[Congressional Record Volume 161, Number 165 (Thursday, November 5, 2015)]
[Senate]
[Pages S7816-S7822]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. DURBIN (for himself and Mr. Casey):
S. 2248. A bill to amend the Public Health Service Act to coordinate
Federal congenital heart disease research efforts and to improve public
education and awareness of congenital heart disease, and for other
purposes; to the Committee on Health, Education, Labor, and Pensions.
Mr. DURBIN. Mr President, every 15 minutes in America, a baby is born
with a congenital heart defect. Many of these congenital heart defects
are simple and can be easily corrected. Others are complex; some can
require a lifetime of specialized medical care.
If you want to know what fear and powerlessness feels like, imagine
being a young parent, listening to a doctor tell you that your new
baby--who appears so perfect to you--has a threatening heart problem.
Fortunately, congenital heart defects aren't as deadly as they once
were. In the 1950s, only 20 percent of American babies with congenital
heart defects survived infancy. Today, 90 percent survive. Many
children born with serious heart defects grow up to be adults with
active, productive lives.
That progress didn't happen by accident. It happened because
Americans made a decision in the 1960s to reduce these mortality
numbers. We invested in research that led to better understanding and
better treatments of the heart, from infancy to old age.
That investment in research has paid off in many ways. Some heart
conditions that used to kill adults quickly often are managed now with
medications and life style changes. The number of Americans with
congenital heart disease living full, healthy lives increases by about
5 percent every year. About 2 million Americans are living with
congenital heart disease today. We have come a long way--but there is
more that we can do.
We know that the sooner a baby with a congenital heart defect is
diagnosed and treated, the better the chances are to live a long and
healthy life. But, the Centers for Disease Control and Prevention
estimates that 30 percent of babies with critical congenital heart
defects aren't diagnosed in the first few days, when treatment is most
effective; 1 in 200 babies die from complications that might have been
avoided if their heart disease had been detected.
In 2009, I introduced the Congenital Heart Futures Act to study
people of all ages with congenital heart disease and coordinate
research. That bill expired this year.
Today I am introducing the Congenital Heart Futures Reauthorization
Act of 2015. This bill will save lives by allowing us to build on the
knowledge we have gained about congenital heart defects and the best
ways to treat them.
My bill directs the Centers for Disease Control and Prevention to
study
[[Page S7817]]
people of all ages with congenital heart disease. The CDC would make
the results of its research available to congenital heart disease
researchers and to Congress. We will enable some of the best scientific
and medical minds in America to evaluate the best ways to diagnose and
treat congenital heart disease.
Many adults living with congenital heart disease are not aware they
need specialized care throughout their lives. And fewer than 10 percent
of adults with complex congenital heart disease receive the care they
need.
The Congenital Heart Futures Reauthorization Act directs the CDC to
create a public awareness campaign to educate both patients and doctors
about congenital heart disease and the need for lifelong specialized
care for those living with congenital heart defects.
Finally, my bill directs the National Institutes of Health to conduct
a review of ongoing research on congenital heart disease, identify
areas of greatest need for research, and identify plans for future
research.
We are not powerless when it comes to congenital heart challenges. We
have made tremendous progress in my lifetime. Millions of Americans
with congenital heart defects are living happy, healthy lives today
because of that progress.
The Congenital Heart Futures Reauthorization Act bill will help us
better understand what congenital heart disease looks like in the
United States and what we can do to help those living with this disease
live longer. This bill will save lives and ultimately it will save
taxpayers money--a lifetime of specialized heart care is expensive.
I would like to thank Senator Casey for joining me in introducing
this bill, and Representatives Bilirakis from Florida and Adam Schiff
from California in the House for introducing the companion bill. I look
forward to working with them on this issue that affects so many
families.
Mr. President, I ask unanimous consent that the text of the bill be
printed in the Record.
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:
S. 2248
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 ``Congenital Heart Futures
Reauthorization Act of 2015''.
SEC. 2. NATIONAL CONGENITAL HEART DISEASE COHORT STUDY AND
AWARENESS CAMPAIGN.
Section 301 of the Public Health Service Act (42 U.S.C.
241) is amended by adding at the end the following--
``(f) National Congenital Heart Disease Cohort Study.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall plan, develop, implement, and submit annual reports to
the Congress on surveillance and research activities of the
Centers for Disease Control and Prevention, including a
cohort study to improve understanding of the epidemiology of
congenital heart disease (referred to in this subsection and
subsection (g) as `CHD') across the lifespan, from birth to
adulthood, with particular interest in the following:
``(A) Health care utilization and natural history of those
affected by CHD.
``(B) Demographic factors associated with CHD, such as age,
race, ethnicity, gender, and family history of individuals
who are diagnosed with the disease.
``(C) Outcome measures, such that analysis of the outcome
measures will allow derivation of evidence-based best
practices and guidelines for CHD patients.
