Paul Wellstone

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I thank Chairman Specter and ranking member, Senator Harkin, for working with me to see that funding is increased for the Perkins Loan Cancellation Program. I filed an amendment that would have increased the level of the Perkins Loan Cancellation Program by $30 million to $90 million. I am very appreciative that the committee increased funds for this valuable program by $30 million--especially given the terrible budget constraints on this bill. I am especially thankful that the Managers of this bill have agreed to raise the appropriation by another $15 million. This will get the government half way to where it needs to be to reimburse Perkins Revolving Funds for what they have lost to the Loan Cancellation Program. It is an important step. The reason I asked for more is simple. If we give the extra $30 million, the federal government can pay back what it owes to the universities and colleges for the loans that have been canceled. This amendment would simply fulfill its IOUs to the Perkins program. Mr. President, we have a $1.9 trillion surplus, it is ironic and probably an oversight that we are still in debt to America's colleges and universities that provide loans to low income students, but it is a debt that I think we can and should repay. That is why I am thankful for the Managers' efforts, and that is why I will continue to push for the full $90 million in the future. Both the cancellation program and the Perkins Loan Program are seriously undermined if the government does not fulfill its debt obligations to the universities and colleges that choose to administer it. The Perkins Loan Program (formerly called the National Defense Student Loan Program) provides long-term, low-interest (5% per year) loans to the poorest undergraduate and graduate students. 25 percent of the loans go to students with family incomes of $18,000 or less, and 83% of the loans go to students with family incomes of $30,000 or less. Since its inception, 11 million students received $15 billion in loans through the Federal Perkins Loan Program. In the academic year 1997/98, 698,000 students received Perkins loans. Perkins is exceptional because it is a public/private partnership that leverages taxpayers' dollars with private sector funding. The yearly Federal contribution to Perkins Loans revolving funds leverages more than $1 billion in student loans. This is because Perkins Loans are made from revolving funds, so the largest source of funding for Perkins Loans is from the repayment of prior-year loans. The Perkins Loan Cancellation Program entitles any student who has received a Perkins loan who enters teaching, nursing and other medical services, law enforcement or volunteering to cancel their loans. This past year, more than 45,000 low income students who chose to enter these important professions were able to have their loans canceled. Last year, 26,000 teachers, 10,500 nurses and medical technicians, 4,000 people who work with high-risk children and families, 4,000 law enforcement and 700 volunteers had their loans canceled under this program. This year, thanks to the efforts of Senator Durbin and others, it looks like we may be able to expand the professions eligible for cancellation to include public defenders. The value of Perkins loans is enormous. Since 1980 to 1998, the cost of higher education has almost tripled, leading to a decline in the purchasing power of federal grant programs. The maximum Pell grant this year is worth only 86% of what it was worth in 1980, making the Perkins program, and all loan programs, a more important part of low income students' financial aid packages. The value of the cancellation program is also enormous. It provides the lowest income people who want to enter public service a small break from the crushing debts they incur attending higher education. Offering loan cancellation also highlights the need for well-trained people to enter public service and honors those who choose to enter public service. This is the kind of incentive and reward we should be doing more of and I thank the Senate for accepting my amendment earlier that would provide Stafford loan forgiveness for child care workers. Mr. President, I am here today because the future of both of these programs is in great jeopardy because we are unable to repay the universities' revolving funds what they are owed for the cancellation program. There are colleges that receive only 47% of what they are owed by the government. They are given the rest on an IOU. Because Perkins loans are funded through revolving loans, the people who end up paying the price for this IOU are low income students who are eligible for Perkins loans in the future. As loans are canceled, and the government is unable to reimburse the revolving funds, there is less and less money available in the funds to generate new loans. It is estimated that 40,000 fewer students will be eligible for Perkins loans because of the declining money available in the revolving fund. When you combine the pressure from the unfulfilled government obligations with recent cuts to the Perkins program in general, I believe that both these key programs are at risk. Congress has cut the yearly Federal contributions to the Perkins Loans revolving funds by $58 million since fiscal year 1997. Since 1980, the Federal Government's contributions have declined by almost 80%. 900 colleges and universities around the country have cut their Perkins programs at least in part because they were not economically viable. In MN, colleges such as Metro State University have ended this valuable program in large part because they cannot afford to keep it going. This means one thing and one thing only. There are less and less loans available for the lowest income students. The $15 million the manager's package will provide will go far to reverse this situation. Reducing the number of loans available is not the direction we want to be going given what we know about the rising importance of college education and the increasing need for financial aid. A study from Minnesota indicates that for every $1 that is invested in higher education, $5.75 is returned to Minnesota's economy. A 1999 Department of Education study indicates that the real rate of return on investment in higher education is 12% based on earnings alone. This does not include savings on health care and other factors. Further, a recent poll found that 91% of the American Public agree that financial aid is an investment in America's future (Student Aid Alliance, 1999). The numbers indicate that this is true. In 1998, men who had earned a bachelors degree earned 150% more than men who had received only a high school diploma. Women earned twice as much. (NCES, ``Condition of Education, 2000,'' 2000). College graduates earn on average $600,000 more in their lifetime than people with only a high school diploma. (US Department of Commerce, Bureau of the Census, 1994. Despite the obvious benefits of investments in higher education, funding is declining. Since 1980 to 1998, the cost of higher education has almost tripled, leading to a decline in the purchasing power of federal grant programs. The maximum Pell grant this year is worth only 86% of what it was worth in 1980, making the Perkins program a more important part of low income students' financial aid package. Yet, the numbers of institutes of higher education offering the Perkins Loan Program has declined by 80% over the past 20 years. During the last decade, student aid funding has lagged behind inflation, yet in the next ten years, more than 14 million undergraduate students will be enrolled in the nation's colleges and universities, an increase of 11 percent. One-fifth of these students are from families below the poverty line. Many of them are the first in their families to go to college. The effect of the decline in funding has a disproportionate impact on low income students--the very students that Perkins is designed to help. Studies show that an increase in tuition of $100 lowers the enrollment of low income students by 1%. (McPherson and Shapiro, 1998). In Minnesota, students from families that make $50,000 per year or more are three times as likely to attend a four year college as students from families who make $30,000 per year or less (and I remind my colleagues that 83% of Perkins loans would go directly to these students with incomes less than $30,000.) Further, more than 1/3 of students who enter college drop out. Often this is because they cannot afford to continue. The Perkins Loan Program is vital to helping these low income students enter and stay in college. It would be a shame if the program failed because the government failed to pay universities back the money it owes this valuable program. By increasing the appropriation for the cancellation program, the managers have taken a strong step toward getting the government out of debt. I am also committed to seeing that this program is fully funded in the future. We have on-budget surpluses of $1.9 trillion. We should use this appropriation to ensure that we are not in debt to the 40,000 fewer students who will not receive the Perkins loans they once could have because the federal government did not meet its obligation to pay for its own cancellation program. These are America's poorest students who are simply trying to afford a college education. With a $1.9 trillion surplus, we owe it to them to pay it back.

