Barbara Mikulski

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to introduce the National Great Black Americans Commemoration Act. I am proud to sponsor this legislation. Black Americans have a rich history that must be cherished and remembered. This bill will honor African American leaders from across the country--some who are well known, and others who are almost forgotten--by helping to preserve their names, faces, and stories for generations to come. This legislation will provide Federal assistance to expand exhibits and educational programs at the National Great Blacks in Wax Museum and Justice Learning Center in Baltimore, Maryland. The museum showcases the lives of great Black Americans who have proudly served the United States--from civil servants like Mary McLeod Bethune, to military heroes like Colin Powell, to Congressional leaders like Senator Edward Brooke, R-MA, and civil rights leaders like Rosa Parks. Some are household names, like Frederick Douglass and Dr. Martin Luther King, Jr. Yet many more are unfamiliar, like the 22 African Americans who served in Congress in the 1800s. It's time we give these pioneers the recognition they deserve. Maryland is proud to be home to so many important figures in black history. From the dark days of slavery through the civil rights movement, Marylanders have led the way. The brilliant Frederick Douglass was the voice of the voiceless in the struggle against slavery. The courageous Harriet Tubman delivered 300 slaves to freedom on the Underground Railroad. The great Thurgood Marshall argued the Brown v. Board of Education Case before the Supreme Court, and later became a Supreme Court Justice himself. Maryland is home to contemporary leaders, too. The dynamic Kweisi Mfume, president of the NAACP, who, like me, came out of the Baltimore City Council. The passionate Elijah Cummings, Chair of the Congressional Black Caucus. Clarence Mitchell who was called by many the 101st Senator. Parren Mitchell and Al Wynn, fighting for their constituents. And all the members of the NAACP, which calls Baltimore home. It is fitting that the national Great Blacks in Wax Museum and Justice Learning Center also calls Baltimore home. The museum and learning center is a popular and respected black history museum. Approximately 300,000 people a year from around the country and the world visit the museum. Many are school children, who can see historical figures come to life in the museum's exhibits. Expansion will allow the museum to teach even more visitors about the important contributions of Black Americans. It will also help revitalize a poor neighborhood in East Baltimore. There will be new jobs. There will be more tourists. There will be new small businesses. And most important, there will be new inspiration for our young people. The State of Maryland and City of Baltimore have already contributed over $5 million toward this expansion project. Private donors are contributing too. Now it's time for the Federal Government to do its part. Let's help make this museum a treasure for the entire Nation. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MIKULSKI

Ms. MIKULSKI. I thank the Chair, and, Mr. President, I thank my colleagues for their courtesy, particularly Senator Dorgan. I am very appreciative. Mr. President, seniors are facing a crisis, and it is caused by the high cost of prescription drugs. For so many years, Congress has talked about prescription drugs in Medicare. Let me tell you what my seniors say: Talk, talk, talk. They are fed up with our talk, and they want us to take action. They tell me: You can't talk yourself out of high cholesterol; you need Lipitor. You can't talk your way out of diabetes; you need insulin. The problem with the Senate, they say, is when all gets said and done, more gets said than gets done. The time for talking is over, and we need to listen to the seniors, to business, and we need to act. I have been in communities all over Maryland, from diners to boardrooms, listening to seniors who are desperate, listening to their families who want to help their parents and listening to employers in boardrooms who really want to help their retirees but are wondering if they can afford to do so. Here is what they tell me: Congress must do something about the prescription drug benefit, and they want us to do it now to help our seniors, our families, business, and our economy. There are several different plans floating around, and a lot of them have wonderful new language: Medicare Choice, Medicare Advantage, et cetera. I am not sure what will happen, but what I know is, we must have a meaningful prescription drug benefit, not just slogans and sound bites, not just something out of the Heritage Foundation, not something out of a think tank, but something that enables seniors to afford the prescription drugs, which they paid for the research to develop. I have five principles for a prescription drug benefit. These principles are the yardstick by which I am going to measure any proposal. First, the cornerstone of any prescription drug benefit must be Medicare. It must be in Medicare. It must stay in Medicare. Medicare must be the cornerstone. I am absolutely opposed to the privatization of Medicare either overtly or covertly. Let me repeat, I am absolutely opposed to the privatization of Medicare. Any prescription drug benefit that has a private insurance component to it must be in addition to a Medicare benefit, not in lieu of a Medicare benefit. It must keep a traditional Medicare component to it. Any private insurance program must be an option, and it must not be mandatory. That goes to my second principle: voluntary. No one should be coerced or forced into a private program or forced to give up coverage if they already have it. It must be affordable. Benefits must be affordable to business and affordable to seniors. That means a definite premium and a reasonable copayment. It must be accessible, available to all seniors regardless of where they live, and it must be portable so they can take it with them if they visit their grandchildren in another State. It must be meaningful and genuine. It must cover the drugs that doctors say they need, not what insurance executive gatekeepers say they are willing to give them. Let's talk about the meaningful benefit. Congress cannot leave this up to the insurance companies. We have been down that road in Maryland, and it was a rocky road, not only filled with potholes but with landmines. We had something called Medicare+Choice that turned out to be nothing more than a racket for seniors to be gouged and abandoned in my own State. I am not going to support any more rackets or gimmicks under the illusion of being able to help our seniors. Insurance companies came in. Seniors were going to have choice. They ended up with no choice and no coverage. The companies came in. They took the money from our seniors. Then they said, oh, it is too expensive to do this, and they left town. They left over 100,000 Maryland seniors without coverage. We are not going to go that way. So I do not trust the insurance companies to be there for the seniors. Getting rid of Medicare by forcing them into this is not going to be the way we go. Medicare is the answer. Medicare is not the problem. I believe honor thy mother and father is not just a good commandment to live by, it is good public policy to govern by. That is why I feel so strongly about Medicare. Congress created Medicare to provide a safety net for seniors. In 1965, seniors' biggest fear was the cost of hospital care. One heart attack could put a family into bankruptcy. That is what Medicare Part A is all about. Then Congress added Medicare Part B to help seniors pay for doctor visits, an important step to keep seniors healthy and financially secure. New advances in medicine mean seniors are living longer. New treatments and therapies such as prescription drugs prolong life and maintain quality of life. These costs were not envisioned in 1965. So as we look at this problem, we need to know that Medicare has served the Nation well. Now we know it is time to expand it to a prescription drug benefit. We have covered hospitalization. We have covered doctor visits. Yet because of the advances in medical science in this country, prescription drugs and medical devices save lives and help manage chronic conditions such as high blood pressure and diabetes. This is what we need to be focusing on. Let's focus on the American people for a change and not on the so-called hollow opportunities of structural reform. It is a problem for middle class families. Families worry about their jobs and the weak economy. They do not know how they are going to take care of their children and their elderly parents. American businesses are wondering about things such as legacy costs, and small business is wondering how they can afford health insurance as well. A lot of companies want to do the right thing for their employees and retirees. They want to offer comprehensive health care benefits, but they are struggling under the cost. That is why I fought for tax incentives for small businesses to provide health coverage for their employees. But those who supported the tax bill care more about special breaks for Joe Billionaire than about basic health care for families. Our businesses do not get any help, but their competitors sure do. The playing field is not level. When competitors in other countries do not have to pay for prescription drug coverage because they have a national health care system, in my own State of Maryland this means people are losing jobs in the automobile industry and the steel industry. That is why I fought for tax incentives for small businesses to provide health coverage for their employees, but those who supported the tax bill care more about special breaks for Joe Billionaire than about basic health care for families. We have to get real, and the first place we have to get real is to have a real prescription drug benefit. The Nation cannot afford to do nothing. Prescription drugs are lifelines to millions of Americans. They enable seniors to prevent and manage disease. Without access to medication, seniors are going to end up with trips to the hospital, longer hospital stays, more visits to emergency rooms. All the great research done at NIH is meaningless if people cannot afford the cures. It is time to make prescription drug coverage a national priority so we can help our seniors, families, American business, and our economy. When we stand up for America, we stand up for what America stands for, which is a safety net for our seniors and really helping our families be able to help themselves. By passing a real prescription drug benefit, Congress will deliver real security to America's seniors. Retirement security means more pension security. Seniors need healthcare security to be at ease in their retirements. In today's world, we cannot have healthcare security without prescription drug coverage. Congress must keep this promise to America's seniors. I now yield the floor, but if they come in with some more gimmicks, I will not yield the floor in this debate.