``(2) Permissible considerations.--The study under this
subsection may--
``(A) gather data on the health outcomes of a diverse
population of those affected by CHD;
``(B) consider health disparities among those affected by
CHD which may include the consideration of prenatal
exposures; and
``(C) incorporate behavioral, emotional, and educational
outcomes of those affected by CHD.
``(3) Public access.--Subject to paragraph (4), the data
generated from the studies under this subsection shall be
made available to CHD researchers subject to appropriate
privacy protections, and aggregate data from such studies
shall be made available to the public.
``(4) Patient privacy.--The Secretary shall ensure that the
study under this subsection is carried out in a manner that
complies with the requirements applicable to a covered entity
under the regulations promulgated pursuant to section 264(c)
of the Health Insurance Portability and Accountability Act of
1996.
``(g) Congenital Heart Disease Awareness Campaign.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall establish and implement an awareness, outreach, and
education campaign regarding CHD across the lifespan. The
information expressed through such campaign may--
``(A) emphasize that CHD is the most prevalent birth
defect;
``(B) identify CHD as a condition that affects those
diagnosed throughout their lives; and
``(C) promote the need for pediatric, adolescent, and adult
individuals with CHD to seek and maintain lifelong,
specialized care.
``(2) Permissible activities.--The campaign under this
subsection shall--
``(A) utilize collaborations or partnerships with other
agencies, health care professionals, and patient advocacy
organizations that specialize in the needs of individuals
with CHD; and
``(B) include the use of print, film, or electronic
materials distributed via television, radio, Internet, or
other commercial marketing venues.''.
SEC. 3. CONGENITAL HEART DISEASE RESEARCH.
Section 425 of the Public Health Service Act (42 U.S.C.
285b-8) is amended by adding the end the following:
``(d) Report From NIH.--Not later than 1 year after the
date of enactment of the Congenital Heart Futures
Reauthorization Act of 2015, the Director of NIH, acting
through the Director of the Institute, shall provide a report
to Congress--
``(1) outlining the ongoing research efforts of the
National Institutes of Health regarding congenital heart
disease; and
``(2) identifying--
``(A) future plans for research regarding congenital heart
disease; and
``(B) the areas of greatest need for such research.''.
______
By Mr. UDALL (for himself, Mr. Heinrich, Mr. Bennet, Mr. Wyden,
and Mr. Markey):
S. 2254. A bill to modify the requirements applicable to locatable
minerals on public domain land, and for other purposes; to the
Committee on Energy and Natural Resources.
Mr. UDALL. Mr. President, I rise today to introduce the Hardrock
Mining Reform and Reclamation Act of 2015.
First, I thank Senator Heinrich, who will be here with me in a
moment, for working with me on this bill. He is a dedicated
conservation Senator from the West and really cares about this issue,
and we have both been working together on this bill. I so much
appreciate all of his hard work and his commitment to this important
legislation. I also thank Senator Bennet and Senator Wyden for their
hard work and support on this bill. I also thank our New Mexico
colleague, Congressman Ben Ray Lujan, for his efforts on the House
side.
We are proposing this bill for one reason: to reform the mining law
of 1872. It is a matter of simple fairness, it is a matter of common
sense, and it is a reform that is long overdue.
The 1872 mining law played a historic role in the settling of the
West. It encouraged mining for silver, gold, copper, uranium, and other
minerals on public lands. It helped the West to grow, but there was a
price--one we are still paying. It did almost nothing to compensate the
public, it did nothing to protect the environment, and it did nothing
to require mines to clean up the mess. It did nothing to require those
mines to clean up the mess. The legacy is clear--thousands of abandoned
mines, contaminated land, polluted streams, costly cleanup, and
taxpayers stuck with the bill. We have a 19th-century law which is
totally inadequate to 21st-century challenges.
The spill at the Gold King mine earlier this year tells the story.
With terrible damage in my State, in other States, and in the Navajo
Nation, this is a disaster on many levels--to our water, our economy,
and to our culture.
Mistakes were made at the Gold King mine. We have to do all we can to
make sure they are not made again and to make sure our communities are
fairly compensated for losses. That is why Senator Heinrich and I
introduced the Gold King Mine Spill Recovery Act of 2015.
The Gold King mine disaster is also a wakeup call. The mine is still
there; the owners are not. There are up to 500,000 abandoned mines in
our country. They are a ticking timebomb. They are leaking toxins into
our rivers and streams in the West and have been for decades. It will
cost tens of billions of dollars to fix this. The estimates are
anywhere from $20 billion to $54 billion, with a ``b''--billions. A
mining royalty will bring fairness to taxpayers and help pay for the
cleanup.
[[Page S7818]]
I have pushed for--and will keep pushing for--mining reform, first in
the House and now in the Senate because I believe in the simple
principle that the polluter pays. The polluter pays, but under current
law the mining companies do not pay--not for the minerals they take,
not for the damage they have done. This cannot continue. They cannot
continue to reap all the benefits and hundreds of millions of dollars
while taxpayers continue to shoulder all the burden. This goes against
every notion of simple fairness. Working Americans know this, middle-
class families know this, and both sides of the aisle know this.
