Kay Hagan

Mrs. HAGAN

Mrs. HAGAN. Mr. President, I am pleased to join this colloquy and to hear the Senator from Tennessee and the senior Senator from Arkansas work together on this issue. I think it is something of prime importance. Just as Senator Isakson went across Georgia this past week, I was in many cities and communities in North Carolina, and people are concerned, as he said, with such a low approval rating of the Congress. They are asking us: Why can't you work together? And, as the Senator from Tennessee said, when we have 47 Members in one party and 53 Members in the other party and today we need 60 votes in order to get something done, we are going to have to work together in this Chamber. That also means the Senate and the House are going to have to come together and have conferences that actually work so we can get legislation passed--in the case we are talking about right now, getting the 12 appropriations bills passed. When I was in the North Carolina Senate, I was one of the cochairs of the Budget Committee. We know how to do this. We know how to get things done. Obviously this is a much bigger piece of the pie up here, but it is important to the people throughout our country that we work together to get these bills passed. So I am very pleased to hear this debate and colloquy and the commitment we have standing here and talking about and pledging to work together. I am pleased that Senator Inouye, the chairman of this committee, and the ranking member, Senator Cochran, are putting this together and bringing this forward. I applaud both the Senator from Tennessee and the Senator from Arkansas for holding this colloquy and bringing this out so the American people can hear what we are talking about and the commitment to move forward. I thank the Chair. We are here to make this place work, to make our country work better every day. We are going to have our differences of opinion. The way the Senate is structured, we should bring the bill to the floor and offer amendments. Let's have a vote. Let's have our differences of opinion. When we don't do that, we are not doing our job. I see the Senator from South Carolina has arrived. I wish to say this to him: For the last 45 minutes, we have had a stream of Democratic and Republican Senators who have come to the floor and who have congratulated the majority leader, the Republican leader, and the chairman and the ranking member of the Appropriations Committee, for saying we should take all 12 appropriations bills this year, bring them through committee properly, have all of our hearings, do our oversight, bring them to the floor, and then let's pass them. More than that, we have said we know our leaders can't be leaders if they don't have any followers, and it is part of our job to create an environment in which they can succeed. So we have come to the floor to say that, to pledge we are going to do that. It is not just those who come tonight. We represent a preponderance of Senators on our side of the aisle and, I am told, a preponderance of the Democrats as well. I would say to the Senator from South Carolina that the Senator from Virginia, Mr. Warner, was here a little earlier and he said the exercise tonight reminded him of a volunteer fire department. I believe I first heard those words from the Senator from South Carolina. The Senator from South Carolina has seen the House of Representatives and he has seen the Senate and he has seen the condition of our country. I wish to yield to him in this colloquy for his thoughts on what we are doing here tonight.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, today I am proud to introduce the Transforming the Regulatory Environment to Accelerate Access to Treatments, TREAT, Act. This bill empowers the Food and Drug Administration to ensure consistent processes and a clear and effective pathway that will encourage the development of innovative treatments to benefit patients, particularly subpopulations and those with rare diseases, and improve the public health. Without question, the FDA plays a critical role in helping to ensure that new medicines are safe and effective. At the same time, by promoting investment in and development of innovative treatments for unmet medical needs, the FDA can positively influence our national strategy to identify and treat serious and life-threatening diseases and improve the quality of life for millions of Americans. In order for FDA to accomplish this goal, however, Congress needs to give the agency the tools necessary to transcend existing barriers, reform its processes, and provide greater clarity, consistency, and transparency to industry. The bill accomplishes this in three ways. First, it provides the FDA with the authorities and tools that are reflective of the agency's responsibilities and that are necessary to ensure maximum operational excellence by updating FDA's mission statement and creating a management review board. Second, it advances regulatory science and innovation within FDA to ensure that evaluations of innovative treatments, therapies, and diagnostics are conducted by those who have the best available knowledge. To do this, the bill creates a chief innovation officer and chief medical policy officers, and expands participation on advisory committees by those experts most familiar with the disease being considered. Finally, the bill promotes the utilization of modern scientific tools and methodologies to ensure patients have timely access to innovative products by creating a clinical informatics coordinator, providing more information to drug sponsors when an application has not been approved, and enhancing and codifying the accelerated approval process. In the nearly 2 decades since the accelerated approval mechanism was established by FDA to more expeditiously approve treatments, advances in medical sciences, including genomics, molecular biology, and bioinformatics, have provided scientists with an unprecedented understanding of the underlying biological mechanisms and pathogenesis of disease. A new generation of modern, targeted, personalized medicines is currently under development to treat serious and life-threatening diseases. Some apply drug development strategies based on biomarkers or pharmacogenomics, predictive toxicology, clinical trial enrichment techniques, and novel clinical trial designs, such as adaptive clinical trials that can be altered based on observed patient outcomes in the interim. In order to ensure these scientific advances are translated into treatments that benefit patients, Congress should allow FDA to implement a more effective process for the expedited development and review of innovative new medicines intended to address unmet medical needs for serious or life-threatening diseases or conditions. FDA is already doing this, to some extent. However, application of the accelerated approval process has been somewhat limited, largely to HIV and oncology drugs, and inconsistently applied to other disease targets. For example, a 2011 report by the National