[Congressional Record (Bound Edition), Volume 155 (2009), Part 3]
[Senate]
[Pages 3446-3451]
[From the U.S. Government Publishing Office, www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Ms. SNOWE (for herself, Mr. Baucus, Mrs. Lincoln, Mr. Burr, 
        and Ms. Collins):
  S. 402. A bill to improve the lives of our Nation's veterans and 
their families and provide them with the opportunity to achieve the 
American dream; to the Committee on Veterans' Affairs.
  Ms. SNOWE. Mr. President, I rise today with Senator Baucus, Senator 
Lincoln, Senator Burr, and Senator Collins to introduce the Keeping Our 
Promise to America's Military Veterans Act. Quite simply, my colleagues 
and I strongly believe that Congress must remain focused on fully 
supporting our veterans and their families in the 111th Congress. As we 
begin this new Congress, our legislative priorities should reflect the 
unending gratitude of the American people for the sacrifices of our 
veterans and their families in defending the Nation and our way of 
life.
  To date, the war on terrorism has already generated nearly 1 million 
discharged veterans and their ranks will grow with nearly 300,000 new 
veterans per year. The Congress must not waver in our commitment of 
support for their service, as well as the service and sacrifices of 
each of our citizens who have taken that extra step and donned the 
uniform of this great Nation. The bill that we are introducing would 
express the sense of Congress that legislation should be enacted in the 
111th Congress to improve the lives of our Nation's veterans and their 
families and provide them with the opportunity to achieve the American 
dream, including legislation to assure funding for medical care and for 
timely and accurate adjudication of all benefit claims, to assure 
accesses to high quality treatment for PTSD and TBI conditions, and to 
assure a seamless transition for veterans and their families from 
military to civilian life.
  As we consider legislation for this Congress, I point out, for 
example, the problem of providing the VA health care system with 
funding in a timely and predictable manner. With the exception of last 
year, VA appropriations have historically not met this simple

[[Page 3447]]

standard. To correct this problem, I have supported, and will continue 
to support measures to make VA appropriations mandatory, or to provide 
advance appropriations to the VA. Neither are new budget concepts, but 
rather a means of achieving timely, predictable, and sufficient funding 
of VA health care via the current annual appropriations process. I 
joined with a number of senators in the last Congress, including then-
Senator Barack Obama, on legislation to provide advance appropriations 
to the VA, and will continue to work to this end in the 111th.
   Of the many challenges on which this Congress must act in the weeks 
and months ahead, we believe that it is imperative that we not waver in 
our support for our Nation's veterans and their families. I sincerely 
hope that my colleagues will join Senator Baucus, Senator Lincoln, 
Senator Burr, Senator Collins, and me and offer their support for this 
important legislation.
                                 ______
                                 
      By Mr. AKAKA (for himself and Mr. Burris):
  S. 404. A bill to amend title 38, United States Code, to expand 
veteran eligibility for reimbursement by the Secretary of Veterans 
Affairs for emergency treatment furnished in a non-Department facility, 
and for other purposes; to the Committee on Veterans' Affairs.
  Mr. AKAKA. Mr. President, today I introduce legislation to correct a 
deficiency in the law governing health care for veterans. Under current 
law, originally enacted on November 30, 1999, a veteran who is enrolled 
in VA's health care system can be reimbursed for emergency treatment 
received at a non-VA hospital. However, the statute only permits such 
VA reimbursement if the veteran has no other outside health insurance, 
no matter how limited that other coverage might be.
  This sole payor provision means that a veteran who has any insurance 
is not entitled to reimbursement from VA for emergency medical 
treatment received at a non-VA facility. This is true even if the 
veteran's insurance policy does not cover the full amount owed.
  The bill I am introducing would amend current law so that a veteran 
who has outside insurance would be eligible for reimbursement in the 
event that any outside insurance does not cover the full amount of the 
emergency care. VA would be authorized to cover the difference between 
the amount the veteran's insurance will pay and the total cost of care. 
In essence, VA would become the payor of last resort in such cases. 
This would keep the veteran from being burdened by exorbitant medical 
fees with no insurance with which to pay them.
  In addition to amending current law in a prospective manner, this 
legislation would also allow the Secretary of Veterans Affairs to 
retroactively apply this law to emergency treatment received between 
the effective date of the current law and the date of enactment of the 
legislation I am introducing today.
  One example of the sort of case to which this discretionary authority 
might apply is one that came to the Committee's attention involving a 
disabled Vietnam veteran who was in a serious motorcycle accident which 
led to a medical bill for emergency room care of over $100,000. This 
veteran, who lived in Illinois, had state mandated auto insurance which 
included a medical benefit of $10,000. Since he had this other 
insurance, VA was precluded from paying for his care and the veteran 
was personally responsible for the difference between the amount 
covered by his state-required policy and the total charge for his care. 
Had this veteran had no insurance at all, VA would have paid the entire 
amount.
  I urge our colleagues to cosponsor this legislation and to work with 
me and the other members of the Veterans' Affairs Committee to address 
this gap in VA benefits.
  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. 404

