Hillary Clinton

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mrs. CLINTON. Mr. President, I come to the floor on two very important issues, issues that really do go to the heart of the kind of economy and future that our Nation will have. One is the Employee Free Choice Act, which we will be voting on in the next day or two, and the other is the very important Energy bill that we have been debating. With respect to the Employee Free Choice Act, for me, this is about preserving, supporting, and growing the American middle class. The middle class is the backbone of the American economy, and our unions are the backbone of the American middle class. It is time we passed into law the Employee Free Choice Act to give unions a level playing field so they can organize for fair wages, safe working conditions, and the hard-won rights and responsibilities that American workers demand and deserve. This is a moment of profound challenge for our country. There is a deep sense of concern that I have certainly heard and listened to as I have traveled throughout America. Americans know they cannot win in the global economy unless the middle class wins, but there is a feeling that some people are betting against the American middle class. Some people have assumed that in a global economy one of the changes that will have to be made is that the middle class will have to shrink; that inequity is inevitable; that globalization is a harsh phenomenon that we have to accept. Well, I do not, and our families are right to be concerned. In 2005 all income gains went to the top 10 percent of households. The vast majority of people--the other 90 percent--saw their incomes decline. Health care costs are up, gas prices are up, the cost of college is up, and for 6 straight years worker productivity, which means how hard people work--because American workers are the hardest working people in the world--has gone up. But wages have either been stagnant or falling. 2005 was the first year since the Great Depression that average personal savings were negative for a whole year. There is a sense that we are losing something in America; that basic bargain that allowed our country to succeed: if you work hard, you and your family can reach the middle class. You can have that American dream. So it is not surprising that we are seeing the weakening of the American middle class at the same time we see unions under assault. In the early years of the National Labor Relations Act, the majority sign- up procedure was the presumptively valid way in which employees could choose a union. Over the years, however, culminating in the 1960s, a number of decisions shifted us to a new regime, a regime where employers can choose to require their employees to vote for unions through a one-sided election process, dominated by employers, in order to secure collective bargaining rights. Some employers even began to make efforts to push unions out of the workplace. Just consider these comparative facts: In the 1950s, companies illegally fired or punished during organizing campaigns, or they otherwise violated National Labor Relations Act rights, fewer than 1,000 employees. The number increased to 6,000 workers in 1969. And now, today, it is 31,000 workers who have been illegally fired or otherwise punished for wanting to exercise a fundamental right, one that we believe people should be able to exercise not only here in our country but around the world. As the number of labor violations have increased, we have seen it become harder and harder for workers to organize. In 1956, unions represented 35 percent of the private workforce. The number today is only 7 percent. Our middle class, which unions helped to build in the 1930s, the 1940s, the 1950s, and the 1960s is suffering as a result. Studies show that the decline in union membership has been responsible for at least 20 percent of the rise in income inequality over the last three decades. I think it is probably much more than that, but that is what we can quantify. It is time, therefore, that we modernize labor laws that are stacked against working people and stacked against their right to unionize. Right now, employers have unlimited access to employees in one-sided union representation elections. Employers are given every opportunity to dissuade workers in mandatory one-to-one meetings. They can delay votes for years. There are no fines or penalties or sanctions if an employer illegally fires or discriminates against a worker for collective bargaining. At most, the worker is reinstated with backpay, an award that is, on average, so small that many employers regard it as a cost of doing business. Finally, 32 percent of workers who choose to unionize, still do not have a contract after a year of making that choice. The system is broken. It is not only our collective bargaining and unionization system, it is our economy as it affects our middle class. Our country needs reforms that will bring balance to our labor laws, and our workers need the opportunity to unite with their coworkers to obtain the protections and benefits of America's labor movement. Union wages are 20 percent higher than nonunion wages. Union members are almost twice as likely to be covered by health insurance and to participate in employer-provided retirement plans. Unions improve safety conditions. For example, deaths in nonunion mines are almost twice as likely as deaths in mines where the workers are union members. Unions certainly provide opportunities for women and minorities. Women in unions earn an extra $179 per week. African Americans in unions earn an extra $187 per week. Latinos in unions earn an extra $217 per week. Nonunion employees benefit from the efforts of the unions to seek benefits and protections. That is why it is so important we pass the Employee Free Choice Act. It is long past time to enact real financial penalties against those employers who illegally fire or retaliate against workers during an organizing campaign. It is long past time to allow employees to decide if they want to use majority sign-up to organize. Finally, it is long past time to allow either employers or employees to request mediation if they are unable to negotiate a contract after 90 days of collective bargaining. These changes will finally give employers an incentive to bargain in good faith and to avoid situations where years, and even decades, can pass without a bargaining agreement. I believe in the basic bargain. I believe that unions help keep that bargain for America's working people. I hope this Congress will uphold its end of that basic bargain; that this Congress will pass the Employee Free Choice Act; that the Senate will join the House, which has done so, to give employees the real, fair chance to garner the protections and benefits of unions and to give unions the opportunity to help bring workers into the middle class. That is part of the equation; to respect and protect the rights of those in the workplace and to give them the opportunity to unionize. The other part of the equation is to have good jobs, good jobs with rising incomes. We need a source of new, good jobs in America. That is why this Energy bill is so important. Much of the debate about the Energy bill has been, rightly so, about the need to reduce our dependence on foreign oil--which I agree with 100 percent; the need to begin, finally, to address seriously global warming--which I think is way overdue. But there has not been enough talk about why this Energy bill is critical to the economy of the United States in the way it will help to create millions of new jobs. As the Presiding Officer knows, he and I offered an amendment, which we are pleased the managers accepted, to provide incentives for training and equipping and preparing the workforce to do what are called green-collar jobs. These are jobs that can't be outsourced, by and large. If we finally get serious--and I hope we will get back to visit some of the financial incentives that need to be in this bill that unfortunately we were unable to include-- we will begin to join other countries that have gotten smart about this. Germany gets a lot of its electricity now generated by solar--you know, panels on the roofs of residences and offices. The last time I checked, Germany was not a tropical climate, but they have taken advantage of government-incentives to move the market toward using solar. Denmark is also moving toward more wind energy. The United Kingdom, which went into Kyoto when our country left it, has created tens of thousands of new jobs weatherizing homes, installing new energy technology such as solar, such as wind. We could do this many times over. We believe we could create millions of new, good-paying jobs for hard-working Americans. Every so often we have to regenerate our job creation in America. During the 1990s, we had a lot of new jobs that were related to telecom and information technology. We saw the creation of 22 million new jobs between 1993 and 2001. We saw more people lifted out of poverty than at any time in our country's history. We saw shared prosperity--not what we are seeing today, where the bulk of the benefits go to a very small sliver of us. This Energy bill is about jobs, it is about creating new, good-paying jobs for hard-working Americans. What I am looking at when I think of the Employee Free Choice Act and when I think of this Energy bill is how we get back into balance, how we get back to where the economy works for everybody, where the market is not stacked against those who are not already privileged, where unions can once again be a vehicle for people moving into and staying in the middle class and, comparably, where we can have a new source of jobs. We also have to recognize how we have to look at the jobs that are already in the economy and how the Energy bill will affect them. I am hopeful we will think seriously about lifting the health care costs off a lot of our labor-intensive, energy-intensive, capital-intensive industries in America, such as the automobile industry, because laboring under the costs of health care is an uncompetitive position for them in the global economy. There is a lot to be done. I wish to be sure that as we look at the economy and begin to try to get it back into that balance that works best for America, that we vote for the Employee Free Choice Act, which is a way of giving employees the choice to have a better life for themselves and their families. There is a lot to be done in our country. I am very optimistic we can begin tackling our challenges. But so much of what we have to do to create the framework for our people to have that better future has to come from this Chamber. Let's look at the future together. Let's make decisions that will give the tools to our people to show they are the best workers and the most competitive and productive people in the world, to unleash that dynamism in the American economy, and to demonstrate clearly that we stand with the American middle class. I yield the floor.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I am pleased to introduce the Nursing Education and Quality of Health Care Act of 2007. This legislation is essential for addressing our current and future nursing shortages. I have been hearing from nurses and health care providers from every part of New York that we are facing an impending nursing crisis and their stories echo what nurses across the Nation tell me. By 2014, the Bureau of Labor Statistics forecasts that there will be over 1 million job openings for registered nurses. In New York alone, we will need to produce over 80,000 new RNs to meet these projections. One of our greatest needs will be in rural areas where the pool of nurses is small and the loss of just one nurse from the workforce can have a profound impact on the health of the community. I can proudly say we have made good progress in New York on one front. In 2006, 30 percent more registered nurses graduated than in 2004. I believe that we can credit this increase to the Nurse Reinvestment Act that was signed into law in 2002. Through this bipartisan legislation, we were able to make great strides in strengthening our Nation's nursing workforce. The Nurse Reinvestment Act included a number of critical initiatives including one from the bipartisan bill I introduced with Senator Smith to retain nurses who are already in the profession by encouraging hospitals to become magnet hospitals. Hospitals that have achieved magnet status report lower mortality rates, higher patient satisfaction, greater cost-efficiency, and patients experiencing shorter stays in hospitals and intensive care units underlining the importance of nursing in our health care system. I am here today because nurses are still facing an urgent situation that requires our action. Even though we are making progress in graduating more nurses, in 2006 over 32,323 qualified applicants were turned away from nursing schools in the United States. In New York, it is estimated that nearly 3,000 nursing school applicants were denied entry. Put simply, we don't have the capacity in our nursing schools to train qualified potential students. Not only are we facing a nursing shortage, we are setting ourselves up for a potential nursing crisis if we don't address the impending faculty shortage that will occur as baby boomer nurse faculty reach retirement age, leaving fewer and fewer faculty to teach the next generation of nurses. We need to pave the way and recruit more people into the nursing profession. This shortage impacts not only nurses, but also patients since we know that the quality of care they receive is directly related to nurses. The Nursing Education and Quality of Health Care Act supports recruitment, education, and training to help alleviate the nursing shortage in New York and in the rest of the Nation. This act will establish distance learning opportunities for peop1ein rural communities who wish to pursue the nursing profession without leaving their home town. This legislation will also provide tuition assistance and loan forgiveness for those who choose to practice in rural communities. To increase the number of nurses in the workforce we need to expand the nursing faculty so that thousands of qualified students are not turned away from the profession. This legislation will fund programs that enhance recruitment of faculty and allow for the expansion of nursing education programs by funding distance learning innovation, and by expanding the recruitment and training of community-based faculty for classroom and clinical education. We also need nurses to participate and collaborate in patient-safety initiatives for the well-being of patients. The Nursing Education and Quality of Health Care Act will take the lead by supporting projects that integrate patient safety practices into nursing education programs and enhance the leadership of nurses in improving patients' outcomes within their health care settings. We will all rely on nurses sometime in our life, and we need to make sure that this essential member of the health care team will always be present at our bedsides. I am pleased to introduce legislation that supports nurses and that is supported by nursing organizations like the American Association of Colleges of Nursing, the American Nurses Association, the American Organization of Nurse Executives, the Brooklyn Nursing Partnership, and the New York State Area Health Education Center System. Nurses are critical to the successful operation of our hospitals and the quality of care patients receive and we must do everything we can to address the nursing shortage and make nursing an attractive and rewarding profession.