[Congressional Record Volume 149, Number 73 (Thursday, May 15, 2003)]
[Senate]
[Pages S6509-S6514]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. DODD (for himself and Mr. DeWine):
  S. 1068. A bill to amend the Public Health Service Act to establish 
grant programs to provide for education and outreach on newborn 
screening and coordinated followup care once newborn screening has been 
conducted, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. DODD. Mr. President, I am pleased today to join with my colleague 
Senator DeWine to introduce legislation to protect the most vulnerable 
members of our society: newborn infants. As a first-time dad of a 20-
month old baby girl, I now know the joy of being able to experience 
every pleasure that comes with being a father. What I also now share 
with parents everywhere is a constant sense of worry about whether our 
kids are doing well, are feeling well, and are safe. Nothing is of 
greater importance than the health and well-being of our children.
  Thanks to incredible advances in medical technology, it is now 
possible to test newborns for more than 30 genetic and metabolic 
disorders. Many of these disorders, if undetected, would lead to severe 
disability or death. However, babies that are properly diagnosed and 
treated can go on to live healthy lives. In the most direct sense, 
newborn screening saves lives.
  Frighteningly, the disorders that newborn screening tests for can 
come without warning. For most of these disorders, there is no medical 
history of the condition in the family, no way to predict the health of 
a baby based on the health of the parents. Although the disorders that 
are tested for are quite rare, there is a chance that any one newborn 
will be affected--a sort of morbid lottery. In that sense, this is an 
issue that has a direct impact on the lives of every family.
  Fortunately, screening has become common practice in every State. 
Each year, over four million infants have blood taken from their heel 
to detect these disorders that could threaten their life and long-term 
health. As a result, about one in 4,000 babies is diagnosed with one of 
these disorders. That means that newborn screening could save 
approximately 1,000 lives each year. That is 1,000 tragedies that can 
possibly be averted--families left with the joy of a new infant rather 
than absolute heartbreak.
  That is the good news. However, there is so much more to be done. For 
every baby saved, another two are estimated to be born with potentially 
detectable disorders that go undetected because they are not screened. 
These infants and their families face the prospect of disability or 
death from a preventable disorder. Let me repeat that--disability or 
death from a preventable disorder. The survival of a newborn may very 
well come down to the State in which it is born. Only two States, 
including my home state of Connecticut thanks to recent legislation, 
will test for all 30 disorders. While the number of genetic and 
metabolic disorders screened for varies among different states, the 
vast majority test for eight or fewer.
  The General Accounting Office, GAO, released a report in March 
highlighting the need for this legislation. According to the report, 
most States do not educate parents and health care providers about the 
availability of tests beyond what is mandated by the State. States also 
reported that they do not have the

[[Page S6510]]

resources to purchase the technology and train the staff needed to 
expand newborn screening programs. Finally, even when States do detect 
an abnormal screening result, the majority do not inform parents 
directly.
  Last year, I chaired a hearing on this issue during which I related a 
story that illustrates the impact of newborn screening, or the lack of 
newborn screening, in a very personal sense. Jonathan Sweeney is a 
three-year-old from Brookfield, CT. At the time of his birth, the State 
only tested for eight disorders. He was considered a healthy baby, 
although he was a poor sleeper and needed to be fed quite frequently. 
One morning in December of 2000, Jonathan's mother, Pamela, found 
Jonathan with his eyes wide open but completely unresponsive. He was 
not breathing and appeared to be having a seizure. Jonathan was rushed 
to the hospital where, fortunately, his life was saved. He was later 
diagnosed with L-CHAD, a disorder that prevents Jonathan's body from 
turning fat into energy.
  Despite this harrowing tale, Jonathan and his family are extremely 
fortunate. Jonathan is alive, and his disorder can be treated with a 
special diet. He has experienced developmental delays that most likely 
could have been avoided had he been tested for L-CHAD at birth. This 
raises a question. Why was he not tested? Why do 47 States still not 
test for L-CHAD?
  The primary reason for this unfortunate reality is the lack of a 
consensus on the Federal level about what should be screened for, and 
how a screening program should be developed. Twenty disorders can only 
be detected using a costly piece of equipment called a Tandem Mass 
Spectrometer. Currently, only 21 States have this resource.
  Many health care professionals are unaware of the possibility of 
screening for disorders beyond what their State requires. Parents, and 
I include myself, are even less well-informed. My daughter Grace was 
born in Virginia, where they screen for nine disorders. I was extremely 
relieved when all of those tests came out negative. However, at that 
time I did not know that this screening was not as complete as it could 
have been. My ignorance had nothing to do with my love for my daughter 
or my capability as a parent. The fact is that the majority of parents 
do not realize that this screening occurs at all, nor are they familiar 
with the disorders that are being screened for. In fact, only one out 
of four States inform parents that they have the option to obtain 
testing for disorders that are not included on the State's screening 
program. For that reason, one of the most important first steps that we 
can take to protect our children is to educate parents and health care 
professionals.

