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[Page: S11816] GPO's PDF---
Mr. KENNEDY. Mr. President, I expect to support the omnibus legislation that will implement the final appropriations agreement for this Congress because it makes the kinds of investments in education , health, and work opportunities that are needed by all American families. In the long run, only through these basic investments can we preserve our capacity to keep our nation strong. I commend my colleagues for their diligence in crafting legislation that respects the highest priorities of the American people. Senator HARKIN and Senator SPECTER have shown the power of bipartisan cooperation throughout their work on this legislation. We have all benefitted from the example and leadership of Senator STEVENS and Senator BYRD as well.
While this legislation is not perfect and certainly is no substitute for the unfinished work of the 106th Congress, it is good for the American people, and it shows what is possible when we resolve to work together. In this sense, it offers considerable hope for the 107th Congress.
EDUCATION
In the critical area of education and the nation's schools, this appropriations agreement is a resounding victory for parents and communities across the country. Congress has lived up to its
commitment to increase education funding. We are taking a giant step forward to ensure that children across the country receive the support they need to succeed in school and to make college more affordable for every qualified student. I'm proud to highlight a few of the key education accomplishments.
For the first time, communities across the country will qualify for over $1.2 billion in federal aid to address their most urgent school building repair needs, such as fixing roofs, plumbing and electrical systems, and meeting fire and safety codes.
Schools across the country will receive $1.623 billion, a 25 percent increase over last year, to continue hiring and training new teachers to reduce class sizes in the early grades. This year's funding increase will place 8,000 more teachers in classrooms, placing the goal of 100,000 new teachers well within reach.
Teacher quality will improve as well this year. Schools will receive $485 million, a 45 percent increase over last year, to help teachers improve their skills through professional development activities, reducing the number of uncertified and out-of-field teachers.
Title I of the Elementary and Secondary Education Act, which helps disadvantaged students master the basics and achieve to high standards, is increased by $506 million, for a total of $8.4 billion.
We know that children are most likely to engage in risky behavior in the hours just after school. Congress has responded by increasing support for after-school programs by 87 percent this year, to $851 million. This increase will help more children stay out of trouble after school and get extra help with their schoolwork.
The bill also provides an additional $91 million, for a total of $225 million, to support state and local efforts to turn around low-performing schools.
Vocational and technical education programs received $1.240 billion, a $48 million increase, to improve programs that give students skills they need in order to meet the demands of the new high tech workforce.
College students will also receive much needed support under this bill. The GEAR UP programs will receive $295 million, an increase of $95 million, and TRIO programs will receive $730 million, a $85 million increase, to help more low-income and minority middle and high school students prepare for college and succeed in college.
Of all high school students in Boston, 80 percent of them now are tied into colleges. We have 12 different colleges that are tied into the high schools, where they are not just taking the individuals who show promise, which the TRIO Program does and does with extraordinary success, but to try to take the whole class together and move the whole class up. It is a relatively new concept and one which has worked very successfully in the several pilot areas where it has been tried. We are finding extraordinary response, positive response from colleges that engage in this undertaking, and extraordinary response from the schools. I think it will be one of the more important programs to enhance academic achievement for high school students.
This legislation will also enable more undergraduate and graduate students to pay for college through part-time work assistance because the Federal Work Study program received a $77 million increase.
This bill also strengthens Pell Grants, enabling many more students to take advantage of them. The maximum grant is increasing by $450--from $3,300 to $3,750. Because there are so many young people who, even though they are eligible for the maximum Pell Grant, just couldn't make it with the lower maximum, this is perhaps the most important educational enhancement we have.
It recognizes that many children are advantaged in their academic achievement and accomplishment but disadvantaged in the amount of resources they have.
EARLY LEARNING
As we strengthen our commitment to quality education at the elementary, secondary, and college levels, a strong body of research challenges us to broaden our commitment to education as well. Education is a continuum that begins at birth and continues long after graduation. On the birth-to-kindergarten side, we have much work to do. For the sake of each child, the nation, and our education system itself, all children must have access to the early learning opportunities that will enable them to enter school ready to learn.
Today, 12 million children under age five have mothers who work outside the home. Yet many of these children are assigned to waiting lists instead of quality early learning programs because federal funding isn't adequate to meet existing needs, and more and more parents are accepting the responsibility of work under welfare reform.
