Lisa Murkowski

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise today to introduce legislation that should allow the entity we created just 2\1/2\ years ago to oversee and expedite construction of a gas line to bring Alaska's huge reserves of natural gas to markets in the lower 48 States to work better and function more smoothly and quickly. I, and Senator Ted Stevens who is co-sponsoring this legislation, are introducing this bill in an effort to help speed the full functioning of the Office of Pipeline Coordinator, the entity that we created in fall 2004 to oversee the permitting, design and then construction of an Alaska Natural Gas Pipeline project, intended to bring Alaska's reserves of gas to a Nation in need of additional natural gas supplies. In 2004 we passed two sets of provisions. The first in that year's Military Construction Appropriations Act, H.R. 4837, P.L. 108-324/15 U.S.C. 720, set up an Office of Federal Pipeline Coordinator to oversee the 15 Federal agencies that will have a role to play in construction and financing of a pipeline system. The bill also set up a streamlined permitting and expedited court review process to limit unnecessary delays in the project--and hopefully prevent costly delays from driving up the project's price. That bill also included an $18 billion Federal loan guarantee. The second of that year's pipeline related bills, the FSC-ETI Act (H.R. 4520/P.L. 108-357) provided the Federal financial incentives expected to be needed to aid financing of the project. They included a tax credit for the cost of the pipe in Alaska and a tax credit for the cost of construction of an Alaskan North Slope gas conditioning plant. The two credits were believed to produce about three-quarters of a billion dollars of benefit to the project. The project itself involves building a system, either an overland pipeline through Canada or a pipeline through Alaska leading to a natural gas liquefication facility at tidewater in Alaska, to move gas to markets in the lower 48 States. Alaska has 35 trillion cubic feet of known gas in the Prudhoe Bay oil field and likely holds another 150 to 200 trillion cubic feet of gas both on and offshore in northern Alaska. Getting that gas to market would help to meet a likely gas shortage in the lower 48 States within a decade, helping to keep the United States from becoming even more dependent on imported LNG from foreign suppliers. Currently Alaska's new Governor is in the process of calling for proposals from gas producers, pipeline companies and others interested in building the project, one currently estimated to cost between $30 billion and about half that amount--depending on whether the line through Canada or an LNG project is deemed most economic. Congress last year funded the creation of the Federal Coordinator's office to begin the process of bringing Federal and State agencies together to oversee the permitting, design, and construction of a pipeline. The Office of the Federal Coordinator was funded for fiscal year 2007 initially with a $403,000 transfer of funds from the Department of Energy, with perhaps another $450,000 to $500,000 soon to be transferred. A coordinator, Alaskan former State Senate President Drue Pearce, was also named, confirmed and is now at work, and the office has reached an agreement with all of the 15 Federal agencies it will oversee on how a pipeline is to be permitted. The Bush administration has proposed $2.3 million in its fiscal year 2008 budget request to better fund the Coordinator's Office. But development of the office has shown three problems that need corrective action by Congress, the first immediately. First, the 2004 act made the Coordinator follow Federal personnel law, specifically Title 5 that is a slow and cumbersome personnel process. This bill grants a waiver to Title 5 hiring procedures so that the Federal Coordinator can hire and fire her staff, based on their competence. That should cut the time needed to staff the office with experts in pipeline construction by 6 to 9 months. Given how important it is that the agency has specialists quickly to assist the State of Alaska in its efforts to select a pipeline builder, passing legislation to speed the hiring of Office staff is vital. The waiver, also is common practice for smaller Federal agencies as a host of agencies, from the Election Assistance Commission to the Vietnam Education Foundation, enjoy the hiring waiver. Second, the bill gives the coordinator the ability to establish reasonable permit filing and service fees and charges to defray the cost of regulating and the oversight of any pipeline project. While the proposed budget may pay for a half dozen to a dozen employees, nearly 400 were employed in oversight of construction of the Trans-Alaska Oil Pipeline, some 30 years ago. The bill copies the structure that is currently employed by the Bureau of Land Management's oil and gas leasing division, FLP&MA Section 304, so that it follows a known process in allowing the Federal Coordinator to set and collect fees. Third, the bill in its Section 2 clarifies part of the original 2004 act's Section 107. That section set up an expedited review process so that any suit concerning the pipeline under its enabling legislation or concerning its compliance with the National Environmental Policy Act would go first to the U.S. Circuit Court of Appeals, D.C. Circuit. All cases would have to be filed within 60 days of an action and the court would have to ``expedite'' decisions on all such cases. This action simply also adds that suits stemming from the pipeline's permitting or construction that relates to the Administrative Procedures Act, the Endangered Species Act, and the National Historic Preservation Act, besides NEPA, would also go to the D.C. Circuit for expedited review. It clearly follows the original intent of the 2004 act, but does not limit litigation unfairly. The goal of this legislation, if it can be approved quickly by this Congress, would be to help the Pipeline Coordinator staff her office more quickly and then to provide the office the possibility of a more readily available source of funding, should a pipeline applicant move to proceed: The bill also will clarify the legal process for review of a pipeline, helping to speed the project and reduce the chances for cost overruns in construction of potentially the largest private capital construction project in the world's history. This is a vital project. It has the ability to move from 4.5 to 6 billion cubic feet of gas a day, about 5 percent of the Nation's total gas needs in 2018--the first year the pipeline could go into service, if a final overland project was selected and proposed within the next year. It would likely produce about a third of that initially, if an LNG project was selected to be built. This should not be a controversial measure. It should have no nonappropriated costs involved in carrying out its provisions. Section 2 of the bill will save the Nation untold millions of dollars in overseeing permitting and construction of a pipeline, once a firm project is selected. Some will say that the bill is not needed since the State of Alaska has yet to reach final agreement with Alaska North Slope gas producers on a firm agreement to build a line. I would argue, however, that this bill needs to pass now to provide additional assistance to help the State hammer out such an agreement and so the regulatory process is clearly in place, once such an agreement is reached. The Coordinator's Office is already involved in a host of discussions and actions relating to a pipeline and the pace is likely to quicken in coming months, provided the office has the expertise it needs to provide technical information to further a project. I hope the Senate and the Congress will review and approve this bill quickly. The Alaska gas line project is too important for this Nation's energy future, for our energy security, for our national security and for our balance of payments deficit for it to be delayed needlessly. These changes will likely speed the process of proceeding with a pipeline.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise tonight to speak about an amendment that I will be modifying, amendment No. 551, that will increase funding for renewable energy development in this country. This amendment is offset. It is intended to provide funds for three areas of renewables that have the potential, I believe, to do great benefit for this Nation's electrical power generation, all without generating any greenhouse gases or having any negative environmental consequences. My colleague, Senator Stevens, and I are seeking to raise funding for geothermal power, for ocean energy, and for small hydroelectric development. I first wish to say I understand this budget resolution does raise funding for renewables and energy efficiency, and I applaud that effort, even though it falls somewhat short of the levels of funding we were hoping for when we passed the Energy Policy Act of 2005 a couple years ago. But I fear the budget shortchanges three areas of great potential energy, and that is, again, the area of geothermal, ocean energy, and small hydroelectric development. By this amendment, I wish to make a clear statement that this Senator wants to see money not just restored but increased for geothermal energy research and development and funding provided for research and development of all forms of ocean energy--current, tidal, wave projects--and also for the small hydroelectric developments, those that do not involve the damming of major river systems but instead use water from lake taps, creeks, or from run-of-river projects to generate the power. We know that renewable energy is certainly growing in popularity and endorsements, and I very strongly support funneling additional Federal funds for research and development into the areas of wind, solar, biomass, coalbed methane, landfill gas, and all the other types of renewable energy projects we authorized in the Energy Policy Act of 2005. But we largely have not done as well with geothermal funding and certainly have done far less to promote ocean and small hydroenergy developments. On the geothermal issue, funding in recent years has dipped precipitously. This year, the Department of Energy is proposing no funding for geothermal. Last week, they did agree to effectively make a total of $5 million of new money available to study one possible area of geothermal, and this is in the area of heat mining, but this is just for the remainder of this fiscal year. After that, there is no funding. This cut in funding, this zeroing out comes as MIT has released a report on the ``Future for Geothermal Energy.'' That report suggests enhanced geothermal system technology could provide 100,000 megawatts of baseload power, all without greenhouse gas emissions by 2050 if the Government increases its research commitment to resource characterization and assessment. The cut in funding also comes just as the Department of Energy has had a major success in proving the ability to convert low-temperature geothermal resources--this is subsurface water that is far below the boiling point, perhaps as low in temperature as 160 degrees--to power generation. This success in using new types of heat exchanges to drive power generation came about and was perfected in Alaska. We have a location, Chena Hot Springs Resort, outside Fairbanks. The owner, Bernie Karl, has been dogged in his approach to making this happen, to defy the critics and the odds stacked against him to install the first low-temperature generation working process. This project has won accolades and engineering awards in the past year. Mr. Karl did what everybody said he couldn't do. Some in the Energy Department seem to feel this project perhaps is not representative of anything other than this nice minor energy project in Alaska. But they don't seem to recognize that about 70 percent of the villages in Alaska and in many small towns in the American West all lie above potentially similar low water, shallow ground geothermal resources. They are sitting right on top of the resource. So in a State such as Alaska, where electricity can cost 80 cents per kilowatt hour generated by diesel fuel--this is how most of my villages are getting their fuel now--geothermal power at an operating cost of perhaps one-sixth to one- eighth of that amount is potentially a godsend. But there is no money in the budget to fund anything to support the geothermal energy. There is also nothing to encourage traditional geothermal assessment and production, which has proven its worth in States from Nevada and California to the Intermountain West. By specifically adding money to this budget and specifically saying that this addition is intended to provide an additional $50 million to geothermal for this year, it increases greatly the chances that appropriators later this year will not only restore but perhaps boost funding for geothermal energy. On the ocean energy front, the Electric Power Research Institute estimates that this country has the potential from wave power to generate 2,100 terawatt hours of power, and if we were to capture 15 percent of that power, it would equal all of the hydroelectric generation in this country today. We know that in a State such as Alaska, where we are surrounded literally on three sides by water, ocean energy is a huge potential source of power. But it is also an enormous source of power along the east coast, if we perfected devices to capture it so we have the economies of scale that make this power truly economic. Look at the west coast with California. We have the potential for so much with ocean energy. Ocean energy is clean. It has no air emissions, minimal visual impacts, and it could provide plentiful power for everything from freshwater desalination to hydrogen production. It could help economic development by providing a cheaper, more plentiful supply of power in so many areas across this country. So my amendment is intended to provide $50 million of funding for ocean energy research in fiscal year 2008. It would be a powerful statement that Congress supports this form of clean renewable energy. A final component of the amendment seeks to encourage a $25 million expenditure for small hydro development. Again, this is not damming rivers to produce electricity but tapping non-fish-bearing lakes or diverting water from creeks to fuel smaller hydro units. These projects have little or no environmental impact on wildlife but can produce large amounts of greenhouse-gas-free energy. But the minimal grant and research assistance to continually improve the turbines will be quite beneficial. In Alaska, we have over 100,000 rivers and large creeks. So we are a location, again, where small hydro can supply a large share of our future electrical needs, as it has done without environmental consequences for about 100 years, especially if we have this additional Federal assistance. I come to the floor tonight to encourage adoption of an amendment that will help to encourage additional funding for renewable energy for those, I believe, neglected areas of the renewable energy portfolio. I mentioned the amendment is fully offset. The $125 million total comes from the function 920 portion of the budget, miscellaneous allowances portion of our budget. I will not belabor this further except to encourage my colleagues to support this amendment as a way of sending a clear signal that we support additional funding for renewable energy and for a wider portfolio of renewable energy projects. We don't want to repeat the mistakes of the past, where we limit support to a few technologies so that we in Congress essentially pick the winners and the losers. By adding additional research and development assistance for geothermal, ocean energy, and small hydro, we can increase the possibilities that will allow these renewables to blossom. This comes at a modest impact on the budget, but I believe it could pay a huge benefit for our energy production in the future. I yield the floor.

