[Congressional Record Volume 152, Number 104 (Tuesday, August 1, 2006)]
[Senate]
[Pages S8538-S8547]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. GRASSLEY (for himself and Mr. Baucus):
S. 3767. A bill to delay the full implementation of the occupational
mix adjustment to the wage index under the Medicare inpatient hospital
prospective payment system; to the Committee on Finance.
Mr. GRASSLEY. Mr. President, I am pleased to join once again my good
friend and colleague Senator Baucus to introduce the Wage Index
Accuracy Improvement Act.
The Wage Index Accuracy Improvement Act enables the Centers for
Medicare & Medicaid Services, CMS, to improve the accuracy of Medicare
payments for acute care hospital services.
Under Medicare, acute care hospitals are paid for inpatient services
through the hospital inpatient prospective payment system, IPPS. Around
3,500 hospitals received payment through the
[[Page S8539]]
IPPS totaling approximately $100 billion in fiscal year 2004.
As you know, hospitals in the United States vary greatly in terms of
size, geographic location, types of patients served and staffing. Since
a ``one size fits all'' approach to paying hospitals would not fairly
compensate hospitals for the inpatient services they provide to
Medicare patients, payments under the IPPS are adjusted to take into
account these differences.
CMS has been refining one such adjustment, as required by law, and
has limited its application until it has been adequately developed.
This significant adjustment, the area wage index, is intended to
account for differences in prices for labor in different markets.
In order to ensure that the wage index accurately reflects the
difference in labor costs among different areas and not a hospital's
employment choices, an occupational mix adjustment is also applied to
the wage index.
For example, a hospital choosing to employ predominantly registered
nurses would have higher labor costs than a hospital employing--less-
expensive--licensed practical nurses. Because a hospital's staffing
practices are unrelated to area wages, its staff composition should not
influence the area wage index.
CMS collected data in 2004 from hospitals for purposes of calculating
the occupational mix adjustment; however, because of reasons including
the agency's lack of confidence in the data, only 10 percent of the
wage index was adjusted for occupational mix in fiscal years 2005 and
2006.
Questions concerning the reliability of these data can be seen in my
home State of Iowa. Since the State is largely rural, Iowa hospitals
generally employ a less expensive mix of personnel. One would expect
the occupational mix adjustment to the wage index to benefit these
hospitals; however, the opposite effect has occurred. In fact, it is
estimated that the occupational mix adjustment has adversely affected 8
of the 10 geographic locations in Iowa.
CMS originally proposed to continue this limited adjustment for
occupational mix in fiscal year 2007, but a Federal appellate court
ordered the agency to apply the occupational mix adjustment, based on
data collected in 2006, to 100 percent of the wage index effective for
fiscal year 2007.
CMS collected these data hurriedly, using only 3 months of data, and
will not be able to post the final wage index information until after
the fiscal year 2007 inpatient hospital rates are announced. Moreover,
since the data collection instrument has changed from the last time CMS
collected data, CMS will not have sufficient time to analyze fully the
data and determine their accuracy.
Given the lack of opportunity to ensure data accuracy, the
uncertainty of how the occupational mix adjustment will affect hospital
payments, and the disruption that can occur in moving immediately from
a 10-percent adjustment for occupational mix to a 100-percent
adjustment, the Medicare Wage Index Improvement Act would limit
application of the occupational mix to the current rate for a 2-year
period.
This legislation would give CMS the opportunity to look at the data
and act accordingly both to apply the occupational mix adjustment to
the wage index appropriately and to avoid disruptions.
In the meantime, the Medicare Wage Index Improvement Act would
require CMS to evaluate the way in which they collect data for and
calculate the occupational mix adjustment and present us with
recommendations by January 1, 2008.
I would also like to point out that the changes required under this
legislation would be budget neutral because the Social Security Act
requires that aggregate payments under this adjustment not be greater
or less than payments made without the adjustment.
Mr. President, adjusting inpatient hospital payments under Medicare
can have significant effects on a hospital's financial health. These
adjustments should therefore be adequately developed to ensure that
payments are accurate and not fully implemented until they are ready.
In the case of the wage index adjustment, let's provide CMS the
opportunity to get the job done right.
Mr. BAUCUS. Mr. President, today, along with Finance Committee
Chairman Chuck Grassley, I am introducing the Wage Index Accuracy
Improvement Act. This bill would help ensure access to quality,
affordable health care in rural America. And this bill would improve
accuracy, reduce volatility, and ease uncertainty in the way that
Medicare pays hospitals.
Medicare pays most hospitals through the inpatient prospective
payment system, or IPPS. Under the IPPS, Medicare pays hospitals a
standardized amount for each patient discharged. The Government's
Centers for Medicare and Medicaid Services, or CMS, adjusts this amount
for local wages, with a mechanism known as the area wage index. CMS
intends that the area wage index help adjust for the wide variation of
prices for labor and supplies across the Nation. After adjusting for
wages, CMS then multiplies the standardized amount by the relative
weight of the diagnosis--the diagnosis related group or DRG--to
determine the total payment to the hospital. CMS further increases
payments if the hospital is a teaching hospital, cares for a
disproportionate share of low-income patients, or treats an
exceptionally costly case.
Rural providers have had concerns about the accuracy of the wage
index. Largely in response to these concerns, Congress enacted an
important provision as part of the Medicare Modernization Act, or MMA,
in 2003. For hospitals with wage indexes below 1.0--that is, hospitals
where CMS thinks that local wages are below average--section 403 of the
MMA reduced the portion of the standardized amount subject to wages to
62 percent, down from about 70 percent. This provision increased
payments to hospitals in low-wage areas by an estimated $5.2 billion
over 10 years. And this change was an important step toward ensuring
access to quality, affordable health care in rural areas.
Nonetheless, significant problems with the wage index still exist.
Some of those problems relate to section 304 of the Benefits
Improvement and Protection Act of 2001. In that law, Congress required
CMS to collect data on hospitals' occupational mix, in order to remove
incentives to employ a relatively more expensive workforce.
For instance, a hospital that employs predominantly higher paid
registered nurses would typically have higher labor costs than a
facility employing mostly lower paid licensed practical nurses. In an
effort to remove the influence of these staffing choices on Medicare
hospital payments, section 304 required CMS to adjust the wage index
for occupational mix. Congress intended through section 304 to bring
greater accuracy to the payment system, leading to fairer reimbursement
for hospitals. I am concerned that this provision may well have the
opposite effect.
CMS collected data for occupational mix adjustment in 2004. But given
concerns over the accuracy of the data, in fiscal years 2005 and 2006,
CMS applied only a 10-percent adjustment for occupational mix. CMS
proposed the same adjustment--10 percent--for fiscal year 2007.
On April 3, 2006, the Second Circuit Court of Appeals ordered CMS to
apply 100-percent of the occupational mix adjustment for fiscal year
2007. The court directed CMS to complete data collection and
measurement by September 30, 2006, and then apply the adjustment in
full.
Mr. President, if CMS proceeds with a 100 percent occupational mix
adjustment, hospital payments will be subject to inaccuracy,
uncertainty, and volatility. Congress can prevent these outcomes, by
passing the Wage Index Accuracy Improvement Act that we introduce
today.
