Medicare Vision Rehabilitation Services Act of 2003

Mr. President, on behalf of Senator Boxer and myself, I rise today to introduce the Calfed Bay-Delta Authorization Act. This bill, an $880 million authorization, is a 33 percent match for state and local dollars over the next 4 years to address California's water needs through a balanced program.

Last year's bill passed the Energy and Natural Resources Committee by a vote of 18-5, and since that time I have worked with Republicans, most notably Senator Jon Kyl of Arizona, to come up with an even stronger bill.

The result: the legislation we introduced today is greatly improved from last year's bill--it is smaller, the authorizations are more specific, and it does a better job of ensuring that the CALFED program be implemented in a balanced manner. Let me describe how the bill is improved:

First, many Senators from other States were afraid CALFED was going to use up the Bureau of Reclamation's entire budget. To meet these concerns, we have cut the authorization level, ultimately to $880 million over four years. We also limited the Federal cost-share to one- third.

Second, some Republican Senators were afraid that environmental projects not needing authorization would sail smoothly ahead, while storage projects lacking Congressional approval would languish. To meet this concern, we required balanced implementation. The Secretary of the Interior must certify annually that the CALFED program is progressing in a balanced manner toward achieving all of its different components.

Third, other Republican Senators were concerned that they had no good handle on the Federal funding of the many different agencies involved in CALFED. We meet this concern by requiring the Office of Management and Budget, OMB, to prepare a cross-cut budget showing the Federal funding of each of the different agencies. We also prepared a specific list of the projects to be funded and how much each one would receive.

In my view, these changes make the bill stronger and more likely to pass both the Senate and the House. Just as importantly, the bill continues to provide the funding necessary to implement the key elements of the CALFED program. In fact, the pieces of the legislation work together to solve our water needs:

One need is water storage. I don't believe we can meet all of our future water needs without increased water storage that is environmentally benign, that if off stream and that provides flexibility in the system for us to increase water supply, improve water quality, and enhance ecosystem restoration.

We must be able to take water in wet years and store it for use in dry years. The bill provides $102 million for planning and feasibility studies for water storage projects--and an additional $77 million for conveyance.

Next is ecological restoration. This means improving fish passages, restoring streams, rivers and habitats and improving water quality. The bill provides $100 million for ecological restoration.

The bill authorizes $153 million for water conservation and recycling, including $84 million for desalination and water recycling projects, leveraging substantial additional water supplies for California with relatively little Federal investment.

The bill would also improve water quality for drinking through investment in treatment technology demonstration projects and water quality improvements in the San Francisco Bay Delta, the San Joaquin Valley, and other parts of the State.

I would also like to emphasize that the bill includes a grants program for local and regional communities throughout California, including the northern part of the State. The bill authorizes up to $95 million for local California communities to develop plans and projects to improve their water situation. This State-wide grants program is an example of how the bill will benefit all Californians. The bill also includes $50 million for watershed planning and assistance.

The bill also includes other important provisions on levee stability, with $70 million, ensuring CALFED has strong supporting science, with $50 million, and $25 million for program management, oversight, and coordination. There is also $75 million for the environmental water account, which purchases available water for environmental and other purposes.

The bill also includes balance and cross-cut budget reporting requirements.

Through the CALFED process, we have discovered that, as Californians, we have many common water interests. For example, if we both conserve water and build new environmentally responsible off-stream storage, then we have

found two ways to increase the supply of water for everyone's use. And if we make intelligent investments in ecological restoration, we can continue to use water for growing our economy while benefitting our environment at the same time.

CALFED emerged after years of negotiations between Californians of different backgrounds who care about water. This bill proposes specific projects for each of CALFED's basic parts--and it appropriately defines the Federal role so that other states know that California is taking full responsibility for its own situation.

It is my strong belief that the Western energy crisis is a forerunner to what California will soon experience with water. Just consider the following: California has a population of over 35 million people, which is expected to grow to 50 million in twenty years, yet our water system infrastructure was built when the State had only 16 million people.

California is the sixth largest economy in the world. It is the number one agricultural producing State in the Nation. It is the leading producer of agriculture products, such as dairy, wine, grapes, strawberries, almonds, lettuce and tomatoes--the list goes on and on.