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I am pleased to join Senators Kennedy, Cochran, Bingaman, Obama, Durbin and Brown in introducing the Minority Health Improvement and Health Disparity Elimination Act 2007. As we debate health care issues, we often discuss what is wrong with our health care system: Costs are spiraling upward, the ranks of uninsured have increased, and the strains on our system and its ability to provide quality care have worsened. And while the impact of these situations are felt by all Americans, the problems with our health care system often disproportionately impact our racial and ethnic minority populations. We continue to have disparities in health care for our minority populations--disparities in access, disparities in quality, and disparities in outcomes. The Agency for Healthcare Research and Quality (AHRQ) tracks these in its annual National Healthcare Disparities Report, aggregating data from a variety of Federal health surveys and databases. And the findings from the report are staggering, inc1uding the following: Minorities had worse access to care than whites; Blacks and Hispanics received poorer quality care than Whites on more than 70 percent of the measures used by AHRQ; and While gains were made on approximately one-quarter of the quality indicators, disparities actually got worse for all minority populations on one-third of the quality indicators. These system wide disparities have translated into increased burden of disease for our racial and ethnic minority populations. HIV/AIDS is devastating our African-American communities. Blacks account for about half of all new HIV/AIDS diagnoses. In New York City, the rate of new HIV diagnoses is six times higher among Blacks than Whites. In addition, the AIDS case rate among Hispanic populations is about 3.5 times higher than that of Whites. The incidence of asthma is highest among Puerto Rican populations, with 22 percent of these individuals receiving a diagnosis of asthma, a rate roughly double that of White populations. Although African- Americans have slightly higher rates of asthma than White populations, they experience disparities in asthma management and access to care. The emergency department visit rate for Blacks seeking asthma treatment was 350 percent higher than that of the rates for Whites, while the hospitalization rate for Blacks with asthma was 240 percent higher than that for Whites with asthma. One out of every 10 Asian Americans will be diagnosed with diabetes. Among all Americans with diabetes, Blacks are about two times more likely to require amputations, two to five times more likely to have kidney disease, and twice as likely to suffer from diabetes-related blindness. The impact of health disparities are experienced not only by racial and ethnic minority communities but by all of us. They are symptomatic of the underuse and misuse of health care. And the costs associated with these disparities--such as delayed diagnoses and complications that result from lack of access to primary care--add unnecessary costs to our health care system. The Minority Health Improvement and Health Disparity Elimination Act of 2007 would allow us to address healthcare disparities through a variety of mechanisms. The bill will create a cultural competency clearinghouse, helping providers to understand, first of all, the concept of cultural competence, and second, how to better tailor care to their patients of diverse backgrounds. We cannot, for example, ask a person with diabetes to make changes to their diet if we do not understand what foods are part of their diet. Having a culturally competent health care system is especially important in my home State of New York, where our residents come from all over the world. With the information that will be available in this clearinghouse, we will make it easier for both patients and providers to communicate and understand essential concepts of care. The Minority Health Improvement and Health Disparity Elimination Act will improve health professions programs that increase recruitment and retention of underrepresented minorities in the health professions. New York's population is 15 percent Black and 15.6 percent Hispanic, yet the percentage of Black physicians practicing in our State is 3.2 percent, and the percentage of Hispanic physicians practicing in our State is 2.3 percent. This bill will reauthorize the Centers of Excellence established by the Health Resources and Services Administration, HRSA--a program that has benefited the Mt. Sinai School of Medicine--and establish new programs to train mid-career individuals in the health professions. It will codify currently existing health promotion and disease prevention activities targeted toward racial and ethnic minorities, including the Centers for Disease Control and Prevention's Racial and Ethnic Approaches to Community Health, REACH. REACH grantees working in northern Manhattan have managed to increase childhood immunization rates by 10 to 15 percent. It will also codify the Health Disparities Collaboratives program operated by HRSA, through which health centers across the country focus on improving their treatments for specific diseases, or implementing models to improve patient care. These centers include Whitney Young Health Center in Albany, NY, which, through this collaborative, successfully helped more than 200 patients learn how to manage their asthma. The legislation will establish new programs to increase community health workers, address environmental health concerns, and improve outreach and enrollment, thus reducing barriers to accessing care. It will increase support for the Agency for Healthcare Research and Quality's research into healthcare disparities and help to improve overall data collection. The Minority Health Improvement and Health Disparity Elimination Act will reauthorize the National Center for Minority Health and Health Disparities at the National Institutes of Health, which is designed to conduct and support health disparities research; disseminate information about disparities, and reach out to racial and ethnic minority disparity communities. Through the Center, New York University received support for its Center for the Study of Asian American Health, a collaboration between researchers, health providers, and community organizations that is designed to reduce the disparities faced by Asian Americans in New York City. Finally, the legislation would reauthorize and strengthen the Office of Minority Health, OMH, at HHS, requiring it to develop a National Action Plan to address disparities in collaboration with other Federal health agencies. The OMH has provided support to New York's Office of Minority Health, as well as community-based organizations in Syracuse, Buffalo, and Lower Manhattan, and this reauthorization of the office will allow them to support and sustain more programs at the State and local level. I am excited about this legislation because I have seen what happens in communities when we come together--providers, researchers, and neighborhood leaders--to address these concerns. Last month, the University of Rochester and the Monroe County Health Department announced that an initiative to increase pneumococcal immunization rates in African-American seniors resulted in a more than 30-percent gain in immunization rates--protecting more New Yorkers against pneumonia and reducing the vaccination disparity between Blacks and Whites. I believe that the Minority Health Improvement and Health Disparity Elimination Act will allow us to create, maintain, and support this type of collaboration across the Nation. It will make a real change in the health care for our minority communities and improve the quality of care received by all Americans. I look forward to working with my colleagues in Congress to pass this legislation as quickly as possible.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I am pleased to join Senators Kennedy, Cochran, Bingaman, Obama, Durbin and Brown in introducing the Minority Health Improvement and Health Disparity Elimination Act 2007. As we debate health care issues, we often discuss what is wrong with our health care system: Costs are spiraling upward, the ranks of uninsured have increased, and the strains on our system and its ability to provide quality care have worsened. And while the impact of these situations are felt by all Americans, the problems with our health care system often disproportionately impact our racial and ethnic minority populations. We continue to have disparities in health care for our minority populations--disparities in access, disparities in quality, and disparities in outcomes. The Agency for Healthcare Research and Quality (AHRQ) tracks these in its annual National Healthcare Disparities Report, aggregating data from a variety of Federal health surveys and databases. And the findings from the report are staggering, inc1uding the following: Minorities had worse access to care than whites; Blacks and Hispanics received poorer quality care than Whites on more than 70 percent of the measures used by AHRQ; and While gains were made on approximately one-quarter of the quality indicators, disparities actually got worse for all minority populations on one-third of the quality indicators. These system wide disparities have translated into increased burden of disease for our racial and ethnic minority populations. HIV/AIDS is devastating our African-American communities. Blacks account for about half of all new HIV/AIDS diagnoses. In New York City, the rate of new HIV diagnoses is six times higher among Blacks than Whites. In addition, the AIDS case rate among Hispanic populations is about 3.5 times higher than that of Whites. The incidence of asthma is highest among Puerto Rican populations, with 22 percent of these individuals receiving a diagnosis of asthma, a rate roughly double that of White populations. Although African- Americans have slightly higher rates of asthma than White populations, they experience disparities in asthma management and access to care. The emergency department visit rate for Blacks seeking asthma treatment was 350 percent higher than that of the rates for Whites, while the hospitalization rate for Blacks with asthma was 240 percent higher than that for Whites with asthma. One out of every 10 Asian Americans will be diagnosed with diabetes. Among all Americans with diabetes, Blacks are about two times more likely to require amputations, two to five times more likely to have kidney disease, and twice as likely to suffer from diabetes-related blindness. The impact of health disparities are experienced not only by racial and ethnic minority communities but by all of us. They are symptomatic of the underuse and misuse of health care. And the costs associated with these disparities--such as delayed diagnoses and complications that result from lack of access to primary care--add unnecessary costs to our health care system. The Minority Health Improvement and Health Disparity Elimination Act of 2007 would allow us to address healthcare disparities through a variety of mechanisms. The bill will create a cultural competency clearinghouse, helping providers to understand, first of all, the concept of cultural competence, and second, how to better tailor care to their patients of diverse backgrounds. We cannot, for example, ask a person with diabetes to make changes to their diet if we do not understand what foods are part of their diet. Having a culturally competent health care system is especially important in my home State of New York, where our residents come from all over the world. With the information that will be available in this clearinghouse, we will make it easier for both patients and providers to communicate and understand essential concepts of care. The Minority Health Improvement and Health Disparity Elimination Act will improve health professions programs that increase recruitment and retention of underrepresented minorities in the health professions. New York's population is 15 percent Black and 15.6 percent Hispanic, yet the percentage of Black physicians practicing in our State is 3.2 percent, and the percentage of Hispanic physicians practicing in our State is 2.3 percent. This bill will reauthorize the Centers of Excellence established by the Health Resources and Services Administration, HRSA--a program that has benefited the Mt. Sinai School of Medicine--and establish new programs to train mid-career individuals in the health professions. It will codify currently existing health promotion and disease prevention activities targeted toward racial and ethnic minorities, including the Centers for Disease Control and Prevention's Racial and Ethnic Approaches to Community Health, REACH. REACH grantees working in northern Manhattan have managed to increase childhood immunization rates by 10 to 15 percent. It will also codify the Health Disparities Collaboratives program operated by HRSA, through which health centers across the country focus on improving their treatments for specific diseases, or implementing models to improve patient care. These centers include Whitney Young Health Center in Albany, NY, which, through this collaborative, successfully helped more than 200 patients learn how to manage their asthma. The legislation will establish new programs to increase community health workers, address environmental health concerns, and improve outreach and enrollment, thus reducing barriers to accessing care. It will increase support for the Agency for Healthcare Research and Quality's research into healthcare disparities and help to improve overall data collection. The Minority Health Improvement and Health Disparity Elimination Act will reauthorize the National Center for Minority Health and Health Disparities at the National Institutes of Health, which is designed to conduct and support health disparities research; disseminate information about disparities, and reach out to racial and ethnic minority disparity communities. Through the Center, New York University received support for its Center for the Study of Asian American Health, a collaboration between researchers, health providers, and community organizations that is designed to reduce the disparities faced by Asian Americans in New York City. Finally, the legislation would reauthorize and strengthen the Office of Minority Health, OMH, at HHS, requiring it to develop a National Action Plan to address disparities in collaboration with other Federal health agencies. The OMH has provided support to New York's Office of Minority Health, as well as community-based organizations in Syracuse, Buffalo, and Lower Manhattan, and this reauthorization of the office will allow them to support and sustain more programs at the State and local level. I am excited about this legislation because I have seen what happens in communities when we come together--providers, researchers, and neighborhood leaders--to address these concerns. Last month, the University of Rochester and the Monroe County Health Department announced that an initiative to increase pneumococcal immunization rates in African-American seniors resulted in a more than 30-percent gain in immunization rates--protecting more New Yorkers against pneumonia and reducing the vaccination disparity between Blacks and Whites. I believe that the Minority Health Improvement and Health Disparity Elimination Act will allow us to create, maintain, and support this type of collaboration across the Nation. It will make a real change in the health care for our minority communities and improve the quality of care received by all Americans. I look forward to working with my colleagues in Congress to pass this legislation as quickly as possible.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I call up amendment No. 1183, as further modified, and ask unanimous consent for its consideration.

