[Congressional Record Volume 150, Number 47 (Tuesday, April 6, 2004)]
[Senate]
[Pages S3792-S3796]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. NELSON of Nebraska (for himself and Mr. Brownback):
  S. 2284. A bill to expand the medicare rural community hospital 
demonstration program to include outpatient services; to the Committee 
on Finance.
  Mr. NELSON of Nebraska. Mr. President, today I introduce legislation 
to continue the relief to six hospitals in Nebraska that have been 
struggling financially under the current Medicare payment structure.
  Local hospitals can best meet the unique needs of rural communities 
which is why I am committed to ensuring that these hospitals have the 
resources they need. Vital services like hospitals are increasingly 
important for the survival of our rural communities. Towns can't 
adequately serve residents--or attract new residents--without access to 
basic services. We need to focus on ensuring that hospitals and other 
vital services have the resources they need, so that communities will 
have the essential services they require.
  Last year, Senator Brownback and I proposed legislation to provide 
cost-based reimbursement for rural community hospitals. Rural Community 
Hospitals (RCH) are hospitals with between 25-50 beds. Those hospitals 
had been adversely affected by Medicare formulas that set rates for 
reimbursement nationwide. These rates did not take into account the 
higher costs of practicing medicine in rural areas as these areas do 
not have the benefits of volume that larger hospitals enjoy. RCHs are 
also too large to qualify for critical access designation given to 
hospitals with fewer than 25 beds.

[[Page S3793]]

  I am pleased that provisions from this legislation were included in 
the Medicare Prescription Drug, Improvement, and Modernization Act of 
2003 as a pilot program. The program provided cost-based reimbursements 
for inpatient services.
  The legislation Senator Brownback and I are introducing today will 
expand the pilot program to cover outpatient services as well. This 
legislation will again address a critical shortcoming in current 
reimbursement practices and help Rural Community Hospitals serve their 
communities and invest in the future of rural health care.
  Six Nebraska hospitals would be affected by expanding the scope of 
the pilot program. Those hospitals are: Beatrice Community Hospital, 
Columbus Community Hospital, McCook Community Hospital, Jennie Melham 
Memorial Medical Center in Broken Bow, Phelps Memorial Health Center in 
Holdrege, and Tri County Hospital in Lexington.
  We made some progress for our rural hospitals by creating the RCH 
pilot program last year. This legislation would expand on that victory 
by ensuring that all Medicare treatments, whether inpatient or 
outpatient, would receive cost-based reimbursement. Expanding this 
program will make a big difference to these hospitals and more 
importantly, the patients they serve.
                                 ______
                                 
      By Mr. HATCH (for himself and Mr. Bennett):
  S. 2285. A bill to direct the Secretary of the Interior to convey a 
parcel of real property to Beaver County, Utah; to the Committee on 
Energy and Natural Resources.
  Mr. HATCH. Mr. President, I rise today to introduce a bill that would 
direct the Secretary of the Interior to convey a parcel of property to 
Beaver County, UT. This bill would allow Beaver County in Southwestern 
Utah to obtain and maintain, without restrictions, the former 
Minersville State Park. In sum, this bill is necessary to allow County 
officials to sell a small portion of this land--which has essentially 
been under their control for over 40 years--in order to offset funding 
needed to maintain the remainder of the park.
  Some history might be beneficial at this point. In 1961, Beaver 
County obtained a lease for 207 acres of land from the Bureau of Land 
Management (BLM) to develop a recreational locale under the Recreation 
and Public Purposes Act. In 1963, Beaver County turned over the acreage 
to the State for the development of a park. Over the course of nearly 
40 years, the State of Utah spent about one million dollars to develop 
campsites, a boat ramp, a dock, and other camping amenities to turn 
this area into the Minersville Reservoir State Park. In 2002, in an 
endeavor to reduce operating costs, Utah State Parks transferred 
control of the area back over to Beaver County. As County officials 
stated during negotiations, in order for Beaver County to afford 
management of the day to day operations of the would-be county park, 
they would need to sell some of the property to private investors. 
However, it was not until after park management responsibility was 
transferred to the county that the BLM pointed out that the state had 
not yet acquired the property through the Recreation and Public 
Purposes Act process. The plan for Beaver County to sell some of the 
land to pay for park operation, however, is not allowed under the 
Recreation and Public Purposes Act lease, which only allows the 
property to be developed for recreation or other purposes. The only way 
for Beaver County to undertake responsibility for park is to remove the 
current Federal restrictions on the property.
  Today, Beaver County faces financial constraints in operating this 
park that threaten its continued use. Due to the prevailing 
restrictions in the Recreation and Public Purposes Act lease, initiated 
more than 40 years ago, the good people of southern Utah and visitors 
to the area will not be able to access and enjoy this county park. The 
campsites would be littered and unkept. The boat ramp and the boat 
docks would have to be closed. The park would become a destitute 
recreation area, because there would be no one to administer park 
maintenance and upkeep. The only public access to Minersville 
Reservoir, which features a converted blue ribbon trout fishery, would 
go to waste because of the Federal government's current Recreation and 
Public Purposes Act lease restriction.
  I don't believe that letting management of the park revert to the BLM 
is a viable option either. The intensive, day to day management this 
small park requires can be best accomplished to local officials. If 
Beaver County acquires the property, it will continue to make this park 
an excellent recreational refuge, a superb fishery, and a great place 
to visit. Beaver County will be able to provide a clean and safe park 
enjoyed by all who visit. That is why I am introducing this legislation 
this legislation that would convey the Minersville Park land to Beaver 
County.
  I thank the Senate for the opportunity to address this issue today, 
and I urge my colleagues to support this legislation.
                                 ______
                                 
