Hearing Health Accessibility Act of 2005

Mr. President, for more than a decade, I have spoken out about the need to fundamentally reorient our approach to health care in America--to reorient it towards prevention, wellness and self care.

I don't think you'll find too many people who would argue with the statement that if you get sick, the best place in the world to get the care you need is here in America. We have the best trained, highest- skilled health professionals in the world. We have cutting-edge, state- of-the-art equipment and technology. We have world-class health care facilities and research institutions.

But, when it comes to helping people stay healthy and stay out of the hospital, we fall woefully short. In the U.S., we spend in excess of $1.8 trillion a year on health care. Fully 75 percent of that total is accounted for by chronic diseases--things like heart disease, cancer, and diabetes. And what these diseases have in common is that--in so many cases--they are preventable.

In the United States, we fail to make an up-front investment in prevention. So we end up spending hundreds of billions on hospitalization, treatment, and disability. This is foolish--and, clearly, it is unsustainable. In fact, I've long said that we don't have a health care system here in America, we have a ``sick care'' system. And it is costing us dearly both in terms of health care costs and premature deaths.

Consider the cost of major chronic diseases--diseases that, as I said, are so often preventable.

For starters the annual cost of obesity is $117 billion. For cardiovascular disease is about $352 billion. For diabetes it's $132 billion. For smoking it's more than $75 billion. And for mental illness it's $150 billion; indeed, major depression is the leading cause of disability in the United States.

Now, if I bought a new car, drove that car off the lot, and never maintained it--never checked the oil, never checked the transmission fluid, never got it tuned up--you'd think I was crazy, not to mention grossly irresponsible. The common-sense principle with an automobile is: ``I pay a little now to keep the car maintained, or I pay a whole lot later.''

Well, it's the same with our national health priorities. Right now, our health care system is in a downward spiral. We are not paying a little now; so we are paying a whole lot later.

For example, we are failing to address the nation's growing obesity epidemic. Today 65 percent of our population is overweight or obese. Obesity is associated with numerous health problems and increased risks of diabetes, heart disease, stroke, and several types of cancer, to name just a few.

Another contributing factor to our health crisis is tobacco. We don't hear as much about the dangers of tobacco use, today, as we used to. That's because there is a perception that we've turned the corner--that we've done all that we need to do. But that perception is not accurate. In 2002, 46 million American adults regularly smoked cigarettes--that 26 percent of our population. Nearly 40 percent of college-aged students smoke. What this means is that after decades of education and efforts to stop tobacco use, more than one in every four Americans is still addicted to nicotine and smoking.

Mental health is another enormous challenge that we are grossly neglecting. Mental health and chronic disease are intertwined. They can trigger one another. It is about time we stop separating the mind and body when discussing health. Prevention and mental health promotion programs should be integrated into our schools, workplaces, and communities along with physical health screenings and education. Surely, at the outset of the 21st century, it's time to move beyond the lingering shame and stigma that often attend mental health.

Seventy percent of all deaths in the U.S. are now linked to chronic conditions such as heart disease, cancer, and diabetes. In so many cases, these chronic diseases are caused by poor nutrition, physical inactivity, tobacco use, and untreated mental illness. This is unacceptable.

After many months of meetings and discussions with Iowans and experts across the nation, today I am re-introducing comprehensive legislation designed to transform America's ``sick care'' system into a true health care system--one that emphasizes prevention and health promotion.

I am calling this bill the HeLP America Act, with HeLP as an acronym for Healthy Lifestyles and Prevention. The aim is to give individuals and communities the information and tools they need to take charge of their own health.

Because if we are serious about getting control of health-care costs and health-insurance premiums, then we must give people access to preventive care . . . and we must give people the tools they need to stay healthy and stay out of the hospital.

This will take a sustained commitment from government, schools, communities, employers, health officials, and the tobacco and food industries. But a sustained effort can have a huge payoff--for individuals and families, for employers, for society, for government budgets, and for the economy at large.

As I said, the HeLP America Act is comprehensive legislation. It a very complex, multifaceted bill. But, this afternoon, I'd just like to outline the bill's major elements:

The first component addresses healthy kids and schools. Prevention and the development of a healthy habits and lifestyles must begin in the early years, with our children. Unfortunately, today, we are heading in exactly the wrong direction. More and more children all across America are suffering from poor nutrition, physical inactivity, mental health issues, and tobacco use.

For example, just since the 1980s, the rates of obesity have doubled in children and tripled in teens. Even more alarming is the fact that a growing number of children are experiencing what used to be thought of primarily as adult health problems. Almost two-thirds--60 percent--of overweight children have at least one cardiovascular disease risk factor. Recent studies of children have shown that increasing weight, greater salt consumption from fast food, and poor eating habits have contributed to the rise in blood pressure, higher cholesterol levels, and a shockingly rapid increase in adult-onset diabetes.

The HeLP America Act will more than double funding for the successful PEP program, which promotes health and physical education programs in our public schools. I find it disturbing that more than one third of youngsters in grades 9 through 12 do not regularly engage in adequate physical activity. This is a shame, because studies show that regular physical activity boosts self-esteem and improves health.