  In the Children's Health Act of 2000, I supported the creation of an 
advisory committee on newborn screening within the Department of Health 
and Human Services. The purpose of this committee would be to develop 
national recommendations on screening, hopefully eliminating the 
arbitrary disparities between states that currently exist. The 
Children's Health Act also included a provision to provide funding to 
States to expand their technological resources for newborn screening. 
Unfortunately, funds were not appropriated for either of these 
provisions. Senator DeWine and I have led a campaign to secure $25 
million in appropriations needed for this crucial initiative. It is 
unconscionable for us to not do all we can to help prevent children 
from dying of treatable disorders.
  The legislation that we are introducing today, the Newborn Screening 
Saves Lives Act of 2003, seeks to address the shocking lack of 
information available to health care professionals and parents about 
newborn screening. Every parent should have the knowledge necessary to 
protect their child. The tragedy of a newborn's death is only 
compounded by the frustration of learning that the death was 
preventable. This bill authorizes $10 million in fiscal year 2004, and 
such sums as are necessary through fiscal year 2008, to HRSA for grants 
to provide education and training to health care professionals, State 
laboratory personnel, families and consumer advocates.
  Our legislation will also provide States with the resources to 
develop programs of follow-up care for those children diagnosed by a 
disorder detected through newborn screening. While these families are 
the fortunate ones, in many cases they are still faced with the 
prospect of extended and complex treatment or major lifestyle changes. 
We need to remember that care does not stop at diagnosis. For that 
reason, this bill authorizes $5 million in fiscal year 2004, and such 
sums as are necessary through FY 2008, to HRSA for grants to develop a 
coordinated system of follow-up care for newborns and their families 
after screening and diagnosis.
  Finally, the bill directs HRSA to assess existing resources for 
education, training, and follow-up care in the States, ensure 
coordination, and minimize duplication; and also directs the Secretary 
to provide an evaluation report to Congress two and a half years after 
the grants are first awarded and then after five years to assess impact 
and effectiveness and make recommendations about future efforts.
  I urge my colleagues to support this important initiative so that 
every newborn child will have the opportunity for a long, healthy and 
happy life; and to spare thousands of families from an avoidable 
tragedy.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1068

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Newborn Screening Saves 
     Lives Act of 2003''.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) Currently, it is possible to test for at least 30 
     disorders through newborn screening.
       (2) There is a lack of uniform newborn screening throughout 
     the United States. While a newborn with a debilitating 
     condition may receive screening, early detection, and 
     treatment in one location, in another location the condition 
     may go undetected and result in catastrophic consequences.
       (3) Each year more than 4,000,000 babies are screened to 
     detect conditions that may threaten their long-term health.
       (4) There are more than 2,000 babies born every year in the 
     United States with detectable and treatable disorders that go 
     unscreened through newborn screening.

     SEC. 3. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.

       Part Q of title III of the Public Health Service Act (42 
     U.S.C. 280h et seq.) is amended by adding at the end the 
     following:

     ``SEC. 399AA. NEWBORN SCREENING.

       ``(a) Authorization of Grant Programs.--
       ``(1) Grants to assist health care professionals.--From 
     funds appropriated under subsection (h), the Secretary, 
     acting through the Associate Administrator of the Maternal 
     and Child Health Bureau of the Health Resources and Services 
     Administration (referred to in this section as the `Associate 
     Administrator') and in consultation with the Advisory 
     Committee on Heritable Disorders in Newborns and Children 
     (referred to in this section as the `Advisory Committee'), 
     shall award grants to eligible entities to enable such 
     entities to assist in providing health care professionals and 
     State health department laboratory personnel with--
       ``(A) education in newborn screening; and
       ``(B) training in--
       ``(i) relevant and new technologies in newborn screening; 
     and
       ``(ii) congenital, genetic, and metabolic disorders.
       ``(2) Grants to assist families.--From funds appropriated 
     under subsection (h), the Secretary, acting through the 
     Associate Administrator and in consultation with the Advisory 
     Committee, shall award grants to eligible entities to enable 
     such entities to develop and deliver educational programs 
     about newborn screening to parents, families, and patient 
     advocacy and support groups.
       ``(3) Grants for newborn screening followup.--From funds 
     appropriated under subsection (h), the Secretary, acting 
     through the Associate Administrator and in consultation with 
     the Advisory Committee, shall award grants to eligible 
     entities to enable such entities to establish, maintain, and 
     operate a system to assess and coordinate treatment relating 
     to congenital, genetic, and metabolic disorders.
       ``(b) Application.--An eligible entity that desires to 
     receive a grant under this section shall submit an 
     application to the Secretary at such time, in such manner, 
     and accompanied by such information as the Secretary may 
     require.
       ``(c) Selection of Grant Recipients.--
       ``(1) In general.--Not later than 120 days after receiving 
     an application under subsection (b), the Secretary, after 
     considering the approval factors under paragraph (2), shall 
     determine whether to award the eligible entity a grant under 
     this section.
       ``(2) Approval factors.--
       ``(A) Requirements for approval.--An application submitted 
     under subsection (b) may not be approved by the Secretary 
     unless