Ms. MIKULSKI

Ms. MIKULSKI. Madam President, I rise to introduce the Family Caregiver Relief Act of 2003--my legislation to help those who face the crushing consequences of caring for a chronically ill family member. While we stand up for America, we must also stand up for what America stands for. That means strengthening the safety net for those who need it most. That means standing up for American families. Families are hurting. The economy is weak. Many are holding down two jobs to make ends meet, going into debt to put kids through college, or finding and paying for health insurance. Some families are facing extraordinary challenges. They are caring for a loved one with special needs which could be a child with autism, or cerebral palsy, a parent with alzheimer's, or a spouse with multiple sclerosis. These families struggle every day to take care of their loved ones. I want to give help to those who practice self-help. My bill would provide a tax credit of up to $5,000 for family caregivers. This tax credit would help people pay for prescription drugs, home health care, specialized day care, respite care, transportation to chronic care or medical facilities, specialized therapy, including occupational, physical, or rehabilitational therapy, and other specialized services for children, including day care for children with special needs. Family caregivers face so many stresses--emotional, physical, and financial stresses of caregiving. They face long days, supporting a family--while caring for a loved one with a chronic condition. A dad might have to work two jobs to meet the costs of care which places strains on marriage and relationships with other family members. Caregivers also face high costs for medications, home health care, adult day care, physical therapy, durable medical equipment like a wheelchair, day care for children with special needs, and medical bills from care with specialists. People who care for chronically ill family must patch together whatever care they can afford. Too often they go into debt, use their college accounts or their retirement savings or go without the care their loved ones need. I have heard from families from around Maryland who are facing these strains, who are trying to make ends meet, and who are caring for a loved one who is chronically ill or needs assistance with activities of daily living. The Hart family from Baltimore has a 2 year old son named Jackson who was born with severe brain abnormalities. He has the motor skill development of a 4 month old. He has daily seizures, so he needs total, round the clock care. The emotional cost of caring for a severely disabled child are incalculable and the financial costs are crushing. For the Harts, the costs include: $650 a month for day care for medically fragile children; $1,400 for a wheel chair; and, $700 for a special shower chair--since Jackson can't sit up in the bath. My proposal would help them meet these costs by providing them with a tax credit of $2,750. I know of a a couple in Baltimore where the wife is in the final stages of Alzheimers. She was a school teacher and once spoke 5 languages. Now, she can only say a few words. She needs 24 hour-a-day care which costs almost three thousand dollars a month. Their retirement savings are gone though this couple is only in their early sixties. My bill would only provide a tax credit of five thousand to this couple. I know that this would help this couple as they face the challenges of her final days. My last example is a woman in Potomac, MD who is caring for her husband who has multiple sclerosis. He can no longer talk, walk, stand or feed himself. She works full time to support them and cobbles together whatever home care she can afford. She is not able to afford respite care to run errands, or take herself to the doctor. This couple made a commitment in sickness or in health. These are just a few examples of the stresses facing thousands of American families. One in five Americans has multiple chronic conditions. About 26 million people in this country care for a family members who is chronically ill or disabled. My legislation is supported by groups who see everyday the human cost of family caregiving, including: Autism Society of America; Cystic Fibrosis Foundation; National Organization for Rare Disorders; Easter Seals; United Cerebral Palsy Associations; Arc of the United States; National Health Council; National Council on the Aging; Paralyzed Veterans of America; Family Voices; National Respite Coalition; National Family Caregivers Association; and National Alliance for Caregiving. One of my first milestones in the Senate was the enactment of the Spousal Anti-Impoverishment Act to change the cruel rules of Medicaid so that families would not have to go bankrupt before Medicaid would pay for nursing home care for a spouse. Under this law, the spouse living in the community could keep the family home, keep a car, and keep some income each month to live on. This law helped one million people. But this was only a down payment. Not much has been done since then except the National Family Caregiver Support Program and long-term care insurance for federal employees. I was proud to sponsor and work on both of these bills on a bipartisan basis to get them signed into law. Now it is time to help family caregivers. They are the backbone of the long term care system in this country. They must be a priority in the Federal law books and the tax code. I thank Senators Clinton, Corzine, Sarbanes, Johnson, Lautenberg, Murray, Kennedy, Landrieu, Dayton, and Harkin for cosponsoring the Family Caregiver Relief Act. I ask unanimous consent that the text of my bill be printed in the Record.