Ms. MURKOWSKI. I thank the Chair. I wanted to make sure I was still in the queue.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise again this evening to speak about a growing crisis in rural America. This crisis is found in rural New England, throughout Appalachia, spans the Great Plains, crosses the Western deserts, and reaches the mountains of the great Northwest. It impacts the seniors, children, the women, and the men of rural America. What I am speaking about today is a lack of access to quality health care. In rural America, patients have long gone without care. Despite the fact that one-fifth of the U.S. population lives in rural America, only 9 percent of the Nation's physicians are practicing in these areas. Over 50 million of these rural Americans live in areas that have a shortage of physicians to meet their basic needs. Now, physician recruitment to rural America is a big problem. Part of this problem comes about through high student debt, which often forces many students away from a rural practice and into urban specialty medicine where they can probably command higher salaries. I recently held a Senate HELP Committee field hearing in Alaska. This was during the February recess. I held this field committee hearing on the physician shortage crisis in rural America. At that hearing, I had a young woman come up and speak. She is a medical student who is currently part of the WAMI Program, the Western States medical program. This young woman, Melissa Howell, is 26 years old. She stated the student debt she has accumulated is a huge concern that hangs over the decisions she makes as she decides where she is going to practice. Simply put, she said that the $100,000 student debt she faces is ``kind of scary.'' I have to admit, that is kind of scary. A dozen States already report severe physician shortages. These shortages exist in the areas of cardiology, radiology, neurology, to name a few. But the greatest shortages persistently have been in primary care. In fact, the shortage of primary care physicians in rural areas of the United States represents one of the most intractable health policy problems of the past century. It will only worsen. In 20 years, 20 percent of the U.S. population will be 65 or older, and this is a percentage larger than at any other time in our Nation's history. Just as this aging population places the highest demand on our health care system, we have some experts who predict a national shortage of close to 200,000 physicians. If that becomes a reality, 84 million patients could be potentially left without a doctor's care. So the question has to be asked, where are the doctors going? We are losing some of our doctors through attrition. One-third of physicians are 55 years old and older and are likely to retire as this baby boom generation moves into its time of greatest medical need. Additionally, for the last quarter of a century, medical schools have kept their student enrollments virtually flat. We are also losing a lot of our doctors, quite simply, through frustration. Low Medicare and Medicaid reimbursement rates, coupled with complex regulations and paperwork, leave physicians aggravated, leave them disappointed with the practice of medicine. In Alaska, we have lived with provider shortages since statehood. I grew up in a part of the State down in the southeastern area where you did not have doctors who were available to deliver babies except on Tuesdays and Thursdays. You hoped you could give birth on a Tuesday or a Thursday. Still, in many parts of our State, we do not have providers who can deliver. If you are out in the Aleutian chain, you are told by your physician's attendant to come to Anchorage, some 600 miles away, to wait out the remaining month of your pregnancy because they do not have the facilities, do not have the doctors available to take care of you in the event of an emergency. So we have lived with provider shortages for a long time. Because our State is larger than Texas and California and Montana combined, ``rural'' brings on a new meaning and the physician shortage crisis is even more amplified, as I have given in my two examples. But we have had some recent events in the State that have created a situation far worse than Alaska has known in the past. Currently, in the State, we have the sixth lowest ratio of physicians to population in the United States. That is when you take into account Anchorage, which is our largest population center. In rural Alaska, it is the worst physician- to-population situation in the Nation. Alaska needs nearly 400 more doctors to provide the same level of care as elsewhere in the country. One of our problems is we do not have a medical school, and we are not likely to be getting a medical school in the near future. We also have the lowest per capita number of medical school slots in the country and the lowest number of residency slots. We have two small but very successful programs; this is the University of Washington Medical School Partnership and the Alaska Family Residency Program. These two programs help train Alaskans as physicians and also help us bring doctors to Alaska. But despite the success of these programs, each is far too small to meet our population's needs. Each week, without fail, I receive faxes, phone calls, letters, and e-mails from Alaskan seniors who simply cannot find a doctor to treat them. I wish to read a few excerpts from recent e-mails we have received. The first one is from a gentleman in Anchorage. Keep in mind, Anchorage is our largest population center; about half the population of the State is here. He writes: My mother . . . has had difficulty in the extreme in getting a doctor who will take her on as she is a medicare patient . . . doctors are telling potential patients that they are no longer taking medicaid. My mother has made in excess of 100 calls to physicians in Anchorage. Another constituent writes--and this is also from Anchorage: During the past year, I've tried to find a doctor that accepts Medicare. I used the Anchorage Yellow pages and called over 100 doctors, only to be told that they won't accept any more Medicare patients. She then writes to say: I'll tell you ahead of time, we'll be going to the hospital emergency rooms, to receive, even the basic medical care, i.e.: colds, flu, and other basic medical care, that could have been treated through seeing a doctor, at their established practice. This doesn't sound like good fiscal management. Another constituent--and this was actually in a letter to the editor in the Anchorage Daily News--says: My friends telephoned more than 80 doctors recently, and not one was accepting new Medicare patients. A third gentleman from Kenai, AK, writes: My mom has Medicare and she had to wait 5 months to be seen by a Neurologist because she had been put on a waiting list to be seen due to the fact she was a Medicare patient. Another woman from Anchorage says: I just got through trying to find a physician for an elderly Medicare-dependent friend. At this time I have found no one who will take her. Most physicians take no Medicare patients or have a quota which is full. The Providence health care provider list has no one who takes Medicare. The last e-mail was from Anchorage stating: Almost no family practice office in Anchorage is accepting new Medicare patients. This is just a sample of what we get from constituents around the State of Alaska saying: I don't have anyone who can see my mother. I can't get in to see anyone myself. I mentioned in my comments this is a crisis that is growing. In Alaska, we don't often think of it as being a State where we have a large senior population. We think of some of the Southern States as being the ones that attract our seniors. But the fact is Alaska has the second fastest-growing senior population in the Nation, second only to Nevada. So again we ask the question: Why aren't Alaska's doctors able to provide care to our seniors? Why are they saying: No, we are not accepting any new Medicare patients? Well, a lot of it has to do with the reimbursement rates. Recent Federal reductions in Alaska Medicare reimbursement rates have been so severe that primary care physicians report that Medicare pays them only 37 cents--it is actually between 37 cents to 40 cents--for every dollar that it costs to treat a patient. So the doctor is spending a dollar in the care provided but is getting reimbursed about 40 cents to every dollar. We had one physician testify at the field hearing, and he said that in order for him to basically break even with his medical practice, he would have to see one Medicare patient every 7 minutes in order for him not to lose money. For those of us who go into our doctor's office, if we only had 7 minutes in there with our medical provider, I don't think we would feel we were getting the care and the attention our medical issues deserve. Losing money by seeing Medicare patients has meant that many of our physicians have stopped accepting Medicare patients entirely. They are making a decision not to accept any new Medicare patients. Or if you have been a patient of a particular physician and you turn 65, you may have had a good relationship with that physician, but if he tells you: I am sorry, I am not accepting any new Medicare patients, that date of your birthday comes and all of a sudden you don't have the care that you had relied on for some period of time. During this committee field hearing, we had testimony that revealed that only one neighborhood health clinic in the entire city of Anchorage-- and again, this is a city that has half the State's population--only one neighborhood health clinic is still accepting new Medicare patients. So if you are lucky enough to find a physician, it often takes weeks or months for an appointment. So when you are faced with this kind of a delay, you have one of two options. You either go to the emergency room if the conditions are severe enough or you go without care entirely, putting it off until perhaps it becomes even more complicated down the road. We had testify at the field hearing one gentleman who is from the city of Bethel. Bethel is in the western part of the State. He said he was willing to fly the 500-some-odd miles from Bethel to Anchorage if only he could find a primary care doctor who would accept him. He kind of joked because he said he counted himself lucky because he had a heart condition, and he was at least able to get in to see a specialist once in awhile. The chairman of the Alaska Commission on Aging, Mr. Frank Appel, called the lack of access to health care for seniors ``the most critical problem facing Alaska's seniors.'' I know Alaska is not alone. The crisis is not just Alaska. It is nationwide. We as a body, as a Congress, should find this situation intolerable. I haven't been in the Senate for as long as many of my other colleagues, but I have been here long enough to know that we fight a lot about health care. We debate the solvency issues, the funding issues, the insurance, the benefit coverage, universal coverage, health savings accounts, the prescription drug benefit. We debate and argue about a lot of these issues as they relate to health care, and each and every one of these issues is certainly worthy of great debate. But I would submit that not one of those very worthy debates matters in the least to one of the seniors I have mentioned in these letters who can't find a primary care doctor after making 100 phone calls. So instead of this body debating how health care is delivered, it is time we focus on the fact that it is not delivered in much of America. We have a crisis that, simply put, cannot wait. We have to do two things. We have to help current physicians stay in the practice of medicine, and we must vastly increase our health care work force. Earlier this year, Senator Stevens and I introduced the Rural Physician Relief Act, and this is a bill that provides tax incentives for physicians to practice in our most rural and frontier locations in the country. Today, along with my colleagues, Senator Schumer, Senator Stevens, and Senator Sanders, we are introducing legislation entitled the ``Physician Shortage Elimination Act.'' This legislation will double the funding for the National Health Service Corps, a program that is dedicated to meeting the needs of the underserved. Despite its success over the years, it has been vastly underfunded. We understand that 85 percent of the applicants to this worthy program have to be turned away each year because we don't fund it. This legislation will also allow rural and underserved physician residency programs to expand by removing barriers that prevent programs from developing rural training programs. We will also double certain title VII funding to create programs that target disadvantaged youth in rural and underserved areas and nurture them to create a pipeline to careers in health care. We need to get more people interested in the field. Finally, we must bolster the cornerstone of rural health care, which is the community health center, through additional grants and by allowing them to expand their residency programs. I would suggest that the prognosis for the quality of health care in America is poor. Fifteen million Americans in underserved areas across the Nation already do without care. Soon, with even greater physician shortages, it could mean that potentially another 84 million patients will be left without a physician's care. The time for Congress to act is now. In fact, it is past time. I look forward to working with my colleagues on this issue that again is not just Alaska-specific. I think the facts on the ground up North perhaps make the arguments more accentuated, but I think it points to a situation in this Nation that we must deal with now before the crisis is felt throughout the country. I appreciate the attention of the Chair.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise again this evening to speak about a growing crisis in rural America. This crisis is found in rural New England, throughout Appalachia, spans the Great Plains, crosses the Western deserts, and reaches the mountains of the great Northwest. It impacts the seniors, children, the women, and the men of rural America. What I am speaking about today is a lack of access to quality health care. In rural America, patients have long gone without care. Despite the fact that one-fifth of the U.S. population lives in rural America, only 9 percent of the Nation's physicians are practicing in these areas. Over 50 million of these rural Americans live in areas that have a shortage of physicians to meet their basic needs. Now, physician recruitment to rural America is a big problem. Part of this problem comes about through high student debt, which often forces many students away from a rural practice and into urban specialty medicine where they can probably command higher salaries. I recently held a Senate HELP Committee field hearing in Alaska. This was during the February recess. I held this field committee hearing on the physician shortage crisis in rural America. At that hearing, I had a young woman come up and speak. She is a medical student who is currently part of the WAMI Program, the Western States medical program. This young woman, Melissa Howell, is 26 years old. She stated the student debt she has accumulated is a huge concern that hangs over the decisions she makes as she decides where she is going to practice. Simply put, she said that the $100,000 student debt she faces is ``kind of scary.'' I have to admit, that is kind of scary. A dozen States already report severe physician shortages. These shortages exist in the areas of cardiology, radiology, neurology, to name a few. But the greatest shortages persistently have been in primary care. In fact, the shortage of primary care physicians in rural areas of the United States represents one of the most intractable health policy problems of the past century. It will only worsen. In 20 years, 20 percent of the U.S. population will be 65 or older, and this is a percentage larger than at any other time in our Nation's history. Just as this aging population places the highest demand on our health care system, we have some experts who predict a national shortage of close to 200,000 physicians. If that becomes a reality, 84 million patients could be potentially left without a doctor's care. So the question has to be asked, where are the doctors going? We are losing some of our doctors through attrition. One-third of physicians are 55 years old and older and are likely to retire as this baby boom generation moves into its time of greatest medical need. Additionally, for the last quarter of a century, medical schools have kept their student enrollments virtually flat. We are also losing a lot of our doctors, quite simply, through frustration. Low Medicare and Medicaid reimbursement rates, coupled with complex regulations and paperwork, leave physicians aggravated, leave them disappointed with the practice of medicine. In Alaska, we have lived with provider shortages since statehood. I grew up in a part of the State down in the southeastern area where you did not have doctors who were available to deliver babies except on Tuesdays and Thursdays. You hoped you could give birth on a Tuesday or a Thursday. Still, in many parts of our State, we do not have providers who can deliver. If you are out in the Aleutian chain, you are told by your physician's attendant to come to Anchorage, some 600 miles away, to wait out the remaining month of your pregnancy because they do not have the facilities, do not have the doctors available to take care of you in the event of an emergency. So we have lived with provider shortages for a long time. Because our State is larger than Texas and California and Montana combined, ``rural'' brings on a new meaning and the physician shortage crisis is even more amplified, as I have given in my two examples. But we have had some recent events in the State that have created a situation far worse than Alaska has known in the past. Currently, in the State, we have the sixth lowest ratio of physicians to population in the United States. That is when you take