Pete Stark

Mr. STARK

Mr. STARK. Mr. Speaker, today I rise in strong opposition to the impeachment proceedings. Impeachment of President Clinton is not warranted by the facts of this case. Although the Republicans have couched their arguments in terms of perjury, obstruction of justice, abuse of power and their constitutional duty to do the ``right thing,'' this proceeding is in fact a political move to use private, consensual sexual conduct to subvert the constitution and remove a President. Our constitution provided impeachment as a mechanism to remove a President for crimes against the state such as ``treason, bribery, and other high crimes and misdemeanors.'' The allegations in the Starr referral, even if assumed to be true, do not rise to the level of impeachable offenses. On this point, almost 900 constitutional scholars, law professors and American historians agree. Yet, we proceed with the impeachment process as if compelled to do so by our constitution. It is not, however, the constitution which compels today's action; it's not even partisanship that brings us this sad day. Beyond partisanship, this majority leadership has abused their power in a dictatorial manner to impeach a President to satisfy a small block of right wing conservatives. The majority leadership rejected the request of over 200 Members of this body to allow a vote on censure, an option that has the clear support of the American public, because the conservation faction demands impeachment. When the House completes this frenetic activity this weekend, history will judge our activity. There will be no avoiding the fact that this whole process has been propelled by a small group obsessed with political revenge, not crimes against the state. This is not what the Framers intended or what the people want. Today defines the GPO as a group of vindictive, reactionary pharisees. It is a sad day for our country.

Mr. STARK. Mr. Speaker, I would like to include in the Congressional Record a letter that I received from Mayor Roberta Cooper of Hayward, CA. Mayor Cooper writes to express the sentimant that runs strong in my district that the impeachment proceedings being conducted by House of Representatitives are not in the best interest of our Nation and not supported by our citizens. City of Hayward, Hayward, CA, October 26, 1998. Hon. Pete Stark, Member, House of Representatives, Cannon Office Building, Washington, DC. Dear Pete: On the issue of the partisan driven Presidential Impeachment, its time for you and the members of California Congressional Delegation to hear from us at home! Frankly, the speed at which this proceeding is proceeding, it's as if the voice of the American people has fallen on deaf ears and blind eyes! Doesn't Congress see that President Clinton's ratings, among the American people, are holding steady? Can't Congress grasp the fact that we've had enough? Isn't it glaringly clear that pursuing this matter with the level of ruthlessness and aggression can ultimately serve no greater public good? Is Congress completely blind to the fact that the collective mind and spirit of the United States of America will suffer a massive societal depression should it succeed in its effort to destroy President Clinton? Is it Congress's intention to bring the citizens down with the President? I am extremely troubled by the far reaching implication and tremendously adverse outcomes presented by this partisan feeding frenzy should it succeed. I implore you to let your colleagues know that we strongly object the proposal to impeach the President and urge that this matter be resolved by means other than impeachment. Sincerely, Roberta Cooper, Mayor.

Mr. STARK

Mr. STARK. Mr. Speaker, I support our troops in their mission to eliminate Saddam Hussein's ability to use weapons of mass destruction. Althought I prefer a tight, multinational embargo around Iraq to disable Saddam's regime, that path was not taken. At this juncture, with repeated warnings to Iraq by the United States to comply with Iraq's pledge to disarm and with repeated violations by Saddam, we have little choice but to proceed with military action. For these reasons, I will vote for the resolution before the House of Representatives today to support our troops and to reaffirm that the policy of the United States to drive Saddam Hussein from power in Iraq.

Mr. STARK

Mr. STARK. Mr. Speaker, the omnibus appropriations agreement will pass the Congress with ease this week and Members of Congress will exchange accolades about what a wonderful bill it is. Baloney! For the first time since the budget process was established in 1974, Congress failed to pass a budget resolution--a roadmap for spending your tax dollars. Without a roadmap, you run amuck. That's exactly what is happening in Washington this week. This omnibus appropriation bill rolls eight separate appropriations bills together and includes special interest provisions designed to buy votes for final passage. The resulting bill is an abomination. The big picture is that any semblance of budget discipline has disintegrated. The last minute horse trading spent $20.8 billion in funds that were ``surplus'' only by government accounting semantics. The so-called surplus funds are really attributable to a temporary surplus in the Social Security trust funds. The trust funds need this entire surplus--and much more--to fund payments to the Baby Boomers when they retire. This bill spends an extra $20.8 billion because the negotiators were more interested in saving face than saving money. The taxpayers will pay the multi-billion dollar price for this ``one-for-me and one-for-you'' final agreement. The fine print isn't any prettier: another $1 billion for a star wars-like missile defense system that won't work; $6.8 billion in supplemental defense spending on top of the $271 billion already appropriated through the regular process; the repeal of the tax-exempt status of the National Education Association to get even with teachers who have been supportive of Democratic priorities on education; an increase in the number of H-1B visas so that high tech companies can import cheap labor rather than train US workers; a ban on needle exchange programs in the District of Columbia in spite of all the studies showing that such programs save lives; a moratorium on federal regulations designed to allocate organs fairly in contrast to today's gerrymandered allocation system that needlessly costs lives. I can count noses and see that this bill will pass. However, I won't be a party to this charade.

Mr. STARK

Mr. STARK. Mr. Speaker, human rights violations are occurring every day in the United States--worse yet, the victims and the Federal Government are funding these atrocities. While many nursing homes do an excellent job, all too many nursing homes throughout the country are not providing adequate care for elderly patients. As the proportion of older Americans in the population continues to grow and the number of those requiring long term care also rises, we must find a better way to improve quality in nursing homes. A Special Report on Nursing homes in the October 12, 1998 edition of USA Today profiles the devastating conditions in some Florida nursing homes. According to the article, the Brian Center in Tampa exemplifies the neglect which is all too frequent in the nursing home industry. More than a dozen ``residents' rights'' lawsuits, including a class- action claim, are pending against Brian Center of Tampa. These lawsuits accuse Brian Center and its succession of owners and management companies of systematic fraud, abuse and neglect orchestrated to inflate profits at the expense of vulnerable patients. As the USA Today article describes, enforcement lawsuits against nursing home owners take up to four months to be heard in court, and an additional month to be decided. Fines are limited to $5,000 per violation. Nursing homes only need to prove that they have improved the conditions of the home by the time of the hearing to defeat the enforcement lawsuit. There is no substantial punishment for nursing homes which fail to adequately care for their patients. Further increasing the likelihood of poor care, government and private authorities like the Joint Commission on Accrediting Health Care Organizations do not effectively inspect facilities to identify existing problems. The date of annual inspections are rarely varied by more than a week, allowing nursing homes to present a positive example for the inspectors and then return to a poor standard once the inspection was finished. The Brian Center and similar examples point out the problems with the Joint Commission on Accrediting Health Care Organizations, the national organization responsible for approving hospitals and nursing homes for medicare coverage. The October 19, 1998 edition of The Wall Street Journal contains a succinct description of the problems with the current accreditation and ranking process for HMO's, ``Who's on First?'' by Nancy Ann Jeffery. Both JCAHO and National Committee for Quality Assurance accredit HMO's, but each uses a different standard. JCAHO itself provides multiple accreditation plans which allows each plan to measure their most positive indicators. Using different standards for different accreditation renders the results of such accreditations useless. The rankings by JCAHO and NCQA are not standardized so comparing accreditation reports among provider groups is difficult and/or meaningless. The Wall Street Journal article also identifies the key flaw in the JCAHO type of accreditation: conflict of interest. When it comes to policing health-care quality, some groups are afraid to bite the hand that feeds them. In 1994 the Joint Commission rolled out a set of standardized performance measures off hospitals, at a cost of more than $5 million, creating a much sought-after single yardstick for comparing one hospital with another. There was just one problem: Some hospitals would look bad. The hospitals balked. So the Joint Commission, with a board dominated by the hospital industry and medical associations, backed off the plan.\1\ --------------------------------------------------------------------------- \1\ Jeffery Nancy Ann, The Ratings Game: Who's on First? The Wall Street Journal. October 19, 1998 pg. R16. The Federal Government needs to improve the oversight of accrediting organizations to ensure that they are protecting the consumer, and providing useful material.