Mrs. CLINTON. Mr. President, I ask unanimous consent that the majority leader, Senator Reid, and Senator Dodd be added as cosponsors to the amendment.

Mrs. CLINTON. Mr. President, I know there are very strongly held and honestly felt disagreements in this Chamber on the legislation before us. Many of these differences are mirrored across our country. The issue of immigration strikes deeply at our values and our concept of America and stirs our emotions. While we may reach different conclusions, we all have to begin at the same place. Our immigration system is in crisis. I have concerns about this underlying bill, but we all do. This is not the bill any of us individually would have written and produced for the Senate's consideration. But I commend the primary sponsors for bringing this to the floor of the Senate so we can debate the issues it raises and try to craft a solution that simultaneously honors our Nation's strong immigrant heritage and respects the rule of law. As a nation, we place a premium on compassion, respect, and policies that help families. But our immigration laws don't reflect that. In fact, our current laws tear families apart. For lawful permanent residents and their spouses and minor children, this bill not only fails to help them, it actually makes matters worse. It is time to take all the rhetoric about family values and put it into action and show that we mean what we say when we talk about putting families first. That is what my amendment does. This amendment is a bipartisan amendment offered with Senator Hagel and Senator Menendez. It is our view we must make reuniting families a priority in our immigration system, that we should show compassion for those living apart from their spouses and minor children, that we should reform immigration in a way that honors families and brings them together. Unfortunately, the compromise bill before us fails to help families and children stuck in a bureaucratic quagmire created by our tangled, broken immigration system. Spouses and minor children of lawful permanent residents applying for a green card are required to remain overseas while awaiting their new legal status. The problem is there is a huge backlog. Despite what some have suggested this week, the visa backlog for spouses and minor children of lawful permanent residents is significant and substantial. According to the June 2007 State Department visa bulletin, the backlog is currently more than 5 years long. For some, that backlog could stretch even longer. What does that mean? In very human terms it means parents are forced apart from their children. Husbands are separated from their wives. Tax-paying, law-abiding, legal immigrants who are doing the right thing are treated as though their families don't matter at all. If you are a lawful permanent resident and your spouse and minor children are caught in this long line, your family is not allowed to enter the United States even for a brief visit. You are limited in your ability to leave the United States to visit your spouse and children overseas. Under our current policies, lawful permanent residents are forced to choose between their newly adopted country and living with their spouse or children. Five years may not seem long to some of us. We serve 6 years in the Senate. It seems to go by very fast. But 5 years in the life of a young child or in a marriage is precious time indeed. For a 10-year-old child, it is half their life. It is time that can never be recaptured. Unfortunately, that 5-year timeframe is often much less than what actually happens to these families. We are proposing that spouses and minor children of lawful permanent residents be exempt from the visa caps and that we finally allow these nuclear families who have been separated for far too long to be reunited. This amendment is necessary because the compromise bill does absolutely nothing to bring these families together. In fact, the compromise actually reduces the number of visas for spouses and minor children of lawful permanent residents. It does not allocate a single visa to address the existing backlog for these family members. As I have said many times, we have a national interest in fostering strong families. This amendment is supported by more than 100 faith- based, family, and immigrant advocacy organizations and denominations. I thank all of these organizations that have endorsed and rallied support for the Clinton-Hagel-Menendez amendment. They do an invaluable service in speaking out for people whose voices would otherwise not be heard. The amendment is not considered a bill killer. It is not considered an amendment everybody has to vote against who has agreed to the compromise, because many of us know these legal permanent residents. Many of us actually work with them. Some of them even contribute to the campaigns of people in this Chamber. These are people who are doing everything they can to play by the rules, except they are divided for years from their spouses and minor children. I hope the Chamber will endorse this act of compassion and common sense. I yield the floor.

Mrs. CLINTON. Mr. President, may I inquire, was a budget point of order or other point of order made against the amendment?

Mrs. CLINTON. Mr. President, let me, just if I could, respond.

Mrs. CLINTON. Mr. President, I thank the Senator. I think it is important to recognize that there are many distinctions between a U.S. citizen and a foreigner living legally in the United States which uphold the value of citizenship, but the right to marry and to live with your family should not be one of them. Denying legal permanent residents, who are on the pathway to pledging their allegiance to the United States, the right to marry and live together in our country is an obstacle to their becoming the kind of full-fledged citizens we want them to be. Also, under current law, guest workers, students, and others can be with their spouses and minor children and then adjust to legal permanent resident status with them. Due to the backlogs, only lawful permanent residents are treated differently. So, Mr. President, I understand that those who worked so hard on coming up with this compromise may not be able to find their way clear to support this at this time, but I do not believe we have a national interest in separating legal permanent residents from their spouses and minor children. I yield the floor.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I rise today to introduce a resolution which supports the goals and ideals of Pancreatic Cancer Awareness Month. This resolution is an important step toward bringing the public awareness, funding for research, and congressional attention that is essential for addressing one of the most lethal cancers we face as a Nation. I doubt that there is one person who hasn't lost a friend or family member to cancer, or knows someone who has. The American Cancer Society tells us that pancreatic cancer is the fourth leading cause of cancer death in the United States. The reality is that pancreatic cancer will take over 33,000 American lives this year, more than 2,330 in New York. And yet, there are no early detection methods and our best treatment is a surgical procedure that is more than 70 years old. I believe that we can do better. This resolution encourages communities across the country to use the month of November to bring attention to what we have left to tackle. We need research dollars to create early detection methods, to find effective treatments, and to raise awareness about this deadly disease. I am proud to introduce the Pancreatic Cancer Awareness Month resolution today, and I hope my colleagues will join me in supporting this critical health issue.