Organization for Rare Disorders compared the approval process for 135 non-cancer orphan therapies approved by FDA from 1983 through June 2010. The report found that 45 went through the conventional approval process; 32 were approved with some sort of administrative flexibility; and 58 were approved on a case-by-case flexibility process. This report illustrates that while FDA does have the authority to approve these treatments with some flexibility, there does not appear to be uniformity or consistency in employing this flexibility. The TREAT Act allows FDA to tap into modern scientific advances by using a broad range of surrogate or clinical endpoints and modern scientific tools earlier in the drug development cycle, when appropriate, to approve treatments for patients. Employing these modern scientific tools may result in fewer, smaller, or shorter clinical trials for the intended patient population or targeted subpopulation without compromising or altering FDA's existing high standards for the approval of drugs. It is the patients suffering from these serious and life-threatening diseases that benefit from expedited access to safe and effective innovative therapies. For the 30 million Americans living with rare diseases, new advances in science and medicine cannot come fast enough. That is why I am proud that this bill has the support of the National Organization for Rare Disorders (NORD) and Friends of Cancer Research. The TREAT Act provides FDA with the tools needed to modernize its processes and encourage the development of innovative products to benefit patients, particularly subpopulations and those with rare diseases. I urge my other colleagues to join us in supporting this important bill.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, today I am proud to introduce the Transforming the Regulatory Environment to Accelerate Access to Treatments, TREAT, Act. This bill empowers the Food and Drug Administration to ensure consistent processes and a clear and effective pathway that will encourage the development of innovative treatments to benefit patients, particularly subpopulations and those with rare diseases, and improve the public health. Without question, the FDA plays a critical role in helping to ensure that new medicines are safe and effective. At the same time, by promoting investment in and development of innovative treatments for unmet medical needs, the FDA can positively influence our national strategy to identify and treat serious and life-threatening diseases and improve the quality of life for millions of Americans. In order for FDA to accomplish this goal, however, Congress needs to give the agency the tools necessary to transcend existing barriers, reform its processes, and provide greater clarity, consistency, and transparency to industry. The bill accomplishes this in three ways. First, it provides the FDA with the authorities and tools that are reflective of the agency's responsibilities and that are necessary to ensure maximum operational excellence by updating FDA's mission statement and creating a management review board. Second, it advances regulatory science and innovation within FDA to ensure that evaluations of innovative treatments, therapies, and diagnostics are conducted by those who have the best available knowledge. To do this, the bill creates a chief innovation officer and chief medical policy officers, and expands participation on advisory committees by those experts most familiar with the disease being considered. Finally, the bill promotes the utilization of modern scientific tools and methodologies to ensure patients have timely access to innovative products by creating a clinical informatics coordinator, providing more information to drug sponsors when an application has not been approved, and enhancing and codifying the accelerated approval process. In the nearly 2 decades since the accelerated approval mechanism was established by FDA to more expeditiously approve treatments, advances in medical sciences, including genomics, molecular biology, and bioinformatics, have provided scientists with an unprecedented understanding of the underlying biological mechanisms and pathogenesis of disease. A new generation of modern, targeted, personalized medicines is currently under development to treat serious and life-threatening diseases. Some apply drug development strategies based on biomarkers or pharmacogenomics, predictive toxicology, clinical trial enrichment techniques, and novel clinical trial designs, such as adaptive clinical trials that can be altered based on observed patient outcomes in the interim. In order to ensure these scientific advances are translated into treatments that benefit patients, Congress should allow FDA to implement a more effective process for the expedited development and review of innovative new medicines intended to address unmet medical needs for serious or life-threatening diseases or conditions. FDA is already doing this, to some extent. However, application of the accelerated approval process has been somewhat limited, largely to HIV and oncology drugs, and inconsistently applied to other disease targets. For example, a 2011 report by the National Organization for Rare Disorders compared the approval process for 135 non-cancer orphan therapies approved by FDA from 1983 through June 2010. The report found that 45 went through the conventional approval process; 32 were approved with some sort of administrative flexibility; and 58 were approved on a case-by-case flexibility process. This report illustrates that while FDA does have the authority to approve these treatments with some flexibility, there does not appear to be uniformity or consistency in employing this flexibility. The TREAT Act allows FDA to tap into modern scientific advances by using a broad range of surrogate or clinical endpoints and modern scientific tools earlier in the drug development cycle, when appropriate, to approve treatments for patients. Employing these modern scientific tools may result in fewer, smaller, or shorter clinical trials for the intended patient population or targeted subpopulation without compromising or altering FDA's existing high standards for the approval of drugs. It is the patients suffering from these serious and life-threatening diseases that benefit from expedited access to safe and effective innovative therapies. For the 30 million Americans living with rare diseases, new advances in science and medicine cannot come fast enough. That is why I am proud that this bill has the support of the National Organization for Rare Disorders (NORD) and Friends of Cancer Research. The TREAT Act provides FDA with the tools needed to modernize its processes and encourage the development of innovative products to benefit patients, particularly subpopulations and those with rare diseases. I urge my other colleagues to join us in supporting this important bill.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, I ask unanimous consent that all time in the quorum call be divided equally.