California's trade, manufacturing, and service sectors are substantial contributors to the American economy. Clearly, these sectors would be put at risk if there is not an adequate supply of water.

California has more endangered species than any State except Hawaii, as well as the largest population.

To make matters worse, a recent study by the Scripps Institute of Oceanography predicts that global warming could reduce the West's water suppy by an much as 30 percent by 2050.

Clearly, California's water needs are tremendous; meanwhile, the last major infrastructure improvement in the state occurred in the 1970s. We need to prepare for the future and we need to do so in an environmentally sensitive way. If there is one lesson to learn from California's damaging energy crisis, it is that time to address a crisis is not while it is happening, but beforehand.

California is struggling to build more power plants, while also doing everything possible to reduce demand through increased efficiency and conservation. But because this started so late, we have encountered some serious problems in the past two years, which is why it is even more important that we fix our water problem before it, too, reaches a crisis stage.

I ask unanimous consent that the bill be printed in the Record.

Mr. President, I rise today to introduce the National Cancer Act of 2003. I am pleased to have the support of Senators Smith, Daschle, Jeffords, Kennedy, Collins, Landrieu, Hutchison, Johnson, Corzine, Lincoln, Clinton, Cantwell, Lautenberg, Murray, Dodd, Boxer, Stabenow, Bill Nelson, Schumer, Hollings, Reed, Kerry, Mikulski, and Leahy on this important piece of legislation.

Today, cancer is the Nation's second cause of death, trailing heart disease. Over the next 30 years, however, cancer will surpass heart disease and become the leading cause of death as the Baby Boomers age.

This bill represents a comprehensive national battle plan to re- energize the Nation's war on cancer, a war that began on January 22, 1971 when President Richard Nixon proposed to Congress that we launch a war on cancer.

That commitment marked a critical first step. But it is clear that we must take further steps to address the scourge of cancer in every respect.

I am the Vice-Chair of the National Dialogue on Cancer--and in discussions with cancer experts from this group, it became clear to me that the National Cancer Act of 1971 was out of date.

We are now in the genomic era, on the cusp of discoveries and cures that we could only have dreamed about in 1971. The science of cancer has advanced dramatically with the revolution in molecular and cellular biology creating unprecedented opportunities for understanding how genetics relate to cancer.

The explosion in knowledge about the human genome and molecular biology will enable scientists to better target cancer drugs.

I believe that if we work smart we could find a cure for cancer in my lifetime.

Given these advances, I strongly believe that it is time to update the National Cancer Act of 1971, to reflect these breakthroughs. At the same time, I wanted to get input from some of the nation's foremost cancer experts.

To that end, I asked John Seffrin, CEO of the American Cancer Society, and Dr. Vincent DeVita, Director of the Yale Cancer Center, to form a special committee of cancer experts to provide recommendations on a national battle plan to conquer cancer.

The committee produced an ambitious plan, and what I have tried to do is take the most important components, in light of the current budget

situation, and develop a piece of legislation that could pass the Senate.

On November 7, 2001, President George W. Bush commended the work of the Committee when he wrote, ``The journey ahead will not be easy. But 30 years ago, no one would have imagined coming as far as we have. Working together, we will take the next steps necessary to defeat this deadly disease.''

Today, I invite the President to join me again in taking these steps by supporting this legislation.

Finding a cure for cancer is a very personal goal. I lost both my father and my husband to cancer. I saw its ravages firsthand, and I experienced the frustrations, the difficulties, and the loneliness that people suffer when a loved-one has cancer. I determined that I would do all I could to reduce the number of people who go through this devastating experience.

And it is my great hope that this legislation will help do just that, and enable us to find a cure for cancer in my lifetime.

This may in fact be the most important thing I do during my time in the Senate.

And I believe that this legislation addresses the issue in the right way, and I hope that my colleagues will agree.

The National Cancer Act of 2003 takes a multi-pronged approach to winning the war against cancer. Here's what the bill will do: 1. Accelerate Scientific Discovery. The advances in science that I spoke of earlier, regarding the human genome and molecular biology, have produced medications that can target the unhealthy cancer cells and leave healthy cells intact.