[[Page S6511]]

     the application contains assurances that the eligible 
     entity--
       ``(i) will use grant funds only for the purposes specified 
     in the approved application and in accordance with the 
     requirements of this section; and
       ``(ii) will establish such fiscal control and fund 
     accounting procedures as may be necessary to assure proper 
     disbursement and accounting of Federal funds paid to the 
     eligible entity under the grant.
       ``(B) Existing programs.--Prior to awarding a grant under 
     this section, the Secretary shall--
       ``(i) conduct an assessment of existing educational 
     resources and training programs and coordinated systems of 
     followup care with respect to newborn screening; and
       ``(ii) take all necessary steps to minimize the duplication 
     of the resources and programs described in clause (i).
       ``(d) Coordination.--The Secretary shall take all necessary 
     steps to coordinate programs funded with grants received 
     under this section.
       ``(e) Use of Grant Funds.--
       ``(1) Grants to assist health care professionals.--An 
     eligible entity that receives a grant under subsection (a)(1) 
     may use the grant funds to work with appropriate medical 
     schools, nursing schools, schools of public health, internal 
     education programs in State agencies, nongovernmental 
     organizations, and professional organizations and societies 
     to develop and deliver education and training programs that 
     include--
       ``(A) continuing medical education programs for health care 
     professionals and State health department laboratory 
     personnel in newborn screening;
       ``(B) education, technical assistance, and training on new 
     discoveries in newborn screening and the use of any related 
     technology;
       ``(C) models to evaluate what a newborn should be screened 
     for and when and where that screening should take place;
       ``(D) models to evaluate the prevalence of, and assess and 
     communicate the risks of, newborn disorders, including the 
     prevalence and risk of certain newborn disorders based on 
     family history;
       ``(E) models to communicate effectively with parents and 
     families about--
       ``(i) the process and benefits of newborn screening;
       ``(ii) how to use information gathered from newborn 
     screening;
       ``(iii) the meaning of screening results, including the 
     rate of false positives;
       ``(iv) the right of refusal of newborn screening; and
       ``(v) the potential need for followup care after newborns 
     are screened;
       ``(F) information and resources on coordinated systems of 
     followup care after newborns are screened;
       ``(G) information on the disorders for which States require 
     and offer newborn screening and options for newborn screening 
     relating to conditions in addition to such disorders;
       ``(H) information on supplemental newborn screening that 
     the States do not require and offer but that parents may 
     want; and
       ``(I) other items to carry out the purpose described in 
     subsection (a)(1) as determined appropriate by the Secretary.
       ``(2) Grants to assist families.--An eligible entity that 
     receives a grant under subsection (a)(2) may use the grant 
     funds to develop and deliver to parents, families, and 
     patient advocacy and support groups, educational programs 
     about newborn screening that include information on--
       ``(A) what is newborn screening;
       ``(B) how newborn screening is performed;
       ``(C) who performs newborn screening;
       ``(D) where newborn screening is performed;
       ``(E) the disorders for which the State requires newborns 
     to be screened;
       ``(F) different options for newborn screening for disorders 
     other than those included by the State in the mandated 
     newborn screening program;
       ``(G) the meaning of various screening results including 
     the rate of false positives;
       ``(H) the prevalence and risk of newborn disorders, 
     including the increased risk of disorders that may stem from 
     family history;
       ``(I) coordinated systems of followup care after newborns 
     are screened; and
       ``(J) other items to carry out the purpose described in 
     subsection (a)(2) as determined appropriate by the Secretary.
       ``(3) Grants for quality newborn screening followup.--An 
     eligible entity that receives a grant under subsection (a)(3) 
     shall use the grant funds to--
       ``(A) expand on existing procedures and systems, where 
     appropriate and available, for the timely reporting of 
     newborn screening results to individuals, families, primary 
     care physicians, and subspecialists in congenital, genetic, 
     and metabolic disorders;
       ``(B) coordinate ongoing followup treatment with 
     individuals, families, primary care physicians, and 
     subspecialists in congenital, genetic, and metabolic 
     disorders after a newborn receives an indication of the 
     presence of a disorder on a screening test;
       ``(C) ensure the seamless integration of confirmatory 
     testing, tertiary care medical services, comprehensive 
     genetic services including genetic counseling, and 
     information about access to developing therapies by 
     participation in approved clinical trials involving the 
     primary health care of the infant;
       ``(D) analyze data, if appropriate and available, collected 
     from newborn screenings to identify populations at risk for 
     disorders affecting newborns, examine and respond to health 
     concerns, recognize and address relevant environmental, 
     behavioral, socioeconomic, demographic, and other relevant 
     risk factors; and
       ``(E) carry out such other activities as the Secretary may 
     determine necessary.
       ``(f) Reports to Congress.--
       ``(1) In general.--Subject to paragraph (2), the Secretary 
     shall submit to the appropriate committees of Congress 
     reports--
       ``(A) evaluating the effectiveness and the impact of the 
     grants awarded under this section--
       ``(i) in promoting newborn screening--