Mr. STARK

Mr. STARK. Mr. Speaker, I am pleased to introduce the Child Care Quality Improvement Act of 1998. This bill creates Quality Improvement Grants as incentives for states to improve the quality of child care for young children in licensed facilities. Each state can use the Quality Improvement Grants for state and local activities designed to enhance the quality of child care available to its citizens. In recent decades, the number of working women with children, especially those with children under 6 years of age, has increased dramatically. In 1975, 39 percent of women with children under the age of 6 were in the labor force. By contrast, 65 percent were in the labor force in 1997. Good quality child care is critical for millions of working families. Currently, there is a patchwork of private arrangements used to care for more than 10 million children. This patchwork includes relatives, neighbors, child care centers, and neighborhood child care homes. Child care centers care for the largest proportion--almost 30 percent--of children with working mothers. Researchers state clearly that high quality child care has a positive impact on the social, emotional, cognitive, and physical development of all children. This is particularly true for at-risk families. Researchers and best professional practices have shown that there are identifiable features of child care settings that are associated with high quality care. These include a safe and healthy environment; caregivers who are nurturing and knowledgeable about children's development, and a stable presence in children's lives; and low numbers of children per caregiver to ensure that each child receives personal attention. Child care shapes the way children think, learn, and behave for the rest of their lives. While quality child care promotes children's healthy developments and early learning, lower quality care can hinder their development and, ultimately, their success in school. When parents can't afford quality care and child care providers can't access help to improve their services, children suffer. Children in lower quality child care have delayed language and reading skills and are more aggressive toward other children. Yet little public attention is being paid to the quality of child care experiences. Recent studies have found that much of the child care in the United States is poor to mediocre. One study found fully 40 percent of the rooms serving infants in child care centers to be of such poor quality as to jeopardize children's health, safety, or development. State and local governments are responsible for the oversight of child care providers that operate in their state. Each state establishes its own child care standards, determining the areas that standards will cover and the specific measures against which provider compliance will be determined. Recent work by the General Accounting Office found a clear consensus about which standards appear to be good predictors of high quality child care. These standards focus on caregiver education and training, child-to-staff ratios, group size, and safety and health. The Child Care and Development Block Grant (CCDBG) helps states make child care more affordable for working parents and supports improvements in the quality of child care and after-school programs. Under the CCDBG, each state is able to set its own goals and priorities for the funds, and can fund a wide range of activities, including direct service, resource and referral, licensing and monitoring, grants and loans to help providers meet licensing standards, and funds to improve compensation. The Child Care Quality Improvement Act of 1998 will enhance a state's ability to improve the quality of child care. The Child Care Quality Improvement Act increases the CCDBG and designates those funds for quality initiatives. Quality Improvement Grants would be available to states that establish quantifiable goals for child care improvements in six areas: increased caregiver training, expanded licensing standards, reduced numbers of unlicensed facilities, increased monitoring and enforcement, reduced caregiver turnover, and higher levels of facility accreditation. Quality Improvement Grant funds can be used for state and local activities that help realize state goals for improvement in each of those areas. The Child Care Quality Improvement Act also establishes an Advisory Commission on Quality Child Care to examine issues affecting child care quality and develop and make recommendations for feasible goals and targets for state child care programs and national standards for quality of care. In addition, it requires the Department of Health and Human Services to conduct a consumer education campaign to promote informed child care choices. The need for quality, affordable child care is a daily reality for millions of America's working families. Every child has incredible potential, and there is nothing more satisfying than seeing a child learn and develop. Parents need safe, reliable care for their children while they are at work. Children need quality early learning experiences that help them develop to their full potential and enter school ready to learn. I urge my fellow Members of Congress to join me in support of the Child Care Quality Improvement Act of 1998. We must seize the opportunity to make an important investment in America's children by ensuring and improving the quality of child care.