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Veterans' Emergency Care 
     Fairness Act of 2009''.

     SEC. 2. EXPANSION OF VETERAN ELIGIBILITY FOR REIMBURSEMENT BY 
                   SECRETARY OF VETERANS AFFAIRS FOR EMERGENCY 
                   TREATMENT FURNISHED IN A NON-DEPARTMENT 
                   FACILITY.

       (a) Expansion of Eligibility.--Subsection (b)(3)(C) of 
     section 1725 of title 38, United States Code, is amended by 
     striking ``, in whole or in part,''.
       (b) Limitations on Reimbursement.--Such section 1725 is 
     further amended--
       (1) in subsection (c), by adding at the end the following 
     new paragraph:
       ``(4)(A) If the veteran has contractual or legal recourse 
     against a third party that would, in part, extinguish the 
     veteran's liability to the provider of the emergency 
     treatment and payment for the treatment may be made both 
     under subsection (a) and by the third party, the amount 
     payable for such treatment under such subsection shall be the 
     amount by which the costs for the emergency treatment exceed 
     the amount payable or paid by the third party, except that 
     the amount payable may not exceed the maximum amount payable 
     established under paragraph (1)(A).
       ``(B) In any case in which a third party is financially 
     responsible for part of the veteran's emergency treatment 
     expenses, the Secretary shall be the secondary payer.
       ``(C) A payment in the amount payable under subparagraph 
     (A) shall be considered payment in full and shall extinguish 
     the veteran's liability to the provider.
       ``(D) The Secretary may not reimburse a veteran under this 
     section for any copayment or similar payment that the veteran 
     owes the third party or for which the veteran is responsible 
     under a health-plan contract.''; and
       (2) in subsection (f)(3)--
       (A) in subparagraph (A), by inserting before the period at 
     the end the following: ``, including the Secretary of Health 
     and Human Services with respect to the Medicare program under 
     title XVIII of the Social Security Act (42 U.S.C. 1395 et 
     seq.) and the Medicaid program under title XIX of such Act 
     (42 U.S.C. 1396 et seq.)''; and
       (B) in subparagraph (B), by inserting before the period at 
     the end the following: ``, including a State Medicaid agency 
     with respect to payments made under a State plan for medical 
     assistance approved under title XIX of such Act (42 U.S.C. 
     1396 et seq.)''.
       (c) Effective Date.--
       (1) In general.--The amendments made by subsections (a) and 
     (b) shall take effect on the date of the enactment of this 
     Act, and shall apply with respect to emergency treatment 
     furnished on or after the date of the enactment of this Act.
       (2) Reimbursement for treatment before effective date.--The 
     Secretary may provide reimbursement under section 1725 of 
     title 38, United States Code, as amended by subsection (a) 
     and (b) for emergency treatment furnished before the date of 
     the enactment of this Act if the Secretary determines that, 
     under the circumstances applicable with respect to the 
     veteran, it is appropriate to do so.
                                 ______
                                 