Mrs. HAGAN. Mr. President, I suggest the absence of a quorum.

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

Mrs. HAGAN. Mr. President, I wish to thank the chairman and the ranking member for allowing this colloquy to take place. I also wish to state that I believe the Senator from Oklahoma laid out a little bit of the groundwork of what we are discussing now. I rise to discuss the depot maintenance issues associated with the House-adopted language in the conference. We must avoid doing anything that may upset the existing balance between DOD's internal depots, logistic centers, arsenals and specialty facilities, and the industrial base. The House-adopted provision can disrupt that delicate balance and have unintended consequences. We just don't know who may be impacted. We need time to get this right, and we need to ensure a transparent process in which all stakeholders can make their position known to Members of Congress. The sensitivity associated with maintenance workload is at an all- time high. Disrupting the balance of depot-level maintenance comes at a time when our economy is struggling and when DOD is consolidating depot source-of-repair work for current and emerging weapons systems. Additionally, prematurely disrupting the readiness of our weapons systems fleet is not an option, especially with the operational tempo of our military. It is critically important to preserve the capability and competencies of DOD's internal depot-level maintenance facilities while also sustaining the defense industrial base in order to preserve our technological advantages and readiness on the battlefield. Both face considerable challenges within a fiscally constrained environment. Both the depots and the defense industrial base are reshaping and restructuring their operations in anticipation of this. As our military said, ``It's one team, one fight.'' The research, development, and manufacturing communities within DOD, as well as in our universities, small businesses, and large corporations, are essential partners in our national security. That being said, we need to acknowledge the fragile nature of DOD's depot-level maintenance facilities and the defense supply chain within a heavily consolidated defense industrial sector. Our country simply cannot lose skilled manufacturing research and development expertise to global competitors. Congress needs to do our due diligence to address the concerns of DOD's internal base involving maintenance, repair, and overhaul of the military equipment. At the same time, we need to facilitate public- private partnerships and healthy competition that will be mutually beneficial to the Department and the industrial base. I know my colleagues are concerned about the impact this language may have in their States. I wish to highlight Fleet Readiness Center-East in North Carolina. Reducing FRC-East's workload is not an option. It would negatively impact the quality and cost-effective maintenance and logistics support for Navy and Marine Corps aviation. The operational readiness and availability of deployable Navy and Marine Corps aircraft would be undermined without preserving FRC-East's capabilities. I certainly understand the incredible pressure the chairman and the ranking member were under trying to resolve hundreds of issues in conference over a very short period of time, and I certainly do appreciate their willingness to engage members of the committee and other interested stakeholders in a more comprehensive process next year so we can be sure we get this right. Thank you, Mr. President. I yield the floor to the Senator from Alabama.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, today I am proud to introduce the March of Dimes Commemorative Coin Act. For almost 75 years, the March of Dimes has fought to combat and prevent diseases that strike our youngest children, while also supporting mothers-to-be and families with infants in intensive care. The March of Dimes was founded in 1938 by President Franklin Roosevelt as the National Foundation for Infantile Paralysis, at a time when polio was on the rise. The Foundation established a polio patient aid program and funded research for vaccines developed by Jonas Salk, MD, and Albert Sabin, MD. These vaccines effectively ended epidemic polio in the United States. Today one in 33 babies born in the United States is affected by a birth defect, and tragically, more than 5,500 infants die every year because of a birth defect. Moreover, an additional 500,000 children are diagnosed with developmental disabilities each year. Almost 13 percent of babies born in America are born prematurely--an increase of 36 percent since the early 1980s. In 2003, the March of Dimes took on the cause of reducing the number of infants who are born prematurely. And thanks to the great work of the March of Dimes and others, after three decades of increase, the pre-term birth rate has now dropped for the third year in a row. You would be hard pressed to find someone today who doesn't have a friend, a family member, a neighbor or a coworker who's had a baby born prematurely or born with some kind of birth defect. A month ago, I had the pleasure of meeting the 2011 March of Dimes National Ambassador: Lauren Fleming, and her parents, Nikki and Densel from Marvin, NC. Lauren was born three and a half months early and weighed just 2 pounds, 1 ounce. She spent the first 5 months of her life in the intensive care unit, being treated for respiratory distress and undergoing multiple surgeries. In part, because of the research and support provided by the March of Dimes, Lauren is now an adorable, vivacious 7-year old, and a hero to young children and their families throughout the country. Although some progress has been made over the past several decades on reducing and preventing birth defects and prematurity, we need organizations such as the March of Dimes to continue to push for more research, more innovation and more prevention efforts. The March of Dimes makes a difference. By investing millions of dollars to study premature births, birth defects, and