This bill would maintain the current 10 percent occupational mix
adjustment for the next 2 fiscal years, giving CMS time to collect
accurate data. The bill would require CMS to report on its data
collection for the occupational mix adjustment by January 1, 2008. Both
of these actions will give hospitals more time--and more information--
to better understand the effect of the occupational mix adjustment.
Mr. President, Medicare pays for more than $100 billion of hospital
inpatient services every year. This system should be as accurate as
possible. This system should not be subject to swings resulting from
quickly-collected data, applied at the last minute. I urge my
[[Page S8540]]
colleagues to join Chairman Grassley and me in passing this important
legislation as soon as possible.
______
By Mr. LEAHY (for himself, Mr. Specter, Mr. Dorgan, and Mr.
Harkin):
S. 3768. A bill to prohibit the procurement of victim-activated
landmines and other weapons that are designed to be victim-activated;
to the Committee on Armed Services.
Mr. SPECTER. Mr. President, today I join Senator Leahy in introducing
the Victim-Activated Landmine Abolition Act of 2006, which will
prohibit the procurement of victim-activated landmines. Antipersonnel,
victim-activated landmines are small, inexpensive weapons that kill or
maim people upon contact. Indiscriminate use has produced many civilian
casualties and has resulted in an international effort to control or
ban these weapons.
As a member of both the Appropriations Subcommittee on Defense and
Foreign Operations, I have supported efforts to create alternatives to
victim-activated munitions, to mitigate the associated risks for
innocent civilians, and to help those who have been inadvertently
harmed. The United States sets an example for the world by remaining a
global leader in providing funds for mine clearance, mine risk
education, and mine survivor assistance activities. According to the
Congressional Research Service, the United States has dedicated an
estimated $500 million for demining efforts over the last 10 years.
Furthermore, the U.S. Department of Defense, in conjunction with
industry partners, has developed technology which permits the
deployment of mines that cannot be activated by the victim. This ``man-
in-the-loop'' technology will ensure that innocent civilians are not
harmed by mines.
On September 18, 1997, diplomats from almost 90 countries met in
Oslo, Norway, and adopted the text of the Convention on the Prohibition
of the Use, Stockpiling, Production and Transfer of Anti-Personnel
Mines and on their Destruction, commonly referred to as the Ottawa
Convention or the Mine Ban Treaty. The Mine Ban Treaty went into effect
on March 1, 1999, and mandates that countries discontinue the
production, stockpile, use or exportation of antipersonnel landmines.
It further mandates that countries clear their territory of mines and
destroy stockpiles. The Mine Ban Treaty is credited with the reduction
in victims and procurement of mines.
Although the U.S. has declined to participate in the treaty, the U.S.
continues to lead the world in dollars spent on aid and efforts to help
foreign nations demine fields and dispose of thousands of antipersonnel
landmines, which is a costly and dangerous undertaking. The U.S. has
not used antipersonnel mines since the 1991 Persian Gulf war. Since
1992, the U.S. has prohibited exportation of antipersonnel mines and
U.S. production was halted in 1997.
A review of the facts surrounding landmines and the tragic
consequences that have resulted from their use has convinced me that
the indiscriminate use of these weapons must be stopped. The
International Campaign to Ban Landmines estimates that there are more
than 80 million landmines in the ground in more than 80 countries and
that 15,000-20,000 people are maimed or killed by landmines each year.
UNICEF estimates that 30 to 40 percent of mine victims are children
under 15 years old. Millions more suffer from the economic and
psychological impact of these weapons.
Innocent civilians in foreign countries are not the only victims that
suffer the debilitating effects of these weapons. Landmines have
injured and killed thousands of U.S. and allied troops in every U.S.-
fought conflict since World War II, including those in Iraq and
Afghanistan. Although landmines cost as little as $3 to produce, they
can cost as much as $1,000 per mine to clear.
The legislation introduced today calls on the United States to
continue to set an example for other countries by implementing a ban on
the procurement of victim-activated weapons systems. Further, it
recognizes that the U.S. has acquired reliable technology that enables
all weapons systems to be equipped with man-in-the-loop targeting and
triggering capabilities, meaning that the device can be deployed and
triggered only in response to an intentional action by a person.
I yield the floor.
Mr. LEAHY. Mr. President, I am today introducing, with my friend from
Pennsylvania, Senator Specter, and Senators Dorgan and Harkin, The
Victim-Activated Landmine Abolition Act of 2006.
This legislation would prohibit the procurement of victim-activated
landmines and other weapons that are designed to be victim-activated.
It builds on a long history of leadership by the Congress on the issue
of landmines, which indiscriminately kill and maim innocent people, as
well as U.S. troops, around the world.
I will have another statement on this subject when we return from the
August recess, but I want to make a couple of points today.
First, Senators should know that since 1997 when an international
treaty banning the manufacture, use, export and stockpiling of
antipersonnel landmines was initialed at Ottawa, 154 nations have
signed and 151 have ratified the treaty.
This is an extraordinary achievement, for which Lloyd Axworthy,
Canada's Foreign Minister at the time, and the International Campaign
to Ban Landmines deserve enormous credit. Unfortunately, the United
States is not a signatory to the treaty and at one time even worked
against it.
Thanks to the treaty, the manufacture and export of antipersonnel
landmines has decreased significantly, and the number of victims has
also declined. But mines continue to be a weapon of choice, especially
for rebel groups such as the FARC in Colombia and Hezbollah in Lebanon.
Second, the United States has not exported antipersonnel mines since
1992, produced antipersonnel mines since 1997, or used anti personnel
mines since 1991. This is not a weapon we need.
Moreover, for the past decade the Department of Defense has been
developing alternatives to landmines. The goal has been to replace
mines that cannot distinguish between an enemy combatant and a U.S.
soldier, an innocent child, a farmer or a refugee.
That program has produced man-in-the-loop technology that is ready to
be deployed in a new generation of mines that are not victim-activated.
I have long supported this program and I commend the Department of
Defense for its support for the development of this technology. I
believe it will provide the U.S. military with the force multiplier and
protection afforded by conventional landmines without impeding the
mobility of our troops or endangering innocent civilians. It will
enable the military to finally stop using or stockpiling victim-
activated landmines that have no place in the arsenal of a civilized
nation, much less the world's only superpower.
As we see daily in Iraq, Afghanistan, and Lebanon, civilians bear the
brunt of wars today. They do not have body armor or armored vehicles.
They are routinely caught in the crossfire. At any moment they are at
risk of being killed or maimed by a landmine or other improvised
explosive that lies in wait until triggered by whoever steps on it or
drives over it.
I want to emphasize that the need for this legislation is not because
the United States is causing the mine problem. It is not. As I
mentioned, we have not used or exported antipersonnel mines for 15
years, despite fighting wars in Afghanistan and Iraq. We are also the
largest contributor to humanitarian demining in countries that have
been severely affected by mines, and we support programs to assist mine
survivors.
But just as a solution to the Middle East conflict depends on the
active, sustained engagement and leadership of the United States, so
does the problem of landmines.
