Departments of Labor , Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 -- Continued
Floor Speech
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION APPROPRIATIONS ACT, 2008--Continued -- (Senate - October 23, 2007)
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Mr. SANDERS. Madam President, let me take this opportunity to thank Senator Harkin and his staff for their very hard work on the Labor-HHS legislation and commend the ranking member, Senator Specter, and his staff as well. The reality is that the needs facing the people of our country who are impacted by this bill are enormous. There is, unfortunately, not enough funding available to accommodate those needs, and within that context, Senator Harkin and Senator Specter have done their very best.
I wish to say a few words about one particular program which is important to me, which is important to the people of Vermont, and which is vitally important to this whole country as we try to deal with the health care crisis our country is now facing, a crisis in which 47 million Americans have no health insurance, even more are underinsured, and the cost of health care is soaring every day. What this legislation deals with and I think deals with quite well is understanding that it is important for us to grow the number of community health centers in this country.
The community health center program is a wonderful success story, and it is widely recognized as one of the most cost-effective programs in the entire Federal Government. Community health centers are community-run. They are run by the people in the community themselves. They are run on a nonprofit basis. They provide not only affordable health care to their people but affordable dental care, which is a growing crisis all over rural America and in the State of Vermont. They provide mental health counseling--another serious issue. They provide low-cost prescription drugs--in fact, the lowest cost prescription drugs available in America.
These federally qualified health centers serve people from all walks of life and all incomes. Whether you have private insurance, whether you have Medicare, whether you have Medicaid, or whether you have no health insurance, you are welcome into these community health centers. For those with no health insurance, payment is based on a sliding scale. If you don't have a whole lot of money, you don't have to pay a lot for your health or dental care.
Today, over 16 million Americans--16 million--benefit from the services health centers provide in every State and in almost every congressional district in our country. For an average Federal grant expenditure of only $124 per patient per year, these centers offer comprehensive health care, regardless of ability to pay. At a time when more and more Americans are losing their health insurance, when they are finding it hard to secure primary health care, these centers play an extraordinary role, and they deserve to be adequately funded.
This legislation provides $2.24 billion for the community health center program--a $250 million increase above the fiscal year 2007 level. I thank Senators Harkin and Specter very much for their support for this program. It is estimated that this increase will allow us to expand or create some 500 new community health centers all over this country, serving an additional 2 million Americans. That is a big deal at a time when millions and millions of people are unable to find primary health care or just don't have the funds to pay for it. Given the fact that we have 47 million uninsured, it is clear this is not enough, but it is a significant step forward.
In Vermont in recent years, we have expanded the number of federally qualified health centers from two to six, and my hope is that we can add an additional three or four more centers in the next 3 years. These centers now serve over 86,000 Vermonters and provide quality health care, quality dental care, low-cost prescription drugs, and mental health counseling in some 23 different locations around the State of Vermont. The centers are the medical home for 24 percent of Vermont's Medicaid beneficiaries and serve 19 percent of our uninsured.
Nationally, health centers are not only providing quality, efficient care in underserved communities, they are filling a major gap in our Nation's health care system where primary care is becoming a lost profession. It is no secret that in many parts of America, especially rural America, it is very, very hard for people to locate a primary health care physician. It is also imperative that these centers play a role, which allow people to go to them rather than flooding emergency rooms in hospitals, which are much more expensive.
In addition to this appropriations bill, we are also in the process of reauthorizing the community health center program in the Health, Education, Labor and Pensions Committee on which I serve, and I thank our chairman and our ranking member for putting forth this important legislation that has the support of 68 Members from both sides of the aisle.
So I think this issue of community health centers is very much an issue and an area supported by people from different political perspectives. It is doing an enormous job in providing health care to millions of Americans. I am glad we are going to take a step forward when we pass this legislation.
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The Senator from Iowa [Mr. Grassley], for himself and Mr. Sanders, proposes an amendment numbered 3396, as modified, to amendment No. 3325.
The amendment is as follows:
At the appropriate place, insert the following:
SEC. __. AMERICAN COMPETITIVENESS SCHOLARSHIP PROGRAM.
(a) Short Title.--This section may be cited as the ``American Competitiveness Scholarship Act of 2007''.
(b) Establishment.--The Director of the National Science Foundation (referred to in this section as the ``Director'') shall award scholarships to eligible individuals to enable such individuals to pursue associate, undergraduate, or graduate level degrees in mathematics, engineering, health care, or computer science.