That is why this legislation establishes a grant program of $20 million a year, specifically for research that focuses on the development of a molecularly-oriented knowledge-based approach to cancer drug discovery and development.

It also includes a sense of the Senate to encourage the Federal Government to continue its investment in cancer research by staying on track to funding the NCI bypass budget.

NCI now funds approximately 4,500 research project grants at nearly 600 institutions every year. This represents 28 percent of the 16,000 grant proposals NCI receives. NCI scientists think funding 40 percent will allow them to fund the most promising grants. Yet at 28 percent, it does not happen.

Funding basic research marks a full frontal assault on cancer--an assault that will lead to more breakthroughs, more treatments, and ultimately, I believe, to a cure.

We now have drugs, like Gleevec for Chronic Myeloid Leukemia and Herceptin for breast cancer, that can target and destroy cancer cells while leaving healthy cells unharmed.

Patients, who were considered terminal, have taken Gleevec and were able to get out of their beds and leave the hospice within days of treatment. After one-year of clinical trials for Gleevec, 51 out of 54 patients were still doing well. With 4,500 Americans diagnosed with Chronic Myeloid Leukemia a year, the potential for this drug is tremendous.

From the Bench to the Bedside: Expanding Access to Clinical Trials. First, the bill will provide $100 million per year for new grants for what is called ``translational'' research, work that moves promising drugs from the ``bench to the bedside.''

The purpose of this provision is to greatly accelerate the movement of basic research to the patient, from the ``bench to the bedside,'' so that we can conduct more clinical trials.

Clinical trials test the safety and efficacy of drugs, devices or new medical techniques. They are required for FDA approval. These trials require thousands of participating people to help determine if drugs are safe and effective.

The bill includes several steps to expand clinical trials, those research projects that require thousands of people to determine whether new drugs are safe and effective.

Right now, there are many new drugs under development that are stuck, as if in a funnel, because we have not put the resources into having the people-based research to test those drugs. There are approximately 400 new drugs that are held up in the development process because the resources are not available to fund clinical research to test those drugs.

For every one drug approved, 5,000 to 10,000 were initially considered. The entire process can take as long as 15 years.

Second, the bill will require insurers to pay the routine or non- research costs for people to participate in clinical trials, while the drug sponsor would continue to pay the research costs. California already requires this coverage by private insurers.

Third, the bill requires the National Cancer Institute to establish a program to recruit patients and doctors to participate in clinical trials. Dr. Robert Comis, President of the Coalition of National Cancer Cooperative Groups, has said that eight out of ten cancer patients do not consider participating in a clinical trial. They are unaware that they might have the option. He has found that physician involvement is key.

This is why we must work to make both physicians and patients more aware of the importance of participating.

Currently, only 4 to 5 percent of adult cancer patients participate in clinical cancer trials. But Research America polls found that 61 percent of Americans would participate in a clinical trial if they could.

We should heed the example of what is called the ``pediatric model.'' Over 60 percent of children with cancer participate in clinical trials. Children in these trials get optimal care, with an overall physician manager or ``quarterback.'' The five-year survival rates for children with cancer have increased significantly.

In the 1960s, childhood leukemia could not be cured. It was a death sentence. Today, 70 percent of children with acute lymphoblastic leukemia enter remission. This is but one example of the power and importance of clinical trials. An investigational treatment yesterday is standard treatment today.

Only by injecting new funding into cancer research will we enable cancer researchers to conduct the trials that are necessary to bring promising new drugs to market.

3. Transforming Research Into Treatments. Scientists say we will stop defining cancer by body part, like breast cancer or prostate cancer. Because everyday we are understanding better the genetic basis of cancer and can focus drugs on molecular targets. For example, we may have 50 different kinds of breast cancer, defined by their genetic basis.

As NCI's Dr. Rabson has said, ``As we've come to understand the molecular signatures of cancer cells, we can classify tumors according to their genetic characteristics.''

This means that we need to create incentives to encourage companies to make these targeted drugs, because as we redefine cancer, we will have smaller numbers of people who have that particular kind of breast cancer. Companies are often reluctant to make drugs for small patient populations.

