Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2004-Continued

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2004—CONTINUED

Mr. SPECTER. Mr. President, I thank the Senator from Iowa for what he has done. I am delighted to join him in sponsoring the amendment to name the Muscular Dystrophy Operative Research Center after Senator Wellstone. Senator
Wellstone attended many of our appropriations subcommittee hearings on neurological disorders and was a tireless advocate for medical research regarding the cause of muscular dystrophy. He was the original sponsor of the Muscular Dystrophy Care Act of 2001. This was the first disease-specific piece of legislation in the 107th Congress, the first major piece of health care legislation signed by President George Bush, and the first piece of legislation to ever address a very lethal childhood disorder.

Just a few weeks before he died, Senator Wellstone visited a little boy named Jacob who was afflicted with muscular dystrophy. He and Jacob made some television ads, which sadly didn't air because of Senator Wellstone's tragic death. Senator Wellstone made a difference in the lives of thousands of children afflicted with this deadly disease. He leaves a legacy of unprecedented Federal commitment to muscular dystrophy research and development. I have no doubt that someday soon we will win the fight against muscular dystrophy because of Paul Wellstone's work.

Mr. President, I yield to my distinguished colleague from Pennsylvania, Senator Santorum.

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Mr. SPECTER. Mr. President, I congratulate the Senator from Ohio for his outstanding work. I congratulate my colleague from Pennsylvania for his contribution. The Senator from Ohio only talked to me about this amendment about 79 times during the course of the last 2 days. To say that he was persistent would be a vast understatement.

We are prepared to accept this $61 million for the global AIDS for the CDC, of which $60 million is for the mother-to-child transmission prevention initiative and $1 million is for other global AIDS activities. This offset will be made from the administrative costs of the Departments of Labor, Health and Human Services, and Education.

During the course of the debate, we have had a great many AIDS amendments offered, and we wish we could have accepted more of them. But this particular one is very precisely targeted. I know the Senator from Ohio just came back from Africa and feels very deeply about this issue.

We are pleased to accept this amendment, with our compliments to the Senator from Ohio, Mr. DeWine, the Senator from Pennsylvania, Mr. Santorum, and the Senator from Illinois, Mr. Durbin.

I yield the floor.

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CENTERS FOR CHILDREN'S ENVIRONMENTAL HEALTH AND DISEASE PREVENTION RESEARCH

Mr. SPECTER. I am glad to join Senator Harkin in confirming our intent that funding in the Labor-HHS appropriations bill be used in part to continue funding 12 Centers for Children's Environmental Health and Disease Prevention Research. These centers were established through a joint initiative of the Environmental Protection Agency and the National Institute of Environmental Health Sciences, and combine a new, unique, multidisciplinary approach to researching, identifying, treating, and ultimately preventing health risks posed to children by environmental hazards in the communities in which they live, play and attend school. As you know, we do not earmark NIH.

I ask Senator Clinton, how much does NIEHS provide in funding for the centers?

Mrs. CLINTON. NIEHS has provided $750,000 per center, for a total of $9 million per year to provide for direct and overhead costs that the centers incur. I hope that EPA will also continue to hold up its end of the funding to continue funding 12 centers. I thank Senators Specter and Harkin for their continued support of the centers, which are directly in line with our shared goal of addressing environmental factors that may cause or contribute to childhood illnesses such as asthma, or that can interfere in the proper growth and development of our Nation's children.

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Mr. SPECTER. Mr. President, I thank my esteemed colleague, the Senator from Hawaii, for bringing this matter to our attention and I look forward to working with him and the NIH to resolve this matter. This subcommittee has successfully doubled the NIH budget over the last 5 years. Thus this speaks to this subcommittee's commitment to all types of scientific health research, including behavioral health.

Basic behavioral research is essential if we are to successfully address the many public health issues plaguing our Nation.
Since September 11, 2001, the psychological and physiological effects of terrorism and stress became real to all Americans across this great Nation. It is imperative that we, as a nation, better understand the psychological effects of sustained stress and the role of the behavioral health sciences in the prevention and treatment of the leading causes or morbidity and mortality. The leading causes of death and chronic illness are related to high risk behaviors such as: unintentional injuries and violence, tobacco use, alcohol and drug use, dietary behaviors, sexual behaviors, and inactivity. I am committed to working with you and Senator HARKIN to help ensure that NIH understands the wishes of this Subcommittee.