      By Mr. LEAHY (for himself, Mr. Bennett, Mr. Bayh, Mrs. Boxer, Mr. 
        Brown, Mr. Cochran, Mr. Dodd, Mr. Durbin, Mr. Johnson, Mr. 
        Kennedy, Mr. Sanders, Mr. Schumer, and Mr. Whitehouse):
  S. 405. A bill to amend the Internal Revenue Code of 1986 to provide 
that a deduction equal to fair market value shall be allowed for 
charitable contributions of literary, musical, artistic, or scholarly 
compositions created by the donor; to the Committee on Finance.
  Mr. LEAHY. Mr. President, today we reintroduce the Artist-Museum 
Partnership Act, and once again, I am pleased to be joined in this 
effort by my good friend Senator Bennett from Utah.
  This bipartisan legislation would enable our country to keep 
cherished art works in the United States and to preserve them in our 
public institutions. At the same time, this legislation will erase an 
inequity in our tax code that currently serves as a disincentive for 
artists to donate their works to museums and libraries. We have 
introduced this same bill in each of the past five Congresses, and I am 
hopeful that this will be our year. In the past, our bill has been 
included in the Senate-passed version of the 2001 tax reconciliation 
bill, the Senate-passed version of the 2003 Charity Aid, Recovery, and 
Empowerment Act, and the Senate-passed version of the 2005 tax 
reconciliation bill. I would like to thank Senators Bayh, Boxer, Brown, 
Cochran, Dodd, Durbin, Johnson, Kennedy, Sanders,

[[Page 3448]]

Schumer, and Whitehouse for cosponsoring this non-partisan bill.
  Our bill is sensible and straightforward. It would allow artists, 
writers, and composers to take a tax deduction equal to the fair market 
value of the works they donate to museums and libraries. This is 
something that collectors who make similar donations are already able 
to do. Under current law, artists who donate self-created works are 
only able to deduct the cost of supplies such as canvas, pen, paper and 
ink, which does not even come close to their true value. This is unfair 
to artists, and it hurts museums and libraries large and small that are 
dedicated to preserving works for posterity. If we as a nation want to 
ensure that works of art created by living artists are available to the 
public in the future for study and for pleasure this is something that 
artists should be allowed to do.
  In my State of Vermont, we are incredibly proud of the great works 
produced by hundreds of local artists who choose to live and work in 
the Green Mountain State. Displaying their creations in museums and 
libraries helps develop a sense of pride among Vermonters, and 
strengthens a bond with Vermont, its landscape, its beauty, and its 
cultural heritage. Anyone who has contemplated a painting in a museum 
or examined an original manuscript or composition, and has gained a 
greater understanding of both the artist and the subject as a result, 
knows the tremendous value of these works. I would like to see more of 
them, not fewer, preserved in Vermont and across the country.
  Prior to 1969, artists and collectors alike were able to take a 
deduction equivalent to the fair market value of a work, but Congress 
changed the law with respect to artists in the Tax Reform Act of 1969. 
Since then, fewer and fewer artists have donated their works to museums 
and cultural institutions. For example, prior to the enactment of the 
1969 law, Igor Stravinsky planned to donate his papers to the Music 
Division of the Library of Congress. But after the law passed, his 
papers were sold instead to a private foundation in Switzerland. We can 
no longer afford this massive loss to our cultural heritage. Losses to 
the public like this are an unintended consequence of the 1969 tax bill 
that should be corrected.
  Congress changed the law for artists more than 30 years ago in 
response to the perception that some taxpayers were taking advantage of 
the law by inflating the market value of self-created works. Since that 
time, however, the government has cut down significantly on the abuse 
of fair market value determinations.
  Under our legislation, artists who donate their own paintings, 
manuscripts, compositions, or scholarly compositions would be subject 
to the same new rules that all taxpayer/collectors who donate such 
works must now follow. This includes providing relevant information as 
to the value of the gift, providing appraisals by qualified appraisers, 
and, in some cases, subjecting them to review by the Internal Revenue 
Service's Art Advisory Panel.
  In addition, donated works must be accepted by museums and libraries, 
which often have strict criteria in place for works they intend to 
display. The institution must certify that it intends to put the work 
to a use that is related to the institution's tax exempt status. For 
example, a painting contributed to an educational institution must be 
used by that organization for educational purposes and could not be 
sold by the institution for profit. Similarly, a work could not be 
donated to a hospital or other charitable institution that did not 
intend to use the work in a manner related to the function constituting 
the recipient's exemption under Section 501 of the tax code. Finally, 
the fair market value of the work could only be deducted from the 
portion of the artist's income that has come from the sale of similar 
works or related activities.
  This bill would also correct another disparity in the tax treatment 
of self-created works--how the same work is treated before and after an 
artist's death. While living artists may only deduct the material costs 
of donations, donations of those same works after death are deductible 
from estate taxes at the fair market value of the work. In addition, 
when an artist dies, works that are part of his or her estate are taxed 
on the fair market value.
  I want to thank my colleagues again for cosponsoring this bipartisan 
legislation. The time has come for us to correct an unintended 
consequence of the 1969 law and encourage rather than discourage the 
donations of art works by their creators. This bill will make a crucial 
difference in an artist's decision to donate his or her work, rather 
than sell it to a private party where it may become lost to the public 
forever.
  Mr. President, I ask unanimous cnsent 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. 405

       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 ``Artist-Museum Partnership 
     Act''.