Mrs. CLINTON

Mrs. CLINTON. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 1176

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I rise today to introduce the Investing for Tomorrow's Schools Act of 2007, an act that is critical in bringing our Nation's schools into the 21st century. If passed, this legislation would provide States with an economical way to fund school construction. Please allow me to express my thanks to my friend, Senator Harkin, for joining my efforts in the Senate, as well as to Representative Tauscher for his leadership in the House and his introduction of the companion bill. The American Society of Civil Engineers gave our Nation's school buildings a D in their last report card, with 75 percent of facilities deemed inadequate for education. Yet our children attend these schools every day. When students attend rundown schools, their well-being and ability to learn is threatened. In 2004, in Washingtonville, NY, the roof over a classroom, in the 44-year-old Taft Elementary, collapsed. Had the collapse occurred just 32 days later, 15 children and 2 teachers could have been seriously injured or even killed. This past January, New York's Manhasset School District issued a report describing the condition of its only high school. The 72-year-old building has exceeded its life expectancy, with a roof ``beyond the stages of patching and repairing'' and in need of replacement. Last school year, part of the ceiling collapsed in one of the stairwells. Buildings like this one, in use beyond their life expectancy, are dangerous and don't meet the demands of the 21st century. The lack of adequate school buildings hampers today's most promising and innovative efforts to boost student achievement. Many older school buildings are in a dangerous state of disrepair and have seriously outdated facilities. Many do not even have the proper wiring for computer networks. While we work to give students the academic tools they need to compete in the 21st century, we must also upgrade school facilities to give students a learning environment conducive to success. This is why we included a new provision in this legislation creating healthy high-performance schools guidelines to direct schools during renovation and construction in order to create schools that will foster the development of children. According to the National Education Association, repairs and modernization nationwide will cost $322 billion. Last year, over $20 billion was spent nationwide on school construction. At that rate, it will take more than 16 years to modernize school buildings, when today's kindergartners could be graduating from college. Clearly, school construction is costly, but a price cannot be put on the value of our children's education and well-being. We must use innovative methods in providing funding for schools to make these essential renovations. That is why I am introducing this bill. At the center of this bill is the creation of State infrastructure banks, which would improve financing for school construction. This financing mechanism was pioneered by the Reagan administration, which used it to help local communities fund water treatment and clean water facilities. The Clinton administration also used State infrastructure banks to help States finance transportation projects. State infrastructure banks have been successful in financing public projects at a low cost to taxpayers. They would offer school districts flexible options of loan and credit enhancement assistance, such as low-interest loans, bond-financing security, loan guarantees, and credit support for financing projects, which result in lower interest rates. State infrastructure banks would not strain the Federal Treasury or the American taxpayer. After initial funding, they would require no ongoing Federal appropriations. As loans are repaid, funds would be replenished, and banks could make new loans available. Passage of this bill would help provide immediate aid to the neediest schools and help local communities fund affordable construction far into the future. This modest proposal is one step in the school construction solution. We must continue to move forward in this Congress by creating an academic setting that will prepare our students for the 21st century workplace. I ask my colleagues to join me and Senator Harkin in supporting this critical piece of legislation.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, I rise today to introduce the Investing for Tomorrow's Schools Act of 2007, an act that is critical in bringing our Nation's schools into the 21st century. If passed, this legislation would provide States with an economical way to fund school construction. Please allow me to express my thanks to my friend, Senator Harkin, for joining my efforts in the Senate, as well as to Representative Tauscher for his leadership in the House and his introduction of the companion bill. The American Society of Civil Engineers gave our Nation's school buildings a D in their last report card, with 75 percent of facilities deemed inadequate for education. Yet our children attend these schools every day. When students attend rundown schools, their well-being and ability to learn is threatened. In 2004, in Washingtonville, NY, the roof over a classroom, in the 44-year-old Taft Elementary, collapsed. Had the collapse occurred just 32 days later, 15 children and 2 teachers could have been seriously injured or even killed. This past January, New York's Manhasset School District issued a report describing the condition of its only high school. The 72-year-old building has exceeded its life expectancy, with a roof ``beyond the stages of patching and repairing'' and in need of replacement. Last school year, part of the ceiling collapsed in one of the stairwells. Buildings like this one, in use beyond their life expectancy, are dangerous and don't meet the demands of the 21st century. The lack of adequate school buildings hampers today's most promising and innovative efforts to boost student achievement. Many older school buildings are in a dangerous state of disrepair and have seriously outdated facilities. Many do not even have the proper wiring for computer networks. While we work to give students the academic tools they need to compete in the 21st century, we must also upgrade school facilities to give students a learning environment conducive to success. This is why we included a new provision in this legislation creating healthy high-performance schools guidelines to direct schools during renovation and construction in order to create schools that will foster the development of children. According to the National Education Association, repairs and modernization nationwide will cost $322 billion. Last year, over $20 billion was spent nationwide on school construction. At that rate, it will take more than 16 years to modernize school buildings, when today's kindergartners could be graduating from college. Clearly, school construction is costly, but a price cannot be put on the value of our children's education and well-being. We must use innovative methods in providing funding for schools to make these essential renovations. That is why I am introducing this bill. At the center of this bill is the creation of State infrastructure banks, which would improve financing for school construction. This financing mechanism was pioneered by the Reagan administration, which used it to help local communities fund water treatment and clean water facilities. The Clinton administration also used State infrastructure banks to help States finance transportation projects. State infrastructure banks have been successful in financing public projects at a low cost to taxpayers. They would offer school districts flexible options of loan and credit enhancement assistance, such as low-interest loans, bond-financing security, loan guarantees, and credit support for financing projects, which result in lower interest rates. State infrastructure banks would not strain the Federal Treasury or the American taxpayer. After initial funding, they would require no ongoing Federal appropriations. As loans are repaid, funds would be replenished, and banks could make new loans available. Passage of this bill would help provide immediate aid to the neediest schools and help local communities fund affordable construction far into the future. This modest proposal is one step in the school construction solution. We must continue to move forward in this Congress by creating an academic setting that will prepare our students for the 21st century workplace. I ask my colleagues to join me and Senator Harkin in supporting this critical piece of legislation.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, today Senator Domenici and I are introducing the Public Mental Health Emergency Preparedness Act of 2007. I originally introduced this legislation during the 109 Congress to address mental health needs of those affected by disasters and public health emergencies, and I want to thank Senator Domenici for his support of this legislation and for his strong leadership on mental health issues. The Public Mental Health Emergency Preparedness Act of 2007 would take several important steps toward preparing our Nation to effectively address mental health issues in the wake of public health emergencies, including potential bioterrorist attacks. We are pleased to be introducing this important legislation in anticipation of reauthorization of the Substance Abuse and Mental Health Services Administration SAMHSA. I want to acknowledge and thank our partners from the mental health community who have collaborated with us and have been working diligently on these issues for several years, including the American Psychological Association, the American Public Health Association, the National Association of Social Workers, and the American Academy of Child and Adolescent Psychiatry, and all the other groups who have lent their support. The events of September 11, Hurricanes Katrina and Rita, and other recent natural and man-made catastrophes have sadly taught us that our current resources are not sufficient or coordinated enough to meet the mental health needs of those devastated by emergency events. We need a network of trained mental health professionals, first responders and leaders, and a process to mobilize and deploy mental health resources in a rapid and sustained manner at times of an emergency. It is clear that the consequences of emergency events like hurricanes or terrorist attacks result in increased emotional and psychological suffering among survivors and responders, and we must do more to assist all who are affected. That is why I, along with Senator Domenici, am introducing the Public Mental Health Emergency Preparedness Act of 2007. This bill would require the Secretary of Health and Human services to establish the National Center for Public Mental Health Emergency Preparedness the National Center to coordinate the development and delivery of mental health services in collaboration with existing Federal, State and local entities when our Nation is confronted with public health catastrophes. This legislation would charge the National Center with five functions to benefit affected Americans at the community level, including vulnerable populations like children, older Americans, caregivers, persons with disabilities, and persons living in poverty. First, the Public Mental Health Emergency Preparedness Act of 2007 would make sure we have evidence-based or emerging best practices curricula available to meet the diverse training needs of a wide range of emergency health professionals, including mental health professionals, public health and health care professionals, and emergency services personnel, working in coordination with county emergency managers, school personnel, spiritual care professionals, and State and local government officials responsible for emergency preparedness. By using these curricula to educate responders, the National Center would build a network of trained emergency health professionals at the State and local levels. Second, this legislation would establish and maintain a clearinghouse of educational materials, guidelines, and research on public mental health emergency preparedness and service delivery that would be evaluated and updated to ensure the information is accurate and current. Technical assistance would be provided to help users access those resources most effective for their communities. Third, this bill would create an annual national forum for emergency health professionals, researchers, and other experts as well as Federal, State and local government officials to identify and address gaps in science, practice, policy and education related to public mental health emergency preparedness and service delivery. Fourth, this bill would require annual evaluations of both the National Center's efforts and those across the Federal Government in building our Nation's public mental health emergency preparedness and service delivery capacity. Based on these evaluations, recommendations would be made to improve such activities. Finally, the Public Mental Health Emergency Preparedness Act of 2007 would ensure that licensed mental health professionals are included in the deployment of Disaster Medical Assistance Teams DMAT. Deployment of licensed mental health professionals will increase the efficacy of the medical team members by providing psychological assistance and crisis counseling to survivors and to the other DMAT team members. Further, this legislation would mandate that licensed mental health professionals are included in the leadership of the National Disaster Medical System, NDMS, to provide appropriate support for behavioral programs and personnel within the DMATs. We must not wait until another disaster strikes before we take action to improve the way we respond to the psychological needs of affected Americans. I look forward to working with all of my colleagues to ensure passage of this bill that would take critical steps toward preparing our nation to successfully deal with the mental health consequences of public health emergencies. I ask unanimous consent that the text and a letter of support be printed in the Record. Thank you.