Ms. MIKULSKI. Mr. President, I am pleased to join Senator Enzi in introducing the Elder Fall Prevention Act of 2003. Falls are a serious public health problem that affect millions of seniors each year. This bill expands research and education on elder falls to help keep seniors safe and in their own homes longer. The facts are staggering. One out of every three Americans over age 65 falls every year. In 2000, over 10,200 seniors died and approximately 1.6 million seniors visited an emergency department as a result of a fall. Falls are the leading cause of injury deaths among seniors, accounting for 64,000 traumatic brain injuries and 340,000 hip fractures each year. Falls can be financially disastrous for families, and falls place a serious financial strain on our health care system. By 2020, senior falls are estimated to cost the health care system more than $32 billion. These facts do not begin to tell the story of what falls can mean for seniors and their loved ones. Falls don't discriminate. Kay Graham was the victim of a fall. Many of us have friends or relatives who have fallen. A fall can have a devastating impact on a person's physical, emotional, and mental health. If an older woman loses her footing on her front porch steps, falls, and suffer a hip fracture, she would likely spend about two weeks in the hospital, and there is a 50 percent chance that she would not return home or live independently as a result of her injuries. Last year, I chaired a hearing of the Subcommittee on Aging on the problem of elder falls. The Subcommittee heard testimony from Lillie Marie Struchen, a 91-year-old woman who had recently fallen in her bathroom when she slipped on the tile. Lillie Marie could not reach the panic button in her apartment, and it took her some time before she could get to her feet and call for help. Lille Marie was lucky. She recovered from her fall and returned to her normal routines. She shared with the Subcommittee some steps that she and her family had taken to prevent future falls, knowing that she may not be so lucky next time. These falls, like the ones that Lillie Marie and thousands of others suffer from each year, can be prevented. With some help, there are simple ways that seniors can improve the safety of their homes and make a fall far less likely. Home modifications like hand rails in the bathroom, rubber mats on slippery tile floors, and cordless telephones that seniors can keep nearby can make a big difference. Well-trained pharmacists can review medications to make sure that two drugs do not interact to cause dizziness and throw a senior off balance. That's what this legislation is about--getting behind our Nation's seniors and giving help to those who practice self-help. This bill creates public education campaigns for seniors, their families, and health care providers about how to prevent falls. It expands research on elder falls to develop better ways to prevent falls and to improve the treatment and rehabilitation of elder falls victims. This legislation also requires an evaluation of the effect of falls on Medicare and Medicaid, to look at potentially reducing costs by expanding coverage to include fall-related services. Reducing the number of falls will help seniors live longer, healthier, more independent lives. This bill has the strong support of the National Safety Council and has been supported in the past by over 30 national and local aging and safety organizations. I look forward to working with Senator Enzi and my colleagues on the Health, Education, Labor, and Pensions Committee to get this bill signed into law.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise today to honor a member of ``the greatest generation,'' a World War II veteran who passed away on January 11, 2003. Buck Conrad was born in my hometown of Baltimore in 1921 and was raised just blocks from my childhood home. He is survived by a former neighbor of mine, Evelyn Dasch Conrad, his loving wife of 61 years, who now resides in Alexandria, VA. He was the proud father of two daughters, Karlene Conrad and Cindy Schafer, and Cindy's husband George Schafer, formerly of Catonsville, MD, as well as three grandchildren and great-grandchildren. He is also survived by numerous relatives in the Baltimore area, including his brother and sister-in- law, Tom and Joyce Ronci of Glen Burnie. Buck graduated from Baltimore Polytechnic Institute and received his undergraduate degree from the University of Maryland. He was an avid Terrapins fan who would not let his illness stop him from cheering the Terps on to their victory last year in the Peach Bowl. Buck entered the Army in 1944 and retired as a regular Army colonel in 1974. He was involved in personnel and logistics for most of his career, which included tours of duty in the Office of the Joint Chiefs of Staff and as Chief of the Ordnance Branch. Overseas and wartime assignments included the Philippines, Germany, France, Korea, and Vietnam. His military decorations include the Legion of Merit with oak leaf cluster, the Bronze Star with oak-leaf cluster, the Joint Service Commendation, and the Army Commendation with oak-leaf cluster. He was a member of the Infantry OCS Hall of Fame and was designated a Department of the Army Logistician in 1970. COL Conrad was well educated by the Army. He was a graduate of the Artillery School, the Chemical School, the Infantry School, the Command and General Staff College, and the Naval War College. He received a master's degree in business management from Babson College and received a second master's degree in international relations from George Washington University. After retiring from the Army, Buck moved on to a successful career in the private sector and later served as a faculty member of the University of Maryland, University College. Funeral Services were held at the Fort Myer Chapel on Wednesday, February 5, 2003 and COL Conrad was buried at Arlington National cemetery with full military honors. We owe a debt of gratitude to men such as Buck Conrad who quietly served their country when our freedom was in peril. His son-in-law informed me that up to his dying day, COL Conrad expressed concern about the United States becoming embroiled in a war in the Middle East that could take the lives of thousands of our soldiers. Having witnessed personally the impact that war has on our young people and, just as importantly, their families, COL Conrad was hopeful that a peaceful resolution to this conflict could be achieved before any lives are lost, both our own troops and innocents in Iraq and throughout that region.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to introduce the Veterans Burial Benefits Improvement Act. During the upcoming Memorial Day holiday, we will honor our U.S. soldiers who died in the name of their country. These service men and women are America's true heroes and on this day we pay tribute to their courage and sacrifice. Some have given their lives for our country. All have given their time and dedication to ensure our country remains the land of the free and the home of the brave. We owe a special debt of gratitude to each and every one of them. This holiday serves as an important reminder that our nation has a sacred commitment to honor the promises made to soldiers when they signed up to serve our country. As the Ranking Member of the Senate Appropriations Subcommittee that funds veterans programs, I fight hard to make sure promises made to our service men and women are promises kept. These promises include access to quality, affordable health care and a proper burial for our veterans. I am deeply concerned that burial benefits for the families of our wounded or disabled veterans have not kept up with inflation and rising funeral costs. We are losing over 1,000 World War II veterans each day, but Congress has failed to increase veterans' burial benefits to keep up with rising costs and inflation. While these benefits were never intended to cover the full costs of burial, they now pay for only a fraction of what they covered in 1973, when the Federal Government first started paying burial benefits for our veterans. I want to thank my colleagues on the Veterans' Affairs Committee for working with me in the 107th Congress. Together, we were able to increase modestly the service-connected benefit from $1,500 to $2,000, and the plot allowance from $150 to $300. While I believe these increases are a step in the right direction, they are not a substitute for the amounts included in my bill. That's why I am again introducing the Veterans Burial Benefits Improvement Act. This bill will increase burial benefits to cover the same percentage of funeral costs as they did in 1973. It will also provide for these benefits to be increased annually to keep up with inflation. In 1973, the service-connected benefit paid for 72 percent of veterans' funeral costs. Today, this benefit covers just 39 percent of funeral costs. My bill will increase the service-connected benefit from $2,000 to $3,713, bringing it back up to the original 72 percent level. In 1973, the non-service connected benefit paid for 22 percent of funeral costs. It has not been increased since 1978, and today it covers just 6 percent of funeral costs. My bill will increase the non- service connected benefit from $300 to $1,135, bringing it back up to the original 22 percent level. In 1973, the plot allowance paid for 13 percent of veterans' funeral costs. Yet it now covers just 3 percent of funeral costs. My bill will increase the plot allowance from $300 to $670, bringing it back up to the original 13 percent level. Finally, the Veterans Burial Benefits Improvement Act will also ensure that these burial benefits are adjusted for inflation annually, so veterans won't have to fight this fight again. This legislation is just one way to honor our Nation's service men and women. I want to thank the millions of veterans, Marylanders, and people across the nation for their patriotism, devotion, and commitment to honoring the true meaning of Memorial Day. U.S. soldiers from every generation have shared in the duty of defending America and protecting our freedom. For these sacrifices, America is eternally grateful. I ask unanimous consent that the text of this legislation, and letters from several veterans' advocacy groups supporting it, be printed in the Record.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to introduce the Veterans Burial Benefits Improvement Act. During the upcoming Memorial Day holiday, we will honor our U.S. soldiers who died in the name of their country. These service men and women are America's true heroes and on this day we pay tribute to their courage and sacrifice. Some have given their lives for our country. All have given their time and dedication to ensure our country remains the land of the free and the home of the brave. We owe a special debt of gratitude to each and every one of them. This holiday serves as an important reminder that our nation has a sacred commitment to honor the promises made to soldiers when they signed up to serve our country. As the Ranking Member of the Senate Appropriations Subcommittee that funds veterans programs, I fight hard to make sure promises made to our service men and women are promises kept. These promises include access to quality, affordable health care and a proper burial for our veterans. I am deeply concerned that burial benefits for the families of our wounded or disabled veterans have not kept up with inflation and rising funeral costs. We are losing over 1,000 World War II veterans each day, but Congress has failed to increase veterans' burial benefits to keep up with rising costs and inflation. While these benefits were never intended to cover the full costs of burial, they now pay for only a fraction of what they covered in 1973, when the Federal Government first started paying burial benefits for our veterans. I want to thank my colleagues on the Veterans' Affairs Committee for working with me in the 107th Congress. Together, we were able to increase modestly the service-connected benefit from $1,500 to $2,000, and the plot allowance from $150 to $300. While I believe these increases are a step in the right direction, they are not a substitute for the amounts included in my bill. That's why I am again introducing the Veterans Burial Benefits Improvement Act. This bill will increase burial benefits to cover the same percentage of funeral costs as they did in 1973. It will also provide for these benefits to be increased annually to keep up with inflation. In 1973, the service-connected benefit paid for 72 percent of veterans' funeral costs. Today, this benefit covers just 39 percent of funeral costs. My bill will increase the service-connected benefit from $2,000 to $3,713, bringing it back up to the original 72 percent level. In 1973, the non-service connected benefit paid for 22 percent of funeral costs. It has not been increased since 1978, and today it covers just 6 percent of funeral costs. My bill will increase the non- service connected benefit from $300 to $1,135, bringing it back up to the original 22 percent level. In 1973, the plot allowance paid for 13 percent of veterans' funeral costs. Yet it now covers just 3 percent of funeral costs. My bill will increase the plot allowance from $300 to $670, bringing it back up to the original 13 percent level. Finally, the Veterans Burial Benefits Improvement Act will also ensure that these burial benefits are adjusted for inflation annually, so veterans won't have to fight this fight again. This legislation is just one way to honor our Nation's service men and women. I want to thank the millions of veterans, Marylanders, and people across the nation for their patriotism, devotion, and commitment to honoring the true meaning of Memorial Day. U.S. soldiers from every generation have shared in the duty of defending America and protecting our freedom. For these sacrifices, America is eternally grateful. I ask unanimous consent that the text of this legislation, and letters from several veterans' advocacy groups supporting it, be printed in the Record.