     SEC. 2. CHARITABLE CONTRIBUTIONS OF CERTAIN ITEMS CREATED BY 
                   THE TAXPAYER.

       (a) In General.--Subsection (e) of section 170 of the 
     Internal Revenue Code of 1986 (relating to certain 
     contributions of ordinary income and capital gain property) 
     is amended by adding at the end the following new paragraph:
       ``(8) Special rule for certain contributions of literary, 
     musical, or artistic compositions.--
       ``(A) In general.--In the case of a qualified artistic 
     charitable contribution--
       ``(i) the amount of such contribution shall be the fair 
     market value of the property contributed (determined at the 
     time of such contribution), and
       ``(ii) no reduction in the amount of such contribution 
     shall be made under paragraph (1).
       ``(B) Qualified artistic charitable contribution.--For 
     purposes of this paragraph, the term `qualified artistic 
     charitable contribution' means a charitable contribution of 
     any literary, musical, artistic, or scholarly composition, or 
     similar property, or the copyright thereon (or both), but 
     only if--
       ``(i) such property was created by the personal efforts of 
     the taxpayer making such contribution no less than 18 months 
     prior to such contribution,
       ``(ii) the taxpayer--

       ``(I) has received a qualified appraisal of the fair market 
     value of such property in accordance with the regulations 
     under this section, and
       ``(II) attaches to the taxpayer's income tax return for the 
     taxable year in which such contribution was made a copy of 
     such appraisal,

       ``(iii) the donee is an organization described in 
     subsection (b)(1)(A),
       ``(iv) the use of such property by the donee is related to 
     the purpose or function constituting the basis for the 
     donee's exemption under section 501 (or, in the case of a 
     governmental unit, to any purpose or function described under 
     subsection (c)),
       ``(v) the taxpayer receives from the donee a written 
     statement representing that the donee's use of the property 
     will be in accordance with the provisions of clause (iv), and
       ``(vi) the written appraisal referred to in clause (ii) 
     includes evidence of the extent (if any) to which property 
     created by the personal efforts of the taxpayer and of the 
     same type as the donated property is or has been--

       ``(I) owned, maintained, and displayed by organizations 
     described in subsection (b)(1)(A), and
       ``(II) sold to or exchanged by persons other than the 
     taxpayer, donee, or any related person (as defined in section 
     465(b)(3)(C)).

       ``(C) Maximum dollar limitation; no carryover of increased 
     deduction.--The increase in the deduction under this section 
     by reason of this paragraph for any taxable year--
       ``(i) shall not exceed the artistic adjusted gross income 
     of the taxpayer for such taxable year, and
       ``(ii) shall not be taken into account in determining the 
     amount which may be carried from such taxable year under 
     subsection (d).
       ``(D) Artistic adjusted gross income.--For purposes of this 
     paragraph, the term `artistic adjusted gross income' means 
     that portion of the adjusted gross income of the taxpayer for 
     the taxable year attributable to--
       ``(i) income from the sale or use of property created by 
     the personal efforts of the taxpayer which is of the same 
     type as the donated property, and
       ``(ii) income from teaching, lecturing, performing, or 
     similar activity with respect to property described in clause 
     (i).
       ``(E) Paragraph not to apply to certain contributions.--
     Subparagraph (A) shall not apply to any charitable 
     contribution of any letter, memorandum, or similar property 
     which was written, prepared, or produced by or for an 
     individual while the individual is

[[Page 3449]]

     an officer or employee of any person (including any 
     government agency or instrumentality) unless such letter, 
     memorandum, or similar property is entirely personal.
       ``(F) Copyright treated as separate property for partial 
     interest rule.--In the case of a qualified artistic 
     charitable contribution, the tangible literary, musical, 
     artistic, or scholarly composition, or similar property and 
     the copyright on such work shall be treated as separate 
     properties for purposes of this paragraph and subsection 
     (f)(3).''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to contributions made after the date of the 
     enactment of this Act in taxable years ending after such 
     date.