The 1872 mining law also basically gives away Federal land for $5.
Less than what a working American pays for lunch, mining companies can
buy an acre of Federal land if they discover a valuable mineral
deposit. So there is no surprise here. Hard rock mining companies don't
want reform. They have had a free ride for a long time--no wonder they
want to keep it--but it is long past time for that ride to end.
Coal, oil, and gas companies have paid royalties for many decades.
Hard rock mining companies, including foreign mining companies, should
do the same. Our bill will require that they do that. It is not a
radical idea. The oil industry pays a small fee on every barrel of oil,
the coal industry pays a small fee on each ton of coal, and the sky has
not fallen in. And when disasters happen, from oilspills to abandoned
coal mines, these industries bear some of the cost.
History may explain why the 1872 law was created, but it is hard to
see now why it should continue. What began as an effort to settle the
West has become a gravy train for multibillion-dollar companies and not
just American companies but foreign ones as well. We know the taxpayers
are getting shortchanged. We just don't know how much.
In 2011 I asked the General Accounting Office for the numbers. They
couldn't say. Not only do the hard rock mining companies not pay, they
do not disclose, and under current law they do not have to--not how
much they extract from Federal lands, not where the minerals are sold,
not the overall value. Yet at the same time, oil, gas, and coal brought
in $11.4 billion in Federal revenue.
We need to get this done. We can't keep asking working Americans and
struggling communities to foot the bill while mining companies reap the
profits. Let us be clear. The silver and gold on public lands are a
natural resource. They belong to the American people. They should be an
investment for public good, not a giveaway for private gain.
After my father left office after 8 years as Secretary of the
Interior, he was asked what were his big regrets, and he said mining
reform was his greatest unfinished business. Fifty years later we still
need to do this and we still need to do it now. We have an outdated
law. Special treatment for the profits of large hard rock mining
companies is not a reason to keep it, at least not to the taxpayers of
my State.
It is time to stop giving away the store. It is time to reform the
mining law of 1872. It is the right thing to do. It is the fair thing
to do. I urge my colleagues to support this bill and let us get this
done.
Mr. President, I was just in a press conference with Senator Heinrich
and Senator Bennet where we talked, and one of the questions that was
asked was: How are you working at building bipartisan support and is
there bipartisan support? I want to say a word on that because we have
seen very solid bills pass here in Washington with bipartisan support.
One of the ones I wanted to point out was in 2007 in the House. Nick
Rahall had a mining reform bill. He had Republican cosponsors by the
names of Wayne Gilchrest and Representative Christopher Shays--24
Republicans in the House--and the bill was passed 244 to 166. Paul
Ryan, who was in my class when I came into Congress in 1998--we arrived
at the same time and Paul is now the Speaker over in the House--voted
yes for mining reform back in 2007 on this Rahall bill.
So I think if you look at the history, this is a bill where we need
to work with both sides of the aisle, and I hope and wish Congressman
Ryan--Speaker Ryan--the best and I hope he will join us in this effort
to reform this long outdated law.
With that, I see my good friend and partner in this, Senator
Heinrich, is on the floor, so I yield the floor at this time.
The PRESIDING OFFICER. The Senator from New Mexico.
Mr. HEINRICH. Mr. President, I want to begin by thanking my colleague
the senior Senator from New Mexico Tom Udall for the incredible
leadership he has shown on this issue. I know it is something near and
dear to his heart and something he absolutely and truly cares about. We
have had a good team working on this over the course of the last couple
of months. Senator Michael Bennet of Colorado has been a great
contributor to this effort. Congressman Ben Ray Lujan of northern New
Mexico has taken a leadership effort on a similar effort in the House,
and today we are joined by Senator Ron Wyden of Oregon on this
legislation as well.
As many folks know, in August a large plume of bright orange mine
waste spilled into the Animas River, which leads into the San Juan, and
polluted the Four Corners region from Colorado to New Mexico and
through the Navajo Nation.
If you take a look at this photo, which was shared with me by the
president and vice president of the Navajo Nation, this is not what you
want to see when you look at the river that you take your drinking
water from or the river that you use for irrigation or the place you go
fishing or recreate and kayak on. This is not how our mountain streams
in the Southwest are supposed to look. I think visually this got the
attention of people all around the country as to the scope and scale of
this problem.
After the mine spill, I toured affected communities in New Mexico and
the Navajo Nation. I met with impacted residents, including farmers in
Aztec and Shiprock, San Juan County leaders, Navajo Nation President
Russell Begaye, Vice President Jonathan Nez, and the attorney general,
Ethel Branch. In the Southwest, water is by far our most precious
resource, so you can imagine the kind of impact this disaster had on
our communities.