This legislation would expand the current definition of ``orphan drugs'' from ``disease and condition'' to include ``disease or condition or targets and mechanisms of pathogenesis of diseases'' that effect a small patient population, less than 200,000. Current tax and marketing incentives remain the same. With an expansion of the definition, however, more drugs could potentially qualify for this designation.

Beginning with Gleevec and continuing into the future, drugs will target a narrow genetic or cellular mutation.

While this holds great promise for patients, it also means that the number of treatments will proliferate, thereby segmenting cancer patients into smaller and smaller populations. In some cases, this will mean that pharmaceutical companies for strictly financial reasons may not want to produce a given drug.

The impact: This will help to ensure that patients receive the highest quality care, even when the number of people faced with a particular type of cancer is small.

4. Having Enough Scientists. The bill will also create a new initiative to train more cancer researchers. Specifically, it will: 1. Pay off the medical school loans of 100 physicians who commit to spend at least 3 years doing cancer research; and 2. Boost the salaries of postdoctoral fellows from $28,000 to $45,000 per year over 5 years.

Every year, young physicians and researchers avoid the field of cancer research because, frankly, they feel they can make more money elsewhere. This provision will help reverse that trend and add thousands of men and women to the front lines of the fight.

The physician-scientist is endangered and essential, concluded a January 1999 study, showing that the number of first-time M.D. applicants for NIH research projects has been declining. The study, published in Science, said, ``. . . fewer young M.D.'s are interested in (or perhaps prepared for) careers as independent NIH-supported investigators.''

Simply put, young doctors and Ph.Ds do not want to go into cancer research because they can make more money elsewhere. Graduating physicians have medical school debt averaging $75,000 to $80,000. Because of the low pay to be a physician-scientist, these doctors cannot afford to go into research.

Postdoctoral fellows, who conduct the bulk of day-to-day research, receive pay that is neither commensurate with their education and skills nor adequate. To attract the best and the brightest to the field of cancer research, we need to pay them more than $28,000 to start.

The National Academy of Sciences in September 2000 called for increasing their compensation.

5. Quality Cancer Care. All too often having cancer is a lonely and frightening experience. Cancer patients have a team of doctors, from the primary care physician to the radiologist to the oncologist. Yet patients need one doctor to be in charge.

During a June 16, 1999 hearing, The Institute of Medicine told the Senate Cancer Coalition that the care that cancer patients get is all too often just a matter of circumstance: ``. . . for many Americans with cancer, there is a wide gulf between what could be construed as the ideal and the reality of [Americans'] experience with cancer care . . . The ad hoc and fragmented cancer care system does not ensure access to care, lacks coordination, and is inefficient in its use of resources.''

The Institute of Medicine study on the uneven quality of health care says, ``Health care today is characterized by more to know, more to manage, more to watch, more to do, and more people involved in doing it than at any time in the nation's history.''

The bill will require insurance plans to pay doctors, preferably oncologists, to become the overall managers of patients' care, what I call a ``quarterback physician,'' to be with the patient from diagnosis through treatment, to prevent the patient from being forced to navigate the medical system alone.

I developed this concept after meeting Dr. Judy Schmidt, a solo- practicing oncologist from Montana. Dr. Schmidt cares for her patients from diagnosis to treatment, and she is really a model for doctors across the Nation to emulate.

This ``quarterback physician'' would provide overall management of the patient's care among all the providers. Someone would be in charge. This provision could save money because good coordination can reduce hospitalization costs.

The bill authorizes grants to health centers for the development and operation of programs that assign patient navigators, nurses, social workers, cancer survivors and patient advocates, to individuals of health disparity populations, to assist in following-up on a cancer diagnosis and to help them find the appropriate services and follow-up care, which includes facilitating access to health care services.

This program is important because many people receive unequal access to care. The Institute of Medicine issued a report last year called Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. This report emphasized the importance of ``providing advocates for patients who can assist them in asking the appropriate questions, and making the necessary inquiries as they access the health are system . . . ''

Often these are patients without health insurance who are not fluent in English. Having a culturally appropriate ``navigator'' who will assist them in making appointments and understanding the services available to them could help improve quality of life for minorities.

Lastly, the bill also authorizes grants through the Centers for Disease Control and the National Cancer Institute to monitor and evaluate quality cancer care, develop information concerning quality cancer care and monitor cancer survivorship.