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I thank my colleague from Pennsylvania for his genuine concern, and the ways in which, as the chair of this committee, he has supported this initiative. He cares about it deeply. I thank him. I am pleased he will accept the amendment. THE PRESIDING OFFICER. If there be no further debate, the question is on agreeing to the amendment.

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

Mr. WELLSTONE. I am pleased to do so.

Mr. WELLSTONE. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. WELLSTONE. Mr. President, might I ask my colleagues, there is some order here. There is going to be a Reed amendment--is that correct?--next, and then a Kennedy amendment. I have an amendment with Senator Reid that deals with mental health and suicide prevention. Might I add that I follow Senator Kennedy? I am ready to keep rolling.

Mr. WELLSTONE. Can I ask my colleague in that sequence, that following Senator Kennedy there be a Republican and then I be allowed-- --

Mr. WELLSTONE. Suicides.

Mr. WELLSTONE. Mr. President, we will move forward and not go through any unnecessary delay. This amendment would support a certification program to improve and evaluate the effectiveness and responsiveness of suicide hotlines and crisis centers in the U.S. and to help support and evaluate a national hotline and crisis center network. Let me go through these figures here on the chart. Suicide facts for our country: Every 42 seconds someone attempts suicide. Each 16.9 minutes someone completes suicide. Suicide is the eighth leading cause of all deaths. Death rates from suicide are highest for those over age 75. The incidence of suicide among 15- to 24-year-olds has tripled over the past 40 years, making it the third leading killer in that age group of 15- to 24-year-olds. In the State of Minnesota, it is the second leading killer of young people from age 15 to 24. These statistics that deal with mental illness and suicides are disturbing. I point out to my colleagues that one of the factors that makes it so disturbing is that so much of suicide is connected to mental illness, especially depression or substance abuse, and so much of it is diagnosable. Frankly, it is treatable. Really, there should be a hue and cry in the country for corrective action. I do a lot of work with Senator Domenici, and I get to do this work with Senator Reid and Senator Kennedy as well. There are a whole host of issues that deal with our failure to provide decent mental health coverage for people. I thank Surgeon General David Satcher for doing marvelous work. The Surgeon General's report, which came out recently, talks about 500,000 people every year in our country requiring emergency room treatment as a result of attempted suicide. In 1996, nearly 31,000 Americans took their own lives. I think of Al and Mary Kluesner in the State of Minnesota who started this organization called SAVE. They themselves have lost two children to suicide. Several of their other children have been unbelievably successful in their lives. There has been, up until fairly recently, this shame and people feeling as if it is their own moral failure. But it has so little to do with that. I met a couple weeks ago with Dr. David Shaffer from Columbia University and Kay Jamison from Johns Hopkins University. She has done some of the most powerful writing. It was Dr. Jamison who said before Senator Specter's committee, ``The gap between what we know and what we do is lethal.'' We know so much about the ways in which we can treat this illness and we can prevent people from taking their lives, but we have not done nearly as much. We have many different organizations that support this amendment. I ask unanimous consent that this list be printed in the Record.