into account Anchorage, which is our largest population center. In rural Alaska, it is the worst physician- to-population situation in the Nation. Alaska needs nearly 400 more doctors to provide the same level of care as elsewhere in the country. One of our problems is we do not have a medical school, and we are not likely to be getting a medical school in the near future. We also have the lowest per capita number of medical school slots in the country and the lowest number of residency slots. We have two small but very successful programs; this is the University of Washington Medical School Partnership and the Alaska Family Residency Program. These two programs help train Alaskans as physicians and also help us bring doctors to Alaska. But despite the success of these programs, each is far too small to meet our population's needs. Each week, without fail, I receive faxes, phone calls, letters, and e-mails from Alaskan seniors who simply cannot find a doctor to treat them. I wish to read a few excerpts from recent e-mails we have received. The first one is from a gentleman in Anchorage. Keep in mind, Anchorage is our largest population center; about half the population of the State is here. He writes: My mother . . . has had difficulty in the extreme in getting a doctor who will take her on as she is a medicare patient . . . doctors are telling potential patients that they are no longer taking medicaid. My mother has made in excess of 100 calls to physicians in Anchorage. Another constituent writes--and this is also from Anchorage: During the past year, I've tried to find a doctor that accepts Medicare. I used the Anchorage Yellow pages and called over 100 doctors, only to be told that they won't accept any more Medicare patients. She then writes to say: I'll tell you ahead of time, we'll be going to the hospital emergency rooms, to receive, even the basic medical care, i.e.: colds, flu, and other basic medical care, that could have been treated through seeing a doctor, at their established practice. This doesn't sound like good fiscal management. Another constituent--and this was actually in a letter to the editor in the Anchorage Daily News--says: My friends telephoned more than 80 doctors recently, and not one was accepting new Medicare patients. A third gentleman from Kenai, AK, writes: My mom has Medicare and she had to wait 5 months to be seen by a Neurologist because she had been put on a waiting list to be seen due to the fact she was a Medicare patient. Another woman from Anchorage says: I just got through trying to find a physician for an elderly Medicare-dependent friend. At this time I have found no one who will take her. Most physicians take no Medicare patients or have a quota which is full. The Providence health care provider list has no one who takes Medicare. The last e-mail was from Anchorage stating: Almost no family practice office in Anchorage is accepting new Medicare patients. This is just a sample of what we get from constituents around the State of Alaska saying: I don't have anyone who can see my mother. I can't get in to see anyone myself. I mentioned in my comments this is a crisis that is growing. In Alaska, we don't often think of it as being a State where we have a large senior population. We think of some of the Southern States as being the ones that attract our seniors. But the fact is Alaska has the second fastest-growing senior population in the Nation, second only to Nevada. So again we ask the question: Why aren't Alaska's doctors able to provide care to our seniors? Why are they saying: No, we are not accepting any new Medicare patients? Well, a lot of it has to do with the reimbursement rates. Recent Federal reductions in Alaska Medicare reimbursement rates have been so severe that primary care physicians report that Medicare pays them only 37 cents--it is actually between 37 cents to 40 cents--for every dollar that it costs to treat a patient. So the doctor is spending a dollar in the care provided but is getting reimbursed about 40 cents to every dollar. We had one physician testify at the field hearing, and he said that in order for him to basically break even with his medical practice, he would have to see one Medicare patient every 7 minutes in order for him not to lose money. For those of us who go into our doctor's office, if we only had 7 minutes in there with our medical provider, I don't think we would feel we were getting the care and the attention our medical issues deserve. Losing money by seeing Medicare patients has meant that many of our physicians have stopped accepting Medicare patients entirely. They are making a decision not to accept any new Medicare patients. Or if you have been a patient of a particular physician and you turn 65, you may have had a good relationship with that physician, but if he tells you: I am sorry, I am not accepting any new Medicare patients, that date of your birthday comes and all of a sudden you don't have the care that you had relied on for some period of time. During this committee field hearing, we had testimony that revealed that only one neighborhood health clinic in the entire city of Anchorage-- and again, this is a city that has half the State's population--only one neighborhood health clinic is still accepting new Medicare patients. So if you are lucky enough to find a physician, it often takes weeks or months for an appointment. So when you are faced with this kind of a delay, you have one of two options. You either go to the emergency room if the conditions are severe enough or you go without care entirely, putting it off until perhaps it becomes even more complicated down the road. We had testify at the field hearing one gentleman who is from the city of Bethel. Bethel is in the western part of the State. He said he was willing to fly the 500-some-odd miles from Bethel to Anchorage if only he could find a primary care doctor who would accept him. He kind of joked because he said he counted himself lucky because he had a heart condition, and he was at least able to get in to see a specialist once in awhile. The chairman of the Alaska Commission on Aging, Mr. Frank Appel, called the lack of access to health care for seniors ``the most critical problem facing Alaska's seniors.'' I know Alaska is not alone. The crisis is not just Alaska. It is nationwide. We as a body, as a Congress, should find this situation intolerable. I haven't been in the Senate for as long as many of my other colleagues, but I have been here long enough to know that we fight a lot about health care. We debate the solvency issues, the funding issues, the insurance, the benefit coverage, universal coverage, health savings accounts, the prescription drug benefit. We debate and argue about a lot of these issues as they relate to health care, and each and every one of these issues is certainly worthy of great debate. But I would submit that not one of those very worthy debates matters in the least to one of the seniors I have mentioned in these letters who can't find a primary care doctor after making 100 phone calls. So instead of this body debating how health care is delivered, it is time we focus on the fact that it is not delivered in much of America. We have a crisis that, simply put, cannot wait. We have to do two things. We have to help current physicians stay in the practice of medicine, and we must vastly increase our health care work force. Earlier this year, Senator Stevens and I introduced the Rural Physician Relief Act, and this is a bill that provides tax incentives for physicians to practice in our most rural and frontier locations in the country. Today, along with my colleagues, Senator Schumer, Senator Stevens, and Senator Sanders, we are introducing legislation entitled the ``Physician Shortage Elimination Act.'' This legislation will double the funding for the National Health Service Corps, a program that is dedicated to meeting the needs of the underserved. Despite its success over the years, it has been vastly underfunded. We understand that 85 percent of the applicants to this worthy program have to be turned away each year because we don't fund it. This legislation will also allow rural and underserved physician residency programs to expand by removing barriers that prevent programs from developing rural training programs. We will also double certain title VII funding to create programs that target disadvantaged youth in rural and underserved areas and nurture them to create a pipeline to careers in health care. We need to get more people interested in the field. Finally, we must bolster the cornerstone of rural health care, which is the community health center, through additional grants and by allowing them to expand their residency programs. I would suggest that the prognosis for the quality of health care in America is poor. Fifteen million Americans in underserved areas across the Nation already do without care. Soon, with even greater physician shortages, it could mean that potentially another 84 million patients will be left without a physician's care. The time for Congress to act is now. In fact, it is past time. I look forward to working with my colleagues on this issue that again is not just Alaska-specific. I think the facts on the ground up North perhaps make the arguments more accentuated, but I think it points to a situation in this Nation that we must deal with now before the crisis is felt throughout the country. I appreciate the attention of the Chair.

Mrs. MURKOWSKI

Mrs. MURKOWSKI. Mr. President, I yield the floor, and I suggest the absence of a quorum.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I ask unanimous consent to speak as in morning business.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise to recognize the University of Alaska Fairbanks rifle team for winning the 2007 National Collegiate Athletic Association Rifle Championship on March 10, 2007 in Fairbanks, AK. With a total score of 4,662 points for their performance in the smallbore and air rifle competitions, the undefeated and defending champion University of Alaska Fairbanks ``Nanooks'' posted an 18-point win over the U.S. Military Academy and a 23-point win over Jacksonville State University to claim their ninth national championship title. This was the first time the Nanooks have hosted an NCAA Championship. More than 900 spectators, a record crowd for an NCAA Rifle Championship, were present to help support the local team. Nanooks head coach Dan Jordan, along with each member of the 2007 University of Alaska Fairbanks rifle team, which includes six National Rifle Association All-Americans, should be recognized for their achievements during this past season. I congratulate the team and wish them continued success in future years.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise this afternoon to speak of an issue of great concern in my State of Alaska but also a concern we are seeing across the Nation, and this is access to health care and, more specifically, access to the professionals who provide for our very important health care needs. In just 20 years, 20 percent of the U.S. population will be 65 years or older, a percentage larger than any other time in our Nation's history. And just as this aging population places the highest demand on our health care system, the Council on Graduate Medical Education states that there will be a national shortage of over 100,000 physicians in this country. Other experts look at it from a bit more dire perspective and predict a shortage closer to 200,000 physicians. If that becomes a reality, 84 million patients will be left without a doctor's care. A dozen States already report physician shortages. Across the country, patients are experiencing, or soon will face, shortages in many physician specialties, including cardiology, radiology, and several pediatric and surgical subspecialties. Demand for doctors is accelerating more rapidly than the supply, and yet the number of our medical school graduates has remained virtually flat for over a quarter of a century. During that same time period, the median tuition and fees at medical schools have increased by 750 percent in private schools and by nearly 900 percent in public schools. To add to that, much of the Nation's physician workforce also is graying. They are simply getting older. They are heading for retirement. A third of the Nation's 750,000 active post residency physicians are older than 55 and likely to retire just as this boomer population generation moves into its time of greatest medical need. By the year 2020, physicians are expected to hang up their stethoscopes at a rate nearly 2\1/2\ times the retirement rate of today. A looming doctor shortage threatens to create a national health care crisis by further limiting access to physicians, jeopardizing quality and accelerating cost increases. People are waiting for weeks to get appointments, and emergency departments have lines that fall out the door, literally. Many will go without care entirely, and we know the consequence then in terms of the pressures on the health care system when they go without care. In rural America, patients have long gone without care. In fact, the shortage of physicians, especially primary care physicians, in rural areas of the United States represents one of the most intractable health policy problems of the past century. As a result, rural patients are often denied both access to care and quality of care. One-fifth of the U.S. population lives in rural America. Yet only 9 percent of the Nation's physicians are practicing in these areas. Over 50 million of these rural Americans live in areas that have a shortage of physicians to meet their basic needs. Additionally, physician recruitment to rural America has also been a problem. The high cost of medical school is in large part to blame. Most students, very severely in debt after medical school, are forced away from primary care and forced into more lucrative speciality medicine. Rural areas and their community health centers across the Nation report a declining ability to recruit primary care physicians. Alaska, as my colleagues have heard me say on the floor of the Senate many times, geographically is huge. It is a State larger than Texas, California, and Montana combined. In Alaska, ``rural'' really takes on a new meaning. The physician shortage crisis in Alaska has long been magnified. Health care delivery in the State is extremely difficult because, in part, there are fewer roads than in any other State. Even Rhode Island has more roads than Alaska. This means that for the vast majority of communities in Alaska, our medical supplies, our patients, and our providers all must travel by air, which adds to the cost. Alaska's population is growing, especially its elderly population, which is the second fastest growing in the Nation. People don't typically think of Alaska as having a fair number of seniors, but our senior population is growing at a very rapid rate. However, Alaska's physician workforce, as others across the Nation, is aging. The number of new residents is not keeping up with attrition. Mr. President, 118 physicians in Anchorage alone are expected to retire in the next 10 years. Currently, Alaska has the sixth lowest ratio of physicians to population in the United States. Outside of Anchorage, the ratio is the worst in the Nation. To put it into perspective, if Alaska were to reach its national average of physicians to population, if we were to reach it by the year 2025, we would need a net increase of 980 physicians statewide or 49 more physicians per year. For some in States where their population base is significant, they might say 980 physicians between now and 2025 isn't that bad. We only have about 650,000 people in the State of Alaska. For us to find 980 physicians, or 49 more physicians per year, is a tall order. In Anchorage, many specialties are in serious or in critical shortage, including general internal medicine, neurology, neurosurgery, rheumatology, and infectious diseases. Patients wait for months to be accepted as new patients for general internal medicine. Others have to be flown to Seattle for some critical specialties. I need to repeat this because we are not just talking about ``I don't like this particular doctor, and I want to find somebody else.'' We don't have the physicians to see the patients, so a patient will wait for months for an appointment or the other alternative is to fly outside to Seattle. There is a bright spot, though, on the horizon. Even though Alaska has only one residency training program--and I should also mention we don't have any medical schools in the State of Alaska--our one residency training program trains 12 family medicine residents each year--clearly a number that is far fewer than our population needs. Seventy-seven percent of the residents choose to stay in Alaska--the highest rate of return in the Nation. We know why it is. We figure we have an awful lot to offer those who come to the State, but the problem is drawing them to the State in the first place. In the last Congress, with great fanfare, we provided a Medicare prescription drug benefit. But the question I was asking at that time is, What good is a prescription drug benefit if there is no physician to write prescriptions? In the 21st century, we cannot, as a Government, permit such dire access to care to continue. I do believe the situation is intolerable. We cannot sit by while potentially millions of patients go without care. That is why I am proposing a three-pronged plan to alleviate the Nation's rural health care access crisis. Earlier in the year, I introduced the Rural Physician Relief Act. This is legislation which would provide tax incentives for physicians to practice in our most rural and frontier locations in the country. Today, I am announcing a second step on improving access to health care. Soon, I will introduce the Physician Shortage Elimination Act. This is a strong step in improving access to our health system. Later, as the third prong of my plan, I will introduce comprehensive legislation for improving the plight of the uninsured. To get to the Physician Shortage Elimination Act, it