  Mr. BENNETT. Mr. President, I am proud to join the Senator from 
Vermont today to introduce the Artist-Museum Partnership Act. He and I 
have introduced this legislation in the past, and we hope that our 
colleagues will see this bill for what it is: a reasonable solution to 
an unintentional inequity in our Tax Code.
  This legislation would allow living artists to deduct the fair-market 
value of their art work when they contribute their work to museums or 
other public institutions. As the Tax Code is currently written, art 
collectors are able to deduct the fair market value of any piece of art 
they donate to a museum, but the artist who created the work is only 
able to deduct the material cost, which may be nothing more than a 
canvas, a tube of paint, and a wooden frame, if he or she donated their 
art to a museum. Thus, there exists a disincentive for artists to 
donate their work to museums. The solution is simple: treat collectors 
and artists the same way. This bill would do just that.
  Certainly, this bill would benefit artists, but more importantly, the 
beneficiaries would be the museums that would receive the artwork and 
the general public who would be able to view it in a timely manner. 
This change in the Tax Code would increase the number of original 
pieces donated to public institutions, giving scholars greater access 
to an artist's work during the lifetime of that artist, as well as 
provide for an increase in the public display of such work.
  I would like to thank Senator Leahy for his work on this bill. I urge 
my colleagues to support this commonsense legislation. The benefit of 
the Artist-Museum Partnership Act to our Nation's cultural and artistic 
heritage cannot be overstated. This minor correction to the Tax Code is 
long overdue, and the Senate should act on this legislation to remedy 
the problem.
                                 ______
                                 
      By Mr. SPECTER (for himself and Mr. Casey):
  S. 406. A bill to amend title XIX of the Social Security Act to 
provide Medicaid coverage of drugs prescribed for certain research 
study child participants; to the Committee on Finance.
  Mr. SPECTER. Mr. President, I have sought recognition today to 
introduce Nino's Act, to provide for the continuance of successful 
treatment for children who are required to leave National Institutes of 
Health, NIH, research studies. The NIH provides the greatest medical 
research in the world on innumerable diseases, including cancer, 
Alzheimer's, Parkinson's. The NIH also conducts excellent research on 
diseases that affect children. To conduct that research many brave 
children must partake in research studies including observational, or 
natural history, studies and clinical trials to test experimental 
therapies. This participation is critical to understanding diseases and 
ultimately finding cures at the NIH.
  To participate in the trials and studies, children and their families 
often make considerable sacrifices. Families will travel great 
distances to receive treatment that may provide relief from the child's 
illness. In many cases, parents and doctors will have tried many 
treatments for the child's disease about which little may be known or 
understood. The NIH studies represent an opportunity for both the 
medical community to learn more about the disease and the child to be 
studied and potentially treated by the best researchers in the world.
  When the experimental treatments are successful, it is cause for 
great celebration for the child. The joy, however, can end quickly as 
the studies come to end but the children who have been part of them 
continue to be stricken by these terrible illnesses.
  Nino's Act seeks to transition children out of the NIH studies as 
they end so they don't experience a gap in their important treatment. 
This legislation continues the successful treatment initiated in NIH 
studies by providing access to the same prescription drugs for children 
who are required to leave NIH clinical studies due to the studies 
ending, researcher leaving, or other reason. Often drugs that are used 
successfully in these studies have not yet been approved by the Food 
and Drug Administration or have not been approved for treatment of the 
child's specific disease. As such, it is nearly impossible for children 
to get access or insurance coverage for these drugs. This bill makes 
that access possible by requiring Medicaid to cover the cost of 
treatment in the event that the children's health insurance does not.
  On occasion, insurers will cover the cost of the treatment for these 
children if they have adequate insurance and the FDA has approved the 
drug for off-label uses. More often than not, however, children do not 
have health insurance, or have insufficient insurance to obtain these 
drugs. As a result, children suffer their diseases without relief from 
the treatment as established in the clinical NIH studies. To ensure 
that these children have access to successful care post-study, Nino's 
Act requires Medicaid to cover the cost of treatment for these 
children. While Medicaid access is traditionally based on income, due 
to the importance of these drugs to the child's well-being the income 
component will be waived. To ensure Medicaid is not unnecessarily 
covering medication, Nino's Act requires the physicians participating 
in the research to certify the treatment as successful and essential.
  This important issue was introduced to me by Lori Todaro of Newville, 
PA. Lori's son Nino suffers from Undifferentiated Auto-Inflammatory 
Periodic Fever Syndrome. This disease takes a devastating toll on those 
who suffer from it. The auto-inflammatory disease can cause joint 
inflammation arthritis, Crohns, colitis, irritable bowel syndrome, and 
cyclical high fevers. Treatment for Periodic Fever Syndrome is 
experimental at best; Lori and Nino have visited a number of doctors 
and tried many medications in an effort to control the disease.
  In 2003, Nino was fortunate to be selected to take part in an 
observational study at NIH in Bethesda, Maryland for Undifferentiated 
Auto-Inflammatory Periodic Fever Syndrome. During the course of the 
study, Nino was given a new medication and his condition greatly 
improved. Before he participated in the study he was being fitted for 
wheelchairs and was home schooled because his symptoms were so 
disruptive and unpredictable. The NIH treatment allowed him to resume a 
normal life and enabled him to attend school and play soccer. While 
Nino's treatment was successful he could not remain part of the study 
indefinitely and was encouraged to seek coverage for his treatments 
through his private insurer. Initially, the Todaro's insurer would not 
agree to cover the cost of the experimental drug and only after an 
intense lobbying effort by Lori, did the insurer agree to cover Nino's 
prescriptions.
  Nino's story is a successful one, but also serves to highlight the 
issue that children and their families are facing as they transition 
out of NIH studies. For many, NIH trials are a source of hope for 
relief from the worst diseases known to man. The excellent doctors and 
research teams at NIH make invaluable contributions to our 
understanding of complex and debilitating diseases. This legislation 
seeks to amplify the NIH's contributions by allowing America's sickest 
children to continue their successful treatment under Medicaid 
coverage. I encourage my colleagues to work with Senator Casey and me 
to move this legislation forward promptly.
                                 ______
                                 