Mr. WELLSTONE. Mr. President, I did not hear the Senator.

Mr. WELLSTONE. I say to my colleague from Pennsylvania, my guess is it will take me about 40 minutes on my side. I prefer not to agree to a time limit. I don't think I will go more than that.

Mr. WELLSTONE. I call up amendment 3644.

Mr. WELLSTONE. I ask unanimous consent reading of the amendment be dispensed with.

Mr. WELLSTONE. I yield back my time.

Mr. WELLSTONE. Mr. President, I come to the floor to offer a very simple amendment. This amendment asks only that we appropriate an additional $10 million to fund the loan forgiveness program which was authorized under the Higher Education Act. This is a loan forgiveness program for women and men who go into child care work. This would be taken from administrative expenses in the overall budget. Despite the fact that we know that child care workers struggle to pay back their student loans, and that all too many of them earn poverty- level wages without benefits, which means in turn that many of them are forced to leave their work for higher paid work, we have yet to appropriate one penny for this forgiveness program. I originally offered this amendment calling for loan forgiveness for those men and women who go into the child care field with Senator DeWine. My thought was this is sacred work. This is important work. This is work with small children. If people are going to be paid miserably low wages--many having no health care benefits at all, and we understand the importance of early childhood development--then let's at least have a loan forgiveness that will encourage men and women to go into this area. Right now the child care situation in the United States is critical. We have a system in place where child care is prohibitively high for working families. It is not uncommon for a family to be paying $6,000 per child, $12,000 per year, $10,000 per year. Maybe the family's overall income is $35,000 or $40,000. At the same time, we have child care workers who are taking care of children during the most critical years of development and they don't even make poverty wages. It seems counterintuitive. How can it be that on the one hand child care is so expensive, but on the other hand those men and women who work in this field are so underpaid? The problems of the high costs and the low wages are inevitable under the current system of child care delivery in the United States. Colleagues, this amendment is just one vote, but this is a central issue of American politics. Talk to working families in this country and they will list child care as one of their top concerns. They are not just talking about the cost of child care, but they are also saying when both parents work, or as a single parent working, they worry most of all that their child is receiving the best care--not custodial, not in front of a television for 8 hours, but developmental care. On a personal note, I can remember as a student at the University of North Carolina, barely age 20, Sheila and I had our first child. I will never forget, 6 weeks after David was born, Sheila had to go back to work. That is all the time she could take off. Six weeks is not enough time to bond with a child. We had hardly any money. We asked around and we heard about a woman who took care of children. We took David over. After about 3 days of picking him up, every day he was listless. Before he had gone to this child care, this home child care setting, he was engaged and lively. It was wonderful. I was at school, I was working; Sheila was working. At 5 o'clock or 5:30 we would come to pick him up and he was listless. Finally, after 3 days I got concerned and I showed up at her home in the middle of the day. The problem was she had about 20 children she was trying to take care of. Most of them were in playpens and she had stuck a pacifier in their mouth and they were receiving no real care. There was no real interaction. Parents worry about this. I argue today on the floor of the Senate, one of the keys to making sure there is decent developmental child care--not custodial child care--is to have men and women working in this field being paid a decent wage. Right now, we have a 40-percent turnover in this field. Who pays the price? The children. I have said on the Senate floor before, when I was teaching at Carleton College as a college teacher for 20 years, I had conversations with students who came to me and said: Look, don't take it personally. We think you are a good teacher, Paul, and we really appreciate your work as a teacher. But we would like to go into early childhood development. The problem is, when you make $8 an hour, with no health care benefits, and you have a huge student loan to pay off, especially at a college like Carleton, you can't afford to do it. Some of the people want to go into this field, which we say is so important, but they can't afford to do it. The least we could do is have a small loan forgiveness program. The result of the system we have right now is poverty-level earnings for the workforce. By the way, who are the child care providers in the country today? Mr. President, 98 percent of them are women, and one-third of them are women of color. We can do a lot better. We pay parking lot attendants and men and women who work at the zoos in America twice as much as we pay those men and women who take care of our small children. Something is profoundly wrong when we pay people who care for our cars and our pets more money than we do for those who care for our children. Let me go over the facts. The average teacher based at a child care center earns roughly $7 an hour. Despite above average levels of education, roughly one-third of the child care workers earn the minimum wage. Even those at the highest end of the pay scale, who are likely to have a college degree and several years of experience, make about $10 an hour. Family child care providers--a lot of child care is in homes-- make even less money. People who care for small groups of children in their home make on average about $9,000 per year after all expenses are figured in. A recent study by the Center For The Childcare Workforce finds that family child care providers earn on the average, when you take into account their costs, $3.84 an hour, given their typical 55-hour week. Not only that, but the majority of child care workers in our country receive no health benefits, despite high exposure to illness. A lot