(c) Eligibility.--
(1) IN GENERAL.--To be eligible to receive a scholarship under this section, an individual shall--
(A) be a citizen of the United States, a national of the United States (as defined in section 101(a) of the Immigration and Nationality Act (8 U.S.C. 1101(a))), an alien admitted as a refugee under section 207 of such Act (8 U.S.C. 1157), or an alien lawfully admitted to the United States for permanent residence;
(B) prepare and submit to the Director an application at such time, in such manner, and containing such information as the Director may require; and
(C) certify to the Director that the individual intends to use amounts received under the scholarship to enroll or continue enrollment at an institution of higher education (as defined in section 101(a) of the Higher Education Act of 1965 (20 U.S.C. 1001(a)) in order to pursue an associate, undergraduate, or graduate level degree in mathematics, engineering, computer science, nursing, medicine, or other clinical medical program, or technology, or science program designated by the Director.
(2) ABILITY.--Awards of scholarships under this section shall be made by the Director solely on the basis of the ability of the applicant, except that in any case in which 2 or more applicants for scholarships are deemed by the Director to be possessed of substantially equal ability, and there are not sufficient scholarships available to grant one to each of such applicants, the available scholarship or scholarships shall be awarded to the applicants in a manner that will tend to result in a geographically wide distribution throughout the United States of recipients' places of permanent residence.
(d) Amount of Scholarship; Renewal.--
(1) AMOUNT OF SCHOLARSHIP.--The amount of a scholarship awarded under this section shall be $15,000 per year, except that no scholarship shall be greater than the annual cost of tuition and fees at the institution of higher education in which the scholarship recipient is enrolled or will enroll.
(2) RENEWAL.--The Director may renew a scholarship under this section for an eligible individual for not more than 4 years.
(e) Funding.--The Director shall carry out this section only with funds made available under section 286(w) of the Immigration and Nationality Act, as added by subsection (g).
(f) Federal Register.--Not later than 60 days after the date of the enactment of this Act, the Director shall publish in the Federal Register a list of eligible programs of study for a scholarship under this section.
(g) Supplemental H-1b Nonimmigrant Petitioner Account; Gifted and Talented Students Education Account.--Section 286 of the Immigration and Nationality Act (8 U.S.C. 1356) is amended by adding at the end the following:
``(w) Supplemental H-1B Nonimmigrant Petitioner Account.--
``(1) IN GENERAL.--There is established in the general fund of the Treasury a separate account, which shall be known as the `Supplemental H-1B Nonimmigrant Petitioner Account'. Notwithstanding any other section of this Act, there shall be deposited as offsetting receipts into the account 85.75 percent of the fees collected under section 214(c)(15)(B).
``(2) USE OF FEES FOR AMERICAN COMPETITIVENESS SCHOLARSHIP PROGRAM.--The amounts deposited into the Supplemental H-1B Nonimmigrant Petitioner Account shall remain available to the Director of the National Science Foundation until expended for scholarships described in the American Competitiveness Scholarship Act of 2007 for students enrolled in a program of study leading to a degree in mathematics, engineering, health care, or computer science.
``(x) Gifted and Talented Students Education Account.--
``(1) IN GENERAL.--There is established in the general fund of the Treasury a separate account, which shall be known as the `Gifted and Talented Students Education Account'. There shall be deposited as offsetting receipts into the account 14.25 percent of the fees collected under section 214(c)(15)(B).
``(2) USE OF FEES.--Amounts deposited into the account established under paragraph (1) shall remain available to the Secretary of Education until expended for programs and projects authorized under the Jacob K. Javits Gifted and Talented Students Education Act of 2001 (20 U.S.C. 7253 et seq.).''.
(h) Supplemental and Deficit Reduction Fees.--Section 214(c) of the Immigration and Nationality Act (8 U.S.C. 1184(c)) is amended by adding at the end the following:
``(15)(A) Except as provided under subparagraph (D), if the Attorney General, the Secretary of Homeland Security, or the Secretary of State is required to impose a fee pursuant to paragraph (9) or (11), the Attorney General, the Secretary of Homeland Security, or the Secretary of State, as appropriate, shall impose a supplemental fee and a deficit reduction fee on the employer in addition to any other fee required by such paragraph or any other provision of law, in the amounts determined under subparagraph (B).
``(B) The amount of the supplemental fee shall be $3,500, except that the fee shall be 1/2 that amount for any employer with not more than 25 full-time equivalent employees who are employed in the United States (determined by including any affiliate or subsidiary of such employer).
``(C) Of the amounts collected under subparagraph (B)--
``(i) 85.75 percent shall be deposited in the Treasury in accordance with section 286(w); and
``(ii) 14.25 percent shall be deposited in the Treasury in accordance with section 286(x).