My colleagues in the Environment and Public Works Committee and the
Committee on Indian Affairs have now held hearings to investigate the
Environmental Protection Agency's actions which led to this spill and
to seek to bring proper oversight to the Agency's response. Last week,
the Department of the Interior released a report of its independent
technical evaluation of the EPA's action. The evaluation found that the
EPA did not properly appreciate the engineering complexity of trying to
clean up the Gold King mine and that it could in fact have prevented
what we see here.
I share the anger and frustration that not only my colleagues but,
more importantly, our constituents have expressed over this terrible
accident. It is why Senator Udall and I have introduced separate pieces
of legislation specifically to make these communities whole. We need to
continue to demand the EPA act with urgency to protect the health and
the safety of the affected communities and to repair the damage
inflicted on this watershed. That is our first and top priority.
We are doing a disservice to the American people by not also taking
action to address the thousands--thousands--of other similarly
contaminated abandoned mines that literally litter the West and are
leaking toxins into our watersheds--into the watersheds that provide
drinking water and irrigation to our communities all across the West.
There are estimates that 40 percent of western watersheds have been
polluted by toxic mining waste and that reclaiming and cleaning up
abandoned mines to make this right is going to cost tens of billions of
dollars.
This latest disaster was all too familiar for those of us from the
Four Corners region and to many people around the West. Back in 1975,
in an even larger accident than the Gold King blowout, a tailings pile
near Silverton, CO, spilled 50,000 tons of tailings laden with toxic
heavy metals into the Animas River Watershed--the watershed that drains
from Colorado into New Mexico, into the San Juan and through the Navajo
Nation in Arizona as well.
In 1979, a breached dam at a uranium mill tailings disposal pond near
Church
[[Page S7819]]
Rock in New Mexico on the Navajo Nation sent more than 1,000 tons of
solid radioactive waste and 93 million gallons of acidic liquid into
the Rio Puerco.
Disastrous blowouts and spills like these are easy to see. They get
the media's attention, but the toxins leaking silently out of thousands
of abandoned hard rock mines are doing even more damage to our
watersheds each and every day.
For decades before the spill, the Gold King mine actually leached
water laced with heavy metals and sulfuric acid into Cement Creek,
which is a tributary of the Animas. Over the last 10 years, an average
of 200 gallons of highly polluted water each and every minute, or more
than 100 million gallons per year, flowed out of this mine and into the
Animas River via Cement Creek. The Gold King and other abandoned mines
in the San Juan Mountains in southwestern Colorado continue to pollute
the Animas and the San Juan Watershed as we speak.
Beyond the immediate cleanup of the Gold King spill, it is high time
we as a Congress overhaul our abandoned mine cleanup policies to make
future disasters less likely and to address the thousands and thousands
of abandoned mines that are polluting our watersheds.
The Navajo Nation, which was perhaps most affected by the Gold King
mine blowout, has more than 500 abandoned uranium mines. Last month, I
met with officials at the Navajo Abandoned Mine Lands Reclamation and
Uranium Mill Tailings Remedial Action Office and learned about their
efforts to clean up these literally hundreds of sites. I visited a
large uranium tailings disposal pile in Shiprock--in the town of
Shiprock--that sits close to the San Juan River.
If you look at this map, this is the San Juan River. This is the
community of Shiprock. We have the high school, the fairgrounds, and
the residential area all around a permanent tailings disposal site--
something that is going to require stewardship for literally hundreds,
if not thousands, of years.
Melvin Yazzie, a senior reclamation specialist with the department,
also took me through an abandoned uranium mine site in the Red Valley
Chapter of the Northern Navajo Nation. Carrying a Geiger counter, he
showed me the abandoned mine and a nearby house that was constructed
using materials contaminated with radioactive materials.
Here we see Mr. Yazzie with his Geiger counter. This is obviously no
longer occupied, but it gives us a sense of the impact to members of
the Navajo Nation, some of whom literally have their homes built with
the spillover, the rock materials that came out of these mines, and
live with that irradiation each and every day.
The Navajo Government is doing its best to address this legacy of
uranium mining and milling, but they do not have anywhere close to
enough resources or funding necessary to clean up the waste from
decades and decades of uranium mining.
A large reason why the Navajo Nation lacks adequate resources and why
communities all across Indian Country and the entire West are dealing
with pollution from abandoned mines and lack resources is that we have
not updated our Federal laws on hard rock mining in 143 years.
During the era of manifest destiny, the Federal Government encouraged
Americans to settle newly acquired lands in the West by passing laws--
laws like the Timber and Stone Act of 1878 and the Desert Land Act of
1878, laws like the Homestead Act, which my grandparents took advantage
of. Some of these laws gave away public lands and resources to private
users with no strings attached and often no price tag attached.
The General Mining Act of 1872 came along during this era of
unrestrained western expansion. It allowed individuals and companies to
claim ownership of minerals in the public domain--minerals owned by us
as a nation, such as gold, silver, copper, uranium, molybdenum, and
others--simply by locating a mineral source, staking a claim, and
paying $5 for an acre of land. Miners did not have to consider
environmental impacts or make any plans to clean up the waste, which
has created the pollution and contamination we confront today. This law
drew thousands of people to the West. My father and my mother's father
both made a living working in hard rock mining. But shortsighted policy
also left behind a scarred legacy on our lands.