As was the case with poison gas more than half a century ago, the
solution to the mine problem is the stigmatization of these
indiscriminate weapons so the political price of using them serves as a
deterrent. Will some rebel groups or rogue nations continue to defy the
international norm? Undoubtedly. But by setting an example and using
our influence we can reduce their numbers significantly to the benefit
of our troops and the innocent.
I again want to thank my friend Senator Specter, who has supported
legislation to ban landmines for more than a decade.
[[Page S8541]]
Mr. SPECTER. The `Victim-activated Landmine Abolition Act of 2006',
which I am joining my friend from Vermont, Senator Leahy, in
introducing today would end the procurement of these indiscriminate
weapons by the United States. We neither need these weapons not is it
in our interest to continue to insist on the right to use them. They
cannot distinguish between civilians and combatants, and as long as we
stockpile them we cannot credibly urge others to stop using them
against our troops. Does my friend from Vermont agree with me that our
goal in sponsoring this legislation is to reaffirm United States
leadership on this crucial humanitarian issue and to encourage other
nations to follow our example?
Mr. LEAHY. That is correct and I thank the senior Senator from
Pennsylvania. I have been pleased to have him as a partner over the
years on legislation to eliminate these inhumane weapons, and I welcome
the opportunity to do so again today. We want to send a message to the
world that victim-activated landmines and other weapons designed to be
victim-activated are beyond the pale. We have seen what they can do to
our troops. We have seen what they do to a child who picks up one of
these seemingly harmless objects, only to have it blow off an arm or
worse. These weapons do not belong in the arsenals of civilized
nations.
Mr. SPECTER. I thank my friend, who has led this campaign for so many
years. Landmines and other munitions that are designed to be victim-
activated are inherently indiscriminate. In that sense, they are no
different from poison gas. They should be abolished and replaced with
weapons that have a man-in-the-loop who can distinguish between an
enemy combatant and a civilian. The Department of Defense has this
technology. It is time for the United States to adopt a policy that is
consistent with the force protection needs of our troops and with the
moral values of the American people.
______
By Mr. ENSIGN (for himself, Mr. Nelson of Florida, Mr. Coleman,
Mr. Lieberman, Mr. Santorum, and Mr. Frist):
S. 3769. A bill to encourage multilateral cooperation and authorize a
program of assistance to facilitate a peaceful transition in Cuba, and
for other purposes; to the Committee on Foreign Relations.
Mr. ENSIGN. Mr. President, at long last, Fidel Castro's reign of
terror over the Cuban people may be coming to an end. Fidel Castro is
incapacitated. He has handed over control of the government to his
brother, Raul. The Cuban Government wants us to believe that it is a
temporary measure--that Castro just needs to recuperate from surgery.
But we don't know the truth--we can't know the truth, because lies are
the byproduct of tyranny. And tyrannies are notoriously opaque. For all
we know, it may be that Fidel already has already spent his last day as
Cuba's leader.
I believe that now is the time for the U.S. Government to push for a
peaceful transition to democracy in Cuba. It is a travesty that more
than a decade after the cold war ended, a brutal communist dictatorship
is still oppressing people 90 miles from our border. It would be an
even greater travesty if the United States did not do everything in our
power to ensure that after Fidel leaves power--one way or another--Cuba
becomes free.
Let's join together in support of the Cuban people and in support of
freedom, and let's adopt this bill.
We need to send a signal to all the dissidents and political
prisoners in Cuba that we have no illusions about the nature of Fidel
Castro's regime--that we know of their plight and stand ready to help
them. When Ronald Reagan called Russia the ``evil empire,'' it brought
hope to the dissidents and political prisoners in the Soviet gulags.
They knew that the people and leaders of the United States were united
with them. They were not alone.
That is why I am introducing a bill today that authorizes assistance
to the OAS for Cuba human rights activities and election reform. It
also authorizes a fund to support independent civil society-building
efforts. That includes assistance to political prisoners and their
families, other dissidents, independent libraries, youth organizations,
workers' rights activists, agricultural cooperatives, associations of
the self-employed, journalists, economists, and medical doctors. And it
creates the ``Fund for a Free Cuba'' to provide assistance to a
transition government in Cuba.
This bill is consistent with the recommendations in the July 2006
Commission for Assistance for a Free Cuba report. We need to move this
legislation now, when it can have the biggest impact. The people of
Cuba are watching and listening. We need to show them that the leaders
of the United States are willing to join them in their quest to be
free. They need to know that they are not alone.
______
By Mr. MENENDEZ (for himself and Mr. Lautenberg):
S. 3770. A bill to require a pilot program on the facilitation of the
transition of members of the Armed Forces to receipt of veterans health
care benefits upon completion of military service, and for other
purposes; to the Committee on Veterans' Affairs.
Mr. MENENDEZ. Mr. President, since the March 2003 start of the Iraq
war, more than 19,157 members of our Nation's Armed Forces have been
injured, more than 18,777 of them wounded in action.
Imagine that you are one of those wounded. You are an enlisted marine
serving your country in Iraq. Your convoy is attacked by Iraqi gunmen
and your transport explodes, killing several of your fellow soldiers
and wounding many more. You are seriously wounded, so you're medevaced
to Landstuhl Regional Medical Center and then transported to an
appropriate medical facility in the U.S. for further stabilization and
treatment.
As you begin the long road to recovery in the hospital, you may be
approached by a Department of Veterans Affairs, VA, counselor who
provides you with information about VA medical benefits and vocational
rehabilitation and employment services. You may or may not meet with
someone from the VA. But you're not ready to think about those things
yet. You just want to get better and rejoin your fellow marines in
Iraq.
Several months later, as you convalesce, Department of Defense, DOD,
determines that you should be discharged due to the seriousness of your
injuries. But, the discharge process won't become official for at least
nine months, and you can't access VA services until it does. This
leaves you in limbo, caught somewhere between the DOD and VA systems.
You finally return home, still convalescing from your injuries and
while there, you finally receive your discharge papers. This
development means no more access to the support you received during
active duty, including health care. In order to receive medical care,
you need to begin enrollment in the VA system to access medical
services. Enrollment is a slow and difficult process, and, in your
seriously wounded state, you come up against a blizzard of paperwork,
Byzantine procedures, and a number of overworked VA caseworkers.
Your family has no idea how to get you into the system quickly and
without having to pay more money for interim care until the VA benefits
kick in.
As the conflicts in Iraq and Afghanistan grind on, these stories are
all too frequent. Many wounded soldiers, service men and women are
faced with the prospect of a premature end to their military service
and are struggling to reenter civilian life, often with permanent
disabilities. And they now have to find their way to the VA. They need
help finding their way so they can get the care they deserve. They have
served their country and now their country, their military, owes them
our best in return.
That is why I am proud to introduce the Veterans Navigator Act, a
bill that would expand and enhance the important work done by VSOs and
other non-governmental organizations to guide our Nation's service men
and women to and through the VA healthcare system. It would, in fact,
acknowledge the work of these organizations by providing $25 million in
grants over 5 years to augment their capabilities.