      By Mr. AKAKA (for himself, Mr. Burr, Mr. Rockefeller, Mrs. 
        Murray, Mr. Sanders, Mr. Brown, Mr. Webb, Mr. Tester, Mr. 
        Begich, Mr. Burris, Mr.

[[Page 3450]]

        Specter, Mr. Isakson, Mr. Wicker, Mr. Johanns, and Mr. Graham):
  S. 407. A bill to increase, effective as of December 1, 2009, the 
rates of compensation for veterans with service-connected disabilities 
and the rates of dependency and indemnity compensation for the 
survivors of certain disabled veterans, and for other purposes; to the 
Committee on Veterans' Affairs.
  Mr. AKAKA. Mr. President, today, as Chairman of the Senate Committee 
on Veterans' Affairs, I introduce the Veterans' Compensation Cost-of-
Living Adjustment Act of 2009. This measure would direct the Secretary 
of Veterans Affairs to increase, effective December 1, 2009, the rates 
of veterans' compensation to keep pace with the rising cost-of-living 
in this country. The rate adjustment is equal to that provided on an 
annual basis to Social Security recipients and is based on the Consumer 
Price Index.
  All of my colleagues on the Committee on Veterans' Affairs, including 
Senators Burr, Rockefeller, Murray, Sanders, Brown, Webb, Tester, 
Begich, Burris, Specter, Isakson, Wicker, Johanns, and Graham join me 
in introducing this important legislation. I appreciate their continued 
support of our nation's veterans.
  Congress regularly enacts an annual cost-of-living adjustment for 
veterans' compensation in order to ensure that inflation does not erode 
the purchasing power of the veterans and their families who depend upon 
this income to meet their daily needs. This past year Congress passed, 
and the President signed into law, Public Law 110-324, which resulted 
in a COLA increase of 5.8 percent for 2009. The 2010 COLA has not yet 
been determined.
  The COLA affects, among other benefits, veterans' disability 
compensation and dependency and indemnity compensation for surviving 
spouses and children. Many of the more than 3 million recipients of 
those benefits depend upon these tax-free payments not only to provide 
for their own basic needs, but those of their spouses and children as 
well. Without an annual COLA increase, these veterans and their 
families would see the value of their hard-earned benefits slowly 
diminish, and we, as a Congress, would be neglecting our duty to ensure 
that those who sacrificed so much for this country receive the benefits 
and services to which they are entitled.
  It is important that we view veterans' compensation, including the 
annual COLA, and indeed all benefits earned by veterans, as a 
continuing cost of war. It is clear that the ongoing conflicts in Iraq 
and Afghanistan will continue to result in injuries and disabilities 
that will yield an increase in claims for compensation. Currently, 
there are nearly 3 million veterans in receipt of VA disability 
compensation.
  Disbursement of disability compensation to our nation's veterans 
constitutes one of the central missions of the Department of Veterans 
Affairs. It is a necessary measure of appreciation afforded to those 
veterans whose lives were forever altered by their service to this 
country.
  I urge our colleagues to support passage of this COLA increase. I 
also ask our colleagues for their continued support for our nation's 
veterans.
  Mr. BURR. Mr. President, I rise today to talk about the Veterans' 
Compensation Cost-of-Living Adjustment Act of 2009. As the Ranking 
Member of the Senate Committee on Veterans' Affairs, I am pleased to 
join the Chairman of the Committee, Senator Akaka, and all of the 
Committee's members in introducing this important bill.
  As part of its mission to ``care for him who shall have borne the 
battle, and for his widow, and his orphan,'' the Department of Veterans 
Affairs, VA, provides a range of benefits to veterans and their 
families. These benefits include disability compensation for veterans 
who suffer from disabilities incurred in or aggravated by their 