The HeLP America Act will also expand the Harkin Fruit and Vegetable Program to provide more free fresh fruits and vegetables in more public schools. The bill will also encourage give schools incentives to create healthier environments, including goals for nutrition education and physical activity.

The HeLP America Act would also establish a grant program to provide mental health screenings and prevention programs in schools, along with training for school staff to help them recognize children exhibiting early warning signs. It will improve access to mental health services for students and their families.

New to the HeLP Act this year is a strong focus on breastfeeding promotion. Sound nutrition begins the moment a baby is born and there is a vast body of scientific evidence that shows beyond a shadow of a doubt that mom's milk is the ideal form of nutrition to promote child health. But in the U.S. we don't do enough to encourage breastfeeding. The HeLP America Act seeks to remove some of those barriers and to encourage new mothers to breastfeed.

The second broad component of the HeLP American Act addresses Healthy Communities and Workplaces. For example, the bill aims to create a healthier workforce by providing tax

credits to businesses that offer wellness programs and health club memberships. Studies show that, on average, every $1.00 that is invested in workplace wellness returns $3.00 in savings on health costs, absences from work, and so on.

At a field hearing in Iowa last year, I heard from Mr. Lynn Olson, CEO of Ottumwa Regional Health Center. The Center offers a comprehensive wellness program for its employees, including reduced health insurance premiums for those employees who meet individual health goals. The Center has seen tremendous savings from their investment in health promotion.

My bill also creates a grant program for communities, encouraging them to develop localized plans to promote healthier lifestyles. For example, we want to support efforts like those going on in Webster County and Mason City, IA, where mall walking programs have been expanded into community-wide initiatives to promote wellness.

At the same time, the bill provides new incentives for the construction of bike paths and sidewalks to encourage more physical activity, especially walking. It is shocking that, today, roughly one- quarter of walking trips take place on roads without sidewalks or shoulders. And bike lanes are available for only about 5 percent of bike trips.

As my colleagues know, I have been a longstanding advocate for the rights of people with disabilities. So I have given special attention to health-promotion programs and activities that include this population. I just mentioned the bill's incentives to create bike lanes and sidewalks on newly constructed roads. This will make a big difference to people with disabilities, who often are forced to travel in the street alongside cars because there are no sidewalks or bike lanes available for wheelchairs.

The Centers for Disease Control has funded a program called Living Well with a Disability, which has actually decreased secondary conditions and led to improved health for participants. The program is an eight-session workshop that teaches individuals with disabilities how to change their nutrition and level of physical activity. The program not only increases healthy activities for people with disabilities, but has also led to a 10 percent decline in the cost for medical services, particularly emergency-room care and hospital stays.

In addition, my bill includes a Working Well with a Disability program, which will build partnerships between employers and vocational rehabilitation offices with the aim of developing wellness programs in the workplace.

Mr. President, the third component of the HeLP America Act addresses Responsible Marketing and Consumer Awareness. Having accurate, readily available information about the nutritional value of the foods we eat is the first step toward improving overall nutrition. Unfortunately, because of all the gimmicks and hype that marketers use to entice us to buy their products, determining the nutritional value of the foods we buy can be problematic--especially in restaurants. This is why the HeLP America bill proposes to extend the nutritional labeling requirements of the National Labeling and Education Act, which currently covers the vast majority of retail foods, to restaurants foods as well, which were exempted from the NLEA when it first passed.

The marketing of junk food--especially to kids--is out of control. It was estimated that junk food marketers, alone, spent $15 billion in 2002 promoting their fare. And, I don't have to tell you, they are not advertising broccoli and apples. No, the majority of these ads are for candy and fast food--foods that are high in sugar, salt, fat, and calories.

Children--especially those under 8 years of age--do not always have the ability to distinguish fact from fiction. The number of TV ads that kids see over the course of their childhood has doubled from 20,000 to 40,000. The sad thing is that, way back in the 1970s, the Federal Trade Commission recommended banning TV advertising to kids. And what was Congress's response? We made it even harder for the FTC to regulate advertising for children than it is to regulate advertising for adults. My bill will restore the authority of the FTC to regulate marketing to kids, and it encourages the FTC to do so.

The fourth component of the HeLP American Act addresses Reimbursements for Prevention Services. Right now, our medical system is setup to pay doctors to perform a $20,000 gastric bypass instead of offering advice on how to avoid such risky procedures. The bill will reimburse and reward physicians for practicing prevention and screenings. It will also expand Medicare coverage to pay for counseling for nutrition and physical activity, mental health screenings, and smoking-cessation programs. It also would establish a demonstration project in the Medicare program, long overdue in my opinion, under which we can learn how best to use our health care dollars to prevent chronic diseases rather than just manage them once they've occurred. Frankly, it's a little embarrassing that we haven't done this before.