Mr. STARK

Mr. STARK. Mr. Speaker, I am pleased to join Representative McDermott in introducing legislation to ensure that 100 percent--or as close to 100 percent as humanly possible--of low-income Medicare beneficiaries eligible for QMBy and SLMBy are enrolled in those programs. The bill provides for a data match between the IRS and HHS to detect low income Medicare beneficiaries and presumptively enroll them in the programs. We are introducing the bill in the last hours of the Congress so that the administration, seniors' groups, and others can study the issue over the adjournment period and make suggestions for improvements and changes for a new bill in the 106th Congress. In 1988, Congress enacted provisions to protect low-income Medicare beneficiaries from the financial distress of out-of-pocket health care costs. The protections were embodied in the Qualified Medicare Beneficiary (QMB) Program under which state Medicaid Programs pay Medicare premiums, deductibles and co-insurance for people with limited resources and with incomes of not more than 100 percent of the Federal poverty threshold, currently $691 per month for an individual. In subsequent years similar but more limited provisions were enacted for those with slightly higher incomes. Premium and other cost-sharing protections are critical to the well- being of low-income Medicare beneficiaries. Medicare covers less than half of the total health spending of the elderly and is less generous than health plans typically offered by large employers. Health care spending for low-income beneficiaries who are also eligible for Medicaid is substantially higher--Medicare payments for them are 70 percent higher than for those with higher incomes. Beneficiaries spend, on average, more than $2,500 out-of-pocket on Medicare premiums and cost-sharing, and on health services not included in the Medicare program. This is a third of the annual income of an individual living in poverty. Moreover, on average the health of low-income Medicare beneficiaries is substantially worse than that of the general Medicare population: Low-income beneficiaries are nearly twice as likely as those with higher income to self-report fair to poor health and nearly twice as likely to have used an emergency room in the past year; they are less likely to have a particular physician; and they are three times more likely to have needs for assistance due to functional impairments in activities such as dressing, eating and bathing. Despite the importance of financial protections and their promise of help to low-income beneficiaries, the current QMBy and SLMBy (Specified Low-Income Medicare Beneficiaries, with incomes up to 120 percent of poverty) benefits have failed to reach nearly four million eligible individuals. A recent Urban Institute report estimates that only 10 percent of those eligible are participating in the SLMBy program and less than two-thirds of those eligible are enrolled for QMBy benefits. Complex enrollment processes, requirements to apply at welfare offices, lengthy delays in refunding premiums deducted from cash payments, and the lack of effective, coordinated outreach and problem- solving systems have all been identified as issues that impede program effectiveness. Identifying and enrolling those entitled to benefits has been a significant challenge of the buy-in programs. Moreover, administration of the buy-in programs by different Medicaid systems of the 50 states and the District of Columbia make the benefit unevenly available across the country. The importance of the buy-in programs to low-income Medicare beneficiaries should not be underestimated. Because of their greater- than-average health care costs, and because Medicare does not cover many services critical to older and disabled people, individuals eligible for buy-in programs can benefit greatly from the extra income they retain when they are relieved of cost-sharing responsibilities. The obvious and most important aspect of the buy-in programs is that they put income back into the pockets of low-income people who can use it to pay for food, clothing, shelter, un-reimbursed medical expenses and other necessities of life. Mr. Speaker, we look forward to public comment on the technical features of the bill, and hope it will have widespread support in the 106th Congress.