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Mr. SPECTER. I commend my friend from California for her tireless dedication to ensuring the protection of unaccompanied alien children. Indeed, it was her efforts last year that brought about the transfer of responsibility for these vulnerable children to ORR. I am pleased to have been a supporter of those efforts.

As the Senator knows, the President requested $34.227 million for unaccompanied alien children for fiscal year 2004. The allocation levels the subcommittee received for fiscal year 2004 were so low, the committee had to reduce the overall funding for ORR beneath the President's request. Nonetheless, the committee recommended the full $34.227 million for fiscal year 2004 for unaccompanied alien children that the President requested.

Mrs. FEINSTEIN. I thank the Senator. It is important to note that in making its initial request for fiscal year 2004, the administration acknowledged that it was a preliminary estimate based on less-than-complete information. Since the administration made its initial budget request last January, it has become evident that ORR will need more funds in order to fulfill its unaccompanied alien child responsibilities.

In talking with experts who work with these children as well as with administration officials, it has become evident that this important program will need at least $20 million in additional funding to order to operate effectively in fiscal year 2004.

As the Senate knows, I was prepared to offer an amendment to this bill that would appropriate the additional $20 million for these programs, bringing the total appropriation for unaccompanied alien children for fiscal year 2004 to $54,227,000.
This anticipated that the additional $20 million being appropriated for these functions would be derived from unused refugee and entrant funds from prior fiscal years. These funds have gone unused because of the unfortunate shortfalls that have occurred in refugee admissions during the last several fiscal years.

In the interest of time and in deference to the delicate balance that the committee was forced to achieve in putting together this bill, I will not offer this amendment at this time. However, I ask the chairman for some assurance that he will work with House conferees to secure a minimum of $54.227 million for these functions in conference.

Mr. SPECTER. I thank my friend from California for withholding from offering her amendment. The Senator is correct that the program would benefit greatly from an additional $20 million, and I am dedicated to helping secure that funding before the end of this process.

As the Senator knows, the House mark for Refugee and Entrant Assistance was $33.797 million higher than the Senate was able to recommend. Should the conferees reach agreement on overall ORR funding that is closer to the Senate mark than the House mark, I will work with my colleagues in the Senate and the House to achieve an appropriation for unaccompanied alien children along the lines of the amendment that you have so graciously agreed to withdraw.

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Mr. SPECTER. Mr. President, I thank the Senator from New Hampshire for his support for the subcommittee's efforts in this regard. We should all be concerned about the scourge of obesity among our Nation's youth, and I am committed to assisting the necessary partnerships and programs needed to reverse these devastating trends. Those efforts should include private organizations such as the YMCA to the extent possible and government at all levels should be working with such groups to develop and implement after school physical activity programs to reduce and prevent obesity. I am delighted to work with my colleague from New Hampshire to ensure that national nonprofit organization's like the YMCA and Jewish Community centers have an opportunity to play a leading role in helping achieve the President's goals for a healthier America.

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VACCINE STOCKPILE

Mr. SPECTER. I am glad to join Senator Harkin in confirming our intent that the Vaccines for Children program funding in the Labor-HHS Appropriations bill be used in part to stockpile a 6-month supply of childhood vaccines. Only a year ago, doctors had to turn families away at the door because of national vaccine shortages for eight out of the eleven vaccine-preventable diseases. During the vaccine shortage, children became ill with pneumococcal meningitis and pneumonia, diseases that could have been prevented with an adequate supply of the pneumococcal vaccine. Fortunately, we have witnessed some significant progress since then, which is a credit to a collaborative effort by public health officials, vaccine manufacturers and providers. Shortages have stopped, and childhood vaccines for eleven different diseases are no longer being delayed.

Mr. HARKIN. During the crisis, the HELP Committee met on multiple occasions to study this important issue. I want to thank my friend from Pennsylvania and join him in affirming that it was our intent to use funding in this bill to stockpile a 6-month supply of childhood vaccines. Despite the efforts of the committee and the collaborative effort by many others on this important public health issue, I understand that my home State of Iowa, like the rest of the Nation, only has a one-to-two month stockpile for some of the routinely recommended childhood vaccines. Senator Reed, is it accurate to state that these shortages, temporarily alleviated, could return at any time?