The ``navigator'' concept is not new. It is similar to the Patient
Navigator demonstration program I introduced and which was subsequently
enacted
[[Page S8542]]
into law. There, we also took a successful small-scale program being
used at select medical facilities around the country and expanded it by
providing grants for a scaled-up demonstration program to serve those
with cancer and other chronic diseases, and in particular, to provide
support to medically underserved populations.
With the veterans navigator bill, I propose to do something similar,
capitalizing on the successes of the Patient navigator concept, to help
our troops. The $25 million over 5 years in the bill would allow VSOs
and other organizations to apply for grants so that they could hire and
train navigators to provide assistance, on an individualized basis, to
members of the Armed Forces as they transition from military service to
the VA health care system. They would do so in coordination with DOD
and the VA. Right now, many VSOs rely principally on donations to
perform these services.
At the end of the 5 years, the VA Secretary would submit a report to
Congress on the effectiveness of the veterans navigator demonstration
program and to recommend whether it should be made permanent.
Often called national service officers or counselors, a navigator is
a ``sherpa,'' a guide through the maze of paper and people and
specialists and benefits. A navigator is an advocate for those no
longer able to go it alone. A navigator is a facilitator, someone who
will be with you through the process, to provide the expertise you will
need to transition between active duty and veterans status and to get
the urgent care you need.
Let me be clear: a navigator does not supplant the role of the DOD or
the VA. A navigator is meant to complement the work done by these
organizations, particularly at a time when those systems are struggling
to meet the needs of the soldiers returning from war and will continue
to do so long after the conflicts in Iraq and Afghanistan have ended.
The bill focuses particular attention on four underserved groups in
the military community: the seriously injured or wounded soldiers,
female soldiers, those suffering from psychological problems like post-
traumatic stress disorder, PTSD, and members of the activated National
Guard and Reserves.
These underserved groups have not been sufficiently served in
existing VA and DOD transition programs and activities. It is these
underserved groups who especially need continuity of care as they enter
and wind their way through the VA medical system. Part of the reason
they have not been adequately cared for is that the nature of the
current wars we are fighting, in Iraq, in Afghanistan, are different
from previous conflicts we have undertaken.
During the Iraq and Afghanistan campaigns, we have the largest
activation of National Guard and reservists since World War II. As of
June 1, according to DOD, the United States had 128,789 military
personnel deployed in Iraq. Of these, 102,709 were active component
personnel and 26,080 were National Guard and Reserves. The recent
announcement by President Bush to send additional troops to Baghdad in
the face of increasing sectarian violence will likely only mean that
those numbers will increase.
The GAO released a report last February citing deficiencies in
benefits for these soldiers. The report concluded that National Guard
and Reserve soldiers ``are given little help navigating a thicket of
regulations and procedures necessary to gain access to military
doctors.''
To complicate matters, members of our National Guard who seek medical
care must file for an extension of their active duty status in order to
continue to access military bases and hospitals.
In its report, GAG also concluded that, and I quote, ``the Army has
not consistently provided the infrastructure needed to accommodate the
needs of soldiers trying to navigate their way through the' active duty
medical extension' ADME--process . . . this has resulted in injured and
ill soldiers carrying a disproportionate share of the burden for
ensuring that they do not fall off their active duty orders.''
The Veterans Navigator Act would help minimize such occurrences by
providing National Guardsmen and Reservists someone to help bring them
through the ADME process and to help correct any discrepancies before
they cause a delay in accessing VA medical care.
Veterans with psychological problems also need help. In the last
several years, we have been hearing a lot more about post-traumatic
stress disorder, or PTSD, in veterans and those returning from
conflict. A recent GAO report has concluded that almost four out of
five service members returning from Iraq and Afghanistan who were found
to be at risk for PTSD, were not provided appropriate medical
assistance. All of these factors mean that now, more than ever, our
Nation's soldiers need help moving between the DOD and VA realms.
According to the chief of psychology at Walter Reed Army Institute of
Research, roughly 20 percent of those service men and women returning
from Iraq suffer from PTSD. In its recently released report, GAO
concluded that roughly 78 percent of those servicemembers at risk for
PTSD do not get further evaluation. That means they return to active
duty or are discharged without receiving the appropriate care.
It is the nature of this disorder to appear not right after the
traumatic event is experienced, but often not until an individual
reexperiences an event, has a flashback or is somehow reminded of a
battlefield event. That may not happen until after a servicemember has
been discharged from service. Once PTSD does emerge, the veteran may
not know how to access VA medical assistance, or he or she may not have
yet enrolled into the VA medical system.
Again, as in the case of the severely wounded, time is of the
essence. PTSD can manifest itself so severely as to incapacitate a
soldier, making medical care more urgent. In the case of returning
National Guardsmen and Reservists, the problem is made more complex
because of the 2 year time limit on filing for VA benefits.
Since 1991, opportunities for women in our Nation's Armed Forces have
grown. For the first time, the military is placing women in support
units at the front line. This has come partly as the result of more
than 10 years of policy changes making 91 percent of the career fields
gender neutral.
The Navy and the Air Force have begun to allow female soldiers to fly
fighters and bombers. The Army has expanded the role of women in
ground-combat operations. Right now, ``women command combat military
police companies, fly Apache helicopters, work as tactical intelligence
analysts, and serve in artillery units.
This would have been unheard of a decade ago, but it is happening
right now. Right now, record numbers of female soldiers are fighting on
the front lines and, as a result, more are being seriously wounded or
killed. A Baltimore reporter profiling women soldiers' participation in
Iraq observed that ``the war in Iraq has been an equal opportunity
employer, by killing and injuring a historic number of female soldiers
in combat situations.''
Therefore, a VA medical system designed to treat wounded male
soldiers must now ensure that female soldiers get the right kind of
medical care. They will need help finding that care and getting access
to that care. A veteran navigator can help them do that.
Because of the length and size of the deployment, many more soldiers
are being seriously wounded. According to the GAO, roughly 30 percent
of U.S. soldiers wounded in combat during World War II later died.
Today, that number has dropped to 3 percent for those serving in Iraq
and Afghanistan due to advances in technology and protective gear.
While this is clearly a positive development, it also means that many
of these injured soldiers are returning home with severe disabilities,
including traumatic brain injuries and missing limbs that require
comprehensive inpatient rehabilitation services.
But, severe injuries often mean a lengthy transition from active duty
to veteran status. As my story earlier indicates the physical
evaluation of a seriously wounded service member to determine whether
he or she can return to active duty can take months to complete. In the
interim, the VA has to be able to identify these soldiers so that they
can perform early outreach, provided that they have the information to
do so.
[[Page S8543]]
Despite this, the GAO observed in a March 2005 report that the VA
faces ``significant challenges in providing services to seriously
injured service members.''
In many cases, VA staff have reported that seriously injured service
members are simply not ready to begin thinking about VA benefits or
dealing with the VA system during the recovery process. The problem
here, as GAO has pointed out, is that the VA has no policy for
maintaining contact with these soldiers down the line, once they are
discharged. Contact is often conducted on an ad hoc basis. Navigators
can also help these seriously wounded soldiers.
VSOs such as the Veterans of Foreign Wars, Disabled American
Veterans, Jewish War Veterans and so many others have emphasized the
importance of maintaining contact with seriously injured veterans who
do not initially apply for VA health care benefits because it may be
many months or even years before they are prepared to apply for them.