Mr. STARK

Mr. STARK. Mr. Speaker, we need to take immediate action to make JCAHO accountable to the public. The Administration's July 1, 1998 report on nursing home quality [``Private Accreditation (Deeming) of Nursing Homes, Regulatory Incentives, and Non-Regulatory Initiatives, and Effectiveness of the Survey and Certification System''] shows that the nation's premier, private health accrediting organization--the Joint Commission on Accrediting Healthcare Organizations needs to do a much better job of protecting Medicare patients and dollars. Before JCAHO extends its accrediting activities to other areas--such as hospice agencies where it is applying to be an accrediting organization--it needs to prove it can do its current job of inspecting nursing homes and hospitals. As I said in my opening remarks to the Ways and Means Health Subcommittee on July 1, 1990, ``Validating the JCAHO status is critical given that HCFA, through a process termed `deemed Status' relies on JCAHO to assure that most hospitals are providing quality health services to Medicare beneficiaries. If a hospital (or now other health care facility) is accredited by JCAHO, it is deemed to meet the Medicare conditions of participation.'' We found many problems eight years ago and many still continue, which would indicate a fundamental problem with JCAHO culture caused, I believe, by the system of financing JCAHO inspections. This is why I have introduced H.R. 800 to increase public access to and influence on JCAHO. H.R. 800 will require that one-third of the members of the governing boards of Medicare-accrediting agencies are members of the public. JCAHO currently claims to have 6 public members on its board. In fact, a recent appointee to one of the scarce public seats, is also a director of the second-largest investor-owned hospital company. This recent appointment is just one example of the conflict of interest rampant in JCAHO's operating procedures. My bill also outlines a definition of ``members of the public'' to prevent similar appointments in the future. On July 1, 1998, HCFA issued a Report to Congress entitled, ``Study of Private Accreditation (Deeming) of Nursing Homes, Regulatory Incentives, and Effectiveness of the Survey and Certification System''. This damning report detailed numerous deficiencies in JCAHO's current inspection system. To extend JCAHO's deeming to hospice care would permit an inadequate program greater authority. JCAHO recently announced its intention to expand its scope of inspection to include hospice facilities. JCAHO currently surveys nursing homes, hospitals, and other health providers. But according to a recent HCFA/Abt study, JCAHO is unable to effectively administer surveys, identify problems, and implement problem correction policies. Allowing an organization riddled with problems further authority would be a terrible mistake. JCAHO accredits health care facilities at the facilities' request. The federal government recognizes JCAHO hospital and home health agency accreditation as equivalent to meeting its Medicare Conditions of Participation. According to the recent HCFA/Abt report to Congress, JCAHO has to make drastic changes to meet the basic Medicare requirements. JCAHO continues to deem facilities Medicare eligible, when in fact these facilities do not meet Medicare standards. Facilities that want to be accredited pay JCAHO to survey their site. Allowing JCAHO to accredit facilities that pay for surveys represent a conflict of interest. JCAHO's lack of objectivity plagues the current accreditation process. Furthermore, JCAHO accreditation does not meet current Medicare guidelines for allowing facilities to participate in the program. The most serious allegation against JCAHO is that it overlooks regulatory infractions at the expense of patients for example: One nursing home administrator responded to questions about JCAHO's procedures with the following. ``They (JCAHO) are big into policies and procedures * * * they are more interested in quality improvement and assessment than problem correction.'' \1\ --------------------------------------------------------------------------- \1\ Pp. 617-618 ``Study of Private Accreditation of (Deeming) of Nursing Homes, Regulatory Incentives and Non-Regulatory Initiatives, and Effectiveness of the Survey and Certification'', Health Care Financing Administration. July 1, 1998. --------------------------------------------------------------------------- Lack of problem correction is of special concern given the nature of nursing home residents. This population is one of the most vulnerable parts of the health care population, with 48 percent of nursing home patients suffering from some form of dementia. JCAHO is unable to effectively accredit private nursing homes, and thus should not be allowed to additionally accredit hospice facilities until its inspection system is improved. The results of empirical studies included in the Study demonstrate the need for overhaul of the current regulatory system. While the medicare system may benefit from reduced regulatory costs by using JCAHO, the savings do not outweigh the risk of severe deficiencies in care. Although deeming may save Medicare $2 to $37 million a year by private accreditation, JCAHO surveyors often miss serious deficiencies, which in some cases may even result in unjustified deaths. We must not sacrifice the welfare of the most vulnerable for minimal financial gains. JCAHO does not effectively administrate regulatory surveys. The timing of JCAHO surveys was easy for nursing home administrators to predict. Surveys were never conducted at night or on the weekends. Thus once a provider paid JCAHO to accredit the facility they could hypothetically increase staff levels on only Monday and Tuesday day shifts in anticipation of a pending survey. Furthermore, the current system fails miserably to identify problems. The Incidence of serious deficiencies found decreased with the implementation of the new accreditation program. The new process may also tend to identify deficiencies as less serious than they actually are. Flaws in the problem identification system are evidenced by the fact that simultaneous public accreditation found more serious deficiencies than JCAHO did. More importantly, the current system under-addresses malnutrition and violence problems. Currently nursing home aides are not required to undergo criminal background checks. Furthermore some employers seek out recent parolees knowing that these employees will work for a lower salary. JCAHO fails to detect inadequate and even fraudulent staff training practices: Frequently reported actions to provide in-staff training to staff result in no evidence on quality and content. Very high staff turnover suggests that the staff is not benefitting from the required training. In one case, workers were asked to sign an attendance sheet for an in-staff training session they never attended. \2\ --------------------------------------------------------------------------- \2\ Pg. xii, Executive Summary; Study: HCFA --------------------------------------------------------------------------- HCFA standards are generally more stringent than JCAHO standards. JCAHO surveyors seem to miss serious deficiencies that HCFA surveyors frequently identify. JCAHO standards are heavily weighted toward structure and process measures, while HCFA standards have a more resident-centered and outcome-oriented focus. The JCAHO accreditation and HCFA validation inspections differed widely in their approach as well. JCAHO surveyors spent little time assessing quality of life issues or observing clinical treatments. JCAHO surveyors also spent little time observing clinical care or with residents, and those residents who JCAHO surveyors did interview were often pre-selected by nursing home staff.