[Congressional Record (Bound Edition), Volume 152 (2006), Part 12]
[Senate]
[Pages 16693-16702]
[From the U.S. 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 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

[[Page 16694]]

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 
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.

[[Page 16695]]

  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.
  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

[[Page 16696]]

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 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

[[Page 16697]]

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.
  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

[[Page 16698]]

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 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

[[Page 16699]]

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 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

[[Page 16700]]

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 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

[[Page 16701]]

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 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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