Ms. MIKULSKI

Ms. MIKULSKI. On March 12, 2003, during the debate on S. 3, the Partial Birth Abortion Ban Act, I made the following statement in support of the Durbin amendment: Mr. President, I rise to express my strong support for the Durbin amendment. I support the Durbin amendment because it is consistent with my four principles. These are my principles: It respects the constitutional underpinnings of Roe v. Wade. It prohibits all post-viability abortions, regardless of the procedure used. It provides an exception for the life and health of a woman, which is both intellectually rigorous and compassionate. And it leaves medical decisions in the hands of physicians--not politicians. The Durbin alternative addresses this difficult issue with the intellectual rigor and seriousness of purpose it deserves. We are not being casual. We are not angling for political advantage. We are not looking for cover. The Durbin amendment offers the Senate a sensible alternative, one that would prohibit post-viability abortions while respecting the Constitution and protecting women's lives. I believe it is an alternative that reflects the views of the American people. I support the Durbin amendment because it is a stronger, more effective approach to banning late term abortions. The Durbin amendment respects the Constitution and the Supreme Court's ruling in Roe v. Wade. The Santorum bill before us does not. It is unconstitutional. In fact, the Supreme Court ruled in Stenberg v. Carhart just 3 years ago that a Nebraska State law that bans certain abortion procedures is unconstitutional. The Supreme Court ruled it was unconstitutional for two reasons. First, it did not include an exception for a woman's health. Second, it does not clearly define the procedure it aims to prohibit and would ban other procedures, sometimes used early in pregnancy. The bill before us, the Santorum bill, is nearly identical to the Nebraska law the Supreme Court struck down. The proponents of this legislation say they have made changes to the bill to address the Supreme Court's ruling. They have not. It still does not include an exception to protect the health of the woman. It still does not clearly define the procedure it claims to prohibit. Let me be clear about this. The Santorum bill is unconstitutional. The Santorum bill violates the key principles of Roe v. Wade and other Court decisions. When the Court decided Roe, it was faced with the task of defining, ``When does life begin?'' Theologians and scientists differ on this. People of good will and good conscience differ on this. So the Supreme Court used viability as its standard. Once a fetus is viable it is presumed to have not only a body, but a mind and spirit. Therefore it has standing under the law as a person. The Roe decision is quite clear. States can prohibit abortion after viability so long as they permit exceptions in cases involving the woman's life or health. Under Roe, states can prohibit most late term abortions. And 41 states have done so. In my own state of Maryland, we have a law that does just that. It was adopted by the Maryland General Assembly. It prohibits post viability abortions. It provides an exception to protect the life or health of the woman, as the Constitution requires. It also provides an exception if the fetus is affected by a genetic defect or a serious abnormality. This law reflects the views of Marylanders. It was approved by the people of Maryland by referendum. Like the Maryland law, the Durbin alternative is consistent with Roe. It is a compassionate, Constitutional approach to prohibiting late term abortions. It says that after the point of viability no woman should be able to abort a viable fetus. The only exception can be when the woman faces a threat to her life or serious and debilitating risk to her health as required by the Constitution. The Durbin amendment is stronger than the Santorum bill. It bans all post viability abortions. Unlike the Santorum bill, the Durbin amendment doesn't create loopholes by allowing other procedures to be used. I believe there is no Senator who thinks a woman should abort a viable fetus for a frivolous, non-medical reason. It does not matter what procedure is used. It is wrong, and we know it. The Durbin alternative bans those abortions. It is a real solution. On the other hand, Senator Santorum's bill does not stop a single abortion. It does not ban all late term abortions. It bans certain procedures and diverts doctors to other procedures. This approach is both hollow and ineffective. It bans procedures that may be the safest for a woman's health. But let me be clear. Under Santorum, late term abortions would still be allowed to happen. It does not make late term abortions more rare. It makes them more dangerous. And for that reason, the Santorum approach is ineffective. The Durbin amendment provides a tough and narrow health exception that is both intellectually rigorous and compassionate. It will ensure that women who confront a grave health crisis late in a pregnancy can receive the treatment they need. The Durbin amendment defines such a crisis as a ``severely debilitating disease or impairment caused or exacerbated by pregnancy'' or ``an inability to provide necessary treatment to a life-threatening condition.'' And we don't leave it up to her doctor alone. We require that a second, independent physician also certify that the procedure is the most appropriate for the unique circumstances of the woman's life. I want to be very clear in this. The Durbin amendment does not create a loophole with its health exception. We are not loophole shopping when we insist that an exception be made in the case of serious and debilitating threats to a woman's physical health. This is what the Constitution requires--and the reality of women's lives demands. Let's face it. Women do sometimes face profound medical crises during pregnancy. Breast cancer, for example, occurs in one in 3,000 pregnancies. In some unfortunate circumstances, pregnant women in their second trimester discover lumps in their breasts and are diagnosed with invasive breast cancer. Continuing the pregnancy--and delaying medical treatment--would put a woman's health in grave danger. The Durbin amendment recognizes that to deny a woman in a situation like this access to the abortion that could save her life and physical health would be unconscionable. To deny her other children a chance to know a healthy mother would be unconscionable. When the continuation of the pregnancy is causing profound health problems, a woman's doctor must have every tool available to respond. I readily acknowledge that the procedure described by my colleagues on the other side is a grim one. I do not deny that. But there are times when the realities of women's lives and health dictates that this medical tool be available. I support the Durbin alternative because it leaves medical decisions up to doctors, not legislators. It relies on medical judgement, not political judgement about what is best for a patient. Not only does the Santorum bill not let doctors be doctors, it criminalizes them for making the best choice for their patients. Under this bill, a doctor could be sent to prison for up to two years for doing what he or she thinks is necessary to save a woman's life or health. I say that's wrong. In fact, those who oppose the Durbin amendment say it is flawed precisely because it leaves medical judgements up to physicians. Well, who else should decide? Would the other side prefer to have the government make medical decisions? I disagree with that. I believe we should not substitute political judgement for medical judgement. We need to let doctors be doctors. This is my principle whether we are talking about reproductive choice or any health care matter. Physicians have the training and expertise to make medical decisions. They are in the best position to recommend what is necessary or appropriate for their patients. Not bureaucrats. Not managed care accountants. And certainly not legislators. The Durbin amendment provides sound public policy, not a political soundbite. It is our best chance to address the concerns many of us have about late term abortions. Today we have an opportunity today to do something real. We have an opportunity to let logic and common sense win the day. We have an opportunity to do something that I know reflects the views of the American people. Today, we can pass the Durbin amendment. We can say that we value life, and that we value our Constitution. We can make clear that a viable fetus should not be aborted. We can say that we want to save women's lives and protect women's health. The only way to do this is to vote for the Durbin amendment. I urge my colleagues to support it.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise in support of the amendment offered by Senator Feinstein, Senator Kennedy and others on low-yield nuclear weapons. The Defense Authorization bill would repeal the ban on research and development of low-yield nuclear weapons, sometimes called ``mini- nukes.'' The ban, known as the Spratt-Furse Amendment, was enacted in 1993. That law prohibits ``research and development which could lead to the production by the United States of a low-yield nuclear weapon.'' It even has specific exemptions, including allowing research on existing weapons and research to address proliferation concerns. To state it plainly, this is not about basic research or defensive research. This is about research and development to produce new nuclear weapons. And since these weapons would have yields of less than 5 kilotons of TNT, these are not strategic weapons. That means that if we pass this bill without adopting the Feinstein amendment, we are heading down the path of developing new, low-yield, tactical nuclear weapons. And you can bet that if we develop these weapons on the drawing board, we will see a demand to build and test these weapons to be sure that they would work. Why would we build these mini-nukes if we don't intend to use them? We don't need to go down that path. America has the strongest military in the world. We also have a huge arsenal of strategic nuclear weapons, which can strike anywhere in the world, for deterrence. We don't need tactical nuclear weapons, not even to strike buried targets like bunkers. We have conventional weapons to do that. Our scientists are developing better weapons all the time. I am so proud of the brilliant people at the Naval Surface Warfare Center in Indian Head, Maryland, who developed and produced the ``bunker-buster'' thermobaric bombs used against caves in Afghanistan. But the bottom line is that America doesn't need new nuclear weapons. I don't want to go down that path because it is destabilizing and dangerous to America's national security. Why is it so dangerous? It would signal that the U.S. would no longer use nuclear weapons only for deterrence. That would legitimize nuclear weapons and increase the risk that they'll be used against us or our allies. If we move to testing of nuclear weapons, other nations would almost surely follow our lead. Increasing the range and number of weapons in our nuclear arsenal would fundamentally undermine our nuclear nonproliferation efforts, including the Nuclear Non-Proliferation Treaty, NPT. That would mean more countries developing and deploying nuclear weapons. The production of small nuclear weapons, some of which could even be portable or easily transported in a truck, poses a particular danger. Even if the U.S. would effectively safeguard such weapons, other countries might develop similar weapons. The presence of a large but unknown number of tactical nuclear weapons in Russia poses one of the greatest dangers to our national security. If we are concerned about terrorists getting nuclear bombs, the last thing we should do is develop more small, easily-transported weapons. America's national security will best be served if we keep in place the existing ban on research and development leading to production of low-yield nuclear weapons. I urge my colleagues to join me in support of this amendment.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to introduce the Uterine Fibroid Research and Education Act. This bill expands and coordinates research on uterine fibroids at the National Institutes of Health, NIH, and creates an education campaign to make sure women and their doctors have the facts they need about this painful, chronic condition. I want to thank Representative Stephanie Tubbs Jones for introducing this legislation in the House of Representatives and Senator Clinton for joining me as an original cosponsor. Uterine fibroids are a major health issue for American women. Three quarters of all reproductive age women, and an even greater number of African American women, have uterine fibroids. Although many women with fibroids have few or no symptoms, it is estimated that a quarter of all women in their thirties and forties seek medical care for the abnormal or heavy bleeding, pain, infertility, or miscarriage that uterine fibroids cause. Despite their prevalence, little is known about uterine fibroids, and few good treatment options are available to women who suffer from them. Right now, hysterectomy--the surgical removal of the uterus--is the most common treatment for uterine fibroids. More than 200,000 women undergo a hysterectomy each year to treat their uterine fibroids, which requires a six week recovery, has a 20 to 40 percent risk of complications, and means a women can no longer bear children. Less invasive treatment options, like drug regimes or fibroid embolyzation, are promising, but many have not undergone the rigorous testing that women expect. In fact, the Agency for Healthcare Research and Quality at the Department of Health and Human Services found ``a remarkable lack of high quality evidence supporting the effectiveness of most interventions for symptomatic fibroids.'' Women deserve better. That's why I am introducing the uterine Fibroid Research and Education Act--to find new and better ways to treat or even cure uterine fibroids. This bill does three things. First, it expands research at the National Institutes of Health, NIH, by doubling funding for uterine fibroids every year for the next five years. Despite a budget of over $27 billion, NIH spent just $5 million on uterine fibroids research in 2002. This legislation authorizes $50 million over five years to provide the investment needed to jumpstart basic research and lay the groundwork to find a cure. This additional funding will help researchers find out why so many women get uterine fibroids, why African American women are disproportionately affected, what tests women can take to prevent uterine fibroids, and what are the best ways to treat them. Second, this legislation coordinates research on uterine fibroids through the Office of Research on Women's Health, ORWH. More than a decade ago, I fought to create this Office at NIH to give women a seat at the table when decisions were made about funding priorities. This bill directs this Office to lead the Federal Government's research effort on uterine fibroids. A coordinated research effort is needed to make the best use of limited resources and to give women a one-stop shop to find out what the Federal Government is doing to combat uterine fibroids. Finally, this bill creates education campaigns for patients and health care providers. According to a 1999 survey conducted by the Society for Women's Health Research, as many as one-third of women who have hysterectomies do so without discussing potential alternatives with their doctors. This bill will make sure women can count on their doctors for information about the best possible treatment for uterine fibroids. It will also give women the facts they need to make good health care decisions and take control of their health. Since my first days in Congress, I have been fighting to make sure women don't get left out or left behind when it comes to their health. From women's inclusion in clinical trials to quality standards for mammograms, I have led the way to make sure women's health needs are treated fairly and taken seriously. This legislation builds on these past successes to address this silent epidemic among American women. The Uterine Fibroid Research and Education Act is supported by the National Uterine Fibroid Foundation, the American College of Obstetricians and Gynecologists, the National Medical Association, the American Nurses Association, the Feminist Majority Foundation, the Center for Uterine Fibroids at Brigham and Women's Hospital, the National Urban League,, Delta Sigma Theta, and the Society for Women's Health Research. I look forward to working with these advocates and my colleagues to get this bill signed into law.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise to introduce the Uterine Fibroid Research and Education Act. This bill expands and coordinates research on uterine fibroids at the National Institutes of Health, NIH, and creates an education campaign to make sure women and their doctors have the facts they need about this painful, chronic condition. I want to thank Representative Stephanie Tubbs Jones for introducing this legislation in the House of Representatives and Senator Clinton for joining me as an original cosponsor. Uterine fibroids are a major health issue for American women. Three quarters of all reproductive age women, and an even greater number of African American women, have uterine fibroids. Although many women with fibroids have few or no symptoms, it is estimated that a quarter of all women in their thirties and forties seek medical care for the abnormal or heavy bleeding, pain, infertility, or miscarriage that uterine fibroids cause. Despite their prevalence, little is known about uterine fibroids, and few good treatment options are available to women who suffer from them. Right now, hysterectomy--the surgical removal of the uterus--is the most common treatment for uterine fibroids. More than 200,000 women undergo a hysterectomy each year to treat their uterine fibroids, which requires a six week recovery, has a 20 to 40 percent risk of complications, and means a women can no longer bear children. Less invasive treatment options, like drug regimes or fibroid embolyzation, are promising, but many have not undergone the rigorous testing that women expect. In fact, the Agency for Healthcare Research and Quality at the Department of Health and Human Services found ``a remarkable lack of high quality evidence supporting the effectiveness of most interventions for symptomatic fibroids.'' Women deserve better. That's why I am introducing the uterine Fibroid Research and Education Act--to find new and better ways to treat or even cure uterine fibroids. This bill does three things. First, it expands research at the National Institutes of Health, NIH, by doubling funding for uterine fibroids every year for the next five years. Despite a budget of over $27 billion, NIH spent just $5 million on uterine fibroids research in 2002. This legislation authorizes $50 million over five years to provide the investment needed to jumpstart basic research and lay the groundwork to find a cure. This additional funding will help researchers find out why so many women get uterine fibroids, why African American women are disproportionately affected, what tests women can take to prevent uterine fibroids, and what are the best ways to treat them. Second, this legislation coordinates research on uterine fibroids through the Office of Research on Women's Health, ORWH. More than a decade ago, I fought to create this Office at NIH to give women a seat at the table when decisions were made about funding priorities. This bill directs this Office to lead the Federal Government's research effort on uterine fibroids. A coordinated research effort is needed to make the best use of limited resources and to give women a one-stop shop to find out what the Federal Government is doing to combat uterine fibroids. Finally, this bill creates education campaigns for patients and health care providers. According to a 1999 survey conducted by the Society for Women's Health Research, as many as one-third of women who have hysterectomies do so without discussing potential alternatives with their doctors. This bill will make sure women can count on their doctors for information about the best possible treatment for uterine fibroids. It will also give women the facts they need to make good health care decisions and take control of their health. Since my first days in Congress, I have been fighting to make sure women don't get left out or left behind when it comes to their health. From women's inclusion in clinical trials to quality standards for mammograms, I have led the way to make sure women's health needs are treated fairly and taken seriously. This legislation builds on these past successes to address this silent epidemic among American women. The Uterine Fibroid Research and Education Act is supported by the National Uterine Fibroid Foundation, the American College of Obstetricians and Gynecologists, the National Medical Association, the American Nurses Association, the Feminist Majority Foundation, the Center for Uterine Fibroids at Brigham and Women's Hospital, the National Urban League,, Delta Sigma Theta, and the Society for Women's Health Research. I look forward to working with these advocates and my colleagues to get this bill signed into law.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I ask unanimous consent that further reading of the amendment be dispensed with.