\3\ --------------------------------------------------------------------------- \3\ Pg. 18, Vol. I Study: Health Care Financing Administration --------------------------------------------------------------------------- In the Report to Congress HCFA said that JCAHO lacked the ability to enforce findings and to regulate nursing home care: Some Nursing homes need the punitive threat of review and enforcement to secure improvements. The current system has not worked as well as it should to eliminate poor quality nursing care. \4\ --------------------------------------------------------------------------- \4\ Pg. 13 Vol. I ``Study: Health Care Financing Administration July 1, 1998 --------------------------------------------------------------------------- The Study concludes that JCAHO is not adequately ensuring quality nursing care. The potential cost savings of deeming does not appear to justify the risk to the health and safety of the vulnerable nursing home population. Although the study also found problems with the HCFA survey procedures, these concerns pale in comparison to the inadequacies of JCAHO survey procedures. The result of this study raise alarming concerns about the quality of nursing care in the nations nursing homes. JCAHO has proven itself unable to identify with facilities are providing substandard care and to implement programs which will correct these problems. JCAHO should not be allowed to accredit hospice facilities until we are sure fundamental changes in JCAHO's system of inspections are in place. The federal government has a responsibility to reevaluate the current deeming system to protect its most vulnerable citizens.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise to express my strong opposition to attempts that I understand are currently underway to attach a version of H.R. 4006, The Lethal Drug Abuse Prevention Act of 1998, to the omnibus appropriations bill that will soon be considered by Congress. H.R. 4006 has been scheduled for floor consideration by the Full House several times this year. Each time ti has been pulled from consideration because of the great concerns expressed by our medical community. The bill purports to simply combat the practice of physician-assisted suicide. Unfortunately, that is not all the bill accomplishes. It also presents real barriers to the appropriate care of terminally ill and dying patients. It does not appear that the supporters of this legislation intend to affect pallative care for the dying. But, regardless of intent, it is the effect of this bill. The latest version of the bill would have the same result. If it becomes law, doctors will be deterred from providing appropriate pain management to their terminally ill patients. If you've ever lost a loved one after a long, painful illness, you know the importance of these medications. They are vital to ease the pain of people in their final days of life. It should be up to the patient, the doctor, and the patient's family to develop an appropriate pain management program--without the doctor needing to fear intervention from the federal government. The tools exist today at the state level through the State medical and pharmacy boards to seek out and discipline doctors and other health care providers that violate the law regarding the dispensing of controlled substances. This legislation is not necessary. The medical community is opposed to this action and patient advocacy groups are opposed to it as well. In total, more than 55 such organizations have signed up to express their opposition. The Department of Justice, the very agency that would be required to enforce the policy if it were to become law, has also voiced strong opposition to this action. In a letter to Chairman Hyde regarding H.R. 4006, the Departments states: ``Virtually all potent pain medications are controlled substances. Thus, physicians who dispense these medications to ease the pain of terminally ill patients could well fear that they could be the subject of a DEA investigation whenever a patient's death can be linked to the use of a controlled substance.'' If we've learned anything from the managed care debate, it is that the American public wants medical decisions made by doctors and their patients--not health plan or government bureaucrats. This bill goes in the opposite direction from those desires. We are at this point not because of any need for a new law. We are here because the Christian right is pushing this issue as yet another part of their wish list. They want to force it through the process even though there are serious, legitimate questions about its unintended consequences. Its supporters want it passed regardless of those concerns so that it can send a political message. We should resolve those concerns, not shut our eyes and rush it into law. The last minute appropriations gimmick is Congress at its worst. Because there is legitimate opposition to passing the legislation through the regular legislative process, this is an attempt to tie the Department of Justice's hands via Congress' ability to control their spending authority. I strongly oppose inclusion of this provision in the omnibus appropriations package and urge my colleagues to join me in defeating this misguided legislation, which attempts to please a political constituency at the cost of appropriate medical care for terminally ill patients.

Mr. STARK

Mr. STARK. Mr. Speaker, last week, I introduced H.R. 4753, a bill to provide a Medicare prescription drug benefit. Prescription drug expenses are projected to continue to inflate at a rate far above the general inflation in the economy and in medical care. More and more Americans and Medicare retirees will be facing financial hardship in paying for prescription drugs in the coming years. A national prescription drug insurance program, which would utilize the buying efficiencies of the Medicare program, is the best way to help meet this growing problem. The September/October 1998 issue of Health Affairs contains a major article by HCFA actuaries and economists entitled, ``The Next Ten Years of Health Spending: What Does the Future Hold?'' Following are the paragraphs from the article describing anticipated prescription drug spending. Clearly, if these predictions are half correct, Congress should act to help. Growth in prescription drug spending is expected to continue at a relatively rapid pace, supported by continued declines in our out-of-pocket payments for drugs associated with the shift of Medicare patients into managed care and an acceleration in new product introductions. Drug-price inflation began to rise in early 1998 and is expected to exceed its relatively slow pace of recent years through 2007. Drugs. Recent rapid growth in drug costs over the past two years has often been cited as a contributing factor to health plans' escalating costs. Recent higher spending growth is almost entirely accounted for by rising utilization (number of prescriptions) and intensity (including changes in size and mix of prescriptions). Drug price inflation (as measured by the CPI for prescription drugs), which has historically been a major factor in rapid growth, has been relatively restrained since 1993. Excess inflation for prescription drugs averaged only 0.5 percent for 1993-1997, following a period (1982-1993) of 5.3 percent average growth. Response by both consumers and health plans to slower growth in consumers' out-of-pocket payments for drugs has clearly played a role in the recent rise in utilization. In addition to slower drug price inflation, growth in out-of- pocket expenditures has been low since 1993, which reflects the shift to managed care, in which copayments for drugs tend to be much lower. Growth in drug spending is expected to accelerate moderately through 1998 and to sustain fairly rapid rates of growth through 2007. Real per capita growth is expected to average just below 6 percent, about equal to the average during the 1980's. While drug prices are projected to accelerate from recent lows, average inflation rates are assumed to remain below the exceptionally rapid pace of the 1980's, with excess drug price inflation averaging 1.7 percent for 1998-2007. Rapid growth in use and intensity are expected to continue to account for most of the growth in spending.