Finally, let me point out that the HeLP America Act will be paid for by creating a new National Health Promotion Trust Fund paid for through penalties on tobacco companies that fail to cut smoking rates among children, by ending the taxpayer subsidy of tobacco advertising, and also by reinstating the top income tax rates for wealthy Americans.

It's time for the Senate to lead America in a new direction. We need a new health care paradigm--a prevention paradigm.

Some will argue that avoiding obesity and preventable disease is strictly a matter of personal responsibility. Well, we all agree that individuals should act responsibly. I'm all for personal responsibility. But I also believe in government responsibility. Government has a responsibility to ensure that people have the information and tools and incentives they need to take charge of their health. And that is what the HeLP America Act is all about.

Of course, this description of my bill just scratches the surface. The HeLP America Act is comprehensive. It is ambitious. And I fully expect an uphill fight in some quarters of Congress.

But just as with the Americans with Disabilities Act 14 years ago, I am committed to doing whatever it takes--and for as long as it takes-- to pass this critically needed legislation.

It's time to heed the Golden Rule of Holes, which says: When you are in a hole, stop digging. Well, we have dug one whopper of a hole by failing to emphasize prevention and wellness. And it's time to stop digging.

Mr. President, I rise today to introduce the Economic Development Act of 2005 to authorize States to provide tax incentives for economic development purposes.

This legislation is crucial to preserve tax incentives as an important tool for State and local governments to promote economic development in the wake of last year's decision by the Sixth Circuit Court of Appeals in Cuno v. DaimlerChrysler.

In its decision in Cuno, the Sixth Circuit struck down Ohio's manufacturing machinery and equipment tax credit, which I helped enact while I was Governor of Ohio, on grounds that it violated the ``dormant'' Commerce Clause of the U.S. Constitution. The court ruled that the tax incentive violated the Commerce Clause of the U.S. Constitution because it granted preferential tax treatment to companies that invest within the State rather than in other States.

The Cuno decision has had severe repercussions across the country. The decision immediately cast doubt on the constitutionality of tax incentives presently offered by all fifty States. As

a result, States and businesses have been reluctant to go forward with new projects that depend on the availability of tax incentives out of concern that the Cuno decision may be used to invalidate those incentives. This legal uncertainty has worsened an already challenging economic environment. Furthermore, the decision threatens to undermine federalism by dramatically restricting the ability of States to craft their tax codes to promote economic development in the manner they determine is best. If left standing, this decision will handcuff the States in the Sixth Circuit, as well as States in other circuits where the court chooses to follow Cuno, in their efforts to promote economic growth and create jobs. Additionally, it will cripple their ability to compete internationally. In today's competitive economic environment, we can not afford to unilaterally discard the use of tax incentive to attract business to this country. As a former Governor who had to compete against Japan, Canada, China and Europe for new business projects, I know just how important a role tax incentives can play in attracting new businesses. I can assure you that our competitors are certainly not going to stop using tax incentives. Neither should we.

Fortunately, the U.S. Constitution gives Congress the power to determine which State actions violate the Commerce Clause. The purpose of the Economic Development Act of 2005 is therefore to have Congress override the decision in Cuno by authorizing States to provide tax incentives for economic development purposes. The legislation would remove the legal uncertainty surrounding tax incentives created by the Cuno decision and preserve the States' power to design their tax codes to promote economic development.

The history of the tax incentive struck down in Cuno demonstrates the important role tax incentives can play in promoting economic development. When I was Governor of Ohio, at my request and as part of my jobs incentive package, the Ohio Legislature enacted the manufacturing machinery and equipment tax incentive to encourage businesses to expand their operations in Ohio and to help draw new businesses to Ohio. It worked. Between 1993 and 1997, Ohio was ranked number one in the Nation by Site Selection and Industrial Development magazine three times for highest number of new facilities, expanded facilities, and new manufacturing plants. Since the program's inception, businesses have been eligible to claim a total of $2 billion in credits toward $34 billion in new equipment investments.

Currently, this incentive is part of an incentive package being offered to automobile manufacturer DaimlerChrysler in support of its plans for a $200 million expansion of their Jeep plant. The ruling by the Sixth Circuit in Cuno, however, puts that expansion in jeopardy and threatens to undermine Ohio's competitiveness in attracting new businesses.

In the Cuno decision, the Sixth Circuit ruled that the manufacturing machinery and equipment tax incentive, given by Ohio to DaimlerChrysler as part of its incentive package, violated the Commerce Clause of the U.S. Constitution because it discriminated against interstate commerce by granting preferential tax treatment to companies that expanded within the State rather than in other States.

The Cuno decision is troubling for several reasons. First, I believe the Sixth Circuit failed to appreciate the need for States to condition the availability of certain tax incentives on the undertaking of the specified economic activity within a State. In the case of the manufacturing machinery and equipment tax incentive, Ohio needed to limit the availability of the tax incentive to the investments undertaken in the State. Otherwise, Ohio would have been giving companies a tax incentive for activity that did not benefit the State. In other words, Ohio would have been effectively subsidizing investment in other States. We all know that in economics there is no free lunch and States should not be forced to provide a free lunch when they choose to give tax incentives. If Ohio or any other State is willing to forego tax revenue, it should be allowed to receive something in return, namely investment or other economic activity in the State. Accordingly, Ohio's tax incentive did not discriminate against interstate commerce. It merely required companies, if they chose to take advantage of the incentive, to undertake the investment in Ohio, the same State that would be foregoing tax revenue to provide the incentive.