essentially does four things: First and foremost, it doubles the funding for the National Health Service Corps. This program has operated with 37 years of excellence, providing primary care services to our most vulnerable populations. It is a solution to the many students who find the exorbitant cost of medical school prohibitively expensive. However, the program is just too small to meet the great need in underserved America. Right now, over 4,000 National Health Service Corps clinicians provide primary care to nearly 6 million people nationwide who otherwise would likely have gone without care. Tragically, this still leaves some 50 million people with extremely diminished access to health care. In fact, the American Association of Medical Colleges said the current program only meets 12 percent of the needs of the underserved. Yet this program is so popular with medical students that 80 percent of its applicants in a typical year must be turned away. This National Health Service Corps has a proven track record. Let us build on its success. Doubling our investment in the National Health Service Corps is the most prudent, most cost-effective and expeditious way to meet the current needs and future needs of America's underserved. In fact, the former president of the AAMC stated that the National Health Service Corps: . . . is ideally positioned to alleviate the shortage of physicians in many medically underserved areas but has only had sufficient funding to accommodate only a fraction of those young physicians who are prepared to practice in those areas. The second part of the bill will improve and expand current medical residency programs. Half of all physicians practice medicine within 100 miles of their residency. This means the residents who train in rural or underserved areas are likely to remain in those areas. The small Alaska Family Residency Program, which is a program designed to help meet the needs in rural Alaska, is a great example of this. Of the 55 graduates, 75 percent have stayed in Alaska upon completing their residency--the highest return rate of any graduate medical program in the country. Unfortunately, it is too small to meet the large needs of rural Alaska. Rural and underserved residency programs must be allowed to flourish. We have arcane barriers, and we have artificial caps on residency programs that need to be removed. Students must be allowed to learn their craft in the most rural and underserved areas of the Nation. My legislation will prevent residency programs from being penalized for training in locations where the need is greatest, such as the Indian Health Service locations. Additionally, it will remove barriers that prevent programs from developing rural training rotations and rural experiences in their curriculum. All the experts agree that this is likely one of the most effective ways to prepare students for a rural practice. Further, the legislation will reauthorize the Centers of Excellence Program and the Health Careers Opportunity Program. This did not receive funding for 2006, but these are important programs, and they target disadvantaged and minority students from as young as kindergarten on through high school. They target these young people to develop an interest in the health professions. The programs nurture the youth in rural and underserved areas, and they create a pipeline to careers in the health professions. This concept of ``growing your own,'' if you will, is the most effective way of achieving long-term retention in most rural locations. Finally, my legislation will bolster the cornerstone of health care in rural America, which is the community health center. Community health centers provide quality community-based health care for millions of America's medically underserved and uninsured. This bill will help them do their job. It will expand residency programs and primary care services offered by community health service centers and offer grants to health centers to assist them in recruitment, technical assistance, and physician mentoring programs. Mr. President, as a person coming from a rural area, you know a strong commitment to our community health centers is a smart, cost- effective way of maximizing our health care dollars for our neediest populations. The prognosis for quality of health care in America right now does not look good. The prognosis is poor. Fifty million Americans in underserved areas across the Nation today already must do without care. Soon, we will have greater problems. We will have even greater physician shortages, which will mean another 84 million patients will be left without a physician's care. We must act here in Congress. I ask my colleagues to take a look at the legislation we are introducing, the Physician Shortage Elimination Act, and see if this isn't something we can join together to work on so we can continue to provide the level of care Americans across the country, in both rural and urban areas, deserve and expect. With that, Mr. President, I yield the floor. Order of Procedure

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

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, February is American Heart Month, and heart disease remains the Nation's leading cause of death. Many women believe that heart disease is a man's disease and, unfortunately, do not review it as a serious health threat. However, every year, since 1984, cardiovascular disease claims the lives of more women than men. In fact, cardiovascular disease death rates have declined significantly in men since 1979, while the death rate for women hasn't experienced the same rate of decline. The numbers are disturbing: cardiovascular diseases claim the lives of more than 460,000 women per year; that's nearly a death a minute among females and nearly 12 times as many lives as claimed by breast cancer. One in three females has some form of cardiovascular disease. And one in four females dies from heart disease. That is why I am pleased to join my colleague from Michigan, Senator Stabenow, to introduce important legislation, the HEART for Women Act, or Heart disease Education, Analysis and Research, and Treatment for Women Act. This important bill improves the prevention, diagnosis and treatment of heart disease and stroke in women. In my State of Alaska--taken together--heart disease, stroke and other cardiovascular diseases are also the leading cause of death, totaling nearly 800 deaths each year. Women in Alaska have higher death rates from stroke than do women nationally. Mortality among Native Alaskan women is dramatically on the rise, whereas, it is actually declining among Caucasian women in the Lower 48. Despite being the number one killer, many women and their health care providers do not know that the biggest health care threat to women is heart disease. In fact, a recent survey found that 43 percent of women still don't know that heart disease is the number one killer of women. Perhaps even more troubling, is the lack of awareness among health care providers. According to American Heart Association figures, less than one in five physicians recognize that more women suffer from heart disease than men. Among primary care physicians, only 8 percent of primary care physicians--and even more astounding--only 17 percent of cardiologists recognize that more women die of heart disease than men. Additionally, studies show that women are less likely to receive aggressive treatment because heart disease often manifests itself differently in women than men. This is why the HEART Act is so important. Our bill takes a three- pronged approach to reducing the heart disease death rate for women, through; 1. education; 2. research; and, 3. screening. First, the bill would authorize the Department of Health and Human Services to educate healthcare professionals and older women about unique aspects of care in the prevention, diagnosis and treatment of women with heart disease and stroke. Second, the bill would require disclosure of gender-specific health information that is already being reported to the Federal Government. Many agencies already collect information based on gender, but do not disseminate or analyze the gender differences. This bill would release that information so that it could be studied, and important health trends in women could be detected. Lastly, the bill would authorize the expansion of the Centers for Disease Control and Prevention's WISEWOMAN program (the Well-Integrated Screening and Evaluation for Women Across the Nation program). The WISEWOMAN program provides free heart disease and stroke screening to low-income uninsured women, but the program is currently limited to just 14 States. My State of Alaska is fortunate to have two WISEWOMAN program sites. These programs screen for high blood pressure, cholesterol and glucose in Native Alaskan women and provide invaluable counseling on diet and exercise. One program in Alaska alone has successfully screened 1,437 Alaskan Native women and has provided them with a culturally appropriate intervention program that has produced live-saving results. Mr. President, heart disease, stroke and other cardiovascular diseases cost Americans more than any other disease--an estimated $430 billion in 2007, including more than $280 billion in direct medical costs. To put that number in perspective, that's about the same as the projected Federal deficit for 2007. We, as a nation, can control those costs--prevention through early detection is the most cost-effective way to combat this disease. Tomorrow, as we celebrate Valentine's Day and see images of hearts just about everywhere, let us not forget that the heart is much more than a symbol--it is a vital organ that can't be taken for granted. Coronary disease can be effectively treated and sometimes even prevented--it does not have to be the number one cause of death in women. And, that is why I encourage my colleagues to support the HEART for Women Act.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, February is American Heart Month, and heart disease remains the Nation's leading cause of death. Many women believe that heart disease is a man's disease and, unfortunately, do not review it as a serious health threat. However, every year, since 1984, cardiovascular disease claims the lives of more women than men. In fact, cardiovascular disease death rates have declined significantly in men since 1979, while the death rate for women hasn't experienced the same rate of decline. The numbers are disturbing: cardiovascular diseases claim the lives of more than 460,000 women per year; that's nearly a death a minute among females and nearly 12 times as many lives as claimed by breast cancer. One in three females has some form of cardiovascular disease. And one in four females dies from heart disease. That is why I am pleased to join my colleague from Michigan, Senator Stabenow, to introduce important legislation, the HEART for Women Act, or Heart disease Education, Analysis and Research, and Treatment for Women Act. This important bill improves the prevention, diagnosis and treatment of heart disease and stroke in women. In my State of Alaska--taken together--heart disease, stroke and other cardiovascular diseases are also the leading cause of death, totaling nearly 800 deaths each year. Women in Alaska have higher death rates from stroke than do women nationally. Mortality among Native Alaskan women is dramatically on the rise, whereas, it is actually declining among Caucasian women in the Lower 48. Despite being the number one killer, many women and their health care providers do not know that the biggest health care threat to women is heart disease. In fact, a recent survey found that 43 percent of women still don't know that heart disease is the number one killer of women. Perhaps even more troubling, is the lack of awareness among health care providers. According to American Heart Association figures, less than one in five physicians recognize that more women suffer from heart disease than men. Among primary care physicians, only 8 percent of primary care physicians--and even more astounding--only 17 percent of cardiologists recognize that more women die of heart disease than men. Additionally, studies show that women are less likely to receive aggressive treatment because heart disease often manifests itself differently in women than men. This is why the HEART Act is so important. Our bill takes a three- pronged approach to reducing the heart disease death rate for women, through; 1. education; 2. research; and, 3. screening. First, the bill would authorize the Department of Health and Human Services to educate healthcare professionals and older women about unique aspects of care in the prevention, diagnosis and treatment of women with heart disease and stroke. Second, the bill would require disclosure of gender-specific health information that is already being reported to the Federal Government. Many agencies already collect information based on gender, but do not disseminate or analyze the gender differences. This bill would release that information so that it could be studied, and important health trends in women could be detected. Lastly, the bill would authorize the expansion of the Centers for Disease Control and Prevention's WISEWOMAN program (the Well-Integrated Screening and Evaluation for Women Across the Nation program). The WISEWOMAN program provides free heart disease and stroke screening to low-income uninsured women, but the program is currently limited to just 14 States. My State of Alaska is fortunate to have two WISEWOMAN program sites. These programs screen for high blood pressure, cholesterol and glucose in Native Alaskan women and provide invaluable counseling on diet and exercise. One program in Alaska alone has successfully screened 1,437 Alaskan Native women and has provided them with a culturally appropriate intervention program that has produced live-saving results. Mr. President, heart disease, stroke and other cardiovascular diseases cost Americans more than any other disease--an estimated $430 billion in 2007, including more than $280 billion in direct medical costs. To put that number in perspective, that's about the same as the projected Federal deficit for 2007. We, as a nation, can control those costs--prevention through early detection is the most cost-effective way to combat this disease. Tomorrow, as we celebrate Valentine's Day and see images of hearts just about everywhere, let us not forget that the heart is much more than a symbol--it is a vital organ that can't be taken for granted. Coronary disease can be effectively treated and sometimes even prevented--it does not have to be the number one cause of death in women. And, that is why I encourage my colleagues to support the HEART for Women Act.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise to introduce a bill that will help the commercial fishermen and others whose livelihoods were negatively impacted by the Exxon Valdez oil spill. I am pleased to have Mr. Stevens join me in introducing this important legislation. The Exxon Valdez ran aground on Bligh Reef on March 24, 1989, spilling 11 million gallons of oil into Prince William Sound in Alaska. A class action jury trial was held in Federal court in Anchorage, AK, in 1994. The plaintiffs included 32,000 fishermen among others whose livelihoods were gravely affected by this disaster. The jury awarded $5 billion in punitive damages to plaintiffs. The punitive damage award has been on repeated appeal by the Exxon Corporation since 1994. Many of the original plaintiffs, possibly more than 1,000 people, have already died. Once the punitive damage award of the Exxon Valdez litigation is settled, many fishermen will receive payments to reimburse them for fishing income lost due to the environmental consequences of the Exxon Valdez oil spill. The eventual settlement could be as much as several billion dollars. My bill gives the affected fishermen, as well as other plaintiffs in this case, a fair shake when it comes to contributions to retirement plans and averaging of income for tax purposes. With respect to retirement plan contributions, my bill increases the caps on both deductions and income for traditional IRAs to the extent of the income a plaintiff receives from the settlement or judgment. Also, it allows the plaintiffs to make contributions to Roth IRAs and other retirement plans to the extent of the income received from the settlement or judgment. Fishermen are currently allowed to average their income over three years due to the often inconsistent nature of the fishing business. The litigation stemming from the Exxon Valdez oil spill poses an even more unique situation since fishermen and other plaintiffs have been waiting to receive lost income--in the form of a settlement or judgment--since 1994. My bill allows plaintiffs to average their income for the period of time between December 31 of the year they receive the settlement or judgment payment and January 1, 1994--the year of the original jury award in Federal court. It is imperative that we address this important issue to help those affected by the Exxon Valdez oil spill plan for their retirement. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise to introduce a bill that will help the commercial fishermen and others whose livelihoods were negatively impacted by the Exxon Valdez oil spill. I am pleased to have Mr. Stevens join me in introducing this important legislation. The Exxon Valdez ran aground on Bligh Reef on March 24, 1989, spilling 11 million gallons of oil into Prince William Sound in Alaska. A class action jury trial was held in Federal court in Anchorage, AK, in 1994. The plaintiffs included 32,000 fishermen among others whose livelihoods were gravely affected by this disaster. The jury awarded $5 billion in punitive damages to plaintiffs. The punitive damage award has been on repeated appeal by the Exxon Corporation since 1994. Many of the original plaintiffs, possibly more than 1,000 people, have already died. Once the punitive damage award of the Exxon Valdez litigation is settled, many fishermen will receive payments to reimburse them for fishing income lost due to the environmental consequences of the Exxon Valdez oil spill. The eventual settlement could be as much as several billion dollars. My bill gives the affected fishermen, as well as other plaintiffs in this case, a fair shake when it comes to contributions to retirement plans and averaging of income for tax purposes. With respect to retirement plan contributions, my bill increases the caps on both deductions and income for traditional IRAs to the extent of the income a plaintiff receives from the settlement or judgment. Also, it allows the plaintiffs to make contributions to Roth IRAs and other retirement plans to the extent of the income received from the settlement or judgment. Fishermen are currently allowed to average their income over three years due to the often inconsistent nature of the fishing business. The litigation stemming from the Exxon Valdez oil spill poses an even more unique situation since fishermen and other plaintiffs have been waiting to receive lost income--in the form of a settlement or judgment--since 1994. My bill allows plaintiffs to average their income for the period of time between December 31 of the year they receive the settlement or judgment payment and January 1, 1994--the year of the original jury award in Federal court. It is imperative that we address this important issue to help those affected by the Exxon Valdez oil spill plan for their retirement. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I am pleased to be joined by my colleagues, Senators Ensign, Stevens, Kyl, Craig, Crapo, and Inhofe, in introducing the Circuit Court of Appeals Restructuring and Modernization Act of 2007. Our legislation will create a new Twelfth Circuit comprised of Alaska, Washington, Oregon, Idaho, Montana, Nevada and Arizona and will go far in improving the efficiency and effectiveness of the current Ninth Circuit U.S. Court of Appeals. One need only look at the sheer geographic size of the Ninth Circuit to find reasons for reorganization. The Ninth Circuit extends from the Arctic Circle to the Mexican border, spans the tropics of Hawaii and crosses the International Dateline to Guam and the Northern Mariana Islands. Encompassing nine States and some 1.4 million square miles, the Ninth Circuit, by any means of measure, is the largest of all U.S. circuit courts of appeal. In fact, it is larger than the First, Second, Third, Fourth, Fifth, Sixth, Seventh and Eleventh Circuits combined. The Ninth Circuit serves a population of nearly 60 million, almost twice as many as the next largest Circuit. It contains the States that experience the fastest growth rate in the Nation. By 2010, the Census Bureau estimates that the Ninth Circuit's population will be more than 63 million--an increase which will inevitably create an even more daunting caseload. The only factor more disturbing than the geographic magnitude of the circuit is the magnitude of its ever-expanding docket. The Ninth Circuit has more cases than any other circuit. Based on figures from March, 2006, the Ninth Circuit had 71 percent more cases than the next largest circuit--that is equivalent to the caseload of the Third, Seventh, Eighth and Tenth Circuits combined. Moreover, because of the sheer magnitude of cases brought before the courts, citizens within the court's jurisdiction face intolerable delays in getting their cases heard. The median time to get a final disposition of an appellate case in the Ninth Circuit takes nearly 4 months longer than the national average. Former Chief Justice Warren E. Burger called the Ninth Circuit's docket an ``unmanageable administrative monstrosity.'' The massive size and daunting caseload of the Ninth Circuit result in a decrease in the ability of judges to keep abreast of legal developments within the circuit. The large number of judges scattered over the 1.4 million square miles of the circuit inevitably results in difficulty in reaching consistent circuit decisions. This lack of judicial consistency discourages settlements and leads to unnecessary litigation. Reversal rates by the Supreme Court remain astonishingly high. In 2005, 87.5 percent of the Ninth Circuit cases brought before the Supreme Court were reversed or vacated. In 2006, 96 percent were reversed or vacated. Another problem with the Ninth Circuit is that it is never able to speak with one voice. Because of its size, the Ninth Circuit is the only circuit where all judges do not sit in en banc, or full court, review of panel decisions. Rather than splitting the Ninth Circuit at the time the Fifth Circuit was split, Congress decided to permit the Ninth Circuit to test a ``limited'' en banc procedure. The limited en banc allows a full court to be comprised of 11 members, rather than 28. Therefore, 6 members of the 28 are all that is necessary for a majority opinion. Former Chief Justice Burger strongly opposed the limited en banc procedure: Six judges can now bind more than 100 Article III and Article I judges, and this is simply contrary to how a court should function I strongly believe the Ninth Circuit should be divided. The legislation that I and my colleagues introduce today is the sensible reorganization of the Ninth Circuit. No one court can effectively exercise its power in an area that extends from the Arctic Circle to the tropics. Our legislation creates a circuit which is more geographically manageable, thereby significantly reducing wasted time and money spent on judicial travel. Additionally, caseloads will be much more manageable. Whatever circuit that contains California will always be the giant of the circuits, but as you can see from this chart, caseloads before the new Ninth Circuit and the new Twelfth Circuit are much more in line with other circuits. Such reductions in caseload will clearly improve uniformity, consistency and dependency in legal decisions. Additionally, this legislation is not novel. Since the day the circuit was established, over a century ago, there have been discussions to divide it. Over the last several decades, Congress has held hearings and debated a split and even mandated two congressional commissions to study the issue each of which recommended dividing the circuit. In fact, the scholarly White Commission, which reported to Congress in 1998, concluded that restructuring the Ninth Circuit would ``increase the consistency and coherence of the law, maximize the likelihood of genuine collegiality, establish an effective procedure for maintaining uniform decisional law within the circuit, and relate the appellate forum more closely to the region it serves.'' Furthermore, splitting a circuit to respond to caseload and population growth is by no means unprecedented. Congress divided the original Eighth Circuit to create the Tenth Circuit in 1929 and divided the former Fifth Circuit to create the Eleventh Circuit in 1980. We have waited long enough. The 60 million residents of the Ninth Circuit are the persons who suffer. Many wait years before cases are heard and decided, prompting many to forego the entire appellate process. In brief, the Ninth Circuit has become a circuit where justice is not swift and not always served.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, today I am reintroducing an important bill on a subject that was not resolved last year, and which continues to be an outstanding issue for those of us who are dependent on healthy and productive natural populations of ocean fish and shellfish. Simply put, this bill prohibits further movement toward the development of aquaculture facilities in Federal waters until Congress has had an opportunity to review all of the serious implications, and make decisions on how such development should proceed. For years, some members of the Federal bureaucracy have advocated going forward with offshore aquaculture development without that debate. While the administration has entertained some level of public input, the role of Congress must not be undermined. Doing so, would be an extraordinarily bad idea. The Administration is in the final stages of preparing a bill to allow offshore aquaculture development to occur, and it plans to send the bill to Congress in the very near future. In the last Congress, the Administration proposed legislation to provide a regulatory framework for the development of off-shore aquaculture. While their draft bill is an improvement, it still does not establish clear mandatory environmental standards for the aquaculture industry. I remain steadfast that any proposal should meet the standards of the National Environmental Policy Act, the Magnuson-Stevens Fishery Conservation and Management Act and the Jones Act. Why should this industry be exempt from the same laws that our commercial fisheries are subject to? Why should this industry not go through the same rigorous environmental review as any other activity that will have impacts on the environment? Scientists, the media and the public are awakening to the serious disadvantages of fish raised in fish farming operations compared to naturally healthy wild fish species such as Alaska salmon, halibut, sablefish, crab and many other species. It has become common to see news reports that cite not only the general health advantages of eating fish at least once or twice a week, but the specific advantages of fish such as wild salmon, which contains essential Omega-3 fatty acids that may help reduce the risk of heart disease and possibly have similar beneficial effects on other diseases. Educated and watchful consumers have also seen recent stories citing research that not only demonstrates that farmed salmon fed vegetable- based food does not have the same beneficial impact on cardio-vascular health, but also that the demand for other fish that we use as feed in those fish farms may lead to the decimation of those stocks. Yet the Administration's bill does not address feed in a meaningful way. Those same alert consumers may also have seen stories indicating that fish farms may create serious pollution problems from the concentration of fish feces and uneaten food, that fish farms may harbor diseases that can be transmitted to previously healthy wild fish stocks, and that fish farming has had a devastating effect on communities that depend on traditional fisheries. It is by no means certain that all those problems would be duplicated if we begin to develop fish farms that are farther offshore, but neither is there any evidence that they would not be . . . I certainly don't believe it is prudent to extend the site permits to 20 years, as in the draft bill, given all of the questions and uncertainties of the environmental risks. Not only do the proponents want to encourage such development, they also want to change the way decisions are made so that all the authority rests in the hands of just one Federal agency. I believe that would be a serious mistake. There are simply too many factors that should be evaluated--from hydraulic engineering, to environmental impacts, transportation and shipping issues, fish biology, management of disease, to the nutritional character of farmed fish, and so on--for any existing agency. We cannot afford a rush to judgment on this issue--it is far too dangerous if we make a mistake. In my view, such a serious matter deserves the same level of scrutiny by Congress as the recommendations of the U.S. Commission on Ocean Policy for other sweeping changes in ocean governance. The ``Natural Stock Conservation Act'' I am introducing today lays down a marker for where the debate on offshore aquaculture needs to go. It would prohibit the development of new offshore aquaculture operations until Congress has acted to ensure that every Federal agency involved does the necessary analyses in areas such as disease control, engineering, pollution prevention, biological and genetic impacts, economic and social effects, and other critical issues, none of which are specifically required under existing law. I strongly urge my colleagues to understand that this is not a parochial issue, but a very real threat to the literal viability of natural fish and shellfish stocks, as well as the economic viability of many coastal communities. We must retain the oversight necessary to ensure that if we move forward on the development of off-shore aquaculture. I sincerely hope that Congress will give this issue the attention it deserves. We all want to make sure we enjoy abundant supplies of healthy foods in the future, but not if it means unnecessary and avoidable damage to wild species, to the environment generally, and to the economies of America's coastal fishing communities. I ask unanimous consent that the text of my bill be printed in the Record.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, today I am reintroducing an important bill on a subject that was not resolved last year, and which continues to be an outstanding issue for those of us who are dependent on healthy and productive natural populations of ocean fish and shellfish. Simply put, this bill prohibits further movement toward the development of aquaculture facilities in Federal waters until Congress has had an opportunity to review all of the serious implications, and make decisions on how such development should proceed. For years, some members of the Federal bureaucracy have advocated going forward with offshore aquaculture development without that debate. While the administration has entertained some level of public input, the role of Congress must not be undermined. Doing so, would be an extraordinarily bad idea. The Administration is in the final stages of preparing a bill to allow offshore aquaculture development to occur, and it plans to send the bill to Congress in the very near future. In the last Congress, the Administration proposed legislation to provide a regulatory framework for the development of off-shore aquaculture. While their draft bill is an improvement, it still does not establish clear mandatory environmental standards for the aquaculture industry. I remain steadfast that any proposal should meet the standards of the National Environmental Policy Act, the Magnuson-Stevens Fishery Conservation and Management Act and the Jones Act. Why should this industry be exempt from the same laws that our commercial fisheries are subject to? Why should this industry not go through the same rigorous environmental review as any other activity that will have impacts on the environment? Scientists, the media and the public are awakening to the serious disadvantages of fish raised in fish farming operations compared to naturally healthy wild fish species such as Alaska salmon, halibut, sablefish, crab and many other species. It has become common to see news reports that cite not only the general health advantages of eating fish at least once or twice a week, but the specific advantages of fish such as wild salmon, which contains essential Omega-3 fatty acids that may help reduce the risk of heart disease and possibly have similar beneficial effects on other diseases. Educated and watchful consumers have also seen recent stories citing research that not only demonstrates that farmed salmon fed vegetable- based food does not have the same beneficial impact on cardio-vascular health, but also that the demand for other fish that we use as feed in those fish farms may lead to the decimation of those stocks. Yet the Administration's bill does not address feed in a meaningful way. Those same alert consumers may also have seen stories indicating that fish farms may create serious pollution problems from the concentration of fish feces and uneaten food, that fish farms may harbor diseases that can be transmitted to previously healthy wild fish stocks, and that fish farming has had a devastating effect on communities that depend on traditional fisheries. It is by no means certain that all those problems would be duplicated if we begin to develop fish farms that are farther offshore, but neither is there any evidence that they would not be . . . I certainly don't believe it is prudent to extend the site permits to 20 years, as in the draft bill, given all of the questions and uncertainties of the environmental risks. Not only do the proponents want to encourage such development, they also want to change the way decisions are made so that all the authority rests in the hands of just one Federal agency. I believe that would be a serious mistake. There are simply too many factors that should be evaluated--from hydraulic engineering, to environmental impacts, transportation and shipping issues, fish biology, management of disease, to the nutritional character of farmed fish, and so on--for any existing agency. We cannot afford a rush to judgment on this issue--it is far too dangerous if we make a mistake. In my view, such a serious matter deserves the same level of scrutiny by Congress as the recommendations of the U.S. Commission on Ocean Policy for other sweeping changes in ocean governance. The ``Natural Stock Conservation Act'' I am introducing today lays down a marker for where the debate on offshore aquaculture needs to go. It would prohibit the development of new offshore aquaculture operations until Congress has acted to ensure that every Federal agency involved does the necessary analyses in areas such as disease control, engineering, pollution prevention, biological and genetic impacts, economic and social effects, and other critical issues, none of which are specifically required under existing law. I strongly urge my colleagues to understand that this is not a parochial issue, but a very real threat to the literal viability of natural fish and shellfish stocks, as well as the economic viability of many coastal communities. We must retain the oversight necessary to ensure that if we move forward on the development of off-shore aquaculture. I sincerely hope that Congress will give this issue the attention it deserves. We all want to make sure we enjoy abundant supplies of healthy foods in the future, but not if it means unnecessary and avoidable damage to wild species, to the environment generally, and to the economies of America's coastal fishing communities. I ask unanimous consent that the text of my bill be printed in the Record.