       ``(I) education and resources for families; and
       ``(II) education, resources, and training for health care 
     professionals;

       ``(ii) on the successful diagnosis and treatment of 
     congenital, genetic, and metabolic disorders; and
       ``(iii) on the continued development of coordinated systems 
     of followup care after newborns are screened;
       ``(B) describing and evaluating the effectiveness of the 
     activities carried out with grant funds received under this 
     section; and
       ``(C) that include recommendations for Federal actions to 
     support--
       ``(i) education and training in newborn screening; and
       ``(ii) followup care after newborns are screened.
       ``(2) Timing of reports.--The Secretary shall submit--
       ``(A) an interim report that includes the information 
     described in paragraph (1), not later than 30 months after 
     the date on which the first grant funds are awarded under 
     this section; and
       ``(B) a subsequent report that includes the information 
     described in paragraph (1), not later than 60 months after 
     the date on which the first grant funds are awarded under 
     this section.
       ``(g) Definition of Eligible Entity.--In this section, the 
     term `eligible entity' means--
       ``(1) a State or a political subdivision of a State;
       ``(2) a consortium of 2 or more States or political 
     subdivisions of States;
       ``(3) a territory;
       ``(4) an Indian tribe or a hospital or outpatient health 
     care facility of the Indian Health Service; or
       ``(5) a nongovernmental organization with appropriate 
     expertise in newborn screening, as determined by the 
     Secretary.
       ``(h) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section--
       ``(1) $15,000,000 for fiscal year 2004; and
       ``(2) such sums as may be necessary for each of fiscal 
     years 2005 through 2008.''.

  Mr. DeWINE. Mr. President, I rise today, along with my colleague from 
Connecticut, Senator Dodd, to introduce the Newborn Screening Saves 
Lives Act of 2003, a bill designed to improve genetic newborn screening 
programs in this country. Our legislation would provide education 
grants for physicians and parents, as well as grants to states, to 
improve follow-up and tracking of those children who receive a positive 
result from a heelstick screening for metabolic, genetic, infectious, 
or other congenital conditions that threaten their health and well-
being.
  Each year, newborn screening identifies an estimated 3,000 babies 
with conditions like sickle cell diseases and homocystinuria that, if 
left undetected, would otherwise have had dire consequences. But, 
despite their clear importance, our newborn screening systems are 
fragmented. Quite simply, all children do not have access to the same 
genetic tests. Where a child is born determines the tests that he or 
she receives. In my home state of Ohio, we test for 12 disorders, while 
right across the border in Kentucky, they test for only four, and in 
Pennsylvania, only six. In Massachusetts, on the other hand, newborns 
are tested for 29 disorders.
  Compounding this problem, parents often are not sufficiently informed 
of the number of tests available in their individual states and what 
those tests can help accomplish. Physicians may not know to educate 
parents, or physicians may talk to parents too late in the birthing 
process for it to make a difference. Also, state health departments may 
not follow up adequately with the parents of a child who receives a 
positive test result, and health departments may not have the capacity 
to effectively record or track a large number of positive results.
  The bill we are introducing today would go a long way toward 
streamlining the current newborn screening system by offering grants to 
states to accomplish the following:
  Build and expand existing procedures and systems to report test 
results to individuals and families, primary care physicians, and 
specialists;

[[Page S6512]]

  Coordinate ongoing follow-up treatment with individuals, families, 
and primary care physicians after a newborn receives an indication of 
the presence of a disorder on a screening test;
  Ensure seamless integration of confirmatory testing, tertiary care, 
genetic services, including counseling, and access to evolving 
therapies by participation in approved clinical trials involving the 
primary health care of the infant; and
  Analyze collected data to identify populations at high risk, examine 
and respond to health concerns, and recognize and address relevant 
environmental, behavioral, socioeconomic, demographic, and other 
factors.
  Senator Dodd and I recently requested that the General Accounting 
Office examine state newborn screening programs. The results of this 
study were troubling. The GAO found that many children are not 
receiving critical, life-saving tests due, in part, to strained state 
budgets that cannot fund newborn screening initiatives.
  The grant program established by our bill seeks to help states 
maintain and expand their newborn screening programs. Our legislation 
would be a good start toward ensuring that all newborns receive equal 
access to genetic tests and that their follow-up care, if needed, is 
available and coordinated. The importance of these screenings cannot be 
overstated. It can mean the difference between life and death for a 
newborn. And that, Mr. President, is something we must address.
  I urge my colleagues to support this important children's health 
legislation.
                                 ______
                                 