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, today Senator Domenici and I are introducing the Public Mental Health Emergency Preparedness Act of 2007. I originally introduced this legislation during the 109 Congress to address mental health needs of those affected by disasters and public health emergencies, and I want to thank Senator Domenici for his support of this legislation and for his strong leadership on mental health issues. The Public Mental Health Emergency Preparedness Act of 2007 would take several important steps toward preparing our Nation to effectively address mental health issues in the wake of public health emergencies, including potential bioterrorist attacks. We are pleased to be introducing this important legislation in anticipation of reauthorization of the Substance Abuse and Mental Health Services Administration SAMHSA. I want to acknowledge and thank our partners from the mental health community who have collaborated with us and have been working diligently on these issues for several years, including the American Psychological Association, the American Public Health Association, the National Association of Social Workers, and the American Academy of Child and Adolescent Psychiatry, and all the other groups who have lent their support. The events of September 11, Hurricanes Katrina and Rita, and other recent natural and man-made catastrophes have sadly taught us that our current resources are not sufficient or coordinated enough to meet the mental health needs of those devastated by emergency events. We need a network of trained mental health professionals, first responders and leaders, and a process to mobilize and deploy mental health resources in a rapid and sustained manner at times of an emergency. It is clear that the consequences of emergency events like hurricanes or terrorist attacks result in increased emotional and psychological suffering among survivors and responders, and we must do more to assist all who are affected. That is why I, along with Senator Domenici, am introducing the Public Mental Health Emergency Preparedness Act of 2007. This bill would require the Secretary of Health and Human services to establish the National Center for Public Mental Health Emergency Preparedness the National Center to coordinate the development and delivery of mental health services in collaboration with existing Federal, State and local entities when our Nation is confronted with public health catastrophes. This legislation would charge the National Center with five functions to benefit affected Americans at the community level, including vulnerable populations like children, older Americans, caregivers, persons with disabilities, and persons living in poverty. First, the Public Mental Health Emergency Preparedness Act of 2007 would make sure we have evidence-based or emerging best practices curricula available to meet the diverse training needs of a wide range of emergency health professionals, including mental health professionals, public health and health care professionals, and emergency services personnel, working in coordination with county emergency managers, school personnel, spiritual care professionals, and State and local government officials responsible for emergency preparedness. By using these curricula to educate responders, the National Center would build a network of trained emergency health professionals at the State and local levels. Second, this legislation would establish and maintain a clearinghouse of educational materials, guidelines, and research on public mental health emergency preparedness and service delivery that would be evaluated and updated to ensure the information is accurate and current. Technical assistance would be provided to help users access those resources most effective for their communities. Third, this bill would create an annual national forum for emergency health professionals, researchers, and other experts as well as Federal, State and local government officials to identify and address gaps in science, practice, policy and education related to public mental health emergency preparedness and service delivery. Fourth, this bill would require annual evaluations of both the National Center's efforts and those across the Federal Government in building our Nation's public mental health emergency preparedness and service delivery capacity. Based on these evaluations, recommendations would be made to improve such activities. Finally, the Public Mental Health Emergency Preparedness Act of 2007 would ensure that licensed mental health professionals are included in the deployment of Disaster Medical Assistance Teams DMAT. Deployment of licensed mental health professionals will increase the efficacy of the medical team members by providing psychological assistance and crisis counseling to survivors and to the other DMAT team members. Further, this legislation would mandate that licensed mental health professionals are included in the leadership of the National Disaster Medical System, NDMS, to provide appropriate support for behavioral programs and personnel within the DMATs. We must not wait until another disaster strikes before we take action to improve the way we respond to the psychological needs of affected Americans. I look forward to working with all of my colleagues to ensure passage of this bill that would take critical steps toward preparing our nation to successfully deal with the mental health consequences of public health emergencies. I ask unanimous consent that the text and a letter of support be printed in the Record. Thank you.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, today I am introducing legislation to remove the Federal Emergency Management Agency, FEMA, from the Department of Homeland Security and restore it as an independent, cabinet-level agency. In the days after Hurricanes Katrina and Rita, Americans witnessed incompetence on the part of FEMA, the Department of Homeland Security, and the Administration in responding to a catastrophe of this magnitude. Countless Americans who were left behind were failed by their government when they needed help the most. Sadly, the tragedy continues for the more than 80,000 people still living in trailers and for the cities and towns still struggling to rebuild. In the years since the catastrophes of Katrina and Rita, FEMA's failures have continued. The Inspector General for the Department of Homeland Security found that FEMA awarded $3.6 billion in contracts to maintain trailers for hurricane victims to companies with no ties to the Gulf Coast region and bad paperwork. In the aftermath of Hurricanes Katrina and Rita, FEMA wasted $1 billion in improper payments to individuals. FEMA spent $900 million on trailers that could not be used in flood zones. And FEMA paid $1.8 billion for hotel rooms and cruise ship cabins that were more expensive than apartments. It was reported recently that more than $40 million worth of stockpiled food for the 2006 hurricane season spoiled due to FEMA's lack of preparation. FEMA also disclosed in recent days that it will not have a new national response plan ready in time for the start of this year's hurricane season. It is past time to restore competence and accountability, and to reestablish FEMA as an independent agency outside the Department of Homeland Security. In the Clinton administration, the head of FEMA reported directly to the President of the United States and that direct communication meant the buck stopped with the President, instead of being lost in the bureaucracy. The Government Accountability Office says that managing the transformation of an agency of the size and complexity of the Department of Homeland Security will likely span a number of years. Unfortunately with regard to preparing and recovering from a disaster, we cannot wait years for the Department of Homeland Security to live up to its intended mission. When the next disaster or catastrophe happens, we cannot afford to say that we'll be ready next time. Under my legislation, the Director of FEMA reports directly to the President and would have full authority to coordinate with all agencies and to take the necessary action to ensure resources and recovery personnel are deployed quickly in an emergency to impacted areas. When we created the Department of Homeland Security, in the Homeland Security Act of 2002, I said then that I was deeply concerned about moving FEMA under the Department of Homeland Security because when it operated as an independent agency, especially on September 11 and in the response thereafter, it was highly-functioning, and well-run. I remarked then that moving FEMA under the Department of Homeland Security must not force a highly-functioning and competent agency into a bureaucracy that will challenge integration and diminish FEMA's effectiveness in responding to crises of all kinds. Unfortunately, that seems to be exactly what has happened and that is exactly what we must fix. The bureaucracy created by moving FEMA under the Department of Homeland Security is clearly not working and we must ensure that FEMA has the ability and the authority to respond to a disaster or catastrophe. I thank all of my colleagues who have cosponsored this legislation and I hope that every Senator in this chamber will cosponsor this legislation. I ask unanimous consent that the text of the bill be printed in the Record.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, today I am introducing legislation to remove the Federal Emergency Management Agency, FEMA, from the Department of Homeland Security and restore it as an independent, cabinet-level agency. In the days after Hurricanes Katrina and Rita, Americans witnessed incompetence on the part of FEMA, the Department of Homeland Security, and the Administration in responding to a catastrophe of this magnitude. Countless Americans who were left behind were failed by their government when they needed help the most. Sadly, the tragedy continues for the more than 80,000 people still living in trailers and for the cities and towns still struggling to rebuild. In the years since the catastrophes of Katrina and Rita, FEMA's failures have continued. The Inspector General for the Department of Homeland Security found that FEMA awarded $3.6 billion in contracts to maintain trailers for hurricane victims to companies with no ties to the Gulf Coast region and bad paperwork. In the aftermath of Hurricanes Katrina and Rita, FEMA wasted $1 billion in improper payments to individuals. FEMA spent $900 million on trailers that could not be used in flood zones. And FEMA paid $1.8 billion for hotel rooms and cruise ship cabins that were more expensive than apartments. It was reported recently that more than $40 million worth of stockpiled food for the 2006 hurricane season spoiled due to FEMA's lack of preparation. FEMA also disclosed in recent days that it will not have a new national response plan ready in time for the start of this year's hurricane season. It is past time to restore competence and accountability, and to reestablish FEMA as an independent agency outside the Department of Homeland Security. In the Clinton administration, the head of FEMA reported directly to the President of the United States and that direct communication meant the buck stopped with the President, instead of being lost in the bureaucracy. The Government Accountability Office says that managing the transformation of an agency of the size and complexity of the Department of Homeland Security will likely span a number of years. Unfortunately with regard to preparing and recovering from a disaster, we cannot wait years for the Department of Homeland Security to live up to its intended mission. When the next disaster or catastrophe happens, we cannot afford to say that we'll be ready next time. Under my legislation, the Director of FEMA reports directly to the President and would have full authority to coordinate with all agencies and to take the necessary action to ensure resources and recovery personnel are deployed quickly in an emergency to impacted areas. When we created the Department of Homeland Security, in the Homeland Security Act of 2002, I said then that I was deeply concerned about moving FEMA under the Department of Homeland Security because when it operated as an independent agency, especially on September 11 and in the response thereafter, it was highly-functioning, and well-run. I remarked then that moving FEMA under the Department of Homeland Security must not force a highly-functioning and competent agency into a bureaucracy that will challenge integration and diminish FEMA's effectiveness in responding to crises of all kinds. Unfortunately, that seems to be exactly what has happened and that is exactly what we must fix. The bureaucracy created by moving FEMA under the Department of Homeland Security is clearly not working and we must ensure that FEMA has the ability and the authority to respond to a disaster or catastrophe. I thank all of my colleagues who have cosponsored this legislation and I hope that every Senator in this chamber will cosponsor this legislation. I ask unanimous consent that the text of the bill be printed in the Record.