The veterans navigator can help perform this function. Because this
individual or individuals have reached out to the injured service
member before his or her discharge, they can, in coordination with the
VA caseworkers, remain in contact with them as they recover and prepare
to reenter civilian life. The navigator can also help obtain
information from DOD on seriously injured soldiers earlier on so that
they can help ensure that all service members and veterans benefit from
VA health care services at the right time.
At a time when many active duty service people and veterans have
fought and often made the ultimate sacrifice for their country, we
cannot risk having any soldier fall through the cracks. We cannot take
the risk that our female soldiers, who are fighting alongside their
male colleagues, may not receive the medical care they need. We cannot
risk the lives and health of soldiers with PTSD. We cannot risk the
lives and the health of any service member who put their lives at risk
for our country.
Not so long ago we celebrated Memorial Day, a day when each and every
American honors the service of our Nation's Armed Forces, both past and
present and takes a moment to thank them for helping to keep America
safe and secure. The very least that we can do is to ensure that all of
these brave men and women are able to access the medical benefits to
which they are entitled, particularly in their time of greatest need.
At some point in each of our lives, we might need a guiding hand to
help us find our way. Today, Mr. President, I am proposing to provide
that helping hand to our troops in a time of their greatest need. It is
the very least that we can do.
______
By Mr. HATCH (for himself, Mr. Kennedy, Mr. DeWine, Mr. Dodd, Mr.
Burr, Mr. Harkin, Mr. Bond, Ms. Mikulski, Ms. Snowe, Mr.
Jeffords, Mr. Talent, Mr. Bingaman, Ms. Collins, Mrs. Murray,
Mr. Chafee, Mr. Reed, Mr. Smith, and Mrs. Clinton):
S. 3771. A bill to amend the Public Health Service Act to provide
additional authorizations of appropriations for the health centers
program under section 330 of such Act; to the Committee on Health,
Education, Labor, and Pensions.
Mr. HATCH. Mr. President, today I am introducing the Health Centers
Renewal Act with my colleagues, Senators Kennedy, DeWine, Dodd, Burr,
Harkin, Bond, Mikulski, Snowe, Jeffords, Talent, Bingaman, Collins,
Murray, Chafee, Reed, Smith, and Clinton.
The health centers program was established more than 40 years ago and
it has been successful in providing access to quality, comprehensive
primary health care services throughout the country to a large number
of uninsured or underinsured people, including children, parents and
the elderly. Health centers are located at sites within medically
underserved areas and provide care to those who have limited or no
access to health insurance. Health centers are a critical component of
our Nation's health care safety net, providing quality health care to
over 15 million underserved individuals in the United States.
These health centers include community health centers which are
local, not-for profit 501(c) (3) corporations that provide community-
oriented primary and preventive health care and are governed by boards
of directors that are composed of at least 51 percent health centers
users, to ensure that the patients and the community are represented.
In my home State of Utah, community health centers serve 84,578
patients and provided almost 305,000 patient visits in 2005.
As I travel throughout Utah, I hear nothing but positive remarks
about the vital work of community health centers. I would like to share
some of the comments that I have received from Utahns with my
colleagues.
Midtown Community Health Center in Ogden, UT just opened a very
impressive new center which will enable patients in that community to
receive the latest care for a range of illnesses such as diabetes,
hypertension and asthma. These illnesses are costly and often require
monthly visits, laboratory tests and expensive medication. One of the
patients at Midtown who has diabetes and hypertension, stated that she
would not have anywhere to go to monitor her diabetes if Midtown didn't
exist. She describes Midtown as a ``Godsend'' and said that without her
health care provided by Dr. Gregoire, she would be in serious financial
debt and would have to choose between housing and food or health care.
'
Another Utah health center has a family that comes into the clinic
with a son who is bipolar. The boy's mother called very distraught
because they were having problems affording his medicines and his
illness had created other concerns within their family. The woman's new
husband thought discipline was the solution to the child's mood swings.
The community health center referred the boy to its mental health
worker, who in addition to providing counseling, was able to get his
medication for him at a reduced price. The mother thanked the mental
health worker and she said just having someone to talk to who
understood the boy's condition was helpful to her and her family.
Bottom line, community centers have made a tremendous difference for
Utah's residents with limited or no health insurance. And these
examples are not unique to Utah--patients across the country have had
similar experiences with community health centers.
Due to the difference that health centers have made in so many lives,
Congress has consistently increased funding for them since 2001 in
order to meet President Bush's goal to have 1,200 new or expanded
centers and an additional 6.1 million patients served by 2006.
Currently, the additional funding has provided service to 4 million
additional patients and has added new or expanded facilities in well
over 750 communities nationwide. By reauthorizing this program, we will
allow health centers to provide lowcost health care to many more
uninsured and underinsured individuals.
The legislation that we are introducing today will reauthorize the
health center program for 5 more years at the fiscal year 2007 funding
level of $1.963 billion, which is the administration's fiscal year 2007
budget request for the health centers program.
Utah health centers have made a tremendous difference in the lives of
many--66 percent of patients come from Utah's urban areas and 27
percent are from the rural regions in Utah. Ninety-six percent of
Utah's health center patients lived below 200 percent of the Federal
poverty level and health centers have made a tremendous difference in
their lives. In fact, for most, these health centers serve as a vital
component of the health care safety net for the medically underserved
and uninsured. In rural areas, health centers are often the only health
care provider for many miles.
Midtown Community Health Center coordinates a free comprehensive
screening clinic for women on an annual basis. In 2006, over 250 women
received pap smears, breast examinations, diabetes screening,
cholesterol screening and depression screening. Many of the low-income,
uninsured women served had not received preventive care in many years.
One woman who attended the event had experienced irregular vaginal
bleeding for several months. She had tried to find a medical provider
but was unsuccessful
[[Page S8544]]
due to a lack of health insurance and financial concerns. She came to
Midtown Community Health Center with an enlarged uterus, a uterine mass
and anemia. A Midtown medical provider arranged for an emergency
ultrasound and removal of the tumor within 3 weeks. The patient is
improving and being treated by Midtown for anemia and irregular
menstrual periods.
A 40-year-old man was working as a contractor when his boss noticed
he was losing weight and took him to the hospital. He was diagnosed
with tuberculosis and hepatitis C. He did not have health insurance and
became homeless. The hospital referred him to Wasatch Homeless Health
Care, Inc. where he entered the tuberculosis housing and treatment
program.
The Johnsons manage their own business in a small rural Utah town,
but somehow health insurance coverage has always been difficult for
them to purchase. Without the Wayne Community Health Center in
Bicknell, the family could only seek medical care for emergencies.
These stories are just some of real life experiences which illustrate
how community health centers make a difference. They save lives. They
provide preventive health care. They keep people out of hospitals.
Community health centers are worth every cent that the Federal
Government invests in them. I am pleased and proud to support them by
introducing this legislation today.
I urge my colleagues to support this important legislation which not
only provides individuals with important health care services but also
ensures that the health centers providing these services will have the
necessary support to continue providing health services.