      By Mr. BINGAMAN:
  S. 1071. A bill to authorize the Secretary of the Interior, through 
the Bureau of Reclamation, to conduct a feasibility study on a water 
conservation project within the Arch Hurley Conservancy District in the 
State of New Mexico, and for other purposes; to the Committee on Energy 
and Natural Resources.
  Mr. BINGAMAN. Mr. President, today I am pleased to introduce a bill 
to authorize the Secretary of the Interior to study a proposed water 
conservation project in eastern New Mexico. This project, involving the 
Arch Hurley Conservancy District near Tucumcari, NM, could play a 
significant role in helping to address the chronic water supply issues 
that exist in the eastern part of the state.
  The Conservancy District receives its water supply from Conchas Lake 
on the Canadian River, and delivers it through an unlined canal to 
irrigate approximately 41,400 acres of farmland in the area. The 
district has suggested that it might be possible to line its canal, 
eliminate a large amount of seepage, and convey a portion of the saved 
water to address water supply needs in the Pecos River basin. The non-
conveyed portion of the conserved water would be available to shore up 
the district's supply in times of drought.
  While further investigation is warranted to test the feasibility of 
the proposed project and any issues associated with its implementation, 
the project does hold significant promise, making this legislation 
timely. I appreciate the district's leadership in developing this 
proposal which represents a creative effort to improve water management 
and efficiency within New Mexico. If, in the 21st century, we are to 
maintain the standard of life that we've grown accustomed to in the 
arid West, creative solutions to our water supply problems are 
necessary. This bill is a step in the right direction by encouraging 
efforts to develop, analyze, and ultimately implement those creative 
solutions. I hope my colleagues will support this modest effort to 
address New Mexico's water needs.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1071

       Be it enacted by the Senate and the House of 
     Representatives of the United States of America in Congress 
     assembled,

     SECTION 1. STUDY AUTHORIZATION.

       (a) Authorization.--Pursuant to reclamation laws, the 
     Secretary of the Interior, through the Bureau of Reclamation, 
     and in consultation and cooperation with the Arch Hurley 
     Conservancy District and the State Engineer in New Mexico, is 
     authorized to conduct a study to determine the feasibility of 
     implementing a water conservation project that will minimize 
     water losses from the irrigation conveyance works of the Arch 
     Hurley Conservancy District, and to consider--
       (1) options for utilizing any saved water made available 
     from the conservation project including the possible 
     conveyance of such water, in accordance with State law, to 
     the Pecos River basin to address water supply issues in that 
     basin;
       (2) the impacts that the conservation project could have on 
     the local water supply in and around the Arch Hurley 
     Conservancy District and any appropriate mitigation that may 
     be necessary if the project is implemented; and
       (3) appropriate cost-sharing options for implementation of 
     the project based on the use and possible allocation of any 
     conserved water.
       (b) Report.--
       (1) Upon completion of the feasibility study authorized by 
     this Act, the Secretary of the Interior shall transmit to 
     Congress a report containing the results of the study.
       (2) In developing the report, the Secretary shall utilize 
     reports or any other relevant information supplied by the 
     Arch Hurley Conservancy District or the State Engineer in New 
     Mexico.

     SEC. 2. AUTHORIZATION OF APPROPRIATIONS.

       (a) Amount.--There are authorized to be appropriated 
     $500,000 to carry out this Act.
       (b) Cost Share.--
       (1) The federal share of the costs of the feasibility study 
     shall not exceed 50 percent of the total, except that the 
     Secretary of the Interior is authorized to waive or limit the 
     required non-Federal cost share for the feasibility study if 
     the Secretary determines, based upon a demonstration of 
     financial hardship on the part of the Arch Hurley Conservancy 
     District, that the District is unable to contribute such 
     required share.
       (2) The Secretary of the Interior may accept as part of the 
     non-Federal cost share the contribution of such in-kind 
     services by the Arch Hurley Conservancy District as the 
     Secretary determines will contribute substantially toward the 
     conduct and completion of the study.
                                 ______
                                 