There is also a little legal fiction present in the Cuno decision. The court states that Ohio could have provided a direct subsidy to companies that undertook investment in the State. Because Ohio decided to structure the program as a tax credit, however, the court said that it ran afoul of the Commerce Clause. I do not see how a direct subsidy does not violate the dormant Commerce Clause, but a tax credit does. They are economically the same.

If left standing, the Cuno decision will have a particularly detrimental effect on the U.S. manufacturing sector. From rising energy and health care costs to frivolous lawsuits and unfair international trade practices, the U.S. manufacturing sector and the hard working men and women who drive it are getting squeezed from all sides. Despite all they are up against, it's a testament to their ability and determination that they are still the most productive manufacturers in the world. This Sixth Circuit decision, however, is a new roadblock that threatens to take away one of the most effective and efficient means for assisting manufacturers who want to create new jobs here in America. The Economic Development Act of 2005 will make sure that manufacturers don't lose key tax incentives just when such incentives are needed the most.

The Cuno decision also sets a bad precedent that, if not checked, could upset our carefully balanced federal system. One of the most ingenious aspects of the U.S. Constitution is that it leaves a great deal of power with the States. It gives the States flexibility to devise their own solutions and, in the process, fosters innovation in government. Thus, the States are the laboratories of our democracy and an innovation they have developed to help create jobs and prosperity are programs that encourage new growth through tax incentives for training, job creation, and investment in new plants and equipment. The availability of tax incentives was critical to our success in Ohio and in being number one in new plant construction and expansion. Because Ohio had the ability to devise tax incentives that fit its economic development needs, we were able to create thousands of new jobs. My legislation will guarantee that the States remain our engines of innovation.

This legislation is something that Congress should have done a long time ago. The courts are not well-suited to making the often complex policy decisions regarding whether a tax incentive truly discriminates against interstate commerce and hinders the creation of a national market, or whether a tax incentive actually fosters innovation and job growth. Such decisions necessarily involve a careful weighing of competing and often mutually exclusive interests, and therefore should be made by Congress. Moreover, judicial decisions often fail to provide bright lines on which incentives run afoul of the dormant Commerce Clause, injecting uncertainty about the validity of certain tax incentives that makes businesses weary of relying on them and reduce their effectiveness. Indeed, the Supreme Court itself has called its dormant Commerce Clause jurisprudence a ``quagmire.'' Hence, it is time that Congress provide some clear rules on the treatment of tax incentives under the Commerce Clause.

As Supreme Court Justice Felix Frankfurter stated nearly a half- century ago:

At best, this Court can only act negatively; it can

determine whether a specific state tax is imposed in

violation of the Commerce Clause. Such decisions must

necessarily depend on the application of rough and ready

legal concepts. We cannot make a detailed inquiry into the

incidence of diverse economic burdens in order to

determine the extent to which such burdens conflict with

the necessities of national economic life. Neither can we

devise appropriate standards for dividing up national

revenue on the basis of more or less abstract principles

of constitutional law, which cannot be responsive to the

subtleties of the interrelated economies of Nation and

State.

The problem calls for solution by devising a congressional

policy. Congress alone can provide for a full and thorough

canvassing of the multitudinous and intricate factors which

compose the problem of the taxing

freedom of the States and the needed limits on such state

taxing power. Congressional committees can make studies and

give the claims of the individual States adequate hearing

before the ultimate legislative formulation of policy is made

by the representatives of all the States. . . . Congress

alone can formulate policies founded upon economic realities.

. . .

The Economic Development Act of 2005 is a good first step toward providing the prudent and carefully considered legislation that Justice Frankfurter urged the Congress to pass nearly a half century ago.

At its core, the Economic Development Act of 2005 recognizes that decisions should be made, if possible, at the State and local level. States make and should make decisions about the programs and services they want to provide with their tax dollars, not the least of which are economic development programs. Highway funding, education funding, welfare funding, and funding for seniors programs all vary from state to state because State legislatures, acting on behalf of their citizens, make choices and set priorities. This has allowed government policy to reflect the diversity of interests in our great republic and results in better and more responsive government. Accordingly, states should be allowed to prioritize economic development in an effort to create jobs and prosperity for their citizens, and, yes, attract business from outside their State. If States choose to use tax incentives to promote economic development, then that is not a violation of the interstate commerce clause, that's simply their choice. It is called federalism, and it should not be thwarted by the courts.