      By Ms. COLLINS:
   S. 2288. A bill to amend the Public Health Service Act to assist 
States in establishing, maintaining, and improving systems to reduce 
the diversion and abuse of prescription drugs; to the Committee on 
Health, Education, Labor, and Pensions.
   Ms. COLLINS. Mr. President, the abuse of prescription drugs has 
reached epidemic proportions in this country. In many States, including 
my home State of Maine, deaths from prescription drug overdoses now 
exceed deaths from illicit drugs. Nationwide, emergency room visits for 
prescription drug problems more than doubled in the last decade.
   The number of Americans who divert prescription drugs from their 
intended purposes and abuse them was estimated at 4 million in 1998. 
Today, the estimate is 11 million Americans. At a time when, according 
to the National Institute on Drug Abuse, our young people are turning 
away from marijuana, cocaine, ecstasy, and even alcohol, they 
unfortunately are turning to the medicine cabinet.
   Nearly one in five of our Nation's high school juniors and seniors 
say they abuse prescription drugs.
   The cost of drug abuse to our society in treatment, health care, 
lost productivity, crime, and incarceration exceeds $150 billion a 
year. The cost to its victims is incalculable. That is why today I am 
introducing the Prescription Drug Stewardship Act. I use the word 
``stewardship'' to emphasize our responsibility as individuals and as a 
society to see that these beneficial medications are used for their 
intended purposes, not to cause addiction, disability, and even death.
   This legislation attacks the spiraling cycle of diversion and abuse 
with three key stewardship activities:
   First, computerized prescription drug systems to better track the 
flow of medications.
   Second, ongoing practitioner training to help our busy medical 
professionals keep current with the trends in diversion treatment and 
abuse.
   Third, and perhaps most important, public education to help our 
citizens better understand the dangers posed by the misuse of these 
drugs.
   I have found in talking with experts in this field that many 
individuals who would never think of trying heroin, for example, will 
take leftover prescription drugs that may, in the long run, be equally 
addictive and just as harmful.
   Combined with improved and more accessible substance abuse treatment 
programs, the legislation I am introducing would help to stem the 
rising tide of abuse and addiction that has swamped families and 
weakened communities in my State and across the country.
  My bill would authorize per year for each of the next 3 years to fund 
prescription drug monitoring and education programs at the State level. 
It would create competitive grant programs which would be administered 
by the Substance Abuse and Mental Health Services Administration. They 
would require States to demonstrate their commitment to stewardship 
with matching funds and also to meet the privacy requirements under 
current law as they carry out these important activities.
  What we have found is that the most abused medications are those that 
relieve pain and anxiety. For millions of legitimate patients suffering 
from illness or injury, these medicines are