of kids, when they come, have the flu and they pass it around. Fewer than one-third of the child care providers in this country today have health insurance, and an even smaller percentage of child care workers have any pension plan whatsoever. A recent study in my State of Minnesota found that only 31 percent of child care centers offered full-time employees fully paid health care. The consequences of these dismal conditions are clear. Let me just put it into perspective for colleagues. In the White House Conference on the Development of the Brain, they talked about how important it is that we get it right for children in the very early years of their lives. The medical evidence is irrefutable and irreducible that these are the most critical years. We all want to have our pictures taken next to children --the smaller the children are, the better. Yet at the same time we have done so precious little to make a commitment to this area. We have child care workers, men and women who work in these centers, who do not even make half of what people make who work in our zoos. I think work in the zoo is important, but I also think work with small children is important. We have the vast majority of child care workers barely making minimum wage or a little bit above, only about a third at best having any health care coverage whatsoever. Senator DeWine and I, several years ago, help pass a bill that authorized some loan forgiveness so you would have men and women who could go to college, with the idea they would go into this critically important field and their loans would be forgiven. What I am trying to do, taking it out of administrative expenses, is just finally to get a little bit of appropriation; start out with $10 million so we finally set the precedent that we are willing to fund this. We have not put one penny into this program so far. What happens is that we have this high turnover. As I said before, probably about 40 percent or thereabouts of child care workers in any given year go from one job to another. That figure may be a little high, but it is a huge turnover. Who pays the price? The children pay the price. As I look at my own figures, I guess it is about a third, a third of this country's child care workforce leaves the job each year because they are looking for better work. This leads to a dangerous decline in the quality of child care for our families. The most dangerous decline in quality is the care for toddlers, for infants. They are exposed to the poorest care of all. We have not appropriated one cent for the loan forgiveness program we authorized 2 years ago, and at the same time you have 33 percent of child care workers every year leaving, and you don't have the continuity of care for our children, for families in this country. At the same time, it is the infants and the toddlers who are the ones who are most in jeopardy. At the same time, we have not made any commitment whatsoever to at least--at least, this doesn't change everything in the equation--make sure we have a loan forgiveness program. Another thing that is happening is that as we begin to see a severe teacher shortage, a lot of child care workers are saying that they can't make it on $8 an hour with no health care benefits. A lot of younger people say they can't make it on $8 an hour with no health care benefits and a big loan to pay off. They now become our elementary school teachers or middle school teachers. As a result, what you have is, at the same time the number of child care providers is decreasing, the number of families who need good child care for their children is dramatically increasing. That is not just because of the welfare bill, but because the reality of American families today, for better or for worse--sometimes I wonder--is that you just don't have one parent staying at home. In most families, both parents are working full time. This is a huge concern to families in this country. We could help by passing this amendment. I want to talk about one study in particular that I think, in a dramatic way, puts into focus what I am talking about. It was a recent study by the University of California at Berkeley and Yale University. They found that a million more toddlers and preschoolers are now in child care because of the welfare law. That wouldn't surprise anyone, given the emphasis on people going to work. So far, so good. But they also found that many of these children are in low-quality care, where they lag behind other children in developmental measures. This was a study of 1,000 single mothers moving from welfare to work. They wanted to know where were their children. What they found out was their children were, by and large, placed in child care settings where they watched TV all the time, wandered aimlessly, and there was little interaction with caregivers. Here is the tragedy of it. Many of these toddlers from these families showed developmental delays. Would anybody be surprised? Anyone who has spent any time with small children would not be surprised. When asked to point to a picture of a book from among three different pictures, fewer than two in five of the toddlers in the study pointed to the right picture compared to a national norm of four out of five children. One of the study's authors is quoted as saying: We know that high quality child care can help children and that poor children can benefit the most. So we hope that this will be a wake-up call to do something about the quality of child care in this country. The quality of daycare centers is not great for middle class families, but it is surprising and distressing to see the extent to which welfare families' quality was even lower. I simply want to point out that just because a family is a welfare family or just because a family is a poor family does not mean these small children are not as deserving of good child care. That is not the situation today in the country. Ironically, as we see the child care system deteriorating, we are now putting more and more emphasis on the importance of developmental child care. We are saying at the same time that we want to make sure single parents work and families move from welfare to work. We are putting the emphasis on work, and more families have to work to make it. The median income in our country today is about $40,000 a year. The income profile is not that high. We know investment in early childhood development pays for itself many times