6. Coverage of Preventive Measures. People cannot get good health care if they have no way to pay for it, if insurance plans, public and private, do not cover the basics like screenings for cancer.

My bill will require public plans, like Medicare and Medicaid, and private insurance plans to cover four services important to good cancer care: 1. Cancer screenings; 2. Genetic testing and counseling for people at risk; 3. Smoking cessation counseling; and 4. Nutrition counseling.

Access to mammograms, pelvic exams, along with reducing fat in the diet and stopping smoking--all of which could be enhanced by this bill--can stop cancer before it is too late.

Because too many Americans have no way to pay for their health care when cancer strikes and because seven percent of cancer patients are uninsured, the bill also requires the Institute of Medicine of the National Academy of Sciences to conduct a study of the feasibility and cost of providing Medicare coverage to individuals at any age who are diagnosed with cancer and have no other way to pay for their health care.

Medicare already covers care for people of any age who have End Stage Renal Disease and Amyotrophic Lateral Sclerosis, Lou Gehrig's Disease. This study could provide helpful guidance to the Congress.

Because no assault on cancer is complete without a strong cancer prevention component, the bill provides funds and requires the Centers for Disease Control and Prevention to prepare a model state cancer control and prevention program; expand the National Program of Comprehensive Cancer Control plans, and to assist every state to develop a cancer prevention and control program.

The bill also authorizes $250 million to expand the Center for Disease Control and Prevention's breast and cervical cancer screening program and authorizes $50 million for CDC to begin screening programs for colorectal cancer.

7. Bolstering the Number of Health Care Providers. Because of the aging of the American population, we face a virtual explosion of cancer in the coming 30 years. The number of cases will double. But the sad fact is that we do not have enough nurses and other health care professionals to take care of this expected rise in cancer patients.

My bill will provide $100 million for loans, grants and fellowships to train for the full range of cancer care providers, including nurses for all settings, allied health professionals, and physicians. The bill requires that these applicants have the intention to get a certificate, degree, or license and demonstrate a commitment to working in cancer care.

In nursing alone--those critical people on the front line of care-- many experts say we face a national nursing shortage in virtually every setting, which will peak in the next 10 to 15 years unless steps are taken. By 2020, the RN workforce will be 20 percent short of what will be needed. My home State of California ranks 50th among registered nurses per capita.

And it's not just nurses. The Health Resources Services Administration says that the demand of health care professionals will grow at twice the rate of other occupations.

Cancer is primarily a disease of aging. As the baby boomers age, there will be more cancer. Cancer care is becoming more and more complex as technology improves. Skilled providers, from the nurse assistant to the oncologist are needed to administer the complex therapies. This bill should provide some help.

8. Cancer Survivorship. Thanks to advances in cancer detection and early diagnosis, more aggressive and effective treatments, and better screening tools, about 9 million Americans--nearly one in 30--can call themselves a cancer survivor. This represents 3 percent of the population.

Thirty years ago a cancer diagnosis was a death sentence. That is not the case today. As a result, addressing a person's quality of life post-cancer is becoming increasingly important.

To give you a snapshot picture of what a typical cancer survivor looks

like: about 59 percent of cancer survivors are over the age of 65; 3 million (30 percent) were diagnosed between 5-15 years ago; and, 23 percent are breast cancer survivors and 17 percent are prostate cancer survivors.

Current statistics suggest that for individuals who receive a diagnosis today, 60 percent can expect to be alive in 5 years. The 5- year survival rate for children is even higher--almost 75 percent.

What this means is that more than half of all people, children or adults, diagnosed with cancer today, will become cancer survivors.

We've come a long way. And the survival rate for cancer will only get better as we continue to make improvements in screenings, detection, diagnosis and treatment.

But now we face new challenges. We need to better understand what services are necessary to help address the needs of people who are surviving cancer.

This bill would do several things to help support cancer survivors.

First, it would codify an Office of Cancer Survivorship at NCI. Since 1999, such an Office has been in existence but it has not been officially recognized by Congress or received it's own budget.

This Office is crucial because it sets the research agenda at NCI on survivorship-related issues.