Unlike other 19th-century western settlement laws which have long
since been reformed or replaced, the Mining Act of 1872 remains on the
books today. While developers of resources such as oil, natural gas,
and coal all pay royalties to return fair value to taxpayers for our
public resources, hard rock mining companies still mine publicly owned
minerals for free--for free--and we still don't have a plan to address
a century of pollution from abandoned mines.
We desperately need to bring our mining laws out of the 19th century
and into the 20th century. That is why I am joining my colleagues--
Senator Udall of New Mexico, Senator Bennet of Colorado, and Senator
Wyden of Oregon--to introduce legislation to reform our outdated and
ineffective Federal policy on abandoned mines and on hard rock mining.
Our legislation will require that reasonable royalties and fees from
hard rock mining be used to create a dedicated funding stream for
cleaning up mine waste. A reclamation program will allow States,
tribes, and nonprofit organizations to collaborate on projects to
restore fish and wildlife habitat affected by past hard rock mining and
to repair watersheds that are the very center of our economy in the
West, the source of our essential agricultural and drinking water
supply for western communities up and down the spine of the Rockies.
This legislation will also reform the permitting process for new
mines. Hard rock mining companies will need to protect water and
wildlife resources and provide financial assurance that they can
actually fund reclamation cleanup and restoration efforts after their
mines close so that in the future we don't have this legacy of
abandoned hard rock mines.
These are simply, commonsense reforms--reforms that, frankly,
Congress should have adopted decades ago.
I appreciate the value of the hard rock mining industry. My own
family has benefited from it, and I recognize that the industry
continues to provide good-paying jobs in States throughout the West.
Some mining companies are already stepping up to help clean up old
mining waste sites. I look forward to working with industry
stakeholders to find practical ways to bring our policies into the 21st
century. We cannot wait for more disasters like the Gold King mine
spill for us to act. We cannot continue to do nothing while thousands
of abandoned hard rock mines drain toxic metals into our rivers, water
supplies, and our drinking water each and every day. We must come
together and press forward for pragmatic reforms to our outdated
Federal hard rock mining laws.
______
By Mr. KAINE (for himself and Mrs. Capito):
S. 2256. A bill to establish programs for health care provider
training in Federal health care and medical facilities, to establish
Federal co-prescribing guidelines, to establish a grant program with
respect to naloxone, and for other purposes; to the Committee on
Health, Education, Labor, and Pensions.
Mr. KAINE. Mr. President, I rise to discuss a bill I am introducing
called the Co-prescribing Saves Lives Act.
All across the Nation, and certainly all across my Commonwealth, we
are seeing the scourge of prescription drug abuse and a heroin
epidemic. These opioids are having major impact in communities
everywhere in Virginia, from the coal mines of Appalachia to rural
communities in the Shenandoah Valley, to right here in suburban Fairfax
County.
I have heard, as have my colleagues, stories from parents who have
buried children, from companies that can't find employees who can pass
drug tests, and certainly from law enforcement officials, including
judges, prosecutors, police officials, and sheriffs, who talk about the
dramatic expansion of opioid addiction in this country. The numbers are
kind of shocking. When I came to the Senate and started doing tours
around the State in the spring of 2013, I really wasn't schooled about
this, and I started to hear stories.
Heroin and opioids now account for 25,000 American deaths a year. In
Virginia, and in much of the United
[[Page S7820]]
States, the deaths from opioid overdoses are now exceeding deaths from
motor vehicle accidents. According to the Centers for Disease Control,
in the United States fatal opioid-related drug overdose rates have
quadrupled since 1990 and have never been higher than they are right
now.
The question is, How do we address this crisis? Obviously, the answer
is there is no single answer. There are a lot of things that have to be
done. The Federal Government, State and local communities, faith
communities, nonprofit organizations, families, individuals educating
themselves--there are a lot of answers, but we have to move forward
with steps that we know can reduce overdose deaths.
There is some good news. There are advances that can help us do this,
and one of the advances has been the development of a drug called
naloxone, which is a medicine that is safe and effective as an antidote
to all opioid-related overdoses, including heroin, prescription
opioids, and fentanyl. It is a critical tool--it has been proven to be
a critical tool since its development in preventing fatal opioid
overdoses.
One of the neat things about naloxone is if you come across somebody
who is in respiratory failure from an overdose or for some other
reason, you can administer naloxone to that individual, and if it is
not an overdose, it doesn't have any side effects. It can bring
somebody back from the overdose-caused respiratory failure, but it
doesn't have any negative side effects if it turns out the person is
suffering from something else.