[[Page S3794]]

vital and their availability is proper and humane. They can make the 
difference between suffering and the ability to carry on with a normal 
life for people who are in serious pain or suffering from serious 
disease or injury. It is tragically clear, however, that these 
medications, many of them as powerful or as addictive as illegal drugs, 
increasingly are being diverted from their legitimate use to 
trafficking and abuse.
  I want to emphasize that the problems is not with these medications 
when they are prescribed, dispensed, and consumed responsibly. In fact, 
we know that pain is still undertreated in this country, and that most 
physicians are extremely responsible in trying to relieve pain felt by 
their patients. The problem is what happens when the chain of 
responsibility breaks.
  Oversight of the licensing and practices for prescribing and 
dispensing of these medications has long been a matter of State 
jurisdiction. As a former State regulator who was in charge of 
licensing boards for physicians and pharmacists, for example, I 
certainly have no desire to change that system. The States have not 
shirked their stewardship responsibility. They simply have been 
overwhelmed by this epidemic of diversion and abuse, and they need some 
Federal assistance, not to take over their programs, but to help them 
in a partnership to make them more effective.
  This national calamity has hit rural States particularly hard. The 
Presiding Officer's home State of North Carolina is one of those States 
that has felt the devastating impact of this epidemic. Kentucky, 
Virginia, West Virginia all report prescription drug abuse at epidemic 
levels. But no State, unfortunately, has been hit harder than my State 
of Maine.
  From 1997 to 2002, the number of accidental deaths in Maine from all 
drugs soared from 19 to 126, an increase of more than 500 percent, and 
prescription drugs were present in 60 percent of these deaths.
  The 2002 Main Youth Drug and Alcohol Survey found that a disturbing 
25 percent of my State's high school juniors and seniors abuse 
prescription drugs. That is an astonishing number and a very disturbing 
statistic. In the last 5 years, enrollment in Main clinics that treat 
opiate addiction has increased tenfold.
  These shocking numbers from Main demonstrate that drug abuse and 
addiction is not longer a big-city problem. It is a problem that 
afflicts our citizens no matter where they live, whether it is Los 
Angeles, CA, or Calais, ME. In fact, a hearing I helped put together 
last year demonstrated that there is a terrible problem in Washington 
County in Downeast, ME. Some estimates are that as many as 1,000 of the 
citizens of this county of only 35,000 citizens are struggling with 
drug addiction and abuse. This was a hearing before the HELP Committee. 
It actually was 2 years ago. But last August, I chaired a committee 
meeting of the Governmental Affairs Committee in Bangor, ME, where we 
heard from law enforcement officers, from drug treatment counselors, 
and from many others who are expert in drug addiction and abuse. The 
picture they painted was a startling one. It showed that drug abuse, 
and abuse of prescription drugs in particular, is a problem throughout 
the entire State of Maine.