Ms. MIKULSKI. Mr. President, pursuant to section 904 of the Congressional Budget Act of 1974, I move to waive the applicable sections of that act for the consideration of the pending amendment, and I ask for the yeas and nays.

Ms. MIKULSKI. Mr. President, my amendment is the family caregiver relief amendment. It gives help to those who practice self-help. It will provide tax relief for family caregivers who face the crushing consequence of caring for a chronically ill family member. Some of our families are facing extraordinary challenges, such as caring for a loved one with special needs, a child with autism or cerebral palsy, a parent with Alzheimer's or Parkinson's, or a spouse with multiple sclerosis. I want to give help to those families who are practicing family responsibility. My amendment would provide a tax credit up to $5,000 for family caregivers. This tax credit would help people pay for prescription drugs, home health care, specialized daycare, and respite care. One in five Americans has a multiple chronic condition requiring some type of medical intervention. That means over 26 million people were supported by many organizations. I urge my colleagues to vote for my family caregiver relief tax amendment.

Ms. MIKULSKI. Mr. President, I call up my amendment No. 605.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I support the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003. For 20 years, HIV/AIDS has spread from the devastated region of sub- Saharan Africa to the entire world. It is the fourth leading cause of death in the world, killing over 22 million people. But HIV/AIDS doesn't just kill people. It destroys economies. It ruins nations. It menaces our children and stifles hope. Forty-two million people worldwide have HIV/AIDS. Thirteen million children are now orphans because of its wrath. Three million children are infected. The vast majority of the afflicted live in Africa, but the disease continues to spread at an alarming rate. The peoples of Eastern Europe, China, India and Central Asia are under assault. The world cannot afford a mediocre response to this disease's assault on human life. While the experts know how this disease spreads, we can't afford to rely on one solution. Abstinence, being faithful and condoms is an approach that has been successful in Uganda. The ABC approach is now being followed in other countries as well. But this won't stop rape, sexual abuse and prostitution. We cannot expect women and children refugees to overcome their vulnerability to HIV/AIDS by themselves. They deserve real help--help with empowerment, help in fighting the sex and trafficking industries, and help in keeping their predators away. We also need to help the families that are ruined by AIDS. The costs of caring for a family member afflicted with AIDS are severe, even worse if the person affected is the family's primary wage earner. America must stand up and ensure that families can afford the treatment and care they need to dull the spread and impact of HIV/AIDS. This disease affects whole societies and nations, not just the infected individuals and their families. Economies suffer when labor forces can no longer survive, much less be productive. When the most educated and vital members of society get HIV, economies contract rather than grow. National security suffers when military forces contract HIV, often at rates up to 5 times as high as civilians. But the HIV/AIDS pandemic is not the only threat we need to fight. Tuberculosis and malaria compound the problems of HIV/AIDS in developing countries, where 6 million people died of HIV/AIDS, tuberculosis, or malaria in 2002. The nations and peoples of the world must share the burden of responding to the HIV/AIDs pandemic. Eliminating the scourge of AIDS won't be easy and it won't be cheap. That's why the U.S. needs to make a real contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The $500 million the U.S. has pledged to the fund falls far short of the $7 billion it will need over the next two years to carry out its critical mission. We can do better. We must. America also needs to encourage concerted international action beyond these important monetary contributions. HIV/AIDS is not a unilateral threat. The world must make a sustained, comprehensive global effort to provide a coordinated program of treatment, care and prevention. Together, we must combine the best of our values, service, technology, expertise and diplomacy to fight the great international menace of HIV/ AIDS. The United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 is a good step toward this goal. I applaud President Bush for joining our cause by proposing an Emergency Plan for AIDS Relief, a new mission to help countries in Africa and the Caribbean region address the HIV/AIDS pandemic by providing money, expertise and training. This measure recognizes the critical link between HIV/AIDS care, treatment, prevention, and education efforts. It also responds to the need for health care systems that actually provide the right treatment. I'm proud to vote for this bill because I see as a culmination of our efforts here in the Senate to make this issue less about partisanship, and more about people. I've fought for so many years to provide a more adequate response to HIV/AIDS. I commend my colleagues for uniting in this effort. There are certainly provisions in this bill that concern me. I've voted to try to change some of them. But I'm not going to let those concerns stand in the way of my support for a stronger U.S. and international response to the AIDS pandemic. While this bill is not perfect, it is a good start that may save millions of lives. By passing this bill, the United States is taking real action to live up to its responsibilities as the strongest country in the world. We can show that we really do care about improving the lives and futures of people in the developing world. The American people should be proud of this American leadership.