infant mortality, including $5.6 million in North Carolina over the past 5 years, the March of Dimes is helping to ensure that we can reduce these occurrences. But we can do more. That is why today I am introducing the March of Dimes Commemorative Coin Act of 2011. This bill would mint coins in recognition and celebration of the March of Dimes' 75 anniversary in 2014. Proceeds from the commemorative coin will be used to support the March of Dimes' Prematurity Campaign, an intensive multi-year campaign to raise awareness among health professionals and the general public and find the causes of prematurity. Not only will the Commemorative Coin raise awareness of the March of Dimes' efforts, but it will also help raise more funding for their efforts. I cannot think of a more appropriate way to honor the March of Dimes than to mint actual ``dimes'' celebrating their work. I want to thank my Republican colleague, Senator Susan Collins, as well as Senators Schumer, Kirk, and Akaka for joining me in cosponsoring this measure. I urge my other colleagues to join us in supporting this important bill.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, today I am proud to introduce the March of Dimes Commemorative Coin Act. For almost 75 years, the March of Dimes has fought to combat and prevent diseases that strike our youngest children, while also supporting mothers-to-be and families with infants in intensive care. The March of Dimes was founded in 1938 by President Franklin Roosevelt as the National Foundation for Infantile Paralysis, at a time when polio was on the rise. The Foundation established a polio patient aid program and funded research for vaccines developed by Jonas Salk, MD, and Albert Sabin, MD. These vaccines effectively ended epidemic polio in the United States. Today one in 33 babies born in the United States is affected by a birth defect, and tragically, more than 5,500 infants die every year because of a birth defect. Moreover, an additional 500,000 children are diagnosed with developmental disabilities each year. Almost 13 percent of babies born in America are born prematurely--an increase of 36 percent since the early 1980s. In 2003, the March of Dimes took on the cause of reducing the number of infants who are born prematurely. And thanks to the great work of the March of Dimes and others, after three decades of increase, the pre-term birth rate has now dropped for the third year in a row. You would be hard pressed to find someone today who doesn't have a friend, a family member, a neighbor or a coworker who's had a baby born prematurely or born with some kind of birth defect. A month ago, I had the pleasure of meeting the 2011 March of Dimes National Ambassador: Lauren Fleming, and her parents, Nikki and Densel from Marvin, NC. Lauren was born three and a half months early and weighed just 2 pounds, 1 ounce. She spent the first 5 months of her life in the intensive care unit, being treated for respiratory distress and undergoing multiple surgeries. In part, because of the research and support provided by the March of Dimes, Lauren is now an adorable, vivacious 7-year old, and a hero to young children and their families throughout the country. Although some progress has been made over the past several decades on reducing and preventing birth defects and prematurity, we need organizations such as the March of Dimes to continue to push for more research, more innovation and more prevention efforts. The March of Dimes makes a difference. By investing millions of dollars to study premature births, birth defects, and infant mortality, including $5.6 million in North Carolina over the past 5 years, the March of Dimes is helping to ensure that we can reduce these occurrences. But we can do more. That is why today I am introducing the March of Dimes Commemorative Coin Act of 2011. This bill would mint coins in recognition and celebration of the March of Dimes' 75 anniversary in 2014. Proceeds from the commemorative coin will be used to support the March of Dimes' Prematurity Campaign, an intensive multi-year campaign to raise awareness among health professionals and the general public and find the causes of prematurity. Not only will the Commemorative Coin raise awareness of the March of Dimes' efforts, but it will also help raise more funding for their efforts. I cannot think of a more appropriate way to honor the March of Dimes than to mint actual ``dimes'' celebrating their work. I want to thank my Republican colleague, Senator Susan Collins, as well as Senators Schumer, Kirk, and Akaka for joining me in cosponsoring this measure. I urge my other colleagues to join us in supporting this important bill.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, today I wish to recognize the dedication and selfless service of the Montford Point Marines. The Montford Point Marines were the first African-American men to serve in the U.S. Marine Corps after President Franklin Roosevelt issued Executive Order No. 8802 on June 25, 1941. This brave group of men were trained at Camp Montford Point, near the New River in Jacksonville, NC. In total, 19,168 African-American marines received training at Montford Point between 1942 and 1949. Many of these ``Montford Marines'' went on to serve in the Pacific Theatre Campaign of World War II--at Iwo Jima, Saipan, Okinawa--as well as in Korea and in Vietnam. Although these men served our country with both honor and distinction, they often faced adversity and racism during their time in uniform. Despite their training, they were prohibited from serving in combat units--working instead in the service and supply units. They were not afforded opportunities other marines enjoyed, such as entering nearby Camp Lejeune, without a White counterpart to escort them. The courage and dedication with which these brave men served our country despite these challenges is nothing less than heroic. As the first African Americans in our Marine Corps, they join the Tuskegee Airmen of the Air Force and the Buffalo Soldiers of the Army as heroes who not only forged a new path within our armed services but who brought our country closer to our ideals that ``all men are created equal.'' Many Americans credit the historic firsts--such as Howard P. Perry of Charlotte, NC--who was the first African-American marine private to set foot on Montford Point, and Frederick C. Branch, the first African-American marine second lieutenant at the Marine Base in Quantico, VA--for creating the opportunity they have to serve today. The time has come for us to give these American heroes their long overdue recognition by awarding them the Congressional Gold Medal, the highest civilian award in the United States. I congratulate my colleagues for unanimously passing this legislation on November 9, 2011. It is my personal honor and privilege to recognize the Montford Point Marines.