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All of us remember a number of years ago when the Governors, Republicans and Democrats, met in Charlottesville and announced goals for the Nation in education . Their first goal is to have children ready to learn when they enter kindergarten and first grade, to build the skills they bring to school. The skills that little children need to develop as infants and toddlers self-confidence, self-awareness, some degree of self-esteem, inquisitiveness in academics, and, interestingly enough, a sense of humor.
Eleven years ago, Senator MCCAIN and I introduced the Military Child Care Act, which turned military child care into an early learning model for the nation. Today's legislation takes three important steps toward building on that success in civilian America.
First, it increases federal child care subsidies by 69 percent, enabling states to remove 150,000 children from waiting lists next year. This increase was very much patterned upon the child care initiatives of our colleague, Senator DODD, and I am deeply grateful for his leadership on this issue.
Next, this legislation enables 70,000 of the nation's most at-risk children to participate in Head Start, which is highly regarded because it delivers the promise of early learning so effectively. The legislation also begins implementing the Early Learning Opportunities Act, which Senator STEVENS, Senator JEFFORDS, and Senator DODD and I supported over the past two years. This new law provides for parental education and support services, increased collaboration among early leaning providers, and incentives to improve the quality of early learning services. Its goal is to help the nation build an effective infrastructure of local councils to help each community evaluate how best to put the research on infant and toddler brain development into practice.
The Head Start Program, the Early Head Start Program, and the new Early Learning Opportunities Act included in this appropriations bill will improve early learning in important ways. The Carnegie Commission and other experts who have studied the development of a child's brain in the early years, and made a series of recommendations. With this legislation we are beginning now to follow up on these recommendations by investing in children at early ages. That is extremely important.
These steps show important momentum toward turning the research on children's brain development into sensible national policy, and we should build on this momentum in the next Congress.
We can learn much more from the military's experience with early learning. We can build these lessons into the Child Care and Development Block Grant when it is reauthorized in the next Congress. We can pass additional legislation to turn the current patchwork of federal child care and early learning programs into a seamless structure directed at one goal--quality services to ensure that children enter school ready to learn. We also must continue expanding Head Start until it is available to all children who need it.
The health funding in this bill is also a win for the American people.
GRADUATE MEDICAL EDUCATION
I will now address the excellent work that has been done under the balanced budget act, or BBA, programs, in particular the funding level for pediatric graduate medical education . This is not an area that has a history of proper federal attention. Last year, it received $40 million and virtually no funding prior to that time.
The Medicare Program has provided the funding for the training of much of the American medical personnel who, without question, are the best trained medical personnel in the country. It was funded through the Medicare system. The area of pediatrics never made it, so these children's hospitals, which train the majority of pediatricians, had to provide the additional training services and educational services without the support available to every other physician training program.
That has been significantly corrected with this legislation. There are over 50 major children's hospitals across this country that will benefit from this program. We can be sure that as a result of today's work, the part of the medical profession that is focused upon caring for children will be significantly advanced, and I commend the appropriators for this.
I am particularly pleased with the funding level for pediatric graduate medical education . The legislation allocates $235 million to support medical education costs incurred by freestanding children's hospitals. This figure is nearly a 500 percent increase over last year's appropriation of $40 million, and puts us much closer to fully funding the program.
This program was created last year to address the historical inequities in federal support for graduate medical education activities occurring at independent children's hospitals. Until last year, the federal government has paid for hospital costs related to physician training from Medicare. However, because children's hospitals generally treat very few Medicare patients, they were historically and dramatically underpaid for teaching activities. Prior to enactment of this program, children's hospitals were given just \1/200\th of the federal support for teaching activities that other teaching hospitals received.
Children's hospitals, which represent less than one percent of all hospitals in the country, train approximately 30 percent of the nation's pediatricians and the majority of many pediatric specialists. It is long past time for the federal government to support these activities. Next year, it is my hope that we will achieve permanent, full funding for this essential program.
Children's hospitals around the country will benefit from the increased funds in this legislation. It will enable these important institutions to continue to be regional and national referral centers for children around the country. It will support new and continuing research activities that benefit children and adults alike. And, most importantly, it will help assure a steady supply of pediatricians and pediatric specialists to treat the nation's children now and in the future.
With approximately 200 full-time employees in training at any one time, Boston Children's Hospital has the largest teaching program among independent children's hospitals. It has a
top-notch faculty, and provides excellent teaching, research and patient care. These funds will assure its continued contribution to health of children in Massachusetts, the nation, and the world.