Ms. MIKULSKI

Ms. MIKULSKI. Thank you very much, Mr. President. Mr. President, I understand that the Republicans introduced the wrong tax bill yesterday. I think they got it right. I think the tax bill is the wrong bill. I don't think it was a drafting problem. I think it is an economic problem. I don't think this tax bill is the right solution to what our economy is facing. The tax bill is the wrong bill. It is the wrong bill because it does not create jobs; it adds to our structural deficit; and it doesn't deal with the other economic issues facing our country. I would like to have an economic package which clearly helps create jobs. If we are going to give tax breaks, they should be targeted to help families and small businesses. They should be temporary, such as aid to States and local communities that are reeling with their own problems. And they should not in any way weaken Social Security or weaken Medicare. I think the tax bill is the wrong bill. I believe if we put our heads together and think about targeted tax credits, we can help small business with health care and help families. Later on this week, I will offer an amendment to the tax bill to provide relief for family caregivers and help those who face the crushing consequences of caring for chronically ill family members. Families are hurting. There is a weak economy. They worry about their jobs. They worry about their pension. They worry about skyrocketing health care. They are often holding down two jobs to make ends meet or are going into debt in order to put their children through college. They are finding it more difficult to be able to afford health insurance. My targeted tax credit will give help to those who practice self- help. I think that should be a guiding principle. Let us give help to those who practice self-help. My bill will provide a tax credit up to $5,000 for family caregivers who are caring for someone with a chronic condition. Who would that be? Some families are facing extraordinary challenges--caring for loved ones with special needs, a child with autism or cerebral palsy, a parent with Alzheimer's or Parkinson's, or a spouse with multiple sclerosis. Those are just a few examples of what I mean by a chronic and severe condition. My tax credit would help people pay for prescription drugs, home health care, specialized daycare, respite care, and specialized therapy, including occupational, physical, or rehabilitation therapy. Family caregivers face so many stresses. There is the emotional and physical stress of caregiving. Then there is the financial stress of caregiving, and the long days of raising a family while caring for a loved one with a chronic disease such as cerebral palsy or Parkinson's. A dad would have to work two jobs to meet the cost of care for a handicapped child, or a dad and mom might be working to be able to afford the special care for grandma. It places incredible stress on the family checkbook, and it places great strains on the family marriage. We need to give help to those families who are practicing self-help. If you took the total cost of caregiving, it would be $200 billion. The first caregivers are the families--not government. But government should help the family with its responsibilities. They face high costs for prescription drugs, home health, adult daycare or specialized daycare for a handicapped child, physical therapy, durable medical equipment such as a wheelchair, and medical bills for care by specialists. People who care for a chronically ill family member must often patch together whatever they can afford. They really go into debt. Many of them go into their college accounts or retirement savings or they go without in order to be able to care of their family. Example one: Let's talk about a family in Baltimore who has a child named Jackson. These are real families. They gave me permission to talk about them on the Senate floor so that we would again be focusing on what a family is facing. Family responsibility, yes, but a family's stress needs to be helped. This family has a 2-year-old son named Jackson. He was born with severe brain abnormalities. He has the motor skill development of a 4- month-old. This little guy has daily seizures, so he needs total, round-the-clock care. The emotional costs of caring for a severely disabled child are incalculable. The financial costs are also crushing. It costs $650 a month for daycare for medically fragile children. His little wheelchair costs $1,400. Though his skills are not growing, he is growing, so they need to frequently replace his wheelchair. He even needs a special shower chair which costs $700. Then, of course, with all of those seizures and all the other complications, the cost of prescription drugs goes off the charts. Let's talk about another family. This is a family in Rockville. They have a 10-year-old girl named Rachel. She has autism. The mom does not work because the cost of specialized afterschool care would be so high; yet the family has very high costs, including $200 a month for medication, $150 a week for physical and speech therapy. That is $600 a month for physical and speech therapy. So that is $800 a month or $9,600 a year for just medication and physical and speech therapy. This father works 70 hours a week to provide for his family and to meet Rachel's special needs but also to save for college for his three other children. This places great stress on the family. Then there is a couple where the wife is in the advanced stages of Alzheimer's. She was a teacher and spoke five languages. Now she needs 24-hour-a-day care, but the husband will not put her in a nursing home, which, by the way, would cost over $60,000 a year. This family is spending $3,000 a month or $36,000 a year. They have gone through their savings, but they took a vow, ``for richer or for poorer, and in sickness and in health,'' and that man intends to keep his vow to his wife. What is the social contract that we have with those families? These are real families. This is why we need to have a real tax bill that also gives help to those who practice self-help. There are 26 million people in this country who face those situations. My amendment has been backed by the Autism Society of America, the Cystic Fibrosis Foundation, Easter Seals, the National Organization for Rare Disorders, the United Cerebral Palsy Association, Arc of the United States, the National Health Council, the National Council on the Aging, Paralyzed Veterans of America, Family Voices, the National Respite Coalition, the National Family Caregivers Association, and the National Alliance for Caregiving. Mr. President, one of my first milestones in the Senate was the enactment of something called the Spousal Anti-Impoverishment Act. That changed the cruel rules of Medicaid so families would not go bankrupt before they could get help for nursing home care. I said: Family responsibility, yes, and always. Family bankruptcy due to the cruel rules of government, no. That has helped over 1 million people. Now it is our turn to also help the caregivers. They are the backbone of our long-term care in this country. I thank my colleagues, Senators Clinton and Sarbanes, and others, for supporting this amendment. If we really want to help the economy, let's start by helping the American family. I hope, when the Senate considers whatever is introduced, Senators will favorably consider my targeted tax credit to help family caregivers. Mr. President, I yield the floor.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise in support of ratification of the Protocol to the Washington Treaty to bring seven new members in the NATO alliance. Allies and partners make concrete and indispensable contributions to American national security in the complex and rapidly-changing post- cold war environment. Most security problems cannot be addressed unilaterally, and acting with others helps reduce the backlash against the United States. We are virtually always better off sharing the risks and burdens and costs with our allies. The NATO alliance has been a reliable cornerstone of America's national security since it was founded more than half a century ago. I believe we need to modernize and strengthen NATO as our key alliance in the 21st century. We need to do four things to make NATO stronger: First, we need to overcome differences over Iraq and other issues by working together to develop a common understanding of the threats we face, so we don't again face the challenge of NATO Allies refusing access to U.S. troops or denying protection to another ally. Second, our European partners need to modernize their military capabilities to be ready to take on any potential enemy or military task, and to ensure interoperability between U.S. and European forces. Third, NATO must be ready to act beyond Europe, because our common enemies and shared missions could be anywhere. Finally, NATO must be ready to fight new enemies rather than just conventional military forces. These threats include the proliferation of weapons of mass destruction and missiles, rogue states and ethnic conflicts, and terrorism. The limited debate and sparse opposition to further enlargement of NATO are a tribute to the success of the round of NATO enlargement we ratified in 1996. Poland, Hungary and the Czech Republic are full and reliable NATO allies. They have already contributed to America's security, joining in the unanimous invocation of article 5 of the Washington Treaty, that an attack on one is an attack on all, after terrorists attacked the United States on September 11 of 2001. Poland, Hungary and the Czech Republic are being fully integrated into Europe including membership in the European Union. But they understand the value of the trans-Atlantic alliance. I am particularly proud that Poland is always ready to stand with America. Poland sent ground forces for the war in Iraq, joining only two other allies: the United Kingdom and Australia. I strongly support NATO membership for the three Baltic states: Estonia, Latvia and Lithuania. These countries know freedom and are willing to fight for it, because they suffered so long under Soviet occupation. The Baltic states are working to help America confront new challenges now that the cold war is over. I had the opportunity to visit Estonia, Latvia and Lithuania a few years ago, and participate in the NATO parliamentary assembly meeting in Vilnius. I was truly impressed by the spirit and progress of the Estonian, Lithuanian and Latvian peoples. All three Baltic states are building modern armed forces to contribute to the security of NATO. I am particularly proud of the Maryland-Estonia partnership, under which the Maryland National Guard has helped organize and train Estonia's military. All three Baltic states have contributed to the war on terrorism and international peacekeeping missions. I urge my colleagues to join me in support of further enlargement of NATO. I believe this round of enlargement, like the last, will strengthen NATO. Strengthening NATO strengthens America's national security.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise in support of the IDEA Full Funding Act of 2003. I'm so proud to cosponsor this important legislation. This bill provides mandatory increases for IDEA funding each year, so that the Federal Government will be paying its full share of the cost of special education by 2011. This legislation is long overdue. I think it's shocking that the President is fighting for tax breaks for zillionaires while delaying help for those who need it most--the children with special needs and their parents and teachers. We must fully fund IDEA to ensure that children with disabilities are receiving the services they need to succeed with their classmates in public schools. In 1975, Congress promised to pay 40 percent of the cost of special education when it passed the Individuals with Disabilities Education Act. Yet it has never paid more than 17.5 percent. That means local districts must make up the difference, either by cutting from other education programs or by raising taxes. I don't want to force States and local school districts to forage for funds, cut back on teacher training, or delay school repairs because the Federal Government has failed to live up to its commitment to special education. That's why fully funding IDEA is one of my top priorities. Everywhere I go in Maryland, I hear about IDEA. I hear about it in urban, rural, and suburban communities, from Democrats and Republicans, and from parents and teachers. They tell me that the Federal Government is not living up to its promise, that special education costs about 18 percent of the average school budget, that schools are suffering, and the parents are worried. Parents today are under a lot of stress--sometimes working two jobs just to make ends meet, trying to find day care for their kids, and elder care for their own parents. The Federal Government shouldn't add to their worries by not living up to its obligations. With the Federal Government not paying its share of special ed these parents have real questions in their minds: Will my child will have a good teacher? Will the classes have up-to-date textbooks? Will they be learning what they need to know? Parents of disabled children face such a tough burden already. School should not be one of the many things they have to worry about, particularly when the laws are already on the books to guarantee their child a public school education. The bottom line is that the Federal Government is shortchanging these parents by not paying its share of special ed costs. This bill will give local governments the resources they need to improve education for all children. It will free up money in local budgets for hiring more teachers, buying new textbooks and technology, and repairing old school buildings. It will help the teachers who struggle with teaching the toughest students. It will help students with disabilities and their families by providing enough funding for special education programs so parents can have one less thing to worry about, and students get the opportunities they deserve. Full funding of IDEA is essential. It will give disabled children a chance to succeed in school and in life without shortchanging other vital education programs. It will give parents peace of mind about their children's education. Let's pass this bill as soon as possible.