Ms. MURKOWSKI. Mr. President, I am pleased to be joined by my colleagues, Senators Ensign, Stevens, Kyl, Craig, Crapo, and Inhofe, in introducing the Circuit Court of Appeals Restructuring and Modernization Act of 2007. Our legislation will create a new Twelfth Circuit comprised of Alaska, Washington, Oregon, Idaho, Montana, Nevada and Arizona and will go far in improving the efficiency and effectiveness of the current Ninth Circuit U.S. Court of Appeals. One need only look at the sheer geographic size of the Ninth Circuit to find reasons for reorganization. The Ninth Circuit extends from the Arctic Circle to the Mexican border, spans the tropics of Hawaii and crosses the International Dateline to Guam and the Northern Mariana Islands. Encompassing nine States and some 1.4 million square miles, the Ninth Circuit, by any means of measure, is the largest of all U.S. circuit courts of appeal. In fact, it is larger than the First, Second, Third, Fourth, Fifth, Sixth, Seventh and Eleventh Circuits combined. The Ninth Circuit serves a population of nearly 60 million, almost twice as many as the next largest Circuit. It contains the States that experience the fastest growth rate in the Nation. By 2010, the Census Bureau estimates that the Ninth Circuit's population will be more than 63 million--an increase which will inevitably create an even more daunting caseload. The only factor more disturbing than the geographic magnitude of the circuit is the magnitude of its ever-expanding docket. The Ninth Circuit has more cases than any other circuit. Based on figures from March, 2006, the Ninth Circuit had 71 percent more cases than the next largest circuit--that is equivalent to the caseload of the Third, Seventh, Eighth and Tenth Circuits combined. Moreover, because of the sheer magnitude of cases brought before the courts, citizens within the court's jurisdiction face intolerable delays in getting their cases heard. The median time to get a final disposition of an appellate case in the Ninth Circuit takes nearly 4 months longer than the national average. Former Chief Justice Warren E. Burger called the Ninth Circuit's docket an ``unmanageable administrative monstrosity.'' The massive size and daunting caseload of the Ninth Circuit result in a decrease in the ability of judges to keep abreast of legal developments within the circuit. The large number of judges scattered over the 1.4 million square miles of the circuit inevitably results in difficulty in reaching consistent circuit decisions. This lack of judicial consistency discourages settlements and leads to unnecessary litigation. Reversal rates by the Supreme Court remain astonishingly high. In 2005, 87.5 percent of the Ninth Circuit cases brought before the Supreme Court were reversed or vacated. In 2006, 96 percent were reversed or vacated. Another problem with the Ninth Circuit is that it is never able to speak with one voice. Because of its size, the Ninth Circuit is the only circuit where all judges do not sit in en banc, or full court, review of panel decisions. Rather than splitting the Ninth Circuit at the time the Fifth Circuit was split, Congress decided to permit the Ninth Circuit to test a ``limited'' en banc procedure. The limited en banc allows a full court to be comprised of 11 members, rather than 28. Therefore, 6 members of the 28 are all that is necessary for a majority opinion. Former Chief Justice Burger strongly opposed the limited en banc procedure: Six judges can now bind more than 100 Article III and Article I judges, and this is simply contrary to how a court should function I strongly believe the Ninth Circuit should be divided. The legislation that I and my colleagues introduce today is the sensible reorganization of the Ninth Circuit. No one court can effectively exercise its power in an area that extends from the Arctic Circle to the tropics. Our legislation creates a circuit which is more geographically manageable, thereby significantly reducing wasted time and money spent on judicial travel. Additionally, caseloads will be much more manageable. Whatever circuit that contains California will always be the giant of the circuits, but as you can see from this chart, caseloads before the new Ninth Circuit and the new Twelfth Circuit are much more in line with other circuits. Such reductions in caseload will clearly improve uniformity, consistency and dependency in legal decisions. Additionally, this legislation is not novel. Since the day the circuit was established, over a century ago, there have been discussions to divide it. Over the last several decades, Congress has held hearings and debated a split and even mandated two congressional commissions to study the issue each of which recommended dividing the circuit. In fact, the scholarly White Commission, which reported to Congress in 1998, concluded that restructuring the Ninth Circuit would ``increase the consistency and coherence of the law, maximize the likelihood of genuine collegiality, establish an effective procedure for maintaining uniform decisional law within the circuit, and relate the appellate forum more closely to the region it serves.'' Furthermore, splitting a circuit to respond to caseload and population growth is by no means unprecedented. Congress divided the original Eighth Circuit to create the Tenth Circuit in 1929 and divided the former Fifth Circuit to create the Eleventh Circuit in 1980. We have waited long enough. The 60 million residents of the Ninth Circuit are the persons who suffer. Many wait years before cases are heard and decided, prompting many to forego the entire appellate process. In brief, the Ninth Circuit has become a circuit where justice is not swift and not always served.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise today to bid farewell to one of the longest tenured members of my Senate staff, Mr. William ``Bill'' Woolf. Bill will retire from U.S. Senate employment at the end of January, after 20 years of exceptional service to the citizens of this country and to the residents of the State of Alaska. Bill was born in Washington State and studied at Washington State University and the University of Alaska in Juneau. Growing up in the country, he developed an early and lasting love of the outdoors-- boating, fishing, and hunting--even before moving to the Last Frontier in 1974. He has served as my legislative assistant for fisheries, science, and transportation issues since I entered the Senate in 2002. Prior to that, he worked for the ``other Senator Murkowski'' for 15 years. While I love to catch and eat Alaska' salmon, halibut, crab, and pollock, Bill truly knows not only the biology but also the economic intricacies of both sport and commercial fishing and game management issues. Over the years, he has become an expert in wildlife and fishery biology and management, dedicating himself to protecting and expanding fish and game stocks not just in Alaska but nationwide. Bill moves easily among scientists, government officials, fishermen, and business. He has gained a reputation as a dedicated and knowledgeable advocate for sound, scientific fishery and wildlife management and quality resource development. He has worked tirelessly to help perfect and protect the regional fishery management process, encompassed in the Magnuson-Stevens Fisheries Conservation and Management Act. Despite never serving with a member of the Commerce Committee, Bill has been influential in many of the fisheries laws passed by this body, dealing with subjects as diverse as reflagging of foreign processing ships, banning the use of large-scale driftnets on the high seas, improving safety and quality inspection techniques for fish products, allowing fishermen greater control over secondary market pricing, providing for country of origin seafood labeling, and encouraging action to allow ``organic'' labeling. He also worked with the State Department and others to implement international agreements on fisheries in the central Bering Sea and the Sea of Okhotsk, protection of salmon in the North Pacific, successful negotiations with Canada of the Pacific Salmon Treaty, and many others. He is particularly proud of having drafted, presented, and worked with the staff of U.N. Ambassador Madeleine Albright to achieve U.N. General Assembly approval for the very first international resolution to control bycatch and waste in fisheries worldwide. Bill, however, has not focused solely on fisheries. Over the years, his range of issues has cut across many lines, involved many disciplines, and a wide range of science, transportation, and other issues for the Alaska congressional delegation. Among his accomplishments were writing the first comprehensive law to control wastewater discharges from cruise ships in Alaska, advising the U.S. Arctic Research Commission, representing Alaska's interests in staff negotiations on the Water Resources Development Act, and working long hours and weekends to ensure that the Highway Reauthorization passed by the 109th Congress would help bring Alaska's road system into the 21st century. He also helped organize and staffed a Senate Coast Guard Caucus for several years. After the 2005 hurricanes devastated the gulf coast, he was the key influence behind the successful formation of the Alaska Fishing Industry Relief Mission. This nonprofit corporation moved important equipment all the way from Alaska to Louisiana and Mississippi--including both a 60-ton capacity boat lift and a 30-ton per day ice making machine, both were critically needed to get the gulf coast fishing industry back in play. The formation of the caucus and mission are a lasting testament to Bill's good judgment, hard work, and dedication to intelligently build this Nation's ports and harbors infrastructure and to care for those who depend on them. I also want to mention that Bill started his career as a broadcaster, general manager, news director, correspondent and producer for radio and television stations in Alaska, Washington, and Oregon. He also served a stint as a Senate press secretary and communications' director for the chairman of the Intelligence Committee during the first Persian Gulf war. He understands how important it is for Congress to communicate its policies to the citizens of America and fully explain why we take the actions that we do. While I am sorry to lose one of my staff leaders, I am happy that he will be able to more fully enjoy some of his other interests: woodworking, motorcycling, fishing, hunting, his collection of Alaskan and Asian art, and his beloved German shepherd dogs. I will miss Bill's hard work, vast knowledge, good humor, and sound judgment. It has been a pleasure to have him on my staff. I wish him and his wife Karen the very best and know that Alaskans will benefit for decades to come from his efforts to protect and enhance this Nation natural and biological resources and the environment.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise today to introduce a significant bill to improve energy efficiency in this Nation and reduce greenhouse gas emissions. The bill I am introducing will promote the development of additional forms of renewable energy and also pave the way for improved fuel consumption by vehicles. I rise to introduce the Renewable Energy, Fuel Reduction, and Economic Stabilization and Enhancement Act of 2007, or the REFRESH Act, for short. I consider this a balanced measure, a companion to a bill introduced recently by Alaska's Senior Senator Ted Stevens who proposed to raise the fuel efficiency of automobiles to 40 miles per gallon within a decade, a bill I am proud to be a cosponsor of. This bill will promote alternative energy by providing grants and tax credits to promote development of geothermal power, all forms of ocean energy and small hydro electric development. The bill also seeks to reduce American fossil fuel consumption by nearly 5 million barrels of oil a day by 2025 by not only supporting an increase in the Corporate Average Fuel Efficiency Standard, CAFE, for automobiles, as proposed by Senator Stevens, but by also requiring a study of whether to mandate that a CAFE standard to be imposed on commercial trucks. The bill also requires an improvement in the efficiency of replacement tires for all passenger cars, provides grants to States and local communities to encourage a reduction in traffic congestion by helping States to set up telecommuting and flexible-work programs to keep motorists off roadways during rush hours, and extends and removes a cap on tax credits to encourage the purchase of hybrid and advanced fuel efficient lean-burn vehicles. The bill also authorizes $100 million in additional research assistance for plug-in hybrid and battery storage technology development. The bill also includes a truth in advertising provision requiring that the CAFE standards for vehicles be based on the actual fuel economy that the vehicles will achieve under real-world driving conditions, where acceleration, the use of air conditioning and stop and go driving is considered rather than on a three-decades old testing formula. The bill will reduce carbon dioxide emissions from fossil fuel usage by about 530 million metric tons in the United States by 2025--a 7 percent cut over what emissions otherwise are predicted to be that year. Coming from Alaska where there is no question but that warming temperatures have been in place in recent years, it only makes sense that we take common sense steps now to improve fuel efficiency, to promote the development of a wider range of alternative energy technologies and to encourage Americans to buy more fuel efficient vehicles, as long as their ability to drive safe and affordable vehicles of their own choosing is protected. This bill is a careful balance of steps we can take to reduce fuel usage and thus greenhouse gas emissions, but also of provisions that are economic for Americans to undertake, and will pay for themselves in reduced fuel costs, sometimes in very short order. It will be good insurance for the environment, but also good for the pocketbooks of Americans. Americans understand that we are in a current warming trend. Just this week, our government reported that 2006 was the warmest year worldwide in over a century. There are dozens of examples of the effects on the environment that the warming climate of the past three decades has caused. While I believe the ultimate cause of the climate change we are seeing is not yet certain, it is our responsibility to take affordable steps now to reduce fuel consumption, increase the use of alternative, non-fossil-fuel technologies, and to reduce carbon dioxide and other greenhouse gas emissions. This bill, paired with previous legislation by my colleague Senator Ted Stevens that specifically raises the CAFE standard by 2017, S. 183, will require automobile makers, if it is technologically feasible, to improve fuel efficiency. I am proud to be a supporter of that measure. The two bills will have a host of policy and economic advantages. They will make us less dependent on imported oil, improving our national security and reducing the money we spend overseas to buy imported crude oil. And they will produce more jobs in America