military service and dependency and indemnity compensation for the 
spouses or children of disabled or deceased veterans. Although we can 
never fully repay them for their service or sacrifices, these payments 
may help ease their financial burdens and improve the quality of their 
lives.
  The bill we are introducing today will ensure that more than 3 
million veterans and their family members--including more than 130,000 
in my home state of North Carolina--will receive a cost-of-living 
increase in their VA benefits this year. These annual increases help 
ensure that the value of the benefits provided by a grateful nation 
will not decline over time as a result of inflation.
  Last year, I was proud to support the enactment of the Veterans' 
Compensation Cost-of-Living Adjustment Act of 2008, which resulted in a 
5.8 percent increase in VA benefits. Under this bill, the amount of the 
increase for 2009 would be the same as that provided to Social Security 
recipients, which will be announced later this year.
                                 ______
                                 
      By Mr. INOUYE (for himself, Mr. Hatch, Mr. Kennedy, Mr. Conrad, 
        Mr. Dorgan, and Mr. Akaka):
  S. 408. A bill to amend the Public Health Service Act to provide a 
means for continued improvement in emergency medical services for 
children; to the committee on Health, Education, Labor, and Pensions.
  Mr. INOUYE. Mr. President. Today, along with my colleagues, Senators 
Hatch, Kennedy, Conrad, Dorgan, and Akaka, I introduce The Wakefield 
Act, also known as the Emergency Medical Services for Children Act of 
2009. Since Senator Hatch and I worked toward authorization of EMSC in 
1984, this program has become the impetus for improving children's 
emergency services nationwide. From specialized training for emergency 
care providers to ensuring ambulances and emergency departments have 
state-of-the-art pediatric sized equipment, EMSC has served as the 
vehicle for improving survival of our smallest and most vulnerable 
citizens when accidents or medical emergencies threatened their lives.
  It remains no secret that children present unique anatomic, 
physiologic, emotional and developmental challenges to our primarily 
adult-oriented emergency medical system. As has been said many times 
before, children are not little adults. Evaluation and treatment must 
take into account their special needs, or we risk letting them fall 
through the gap between adult and pediatric care. The EMSC has bridged 
that gap while fostering collaborative relationships among emergency 
medical technicians, paramedics, nurses, emergency physicians, 
surgeons, and pediatricians.
  The Institute of Medicine's recently released study on Emergency Care 
for Children indicated that our Nation is not as well prepared as once 
we thought. Only 6 percent of all emergency departments have the 
essential pediatric supplies and equipment necessary to manage 
pediatric emergencies. Many of the providers of emergency care have 
received fragmented and limited training in the skills necessary to 
resuscitate this specialized population. Even our disaster preparedness 
plans have not fully addressed the unique needs posed by children 
injured in such events.
  EMSC remains the only federal program dedicated to examining the best 
ways to deliver various forms of care to children in emergency 
settings. Reauthorization of EMSC will ensure that children's needs 
will be given the due attention they deserve and that coordination and 
expansion of services for victims of life-threatening illnesses and 
injuries will be available throughout the United States.
  I look forward to reauthorization of this important legislation and 
the continued advances in our emergency healthcare delivery system.
  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 
placed in the Record, as follows:

                                 S. 408

       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 ``Wakefield Act''.