      By Mr. INHOFE (for himself, Mr. Jeffords, Mr. Bond, and Mr. Reid) 
        (by request):
  S. 1072. A bill to authorize funds for Federal-aid highways, highway 
safety programs, and transit programs, and for other purposes; to the 
Committee on Environmental and Public Works.
  Mr. INHOFE. Mr. President, I am pleased to introduce, by request, 
President Bush's proposed ``Safe, Accountable, Flexible and Efficient 
Transportation Equity Act of 2003,'' SAFETEA, which reauthorizes the 
Federal-aid surface transportation program. Joining me are Senators 
Jeffords and Bond.
  Although I am not in complete agreement with the President on this 
proposal, I believe the President deserves the courtesy of getting his 
proposal introduced.
  I do agree with the President's desire to build upon the achievements 
of the Transportation Equity Act of the 21st Century, TEA-21, of 1998 
and the Intermodal Surface Transportation Efficiency Act, ISTEA, of 
1991. In the hearings conducted by the Environment and Public Works 
Committee over the last 12 months, we consistently heard that TEA-21 
works.
  SAFETEA focuses on reducing highway fatalities and injuries, reducing 
congestion, protecting the environment, increasing funding flexibility 
for State and local governments, and providing economic stimulus to the 
Nation's economy. All very worthy goals. Unfortunately, the funding 
proposed in the President's bill is woefully inadequate.
  As Chairman of the Environment and Public Works Committee, I am 
looking forward to working with the President and my Congressional 
colleagues to develop a Senate bill that strengthens the national 
transportation system.
  Mr. JEFFORDS. Mr. President, today, I join my colleagues from the 
Committee on Environment and Public Works in offering, by request, the 
Administration's recommended legislation to reauthorize the Nation's 
surface transportation program. I extend this courtesy, in large 
measure, out of respect for my long time friend and colleague, 
Secretary of Transportation Norman Mineta.
  Norm and I served together, and worked together, for many years in 
the House. Norm is a leader on transportation, an author of many key 
aspects of our transportation law.
  In the 107th Congress, as Chairman of the Committee, I reached out to 
Norm as we began our deliberations on reauthorization. He pledged then 
that U.S.

[[Page S6513]]

DOT would work closely with the Congress, and he kept his word. I 
appreciate his friendship and assistance.
  The administration's proposal is a mixed bag. Its greatest strength 
is its continuity with its predecessors, ISTEA and TEA-21. These are 
landmarks in public policy, due in no small measure to the efforts and 
wisdom of Norm, Senator John Chafee, Senator Pat Moynahan and 
Congressman Bud Shuster. The administration package carries that legacy 
forward.
  Its greatest weakness is its funding levels. The bill sets the right 
target with its emphasis on safety, but comes up short on the funding 
to hit that target. It continues programs that have produced better 
roads and stronger bridges in this country, but then fails to provide 
the dollars to continue this progress. It does less than is needed to 
address congestion and not enough to expand freight capacity.
  Under Chairman Inhofe's leadership, we have fought for higher funding 
levels. We will continue that fight. I will not shortchange the Nation. 
I will not support any legislation that underfunds transportation.
  The Administration's bill would modify our approach to environmental 
protection. My record on clean air, clean water and sound planning is 
clear and consistent. I want to strengthen our efforts, and will oppose 
any measure that reduces our vigilance in these areas. Our 
transportation investments should improve our environment, our air and 
water quality, should strengthen local economies and enhance our 
communities.
  We will have a robust debate on these matters over the next few 
months. I look forward to working with my EPW colleagues, with Chairman 
Young and Mr. Oberstar in the House and with Secretary Mineta to renew 
our surface transportation program for a strong America.
  Mr. REID. Mr. President, today I join my colleagues from the 
Environment and Public Works Committee in introducing the 
administration's bill by request. I do so largely because of my 
friendship with and respect for Secretary of Transportation Norman 
Mineta, whom I served with in my days in the House of Representatives.
  I have always been a proponent of infrastructure spending and the 
economic stimulus and jobs that it creates. For every billion dollars 
we spend on our Nation's surface transportation infrastructure, we 
create over 47,000 well-paid skilled jobs. Reauthorizing our Nation's 
surface transportation laws represents a tremendous opportunity for us 
to impact our economy in a meaningful, lasting way. Unfortunately, the 
administration's reauthorization proposal does not take full advantage 
of this opportunity.
  While the bill continues the spirit of its predecessors, ISTEA and 
TEA-21, the bill is woefully underfunded. The bill correctly places 
added emphasis on important topics such as safety, but then lacks the 
funding to make a real and substantial impact in these areas.
  The administration's bill also would modify certain environmental 
provisions and project permitting requirements. TEA-21 and its 
predecessor, ISTEA, proved we can advance our national transportation 
goals while preserving our environment. I will not support any 
provision that undermines essential environmental protections I have 
spent 20 years in public office trying to preserve. We can increase 
investment in and improve our Nation's surface transportation system in 
a timely, thoughtful, and effective way without jeopardizing the 
environment.
  I look forward to the coming reauthorization debate and to working 
with my colleagues and Secretary Mineta on this most important 
legislation.
                                 ______
                                 