Mrs. CLINTON

Mrs. CLINTON. Madam President, it is with deep regret that I share the following story of a constituent of mine. On April 24, Kristen McCrea, a woman from Amherst, NY, lost her daughter in a nontraffic, noncrash incident. Collett McCrea was only 22 months old. The incident occurred when Kristen left her daughter in their home briefly while backing her car out of the garage. Little did Kristen know that Collett had gotten out of the house and was behind the vehicle. Kristen did not realize she had backed over Collett until her child came into view in front of the car. Sadly, Collett's tragedy is not an isolated incident. In April 2007, the child safety advocacy group, Kids and Cars, has documented 17 fatal backover incidents across the country--from Rochester, NY, and South Bend, IN, to San Francisco and Dallas. Six more incidents of fatal frontovers were reported in April, as well as a brake-shift interlock fatality. While all these tragedies occurred in the last month, the danger of nontraffic, noncrash incidents is not a new trend. On average, a child dies in the United States nearly every other day from a completely preventable accident--backed over by a driver who couldn't see behind his or her vehicle, strangled in a power window, or killed when an automobile inadvertently shifts into gear. Since 2000, over 1,150 children have died in nontraffic, noncrash incidents, and this number has been steadily rising. The average age of victims is between 12 and 23 months. This year alone, according to the research by the child safety group, Kids and Cars, 261 children have been involved in 235 of these incidents, resulting in 17 fatalities. At least 21 children in New York State have been victims of these incidents since 1990. It is time we stopped these tragedies from happening to more families. And that is why I introduced, the Cameron Gulbransen Kids and Cars Safety Act, a bill to improve the child safety features in new vehicles. This bill is named in honor of a 2-year-old Long Island boy who was killed when his father accidentally backed over him in his driveway. The Cameron Gulbransen Kids and Cars Safety Act would make new passenger motor vehicles safer in three important ways. First, it requires a detection system to alert drivers to the presence of a child behind the vehicle. Second, it calls on the Secretary of Transportation to examine power windows technology that reverses panel direction when it detects an obstruction--preventing children from being trapped, injured, or killed. And, finally, the bill will require the vehicle service break to be engaged in order to prevent vehicles from unintentionally rolling away. The bill also establishes a child safety information program administered by the Secretary of Transportation to collect nontraffic, noncrash incident data and disseminate information to parents about these hazards and ways to mitigate them. This bill proves that with modest, cost-effective steps, we can prevent many tragic car-related accidents from occurring. Power window sensors, for example, cost around $10 a window. Brakeshift interlocks are already standard in most passenger vehicles but will cost only $5 where needed. Backover warning systems cost approximately $300 a car, far cheaper than DVD and stereo systems. This inexpensive technology could save thousands of children's lives. I fought long and hard into the last hours of the 109th Congress to get this bill through, and I am proud to be working with families, advocates, and many of my colleagues in the fight to get this bill passed. I am proud to champion the Cameron Gulbransen Kids and Cars Safety Act of 2007 and urge all my colleagues to join me in supporting this bill. Together, we can ensure that we have safer cars and safer kids across our country.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, today, I am introducing the Bridging the Gap for Wounded Warriors Act to provide comprehensive solutions to problems that have arisen from military bureaucracy's failure to meet the medical needs of this generation's wounded warriors as they transition from the Armed Services to civilian life. This is a moment of profound challenge for our country, for our military, and for our men and women in uniform. And while there are often strong disagreements here in Washington, I hope we can unite around our common values and patriotism when it comes to how we treat our servicemembers and veterans. If you serve your country your country should serve you. That is the promise our country must keep to the men and women who enlist, who fight, and who return home often bearing the visible and invisible scars of sacrifice. Sadly, too often in the past several years, that promise has been broken: whether it's a lack of up-armored vehicles on the ground in Iraq or a lack of appropriate care in outpatient facilities at Walter Reed. Last year, I authored and passed into law the Heroes at Home initiative to assist returning servicemembers experiencing the complex, diffuse, and life-altering symptoms of traumatic brain injury and other mental health difficulties. This past March, I followed up with the introduction of the Heroes at Home Act of 2007, S. 1065, the Restoring Disability Benefits for Injured and Wounded Warriors Act of 2007, S. 1064, and the Protecting Military Family Financial Benefits Act of 2007, S. 1063, to serve our servicemembers and send a message: you will be treated as heroes before deployment, during deployment, and upon returning home. You didn't offer excuses and do not deserve to be offered excuses by your country. Finally, Senator Evan Bayh and I introduced the Traumatic Brain Injury Access to Options Act, S. 1113, in order to provide a temporary and immediate solution to the discrepancy in health care services and benefits encountered by TBI patients. However, a broader and permanent solution is needed to assist all members and former members of the Armed Services who have incurred any type of combat-related injury. The mistreatment of servicemembers at Walter Reed and testimony from recent hearings in both the Senate Armed Services and Veterans Affairs Committees have revealed major gaps affecting servicemembers, including discrepancies in benefits for active duty and medically retired servicemembers; difficulties in obtaining needed care for wounded servicemembers transitioning from the Armed Services to civilian life; and disparities between the DoD and VA disability rating systems. Although the military, more often than not, offers quality health care services, wounded servicemembers often encounter barriers to receiving the optimal health benefit. The two major barriers are: (1) a confusing array of benefits; and (2) discrepancies between benefits for those on active duty versus those who are medically retired. Recent events at Walter Reed have highlighted the longstanding need to overhaul the DoD and VA disability rating systems, which are unnecessarily complex and result in delays in payment that hinder efforts of wounded servicemembers to support themselves and their families. On March 6, 2007, the Chief of Staff of the Army General Peter Schoomaker and then-Army Surgeon General Lieutenant General Kevin C. Kiley testified before the Senate Armed Services Committee that soldiers appearing before the Physical Evaluation Board were ``short- changed'' and had not received appropriate disability benefits. According to the Congressional Research Service, since the enactment of the Traumatic Servicemembers Group Life Insurance program at least 45 percent of claims have been denied. In March 2006 the Comptroller General issued GAO Report 06-362: Military Disability System: Improved Oversight Needed to Ensure Consistent and Timely Outcomes for Reserve and Active Duty Service Members--the Department of Defense did not heed the recommendations provided in this report and as a result injured and wounded warriors continue to languish in an inefficient and adversarial disability system. We must stop short-changing our wounded warriors. Finally, a blanket overlap of benefits and disability rating reform are necessary but not sufficient for addressing the needs of those who are wounded. In order to support an all-volunteer force and meet the needs of this generation's wounded warriors, it is critical to achieve efficient DoD and VA collaboration and coordination of assistance to members of the Armed Forces in their transition from Active Duty to civilian life. Thus, the duties of the existent VA Office of Seamless Transition must be terminated and transferred to a new organizational structure that will achieve the long-sought goals of seamless transition between the DoD and VA and improved coordination between these agencies. That's why I am introducing the Bridging the Gap for Wounded Warriors Act today, to ensure a continuum of care for severely injured servicemembers and fix the problems that stymie the transition process. I am grateful to have developed this proposal with the Wounded Warrior Project, the National Military Family Association, and the Military Officers Association of America. We should provide our wounded warriors with the best care options available. This legislation would establish a 2 year blanket overlap of active duty and veterans health services and benefits for severely injured service members to facilitate their recovery and help resolve administrative problems like those found at Walter Reed. All costs of health care, for both active duty and medically retired servicemembers, will be paid for by the DoD. The provisions of this section shall take effect for those injured on or after October 7, 2001, but eligibility shall not include retroactive compensation for payments already made. We should also create a joint DoD-VA Office of Transition for the coordination of assistance to members of the Armed Forces in their transition from service in the Armed Forces to civilian life. The Office of Transition would absorb the duties of the existent VA Office of Seamless Transition as well as the functions and responsibilities of applicable offices within the Office of the Secretary of Defense, OSD. Leadership of the Office of Transition would consist of a Director and Deputy Director, who would both have seats on the Joint Executive Committee, JEC. The Secretaries of DoD and VA would have oversight of the Office of Transition, although the office would also be required to submit mandatory annual reports and biannual briefings to Congress. The GAO would also submit a biennial report on the Office of Transition's activities, in order to ensure that the Office's progress is not being stymied by the DoD or VA. Further, we should reform the current disability rating system to ensure that there is continuity of medical care and no disruption in compensation payments made to wounded service members. My legislation would change the roles of the agencies, so that DoD would no longer assign the actual disability rating but would still determine fitness for duty and document such a decision in writing, while VA would assign final ratings for all service-connected injuries. Further, the legislation would repeal the provision in the Omnibus Reconciliation Act of 1982 that requires the delay in payment of VA benefits until the first day of the second month after they are entitled. This provision would eliminate the gap in payments and allow servicemembers to continue to support themselves and their families. Finally, we should do what we can to ensure that both DoD and VA medical facilities have the appropriate trained professionals to deal with the range of injuries that our wounded servicemembers now incur, including traumatic brain injury, burns, amputations, vision problems, spinal cord injuries, and broken and fractured bones. In order to move in that direction, my legislation would require the GAO to submit a preliminary assessment and final report on the extent to which medical facilities of the DoD and VA offer interdisciplinary medical treatment for wounded members of the Armed Forces. Let us all join together in accepting our responsibility as a nation to those who serve and resolve to achieve efficient DoD and VA collaboration and coordination that is critical for supporting an all- volunteer force and meeting the needs of this generation's wounded warriors. I ask unanimous consent letters of support for this legislation be printed in the Record.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, today, I am introducing the Bridging the Gap for Wounded Warriors Act to provide comprehensive solutions to problems that have arisen from military bureaucracy's failure to meet the medical needs of this generation's wounded warriors as they transition from the Armed Services to civilian life. This is a moment of profound challenge for our country, for our military, and for our men and women in uniform. And while there are often strong disagreements here in Washington, I hope we can unite around our common values and patriotism when it comes to how we treat our servicemembers and veterans. If you serve your country your country should serve you. That is the promise our country must keep to the men and women who enlist, who fight, and who return home often bearing the visible and invisible scars of sacrifice. Sadly, too often in the past several years, that promise has been broken: whether it's a lack of up-armored vehicles on the ground in Iraq or a lack of appropriate care in outpatient facilities at Walter Reed. Last year, I authored and passed into law the Heroes at Home initiative to assist returning servicemembers experiencing the complex, diffuse, and life-altering symptoms of traumatic brain injury and other mental health difficulties. This past March, I followed up with the introduction of the Heroes at Home Act of 2007, S. 1065, the Restoring Disability Benefits for Injured and Wounded Warriors Act of 2007, S. 1064, and the Protecting Military Family Financial Benefits Act of 2007, S. 1063, to serve our servicemembers and send a message: you will be treated as heroes before deployment, during deployment, and upon returning home. You didn't offer excuses and do not deserve to be offered excuses by your country. Finally, Senator Evan Bayh and I introduced the Traumatic Brain Injury Access to Options Act, S. 1113, in order to provide a temporary and immediate solution to the discrepancy in health care services and benefits encountered by TBI patients. However, a broader and permanent solution is needed to assist all members and former members of the Armed Services who have incurred any type of combat-related injury. The mistreatment of servicemembers at Walter Reed and testimony from recent hearings in both the Senate Armed Services and Veterans Affairs Committees have revealed major gaps affecting servicemembers, including discrepancies in benefits for active duty and medically retired servicemembers; difficulties in obtaining needed care for wounded servicemembers transitioning from the Armed Services to civilian life; and disparities between the DoD and VA disability rating systems. Although the military, more often than not, offers quality health care services, wounded servicemembers often encounter barriers to receiving the optimal health benefit. The two major barriers are: (1) a confusing array of benefits; and (2) discrepancies between benefits for those on active duty versus those who are medically retired. Recent events at Walter Reed have highlighted the longstanding need to overhaul the DoD and VA disability rating systems, which are unnecessarily complex and result in delays in payment that hinder efforts of wounded servicemembers to support themselves and their families. On March 6, 2007, the Chief of Staff of the Army General Peter Schoomaker and then-Army Surgeon General Lieutenant General Kevin C. Kiley testified before the Senate Armed Services Committee that soldiers appearing before the Physical Evaluation Board were ``short- changed'' and had not received appropriate disability benefits. According to the Congressional Research Service, since the enactment of the Traumatic Servicemembers Group Life Insurance program at least 45 percent of claims have been denied. In March 2006 the Comptroller General issued GAO Report 06-362: Military Disability System: Improved Oversight Needed to Ensure Consistent and Timely Outcomes for Reserve and Active Duty Service Members--the Department of Defense did not heed the recommendations provided in this report and as a result injured and wounded warriors continue to languish in an inefficient and adversarial disability system. We must stop short-changing our wounded warriors. Finally, a blanket overlap of benefits and disability rating reform are necessary but not sufficient for addressing the needs of those who are wounded. In order to support an all-volunteer force and meet the needs of this generation's wounded warriors, it is critical to achieve efficient DoD and VA collaboration and coordination of assistance to members of the Armed Forces in their transition from Active Duty to civilian life. Thus, the duties of the existent VA Office of Seamless Transition must be terminated and transferred to a new organizational structure that will achieve the long-sought goals of seamless transition between the DoD and VA and improved coordination between these agencies. That's why I am introducing the Bridging the Gap for Wounded Warriors Act today, to ensure a continuum of care for severely injured servicemembers and fix the problems that stymie the transition process. I am grateful to have developed this proposal with the Wounded Warrior Project, the National Military Family Association, and the Military Officers Association of America. We should provide our wounded warriors with the best care options available. This legislation would establish a 2 year blanket overlap of active duty and veterans health services and benefits for severely injured service members to facilitate their recovery and help resolve administrative problems like those found at Walter Reed. All costs of health care, for both active duty and medically retired servicemembers, will be paid for by the DoD. The provisions of this section shall take effect for those injured on or after October 7, 2001, but eligibility shall not include retroactive compensation for payments already made. We should also create a joint DoD-VA Office of Transition for the coordination of assistance to members of the Armed Forces in their transition from service in the Armed Forces to civilian life. The Office of Transition would absorb the duties of the existent VA Office of Seamless Transition as well as the functions and responsibilities of applicable offices within the Office of the Secretary of Defense, OSD. Leadership of the Office of Transition would consist of a Director and Deputy Director, who would both have seats on the Joint Executive Committee, JEC. The Secretaries of DoD and VA would have oversight of the Office of Transition, although the office would also be required to submit mandatory annual reports and biannual briefings to Congress. The GAO would also submit a biennial report on the Office of Transition's activities, in order to ensure that the Office's progress is not being stymied by the DoD or VA. Further, we should reform the current disability rating system to ensure that there is continuity of medical care and no disruption in compensation payments made to wounded service members. My legislation would change the roles of the agencies, so that DoD would no longer assign the actual disability rating but would still determine fitness for duty and document such a decision in writing, while VA would assign final ratings for all service-connected injuries. Further, the legislation would repeal the provision in the Omnibus Reconciliation Act of 1982 that requires the delay in payment of VA benefits until the first day of the second month after they are entitled. This provision would eliminate the gap in payments and allow servicemembers to continue to support themselves and their families. Finally, we should do what we can to ensure that both DoD and VA medical facilities have the appropriate trained professionals to deal with the range of injuries that our wounded servicemembers now incur, including traumatic brain injury, burns, amputations, vision problems, spinal cord injuries, and broken and fractured bones. In order to move in that direction, my legislation would require the GAO to submit a preliminary assessment and final report on the extent to which medical facilities of the DoD and VA offer interdisciplinary medical treatment for wounded members of the Armed Forces. Let us all join together in accepting our responsibility as a nation to those who serve and resolve to achieve efficient DoD and VA collaboration and coordination that is critical for supporting an all- volunteer force and meeting the needs of this generation's wounded warriors. I ask unanimous consent letters of support for this legislation be printed in the Record.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, today, Senator Collins and I will be introducing the Diabetes Treatment and Prevention Act, legislation to help our Federal, State and local governments address the growing epidemic of diabetes across our Nation. According to the Centers for Disease Control and Prevention, CDC, the number of Americans with diagnosed diabetes has doubled over the past 15 years. Over 20 million Americans are currently living with this disease, but 6 million of them have not yet been diagnosed. Another 54 million are classified as ``pre-diabetic,'' with a high risk of developing this condition. Diabetes accounts for over $92 billion in direct medical costs every year, and these numbers are only likely to increase. Last year, the New York Times published an insightful series on diabetes that highlighted the obstacles faced by health care providers and institutions seeking to prevent complications from diabetes. The system will pay tens of thousands of dollars for amputations, but not a low-cost visit to the podiatrist that could have saved the foot. Hospitals struggle to provide preventive treatment and rehabilitation in the Byzantine system of reimbursements. The incentives inside our health care system are backwards, and the payment system is upside- down: too often paying for costly and debilitating treatment but not for low-cost prevention. We know what works. The landmark Diabetes Prevention Program, a government funded clinical trial, found that moderate diet and exercise interventions helped to delay and prevent the onset of type 2 diabetes in persons at high risk for developing the condition. Indeed, the study was so successful that it was ended a year earlier than planned. Yet despite the success of this study, we still haven't found a way to implement these interventions in our communities. The Diabetes Treatment and Prevention Act would provide additional support for the Federal, State and local programs that are working to fight this epidemic. Our legislation would codify the Division of Diabetes Translation at the Centers for Disease Control and Prevention, CDC, giving them definitive authority to carry out activities in diabetes surveillance, translational research, and education efforts. It would direct the CDC to continue its work in coordinating the National Diabetes Education Program, in conjunction with the National Institutes of Health, NIH, and would increase support for its diabetes control and prevention efforts at the State level. This bill would also establish several demonstration projects. One would help to translate the interventions identified as effective by the Diabetes Prevention Program into clinical interventions that can be replicated at the State, local and provider level. Another would allow academic centers, in conjunction with state and local health departments, to examine ways to improve overall health outcomes in people living with diabetes and other co-occurring chronic conditions, such as heart disease, mental illness, or HIV. Finally, the bill would support efforts to increase surveillance and education at the State and local level. The epidemic of diabetes has the potential to place great burdens on our health care system, but it doesn't have to. We can prevent diabetes, we can manage diabetes, and we can reduce the health care costs associated with care and treatment for this condition. The Diabetes Treatment and Prevention Act will help us take necessary steps to supporting our public health infrastructure in dealing with this crisis, and I would urge all of my colleagues to cosponsor this legislation.