over. We know good child care programs dramatically increase the chances for children to do well in school, for children to go on beyond K-12 and go to college and do well in their lives, and we know the lives of low-income families, in particular, quite often lack some of the advantages other families in this country have. Children from low-income families do not always have the same vocabulary; there is not always the opportunity for a parent or parents to read to them. Therefore, the learning gap by kindergarten is wide. Some children start way behind, and then they fall further behind. I cite one study which began in the seventies on the effects of early childhood intervention. Children who received comprehensive, quality, early education did better on cognitive, reading and math tests than children who did not. This positive effect continues through age 21 and beyond. Parents benefit as well. I do not understand where our priorities are. We should want to make a commitment to working families in this country and make a commitment to children. I want to give some evidence from the State of Minnesota, and then I will finish up at least with my first comments. This loan forgiveness program works. First, it gives people an opportunity to go to college who want to become child care workers. Second, the turnover is reduced. Third, this means we get better people. My own State of Minnesota has experimented. We have a State level loan forgiveness program. In 1998, we offered child care providers up to $1,500 in forgivable student loans for the first time. Fifty percent of the money was set aside for what we call the metro area, and 50 percent of the money was set aside for greater Minnesota, outside the metro area. The money was awarded on a first come, first served basis. People began lining up on the first day. In the metro area, all the money was gone by 5 p.m. on the second day, and all of the money for rural Minnesota was awarded within 2 weeks. This year, Minnesota has made over $900,000 available through their loan forgiveness program. They started accepting applications in March, and they have committed nearly half the money to family care providers and 50 percent to center-based providers. A lot of it goes to rural Minnesota and a lot of it goes to urban Minnesota. I am saying to my colleagues, I am hoping I can win on this amendment. I take it out of administrative expenses. We know the budget is going to be better for this Health and Human Services bill. We know we do not have a good budget with which to work right now. We know the cap is going to go up. We know we are going to have more resources with which to work. We all say we are committed to developmental child care. It is one of the top issues of working families. It seems to me several years ago--I did this with Senator DeWine--we authorized legislation that called for loan forgiveness to men and women who want to go into this critical area, and we have not appropriated one penny. We can at least find it in our hearts and find our way to put some appropriations into this legislation. I am calling for $10 million as a start. I am saying to Senators today--and I do not think anybody can argue with me--there is not one Senator who can dispute the clear set of facts that we have to get it right for children. We have to get it right for them before age 3, much less before age 5. Nobody can argue with that. Nobody can argue these are not critical developmental years. Look at the spark in their eyes. They are experiencing all the unnamed magic in the world before them, as long as we encourage them. No one can argue that for working families this is not a huge issue, both the expense of child care, which I cannot deal with in this amendment, and the quality of the care for their children. If both parents are working or a single parent is working, there is nothing more important to them than making sure their child is receiving the best care. They do not want their child warehoused. They do not want their child in front of a television 8 hours a day. They want to make sure their child is stimulated. They want to make sure there is nurturing for their child. They want to make sure there is interaction with their child. I do not know how some of the people who work in the child care field do it. They are saints; they do it out of love for children; but they should not be the ones who subsidize this system. We are not going to have good people in the child care field if they are making $8 an hour. We are not going to have good people if they do not have any health care benefits. I cannot deal with that in this amendment, but I can deal with one thing. I can call on my colleagues, Democrats and Republicans, who say they are committed to good child care, who say they are committed to family values. If they are committed to family values, what better way to value families than to make sure that when people are working, their children are receiving good care? What better way to make sure that happens than to do something about the one-third turnover every year? How can we best deal with the one-third turnover? We need to do a lot of things, but this amendment in its own small way helps. I am simply saying we ought to at least put $10 million into this loan forgiveness program so we can encourage men and women--frankly, I would like to see more men in this field; it is almost all women in this field. At least they know their loan will be forgiven. That will make a huge difference. That is all this amendment is about. I also say to my colleagues, I offer this amendment on behalf of myself and Senator DeWine. I am so pleased Senator DeWine is a cosponsor. I have done a number of different bills and legislation with Senator DeWine. We did the Workforce Investment Act together, and we did this authorization together. I do not think we are asking too much. This is actually a crisis. The fact is, the studies that have come out about the quality of child care in this country are pretty frightening. Sometimes it is downright dangerous, but almost always it is barely adequate, and we have to do something about it. One of the best ways we can show we care is to at least begin putting some funding into this loan forgiveness program. I reserve the remainder of my time if, in fact, there is substantive debate on this issue. Otherwise, I will make a few other points. I reserve the remainder of my time.