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise in support of the IDEA Full Funding Act of 2003. I'm so proud to cosponsor this important legislation. This bill provides mandatory increases for IDEA funding each year, so that the Federal Government will be paying its full share of the cost of special education by 2011. This legislation is long overdue. I think it's shocking that the President is fighting for tax breaks for zillionaires while delaying help for those who need it most--the children with special needs and their parents and teachers. We must fully fund IDEA to ensure that children with disabilities are receiving the services they need to succeed with their classmates in public schools. In 1975, Congress promised to pay 40 percent of the cost of special education when it passed the Individuals with Disabilities Education Act. Yet it has never paid more than 17.5 percent. That means local districts must make up the difference, either by cutting from other education programs or by raising taxes. I don't want to force States and local school districts to forage for funds, cut back on teacher training, or delay school repairs because the Federal Government has failed to live up to its commitment to special education. That's why fully funding IDEA is one of my top priorities. Everywhere I go in Maryland, I hear about IDEA. I hear about it in urban, rural, and suburban communities, from Democrats and Republicans, and from parents and teachers. They tell me that the Federal Government is not living up to its promise, that special education costs about 18 percent of the average school budget, that schools are suffering, and the parents are worried. Parents today are under a lot of stress--sometimes working two jobs just to make ends meet, trying to find day care for their kids, and elder care for their own parents. The Federal Government shouldn't add to their worries by not living up to its obligations. With the Federal Government not paying its share of special ed these parents have real questions in their minds: Will my child will have a good teacher? Will the classes have up-to-date textbooks? Will they be learning what they need to know? Parents of disabled children face such a tough burden already. School should not be one of the many things they have to worry about, particularly when the laws are already on the books to guarantee their child a public school education. The bottom line is that the Federal Government is shortchanging these parents by not paying its share of special ed costs. This bill will give local governments the resources they need to improve education for all children. It will free up money in local budgets for hiring more teachers, buying new textbooks and technology, and repairing old school buildings. It will help the teachers who struggle with teaching the toughest students. It will help students with disabilities and their families by providing enough funding for special education programs so parents can have one less thing to worry about, and students get the opportunities they deserve. Full funding of IDEA is essential. It will give disabled children a chance to succeed in school and in life without shortchanging other vital education programs. It will give parents peace of mind about their children's education. Let's pass this bill as soon as possible.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise today to introduce the Law Enforcement Officers Retirement Equity act of 2003. I am proud to be joined on this bill by my colleagues, Senators Sarbanes, Leahy and Campbell. This legislation will ensure that all Federal law enforcement officers have the same retirement options and that their pay and benefits conform with the Federal law enforcement retirement system. Under current law, most Federal law enforcement officers and firefighters are eligible to retire at age 50 with 20 years of Federal service. But, some Federal law enforcement personnel, such as customs and immigration inspectors at the Department of Homeland Security or police officers at Veterans Affairs, are not eligible for these same benefits. This legislation will amend current law and grant the same pay and 20-year retirement to all law enforcement officers. We must honor our Federal law enforcement personnel. The names of Federal law enforcement officials who have died in the line of duty are engraved on the Law Enforcement Memorial. We include the names of the officers from Homeland Security and Veterans Affairs. We honor them when they die, but we don't recognize them when they are living. We need to make sure that all Federal law enforcement officers earn the pay and benefits that they deserve. These brave men and women are the country's first line of defense against terrorism and the smuggling of illegal drugs at our borders. They have the same law enforcement training as all other law enforcement personnel, and face the same risks and challenges. For example, U.S. Customs inspectors are responsible for the most arrests performed by Customs Service employees. Yet, they do not qualify for law enforcement officer status. Along with U.S. customs agents, uniformed U.S. Customs inspectors are helping provide additional security at the Nation's airports and help enforce U.S. customs laws. They were among the first to respond to the tragedy at the World Trade Center. After September 11, Customs inspectors are playing a critical role in ensuring that terrorists don't get their hands on weapons of mass destruction and smuggle them into the country. In 2002, the U.S. Custom Service impounded over 4,100 pounds of heroin and 167,000 pounds of cocaine, and confiscated over 39,000 firearms and 6.4 million rounds of ammunition. In fact, on a typical day, employees of the Customs Service inspect over 57,000 trucks and containers. Customers inspectors are vital in winning the war on drugs and keeping America safe from terrorism. Like customs inspectors, immigration inspectors at the Department of Homeland Security are also on the front lines of defense against terrorism. Immigration inspectors enforce the Nation's immigration laws at more than 300 ports of entry. In the normal course of their duties, they enforce criminal law, make arrests, interrogate applicants for entry, search persons and effects, and seize evidence. Inspector's responsibilities have become increasing complex as political, economic and social unrest has increased globally. The threat of terrorism only increases these responsibilities. These immigration inspectors help secure our borders. In FY 2001, over 510 million inspections were performed by these inspectors with 700,000 individuals denied entry, and approximately 71,000 criminal aliens were removed from the country. This legislation is cost effective. Any cost that is created by this act is more than offset by savings in training costs and increased revenue collection. A 20-year retirement bill for these critical employees will reduce turnover, increase productivity, decrease employee recruitment and development costs, and enhance the retention of a well-trained and experienced work force. These vital Federal employees bear the same risks and work under similar conditions to other law enforcement officials and deserve to receive the same level of benefits. This bill will improve the effectiveness of our inspector and revenue officer work force to ensure the integrity of our borders and proper collection of the taxes and duties owed to the Federal Government. This bill is supported by the Fraternal Orders of Police and the National Treasury Employees Union. I urge my colleagues to join me again in this Congress in expressing support for this bill and finally getting it enacted. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise today to introduce the Law Enforcement Officers Retirement Equity act of 2003. I am proud to be joined on this bill by my colleagues, Senators Sarbanes, Leahy and Campbell. This legislation will ensure that all Federal law enforcement officers have the same retirement options and that their pay and benefits conform with the Federal law enforcement retirement system. Under current law, most Federal law enforcement officers and firefighters are eligible to retire at age 50 with 20 years of Federal service. But, some Federal law enforcement personnel, such as customs and immigration inspectors at the Department of Homeland Security or police officers at Veterans Affairs, are not eligible for these same benefits. This legislation will amend current law and grant the same pay and 20-year retirement to all law enforcement officers. We must honor our Federal law enforcement personnel. The names of Federal law enforcement officials who have died in the line of duty are engraved on the Law Enforcement Memorial. We include the names of the officers from Homeland Security and Veterans Affairs. We honor them when they die, but we don't recognize them when they are living. We need to make sure that all Federal law enforcement officers earn the pay and benefits that they deserve. These brave men and women are the country's first line of defense against terrorism and the smuggling of illegal drugs at our borders. They have the same law enforcement training as all other law enforcement personnel, and face the same risks and challenges. For example, U.S. Customs inspectors are responsible for the most arrests performed by Customs Service employees. Yet, they do not qualify for law enforcement officer status. Along with U.S. customs agents, uniformed U.S. Customs inspectors are helping provide additional security at the Nation's airports and help enforce U.S. customs laws. They were among the first to respond to the tragedy at the World Trade Center. After September 11, Customs inspectors are playing a critical role in ensuring that terrorists don't get their hands on weapons of mass destruction and smuggle them into the country. In 2002, the U.S. Custom Service impounded over 4,100 pounds of heroin and 167,000 pounds of cocaine, and confiscated over 39,000 firearms and 6.4 million rounds of ammunition. In fact, on a typical day, employees of the Customs Service inspect over 57,000 trucks and containers. Customers inspectors are vital in winning the war on drugs and keeping America safe from terrorism. Like customs inspectors, immigration inspectors at the Department of Homeland Security are also on the front lines of defense against terrorism. Immigration inspectors enforce the Nation's immigration laws at more than 300 ports of entry. In the normal course of their duties, they enforce criminal law, make arrests, interrogate applicants for entry, search persons and effects, and seize evidence. Inspector's responsibilities have become increasing complex as political, economic and social unrest has increased globally. The threat of terrorism only increases these responsibilities. These immigration inspectors help secure our borders. In FY 2001, over 510 million inspections were performed by these inspectors with 700,000 individuals denied entry, and approximately 71,000 criminal aliens were removed from the country. This legislation is cost effective. Any cost that is created by this act is more than offset by savings in training costs and increased revenue collection. A 20-year retirement bill for these critical employees will reduce turnover, increase productivity, decrease employee recruitment and development costs, and enhance the retention of a well-trained and experienced work force. These vital Federal employees bear the same risks and work under similar conditions to other law enforcement officials and deserve to receive the same level of benefits. This bill will improve the effectiveness of our inspector and revenue officer work force to ensure the integrity of our borders and proper collection of the taxes and duties owed to the Federal Government. This bill is supported by the Fraternal Orders of Police and the National Treasury Employees Union. I urge my colleagues to join me again in this Congress in expressing support for this bill and finally getting it enacted. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I rise in strong support of the Graham amendment to increase funding for VA medical care. I am proud to cosponsor the Graham amendment. Our men and women in uniform have my steadfast support. We must support the brave men and women who are fighting for our country. Our troops need to know that America is with them, and we owe them a debt of gratitude. We need to remember our troops in the Federal checkbook. That is why I am proud to cosponsor the Graham amendment. The amendment is simple and straightforward. It would provide $375 million more for VA medical care, so that when our troops return from war, the VA can give them the medical care they deserve. Under a law we passed after the Persian Gulf War, the VA must give priority to returning troops for immediate medical care. But the VA medical care system is strained. Nationally, there are 236,000 veterans waiting longer than 6 months to get their first appointment with a VA doctor. In January, the VA health care system stopped accepting Priority 8 veterans. These are veterans who are not service disabled, and whose income is higher than about $29,000 per year. Our veterans didn't stand in waiting lines when they were called up or they volunteered to serve our country. So they shouldn't have to stand in line or pay toll charges to get the medical care they deserve. As the ranking member on the VA-HUD Appropriations Subcommittee, my guiding principle for the VA budget is that we keep the promises we made to our veterans. In the last four years, the VA-HUD Subcommittee has provided large increases for medical care, including $1.7 billion in 2000, $1.3 billion in 2001, $1 billion in 2002, and $2.4 billion in 2003. We provided these increases because we know that the failure of private health insurance companies and high prescription drug costs are really straining our veterans on fixed incomes. At the same time, our veterans population is growing and getting older. Today, the VA treats 2 million more veterans than in 1996 I am very concerned that the administration's VA budget for next year does not keep promises to our veterans, and will not support the needs of our troops. The VA's budget puts new toll charges and means tests on our veterans. Specifically, the budget proposes four things. First, the budget proposes to keep the VA closed to Priority 8 veterans. Second, the budget proposes a new $250 entrance fee for veterans. Third, the budget proposes to increase outpatient primary care copayments from $15 to $20. Fourth, the budget proposes to increase prescription drug copayments from $7 to $15. I raised my concerns about these proposals with Secretary Principi during the VA-HUD Subcommittee budget hearing last month. We have great respect for Secretary Principi. He is a Vietnam Veteran who continues to serve his country. Now he's battling OMB against a skimpy and spartan budget. But I am concerned that the budget OMB gave VA this year leaves the VA foraging for funding. It will leave our troops without access to the medical care they deserve. I urge my colleagues to support our troops and our veterans in the Federal checkbook by supporting the Graham amendment.