In Virginia there is an organization called Project REVIVE! that
trains people to administer naloxone. In one of our communities in
Russell County in Southwest Virginia, about a year ago I took the
training with a lot of family members and others--just 2 hours of
training--to learn how to do this.
Since naloxone has been developed and come into more common usage
beginning in the late 1990s, it has saved more than 26,000 people who
have been in the throes of an overdose. Naloxone has brought them back
to life. I think a lot of professionals--public safety professionals
and health care professionals around the country--have seen how
effective it is.
One answer to our overdose problem is to co-prescribe naloxone when
someone is getting a prescription for an opioid. Opioids have
legitimate uses, to manage pain. So when somebody is getting a
prescription for that, co-prescribe naloxone so they have the antidote
right there in case of an overdose.
There are overdoses from people who are using drugs inappropriately
and grabbing somebody else's prescriptions and using opioids, but there
are also quite a few overdoses where people who are legitimately
prescribed the drug--and they are usually prescribed it for pain--they
develop a tolerance to the drug. The package may say to take one pill
every 6 hours, but the pain is strong, and after 3 hours they start to
feel it again and somebody thinks, OK, the drug has worn off now so I
can take another one. So a person can start to take too many because of
pain symptoms, and they get into an overdose situation for that reason
too. If a person has a naloxone co-prescribed, they can have the
antidote right there that they can administer themselves, or someone
else can, if they get into an overdose situation.
Many communities, States, national organizations, and medical
organizations have supported co-prescribing naloxone to patients who
are taking opioids as a critical part of this overdose problem, and we
have guidelines. Not everybody who gets an opioid prescription needs
naloxone. My wife broke and dislocated her shoulder two Good Fridays
ago, and she was prescribed a powerful opioid pain killer. She used
about a day and a half's worth of it. It made her sick to her stomach
so she quit using it. Not everybody who gets prescribed a prescription
opioid needs naloxone, but there are certain warning signs--the medical
profession has developed the warning signs--and if you have the warning
signs, you should get the co-prescription. Developing these guidelines
helps physicians, pharmacists, and other providers determine who is at
risk and whom we should be proactive with regarding a co-prescription.
What this bill does is the following: It improves access to naloxone
by encouraging physicians to co-prescribe in a couple of circumstances,
to co-prescribe this lifesaving drug alongside opioid prescriptions and
make it more widely available in Federal health settings.
The Co-prescribing Saves Lives Act would require that the Secretaries
of Health and Human Services, Defense, and Veterans Affairs would
establish physician education co-prescribing guidelines for all Federal
health centers, including VA hospitals, DOD hospitals, the Indian
Health Service, and federally qualified health centers. So within
Federal health care facilities, if there is going to be an opioid
prescription to somebody in a high-risk situation, there would be a
mandate that naloxone would be prescribed as well.
This bill is based upon work that has already been done in the
Federal Government. The VA especially has been a real leader in setting
up these co-prescription guidelines. In addition, the bill would
provide a program of grants through State departments of health that
are interested in doing the co-prescribing guidelines for private
physicians not in Federal settings in their States. The funding would
allow States to purchase naloxone, to provide copay assistance for
uninsured patients, and to fund training for health professionals and
patients. Grant funding could also support State innovation and provide
for community outreach. The kind of program where I trained last
summer, Project REVIVE!, is just a community program trying to battle
opioid overdose deaths in the coalfields of Appalachia. That would be
the kind of program that if other States wanted to do that, could be
eligible for grant funding.
In closing, this is just one solution. Obviously, the real solutions,
the important ones, are still around prevention. Why do Americans get
prescribed so many more opioids than folks in other nations? What do we
do about prescriptions when the quantities that are given are too big
and then we end up with a lot of unused opioids that can be taken by
young people or stolen and sold? There are a lot of issues we have to
solve, but there is this bit of good news; that naloxone saves lives
and it is easy to administer. It doesn't have a negative effect. If we
can broaden access to naloxone for those who have been prescribed
opioids--we have saved lives in the past and we are going to save a lot
more.
I will conclude by saying there is a dad in Northern Virginia--a guy
by the name of Don Flattery--who has been very public about the loss of
his son, Kevin, who was a 26-year-old graduate of UVA in 2014. He
talked about his son, the family, the advantages they had, and his
educational track record of success at UVA, but then he fell into the
just bottomless pit of opioid prescription, opioid addiction, and he
perished in 2014. What Don said is that ``I feel we need to keep
personalizing what is happening. We are not addressing shocking, obtuse
statistics--we are speaking about my son, your daughter, our neighbors
. . . they are real people with real lives, and their losses are the
face of the epidemic we must stop.''
That is what this bill intends to play a part in.
______
By Ms. CANTWELL (by request):
S. 2257. A bill to prepare the National Park Service for its
Centennial in 2016 and for a second century of protecting our national
parks' natural, historic, and cultural resources for present and future
generations and for other purposes; to the Committee on Energy and
Natural Resources.
Ms. CANTWELL. Mr. President, I am pleased to introduce, by request,
the Administration's legislative proposal the National Park Service
Centennial Act.