      By Mr. SPECTER:
  S. 1074. A bill to amend title 38, United States Code, to enhance 
burial benefits for veterans, and for other purposes; to the Committee 
on Veterans' Affairs.
  Mr. SPECTER. Mr. President, I have sought recognition to comment on 
legislation I am introducing today to ensure that veterans across the 
Nation have access to burial in national and State cemeteries. This 
legislation will put in place a comprehensive strategy for addressing 
what has, and will continue to be, a national priority: providing 
lasting memorials to our veterans.
  Four principles guide this legislation: First, areas with large 
veterans' populations merit a national cemetery. Second, State cemetery 
grant funding should encourage the development of State cemeteries to 
serve areas with smaller veterans' populations. Third, State or 
national cemeteries should be located within reasonable distances of 
where veterans lived before death and, presumably, where their families 
still live. And finally, we need creative ways to finance the 
maintenance, repair and operational needs of national cemeteries.
  This bill sets out clear criteria, based on objective measures of 
need, that will serve as a guide for future national cemetery 
construction. It encourages States to participate in the State cemetery 
grant program by permitting State cemeteries to receive plot allowance 
money to defray burial expenses for all--not just poor, disabled and 
wartime--veterans. Lastly, the legislation authorizes VA's National 
Cemetery Administration, NCA, to enter into lease agreements with 
public or non-profit organizations who wish to use unused or 
underutilized land and facilities, and permits proceeds from lease 
agreements to remain with NCA to augment its operational and cemetery 
maintenance needs.
  Burial in a national cemetery--a perpetual tribute to a veteran's 
service to the country--is one of the most important benefits we, as a 
Nation, can provide to veterans and their families. It must be 
available to veterans, and their families, within reasonable distances 
to their homes. This legislation would require the Department of 
Veterans Affairs to establish a national cemetery at sites more than 50 
miles away from an open national or State veterans cemetery where 
170,000 or more veterans reside. The adoption of this criterion would 
assure adequate national access to national cemeteries and would 
require the opening of approximately five new national cemeteries.
  Because it is not practical to build national cemeteries to meet the 
burial needs of every veteran--particularly veterans in more sparsely 
populated areas--it is important that VA cooperate with the States 
through administration of its State cemetery grant program, to meet 
needs in areas where there are smaller veterans' populations. These 
grants provide up to 100 percent of the costs associated with building, 
making large repairs at, and expanding State veterans cemeteries. In 
addition, States are also provided a $300 plot allowance, payable by VA 
to assist in offsetting maintenance costs, for each poor, disabled, or 
wartime veteran who is interred in a State cemetery. If, as this 
legislation would specify, the plot allowance were to be payable for 
burial of all veterans--not just poor, disabled and wartime veterans--
States would be provided with additional maintenance income and further 
incentive to establish additional State veterans' cemeteries. Clearly, 
encouraging the construction of additional State cemeteries is a good 
way to complement VA's National cemetery capacity within the context of 
a nationwide, comprehensive strategy to meet veterans' burial needs.
  Finally, my legislation proposes a creative way for NCA to fund 
additional maintenance projects at national cemeteries. It would 
authorize the Secretary to lease undeveloped, unused or underutilized 
acreage and buildings on NCA lands, and to retain the proceeds from the 
leases. VA has indicated that portions of many national cemeteries are 
not suitable for burials due to, for example, rocky or hilly terrain. 
Such sites, however, might have commercial uses. In addition, there are 
historic lodges and other buildings on VA lands that, if available for 
use, could generate revenue. Allowing NCA to utilize these resources to 
generate revenue would provide VA with an opportunity to put a small 
dent in the $245 million worth of repairs it needs to undertake to 
bring the national cemeteries up to appropriate memorial standards. 
This sort of leasing authority is already extended to VA's hospital 
system, and it has been successfully utilized on VA's medical campuses. 
An extension of this authority to VA cemetery facilities is wholly 
reasonable.
  I ask my colleagues for their support of this bill. I reiterate, 
meeting the burial needs of veterans is a national

[[Page S6514]]

priority. It is a powerful reflection of the value we place on military 
service. And it is an unmistakable message we send to all Americans 
that service to our country will forever be remembered.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1074

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Veterans' Burial Benefits 
     Enhancement Act of 2003''.

     SEC. 2. MODIFICATION OF ELIGIBILITY OF STATES FOR BURIAL PLOT 
                   ALLOWANCE.