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, I was unavoidably detained for rollcall vote No. 204, passage of H.R. 674 as amended. This legislation repeals the imposition of 3 percent withholding on certain payments made to vendors by government agencies. It also includes an amendment I supported to provide our veterans with greater job opportunities in today's difficult economy. Had I been present for rollcall vote No. 204, I would have voted yea on final passage.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, I stand today, just 2 days away from Veterans Day, to urge my colleagues to support our courageous service men and women, our veterans and their families, by voting for the VOW to Hire Heroes Act of 2011. This legislation would have a tremendous impact on every part of our country, but it would be especially significant in my home State of North Carolina, the most military- friendly State in the Nation. In North Carolina we are blessed to be home to so many of our country's heroes. I don't think most people understand that nationwide military servicemembers account for only 1 percent of our country's population. But in North Carolina, more than one-third of our population is either in the military, is a veteran, or has an immediate family member who is in the military or is a veteran. Over 700,000 veterans call North Carolina home. I know that makes our State stronger. I know because, like so many North Carolinians, I too come from a strong military family that instilled in me a sense of responsibility to my community and to my country. My husband, my father, my brother are all Navy veterans. My father-in-law was a two-star general in the Marine Corps, and my two nephews have both served in Iraq and Afghanistan. I know because I have traveled my State's eight military bases from Fort Bragg to Cherry Point to Camp Lejeune to bases in Iraq, Afghanistan, and Kuwait. I have seen up close the incredible demands placed on our military and the remarkable bravery and patriotism they exhibit each and every day. I know because whether I am meeting a general, a young private, a wounded warrior, or a 90-year-old veteran traveling on one of the Flights of Honor that bring our World War II veterans to DC to see their monuments, there are certain qualities that I always recognize in those who serve in the Armed Forces. These are selflessness, personal integrity, and an unmatched work ethic and unwavering courage. I take it personally as a Senator from North Carolina, as well as a proud daughter, wife, and sister of a veteran when our military members and their families are hurting. I take it personally when this country of ours does not live up to the promises we make to our service men and women. Right now our military families are unquestionably hurting. Right now we have lapsed in our commitment to our heroes. As has been said many times on this floor, the unemployment rate among Iraq and Afghanistan war veterans is an unconscionably high 12.1 percent. That is more than 3 percentage points higher than the national average unemployment. That is about a quarter of a million men and women, all of whom have put their lives on the line to protect our country, who are now struggling just to earn a paycheck--240,000 heroes with irreplaceable skill sets and experience who cannot find a job. We cannot forget that every unemployed veteran has a family, a family who has likely spent untold sleepless nights worrying if their loved one is safe. Now, after years of selfless service, these families are forced to worry if they can pay their monthly bills, if they can even afford to keep their homes. According to HUD's 2010 Annual Homeless Assessment Report, more than 1,000 North Carolina veterans are homeless and spend every night without a roof over their head. That is simply 1,000 too many. This is not a fate that we can accept for our veterans. This is not the country we strive to be. We need to support our veterans when they make the transition from the military to the civilian workforce. We need to provide them with the training and resources they need to transfer those skills to the private sector. We need to encourage our business owners to employ some of our country's most highly trained, highly ambitious, and highly motivated individuals. The VOW to Hire Heroes Act does just that. It provides a tax credit of up to $5,600 for hiring veterans. For our wounded warriors it includes a tax credit of up to $9,600--for hiring veterans with service-connected disabilities. It requires our service men and women transitioning to the civilian workforce to participate in the Transition Assistance Program, which provides services such as resume writing workshops and career counseling to help these individuals land the jobs that are available. It expands education and training opportunities at our community colleges and technical schools for 100,000 unemployed veterans who served prior to September 11. I am pleased to say that some provisions of this legislation are very similar to a bipartisan bill that Senator Scott Brown and I introduced earlier this year. The priorities this legislation focuses on are not Democratic priorities. They are not Republican priorities. Supporting our veterans is and has always been an American priority. We owe it to