  My legislation would provide States, such as Maine, with the 
resources to carry out three critical stewardship activities. The first 
would help States to monitor the flow of prescription drugs from 
practitioner to pharmacy to patient. We know that prescription drugs 
often find their way to the street when unscrupulous individuals obtain 
multiple prescriptions from multiple doctors. These so-called doctor 
shoppers operate in every State. Sometimes they act alone and sometimes 
they act in concert with organized gangs of criminals. Each can divert 
hundreds, even thousands, of pills per day. Many of these drugs have a 
street value 10 times the cost at the pharmacy.
  Twenty States now have prescription tracking systems. Maine began 
operating such a system or putting it together just this summer. About 
half of these systems use the latest computer technology and have 
proven that illegal diversion can be curtailed without reducing access 
to these medications by legitimate patients and without breaching that 
essential doctor-patient confidentiality.
  We want to make sure any system we put in place does not chill a 
doctor's ability to prescribe legitimate medication for patients who 
are suffering and need help with their pain.
  These systems have also demonstrated an effective prescription drug 
system more than pays for itself by reducing the tremendous costs 
associated with drug abuse and addiction. Thirty States, however, have 
no system whatsoever for monitoring or tracking prescription drugs in a 
way that would help us identify and put a stop to doctor shopping. My 
legislation would provide the States with the resources to start up 
such a system to help improve its quality or to maintain it.
  The testimony I heard last August in Bangor, ME, before the 
Governmental Affairs Committee, along with my colleague Senator Sununu, 
provided the basis not only for that provision of our bill but also for 
two others. The testimony we heard that day from those who are on the 
front lines, law enforcement, hospital emergency room physicians, and 
treatment clinic personnel, was alarming. They told us medical 
practitioners need our help. Our doctors, our physician assistants, our 
nurses are busy professionals, often far too busy. Many simply do not 
have the time to travel to seminars where they would receive 
information about the latest trends in drug abuse, learn how to 
recognize drug-seeking behavior, dependence, or addiction among their 
patients. The most effective and efficient way to provide that kind of 
training to medical personnel is to take the education to them through 
one-on-one small group mentoring in their offices or in their 
hospitals.
  The second part of my legislation would provide grants for such 
mentoring projects so practitioners with special training in drug abuse 
issues can pass along this vital knowledge to their colleagues who are 
practicing in communities all over America. Experts also tell us a 
major reason so many Americans with no history of abusing illegal drugs 
now are abusing prescriptions drugs is many people have a terrible 
misconception that these prescription drugs are somehow safe to abuse, 
that it is safe to take someone else's prescription. After all, they 
think they are researched in high-tech laboratories, manufactured in 
modern factories, prescribed and dispensed by highly trained medical 
experts; therefore, they must be safe. When they are used properly, 
they are, but as the overdose and addiction statistics prove, when used 
improperly they can be fatal.
  We need an aggressive public education campaign to warn our citizens 
about the dangers of abusing prescription drugs. The reduction in 
smoking rates, in illicit drug use, even in drunk-driving deaths is 
testament to the progress we can make with seemingly intractable 
problems when we commit the resources for public education campaigns in 
partnership with the States. I believe the same approach can help our 
citizens become better stewards of prescription medications.
  I urge my colleagues to join me in support of the legislation I am 
introducing today to address the increasingly devastating problem of 
prescription drug abuse.
                                 ______
                                 
      By Mr. SESSIONS:
  S. 2289. A bill to amend title 18, United States Code, to combat 
terrorism against railroad carriers and mass transportation systems on 
land, on water, or through the air, and for other purposes; to the 
Committee on the Judiciary.
  Mr. SESSIONS. Mr. President, 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. 2289

       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 ``Railroad Carriers and Mass 
     Transportation Protection Act of 2004''.

     SEC. 2. ATTACKS AGAINST RAILROAD CARRIERS AND MASS 
                   TRANSPORTATION SYSTEMS.

       (a) In General.--Chapter 97 of title 18, United States 
     Code, is amended by striking sections 1992 through 1993 and 
     inserting the following:

[[Page S3795]]

     ``Sec. 1992. Terrorist attacks and other violence against 
       railroad carriers and against mass transportation systems 
       on land, on water, or through the air