Mr. STARK

Mr. STARK. Mr. Speaker, today, I introduced legislation that would provide a prescription drug benefit for Medicare beneficiaries. The bill, if enacted, would close the most glaring deficiency in the Medicare program. With pharmaceuticals becoming an ever-more important element in the treatment of diseases, it is essential that we modernize the Medicare program by including a drug benefit. I think there is almost universal agreement that Medicare should cover the cost of prescriptions. The issue is the cost and how to pay for it. I've introduced this bill in the closing hours of the 105th Congress, so that interested parties could think about the issue over the adjournment period. I hope that the various stakeholders will comment over the winter, so that a new and refined bill can be reintroduced at the start of the 106th and have a wide range of support. I have left blank in the bill the question of (1) size of the deductible, and (2) whether there should be caps on total out-of-pocket expense. Where these two numbers are set will determine what the program will cost and thus what the increase in Part B premiums will be. As we fill in these numbers, seniors and taxpayers will decide whether the admitted cost of the program is worth its value. There is no free lunch. If the deductible is set high, the cost will be low, but it will help many fewer people. If it is a low deductible, it will be widely used, and the program's cost will be high. Do we want a low-deductible benefit, or do we want a catastrophic coverage benefit that protects people against the several thousand dollar-plus diseases? This is the heart of the debate, and I hope to hear from the public and the industries involved on this key question. Following is some data that will give readers a feel for the cost of different levels of benefit and the trade-offs involved.

Mr. STARK

Mr. STARK. Mr. Speaker, I am happy to yield 1 minute to the distinguished gentleman from Rhode Island (Mr. Weygand). (Mr. WEYGAND asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I yield 1 minute to the gentleman from Massachusetts (Mr. McGovern).

Mr. STARK. Mr. Speaker, I yield 1 minute to the distinguished gentleman from Vermont (Mr. Sanders).

Mr. STARK. Mr. Speaker, I yield 1 minute to the gentleman from West Virginia (Mr. Rahall).

Mr. STARK. Mr. Speaker, I yield 1 minute to the gentlewoman from Michigan (Ms. Stabenow). (Ms. STABENOW asked and was given permission to revise and extend her remarks.)

Mr. STARK. Mr. Speaker, I yield 1 minute to the gentleman from Michigan (Mr. Levin). (Mr. LEVIN asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I am honored to yield 1 minute to the gentleman from South Carolina (Mr. Spratt), the distinguished ranking member of the Committee on the Budget. (Mr. SPRATT asked and was given permission to revise and extend his remarks.)

Mr. STARK. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, the bill that the gentleman from California (Mr. Thomas) and the Republican leadership have crafted does some good things: The subvention. There are some issues dealing with Medicare payments to people with end-stage renal disease that are helpful. There is an attempt to fix or assist the problems that are being caused in the home health delivery system by the administration's inability to get their act together. Having said that, they have snatched victory from the jaws of defeat and pounded it to death. The bill is now a tax loophole and a stealth pay raise for Members of Congress and it has combined a series of measures and almost assured its defeat in the Senate because it violates the Senate rules and costs $10 billion over the next 10 years. Admittedly we only work in a 5-year time frame. They would raise a point of order in the Senate and need 60 votes and it is unlikely that it would pass there. It extends a tax break to the very wealthy and now includes Members of Congress. Previously we were unable, as Members of Congress, to take advantage of Roth IRAs, and we now will be able to so that we have, and I am sure people will soon discover, we are about to vote ourselves a pay raise. I vote for pay raises, but I like to do it up front so that my constituents know that. I think it is too bad that we are doing it. It violates the budget, the IRA tax breaks have been dropped in conference or must be dropped or the bill is doomed. We had suggested in the Committee on Ways and Means the postponement and reduction of medical savings accounts for seniors, and, interestingly enough, there are not any. There is no company offering medical savings accounts to seniors, and we could have saved a billion dollars and postponed the 15 percent tax cut which the home health industry is staring in the face next year. That was defeated by the Republicans in the Committee on Ways and Means, and I hope that if this bill goes to conference we could reestablish that. It hurts no one, there is no insurance company selling it, no seniors can buy it, we have already lost 300 million in savings which has evaporated. Through the inactivity or ignorance of the Republican bill we are going to let more of that savings disappear which could be used to help home health agencies who need it. Again, this bill gives up, loses, $10.7 billion, does precious little except for the most egregious home health providers and mostly in southern States who have taken most advantage of this payment, and we could have done a better job, Mr. Speaker, we could have not dipped into the surplus so egregiously, and I hope that when this bill comes to conference, if in fact it ever does, that we can correct it at that point. Mr. Speaker, I reserve the balance of my time.

Mr. STARK. Mr. Speaker, I ask unanimous consent that 6 minutes of debate time be allocated to the gentleman from Pennsylvania (Mr. Klink).

Mr. STARK. Mr. Speaker, I yield myself the remainder of the time. Mr. Speaker, I again join with many of my colleagues who support the tenor of the bill but have serious reservations about its budget implications. I would hope that if there is a chance to revisit this bill we can find a more sensible way to pay for it. Further, I would like to, in the spirit of bipartisan suggestion, urge the distinguished chairman of the subcommittee, the gentleman from California (Mr. Thomas), to hark back to the eighties when we tried in the Pepper Commission to develop a long-term care proposal. Let no one make any mistakes. This growth in home health care has been generated by the lack of any ability to pay for long-term care in the Medicare system. Rather than see the industry sneak a long-term care policy into the back door of acute care Medicare, we should honestly propose and debate a long-term care social insurance program. If it were fairly presented, with the problems in long-term care discussed, I think we could find a way to include it in the Medicare system rather than tinkering with ways to squeeze down the cost of home health. Mr. Speaker, I yield back the balance of my time.

Mr. STARK. Mr. Speaker, I yield 2 minutes to the gentleman from Maryland (Mr. Cardin).