Mrs. CLINTON

Mrs. CLINTON. Mr. President, today marks a historic moment for Northern Ireland and for countless people in Ireland, Great Britain, the United States, and around the world who have prayed and hoped and worked for lasting peace. Today, the devolved Government of Northern Ireland stands up to govern peacefully and democratically. The commitment of everyone involved, their constructive negotiations, their sacrifice, and their faith led us to this day of a new government and renewed hope. I am proud of the role my husband and I were able to play in helping to bring about peace in Northern Ireland and to help make today possible. Of course, some doubted that lasting peace could be possible. So many had lived through decades of violence, hate, and ill will; so many had buried loved ones. So many were resigned to what had felt, for them, inevitable: their children and their children's children would suffer the same fate. Their children were destined to grow up, go to school, and start their own families in the shadow of history and hostility. In recent months and years hope was fading. But not for the people of Northern Ireland who have endured great hardships who said to their leaders, ``It is time for peace.'' I remember in my visits to Northern Ireland meeting with women and men, leaders and citizens, who shared the same longing for peace, the same hopes for their children, and the same desire for a better future. It was this spirit that triumphed, that rose above the bad blood, that helped a people overcome a difficult legacy, to escape that shadow. It was this spirit that led to the signing of the Good Friday Agreement in 1998. It is this spirit that we honor on a historic day. I remember when Bill, Chelsea, and I traveled to Ireland in 1996. It was an important trip for lasting peace, and it was a memorable trip for me personally--among the most special in my time in the White House. In Ireland, I met the Nobel prizewinning poet Seamus Heaney. His words would become the theme for our visit and for this moment in Irish history. History says, Don't hope On this side of the grave, But then, once in a lifetime The longed-for tidal wave Of justice can rise up And hope and history rhyme. For mothers and fathers, husbands and wives, and sons and daughters of Northern Ireland, history said to them ``don't hope.'' But they hoped. When we traveled through Ireland in 1996, I spent time with women working for peace. I was struck by so many who had suffered but did not suffer without hope; women who lost husbands and sons and loved ones but did not lose faith. I will always carry the memory of 65-year-old Joyce McCartan, a remarkable woman who founded the Women's Information Drop-in Center in 1987 after her 17-year-old son was shot dead by Protestant gunman. She had lost more than a dozen family members to violence. Joyce and other women had set up the center as a safe house, a place for women of both religions to convene and talk over their needs and fears. I remember Joyce saying, ``It takes women to bring men to their senses.'' I met with Joyce and several women sitting around a table who described over tea how worried they were when their sons and husbands left the house and relieved when they arrived safely home. When I left our meeting, Joyce gave me a teapot to remember them by. Joyce died before having the chance to see the Good Friday Agreement and before this historic day. But when I spoke at the first memorial lecture in her honor in 1997 in Belfast, I brought with me that teapot. I put the teapot on the podium and spoke of the courage of Irish women like Joyce who, at kitchen tables and over pots of tea, helped chart a path to peace. She helped make lasting peace possible; she helped write the song in which hope and history could rhyme. I still fill with emotion whenever I see that teapot or think about her. I hope we can continue to draw inspiration from these stories of courage. There are countless people like Joyce whose names we will never know who helped make this day possible. I also want to commend the political parties. Many people have suffered deep losses and the healing process will continue far into the future. I praise everyone involved, especially Prime Minister Blair and Taoiseach Bertie Ahern, who stayed strong when it seemed hope was fading. I know that the Catholic and Protestant leaders who have been working to see this day become reality are grateful for a bright and prosperous Northern Ireland. During my last visit to Northern Ireland and Ireland I had the pleasure of seeing familiar faces and to visit with party leaders who I know all wanted a new day and a new beginning. And I commend political leaders like Gerry Adams of Sinn Fein, the Reverend Ian Paisley of the DUP, and all the others past and present who have worked hard. I also want to remember the efforts of people like Senator George Mitchell, John Hume, David Trimble, Martin McGuinness, David Ervine Seamus Mallon and Mo Mowlam; people involved so deeply in the negotiations leading up to the 1998 agreement. The sacrifices and compromises made back then formed the basis of today's devolved government. So many worked so hard and sacrificed so much over the past years and I think we must acknowledge everyone for their work and their endurance in traveling the long and difficult road to reach today's milestone. I want to commend my colleagues here in the Senate and across the Rotunda in the House, people like Senators Ted Kennedy, Chris Dodd, and Patrick Leahy; Congressmen Richie Neal, Joe Crowley, Jim Walsh, Peter King, Brian Higgins. I want to commend everyone who labored to show the support of the American people and the Congress. Thank you for your leadership. I have been proud to work among civic and business leaders on a variety of cross-border, cross-community efforts designed to spread the prosperity that is possible when people work together. I am grateful for the business leaders who have been strong partners in furthering the peace process and for the contributions they make to society in spurring job growth, economic investment, and trade throughout Ireland and beyond. What has happened--and what is happening--in Northern Ireland should serve as a model for peace and reconciliation in our world and I believe people will look back upon these times and realize how truly great the accomplishment is for humanity. I also want to recognize the Irish and Scots-Irish Americans who helped make the United States what it is today. Not only does today mark a victory for the people of Northern Ireland, today also marks the 62nd anniversary of Victory in Europe, which helped usher in peace and prosperity across Europe and the world. The movement toward lasting peace in Northern Ireland is a model for how we, as a nation, can engage the rest of the world. But the progress we are commemorating today represents a larger note of hope: peace is possible. I want to honor the leaders who now assume great responsibility to govern, heal and lead Northern Ireland into a new era. America must always stand with those working on behalf of Northern Ireland, and all people working and longing for a brighter, peaceful, more hopeful future.