       (a) In General.--Section 2303(b) of title 38, United States 
     Code, is amended--
       (1) in the matter preceding paragraph (1), by striking ``a 
     burial allowance under such section 2302, or under such 
     subsection, who was discharged from the active military, 
     naval, or air service for a disability incurred or aggravated 
     in line of duty, or who is a veteran of any war'' and 
     inserting ``burial in a national cemetery under section 2402 
     of this title''; and
       (2) in paragraph (2), by striking ``(other than a veteran 
     whose eligibility for benefits under this subsection is based 
     on being a veteran of any war)'' and inserting ``is eligible 
     for a burial allowance under section 2302 of this title or 
     under subsection (a) of this section, or was discharged from 
     the active military, naval, or air service for a disability 
     incurred or aggravated in line of duty, and such veteran''.
       (b) Applicability.--The amendments made by subsection (a) 
     shall apply with respect to the burial of persons dying on or 
     after the date of the enactment of this Act.

     SEC. 3. LEASE OF UNUTILIZED OR UNDERUTILIZED PROPERTY OR 
                   FACILITIES OF NATIONAL CEMETERY ADMINISTRATION.

       (a) In General.--Chapter 24 of title 38, United States 
     Code, is amended by inserting after section 2406 the 
     following new section:

     ``Sec. 2406A. Lease of unutilized or underutilized land or 
       facilities

       ``(a) Subject to the provisions of this section, the 
     Secretary may lease to such lessee, and upon such terms and 
     conditions as the Secretary considers will be in the public 
     interest, any unutilized or underutilized land or facilities 
     of the United States that are part of the National Cemetery 
     Administration as the Secretary considers appropriate.
       ``(b) The term of any lease of land or facilities under 
     subsection (a) may not exceed three years.
       ``(c)(1) A lease under subsection (a) to any public or 
     nonprofit organization may be made without regard to the 
     provisions of section 3709 of the Revised Statutes (41 U.S.C. 
     5).
       ``(2) Notwithstanding section 1302 of title 40 or any other 
     provision of law, a lease under subsection (a) to any public 
     or nonprofit organization may provide for the maintenance, 
     protection, or restoration by the lessee of the land or 
     facilities covered by the lease as a part or all of the 
     consideration for the lease.
       ``(3) Before entering into a lease of land or facilities 
     under subsection (a) to a public or nonprofit organization, 
     the Secretary shall publish in a newspaper of general 
     circulation in the community in which such land or facilities 
     are located appropriate public notice of the intention of the 
     Secretary to enter into the lease.
       ``(d) Notwithstanding any other provision of law, proceeds 
     from the lease of land or facilities under subsection (a) 
     shall be deposited in the National Cemetery Administration 
     account. Amounts so deposited shall be merged with amounts in 
     such account, and shall be available for the same purposes, 
     and subject to the same conditions and limitations, as the 
     amounts with which merged.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of that chapter is amended by inserting after the 
     item relating to section 2406 the following new item:

``2406A. Lease of unutilized or underutilized land or facilities.''.

     SEC. 4. ESTABLISHMENT OF NATIONAL CEMETERIES FOR 
                   GEOGRAPHICALLY UNDERSERVED POPULATIONS OF 
                   VETERANS.

       (a) In General.--Chapter 24 of title 38, United States 
     Code, is amended by adding at the end the following new 
     section:

     ``Sec. 2412. Establishment of national cemeteries: 
       geographically underserved populations of veterans

       ``(a) Except as provided in subsection (c), the Secretary 
     shall establish a national cemetery in each geographic area 
     identified by the Secretary under subsection (b) in order to 
     ensure that the veterans who reside in such geographic area 
     reside not more than 50 miles from an open national cemetery.
       ``(b) The Secretary shall identify each geographic area in 
     the United States in which--
       ``(1) the number of veterans who reside more than 50 miles 
     from an open national cemetery or State cemetery for veterans 
     exceeds 170,000 veterans; or
       ``(2) the number of veterans who reside more than 50 miles 
     from an open national cemetery or State cemetery for 
     veterans, when combined with the number of veterans who 
     reside within 50 miles of a State cemetery for veterans but 
     are ineligible for burial in such State cemetery due to 
     residency requirements, exceeds 170,000 veterans.
       ``(c) If the Secretary determines that the expansion of one 
     or more national cemeteries in a geographic area identified 
     under subsection (b) is adequate and appropriate to meet the 
     needs of veterans and their families in such geographic area, 
     the Secretary shall expand such national cemetery or 
     cemeteries in lieu of meeting the requirement for such 
     geographic area under subsection (a).
       ``(d) A national cemetery established under this section 
     shall be treated as a national cemetery of the National 
     Cemetery Administration under this chapter.
       ``(e) In this section, the term `open', with respect to a 
     national cemetery or State cemetery for veterans, means that 
     the national cemetery or State cemetery for veterans has the 
     capacity for each of the following:
       ``(1) First interment, in-ground casket burials.
       ``(2) Burial or inurnment of cremated remains.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of that chapter is amended by adding at the end the 
     following new item:

``2412. Establishment of national cemeteries: geographically 
              underserved populations of veterans.''.

                          ____________________