Mr. WELLSTONE. Mr. President, I thank my colleague from Alaska. And if this is not presumptuous of me to say, normally I like to call for a recorded vote, but I would be pleased to have a voice vote, if that is what my colleague wants. And there is one reason why. I can't get an ironclad commitment from the Senator from Alaska, but I make a plea to him to please try to help me keep it in conference. It would be a small step toward getting funding for this. I know the Senator is very effective. I don't need to have a recorded vote if he can at least tell me he will certainly try.

Mr. WELLSTONE. Mr. President, I am very glad to hear that. I think I would be pleased to go forward with a voice vote.

Mr. WELLSTONE. Mr. President, I will be quite brief. I apologize. I didn't realize the amendment was coming up now. Senator Reid and I were doing this together. Probably 10 minutes is what I will need. My understanding is that the Senator from Pennsylvania, who has been focused on suicide prevention and trying to do better with mental health treatment, would accept the amendment. I think I can do this in 10 minutes.

Mr. WELLSTONE. I object. I say to my colleague from Pennsylvania, I haven't been out here on the amendment. He knows that, and I don't want the Senator from Nevada to only have a few moments. It is an important issue. I don't think we can do it in that time.

Mr. WELLSTONE. Mr. President, what this amendment does is add $3 million to SAMHSA to support, through grants, a certification program that would evaluate the effectiveness and responsiveness of crisis centers and suicide hotlines across the United States. It also helps to support a national hot line and crisis center network. There are 750 such crisis services in place across the country today. These centers are documented in the directory kept by the American Association of Suicidology. To date, there has been little or no funding to help support the training and to improve the quality of guidance through these hot line and crisis services. This amendment does exactly that. These funds will be used to improve the training and the skills of the staff at the crisis hot lines for suicides. There will be a variety of ways in which we can get the money to people so this work can be done. In awarding these grants, I encourage the Secretary of Health and Human Services to collect an experienced nonprofit organization with significant expertise to administer this program. According to U.S. Surgeon General David Satcher, approximately 500,000 people each year require emergency room treatment as a result of attempted suicide. In 1996 alone, nearly 31,000 Americans took their own lives. In the U.S., suicide is the third leading cause of death of people age 15-34. A suicide takes place in our country every 17 minutes. In some parts of our country, including my own state of Minnesota, suicide is the second leading cause of death for these young people. Three times the number of Minnesotans die from suicide than from homicide. We know, without a doubt, that 90 percent of all completed suicides are linked to untreated or inadequately treated mental illness or addiction. To prevent suicide requires an all-out public health effort that will recognize this problem, and will educate our country that we can no longer afford to turn our eyes away from the unthinkable reality that our citizens, even our children, may want to die. Dr. Satcher and other national mental health experts, such as Dr. Steve Hyman, Director of the National Institute of Mental Health, have helped bring this issue forward, and to help us understand that, with proper treatment, this is one of the most preventable tragedies that we face as a country. In 1996, the World Health Organization also issued a report urging members worldwide to address the problem of suicide, and one result was the creation of a public/private partnership to seek a national strategy for the U.S., involving many government agencies and advocacy groups. This is clearly a serious problem throughout the world. For too long, mental illness has been stigmatized, or viewed as a character flaw, rather than as the serious disease that it is. A cloak of secrecy has surrounded this disease, and people with mental illness are often ashamed and afraid to seek treatment, for fear that they will be seen as admitting a weakness in character. For this reason, they may delay treatment until their situation becomes so severe that they may feel incapable of reaching out. Although mental health research has well-established the biological, genetic, and behavioral components of many of the forms of serious mental illness, the illness is still stigmatized as somehow less important or serious other than illnesses. Too often, we try to push the problem away, deny coverage, or blame those with the illness for having the illness. We forget that someone with mental illness can look just like the person we see in the mirror, or the person who is sitting next to us on a plane. It can be our mother, our brother, our son, or daughter. It can be one of us. We have all known someone with a serious mental illness, within our families or our circle of friends, or in public life. Many people have courageously come forward to speak about their personal experiences with their illness, to help us all understand better the effects of this illness on a person's life, and I commend them for their courage. The statistics concerning mental illness, and the state of health care coverage for adults and children with this disease are startling, and disturbing. One severe