NATIONAL INSTITUTES OF HEALTH
This bill also includes an increase of 13 percent for the National Institutes of Health, raising the NIH budget to more than $20 billion. These new resources will enable NIH to increase its support for the medical research that is urgently needed to develop new cures for the diseases that afflict millions of Americans.
Massachusetts is a leader in medical science. It receives more than one out of every ten dollars that NIH spends on research grants--more than any other state except California--and Boston receives more NIH grant money than any other city in the nation.
Last year alone, doctors and scientists in Massachusetts were awarded more than $1.5 billion in research grants from NIH. The new appropriations bill will increase this already impressive total by more than $180 million, so that Massachusetts will receive an estimated $1.7 billion in NIH research grants in the coming year.
NIH supports essential research across the state. In Boston, research supported by NIH very recently discovered an important relationship between the immune system and the brain that may lead to better treatments for diseases like multiple sclerosis. In Worcester, NIH funds are helping to build a new center for cancer research that will become a leader in this important field. In Cambridge, NIH will help support a major new center to study the nervous system, so that we can better understand brain diseases like Alzheimer's, schizophrenia and depression. NIH grants are essential for funding the basic research that is often considered too risky to be funded by private companies, and ensure that the results of this work are available to all researchers.
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The investment that NIH makes in medical research is the foundation on which the nation's thriving biotechnology industry is built. More than 250 biotech companies in Massachusetts provide good jobs for thousands of professionals across the state, and contribute millions of dollars every year to the state's economy. New partnerships between universities and biotechnology companies form almost every day, embarking research ideas from the academic world to be developed rapidly into new medical breakthroughs that will improve the health of patients across the nation.
By helping develop new cures for deadly diseases and by fostering the important new industry of biotechnology, the renewed commitment to the NIH that we make here today is an investment that will pay dividends now and for many years to come.
BALANCED BUDGET REFORM ACT
This legislation provides ``financial CPR'' for hospitals, home health agencies, nursing homes, and other important Medicare providers around the country. It also takes important steps to improve access to health care through CHIP and Medicaid, though more is needed.
Nearly one million senior citizens and persons with disabilities depend on Medicare to provide high-quality care in Massachusetts. The health care industry is a critical component of the state economy. Today, we are saying that help is on the way.
The Medicare, Medicaid and CHIP Beneficiary Improvement and Protection Act is the most significant relief package since passage of the Balanced Budget Act in 1997. Medicare spending will total $30 billion over five years, and spending for Medicaid and the Children's Health Insurance Program will total $6 billion. In fact, the net cost of the entire package is likely to be closer to $15 billion over five years, because of the offsetting effect of savings achieved by a forthcoming regulation limiting the ability of states to obtain union funded Medicaid payments.
The savings from the Medicaid regulation should be used to expand coverage to low-income populations. I strongly support the provider relief in this package, but I am disappointed that the
Republican leadership opposed bipartisan efforts to enable states to extend health benefits to low-income pregnant women and children who are legal immigrants, but who would otherwise be eligible for CHIP and Medicaid. In addition, the Republican leadership refused to include the bipartisan Grassley-Kennedy Family Opportunity Act, which would have enabled children with disabilities to obtain or maintain health coverage through Medicaid.
Massachusetts providers have estimated that they will receive approximately $450 million--close to half a billion dollars--over the next five years as a result of this legislation. While it is the most significant step Congress has taken to date to restore the unintended cuts made by the Balanced Budget Act of 1997, this Congress failed to finish the job, and we will be back at it again in the 107th Congress.
The record budget surpluses now and projected for the years ahead are largely due to the savings achieved by cutting Medicare payments in the Balanced Budget Act of 1997. Those cuts were expected to total $116 billion over five years, and nearly $400 billion over ten years--more than double the amount ever enacted in any previous legislation.
In reality, these cuts are now estimated to total $200 billion over five years and more than $600 billion over 10 years. These excessive cuts, combined with low payments from private payors and Medicaid programs, have placed many outstanding health care institutions at risk, and threaten quality of care for millions of elderly, disabled and low-income Americans.
In Massachusetts, two out of every three hospitals are losing money on patient care. Community hospitals across the state are struggling to survive. Key providers are questioning whether to participate in HMOs, and HMOs are deciding to cut benefits and trim service areas.
Twenty-five percent of home health agencies in the state no longer serve Medicare patients, and 20 agencies have closed their doors since the BBA was enacted. The remainder see fewer patients, and see them less often.
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