Mr. STARK. Mr. Speaker, this bill is nothing more than a tax break for the wealthy disguised as a Medicare bill. It's a perk for Members of Congress who, along with their spouses, will not be eligible for new tax shelter--Roth IRAs. We have had no chance to study the home health proposal. Relative to the bill reported out of Ways and Means, it moves money toward new, for-profit agencies, who have been the cause of the home health funding crisis. Many of these agencies have been the very definition of fraud, waste, and abuse. The health policy in this bill is not as good as the policy in the bill reported from Ways and Means--but it is not bad. What is horrendous, what is totally unacceptable is the pay for and the budget implications! This bill loses $10.7 billion over 10 years. It is absurd, but true that the Treasury would be better off if the Majority did not try to pay for the bill! With this bill, you are spending the surplus. You are creating a tax loophole for the very upper income, that will cost billions and billions in the out-years-- just when we will need the money to save Medicare and extend its life. This proposal is poor tax policy and poor budget policy. We should be saving the surplus for Medicare--not spending it to please some for- profit home health agencies that have been abusing the program. Between now and 2008 when the Medicare Trust Fund will be exhausted, we will need about $325 billion--yet this bill gives away billions and adds to that pending crisis. Over the next 5 years, Medicare will spend about $1.1 trillion. You would think that we could find zero-point-two (0.2) percent out of current Medicare spending. There is a National Bipartisan Commission on the Future of Medicare that is trying to save Medicare for future generations, but if we can't find 0.2%, and give away billions of dollars that could be saved for Medicare, what does that say about the worth of that Commission? The Majority's pay for will undoubtedly run into budget rules in the Senate, and will be opposed by the Administration. To offer such a pay for smells like a poison pill.

Mr. STARK

Mr. STARK. Mr. Speaker, I rise today to introduce the Medicare Prescription Drug Coverage Act of 1998 to remedy a huge hole in the program's benefits package--outpatient prescription drug coverage. Twice in the past 10 years, Congress has almost provided this benefit, and twice we have failed. We established a drug benefit in the Medicare Catastrophic legislation of 1988, but it was repealed the next year before the benefit could start. A drug benefit was a key component of H.R. 3600, the Health Security Act of 1994, reported by the Ways and Means Committee, but failed to pass that year. It is time to debate this issue again and try some new approaches. While Congress has done nothing, drug costs have been soaring out of the reach of millions of seniors enrolled in traditional Medicare. In 1995, 46% of seniors enrolled in fee-for-service Medicare were without drug coverage. Almost one-quarter of beneficiaries enrolled in Medicare HMOs (about 4% of all beneficiaries) do not have a drug benefit. And in the face of projections that prescription drug prices are about to spike again, following a brief slowdown during the 1993-94 health care reform debate, the number of seniors with no drug benefits could accelerate. By 2007, the Health Care Financing Administration projects drug costs will account for over 8% of total health care costs, up from 6% in 1996. Viewed another way, that could mean double-digit price increases. For many beneficiaries with modest incomes, no retiree health coverage, and too many assets to qualify for Medicaid, these economic trends mean they will be forced to rely on traditional Medicare--with no drug coverage. In effect, we are rapidly creating a large underinsured class of Medicare beneficiaries. So as we approach the millennium, I will pose the question again: Why doesn't Medicare have a drug benefit? Why do nearly all Americans who have private insurance, which includes every member of Congress, enjoy drug coverage, while millions of seniors do not? Most Americans have heard stories about seniors who must make repeated, difficult choices to buy either prescription drugs or other necessities--like food. The health toll this produces is not easy to quantify. Researchers report that seniors without drug coverage frequently decide to go without medications for conditions such as headaches and muscle aches. What is less well known is that many of these same seniors also decide to skimp on drugs to treat potentially serious diagnosed conditions, including leg swelling and diabetes. This year, I have heard from many, many distraught seniors who have written to tell me they are going broke trying to pay for drugs their doctor told them they must take. I believe that some will wind up in worse health when they decide to forgo or cut back on the very drugs designed to keep them clinically stable. The absence of a prescription drug benefit in Medicare that forces elderly people to skip and skimp on drugs is inexcusable. It is time for Congress to debate and enact legislation that will provide all seniors who want it access to affordable Medicare-sponsored drug coverage. There really aren't any good alternatives. Trends in employer- sponsored retiree health coverage--which has traditionally featured a drug benefit--show it is eroding. A somber General Accounting Office report released last summer warns that ``while an estimated 60 to 70% of large employers offered retiree health coverage during the 1980's, fewer than 40% do so today, and that number is continuing to decline despite the recent period of strong economic growth.'' That's a polite way of pointing out that the number of U.S. companies offering their retirees health coverage in the last decade has been dropping like a stone. For those seniors who don't--and won't--have retiree health coverage, purchasing a supplemental policy with good drug coverage may soon be unaffordable. Supplemental Medigap policies now costs on average more than $1,200 per year, according to the American Association of Retired Persons. But Medigap policies with drug coverage can cost far more. The range in costs for Medigap policies with drug coverage is also large: In Los Angeles, Bankers' Life Insurance and Casualty sells a drug-Medigap policy for $6,381 at age 65. At age 75, the same policy costs $9,174! The difficulty that seniors have in affording comprehensive supplemental insurance is illustrated by the fact that in 1994-95, a mere 15% of seniors purchasing a Medigap policy had drug coverage. The hard fact is that a Medigap policy with drug coverage is not now--and will never be--within the financial reach of millions of Medicare beneficiaries, particularly the very old, who are spending down their assets. That brings us to Medicare managed care. Remember, one quarter of those who are enrolled today don't have any drug coverage. Those who do are facing ever-higher deductibles and copayments, and ever-lower annual reimbursement caps. In Massachusetts, where state law has long required all HMOs to offer drug coverage, Medicare managed care plans are now asserting that last year's Balanced Budget Act says they don't have to comply! Only recently have seniors begun to understand that the comprehensive drug benefit they were promised in glossy HMO marketing materials is the equivalent of a ``low introductory rate'' pitch made by credit card companies. It's great while it lasts. But after that, you could be in trouble. The Medicare Prescription Drug Coverage Act is carefully designed to help those who most need an outpatient drug benefit--who don't get it from a former employer, from Medicaid or any other federal health program, and who pay an extra premium under Part B for Medicare drug coverage. I am introducing this bill, roughly modeled on the 1994 legislation, so that consumers, pharmaceutical providers and others can study the issue over the winter, comment and suggest changes for a revised bill to be introduced at the beginning of the 106th Congress. I am leaving the numbers for the deductible, the caps, and the premiums blank, so that groups can comment on what they think the appropriate combination of figures should be. In a separate statement, I am reprinting some of the literature that is available on the cost of different prescription drug benefit plans at different deductible levels. Clearly, there is a tradeoff between the size of the benefit and its affordability: Striking the right balance is the key to the passage of successful legislation. There is a critical distinction between previous proposals for Medicare drug coverage and the legislation I am introducing today: If you already have an adequate prescription drug benefit, you will not have to ``pay again'' in higher Part B premiums. If you have coverage, there will be no change and no new cost to you. If you do not have a prescription drug benefit, you will face a higher Part B premium, but if you are low income, you will get assistance in paying for it. While it is tempting to say that the decision to enroll in the prescription drug benefit could be voluntary, the adverse risk selection (i.e., only sick people needing lots of costly prescriptions would be likely to sign up) would make the cost of premiums to those enrollees prohibitive. Adding an outpatient drug benefit to Medicare is not cheap. But IF prices are set at the ``wholesale'' level that physicians, medical suppliers and other purchasers pay, and IF all budgetary savings are not immediately earmarked for tax cuts, then Medicare drug coverage is affordable. In the next Congress, we will have another opportunity to reshape Medicare to make it a better program. As we work to stabilize the program's financing, we must also improve it for those it was created to serve--our nation's seniors. Without drug coverage, more and more seniors will fall through the widening cracks of a health care system that is getting leaner and meaner. Without drug coverage, we'll see more seniors who can't afford to take their medications treated in the emergency room, where health care costs are highest. Adding a prescription drug benefit to Medicare along with a requirement that costs be held to reasonable levels and a reasonable rate of growth is a clear way out of this dilemma. It is legislation that is 33 years overdue. I hope my colleagues will join me in vigorously advocating for passage of the Medicare Prescription Drug Coverage Act in the 106th Congress.