``(D) Public hospitals, which are owned and operated by a State or a political subdivision of a State shall not be subject to the supplemental fees imposed under this paragraph.''.
The PRESIDING OFFICER. Who yields time?
Mr. SANDERS. Mr. President, I will say a few words about this amendment.
I thank Senator Grassley for working with me on this amendment. We modified the original amendment. This amendment is substantially similar to the amendment Senator Grassley and I offered last May on the immigration reform bill which passed the Senate with a bipartisan vote of 59 to 35.
This amendment is motivated by one major concern. We want to make certain that young Americans receive the educational opportunities they need in order to obtain the professional, good-paying jobs that are coming about in this country. To do that, we need to make sure they have the college education they need in math, science, engineering, health care, and other professional fields.
This amendment also expands the Jacob Javits Gifted and Talented Educational Program, long supported by Senator Grassley.
This amendment will accomplish these goals by adding a $3,500 surcharge on companies that utilize the H-1B program, the same surcharge that 59 Senators supported last May.
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Mr. SANDERS. Mr. President, I first want to thank Chairman Harkin and
Ranking Member Specter for their terrific work on the Labor-HHS appropriations bill. I appreciate how well the chairman and the ranking member were able to address so many of the important issues in this bill despite the overwhelming needs of so many worthy programs that have been terribly underfunded during the Bush administration. With this in mind, I want to enter into a colloquy to clarify a key issue concerning this measure.
As a member of the HELP Committee and its Retirement and Aging Subcommittee, I am a strong supporter of the Senior Community Service Employment Program, SCSEP, which provides part-time community service opportunities at minimum wage for unemployed low-income seniors over the age of 55 with poor employment prospects. This year, approximately 100,000 seniors nationally will have access to assistance from the SCSEP program. Last year, approximately 94,000 were served and 40 million hours of community services were provided at local community-based organizations, and 33 percent of participants obtained employment as a result of participating in this program.
Through SCSEP, low-income older people benefit from training, counseling, and community service assignments at nonprofit organizations and public agencies before transitioning into the workforce. Participants' community service assignments benefit schools, health facilities, homeless shelters and food banks, disaster relief agencies, and aging services. The wages participants earn makes the difference in their ability to care for basic necessities of life such as food and medicine. Many participants overcome homelessness and other obstacles such as disabilities, literacy deficiency, language, or lack of self-esteem through their participation, and are able to compete for jobs in their local communities. Each year thousands of participants transition to employment, allowing additional older workers to benefit from the SCSEP.
The SCSEP program was reauthorized last year as part of the Older Americans Act with strong bipartisan support as a result of the tremendous difference the program makes in the lives of our Nation's low-income seniors and our communities. As our population continues to grow grayer, the need for SCSEP services is anticipated to grow accordingly.
SCSEP rewards work and the important contribution our Nation's seniors can make to our society. However, program costs will rise this coming year as the increase in the minimum wage results in higher costs for the SCSEP program due to the minimum wage payments made to program participants. In order to continue current participant service levels, the House bill provided $531 million for SCSEP, which provides adequate funds to cover the 2008 minimum wage increase.
I know that Senator Harkin and Ranking Member Specter are supporters of the program but had a funding allocation $2 billion lower than their counterparts in the House.
Can the chairman provide his commitment of his intent to fund SCSEP at the House-passed level when he moves to conference with the House?
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Mr. SANDERS. I would like to congratulate the chairman and ranking member for their ongoing championing of critical programs that support health care access, including making substantial investments in the Nation's community health centers. The expansion of the National Health Service Corps is essential if health centers are to continue to meet the health care needs of their growing disadvantaged populations, and if we are to address the impending crisis in the supply of primary care doctors and dentists. Increasing the program's funding over the next several years is an important goal. The program is strongly supported by the Association of American Medical Colleges, which has called for an increase of 1,500 Corps awards per year to help meet the need for physicians caring for underserved populations and to help address rising medical student indebtedness.
In fiscal year 2007, the National Health Service Corps was funded at $126 million and the current level approved by the Appropriations Committee for fiscal year 2008 would level-fund the program. I thank the committee members for rejecting the administration's proposal which would have actually reduced funding by $10 million for this vital resource in the face of a dwindling supply of primary care doctors and dentists. While I recognize the many competing needs of important programs within the Labor, Health and Human Services, and Education appropriations bill, at the very least, I would like to see the National Health Service Corps program funding increased by the $5.8 million approved by the House of Representatives.
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