       ``(a) General Prohibitions.--Whoever, in a circumstance 
     described in subsection (c), knowingly--
       ``(1) wrecks, derails, sets fire to, or disables railroad 
     on-track equipment or a mass transportation vehicle;
       ``(2) with intent to endanger the safety of any passenger 
     or employee of a railroad carrier or mass transportation 
     provider, or with a reckless disregard for the safety of 
     human life, and without previously obtaining the permission 
     of the railroad carrier--
       ``(A) places any biological agent or toxin, destructive 
     substance, or destructive device in, upon, or near railroad 
     on-track equipment or a mass transportation vehicle; or
       ``(B) releases a hazardous material or a biological agent 
     or toxin on or near the property of a railroad carrier or 
     mass transportation provider;
       ``(3) sets fire to, undermines, makes unworkable, unusable, 
     or hazardous to work on or use, or places any biological 
     agent or toxin, destructive substance, or destructive device 
     in, upon, or near any--
       ``(A) tunnel, bridge, viaduct, trestle, track, 
     electromagnetic guideway, signal, station, depot, warehouse, 
     terminal, or any other way, structure, property, or 
     appurtenance used in the operation of, or in support of the 
     operation of, a railroad carrier, without previously 
     obtaining the permission of the railroad carrier, and with 
     intent to, or knowing or having reason to know such activity 
     would likely, derail, disable, or wreck railroad on-track 
     equipment; or
       ``(B) garage, terminal, structure, track, electromagnetic 
     guideway, supply, or facility used in the operation of, or in 
     support of the operation of, a mass transportation vehicle, 
     without previously obtaining the permission of the mass 
     transportation provider, and with intent to, or knowing or 
     having reason to know such activity would likely, derail, 
     disable, or wreck a mass transportation vehicle used, 
     operated, or employed by a mass transportation provider;
       ``(4) removes an appurtenance from, damages, or otherwise 
     impairs the operation of a railroad signal system or mass 
     transportation signal or dispatching system, including a 
     train control system, centralized dispatching system, or 
     highway-railroad grade crossing warning signal, without 
     authorization from the rail carrier or mass transportation 
     provider;
       ``(5) with intent to endanger the safety of any passenger 
     or employee of a railroad carrier or mass transportation 
     provider or with a reckless disregard for the safety of human 
     life, interferes with, disables, or incapacitates any 
     dispatcher, driver, captain, locomotive engineer, railroad 
     conductor, or other person while the person is employed in 
     dispatching, operating, or maintaining railroad on-track 
     equipment or a mass transportation vehicle;
       ``(6) engages in conduct, including the use of a dangerous 
     weapon, with the intent to cause death or serious bodily 
     injury to any person who is on the property of a railroad 
     carrier or mass transportation provider that is used for 
     railroad or mass transportation purposes;
       ``(7) conveys false information, knowing the information to 
     be false, concerning an attempt or alleged attempt that was 
     made, is being made, or is to be made, to engage in a 
     violation of this subsection; or
       ``(8) attempts, threatens, or conspires to engage in any 
     violation of any of paragraphs (1) through (8);

     shall be fined under this title or imprisoned not more than 
     20 years, or both.
       ``(b) Aggravated Offense.--Whoever commits an offense under 
     subsection (a) of this section in a circumstance in which--
       ``(1) the railroad on-track equipment or mass 
     transportation vehicle was carrying a passenger or employee 
     at the time of the offense;
       ``(2) the railroad on-track equipment or mass 
     transportation vehicle was carrying high-level radioactive 
     waste or spent nuclear fuel at the time of the offense;
       ``(3) the railroad on-track equipment or mass 
     transportation vehicle was carrying a hazardous material at 
     the time of the offense that--
       ``(A) was required to be placarded under subpart F of part 
     172 of title 49, Code of Federal Regulations; and
       ``(B) is identified as class number 3, 4, 5, 6.1, or 8 and 
     packing group I or packing group II, or class number 1, 2, or 
     7 under the hazardous materials table of section 172.101 of 
     title 49, Code of Federal Regulations; or
       ``(4) the offense results in the death of any person;