them, but we also owe it to our future. I hope many saw the August cover story in Time magazine that described our veterans returning from Iraq and Afghanistan as ``the next greatest generation.'' If you have not read it, I highly encourage you to do so. The author, Joe Klein, whom I met on a military transport plane in Afghanistan, spent the past 5 years visiting with Iraq and Afghanistan veterans across the country, including two best friends he met from North Carolina. These friends, Dale Beatty and John Gallina, whom I met last year in Charlotte, joined the North Carolina National Guard together, deployed to Iraq together, and nearly died together when their humvee was blown up by an antitank mine. Dale lost both his legs and John suffered a traumatic brain injury. When a local homebuilders association offered to build Dale a home, Dale and John were both inspired to assist other handicapped veterans. Today their nonprofit Purple Heart Homes, headquartered in Statesville, NC, helps build and adapt homes for service-disabled veterans. Dale and John represent, as ADM Mike Mullen said, ``part of a generation who is flat out wired to contribute, flat out wired to serve.'' As GEN David Petraeus told Time magazine, our veterans ``have had to show incredible flexibility, never knowing whether they're going to be greeted with a handshake or hand grenade. They've been exposed to experiences that are totally unique. . . . I believe they are our next great generation of leaders.'' There are many more Dale Beattys and John Gallinas out there, but we cannot leave our next great generation of leaders standing in an unemployment line. We must come together and fight for our veterans and their families just as hard as they have fought for our freedoms. We must pass the VOW to Hire Heroes Act. I suggest the absence of a quorum.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, today I am proud to introduce the Violence Against Women Health Initiative. October is Domestic Violence Awareness month, and this bill will raise awareness of domestic violence among health care providers and allow them to better assess and treat survivors of domestic violence. The rates of violence and abuse in this country are astounding. Nearly one in four women in the U.S. has reported experiencing domestic violence at some point in her life. In 2007, there were 248,300 reported incidents of sexual assault in the U.S. Young women experience the highest rates of sexual assault and stalking. Sadly, 15.5 million children in the U.S. live in families in which partner violence has occurred in the past year, and 7 million children live in families in which severe partner violence has occurred. Domestic violence has a significant impact on our country's health. According to the Centers for Disease Control and Prevention, CDC, intimate partner violence costs the health care system over $8.3 billion annually. In addition to injuries sustained during violent episodes, survivors suffer lifelong health complications. Research published in the journal of Women's Health in 2007 found that women who are victimized by violence have 17 percent more primary care doctor visits, 14 percent more specialist visits, and 27 percent more prescription refills than non-abused women. Physical and psychological abuse are linked to a number of adverse physical health effects. A study released in 2010 that compared victims with never-abused women found abuse victims had an approximately six- fold increase in clinically-identified substance abuse, a more than three-fold increase in depression diagnoses, a three-fold increase in sexually transmitted diseases, and a two-fold increase in lacerations. But it is not just the spouse who suffers these lifelong consequences. It is their children, too. Children who witness domestic violence are more likely to exhibit behavioral and physical health problems, including depression, anxiety, and violence towards peers. They are also more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution, and commit sexual assault crimes. Fifty percent of men who frequently assault their wives also frequently assault their children, and the U.S. Advisory Board on Child Abuse and Neglect suggests that domestic violence may be the single major precursor to child abuse and neglect fatalities in this country. Without question, we must tackle the underlying causes of domestic violence and abuse in this country. At the same time, we must strengthen our health care response to this abuse. Despite the commitment of health care providers to help domestic violence victims, a critical gap remains in the delivery of health care to victims. Health care providers often only address immediate injuries, without tackling the underlying cause of those injuries. For example, each year, about 324,000 pregnant women in this country are battered by their intimate partners. However, few physicians screen pregnant patients for abuse. This highlights the need to ensure that health care providers have the necessary training and support in order to assess, refer, and support victims of domestic and sexual violence. Victims know and trust their health care providers. Almost 3/4 of survivors say that they would like their health care providers to ask them about violence and abuse. Multiple clinical studies have shown that short interventions in the medical environment protect the health and safety of women. These interventions are short between 2 and 10 minutes, and effective. In repeated clinical trials, violence decreased and health status improved following simple assessment and referral protocols. Integrating these effective protocols into our health care system will save lives. This is why routine assessments for intimate partner violence have been recommended for health care settings by the American Medical Association, American Psychological Association, American Nurses Association, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and the Joint Commission on the Accreditation of Health Care Organizations. Since its passage in 1994, the Violence Against Women