There are a couple of points about this legislation that I would like to discuss. First, this legislation is carefully crafted to protect the most common and benign forms of tax incentives, but not to authorize those tax incentives that truly discriminate against interstate commerce. I believe this bill strikes the right balance between protecting States' tax rights and preserving long-established protections against truly discriminatory State tax practices. Second, this legislation does not invalidate any tax incentives. It only authorizes tax incentives. Any tax incentive not covered by the legislation's authorization is simply subject to the traditional dormant Commerce Clause review by the courts. Third, this legislation does not require any state to provide tax incentives. Although I had success using tax incentives to foster economic growth in Ohio while I was Governor, I recognize that some states have concerns about whether and how to offer tax incentives and therefore believe it should be left to the states to resolve these concerns.

I am pleased that this legislation is being co-sponsored by all of the Senators representing States in the Sixth Circuit. We all realize that the right of states to make their own decisions about the programs and services they offer within their boundaries is their own and should not be taken away. Moreover, if the Supreme Court fails to review the Cuno decision, then our States, the States in the Sixth Circuit, will be at a competitive disadvantage in attracting businesses against other states which are not affected by the Cuno decision and can offer tax incentives.

The bill has also been endorsed by Governor Bob Taft of Ohio, the National Governors Association, the National League of Cities, the National Association of Counties, the National Conference of Mayors and the Federation of Tax Administrators, as well as by broad-based business coalitions and the Teamsters.

I am hopeful that the seriousness of this issue, and the severity of the ruling's possible ramifications, will allow us to see quick and positive consideration of my bill. The States are in a crisis mode because of this ruling. In Ohio, as I'm sure is the case across the country, many important projects have been put on hold as we await the court's further action.

The challenges that manufacturers and workers face today are daunting but surmountable. The last thing we need, however, is an artificial legal hurdle that threatens to trip us up. I urge my colleagues to support the Economic Development Act of 2005 so that we can preserve the ability of the States to foster economic development and help put our economy, and especially our manufacturing industries, back on the road to recovery and prosperity.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I am pleased to join with my colleagues Senator Kennedy, Senator Mikulski, Senator Murray, Senator Clinton, Senator Durbin, Senator Lautenberg, Senator Leahy, Senator Akaka, Senator Boxer, and Senator Corzine, to introduce the ``Family and Medical Leave Expansion Act.'' Today marks the 12th anniversary of the enactment of the Family and Medical Leave Act. This landmark legislation was nearly a decade in the making, but today, more than 50 million Americans have taken leave under FMLA.

Despite the many Americans the Family and Medical Leave Act has helped, too many continue to be left behind. Too many continue to have to choose between job and family. The facts are clear: millions of Americans remain uncovered by the Family and Medical Leave Act. And too many who are eligible for the Family and Medical Leave Act cannot afford to take unpaid leave from work. The ``Family and Medical Leave Expansion Act'', which we are introducing today addresses both these problems.

The ``Family and Medical Leave Expansion Act'' would expand the scope and coverage of FMLA. It would fund pilot programs at the state level to offer partial or full wage replacement programs to ensure that employees do not have to choose between job and family.

Times have changed over the years. More and more mothers are working. While decades ago only a tiny fraction of mothers with infants under one year of age were working, in 2004 about 55 percent of mothers with infants were working. Even as employment rates within this group rises, family responsibilities remain constant, a reality that lies at the core of the FMLA. According to an employee survey by the Department of Labor, about one-fifth of U.S. workers have a need for some form of leave covered under the FMLA, and about 40 percent of all employees think they will need FMLA-covered leave within the next 5 years.

According to a Department of Labor study in 2000, leave to care for one's own health or for the health of a seriously ill child, spouse or parent, together account for almost 80 percent of all FMLA leave. Approximately 52 percent of the leave taken is due to employees' own serious health problems, while 26 percent of the leave is taken by young parents caring for their children at birth or adoption.

The FMLA requires that all public sector employers and private employers of 50 or more employees provide up to 12 weeks of unpaid leave for medical and family care reasons for eligible employees. About 77 percent of employees in the private and public sector currently work in FMLA-covered sites, although only 62 percent of employees are actually eligible for leave.

However, only 11 percent of private sector work sites are covered under FMLA. Individuals working for smaller private employers deserve the same work protections afforded to other employees. As a step toward expanding protection to more hard-working Americans, this bill would extend FMLA coverage to all private sector worksites with 25 or more employees within a 75-mile radius. This would mean that an additional 13 million Americans would be eligible for leave under the Act--roughly 240,000 in my own State of Connecticut.

Mothers and fathers, adult sons and daughters have the same family responsibilities and personal health problems, regardless of whether they work for the government, a large private enterprise, or a medium- sized private business. Expanding the FMLA to businesses with 25 or more employees is a crucial acknowledgment of this reality.

The bill recognizes the enormous physical and emotional toll domestic violence takes on victims. The bill expands the scope of FMLA to include leave for individuals to care for themselves or to care for a daughter, son, or parent suffering from domestic violence.

Expanding the scope and coverage of FMLA is a positive step for many Americans. But, alone, it is not enough. According to a Department of Labor study, 3.5 million covered Americans needed leave but--without wage replacement--could not afford to take leave. Over four-fifths of those who needed leave but did not take it said they could not afford unpaid leave.