through the development of new alternative-fuel industries. The bill I introduce today, for example, will require all tire manufacturers to make and sell only low, rolling, resistance tires for replacement tire purposes within five years--the same tires found on new cars today. The tires, while they will add on average $20 to the cost of a set of two replacement tires, will improve fuel efficiency by 1.5 to 4.5 percent. Thus if the price of gasoline is only $2 a gallon, drivers will save from $87 to $260 a year in fuel costs per year, the change saving the typical driver money within the first year, according to estimates by the National Commission on Energy Policy that recommended the change in a 2005 report. The bill also will require the National Highway Traffic Safety Administration (NHTSA) to study the savings that would result and the costs of imposing a CAFE standard on commercial trucks, a key requirement before Congress can actually impose such a standard. Commercial trucks consume between 1.5 and 2 million barrels of oil a day in fuel. According to estimates by the Department of Energy's 21st Century Truck Program and by Argonne National Laboratory, fuel economy for tractor-trailers should be able to improve by 30 to 60 percent by 2015 through use of a CAFE standard. While such improvements might increase the cost of a tractor-trailer by $7,000 at time of purchase, it would save some $11,000 in fuel costs over the life of the vehicle, achieving payback for the typical truck owner in less than three years. Imposing such a CAFE on trucks was proposed by the Energy Security Leadership Council in a report just last month. The $50 million in grants to reduce traffic congestion could pay for themselves nearly immediately, since the National Commission on Energy Policy estimated that American motorists consume between 65,000 and 260,000 barrels of oil a day in wasted fuel because of urban traffic congestion, costing the Nation up to $13 million a day at current fuel prices. And the tax credit provisions, making all forms of ocean energy: wave, current, tidal and thermal, and small hydro electric power qualified to receive the Federal Production Tax Credit that currently reduces the cost of wind, solar and biomass energy by 1.9 cents per kilowatt hour generated, would help to increase renewable energy production nationwide. Geothermal energy is already covered by the PTC, as are wind, solar and biomass projects. Congress two years ago in the Energy Policy Act of 2005, which I helped formulate, provided both grant and the tax assistance to encourage the development of wind, solar and biomass energy. But when you consider that large portions of the country, including 70 percent of Alaska, may contain geothermal resources, that there are thousands of lakes and small rivers and creeks that can power small-scale hydro electric development without requiring dams or affecting fisheries or the environment in the least, and that thousands of miles of U.S. coastlines and river systems can generate electricity from emerging ocean energy systems, it only makes sense to expand the scope of Federal assistance to encourage wider development and use of these other renewable technologies. The Electric Power Research Institute has estimated that wave energy off U.S. coasts alone could conservatively generate 252 million megawatt hours of electricity, 6.5 percent of all energy now produced in America. Alaska has nearly 80 coastal and river communities that could benefit greatly by development of ocean energy systems. To facilitate ocean and geothermal development, the bill authorizes $100 million in Federal research and development grant assistance to both types of development. This bill is not a cure all for all of our energy woes. I recently co-sponsored legislation by Senators Jim Bunning and Barack Obama that will provide additional incentives to develop fuel from coal and that will encourage the sequestration of carbon from coal processed in fuel- to-liquid plants. I will support additional assistance to promote wind, solar and biomass alternative energy development. I have supported and will continue to support development of the next generation of nuclear power that can produce energy without any greenhouse gas emissions. And I will continue to support research and development of biofuels, such as ethanol, especially celluosic ethanol, and of development of hydrogen-fueled vehicles and fuel distribution systems for the new fuels. I also will support production of more domestic energy from conventional sources, whether it be more oil and natural gas from the ground onshore and from under some of our seas offshore where it can be done in an environmentally friendly way, or more novel forms of fossil fuels, be they from oil shales, oil sands, coal or from gas hydrate deposits. In my view we need to do everything we can to find economic forms of the energy we will need during the remainder of the 21st Century. This bill only represents one piece of a balanced plan to improve this Nation's energy outlook. But it is an important piece. This bill has the ability to restore and refresh our environment by reducing greenhouse gas emissions. It will encourage development of more renewable energy. We can't afford not to find the funds to pay for its provisions. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise today to introduce a significant bill to improve energy efficiency in this Nation and reduce greenhouse gas emissions. The bill I am introducing will promote the development of additional forms of renewable energy and also pave the way for improved fuel consumption by vehicles. I rise to introduce the Renewable Energy, Fuel Reduction, and Economic Stabilization and Enhancement Act of 2007, or the REFRESH Act, for short. I consider this a balanced measure, a companion to a bill introduced recently by Alaska's Senior Senator Ted Stevens who proposed to raise the fuel efficiency of automobiles to 40 miles per gallon within a decade, a bill I am proud to be a cosponsor of. This bill will promote alternative energy by providing grants and tax credits to promote development of geothermal power, all forms of ocean energy and small hydro electric development. The bill also seeks to reduce American fossil fuel consumption by nearly 5 million barrels of oil a day by 2025 by not only supporting an increase in the Corporate Average Fuel Efficiency Standard, CAFE, for automobiles, as proposed by Senator Stevens, but by also requiring a study of whether to mandate that a CAFE standard to be imposed on commercial trucks. The bill also requires an improvement in the efficiency of replacement tires for all passenger cars, provides grants to States and local communities to encourage a reduction in traffic congestion by helping States to set up telecommuting and flexible-work programs to keep motorists off roadways during rush hours, and extends and removes a cap on tax credits to encourage the purchase of hybrid and advanced fuel efficient lean-burn vehicles. The bill also authorizes $100 million in additional research assistance for plug-in hybrid and battery storage technology development. The bill also includes a truth in advertising provision requiring that the CAFE standards for vehicles be based on the actual fuel economy that the vehicles will achieve under real-world driving conditions, where acceleration, the use of air conditioning and stop and go driving is considered rather than on a three-decades old testing formula. The bill will reduce carbon dioxide emissions from fossil fuel usage by about 530 million metric tons in the United States by 2025--a 7 percent cut over what emissions otherwise are predicted to be that year. Coming from Alaska where there is no question but that warming temperatures have been in place in recent years, it only makes sense that we take common sense steps now to improve fuel efficiency, to promote the development of a wider range of alternative energy technologies and to encourage Americans to buy more fuel efficient vehicles, as long as their ability to drive safe and affordable vehicles of their own choosing is protected. This bill is a careful balance of steps we can take to reduce fuel usage and thus greenhouse gas emissions, but also of provisions that are economic for Americans to undertake, and will pay for themselves in reduced fuel costs, sometimes in very short order. It will be good insurance for the environment, but also good for the pocketbooks of Americans. Americans understand that we are in a current warming trend. Just this week, our government reported that 2006 was the warmest year worldwide in over a century. There are dozens of examples of the effects on the environment that the warming climate of the past three decades has caused. While I believe the ultimate cause of the climate change we are seeing is not yet certain, it is our responsibility to take affordable steps now to reduce fuel consumption, increase the use of alternative, non-fossil-fuel technologies, and to reduce carbon dioxide and other greenhouse gas emissions. This bill, paired with previous legislation by my colleague Senator Ted Stevens that specifically raises the CAFE standard by 2017, S. 183, will require automobile makers, if it is technologically feasible, to improve fuel efficiency. I am proud to be a supporter of that measure. The two bills will have a host of policy and economic advantages. They will make us less dependent on imported oil, improving our national security and reducing the money we spend overseas to buy imported crude oil. And they will produce more jobs in America through the development of new alternative-fuel industries. The bill I introduce today, for example, will require all tire manufacturers to make and sell only low, rolling, resistance tires for replacement tire purposes within five years--the same tires found on new cars today. The tires, while they will add on average $20 to the cost of a set of two replacement tires, will improve fuel efficiency by 1.5 to 4.5 percent. Thus if the price of gasoline is only $2 a gallon, drivers will save from $87 to $260 a year in fuel costs per year, the change saving the typical driver money within the first year, according to estimates by the National Commission on Energy Policy that recommended the change in a 2005 report. The bill also will require the National Highway Traffic Safety Administration (NHTSA) to study the savings that would result and the costs of imposing a CAFE standard on commercial trucks, a key requirement before Congress can actually impose such a standard. Commercial trucks consume between 1.5 and 2 million barrels of oil a day in fuel. According to estimates by the Department of Energy's 21st Century Truck Program and by Argonne National Laboratory, fuel economy for tractor-trailers should be able to improve by 30 to 60 percent by 2015 through use of a CAFE standard. While such improvements might increase the cost of a tractor-trailer by $7,000 at time of purchase, it would save some $11,000 in fuel costs over the life of the vehicle, achieving payback for the typical truck owner in less than three years. Imposing such a CAFE on trucks was proposed by the Energy Security Leadership Council in a report just last month. The $50 million in grants to reduce traffic congestion could pay for themselves nearly immediately, since the National Commission on Energy Policy estimated that American motorists consume between 65,000 and 260,000 barrels of oil a day in wasted fuel because of urban traffic congestion, costing the Nation up to $13 million a day at current fuel prices. And the tax credit provisions, making all forms of ocean energy: wave, current, tidal and thermal, and small hydro electric power qualified to receive the Federal Production Tax Credit that currently reduces the cost of wind, solar and biomass energy by 1.9 cents per kilowatt hour generated, would help to increase renewable energy production nationwide. Geothermal energy is already covered by the PTC, as are wind, solar and biomass projects. Congress two years ago in the Energy Policy Act of 2005, which I helped formulate, provided both grant and the tax assistance to encourage the development of wind, solar and biomass energy. But when you consider that large portions of the country, including 70 percent of Alaska, may contain geothermal resources, that there are thousands of lakes and small rivers and creeks that can power small-scale hydro electric development without requiring dams or affecting fisheries or the environment in the least, and that thousands of miles of U.S. coastlines and river systems can generate electricity from emerging ocean energy systems, it only makes sense to expand the scope of Federal assistance to encourage wider development and use of these other renewable technologies. The Electric Power Research Institute has estimated that wave energy off U.S. coasts alone could conservatively generate 252 million megawatt hours of electricity, 6.5 percent of all energy now produced in America. Alaska has nearly 80 coastal and river communities that could benefit greatly by development of ocean energy systems. To facilitate ocean and geothermal development, the bill authorizes $100 million in Federal research and development grant assistance to both types of development. This bill is not a cure all for all of our energy woes. I recently co-sponsored legislation by Senators Jim Bunning and Barack Obama that will provide additional incentives to develop fuel from coal and that will encourage the sequestration of carbon from coal processed in fuel- to-liquid plants. I will support additional assistance to promote wind, solar and biomass alternative energy development. I have supported and will continue to support development of the next generation of nuclear power that can produce energy without any greenhouse gas emissions. And I will continue to support research and development of biofuels, such as ethanol, especially celluosic ethanol, and of development of hydrogen-fueled vehicles and fuel distribution systems for the new fuels. I also will support production of more domestic energy from conventional sources, whether it be more oil and natural gas from the ground onshore and from under some of our seas offshore where it can be done in an environmentally friendly way, or more novel forms of fossil fuels, be they from oil shales, oil sands, coal or from gas hydrate deposits. In my view we need to do everything we can to find economic forms of the energy we will need during the remainder of the 21st Century. This bill only represents one piece of a balanced plan to improve this Nation's energy outlook. But it is an important piece. This bill has the ability to restore and refresh our environment by reducing greenhouse gas emissions. It will encourage development of more renewable energy. We can't afford not to find the funds to pay for its provisions. I ask unanimous consent that the text of the bill be printed in the Record.