Act, VAWA, has transformed our criminal justice system and social service system, helping to prevent and respond to domestic violence. The last reauthorization of VAWA, set to expire this year, included a new title authorizing three programs that support the health system's efforts to help victims, preventing further abuse and improving the health status of women. The bill I am introducing today will continue those important efforts. This bill would consolidate the three existing health programs into one program, while increasing evaluation and accountability. Specifically, this bill would foster public health responses to intimate partner violence and sexual violence; provide training and education of health professionals to respond to violence and abuse; and support research on effective public health approaches to end violence against women. I urge my colleagues to join us in supporting this important bill.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, today I am proud to introduce the Violence Against Women Health Initiative. October is Domestic Violence Awareness month, and this bill will raise awareness of domestic violence among health care providers and allow them to better assess and treat survivors of domestic violence. The rates of violence and abuse in this country are astounding. Nearly one in four women in the U.S. has reported experiencing domestic violence at some point in her life. In 2007, there were 248,300 reported incidents of sexual assault in the U.S. Young women experience the highest rates of sexual assault and stalking. Sadly, 15.5 million children in the U.S. live in families in which partner violence has occurred in the past year, and 7 million children live in families in which severe partner violence has occurred. Domestic violence has a significant impact on our country's health. According to the Centers for Disease Control and Prevention, CDC, intimate partner violence costs the health care system over $8.3 billion annually. In addition to injuries sustained during violent episodes, survivors suffer lifelong health complications. Research published in the journal of Women's Health in 2007 found that women who are victimized by violence have 17 percent more primary care doctor visits, 14 percent more specialist visits, and 27 percent more prescription refills than non-abused women. Physical and psychological abuse are linked to a number of adverse physical health effects. A study released in 2010 that compared victims with never-abused women found abuse victims had an approximately six- fold increase in clinically-identified substance abuse, a more than three-fold increase in depression diagnoses, a three-fold increase in sexually transmitted diseases, and a two-fold increase in lacerations. But it is not just the spouse who suffers these lifelong consequences. It is their children, too. Children who witness domestic violence are more likely to exhibit behavioral and physical health problems, including depression, anxiety, and violence towards peers. They are also more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution, and commit sexual assault crimes. Fifty percent of men who frequently assault their wives also frequently assault their children, and the U.S. Advisory Board on Child Abuse and Neglect suggests that domestic violence may be the single major precursor to child abuse and neglect fatalities in this country. Without question, we must tackle the underlying causes of domestic violence and abuse in this country. At the same time, we must strengthen our health care response to this abuse. Despite the commitment of health care providers to help domestic violence victims, a critical gap remains in the delivery of health care to victims. Health care providers often only address immediate injuries, without tackling the underlying cause of those injuries. For example, each year, about 324,000 pregnant women in this country are battered by their intimate partners. However, few physicians screen pregnant patients for abuse. This highlights the need to ensure that health care providers have the necessary training and support in order to assess, refer, and support victims of domestic and sexual violence. Victims know and trust their health care providers. Almost 3/4 of survivors say that they would like their health care providers to ask them about violence and abuse. Multiple clinical studies have shown that short interventions in the medical environment protect the health and safety of women. These interventions are short between 2 and 10 minutes, and effective. In repeated clinical trials, violence decreased and health status improved following simple assessment and referral protocols. Integrating these effective protocols into our health care system will save lives. This is why routine assessments for intimate partner violence have been recommended for health care settings by the American Medical Association, American Psychological Association, American Nurses Association, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and the Joint Commission on the Accreditation of Health Care Organizations. Since its passage in 1994, the Violence Against Women Act, VAWA, has transformed our criminal justice system and social service system, helping to prevent and respond to domestic violence. The last reauthorization of VAWA, set to expire this year, included a new title authorizing three programs that support the health system's efforts to help victims, preventing further abuse and improving the health status of women. The bill I am introducing today will continue those important efforts. This bill would consolidate the three existing health programs into one program, while increasing evaluation and accountability. Specifically, this bill would foster public health responses to intimate partner violence and sexual violence; provide training and education of health professionals to respond to violence and abuse; and support research on effective public health approaches to end violence against women. I urge my colleagues to join us in supporting this important bill.