Mr. REED. Yes, unfortunately, the General Accounting Office report confirmed that a pause in production for safety reasons could happen again and would have a critical and devastating impact on the ability to vaccinate children and adults. That is why I appreciated the administration's announced commitment to provide funds in the 2004 Budget for a vaccine stockpile. Senator Clinton, how much funding does the administration plan to provide in Fiscal Year 2004 for a stockpile?

Mrs. CLINTON. The administration plans to provide $124 million in fiscal year 2004 so that it can store a 6-month supply of childhood vaccines by 2006. I thank Senators Specter and Harkin for affirming the administration's commitment to prevent further vaccine shortages by stockpiling a 6-month supply of childhood vaccines. Senators DeWine and Reed and I introduced the Childhood Vaccine Supply Act along with to strengthen and support the administration's authority in these efforts and assure that the stockpile includes adults as well as all children, who were affected by the tetanus-diphtheria toxoid shortage last year. Senator DeWine, is a vaccine stockpile sufficient to prevent future shortages?

Mr. DEWINE. No. We also need an additional buffer because CDC acknowledges that it will take until 2006 before we can have a six-month stockpile of childhood vaccines. That is why I joined you and Senator Reed in introducing the Childhood Vaccine Supply Act, which would provide a notification mechanism so that CDC can work with other manufacturers to maintain the vaccine supply when a manufacturer cannot produce an adequate supply of vaccine. Each of the four major vaccine producers has stated that they do not object to this sort of an advance notice provision. We have worked amicably with Senators Frist, Gregg, and Kennedy on both of these vaccine provisions. We have worked amicably with Senator Frist on this issue and our vaccine provisions, and fully expect to continue working with this bipartisan group of Senators to accomplish the important goal of assuring safe vaccines for all children.

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Mr. SPECTER. Mr. President, I thank my colleagues from Hawai'i, Virginia, and Nebraska for raising this very important issue. I agree that the funding levels for Mentoring Programs and Mentoring for Children of Prisoners should be examined carefully in Conference. We have a great many wonderful mentoring programs throughout Pennsylvania that could use more funding in order to continue their good work with young people.

I applaud the three Senators in their goal that these two programs receive the $75 million funding level proposed by the other body. I will work with them and my colleagues in the other body to try to achieve this goal during conference.

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Mr. SPECTER. Mr. President, I thank the distinguished majority leader for his comments and for his leadership on these very important issues. He has truly been a leader in this area, and he has consistently pushed for improvements in Federal programs to eliminate health disparities. In fact, he authored the Title VII and Title VIII Reauthorizations as chairman of the Senate Health, Education, Labor, and Pensions Committee's Public Health Subcommittee during the 105th Congress.

As he knows, our subcommittee has a long history of supporting HRSA's Health Professions Training programs. Senator
HARKIN and I appreciate the contributions these programs make to our provider workforce through a variety of scholarships, loans, grants and contracts. Unfortunately, the allocation that was provided to the subcommittee for FY04 did not permit us to fully support these worthy initiatives. I agree with the majority leader that a restoration of funding for all health professions programs should be our goal in conference. I am pleased to commit to the majority leader that I will do all I can to fully restore funds for the four diversity programs and, at a minimum, bring funding for the other programs to the House level.

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Mr. SPECTER. I thank the distinguished Senators from South Carolina and Iowa. The Senate Appropriations Committee approved $2,496,889,000 for Medicare operations, the full amount of the President's budget request and an increase of $110,209,000 over the FY 2003 level. I share your concerns that beneficiaries and providers receive the highest level of service by adequately funding Medicare contractors. We also must ensure that the trust fund is protected by adequately funding MIP.

I thank the Senator from South Carolina and the ranking member of the subcommittee for raising these important issues, and
I offer my commitment to work with you both to provide Medicare contractors with the resources needed to best serve beneficiaries and providers as well as encourage this Congress to authorize an increase in the MIP funding so that we may appropriate those critically needed dollars.