Mrs. CLINTON

Mrs. CLINTON. Madam President, for many years, the FDA has been considered the gold standard among the world's drug safety bodies. And no one here doubts the desire of the agency's many career employees to continue to carry out its mission of keeping our drug supply safe for all Americans. In the legislation we are considering today, S. 1082, the Food and Drug Administration Revitalization Act, we provide these dedicated employees with the resources necessary to continue their work to ensure the safety and efficacy of drugs and biologic products for Americans. Despite the dedication of the FDA's employees, we know there have been breakdowns at the agency. We know that, at times, it has taken too long to act when a drug may pose a threat. It took many months from the point when scientists became aware of the elevated risk of adverse cardiovascular events associated with Vioxx and the point when it was withdrawn from the market, during which time the FDA had multiple opportunities to engage in stronger actions to protect consumers. In recent years, we have seen the scientific process unduly influenced by political or economic factors. When Senator Patty Murray and I worked to secure a decision for over-the-counter availability of Plan B, we saw the ways in which science-based decisionmaking was compromised. The Government Accountability Office has confirmed that the FDA's 2004 decision not to approve over-the-counter sales of Plan B was politically motivated. Concerns about undue influence from factors other than science extend beyond this one example. According to a Union of Concerned Scientists survey, 61 percent of FDA scientists could cite examples of when ``Health and Human Services or FDA political appointees have inappropriately injected themselves into FDA determinations of actions.'' Twenty percent of those responding had been ``asked explicitly by FDA decision makers to provide incomplete, inaccurate, or misleading information `` Because of these examples, I believe that the American public lost a great deal of confidence in the ability of the agency to ensure the safety of their medications. With this legislation, we can begin the process of rebuilding consumers' confidence in the FDA. Through this bill, we are taking concrete steps to improve drug safety. S. 1082 establishes steps to establish a routine active surveillance system for medications and sets up a process through which the FDA can better manage risks for a range of drugs, from requiring postmarket studies to improving communication about the risks and benefits associated with medications. In addition to establishing a framework to increase drug safety, we are also working to implement an atmosphere where science guides the agency's decisions. We need to put into place the systems to ensure that employees can engage in the open, evidence-based discourse needed as part of the drug approval and review process--discourse not unduly influenced by political concerns. This legislation goes a long way to doing some of that by increasing the transparency around drug approval decisions, addressing conflicts of interests on advisory committees, and creating a climate that protects the rights of employees to publish in peer-reviewed scientific journals. I know that many of my colleagues have raised concerns about safety in the context of reimportation of drugs, and I am pleased to note that on this legislation, we have found a way to allow for safe drug reimportation. S. 1082 contains the provisions of Senator Dorgan and Snowe's Pharmaceutical Access and Drug Safety Act, legislation I am proud to cosponsor. This amendment would establish the framework through which we could phase in drug reimportation from other nations where regulatory authority is similar to that in our country, allowing millions of Americans to safely obtain medically necessary drugs at lower cost. Americans pay higher prices for the exact same prescription drugs being taken by their counterparts in Canada and Europe. The Congressional Budget Office has found that prices for brand-name prescription drugs are 35 percent to 55 percent higher in the United States. This price disparity affects millions of Americans. Our seniors, many of whom are on fixed incomes, end up spending larger portions of their income on drugs, especially when falling into the ``doughnut hole'' or wrestling with other gaps in a Medicare Part D benefit. And this isn't only a problem for seniors--we have 46 million uninsured individuals in our country, many of whom are unable to afford prescription drugs. Without these drugs, manageable chronic conditions, like asthma or high blood pressure, spiral out of control into serious health problems. The lack of affordable drugs does not just hurt those who are uninsured or underinsured, but it also places greater pressure upon our health care system. The cost of treating someone in the emergency room is much higher than the cost of a prescription. But the way our system is set up, we don't help people engage in cost-effective disease management by making those drugs affordable, and I believe that we need to examine the ways in which importation can lower costs not only for consumers but for our overall system. The Dorgan-Snowe amendment contains many provisions that will ensure safety while giving Americans access to cheaper drugs. This bipartisan provision will allow seniors to safely access drugs from Canada starting 90 days after enactment. It will provide the needed authority and funding to the FDA to regulate foreign pharmacies and wholesalers, so that we can be sure that any drugs that enter the United States are safe for our citizens. And it will increase the consumer protections involved with internet pharmacies, so that people who don't live near the border can access imported drugs without being defrauded. We need to make drug reimportation safe, we need to make drug reimportation unambiguously legal, and we need to do so as quickly as possible. The Dorgan-Snowe amendment would allow us to do all of those things, and I would urge all of my colleagues to support this amendment to the bill. In addition to the provisions of this legislation dealing with drug safety and reimportation, I am proud to note that the Food and Drug Administration Revitalization Act has an entire title devoted to pediatric issues. I worked with Senators Dodd, Kennedy, and Enzi to craft these provisions, which will be of great benefit to children. The pediatric device provisions will help us improve the number and types of medical devices designed for pediatric populations, and the reauthorization of the Best Pharmaceuticals for Children Act improves the applicability of the pediatric exclusivity incentive and increases the speed through which these studies can be requested by the FDA. When this bill was passed in 2002, I was able to work with Senator Dodd and the HELP Committee to increase provisions to assist pediatric cancer research, and I am pleased to be a cosponsor of this legislation this time around. S. 1082 also contains most of the provisions of the Pediatric Research Improvement Act, a bill that I introduced earlier this year to reauthorize the pediatric rule. Because of this authority, the Food and Drug Administration is able to ensure that drugs that are marketed for children are safe and effective in children. For the past decade, I have been working to ensure that drugs that are marketed to children are safe and effective in children. As of the early 1990s, only about 20 percent of drugs contained specific pediatric dosing information, but since 1998, we have had over 1,000 drugs fall under the scope of the pediatric rule, resulting in hundreds of studies that have helped us gain valuable data about drugs commonly used by kids. The reauthorization of the pediatric rule contained in this larger bill will allow us to make additional strides in improving pediatric drug development. We will be able to remove unnecessary bureaucratic barriers and improve the ability of the Food and Drug Administration to require testing on already-marketed drugs when sponsors refuse to carry out such testing under the incentive provided by the Best Pharmaceuticals for Children Act. It will improve our ability to collect and analyze data about pediatric clinical trials so that we can better evaluate the impact of such trials upon children's health overall, and it will improve the FDA's ability to coordinate the incentives provided under Best Pharmaceuticals for Children Act with the pediatric rule so that these two pediatric programs of the agency can work together more seamlessly. However, I must note that I am disappointed that this bill does not consider what I believe to be a critical part of the Pediatric Research Improvement Act--the provision which would have made permanent the authority of the FDA to obtain important data through the pediatric rule. Instead, the legislation before the Senate today contains a sunset of this authority, meaning that if this provision isn't reauthorized 5 years from now, the FDA will no longer be able to ensure that drugs used in children are safe and effective in children. We would never dream of placing a sunset on the FDA's authority to certify the safety and efficacy of drugs used in adults, and I fail to understand why we impose a different standard on drugs for children, and I will seek to address this issue as the bill moves forward. We must also improve the FDA's authority in the realm of follow-on biologics. While there is nothing in the version of the legislation that is on the floor today that addresses this issue, Senators Kennedy and Enzi have made a commitment that we will mark up legislation on this issue on June 13 in the HELP Committee and that we will incorporate this legislation into the conference negotiations on this drug safety bill. Earlier this year, in conjunction with a number of bipartisan cosponsors, I introduced the Access to Life-Saving Medicine Act, legislation to provide FDA with the authority to approve safe and effective generic versions of biotech drugs. By bringing safe and effective follow-on biologics to the market, we can provide significant savings to patients, employers, and the government. More than $10 billion worth of biopharmaceuticals will come off patent in the next 5 years, and without this legislation, the manufacturers of these biotech drugs can continue to charge monopoly prices indefinitely. In 2005, the costs of biologics grew 17.5 percent compared to traditional drugs, which increased 10 percent. And in 2006, the Medicare Part B Program spent more than $5 billion on biologic drugs. It is clear that biotech drugs hold great promise, but this promise is wasted if we don't take action to ensure that all Americans have access to safe, effective, and affordable generic versions of these drugs. According to a report released by Engel and Novitt to the Pharmaceutical Care Management Association, PCMA, passage of this legislation could conservatively save an estimated $14 billion over the next 10 years. I look forward to working with Senator Kennedy and my colleagues on the HELP Committee to ensure that we enact legislation that provides the FDA with the authority and flexibility to approve biopharmaceuticals subject to a workable, abbreviated approval pathway that is efficient, effective, and scientifically grounded and that includes measures to ensure timely resolution of patent disputes, as well as adequate incentives for continued innovation. Another issue that has come up during debate on the Food and Drug Administration Revitalization Act is food safety. Recent illnesses involving E. coli in spinach and lettuce, the discovery of Salmonella in peanut butter, and the importation of unsafe pet food ingredients from China illustrate the continued vulnerability of the American food supply and expose weakness in the FDA's food safety program. In the latest case, a chemical used in plastic manufacturing was placed in feed material from China, causing the deaths of an unknown number of pets. This chemical was also consumed by 2.7 million chickens and 345 pigs that were slaughtered for human consumption. Our food system must be prepared to effectively prevent the chemicals found in these animals from endangering the health of consumers. That is why I supported the inclusion of certain provisions in this bill to begin to address many of the agency's problems with food safety, as a prelude to overall committee action on this issue. I have long been concerned about the siloing of authority at the FDA and Department of Agriculture, and I filed an amendment to this bill which would establish a joint task force between the FDA, U.S. Department of Agriculture, USDA, and the Centers for Disease Control and Prevention (CDC) to improve our response to foodborne illnesses. According to the CDC, unsafe foods cause an estimated 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths each year. Despite these statistics, safety tests for domestically produced food have dropped nearly 75 percent when compared to the number conducted in 2003. Meanwhile, the number of food imports has grown from under 4 million food import line items in 1993 to nearly 20 million in 2007. We have a situation where inspections are declining, yet the number of outbreaks and contaminations in our food supply is on the rise. The fragmentation in our food safety system must be addressed in order to protect consumers. With several of my colleagues, I have repeatedly written to the Secretary of Agriculture, the Commissioner of the FDA and the Director of the CDC urging them to create an interagency task force to better enable us to prevent such illnesses. To date, no action has been taken to grant my request. If the delay is due to concerns that these agencies do not have the authority to pursue such authority, I stand prepared, along with many others in the Senate, to provide these agencies with such authority. I look forward to working with my colleagues in the HELP Committee to address concerns about food safety and help restore our Nation's confidence in the ability of both these agencies to protect American consumers. I would like to close by noting that while the Food and Drug Administration Revitalization Act takes several steps that will improve the agency's ability to ensure the safety and effectiveness of drugs and biologics, it is time that we begin to look at drugs in a new way. It is not enough that we have drugs that are effective--in order to reduce overall health care costs, we need to understand how these drugs are effective in comparison to each other, in order to assist providers and patients make the best health care decisions. While the Vioxx controversy highlighted the need for additional safety protections, many of which are contained in the Food and Drug Administration Revitalization Act, it also demonstrates the role comparative effectiveness can play in ensuring the use of the most appropriate treatment for a specific condition. I pushed for inclusion of comparative effectiveness studies in the Medicare Modernization Act. One of the first studies to be carried out under this provision was a systematic review of osteoarthritis drugs, including Cox-2 drugs. If this information had been compiled earlier, it could have helped many evaluate whether to use these drugs, as opposed to other pain relievers, many of which are available at a lower cost without a doctor's prescription. Comparative effectiveness assists physicians and patients in selecting the best treatment and helps to reduce inappropriate uses of treatments that pose unnecessary safety risks to patients--and more and more people are recognizing its potential in improving health care. Earlier today, the Blue Cross and Blue Shield Association announced their support to create a new, independent entity to explore the effectiveness of new and existing medical procedures, drugs, devices, and biologics. I am grateful for their leadership, and I will be introducing legislation shortly to expand comparative effectiveness research and its use at the Federal level. I have been involved in the debate over the Food and Drug Administration Revitalization Act for several months now and believe that the product we have produced represents a step forward for safety. I will be supporting this legislation and look forward to working with my colleagues to ensure that we can continue to strengthen this agency, lower prescription drug costs, and maintain a strong commitment to consumer protection and scientific innovation. Amendment No. 1010