative is the biggest thing to happen in health care since the mid- 1960's. Because of my experience in working on health care, and the children's initiative in particular, I am extremely leery about opening up the children's health legislation for amendment. I know that the chairman of the Senate Finance Committee, Senator Roth, has said exactly that, and I know Senator Moynihan has said exactly that. I am not sure there are many people who have talked against this amendment, which worries me because, on the face of it, it sounds like a reasonable request, a progressive State asking for an exemption because they are doing things at 200 percent of poverty, which most of the rest of the States are not. Mr. President, I can tell you that this was a very difficult agreement to reach, the children's health insurance bill. There was the whole issue of whether funding should be made available for health care services as opposed to health care insurance? There was the whole issue of whether the Federal Government should have a say, since it is Federal dollars, in terms of how the money should be spent. The benefit package, which is something I care enormously about, in the children's health care bill is not as good as Medicaid, which is already currently available to millions of children in this country. And there was the question that I fought for, as did others, and didn't succeed, on whether vision and hearing should be included. You can make an enormously powerful case that if you don't provide hearing services, then you won't catch the problems children are experiencing in hearing, who then will stop learning. And, if you don't offer vision care, all kinds of other things happen. It was a very controversial bill. It was reached with great difficulty; the culmination and the consensus was reached with very great difficulty. I firmly believe it would be very unwise for us to agree to the Gorton-Murray amendment simply because there will be a lot of other people following their lead, and leaders of other States will be following them through the door saying they do 200 percent of poverty, but we do 185 percent or 190 percent of poverty, or we are going to be doing it next year. There will be this and that, and all of a sudden the $24 billion will be quickly eroded. Now, am I saying that as a knee-jerk response against what is a very good-faith effort on the part of the Senators from the State of Washington to improve their situation? No. I am opposing the amendment out of a genuine concern, accompanied by some degree of terror that, if this amendment passes, there will be many others that follow. One can almost say that, for example, had there not been votes this evening, I was meant to go to West Virginia to discuss with the Governor, Cecil Underwood, a Republican, how he and I were going to work together to help implement--to make sure that the children's health insurance bill works successfully in West Virginia. We don't do things as generously as the State of Washington because we cannot, we don't have the money. My point is that the children's health program is just being implemented. The ink is barely dry. The implementation date has not even arrived yet. There is a very genuine concern on the part of those of us who care about health care that if we start modifying the agreement on children's health that was reached by the Congress and the White House that we will be in trouble. There are still 10 million children in this country that do not have health insurance. I remember there was common wisdom on the floor of the Senate that if we got the $16 billion for children's health insurance in the budget we could insure 5 million uninsured children. And if we got extra money--$8 billion or more from the tobacco tax--then we could insure all of the 10 million children. That was the hope for a period of time on this floor. As it turns out, it is much harder. It is much more difficult. And even with the full $24 billion we may only be able to reach 3.6 million American children who do not now have health insurance. In fact, the Congressional Budget Office, I think in responding to the submission of this amendment to them by Senators Gorton and Murray, indicated that, if this amendment is passed, it will result in 30,000 fewer children receiving health insurance coverage--not health services but health insurance coverage. Health insurance coverage is all that matters. That is the wraparound. That is the safety net. That is what guarantees your situation for the future. If we adopt this amendment, others will want special treatment and it would not be long before the $24 billion was eroded away. So, again I emphasize the respect that I have for the two Senators from Washington. I emphasize that they have every right, just on the basis of the progressiveness of their State, to request this kind of an amendment. But, if they do, there are going to be many States--in the South, the Midwest, the Northeast, and the West--that are going to be losing as a result of it because others will come in with other requests, and gradually the $24 billion in new funding disappears. So as somebody who cares passionately about health insurance being available to all 10 million children, and who a few years ago fought for health insurance to be available to 37 million Americans--now 40 million--who don't have it, I am rejoicing in the 3.6 million children who will get health insurance under the children's health insurance bill. But I do not want to see any fewer get it. Therefore, I reluctantly, but energetically, oppose this amendment. I hope that my colleagues will understand that there are a lot of children across America that need to be protected and can best be protected by defeating this amendment. I thank the Presiding Officer. I yield the floor. I note the absence of a quorum.