Others cut their leave short, with the average duration of FMLA leave being 10 days. Of those individuals taking leave under the Family and Medical Leave Act, nearly three-quarters had incomes above $30,000.

While the financial sacrifice is often enormous, the need for leave can be even more so. Every year, many Americans bite the bullet and accept unpaid leave. As a result, nine percent of leave takers go on public assistance to cover their lost wages. Almost twelve percent of female leave takers use public assistance for this reason. These individuals are far from being unwilling to work. Instead, they are trying to balance work with family--often during a crisis, too often with inadequate means to get by.

Other major industrialized nations have implemented policies far more family-friendly to promote early childhood development and family caregiving. At least 128 countries provide paid and job-protected maternity leave, with an average of sixteen weeks of basic paid leave. In 1992, before we enacted the Family and Medical Leave Act, the European Union mandated a paid fourteen-week maternity leave as a health and safety measure. Among the 29 Organization for Economic Cooperation and Development (OECD) countries, the average childbirth- related leave is 44 weeks, while the average duration of paid leave is 36 weeks.

Compared to these other developed nations, the United States is far behind in efforts to promote stronger families and worker productivity. The ``Family and Medical Leave Expansion Act'' builds on current law to provide pilot programs for States and the federal government to provide for partial or full wage replacement for at least 6 weeks. At a minimum, this will ensure that parents can continue to make ends meet while taking family and medical leave.

When we talk about a more compassionate America, nowhere is that more evident than in our caregiving leave policies. No one should have to choose between work and family. Women and men deserve to take leave when family or health conditions require it without fear of losing their job or livelihood. We must not simply pay lip service to family integrity and the promotion of a healthy workplace.

We talk often of our need to strengthen family values. We cite studies about the importance of the first few months of a newborn's life. This bill offers more parents the opportunity to spend time with their families when their families most need them.

I urge my colleagues to support the ``Family and Medical Leave Expansion Act'' to promote our family values and to ensure the welfare and health of hard-working Americans.

I ask unanimous consent that a copy of a brief summary of the Family and Medical Leave Expansion Act be printed in the Record.

Mr. President, I rise and am joined by my colleagues Senators Mikulski, Jeffords, Murray, Lieberman, Sarbanes, Landrieu, Dayton, Levin, Lautenberg, Inouye,

Corzine, Durbin and Akaka to introduce legislation to amend the Higher Education Act to improve access to higher education for low- and middle-income students by raising the authorized maximum Pell Grant to $11,600 within five years. This bill has the strong support of the Student Aid Alliance, whose 60 organizations represent students, colleges, parents, and others who care about higher education.

Pell Grants were established in the early 1970s by our former colleague, I Claiborne Pell, of Rhode Island. They are the largest source of Federal grant aid for college students. For millions of low- and middle-income students they are the difference between attending or not attending college. But, unfortunately, they don't make as much of a difference as they used to.

In 1975, the maximum appropriated Pell Grant covered all of the average student's tuition, fees, room, and board at community colleges. It covered about 80 percent of those costs at public universities and about 40 percent at private universities. In 2003, the average Pell Grant covered 32 percent of tuition, room and board at community colleges, 23 percent of the total charges at public universities, and 9 percent of total charges at private universities. That's not just a drop, it's a free-fall.

For low- and middle-income families, the cost of college also has increased significantly as a percentage of income. College is getting farther and farther out of reach for an entire generation of students.

As a result of all this, low- and middle-income students who want to attend college are forced to finance their education with an ever- increasing percentage of loans as opposed to grants. This increases the cost of attendance for these students even more, and in many cases, keeps them from going to college at all.

For four years now, the Administration has not raised the maximum Pell Grant. On top of leaving millions of children behind by failing to meet the bipartisan promises of the No Child Left Behind Act, they have left even more children behind who work hard and do well in school and want to go on to college. If we're serious about leaving no child behind, if we're serious about having a society where equal opportunity for all is more than just rhetoric, then we need to reinvigorate the Pell program.

It has been said that investing in a student's future is investing in our Nation's future. We can start investing in our Nation's future by supporting this bill to increase the maximum appropriated Pell Grant to $11,600. This bill won't bring the Pell Grant's purchasing power back to where it was in 1975, but it is a critical first step, and I intend to continue my efforts on this matter throughout this Congress. I hope that my colleagues will join me.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I rise today, along with Senators Leahy and Domenici, to introduce a bill that would reauthorize ``America's Law Enforcement and Mental Health Project Act.'' This program addresses the impact that mentally ill offenders have had on our criminal justice system and the impact the system has had on the offenders and their special needs.

My interest in, and experience with this issue began over 30 years ago, when I was working as Assistant County Prosecuting Attorney in Greene County, OH, and then as County Prosecutor. What I learned then-- and what I have continued to encounter throughout my career in public service--is that our State and local correctional facilities have become way stations for far too many mentally ill individuals in our Nation.