mental illness affecting millions of Americans is major depression. The National Institute of Mental Health, an NIH research institute, within the U.S. Department of Health and Human Services, describes serious depression as a critical public health problem. More than 18 million people in the United States will suffer from a depressive illness this year, and many will be unnecessarily incapacitated for weeks or months, because their illness goes untreated. Many will die. I recently had the good fortune to meet with a group of some of the foremost experts on suicide prevention, including Dr. David Shaffer, from Columbia University, and Dr. Kay Jamison, from John Hopkins University. They gave me an extraordinary overview of the many critical points of intervention where suicide may be prevented, and it is my intention to develop a larger bill, in collaboration with Senator Harry Reid, and hopefully many of my colleagues, that will address many of these issues. But this amendment will meet an important need right now, one that is timely, and even with its modest funding can help save many lives. This amendment has the support of Senators Reid and Kennedy, as well as the support of the national groups: American Association of Suicidology, American Foundation for Suicide Prevention, SPAN (Suicide Prevention and Advocacy Network), National Mental Health Association, National Alliance for the Mentally Ill, American Psychiatric Association, American Psychological Association, Bazelon Center for Mental Health Law, and SA/VE, a group based in Minnesota (Suicide Awareness/Voices of Education), headed by Al and Mary Kluesner. My amendment will add $3 million to SAMHSA to support through grants a certification program to improve and evaluate the effectiveness and responsiveness of crisis centers and suicide hotlines across the United States, and to help support a national hotline and crisis center network. Although there are 750 such crisis services in place across our country--these centers are documented in the directory kept by the American Association of Suicidology--to date there has been little or no funding to help support the training and improve the quality of the guidance that is provided through these hotline and crisis services. This amendment will do exactly that. These funds will be used to help improve the training and skills of the staff at crisis hotline suicides, through guidance provided by the American Society of Suicidology, the Center for Mental Health Services, the National Institute Mental Health, and other mental health professionals. It will also help support the development of a national hotline and network of certified crisis centers. In the awarding of grants, I would encourage the Secretary of HHS to select an experienced non-profit organization with significant expertise in this area to administer the certification process, so that this process of training can begin as quickly as possible. Telephone hotlines are only one of the points of intervention, and are not and cannot be the only solution to those who suffer from severe mental illness and the extraordinary despair that leads to suicide. Our country also needs to ensure that Americans have fair access to medical care, that the stigma associated with mental illness is reduced, and more education and training for health care providers is made available. But the hotline does provide a lifeline for those who need to reach out for help and have nowhere else to turn too when they reach the point of despair. The crisis centers that run suicide hotlines are often patched together through a variety of funding sources, and struggle to keep their staff trained and their services of the highest quality. Although some centers are certified by the American Association of Suicidology, and some are connected through the Hope Line Network that is working to establish a national network, this process has only just begun. These centers perform a critically important service and would benefit enormously from a national certification process and regular staff training. The time is right to fund such a process. Staff at crisis centers need to be trained to conduct a suicide risk assessment to determine the seriousness and urgency of someone who may be contemplating suicide. They also need to know when to refer the individual to a local community mental health provider if the person is not in crisis. But most importantly, they need to know when to send the police to the person's home or workplace if the staff person is convinced that a suicide is about to take place. Most people think that there is a national suicide hotline already in place that links people throughout the country. But until recently, this was not so. Crisis centers operated on their own, with volunteer help, and few resources. Recently, a national hotline number (1-800- SUICIDE) was established through the Hope Line Network, through the National Mental Health Awareness Campaign. As an example of the incredible need for such a number, the national hotline found itself flooded with calls after recently advertising on MTV and Fox Family Channel. Additionally, 1.5 million Americans logged onto their website during the 2 weeks after this advertising began. There are obviously many people who are in need of this service. And it needs to be the best possible service, and linked as best it can be to local help. By improving the training and skills of crisis hotline operators, such contact can be of the highest quality. Certification would require rigorous on site training and visits, evaluation of