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, today I rise to introduce the ``Rural Physicians' Relief Act of 2007.'' This important legislation will bring needed assistance to physicians who provide primary health services to rural America. Physicians who provide health care in the most rural locations in America face challenges unlike their more urban counterparts. Often great distances, remote locations, limited transportation, and harsh climate--combine to make health care delivery extremely difficult to say the very least. Patient populations are small and spread out across extremely remote areas. As a result, many of these areas tend to be the most medically underserved areas in the Nation. In my State of Alaska, a State that is larger than the States of California, Texas and Montana combined, nearly one-quarter of the State's population live in communities and villages that are only reachable by boat or aircraft. In fact, Alaska has fewer roads than any other State--even fewer roads than Rhode Island. And, unlike Rhode Island where over 90 percent of the roads are paved, less than 20 percent of the roads are paved in Alaska. This means that approximately 75 percent of Alaskan communities are not connected by road to another community with a hospital. This means that all medical supplies, patients and providers must travel by air. These remote populations tend to be among the poorest in the State. Air travel equates to excessively high health care costs--generally 70 percent higher than costs in the Lower 48 States. In short, ``rural'' takes on a new definition in Alaska. In Alaska, patient access to health care is exacerbated because our State also faces a chilling crisis--we have 25 percent to 30 percent fewer physicians than our population needs. In fact, Alaska has one of the smallest numbers of physicians per capita in the country. We need a minimum of 500 more doctors just to be at the national average of physicians per capita. An American Medical News article recently declared Alaska's precarious situation: ``Alaska has long ranked among the worst states in terms of physician supply.'' Our physician shortage crisis will only worsen. There is an expected retirement of at least 118 physicians in Anchorage alone in the next 10 years. In the 1990s, there were 130 new doctors each year. Now that figure has dropped to only 31 new physicians since 2001. Outside of Anchorage, one in every eight physician positions is vacant. Additionally, many physicians are forced out of the Medicare and Medicaid programs because reimbursement rates simply do not cover the cost to treat those patients. With Alaska's growing population, especially of our elderly, this shortage will lead to the severe health care access crisis for all Alaskans. On top of harsh physical challenges, Alaska's rural population also faces significant human challenges. These rural patient populations are often in the greatest need for primary health care services. Heart disease, stroke and other cardiovascular diseases are the leading causes of death in Alaska. Women in our state have higher death rates from stroke than do women nationally; and mortality among Native Alaskan women is dramatically on the rise, whereas, it is actually declining among Caucasian women in the Lower 48. The prevalence of chronic disease such as diabetes and even tuberculosis is increasing faster in Alaska than any other state. Each of these health concerns is magnified because access to health care--especially in rural Alaska-- remains our greatest challenge. The legislation that I introduce today with Senator Stevens seeks to lessen this problem. It will both assist physicians who currently practice in rural America and will provide an incentive to encourage physicians to practice in these remote and underserved areas. Specifically, it would give a physician who is a primary health services provider a $1,000 tax credit for each month that he/she provides services in a designated ``frontier'' area. Furthermore, physicians who treat a high percentage of patients from frontier areas would also be eligible for the tax credit. My hope is to encourage physicians to practice medicine in rural Alaska and throughout rural America. Creating incentives that offset the high cost of providing care in the most remote areas of nation will go far in recruiting physicians to the areas that are most in need of their services.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, today I rise to introduce the ``Rural Physicians' Relief Act of 2007.'' This important legislation will bring needed assistance to physicians who provide primary health services to rural America. Physicians who provide health care in the most rural locations in America face challenges unlike their more urban counterparts. Often great distances, remote locations, limited transportation, and harsh climate--combine to make health care delivery extremely difficult to say the very least. Patient populations are small and spread out across extremely remote areas. As a result, many of these areas tend to be the most medically underserved areas in the Nation. In my State of Alaska, a State that is larger than the States of California, Texas and Montana combined, nearly one-quarter of the State's population live in communities and villages that are only reachable by boat or aircraft. In fact, Alaska has fewer roads than any other State--even fewer roads than Rhode Island. And, unlike Rhode Island where over 90 percent of the roads are paved, less than 20 percent of the roads are paved in Alaska. This means that approximately 75 percent of Alaskan communities are not connected by road to another community with a hospital. This means that all medical supplies, patients and providers must travel by air. These remote populations tend to be among the poorest in the State. Air travel equates to excessively high health care costs--generally 70 percent higher than costs in the Lower 48 States. In short, ``rural'' takes on a new definition in Alaska. In Alaska, patient access to health care is exacerbated because our State also faces a chilling crisis--we have 25 percent to 30 percent fewer physicians than our population needs. In fact, Alaska has one of the smallest numbers of physicians per capita in the country. We need a minimum of 500 more doctors just to be at the national average of physicians per capita. An American Medical News article recently declared Alaska's precarious situation: ``Alaska has long ranked among the worst states in terms of physician supply.'' Our physician shortage crisis will only worsen. There is an expected retirement of at least 118 physicians in Anchorage alone in the next 10 years. In the 1990s, there were 130 new doctors each year. Now that figure has dropped to only 31 new physicians since 2001. Outside of Anchorage, one in every eight physician positions is vacant. Additionally, many physicians are forced out of the Medicare and Medicaid programs because reimbursement rates simply do not cover the cost to treat those patients. With Alaska's growing population, especially of our elderly, this shortage will lead to the severe health care access crisis for all Alaskans. On top of harsh physical challenges, Alaska's rural population also faces significant human challenges. These rural patient populations are often in the greatest need for primary health care services. Heart disease, stroke and other cardiovascular diseases are the leading causes of death in Alaska. Women in our state have higher death rates from stroke than do women nationally; and mortality among Native Alaskan women is dramatically on the rise, whereas, it is actually declining among Caucasian women in the Lower 48. The prevalence of chronic disease such as diabetes and even tuberculosis is increasing faster in Alaska than any other state. Each of these health concerns is magnified because access to health care--especially in rural Alaska-- remains our greatest challenge. The legislation that I introduce today with Senator Stevens seeks to lessen this problem. It will both assist physicians who currently practice in rural America and will provide an incentive to encourage physicians to practice in these remote and underserved areas. Specifically, it would give a physician who is a primary health services provider a $1,000 tax credit for each month that he/she provides services in a designated ``frontier'' area. Furthermore, physicians who treat a high percentage of patients from frontier areas would also be eligible for the tax credit. My hope is to encourage physicians to practice medicine in rural Alaska and throughout rural America. Creating incentives that offset the high cost of providing care in the most remote areas of nation will go far in recruiting physicians to the areas that are most in need of their services.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise to introduce a bill that will allow the Environmental Protection Agency to continue to provide grant funding and technical assistance to remote communities in Alaska for critical water and sewer projects. These remote communities are only accessible by either aircraft or boat. This important funding was originally authorized as part of the Safe Drinking Water Act Amendments of 1996 and was reauthorized in 2000. Every fiscal year, the EPA transfers funding authorized by this program to the State of Alaska's Village Safe Water Program, which is managed by the Alaska Department of Environmental Conservation. The water and sewer conditions in the villages in Alaska that still need this critical funding rival the conditions in rural communities in third world countries. For example, residents in some villages in Alaska have to go to a central source in the community to get fresh water. Instead of flushing toilets, residents of some villages have to use a device called a ``honeybucket.'' This device is a large bucket with a toilet seat on top. When the honeybucket is full, it is usually dumped in a lagoon or on land. Sometimes, these dump locations are near sources of drinking water. The Village Safe Water program has been a success over the years. Many homes in Alaska's remote communities now have plumbing due to funds authorized by this program. However, 34 percent of homes in these communities still do not have indoor plumbing. It is unacceptable that these Americans still do not have access to conventional plumbing in their homes in 2007. Previously, the Office of Management and Budget published a Program Assessment Rating Tool report concerning this program. This report found several deficiencies concerning the administration of this program. In response to that report, the Alaska Department of Environmental Conservation has put in place several changes to correct these deficiencies, including hiring additional accounting staff and initiating a memorandum of understanding with EPA Region 10 regarding program procedures and requirements. This legislation reauthorizes the program through fiscal year 2010 and increases the authorized funding level from $40 million to $42 million, a modest five percent increase. Also, the legislation requires the State of Alaska to mandate that grant recipients clearly identify the scope and the goal of the project for which funding is sought and how the funds will be used to meet the specific, stated goal of the project; establish long-term goals for the program and carry out regular reviews of grantees to determine if the stated scope and goal of each grant are being met. This bill also requires the State of Alaska to submit an annual report to the EPA that addresses these issues. If a project-specific problem included in the report is not rectified within an amount of time agreed to by the State of Alaska and the EPA or if both entities are not able to agree on a timetable to fix the problem, the EPA will not disburse any additional funding for the project in question. It is imperative that we reauthorize this critically important program soon. The health and well-being of rural Alaskans is at stake. I ask unanimous consent that the text of this bill be printed in the Record.

Ms. MURKOWSKI

Ms. MURKOWSKI. Mr. President, I rise to introduce a bill that will allow the Environmental Protection Agency to continue to provide grant funding and technical assistance to remote communities in Alaska for critical water and sewer projects. These remote communities are only accessible by either aircraft or boat. This important funding was originally authorized as part of the Safe Drinking Water Act Amendments of 1996 and was reauthorized in 2000. Every fiscal year, the EPA transfers funding authorized by this program to the State of Alaska's Village Safe Water Program, which is managed by the Alaska Department of Environmental Conservation. The water and sewer conditions in the villages in Alaska that still need this critical funding rival the conditions in rural communities in third world countries. For example, residents in some villages in Alaska have to go to a central source in the community to get fresh water. Instead of flushing toilets, residents of some villages have to use a device called a ``honeybucket.'' This device is a large bucket with a toilet seat on top. When the honeybucket is full, it is usually dumped in a lagoon or on land. Sometimes, these dump locations are near sources of drinking water. The Village Safe Water program has been a success over the years. Many homes in Alaska's remote communities now have plumbing due to funds authorized by this program. However, 34 percent of homes in these communities still do not have indoor plumbing. It is unacceptable that these Americans still do not have access to conventional plumbing in their homes in 2007. Previously, the Office of Management and Budget published a Program Assessment Rating Tool report concerning this program. This report found several deficiencies concerning the administration of this program. In response to that report, the Alaska Department of Environmental Conservation has put in place several changes to correct these deficiencies, including hiring additional accounting staff and initiating a memorandum of understanding with EPA Region 10 regarding program procedures and requirements. This legislation reauthorizes the program through fiscal year 2010 and increases the authorized funding level from $40 million to $42 million, a modest five percent increase. Also, the legislation requires the State of Alaska to mandate that grant recipients clearly identify the scope and the goal of the project for which funding is sought and how the funds will be used to meet the specific, stated goal of the project; establish long-term goals for the program and carry out regular reviews of grantees to determine if the stated scope and goal of each grant are being met. This bill also requires the State of Alaska to submit an annual report to the EPA that addresses these issues. If a project-specific problem included in the report is not rectified within an amount of time agreed to by the State of Alaska and the EPA or if both entities are not able to agree on a timetable to fix the problem, the EPA will not disburse any additional funding for the project in question. It is imperative that we reauthorize this critically important program soon. The health and well-being of rural Alaskans is at stake. I ask unanimous consent that the text of this bill be printed in the Record.