Mrs. HAGAN

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

Mrs. HAGAN. Madam President, I come to the floor as one of a bipartisan group of my colleagues, proud to be a cosponsor of the Currency Exchange Rate Oversight Act, legislation that will send a clear and direct message to China that the time for playing games with American jobs is over. As many of my colleagues have already explained on the floor, the effects of China's currency manipulation are damaging to our economy. It is estimated that China is undervaluing their yuan by more than 28 percent. What does that mean? It means Chinese goods coming into the United States are unfairly cheap, while goods made in the United States are unfairly expensive when they are exported to China. In other words, it means U.S. goods are less competitive in China, and Chinese goods do have an unfair advantage in the United States. The results of this distorted arrangement are harrowing: reduced American wages, decreased GDP, and lost American jobs. Since China entered the World Trade Organization in 2001, our trade deficit with them went from $84 billion in 2001 to $273 billion in 2010, an increase of close to $200 billion. Madam President, $273 billion is larger than the U.S. trade deficit with the OPEC countries, the EU countries, Canada, Japan, and Mexico combined. This trade deficit has eliminated or displaced over 2.8 million American jobs over the last 10 years. That is an average of 310,000 jobs every year, and 70 percent of those jobs lost from our trade with China were in one sector--manufacturing. Ask anyone in my home State, and they will say the same thing: North Carolina is a manufacturing State. From furniture to yarn, we are known throughout the country and throughout the world for the quality of the work we produce. But we are hurting. Between 2001 and 2010, North Carolina has lost over 107,000 jobs. Those are 107,000 jobs due to trade with China. Only five States in the entire country have suffered a greater net job loss from our country's trade with China. Across the country, the Nation has lost approximately 6 million manufacturing jobs and has seen 57,000 manufacturing plants across our country shut down. Last week, I traveled throughout the foothill regions in North Carolina, in Burke, Rutherford, and Gaston Counties, three of our counties with some of the deepest manufacturing and textile roots in the State. The unemployment rate in these counties is close to 13 percent in Burke, close to 15 percent in Rutherford, and 11.3 percent in Gaston, even higher than the all-too-high 10.4 percent average across the State of North Carolina. The No. 1, No. 2, and No. 3 concerns I heard at every stop I made last week were: jobs, jobs, jobs. There were people, many of them former manufacturing employees, who have lost their jobs. Many of them are continuing to work hard, fighting for small businesses that they now run and looking for survival. At the same time, so many people are attending every job fair they can make. They cannot afford for Washington to continue to allow China to get away with economic deceit and manipulation. They cannot afford for us to continue competing with China with one hand tied behind our back. What they need is for Washington to draw a hard line, to act now, and to get tough on China's currency manipulation. The Currency Exchange Rate Oversight Act is straightforward. If the Treasury Department, using objective criteria, determines that the value of a currency is fundamentally misaligned, it will trigger a process to correct that unfair misalignment. In other words, it allows the United States to use every tool in our toolbox, including countervailing duties, to ensure that American workers and companies are competing on a level playing field. Even though the legislation is simple, its positive effects would ripple through the economy.

Mrs. HAGAN. I ask for 2 more minutes.

Mrs. HAGAN. I thank you, Madam President. A full revaluation of the yuan would mean 2.25 million jobs in the United States, reducing the U.S. unemployment rate by at least 1 full percentage point; an increase of the U.S. GDP of about $285 billion, a nearly 2-percent boost; and a reduction to our budget deficit by as much as $857 billion over 10 years. These are new jobs, more growth, and lower deficits. That is exactly the kind of bill our country needs right now. It is going to require us to be tough. That is why America's workers and North Carolina workers need us to draw this line in the sand. They have always been told that if they work hard and play by the rules, they can get ahead. But now China is not playing by the rules, and it is undermining the ability of our workers and companies to succeed. We need to hold them accountable. American and North Carolina workers are some of the best and most productive in the world. We know this. China knows this. If we compete on a level playing field, we can prosper together. I encourage all my colleagues to join in this bipartisan measure and vote for this bill. It is what America's workers and companies need, and it is what they deserve. I yield the floor.

Mrs. HAGAN

Mrs. HAGAN. Mr. President, I ask unanimous consent that the Committee on Banking, Housing, and Urban Affairs' Subcommittee on Economic Policy be authorized to meet during the session of the Senate on October 5, 2011, at 10 a.m., to conduct a hearing entitled ``Consumer Protection and Middle Class Wealth Building in an Age of Growing Household Debt.''

Mrs. HAGAN. Mr. President, I ask unanimous consent that the Ad Hoc Subcommittee on Contracting Oversight of the Committee on Homeland Security and Governmental Affairs be authorized to meet during the session of the Senate on October 5, 2011, at 2 p.m. to conduct a hearing entitled ``Food Service Management Contracts: Are Contractors Overcharging the Government?''

Mrs. HAGAN. Mr. President, I ask unanimous consent that the Committee on Commerce, Science, and Transportation be authorized to meet during the session of the Senate on October 5, 2011.

Mrs. HAGAN. Mr. President, I ask unanimous consent that the Committee on Foreign Relations be authorized to meet during the session of the Senate on October 5, 2011, at 10 a.m.

Mrs. HAGAN. Mr. President, I ask unanimous consent that the Committee on Homeland Security and Governmental Affairs be authorized to meet during the session of the Senate on October 5, 2011, at 10 a.m.

Mrs. HAGAN. Mr. President, I ask unanimous consent that the Committee on the Judiciary be authorized to meet during the session of the Senate on October 5, 2011, at 2:30 p.m., in room SH-216 of the Hart Senate Office Building, to conduct a hearing entitled ``Considering the Role of Judges Under the Constitution of the United States.''