     SEC. 2. FINDINGS AND PURPOSE.

       (a) Findings.--Congress makes the following findings:

[[Page 3451]]

       (1) There are 31,000,000 child and adolescent visits to the 
     Nation's emergency departments every year.
       (2) Over 90 percent of children requiring emergency care 
     are seen in general hospitals, not in free-standing 
     children's hospitals, with one-quarter to one-third of the 
     patients being children in the typical general hospital 
     emergency department.
       (3) Severe asthma and respiratory distress are the most 
     common emergencies for pediatric patients, representing 
     nearly one-third of all hospitalizations among children under 
     the age of 15 years, while seizures, shock, and airway 
     obstruction are the other common pediatric emergencies, 
     followed by cardiac arrest and severe trauma.
       (4) Up to 20 percent of children needing emergency care 
     have underlying medical conditions such as asthma, diabetes, 
     sickle-cell disease, low birth weight, and bronchopulmonary 
     dysplasia.
       (5) Significant gaps remain in emergency medical care 
     delivered to children. Only about 6 percent of hospitals have 
     available all the pediatric supplies deemed essential by the 
     American Academy of Pediatrics and the American College of 
     Emergency Physicians for managing pediatric emergencies, 
     while about half of hospitals have at least 85 percent of 
     those supplies.
       (6) Providers must be educated and trained to manage 
     children's unique physical and psychological needs in 
     emergency situations, and emergency systems must be equipped 
     with the resources needed to care for this especially 
     vulnerable population.
       (7) Systems of care must be continually maintained, 
     updated, and improved to ensure that research is translated 
     into practice, best practices are adopted, training is 
     current, and standards and protocols are appropriate.
       (8) The Emergency Medical Services for Children (EMSC) 
     Program under section 1910 of the Public Health Service Act 
     (42 U.S.C. 300w-9) is the only Federal program that focuses 
     specifically on improving the pediatric components of 
     emergency medical care.
       (9) The EMSC Program promotes the nationwide exchange of 
     pediatric emergency medical care knowledge and collaboration 
     by those with an interest in such care and is depended upon 
     by Federal agencies and national organizations to ensure that 
     this exchange of knowledge and collaboration takes place.
       (10) The EMSC Program also supports a multi-institutional 
     network for research in pediatric emergency medicine, thus 
     allowing providers to rely on evidence rather than anecdotal 
     experience when treating ill or injured children.
       (11) The Institute of Medicine stated in its 2006 report, 
     ``Emergency Care for Children: Growing Pains'', that the EMSC 
     Program ``boasts many accomplishments ... and the work of the 
     program continues to be relevant and vital''.
       (12) The EMSC Program is celebrating its 25th anniversary, 
     marking a quarter-century of driving key improvements in 
     emergency medical services to children, and should continue 
     its mission to reduce child and youth morbidity and mortality 
     by supporting improvements in the quality of all emergency 
     medical and emergency surgical care children receive.
       (b) Purpose.--It is the purpose of this Act to reduce child 
     and youth morbidity and mortality by supporting improvements 
     in the quality of all emergency medical care children 
     receive.

     SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL SERVICES FOR 
                   CHILDREN PROGRAM.

       Section 1910 of the Public Health Service Act (42 U.S.C. 
     300w-9) is amended--
       (1) in subsection (a), by striking ``3-year period (with an 
     optional 4th year'' and inserting ``4-year period (with an 
     optional 5th year''; and
       (2) in subsection (d)--
       (A) by striking ``and such sums'' and inserting ``such 
     sums''; and
       (B) by inserting before the period the following: ``, 
     $25,000,000 for fiscal year 2010, $26,250,000 for fiscal year 
     2011, $27,562,500 for fiscal year 2012, $28,940,625 for 
     fiscal year 2013, and $30,387,656 for fiscal year 2014''.

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