The National Cancer Institute found in 1999 that ``surviving cancer can leave a host of problems in its wake. Physical, emotional, and financial hardships often persist for years after initial diagnosis and treatment. Many survivors suffer decreased quality of life following treatment, leading one cancer activist and survivor to say, `surviving is not just about a cure, but about living the rest of our lives.' ''

For some, long-term health problems result, for example, because a surgery to remove a cancer tumor has impaired nearby organs which could cause additional health problems.

Additionally, patients who survive one cancer have almost twice the risk of developing a second cancer as the general population. Almost 100,000 people are diagnosed each year with ``second cancers.'' What can be done to reduce the chance of a second diagnosis of cancer?

And the bill also authorizes grants through the Centers for Disease Control for activities including the development of a cancer surveillance system to track the health status of cancer survivors, and the development of a national cancer survivorship action plan.

For 9 years I have co-chaired the Senate Cancer Coalition. We have held ten hearings on cancer. With each hearing, I become more and more convinced that we can conquer cancer in my lifetime. These are the highlights of the cancer battle plan.

It is my hope that this legislation will become the rallying cry for the Cancer community.

Polls by Research America show that the public wants their tax dollars spent on medical research and that in fact people will pay more in taxes for more medical research.

Cancer impacts everyone. Everyone knows someone who has had cancer or will have cancer.

I am thoroughly convinced that if we just marshal the resources, we can conquer cancer in the 21st century. Let's begin. The road ahead is long and treacherous. But if we all work together, I honestly believe we can do it.

Mr. President, I am pleased to join with my colleague from Maine, Senator Collins, and my colleague from Utah, Senator Hatch, to introduce the Prevention and Recovery of Missing Children Act of 2003, to improve the recovery of missing children and the tracking of convicted sex offenders and child predators.

No child or parent should ever have to go through the recent nine- month ordeal of Elizabeth Smart and her family. Yet, from the sparse information we have, we know that over one million families have endured a similar, and sometimes far worse, trauma.

In only the second study of its kind, the National Incidence Studies of Missing, Abducted, Runaway and Throwaway Children, NISMART-2, estimated that 1.3 million children met the criteria for being classified as missing, including runaway, from their caretakers in 1999. It is estimated that almost 800,000 of these cases involved notification to police or missing children agencies to help locate the child. When a parent's worst fear for a missing child materializes, in 91 percent of the cases the child became the victim of a homicide within 24 hours of abduction. In 74 percent of these cases, the homicide occurred within 3 hours of abduction.

With statistics such as these, it is truly a miracle and cause for celebration that Elizabeth Smart returned to her family alive and well nine months after her abduction.

We must build and expand on practices we know lead to the safe return of missing and abducted children. In Elizabeth's case, the family's circulation of the suspect's photograph led to the capture of Elizabeth's captor near her home community in Utah. This success story highlights the importance of the recently enacted National AMBER Alert Networks, which strengthens communication and notification to facilitate the recovery of other abducted children.

As important as AMBER Alert systems are, these are but one tool in our arsenal against child abduction. The bill we are introducing today will strengthen other tools used by law enforcement to help take every step possible to find missing children as soon as possible. For instance, we know now that Elizabeth's captor was already in custody in California during Elizabeth's ordeal. Those officials, at that time, did not have in their possession information to connect him to the Smart case. And so, he was released.

It is clear from this example that accurate, up-to-date information on missing children cases nationwide must be made available to law enforcement, as well. This act fosters the sharing of information about missing child cases among law enforcement by requiring the entry of child information into the National Crime Information Center, NCIC, within 2 hours of receipt. NCIC is a critical resource for linking 16,000 Federal, State, and local law enforcement agencies.

The availability of up-to-date identifying information of known child and sexual predators is a vital investigative tool. The women who signaled police in the Elizabeth Smart case identified the captor after seeing his photograph on television. One of these responsible women noted that it was the photograph, and not the composite sketch, that helped her recognize Elizabeth's captor as he walked down the street.

Whether the suspect in the Smart case had a history of sexual offenses is unclear. But, what is clear is that we can do more to help law enforcement track and investigate individuals with a history of sexual offenses.