Mr. STARK

Mr. STARK. Mr. Chairman, I oppose the Labor, Health and Human Services and Education Appropriations (Labor--HHS) Bill considered in the House today. education suffers under this bill This bill would have devastating effects on students and our education system and I strongly urge my colleagues to reject this bill. My colleagues on the other side of the aisle have been busy with their education agenda this year. We've debated a Constitutional Amendment to allow for prayer in schools and we've tried to eliminate affirmative action programs for minority students. We've also tried to provide public dollars for private schools--not once, but twice, and to eliminate public dollars to be used for the purposes of educating our bilingual students. Lucky for our students, parents and teachers, Democrats have an education agenda, too. The Democratic plan will improve public education. We want to reduce the average class size in the early grades by helping local school districts hire 100,000 new qualified teachers. We want to provide federal tax credits to pay the interest on $22 billion in bonds for the modernization and construction of more than 5,000 schools. We want to make sure that schoolchildren have somewhere to go after school instead of hanging out on the streets. We are promoting after school learning opportunities for students. We support expanding resources for educational technology in order to ensure that every classroom and school library is connected to the Internet by 2001. The Democratic ideas will work; they will provide more opportunities for out kids. Nobody denies that public education is in bad shape. But the majority's solution is to cut funding and eliminate programs and to determine what choices are made available to school districts and teachers. This does not make good sense or good policy. This Education Appropriations bill fails to fund a single one of the Administration's initiatives to modernize schools and build new schools. it is no secret that schools are overcrowded. Schoolteachers in my district are conducting classes in portables, school lunchrooms and even in hallways. The majority, by not addressing this problem in their bill, are putting a bag over their head and hoping the problem goes away. This Education Appropriations bill does not fund the President's Literacy Initiatives and eliminates funding for the America Reads Challenge. Furthermore, the bill cuts funding for the Safe and Drug Free Schools initiative, and does not fund the President's plan to target funds to districts and schools with the largest drug and violence programs. This bill also incorporates the text of a bill that was defeated by the House earlier this year and with regard to bilingual education. This bill would limit the amount of bilingual education a student could receive to a maximum of two years. Reputable research proves that children take between four to seven years to master academic English necessary for higher education success. This bill provides no academic safety net for students who fail to master English in two years. It does not make sense to shove children arbitrarily from an environment where they are learning to one where they are predetemined to fail. The House has already soundly defeated this idea. Why does this bill pander to an extreme minority who has already lost this fight? This bill also prevents students from achieving success in the new millennium by cutting funds for GOALS 2000 by 50%. How does cutting funding for this program help students? I would ask the majority leadership to answer this question. This bill also prevents any funds from being spent to adopt a national testing standard for our kids. These tests have nothing to do with content and would test fourth graders for reading comprehensive and eighth graders for math ability. I support national testing standards. These voluntary tests will have no effect on home schooling or parochial education interests. Testing gives states, local communities and parents one more tool to measure how well their curriculum prepares students in basic reading and math skills. If we are to spend taxpayer money on public schools, we must know that we are getting measurable results. It is clear that my colleagues on the other side of the aisle do not think the same way about education as we do. Their attacks on our basic fundamental obligation to provide a public education for every child in America will have a devastating effect on schoolchildren and our Country's future. A real stand for education is a vote against this terrible bill. Cuts Hurt the Most Vulnerable H.R. 4274 is a confrontational bill--the product of a majority leadership decision to cave to demands from the right wing of its own conference. It does nothing to heal the economic and social divisions within our society. Instead it resembles a blueprint for the reelection of the House Republican leadership. H.R. 4274 is the direct result of the majority's decision to kill tobacco legislation. Instead of using tobacco company revenues to fund a set of fairly balanced domestic priorities, the majority has decided to offset their spending priorities by cutting the programs that benefit the most vulnerable members of our society. H.R. 4274 eliminates funding for LIHEAP. I oppose this provision. There is no programmatic or economic rationale to justify eliminating a program that helps 4.4 million low-income households pay their heating and cooling bills. About 1.5 million of these households have elderly members, 1.3 million have disabled members, and 2.1 million have children in poverty. Two-thirds of LIHEAP recipients earn less than $8,000 per year. Energy prices constitute a significant expense for poorer households whose incomes have not kept up with inflation. I also strongly oppose the bill's prohibitions on Title X funding. Title X family planning clinics offer a wide range of critical services including contraception, screening and treatment for sexually transmitted diseases, HIV screening, routine gynecological exams, and breast and cervical cancer screening. If minors are required to comply with parental consent or notification laws for contraceptive services, not only will they avoid seeking family planning services, they will avoid seeking any of the services at a Title X clinic. Without these services, the authors of this bill can soon take credit for an increase in abortions and sexually transmitted diseases. I oppose this bill for its blatant disregard for the reproductive health, safety, and constitutional rights of America's women. Supporters argue that H.R. 4274 eliminates excessive and burdensome federal regulation and provide enhanced discretion to state and local officials. Yet, the bill prohibits the use of Title X funds by any entity unless it certifies that it encourages family participation in the decision of minors to seek family planning services. It also prohibits a state or locality's contribution of Medicaid matching funds to pay for any abortion or to pay for health benefits coverage offered by a managed care provider that includes coverage of abortion. This Bill Plays Politics With Organ Donations Every day 10 people die in this country waiting for an organ transplant. There is no disagreement about the problem--there aren't enough organs to meet the needs of patients. In March, the Department of Health and Human Services issued proposed regulations to equalize large discrepancies in waiting times for transplant patients around the country and help guide the transplant community to create a fairer transplant system. Now the House Labor-HHS bill includes two riders, which would prohibit the implementation of these regulations and prevent the HHS Secretary from working to increase the number of available organs. The first rider would prevent the Secretary from requiring hospitals to report patient deaths to regional Organ Procurement Organizations. This simple requirement is in effect in Maryland and Pennsylvania and both states report additional organ donations as a direct result. Preventing this regulation from going forward will make more patients die waiting for other organs. This is a matter of life and death and this rider should be removed from the bill. The second rider puts a moratorium on the Secretary's organ allocation plan to make the distribution of organs more fair for patients. The Secretary's organ allocation plan is urgently needed by patients across the country. Patients in the Bay Area wait an average of over 300 days for a transplant, while patients in Tennessee wait 21 days. This isn't fair. The Secretary has proposed to let medical people make medical decisions about the best way to allocate the limited number of donated organs. The Appropriations Committee should allow these regulations to be implemented without further delay. This rider is being pushed by a group of Louisiana transplant surgeons who believe that organs should be hoarded for their own state use. Over 30% of Louisianans needing a transplant leave the state to find better care in other hospitals or because they have been turned down for transplants in Louisiana. The state has recently passed an ``organ hoarding'' law to prevent organs that are made available for transplant in Louisiana from leaving the state. The state has also filed a lawsuit against the Secretary for issuing national regulations, despite the fact that the National Organ Transplant Act specifically requires that the Secretary do so. Fairness is half of this fight; Quality is the other part. There is a lot of money to be made in organ transplants. Too many centers have been opened to increase the prestige and the profits of a local hospital--and not because they do a good job. In fact, in general the lower volume small transplant centers have poorer outcomes than the high volume transplant centers. The fact is that having a transplant center has become the equivalent of health pork. Many of these centers are like the excess projects in the recently-passed highway bill: centers without a justification. But unlike highway pork, these centers sometimes end up killing patients because they do not do as good a job as the high volume centers. I really think it is immoral for centers that have a lower success rate than the high volume centers to be fighting the Department's regulation. Their actions are a disgrace to the Hippocratic Oath. The proliferation of poor quality transplant centers not only wastes lives, it wastes money. The United States has 289 hospitals doing tranplants--and that is an enormous commitment of capital. I have read that a hospital has to invest about $10 million to be able to do heart transplants. These proliferating costs are part of what drives health inflation in the United States and part of what places such huge budget pressures on Medicare. Concentrating transplants in fewer, high-quality, life-saving centers would allow us to save hundreds of millions of dollars in the years to come. The Department's regulation gives us the potential to focus on Centers of Excellence where we not only save lives, but can obtain economies of scale necessary to preserve the Medicare program. If my colleagues are serious about putting patients first, what is so onerous about a system that proposes to base transplant decisions on common medical criteria on a medical need list--not geography, not income, not even levels of insurance coverage--just pure professional medical opinion and medical need. This issue is about putting patients first--not putting transplant bureaucracies first. I can think of no better way to put patients first than to make the system fair for all. I urge my colleagues to support the Department's regulations and to vote against the Labor-HHS bill. The Bill is Bad for Working Families This bill would have devastating effects on working families and I strongly urge my colleagues to reject this bill. America's working families deserve a break. After a few years of record profits for Wall Street and the Fortune 500 companies, it is time to help out the working men and women responsible for this productivity. Instead, some of my colleagues, in their quest to please corporate shareholders, have launched an assault upon the basic protections that working families count on and enjoy. I've heard from numerous young people in my district about the importance of the Summer Youth Employment Training Program (SYETP). They tell me that they have learned the value of a dollar and the importance of being accountable and responsible because of their summer jobs. I've heard from Mayors and School Districts about the need for this program. The Castro Valley Unified School District wrote to me to tell me that ``SYETP is one of those programs that addresses the needs of a segment of our student population and does so with a high degree of success.'' I've included this letter for the Congressional Record to accompany my statement. What has the Majority done in response to this support for the Summer Youth Employment Training Program? They have eliminated all of the funding for it. The Summer Youth Employment Training Program works. It give young people the tools, skills and experience they need to succeed in the workplace after they are finished with school. Eliminating this program is not an investment in our future. This Labor-HHS bill cuts funding for Job Training Partnership Act by $1.5 billion from the President's request. The bill also cuts School- to-work programs by 62 percent from last year's appropriation. The message to young workers is clear: if you stuck in a low paying job or lack a graduate degree, the government will not help you obtain the skills you need to provide for your family. This is the wrong direction for our country to be going. One of the largest roles for government to protect working families is through the Occupational Safety and Health Administration (OSHA). OSHA offers guidelines for employers to provide employees with safe workplaces and enforces safety standards to ensure that the likelihood of injury or death on the job is reduced. OSHA is the safety cop on the beat for working families, and deserves our support. This Labor-HHS bill cuts OSHA funding by $18 million from the Administration's request. Furthermore, the bill includes provisions to require peer-review of the scientific data on which OSHA standards are based. The bill specifically permits a person with a financial interest in the outcome of the standard to set on the pear review panel. I question how many true labor protection standards will make it out of the regulatory process with employers and financial backers making the final decisions about what workers safety standards are really needed. The majority's labor record is clear. Working families should take a back seat to corporate interests and employer decisions. I don't share this view. I believe that working families deserve strong protections at the workplace, should be able to organize and advocate for their common interests and should not have to work in an environment of indentured servitude to guarantee a paycheck. If my colleagues were serious about help out working men and women, they would work to pass a real minimum wage increase and link it to a cost of living adjustment to provide a real working wage for working families. Making investments in people is the highest priority for me. Cutting funding out of programs to provide job skills and job security does not lead to an economically stable society. I urge my colleagues to vote for working families and for worker protections and to vote against this bill. Board of Education, Castro Valley Unified School District Castro Valley, CA, September 14, 1998. Hon. Fortney ``Pete'' Stark, Fremont, CA. Dear Representative Stark: The purpose of this letter is to urge you to support the continuation of the Summer Youth Employment Training Program (SYETP). This program has been a valuable one over the years over the Castro Valley Unified School District as it has provided opportunities for students from low income families to be successful in a work experience environment. Our responsibility as educators is to provide programs and strategies that are diverse in nature in order to address the diversity within our student population. SYETP is one of those programs that addresses the needs of a segment of our student population and does so with a high degree of success. There is no doubt that the elimination of this program will be a major loss for us in the district and the Regional Occupational Program in general. Judging by the information that I have received, the elimination of SYETP nationally would result in approximately 400,000 young people not having an opportunity for work and educational assistance in 1999. This is staggering and unacceptable! We cannot afford to ignore the needs of any of our students and specifically with regard to SYETP, the needs of students who have potential to be productive members of our society when they reach adulthood. Thank you in advance for your support and assistance. Sincerely, George Granger, President.