Mr. KENNEDY. Mr. President, it is an honor to join Senator Hatch
today in introducing this bill to reauthorize the health centers
program. The Health Centers Renewal Act reauthorizes the community
health center program through 2011. Its goal is to make sure that
people across the Nation can obtain the care they need in their
community, regardless of their ability to pay.
What began in the 1960s as a neighborhood health center demonstration
project at two sites--Columbia Point in Massachusetts and Mound Bayou
in Mississippi--has flourished beyond expectation in the years since
then. It has now grown to more than 1,000 community, migrant, and
homeless health centers providing care in every State across the
Nation. Health centers are the ``medical home'' today for over 15
million patients--patients who are overwhelmingly low-income, uninsured
and minorities. Without health centers in their community, most of
these patients would have nowhere to turn for the health care they
need.
Health centers are truly democratic, and are operated in large part
by the patients and communities they serve. We hear a great deal these
days about moving toward ``consumer-directed'' health care but in most
cases that's a code name for cost-shifting to patients. That's not true
of health centers, which are truly consumer-directed. The requirement
of a patient-majority for health centers' governing boards makes sure
the community has a real voice in the services offered and that the
needs of the community are met. This community focus has been essential
to the program's success in reducing barriers to good health care and
overcoming unfair health disparities.
As the number of uninsured and underinsured persons grows each year,
the need for health center services increases. More than 40 percent of
health center patients have no health insurance and their ranks are
increasing. Another 36 percent have coverage through Medicaid or CHIP,
and cuts in these programs affect health centers as well. With the
growing number of patients who rely on health centers, we must provide
the funds needed to open new centers in areas that are underserved and
to provide better funding to existing centers to meet the growing
demand.
Health centers fill a large void by providing quality, cost-effective
care in medically underserved areas. Most health centers are located in
rural areas or economically depressed inner cities, where poverty is
high and the need is great. They truly are part of the community,
providing not just health care, but good jobs and other programs that
benefit the entire community.
Community health centers have proven their value over the past four
decades, and this bill will enable them to expand and grow in the years
ahead, so that they can continue to provide the quality care that their
patients and communities rely on.
Ms. SNOWE. I am pleased to join with my colleagues in the
introduction of the Health Centers Renewal Act. Today health centers
are a critical part of our health care safety net, serving over 15
million Americans.
Community Health Centers, also known as federally qualified health
centers, are the only source of primary and preventive services for
many medically underserved. This is especially true for people living
in rural areas, where provider shortages couple with high health care
delivery costs to make access difficult for many individuals.
The increasing role of health centers truly represents a bipartisan
success story. Since 2001, the Congress has provided increased funding
for health centers to improve and upgrade existing facilities, as well
as to further expand the safety net these centers provide. That has
supported the President's goal to provide 1,200 new or expanded
centers, and is why today an additional four million Americans are now
served by health centers.
In my State of Maine, over 80,000 individuals are served by federally
funded health centers. In fact, one in five uninsured, low-income
Mainers relies on a health center for their primary care. In rural
areas, 1 in 10 of our residents rely on a community health center for
care.
Today's health centers look very different from those of the past.
They are providing comprehensive primary care, and have been moving
forward to adopt new technology and practice models which will ensure
care of the highest quality at modest cost. In fact, the Office of
Management and Budget has recognized the health centers as one of the
top 10 performing programs in the Federal Government.
Community involvement has been key to this success. The requirement
that patients and community play a major role in governance has been
key to the success of these providers in addressing critical local
health needs.
There is much yet that must be done to improve our health care safety
net, including reducing the disparities in care and outcomes which
plague minority and poor populations. Health centers will play a vital
role in meeting those challenges, and that is why I am pleased to
support this vital legislation to enable their continued growth and
support.
______
By Mr. ENSIGN (for himself and Mr. Reid):
S. 3772. A bill to establish wilderness areas, promote conservation,
improve public land, and provide for high quality development in White
Pine County, Nevada, and for other purposes; to the Committee on Energy
and Natural Resources.
Mr. REID. Mr. President, today I rise with my good friend Senator
Ensign to introduce the White Pine County Conservation, Recreation and
Development Act of 2006. This bill creates economic opportunity for the
people of White Pine County, improves public land management, and
protects some of Nevada's most incredible wild lands. It also makes
needed changes to the Southern Nevada Public Land Management Act.
The White Pine County Conservation, Recreation and Development Act is
the product of many years of work. Ranchers, land managers,
conservationists, off-highway vehicle advocates, tribal members, city
and county officials, wilderness advocates and many others have
contributed to this effort. Meetings and tours focused on a White Pine
County land bill have been taking place for more than 5 years.
The result of these many years of dialogue can be found in the sturdy
compromise contained in this legislation. Our bill resolves wilderness
study areas, provides a reasonable expansion of local tribal lands,
authorizes a study and possible designation of an off-highway vehicle
trail, provides for competitive Federal land sales, makes common sense
transfers of land between Federal agencies, expands State parks,
conveys two small tracts of land to the county for economic
development, funds an
[[Page S8545]]
important landscape scale restoration project in eastern Nevada, and
establishes a national heritage route in eastern Nevada and western
Utah.
Like similar legislation that we have worked on and passed for Clark
County and Lincoln County, we do not expect anyone to endorse every
title in this bill. When it comes to the topics of growth, conservation
and stewardship in rural Nevada there are many strong and often
opposing views. We believe that this legislation offers a solid middle
ground and a path forward for the people of White Pine County.
In order to understand why this legislation is necessary, it is
important to first put Nevada and White Pine County in context. Unlike
most states in our Union, nearly nine out of every ten acres in Nevada
are managed by Federal agencies. In White Pine County the number is
even higher. Of the 5.7 million acres that make up White Pine County,
94 percent are managed by the Bureau of Land Management, BLM, the
Forest Service, the National Park Service and the Fish and Wildlife
Service Federal agencies.
This means that local decisions are not always local. Even the
simplest land and stewardship decisions can involve multiple Federal
land agencies, and the associated rules that come along with each
agency. All too frequently, congressional action is needed to bridge
the divide. This is a reality in many parts of the West, but in no
place is it more true than in Nevada.
Moving beyond the borders of White Pine County, our legislation also
makes essential changes to the Southern Nevada Public Land Management
Act that was first passed in 1998. This law has served Nevada well over
the last 8 years, yet changes are needed to ensure that the legislation
is able to meet the many and complex needs of our fast growing State. I
will briefly describe each of these amendments, in addition to the
other major titles of this legislation.
But before moving on to the specifics of each section of this bill,
let me thank my colleagues for their willingness to work with us on
this legislation. Senator Ensign and I have crafted this bill through a
hands-on, ground level process that we think you will appreciate and
support. Throughout this effort we have aspired to make well-reasoned,
beneficial and necessary changes to land management in Nevada.
The first title in this bill creates a mechanism to increase the
amount of privately held land in White Pine County. Currently, 94
percent of the land in the county is managed by Federal agencies. By
increasing the total amount of private land in White Pine Country, we
create essential opportunities for growth and economic development that
will also allow the county to provide greater support to its residents
through an expanded tax base.