     shall be fined under this title or imprisoned for any term of 
     years or life, or both. In the case of a violation described 
     in paragraph (2), the term of imprisonment shall be not less 
     than 30 years; and, in the case of a violation described in 
     paragraph (4), the offender shall be fined under this title 
     and imprisoned for life and be subject to the death penalty.
       ``(c) Circumstances Required for Offense.--A circumstance 
     referred to in subsection (a) is any of the following:
       ``(1) Any of the conduct required for the offense is, or, 
     in the case of an attempt, threat, or conspiracy to engage in 
     conduct, the conduct required for the completed offense would 
     be, engaged in, on, against, or affecting a mass 
     transportation provider or railroad carrier engaged in or 
     affecting interstate or foreign commerce.
       ``(2) Any person travels or communicates across a State 
     line in order to commit the offense, or transports materials 
     across a State line in aid of the commission of the offense.
       ``(d) Nonapplicability.--Subsection (a) does not apply to 
     the conduct with respect to a destructive substance or 
     destructive device that is also classified under chapter 51 
     of title 49 as a hazardous material in commerce if the 
     conduct--
       ``(1) complies with chapter 51 of title 49 and regulations, 
     exemptions, approvals, and orders issued under that chapter, 
     or
       ``(2) constitutes a violation, other than a criminal 
     violation, of chapter 51 of title 49 or a regulation or order 
     issued under that chapter.
       ``(e) Definitions.--In this section--
       ``(1) the term `biological agent' has the meaning given to 
     that term in section 178(1);
       ``(2) the term `dangerous weapon' means a weapon, device, 
     instrument, material, or substance, animate or inanimate, 
     that is used for, or is readily capable of, causing death or 
     serious bodily injury, including a pocket knife with a blade 
     of less than 2\1/2\ inches in length and a box cutter;
       ``(3) the term `destructive device' has the meaning given 
     to that term in section 921(a)(4);
       ``(4) the term `destructive substance' means an explosive 
     substance, flammable material, infernal machine, or other 
     chemical, mechanical, or radioactive device or material, or 
     matter of a combustible, contaminative, corrosive, or 
     explosive nature, except that the term `radioactive device' 
     does not include any radioactive device or material used 
     solely for medical, industrial, research, or other peaceful 
     purposes;
       ``(5) the term `hazardous material' has the meaning given 
     to that term in chapter 51 of title 49;
       ``(6) the term `high-level radioactive waste' has the 
     meaning given to that term in section 2(12) of the Nuclear 
     Waste Policy Act of 1982 (42 U.S.C. 10101(12));
       ``(7) the term `mass transportation' has the meaning given 
     to that term in section 5302(a)(7) of title 49, except that 
     the term includes school bus, charter, and sightseeing 
     transportation;
       ``(8) the term `on-track equipment' means a carriage or 
     other contrivance that runs on rails or electromagnetic 
     guideways;
       ``(9) the term `railroad on-track equipment' means a train, 
     locomotive, tender, motor unit, freight or passenger car, or 
     other on-track equipment used, operated, or employed by a 
     railroad carrier;
       ``(10) the term `railroad' has the meaning given to that 
     term in chapter 201 of title 49;
       ``(11) the term `railroad carrier' has the meaning given to 
     that term in chapter 201 of title 49;
       ``(12) the term `serious bodily injury' has the meaning 
     given to that term in section 1365;
       ``(13) the term `spent nuclear fuel' has the meaning given 
     to that term in section 2(23) of the Nuclear Waste Policy Act 
     of 1982 (42 U.S.C. 10101(23));
       ``(14) the term `State' has the meaning given to that term 
     in section 2266 ;
       ``(15) the term `toxin' has the meaning given to that term 
     in section 178(2); and
       ``(16) the term `vehicle' means any carriage or other 
     contrivance used, or capable of being used, as a means of 
     transportation on land, on water, or through the air.''.
       (b) Conforming Amendments.--
       (1) The table of sections at the beginning of chapter 97 of 
     title 18, United States Code, is amended--
       (A) by striking ``RAILROADS'' in the chapter heading and 
     inserting ``RAILROAD CARRIERS AND MASS TRANSPORTATION SYSTEMS 
     ON LAND, ON WATER, OR THROUGH THE AIR'';
       (B) by striking the items relating to sections 1992 and 
     1993; and
       (C) by inserting after the item relating to section 1991 
     the following:

``1992. Terrorist attacks and other violence against railroad carriers 
              and against mass transportation systems on land, on 
              water, or through the air.''.

       (2) The table of chapters at the beginning of part I of 
     title 18, United States Code, is amended by striking the item 
     relating to chapter 97 and inserting the following:

``97. Railroad carriers and mass transportation systems on land, on 
    water, or through the air...................................1991''.

       (3) Title 18, United States Code, is amended--
       (A) in section 2332b(g)(5)(B)(i), by striking ``1992 
     (relating to wrecking trains), 1993 (relating to terrorist 
     attacks and other acts of violence against mass 
     transportation systems),'' and inserting ``1992 (relating to 
     terrorist attacks and other acts of violence against railroad 
     carriers and against mass transportation systems on land, on 
     water, or through the air),'';
       (B) in section 2339A, by striking ``1993,''; and
       (C) in section 2516(1)(c) by striking ``1992 (relating to 
     wrecking trains),'' and inserting ``1992 (relating to 
     terrorist attacks and other acts of violence against railroad 
     carriers and against mass transportation systems on land, on 
     water, or through the air),''.

[[Page S3796]]



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