The bill authorizes or expands several authorities to assist the
National Park Service in managing the over 400 units of the National
Park System as it prepares for the centennial anniversary of the
agency's establishment in 1916.
While I may not agree with every provision in the administration's
proposed bill, I believe it is important for this legislative proposal
to be considered in the Senate, which is why I agreed to introduce it
by request. At the same time, I will continue to work with other
Senators on both sides of the aisle to develop a bipartisan consensus
on a national park centennial
[[Page S7821]]
bill so that the Senate can consider and pass a bill before the
National Park Service's centennial anniversary next year.
Mr. President, I ask unanimous consent that the administration's
letter to the Senate transmitting the legislative proposal and a
section-by-section summary of the bill prepared by the Department of
the Interior be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
The Secretary of the Interior,
Washington, DC, August 31, 2015.
Hon. Joseph R. Biden, Jr.,
President of the Senate,
Washington, DC.
Dear Mr. President: Enclosed is a draft of a bill
entitled, the ``National Park Service Centennial Act.'' Also
enclosed is a section-by-section analysis of the bill. We
recommend that the bill be introduced, referred to the
appropriate committee for consideration, and enacted.
The National Park Service (NPS) will celebrate its
centennial in 2016. As we look ahead to the next century,
there are a number of key authorities that need to be
authorized, clarified, or expanded to allow us to better
serve the American people.
Title I, the Centennial Declaration, would recognize that
the NPS has responsibility not only for administering the
units of the National Park System, but for programs that
provide financial and technical assistance to states,
communities, and individuals to protect our national
heritage. Title I would also direct the Secretary of the
Interior to utilize these financial and technical assistance
programs to further the conservation and enjoyment of the
natural and cultural heritage of the Nation for the benefit
and inspiration of the public.
Titles II-IV of the proposed legislation would implement
part of the President's Fiscal Year (FY) 2016 Budget request
to Congress. Title II would establish a National Park
Centennial Challenge Fund of up to $100 million for FY 2016,
FY 2017, and 2018 to be used for signature projects that will
help prepare the national parks for another century of
conservation, preservation, and enjoyment.
Title III would provide a mandatory appropriation of $300
million to the NPS Construction Account for FY 2016, FY 2017,
and FY 2018, to correct deficiencies in NPS infrastructure
and facilities.
Title IV would establish the Centennial Land Management
Investment Fund, consisting of a mandatory appropriation
equal to $100 million for FY 2016, FY 2017, and FY 2018 to
provide funding for the Secretaries of the Interior and
Agriculture to jointly establish a competitive program
available to the four Federal land management agencies for
projects that enhance visitor services and outdoor
recreational opportunities, restore lands and waters, repair
facilities or trails, or increase energy and water
efficiency.
Title V would direct the National Park Foundation (NPF) to
establish a special account known as the Second Century
Endowment for the NPS, consisting of gifts or bequests
provided for this purpose, for projects and activities that
further the mission of the NPS.
Title VI would establish the NPS Second Century Fund in the
Treasury, which would be funded through additional lodging or
camping fees and funds collected from purchases of the
lifetime pass for citizens 62 years of age or older.
Title VII would clarify or expand authorities for
activities that the NPS are already conducting to allow us to
better serve the American people. This includes providing
clear authority for the interpretation and education work of
the NPS by consolidating a number of disparate authorities
currently used, and directing the Secretary to ensure that
management of National Park System units and related areas is
enhanced by the availability and utilization of a broad
program of the highest quality interpretation and education.
Title VII would also raise the age limit for participation in
the Public Lands Corp from 25 to 30 and extend the direct-
hire authority from 120 days to 2 years, consistent with
Department of the Interior resource assistant direct-hire
authority. And, this title would remove the $3.5 million
authorization ceiling for the Volunteers in the Parks to
accommodate the funding needed to support this growing
program.
Title VIII would establish the NPS Visitor Services
Management Authority (VMSA), and authorize the Secretary to
establish a program to allow the VMSA to award and manage
contracts for the operation of commercial visitor services
programs and activities.
Title IX would authorize the Secretary to enter into
agreements for the creation of reproductions of a museum
object in which the object and its intellectual property
rights are under the control of the Secretary. The
Administration is developing additional language related to
the protection of NPS intellectual property, which we intend
to transmit under separate cover.
Title X would redesignate the Secretary of the Interior and
the Director of the NPS as ex officio members of the NPF
board. It also would authorize appropriations of $25 million
for each of FY 2016 through FY 2026 to NPF that would be used
to leverage additional non-federal funds to support our
national parks.
The effect of this draft bill on the deficit is:
FISCAL YEARS
[dollars in millions]
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Total
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
45 312 476 386 67 -71 -11 -52 81 -38 -92 1,103
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
The Statutory Pay-As-You-Go (PAYGO) Act of 2010 provides
that revenue and direct spending legislation cannot, in the
aggregate, increase the on-budget deficit. If such
legislation increases the on-budget deficit and that increase
is not offset by the end of the congressional session, a
sequestration must be ordered. This proposal would increase
direct spending, is therefore subject to the Statutory PAYGO
Act, and should be considered in conjunction with all other
proposals that are subject to the Act.