Our bill calls for up to 45,000 acres of land currently managed by
the BLM to be made available for sale in reasonable increments. Each
year a portion of the total acreage will be made available for public
auction after a joint selection is made by the county and the BLM. This
system has worked well in Clark County and Lincoln County, and we
believe that it will greatly enhance the ability of White Pine County
to help plan and shape the long-term growth of its many communities. As
part of the land sale authority, the county may elect to halt the
annual disposal of land when and if appropriate.
Like the Southern Nevada Public Land Management Act and the Lincoln
County Conservation, Recreation and Development Act, this bill directs
the Secretary of Interior to reinvest the proceeds from these land
sales into essential Federal, State, and local environmental
protection, infrastructure development, and recreational enhancements
in the areas and communities where the lands are sold.
These funds also provide an additional revenue source for fulfilling
the various mandates of this bill, including an off-highway vehicle
trail study, designation of new wilderness areas, and the conveyance of
lands into trust for tribal use.
In 1985 when I visited White Pine County to discuss possible
wilderness designations in the Schell Creek and Currant Ranges and the
north and south ends of the Snake Range, I heard from many local
residents who opposed any effort to designate wilderness. Now in 2006,
when I hear from the citizens of White Pine County they are most often
strongly supportive of wilderness designation, particularly in the
areas that they and their families have visited and cherished for
generations.
I believe that much of this change can be attributed to the
successful management of the Mt. Moriah and Currant Mountain wilderness
areas, designated in 1989, where we were able to protect truly wild
lands while still allowing hunting, grazing and other historical uses
to continue. Equally important, many White Pine County residents have
noted that as new waves of people discover the incredible backcountry
of the Great Basin, the identification and protection of lands that are
untouched by permanent development has become a priority.
Accordingly, in this bill we have identified roughly 545,000 acres
for wilderness designation and the release of 67,000 acres of BLM
wilderness study areas. We have benefited greatly from the careful
suggestions of the White Pine County Commission, the Nevada Department
of Wildlife, the Nevada Wilderness Project, hunters, ranchers, miners,
Friends of Nevada Wilderness, and other White Pine County residents
during this process.
We have worked to make careful decisions on the wilderness boundaries
in this bill. Based on feedback from grazers and other users of the
Mount Moriah wilderness area, a number of boundary adjustments have
been included to remove small pipelines and other encumbrances from the
original wilderness area designated in 1989. We have also made careful
choices like along the north end of Red Mountain where the wilderness
boundary follows the banks of the White River so that a number of
primitive campsites between the stream and a nearby road are excluded
from the wilderness area.
While this proposal will surely be criticized as too conservative,
others will see it as too expansive. Senator Ensign and I have both
made important compromises to reach the proposal that we are presenting
today and we stand by the middle ground that we have reached. We are
committed to continue listening to all parties and taking into account
their many and divergent needs.
The third title of this bill makes two important transfers of land
between Federal agencies that will improve public land management in
White Pine County. The first of these changes is a transfer of
approximately 645 acres from the BLM to the Fish and Wildlife Service,
FWS, to be managed as part of the Ruby Lake National Wildlife Refuge.
This land became an inholding within the boundaries of the refuge after
the Fish and Wildlife Service purchased the lands surrounding the BLM
parcel in 2002. Management of this area by the Ruby Lake National
Wildlife Refuge will improve oversight on the land and strengthen the
holdings of this popular refuge.
Our legislation also transfers administrative jurisdiction of roughly
117,000 acres from the Forest Service to the BLM. These lands can be
easily identified on a map as the donut shaped configuration of Forest
Service land currently surrounding Great Basin National Park. Under the
present arrangement, the Park Service, the Forest Service and the BLM
manage an awkward patchwork of lands. In some areas, land managed by
each of the three agencies can be found within a single linear mile.
This division of management and labor makes proper stewardship of this
area complicated and often times unworkable.
In addition to moving the identified lands to the BLM to improve
management efficiency, we also withdraw roughly 50,000 acres of this
land from mineral and land laws and require a management plan for the
roads and trails through the area. These added protections will not
only compliment Great Basin National Park and its mission, but will
also ensure that popular hunting areas remain open and accessible. The
additional 70,000 acres transferred to the BLM will be designated as
the Highland Ridge Wilderness Area.
This title conveys land to expand two existing state parks and one
state wildlife management area. The Charcoal Ovens State Park will
receive approximately 650 acres of BLM land to expand its current
holdings. The land to be conveyed is already managed by the
[[Page S8546]]
state through a Recreation and Public Purposes lease for the operation
of a camping area and trail system. Cave Lake State Park will also
receive a conveyance of land to help improve management of that site,
although the exact boundaries of this designation have not yet been
finalized. This park is exceptionally popular, receiving nearly 100,000
visitors each year, most of which are from southern Nevada.
In addition to expanding these two State parks, this bill conveys
roughly 6,200 acres to the State of Nevada for an expansion of the
Steptoe Valley Wildlife Management Area. The State acquired the 3C
Ranch in 1999 and now manages it as the Steptoe Valley Wildlife
Management Area. The conveyance of BLM land to this popular hunting and
bird watching area will maximize management options while also creating
a safety buffer between hunters and future residential and commercial
development.
Further, our legislation makes two small but important conveyances to
provide for the future economic growth of White Pine County. These
include up to 200 acres for the expansion of the White Pine County
Industrial Park and up to 1,500 acres for the planned expansion of the
White Pine County Airport. The county has been working with the Federal
Aviation Administration on this airport expansion for a number of
years. When completed, it will allow larger jets to land at the
airport, further expanding the economic reach of White Pine County. The
conveyance also allows for the airport to expand and accommodate
additional business tenants. Any funds collected from the lease, sale
or conveyance of either the industrial park or airport lands will be
directed for public uses.
Building on the designation of the Silver State Off-Highway Vehicle
Trail in Lincoln County, this bill authorizes a 3-year study for a
possible extension of the trail into and through White Pine County. If
the Secretary of Interior, working with local citizens and other
stakeholders, is able to identify a route for the trail that would not
significantly impact wildlife, natural or cultural resources, an
extension of the Silver State Trail will be designated at the
conclusion of the study.
Off-highway vehicle use in Nevada has grown exponentially in recent
years, and this rise in use has led to the pioneering of hundreds of
miles of additional trails and roads across Nevada's frontier. The
longer this uncontrolled use continues, the fewer areas we will have in
Nevada that are truly wild and untouched. And when these places are
gone, we will have lost something that cannot be replaced.
With this in mind, the study authorized by this bill is an effort to
recognize that the use of off-highway vehicles is a popular form of
recreation that is here to stay. Many people use their off-highway
vehicles responsibly and we are creating a process with this
legislation that will put advocates for off-highway vehicles, wildlife,
grazing and other land users around the same table.
Perhaps no issue addressed by this legislation has been more
discussed and debated than the conveyance of BLM land to be held in
trust by the United States for the Ely Shoshone Tribe. Currently, the
tribe holds 100 acres in two separate parcels within the city limits of
Ely. For 3 years meetings have been taking place in White Pine County
to discuss possible configurations and areas for a tribal expansion.