operations, records reviews, verification of staff training and skills, and the like. The Surgeon General is to be commended for bringing this issue of suicide forward as a major public health crisis in his 1999 report, Call to Action to Prevent Suicide. In his report, he specifically cited the need for instituting training programs concerning suicide risk assessment and recognition, treatment, management, and aftercare intervention. He also asked that community care resources be enhanced as referral points for mental health services. This amendment helps to support both of these requests. I must emphasize that suicide is often linked to severe depression and other forms of mental illness. These illnesses are not the normal ups and downs everyone experiences. They are illnesses that affect mood, body, behavior, and mind. Depressive disorders interfere with individual and family functioning. Without treatment, the person with a depressive disorder is often unable to fulfill the responsibilities of spouse or parent, worker or employer, friend or neighbor. And far too often, without treatment, a person can reach such a level of despair that they will take their own life. This amendment will fund programs to help people get the treatment they need before it is too late. As Dr. Kay Redfield Jamison stated in a recent Senate hearing on suicide, when it comes to treatment for mental illness, ``the gap between what we know and what we do is lethal.'' The issue of suicide prevention is one that we have discussed before, at a hearing held by Senator Specter, and during other discussions about mental health research and treatment. I am proud of my colleagues who have supported these efforts, including the cosponsors of this amendment, Senator Reid and Senator Kennedy. I am proud to join them in bringing this amendment forward, and I ask you for your support. There is a piece of legislation I have with Senator Domenici called the Mental Health Equitable Treatment Act. We believe, especially when it comes to physician visits and days in hospitals, that people with a mental illness should be treated the same way as people with a physical illness. We think it is time to end this discrimination. I have two other amendments that are included in other legislation which deal with the problem of suicide and mental health--especially with young people--and ways of getting money to communities that can then put the money to use, whether it be substance abuse treatment programs, whether it be family counseling, or whether it be pharmacological treatment, or you name it. The amendment I introduced with Senator Reid is very basic. It is very straightforward. It basically provides the grants through a certification program to improve the effectiveness of these suicide hot lines and crisis centers in the United States. It will help them support and evaluate a national hot line and crisis center network. I say to my colleague from Nevada that this is really incremental. It is not the be all or the end all. But the additional resources will really help SAMHSA. It will help us make sure these crisis hot lines are put to the very best use; that the people who are working there have the best training; that people who will be working these lines will do their very best in taking calls and know how to help people. This is important. It is a network of support for people. It is one step and only one step. But I will finish my remarks and then hear from my colleague from Nevada who really is taking the lead on this amendment. Again, every 42 seconds someone in our country attempts suicide. Every 16.9 minutes someone completes suicide. Suicide is the eighth leading cause of all deaths. This one really gets to me. I admit that until I saw this--I believe I do a lot of work in the mental health area--I didn't realize the suicide rates are highest for those over age 75. I didn't realize that. My focus has really been on young people because in my State of Minnesota, for the age of 15 to 24, suicide is the second leading cause of death. We need to do better. In this piece of legislation, we take this funding from administrative services and put it into this program. I think it will make a very positive difference. I am delighted that my colleagues on the other side of the aisle are going to support this amendment.

Mr. WELLSTONE. Mr. President, two things. First, I thank the Senator from Nevada for his comments. Second, I say to Senator Specter, I am sure he remembers when Kay Jamison testified before his committee, saying the gap between what we know and what we do is lethal. This is just a small step. I am hoping that the Senate--the sooner the better-- will embrace this issue and put some resources back to communities that can put this money to work in terms of suicide prevention. Much of this is diagnosable and preventable. We have some confusion. Before I agree, I say to Senator Reid, I want to suggest the absence of a quorum. We have a disagreement about how we will deal with this amendment.

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

Mr. WELLSTONE

Mr. WELLSTONE. Mr. President, I ask unanimous consent that Vinu Pillai, an intern, Nina Rossomando, a fellow, and Ellen Gerrity be allowed the privilege of the floor this afternoon.

Mr. WELLSTONE

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

Mr. WELLSTONE. Mr. President, I ask the Senator from Pennsylvania and the Senator from Iowa whether or not I should lay down my amendment, and then set it aside when other Members come out. I am pleased to come into play here, if that would help.