The Office of Management and Budget has advised that there
is no objection to the enactment of the enclosed draft
legislation from the standpoint of the Administration's
program.
Sincerely,
Sally Jewell.
____
National Park Service Centennial Act
Section-by-Section Summary
Title I--Centennial Declaration
Recognizes that the National Service has responsibility not
only for administering the units of the National Park System,
but also for programs that provide financial and technical
assistance to states, communities and individuals to protect
our national heritage.
Reaffirms and directs the Secretary of the Interior to
utilize these financial and technical assistance programs to
further the conservation and enjoyment of the natural and
cultural heritage of the nation for the benefit and
inspiration of the public.
Title II--National Park Centennial Challenge Fund
Establishes in the Treasury a fund to be known as the
National Park Centennial Challenge Fund, which will consist
of an annual appropriated amount equal to the qualified
donations received in the same fiscal year not to exceed $100
million for each of fiscal years 2016 through 2018. The fund
will be used for signature projects identified as ones that
will help prepare the National Parks for another century of
conservation, preservation and enjoyment.
Title III--Second Century Infrastructure Investment
Provides a mandatory appropriation of $300 million to the
National Park Service Construction Account for each of fiscal
years 2016 through 2018, to correct deficiencies in National
Park Service infrastructure and facilities.
Title IV--Centennial Land Management Investment Program
Establishes in the Treasury a fund to be known as the
Centennial Land Management Investment Fund, consisting of a
mandatory appropriation equal to $100 million for each of
fiscal years 2016 through 2018. The Secretaries of the
Interior and Agriculture are required to establish jointly a
competitive program available to the four federal land
management agencies for projects that enhance visitor
services and outdoor recreational opportunities, restore
lands and waters, repair facilities or trails, or increase
energy and water efficiency.
Title V--National Park Foundation Endowment
Establishes in the National Park Foundation a special
account to be known as the Second Century Endowment for the
National Park Service, consisting of gifts or bequests
provided for this purpose. The National Park Foundation may
use the funds deposited in the Endowment for projects and
activities approved by the Secretary that further the mission
and purposes of the National Park Service.
Title VI--National Park Service Second Century Fund
Establishes in the Treasury an account to be known as the
National Park Service Second Century Fund, with funds
remaining available to the Secretary of the Interior until
expended and available without further appropriation. Funds
may only be used if matched, on a 1-to-1 basis, by nonfederal
donations to the National Park Service for specified projects
and programs
Funds the account with two sources of funding: (1) fees in
addition to the daily cost of lodging or camping within a
unit of the national park system; and (2) funds from amounts
above $10.00 that are collected from purchases of the
lifetime pass for citizens 62
[[Page S7822]]
years of age or older (passes would be available at the same
cost as the National Parks and Federal Recreational Lands
Pass).
Title VII--National Park Next Generation Stewards
NPS Interpretation and Education Authority
Provides clear authority for the interpretation and
education work of the National Park Service by consolidating
a number of disparate authorities currently used.
Directs the Secretary of the Interior to ensure that
management of National Park System units and related areas is
enhanced by the availability and utilization of a broad
program of the highest quality interpretation and education.
Public Lands Corps Amendments
Raises the age limit for participation in the Public Lands
Corps from 25 to 30. This section also would provide non-
competitive hiring status to a former Public Lands Corps
member from the current 120 days after the member's service
is completed to a period of up to two years.
Volunteers in Parks
Removes the $3.5 million authorization ceiling for the
Volunteers in the Parks to accommodate the funding needed to
support this growing program.
Title VIII--National Park Service Visitor Service Management Program
Authorizes the Secretary of the Interior to establish the
National Park Service Visitor Services Management Authority
(VMSA) to award and manage contracts for the operation of
commercial visitor services programs and activities.
Authorizes the establishment of a VSMA operating board, a
director of the VSMA, and the hiring of staff.
Authorizes the use of funds collected by the VSMA from the
contracts awarded to be available for expenditure by the VSMA
in furtherance of the purposes of the law.
Title IX--Intellectual Property
Authorizes the Secretary of the Interior to enter into
agreements for the creation of reproductions of a museum
object in which the object and its intellectual property
rights are under the control of the Secretary. The agreements
may include provisions for the collection of fees or
royalties, which can be retained and used by the park or
repository where the museum object is held.
Title X--National Park Foundation
Authorizes the Secretary of the Interior and the Director
of the National Park Service as ex officio members of the
National Park Foundation board.
Authorizes appropriations of $25 million for each of fiscal
years 2016 through 2026 to National Park Foundation, and
prohibits the use of these finds for administrative expenses
of the Foundation.
____________________