A recent Justice Department study revealed that 16 percent of all inmates in America's State prisons and local jails today are mentally ill. The American Jails Association estimates that 600,000 to 700,000 seriously mentally ill persons each year are booked into local jails, alone. In Ohio, nearly one in five prisoners need psychiatric services or special accommodations. As these statistics make clear, far too many of our Nation's mentally ill persons have ended up in our prisons and jails. In fact, on any given day, the Los Angeles County Jail is home to more mentally ill inmates than the largest mental health care institution in our country.

How did we wind up in this situation? What happens is that all too often, the mentally ill act out their symptoms on the streets. They are arrested for minor offenses and wind up in jail. They serve their sentences or are paroled, but do not receive any treatment for their underlying mental illness. Not surprisingly, they often find themselves right back in the system only a short time later after committing additional--often more serious--crimes.

Throughout this destructive cycle, law enforcement and corrections spend time and money trying to cope with the unique problems posed by these individuals. Certainly, many mentally ill

offenders must be incarcerated because of the severity of their crimes. However, those who commit very minor, non-violent offenses don't necessarily need to be incarcerated; instead, if given appropriate treatment early, their illnesses could be addressed, helping the offenders, while reducing recidivism and decreasing the burdens on our police and corrections officials.

That is why, six years ago Senator Domenici and I introduced America's Law Enforcement and Mental Health Project, to begin to identify--early in the process--mentally ill offenders within our justice system and to use the power of the courts to assist them in obtaining the treatment they need.

This program has been a success. In pilot programs around the country, mental health courts have begun to help local communities take steps toward effectively addressing the issues raised by the mentally ill in our justice system, and these steps must continue. The legislation that we are introducing today will help do that. Our bill would establish a Federal grant program to help States and localities develop mental health courts in their jurisdictions. These courts are specialized courts with separate dockets. They hear cases exclusively involving nonviolent offenses committed by individuals with a mental illness. Fundamentally, mental health courts enable State and local courts to offer alternative sentences or alternatives to prosecution for those offenders who could be served best by mental health services. These courts are designed to address the historic lack of coordination between local law enforcement and social service systems and bring them together to work within the criminal justice system.

To deal with the separate needs of mentally ill offenders, these mental health courts are staffed by a core group of specialized professionals, including a dedicated judge, prosecutor, public defender, and court liaison to the mental health services community. The courts promote efficiency and consistency by centrally managing all outstanding cases involving a mentally ill defendant referred to the mental health court.

Mental health court judges decide whether or not to hear each case referred to them. The courts only deal with defendants deemed mentally ill by qualified mental health professionals or the mental health court judge. Similarly, participation in the court by the mentally ill is voluntary; however, once the defendant volunteers for the Mental Health Court, he or she is expected to follow the decision of the court.

For instance, in any given case, the mental health court judge, attorneys, and health services liaison may all agree on a plan of treatment as an alternative sentence or in lieu of prosecution. The defendant must adhere strictly to this court-imposed treatment plan. The court must then provide supervision, and quickly deal with any failure. This way, the court can quickly deal with any failure of the defendant to fulfill the treatment plan obligations. The mental health courts provide supervision of participants that is more intensive than might otherwise be available, with an emphasis on accountability and monitoring the participant's performance. In this sense, the mental heath courts function similarly to drug courts.

Offenders with a mental illness who choose to have their cases heard in a mental health court often do so because that is the first real opportunity that many of these people have to seek treatment. A judicial program offering the possibility of effective treatment-- rather than jail time--gives a measure of hope and a chance for rehabilitation to these defendants.

The successes of mental health courts are encouraging and show that we can improve the health and safety of our communities through these programs. In Ohio, the Alcohol, Drug and Mental Health Services Board which serves Athens, Hocking and Vinton Counties, began operating its program on August 2003 after receiving a mental health court grant under the original America's Law Enforcement and Mental Health Project Act. Success stories from this program are numerous, but let me focus on one individual here. D.L. is a 53 year old man who struggled with Bipolar Disorder for years. Arrested for trespassing in 2003, D.L. was the ideal candidate for the Mental Health Court. Having completed individual counseling, and never missing a single psychiatric appointment, D.L. completed the program last May. He is now viewed as a potential mentor for other program participants.

Many jurisdictions across America have established mental health courts as a result of the program that we established four years ago. Our Nation's communities are trying desperately to find the best way to cope with the problems associated with mental illness. Law enforcement agencies and correctional facilities remain challenged by difficulties posed by mental illnesses.

Mental health courts offer a solution.

Mental health courts have shown great success, and we must ensure their continuation. Our Nation has long been enriched by the dual ideals of compassion and justice, and these programs are a wonderful embodiment of both ideals. I urge my colleagues to join in support of this important legislation.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, I am pleased to join with a long list of colleagues in introducing a bill to extend the MILC program. This measure is supported by members from different regions of the country and both political parties. This broad base of support is a clear indication of this issue's importance.