Ms. MIKULSKI. Mr. President, I rise as a proud cosponsor of this amendment that would provide $340 million to State governments to do important education, screening, and monitoring in the delivery of the smallpox vaccine program. I would like to share with my colleagues a story. One of my constituents, who lives on the Eastern Shore of Maryland, died last week from a heart attack 5 days after she received the smallpox vaccine. I am not drawing a conclusion that the two are linked. We will leave that to the appropriate medical and public health officials to decide. But let me tell you the story. She was 55 years old. She just got her nursing degree after having another degree. She wanted to get her nursing degree because the lower Eastern Shore of Maryland is an underserved health community in terms of doctors and nurses. She is a Native American. She is a proud descendant of the Assateague tribe. Her name is Andrea Deerheart Cornitcher. She wanted to volunteer for the smallpox vaccine so she could serve her community, serve her country in the event of a smallpox attack. She was ready to do anything she needed to when she was called. When I spoke to her husband, filled with grief and melancholy, I asked him what he wanted to tell me and, if he could come to the floor of the Senate, what would he tell us. He said: Senator, tell your colleagues, and if you have a chance to talk to the President, tell him, people are ready to volunteer, but they have to have a right to know what they are getting into. They have the right to know how safe the vaccine is. They have to know how safe they will be if they get the vaccine. We need education. We need screening. I might add, we need monitoring and surveillance, so that if you sign up to be part of the bioshield warriors, you will have ongoing monitoring and biosurveillance to make sure there are no physical or other repercussions from this. That is what Mr. Glenn Standing Bear Mayo asked. He said, the way I want to honor my wife, the way we ought to protect America, is to make sure we protect the volunteers. The way to protect the volunteers is through education, better and more amplified screening, and ongoing monitoring and surveillance. You cannot do this on the cheap. Public health departments are already stretched to the breaking point. They are now foraging for funds to be able to meet a Federal mandate to recruit, screen, and do smallpox vaccinations for our first responders who are volunteering. This takes $85 per screening. They don't have it. They are taking money from other funds--from maternal and child health, West Nile virus, or being prepared in case SARS comes to the United States. This is a very modest amount to put into the Federal checkbook. It doesn't even deal with the larger issue of compensation that we will debate at another time, an appropriate time. I salute the Senator from Indiana for advocating this. I advocated it in the authorizing committee just yesterday. It was accepted by the committee. The committee knows this is important. Now is the time to make it a reality by putting screening, testing, and monitoring into the Federal checkbook. So I really ask my colleagues: If the volunteers are going to have enough confidence to participate in the program, they need to know what they are getting into, and they need to be properly screened. They need to know that they will be monitored and that there will be surveillance to protect them as they line up to protect America. They also need to know that there is a safety net for an adequate and responsible compensation program. This amendment does not deal with compensation, but it deals with funding the usual and customary public health protections. It says that people have a right to know, they have a right to be heard about their concerns, and they have a right to be protected. On behalf of Andrea Deerheart Cornitcher, I offer this amendment with my colleagues to the Senate. I yield the floor.

Ms. MIKULSKI

Ms. MIKULSKI. Mr. President, I am pleased to join with my colleagues, Senators Schumer and Clinton, who have been working steadfastly to get the resources we need to properly fund homeland security. They have stood up not only for New York but for all of America because we know that homeland security cannot be done on the cheap. We are at war. We are at war in Iraq, and we need to support our troops. But we are at war here. The President of the United States, George Bush, said we are at war here in the war against terrorism and we need to support the hometown, homeland troops. They are our first responders. Where are they? They are in local governments. They are in fire stations. They are in police stations. They are standing sentry behind the ambulances ready to respond to any emergency need. When a citizen calls 911 because of an event that has happened in their community, it happens locally. The Schumer-Clinton-Mikulski amendment not only gives more money, which is desperately needed, but it brings money to the local communities where it is needed. We live in the capital region, we in Maryland, whether it is Montgomery County or Prince George's or Baltimore City. Our overtime is skyrocketing. We are spending loads of money in the protection for infrastructure. In Baltimore, every time we go to code orange we are spending $50,000 a week on police overtime. Prince George's County needs $50 million just to be able to talk to the rest of the State in interoperable radio equipment. Anne Arundel County is responsible for the protection of the National Security Agency, the Naval Academy, the capitol of the State of Maryland, and BWI Airport. We say: Oh, wow, we can't afford to do it. Let me say this: When the country goes to code orange, our local communities go to red ink. Local governments have no place to turn except higher property taxes. We say no to higher property taxes. We say yes to more funds for homeland security. If we want to wear the flag, let's stand up for the flag and let's stand up for the flag by supporting our first responders in the local community and by putting the money where our patriotism is, right in the Federal checkbook. I yield the floor.