Local residents and interested parties have expressed strong feelings
on all sides of this issue, and our proposal is better as a result of
this dialog.
This bill transfers roughly 3,500 acres in four separate parcels into
trust for the benefit of the Ely Shoshone Tribe. Over half of this
acreage is contained in one parcel to the west of Ward Mountain. This
large area is designated exclusively for traditional tribal uses, such
as ceremonial celebrations and gatherings and pine nut picking.
The conveyance also includes two parcels to the south of Ely and one
approximately 10 miles north of McGill on highway 93. These lands are
available to be used by the tribe for residential and commercial
purposes.
The placement of these conveyances will allow the tribe to be a
partner in the growth and economic development of White Pine County
while also ensuring that the city of Ely has sufficient room to grow
south along highway 93. We have taken special care to ensure that
existing developments, like the KOA, have room to expand.
This conveyance represents a tough compromise between many important
interests. Some have proposed that the tribe should receive in excess
of 20,000 acres of land in and around Ely. Others have fought to block
the tribe from receiving a single acre. We do not expect that the
conveyance in this bill will please anyone completely, but we do
believe it is a fair compromise that addresses the main concerns of all
the concerned parties.
The invasion of non-native species like cheat grass and red brome and
the overgrowth of pinon and juniper woodlands has begun to
fundamentally alter the ecosystems in eastern Nevada. This landscape
level change threatens to bring catastrophic fire to this area while
also destroying essential habitat for many of Nevada's native species.
In order to address the challenges, this legislation makes funds from
the Southern Nevada Public Land Management Act special account
available for the implementation of the Eastern Nevada Landscape
Restoration Project in White Pine and Lincoln Counties. In addition to
funding this vital program, we have authorized the Secretaries of the
Interior and Agriculture to work with Eastern Nevada Landscape
Coalition and the Great Basin Institute in carrying out the landscape-
scale restoration efforts necessary to restore the health of eastern
Nevada's rangelands. In the interest of understanding and fully
addressing the ecosystem changes that are taking place all across the
Great Basin, this bill also authorizes a feasibility study for an
interagency research facility and experimental rangeland in eastern
Nevada.
In addition to preventing major and repeated fires, this restoration
initiative will benefit ranchers, sportsmen, private land owners,
communities of all sizes, and of course the wildlife and rangelands on
which we depend. It is my sincere hope that this program will make a
long lasting and beneficial change in the health of the ecosystems in
eastern Nevada.
Since the passage of the Southern Nevada Public Land Management Act,
SNPLMA, in 1998, thousands of acres of BLM land have been auctioned in
southern Nevada. These sales have produced significant funding for
conservation efforts, enhancements to our most prized public lands, and
the acquisition of sensitive lands throughout our State.
Now, 8 years after its passage, we are seeking to update the
legislation so that it continues to serve the full interests of the
people of Nevada, our public lands, and the federal agencies that
administer the programs funded by the original legislation.
In this bill we provide funding for two separate 10-year hazardous
fuels reduction programs, one for the Spring Mountains and one for the
Lake Tahoe Basin including the adjacent lands in the Carson Range in
Washoe and Douglas Counties and Carson City. We also provide funding
for the implementation of the Clark County Multispecies Habitat
Conservation Plan, allow SNPLMA to be used for improvements to state
parks in Clark County, authorize reimbursement for water saving
landscaping undertaken by public institutions, and make the Clean Water
Coalition eligible for funding to implement an essential wastewater
project that will improve the water quality in Lake Mead and provide a
sustainable future for the Las Vegas Wash.
In order to make SNPLMA more manageable for the agencies and
municipalities that administer the special account and its many
programs, we have included authority that allows all federal agencies
that carry out SNPLMA projects to get reimbursed for their direct
costs. We have also provided an important authority for the BLM to use
SNPLMA funds to properly clear and protect vacant parcels in the Las
Vegas Valley from dumping. The current practice of providing funding
for approved projects only through reimbursement is also brought to an
end. Under this legislation the Department of Interior is required to
distribute funds for approved SNPLMA projects no later than 60 days
after a transfer of funds is requested.
Of special note, these amendments also include a 5-year authorization
for Washoe County to acquire up to 250
[[Page S8547]]
acres of land for a county park. The residents of Washoe County have
been and remain strong advocates for open space and we hope that they
will take advantage of this opportunity.
Perhaps the most important change that we make to SNPLMA is a
complete rewrite of the legislation's affordable housing title. While
language was included in the original legislation that allows for land
to be acquired at less than fair market value for the development of
affordable housing, it took the BLM over 4 years to promulgate the
guidelines for implementing this provision. Since that time no eligible
party has successfully used these guidelines to secure land and build
affordable housing anywhere in Nevada.
With an estimated 170,000 housing units needed in southern Nevada for
affordable and workforce housing in the next 10 years, immediate action
is needed. As a result, we have struck the largely unworkable language
from the original legislation. We have replaced it with an authority
allowing all legitimate interested parties to work with the BLM to
pursue land for the development of affordable and workforce housing. We
also take a further step and require that any parcel of Federal land
over 200 acres in size that is auctioned in the Las Vegas Valley must
include at least 5 percent affordable and workforce housing.
These new affordable and workforce housing provisions are by no means
a complete answer to the housing crisis facing southern Nevada, but
they are a step in the right direction. I applaud the work that has
been done at the local and State levels to address this issue and I am
committed to continuing to work on broad based solutions to ensure that
we can meet the affordable housing needs in all of Nevada's
communities.
The last title of this bill establishes the Great Basin National
Heritage Route. Encompassing Millard County, Utah; the Duckwater Indian
Reservation in Nevada; and White Pine County, Nevada, this historic
area includes historic mining camps and ghost towns, Mormon and other
pioneer settlements, as well as Native American communities. The Route
passes through classic Great Basin country along the trails of the Pony
Express and the Overland Stage. Cultural resources within the route
include highly valued and culturally important Native American
archaeological sites dating back to the Fremont Culture.
Designation of the corridor as a heritage route will ensure long-term
protection of key educational and recreational opportunities while also
bringing attention to the Great Basin's rich natural wonders like the
bristlecone pine, the old living things on Earth, and the rare
Bonneville cutthroat trout. In short, the Great Basin National Heritage
Route will provide a framework for celebrating eastern Nevada's and
western Utah's rich historic, archaeological, cultural, and natural
resources for both visitors and residents.
I have been proud to support the designation of the Great Basin
Heritage Route for many years and have helped pass legislation through
both the Senate and the House calling for establishment of the route.
Unfortunately, in each instance the legislation was included in a
larger package of bills that failed to reach the President for
signature. Having received the approval of both bodies of Congress for
this measure, it is my hope that we can finally make this route a
reality as part of this comprehensive legislative package for White
Pine County.
The White Pine County Conservation, Recreation and Development Act of
2006 is an ambitious, timely and complex piece of legislation. By
making long-term and forward looking improvements to public land
management and the stewardship of our shared natural resources, we
believe we have crafted a bill that will serve the best interests of
the people of White Pine County, eastern Nevada and our entire State.
I look forward to working with the chairman and ranking member of the
Senate Energy and Natural Resources Committee to ensure timely review
and passage of this bill.
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