MILC, as most of my colleagues know, is the program created in the 2002 Farm Bill after a very painful battle over the Northeast Dairy Compact. Many recall what a difficult time that was, with one group of dairymen pitted against another. I don't want to revisit that time. The MILC program bridged a bitter regional divide by providing a critical safety net when prices are low. And when prices rebound, the MILC program becomes dormant and costs nothing. The problem with MILC is that it expires on September 30 of this year--two years before the rest of the Farm Bill.

In addition to the cosponsors, MILC extension is supported by sixteen governors, including the governors of Wisconsin, Minnesota, Virginia, Vermont, Missouri, North Carolina, Pennsylvania, Idaho, Maine, Iowa, Michigan, New York, South Dakota, Ohio, Louisiana, and North Dakota. Moreover, the President of the United States committed himself to MILC extension during the presidential campaign.

I am hopeful the President's budget will include MILC extension when we receive it next Monday. That would be a helpful next step. But the fact of the matter is that budget resolutions never get signed into law in and of themselves. They are merely a framework for further discussion and work. And it will take effort both from Congress and the administration to see this extension translated into law. I look forward to working with the President and his new Secretary of Agriculture to make sure that happens.

Mr. President, I am introducing legislation today with Senator Snowe to reauthorize funding for the Hollings Manufacturing Extension Partnership. This successful Commerce Department program, based in the National Institute of Standards and Technology, is a nationwide network of Hollings Manufacturing Extension Partnership Centers working with small- and medium-sized manufacturers in all 50 States. These local centers have played a critical role in helping our manufacturers turn out the most advanced products, using cutting edge technology and processes, to prevent these firms from being forced out of the global marketplace.

My State of Wisconsin is a great manufacturing State. Small- and medium-sized manufacturers and a few larger concerns make us the State economy most dependent on manufacturing--save Indiana. Thus, I am keenly aware of the devastating job losses experienced by American manufacturers. In Wisconsin alone, we lost more than 90,000 manufacturing jobs over the last four years.

While 2004 brought encouraging news in which we saw a net gain of 3.1 percent or 15,400 manufacturing jobs in my State, this pace of economic growth will never bring us back to where we were before.

That is why I am committed to doing all I can to help our manufacturers. And that is why I am such a strong supporter of the MEP program, one of the only Federal programs which has provided tangible assistance to the manufacturing sector to help companies stay in business and retain jobs. The MEP program served 18,422 manufacturers in fiscal year 2003 alone, and over the life of the program has assisted more than 184,000 firms across the Nation.

MEP's top areas of assistance are process improvement, quality inspection, business system and management, human resources, plant layout and manufacturing cells and product development. MEP streamlines operations, integrates new technologies, shortens production times and lowers costs, leading to improved efficiency by offering resources to manufacturers, including organized workshops and consulting projects. MEP removes the drag on profits and maximizes the potential of our manufacturing firms.

Wisconsin is the home to two MEP centers which have both had a significant impact on the productivity of companies throughout the State. Since 1996, Wisconsin MEP has helped over 1,300 Wisconsin manufacturers improve their productivity and profitability. Over that time WMEP customers have reported a positive impact of nearly $400 million in improvements attributable to the assistance provided by MEP. And, since 1994, the Northwest Wisconsin Manufacturing Outreach Center, targeting the more rural northwestern part of the State, has provided over 3,189 technical assistance activities to over 942 companies, created or retained 1,979 jobs, and achieved client-reported impacts of over $132 million.

One of the novel aspects of the MEP program is that it is a Federal- State-private partnership. Federal funding leverages State and private funding. Manufacturers pay reduced fees for the services and States match the Federal funding. In many cases, the Federal component is only one-third of the funding for the program.

Although the MEP program has broad bipartisan support, with 55 senators writing a letter in support of the program last year, we have had to struggle in recent years to ensure that MEP centers receive the funding they deserve. In the last two years, the Administration has proposed deep reductions in the program that would have forced MEP centers around the country to close. In fiscal year 2004, despite Senate support for full funding for the MEP Program, funding was reduced by 60 percent from $106 million to $39.6 million. As a result, 58 MEP centers closed and staff was reduced by 15 percent. Working with several other Senators, we succeeded in having amendments adopted on the fiscal year 2005 Defense authorization and appropriations bills to permit and direct the Commerce Department to reprogram unobligated funds to the MEP program in fiscal year 2004 to keep the MEP network intact. Fortunately, in the fiscal year 2005 Omnibus Appropriations bill, MEP received $109 million and was renamed the Hollings MEP program, in recognition of the strong support Senator Hollings gave this program during his tenure in the Senate.

Next week the President will be sending us his proposed budget for fiscal year 2006. I am deeply concerned at reports that indicate that the Administration intends to propose yet again to cut this vital program. We have introduced this legislation today as a sign that there continues to be bipartisan support for the Manufacturing Extension Partnership. I hope that these reports were incorrect and that the Administration recognizes that we cannot abandon our small- and medium- sized manufacturers. They are the key to economic growth, good paying jobs, and a healthy balance of trade.

I ask unanimous consent that the text of this bill be printed in the Record.