Over the last decade, Congress enacted several laws designed to improve the tracking of convicted sex offenders and the recovery of missing children, including The Jacob Wetterling Crimes Against Children and Sexually Violent Offender Registration Act of 1994, Megan's Law of 1996, and The Pam Lychner Sex Offender Tracking and Identification Act of 1996. Collectively, these acts established minimum standards for State sex offender registration programs and created systems to track convicted sex offenders.

While these current federal laws address the main features of an effective registry system, the discretion over registry details and procedures is left up to the states. This has led to a lack of consistency and wide disparities between states. For example, state requirements for sex offender notification of registration changes range from 1 day to 40 days, and state requirements for a sex offender to register an address after moving to a new state range from 48 hours to 70 days.

In addition, many States place the burden to notify changes in registry information solely on the sex offender. We need to tighten registry systems so that law enforcement in all states is better equipped to track sex offenders. This bill strengthens the registry foundation for all states. It builds upon successful practices already in place in some States, to better protect our communities nationwide.

Sex offenders pose an enormous challenge for policy makers and create unparalleled fear among citizens. Most of their victims are children and youth. Two-thirds of imprisoned sex offenders report that their victims were under age 18, and nearly half report that their victims were ages 12 and younger.

The tracking of released sex offenders is critical to protecting our children. Most sex offenders are not in prison--about 60 percent of convicted sex offenders are under conditional supervision in the community--and those who are in prison often serve limited sentences. This is of great concern because sex offenders, particularly if untreated, are at risk of re-offending.

For over two years, newspapers across the country, including the Hartford Courant, have highlighted the inadequacy of reporting information in missing child cases and tracking of convicted sex offenders and known child predators. One tragic example reported a convicted sex offender who moved from Massachusetts to Montana, where police were never contacted about his history. He brutally murdered several Montana children before he was apprehended, and was later linked to 54 cases of child abduction and molestation in several states.

In many cases, convicted sex offenders and child predators slip through law enforcement loopholes and continue to prey on children. While all 50 states have laws to create sex offender registry databases, states are unable to

adequately track these felons. For instance, in California, 33,000, or 44 percent of registered offenders are missing; it is estimated that states on average are unable to account for 24 percent of sex offenders.

Recently, the Supreme Court ruled against challenges from Alaska and Connecticut, and upheld current law pertaining to sexual offender registries. With the support of both Congress and the highest court of our land, it is inconceivable to me that we now allow bookkeeping challenges to deter law enforcements' ability to identify and locate child predators.

This bill makes several important changes to improve the tracking of sex offenders and the recovery of missing children. The bill: modifies the definition of ``minimally sufficient program'' to include: the registration of all convicted sex offenders prior to release; the collection of information to assist in tracking individuals, including a DNA sample, current photograph, driver's license and vehicle information; and verification of address and employment information for all offenders every 90 days. Modifies penalties for non-compliance with registry requirements. It provides that State programs must designate non-compliance as a felony and permits the issuance of a warrant. This provision is intended to encourage compliance by offenders as well as provide a tool for law enforcement and prosecutors. Improves the chances for recovering missing children and aids law enforcement in solving cases by preventing the removal of missing children from the National Crime Information Center (NCIC) database. Improves the chances for recovery of missing children by requiring entry of child information into the NCIC database within 2 hours.

We must make the tracking of convicted sex offenders and the post- release supervision of child sexual predators a higher priority. Since most sex offenders are in the community, we must ensure there is continuing contact and supervision of released sex offenders. Data management challenges are simply inexcusable reasons for not protecting our innocent children from crimes committed against them.

We have an obligation to protect our children from the abductors, sex offenders and sexual predators who prey on our children. I urge my colleagues to join myself, Senator Collins and Senator Hatch in supporting and furthering this legislation.

Mr. President, I rise today to introduce the Highway Funding Equity Act of 2003. I am joined on a bipartisan basis by Senators Levin, Stabenow, Bayh, Lugar, Hutchison, Cornyn, Warner, Chambliss, Lott, Lindsey Graham, Bill Nelson, Alexander, DeWine, Dole, Cochran, Landrieu, Miller, Hollings, Breaux, and Bunning.

The Transportation Equity Act for the 21st century, TEA-21, authorized more than $218 billion for transportation programs and will expire in September 2003. TEA-21 requires certain States, known as Donor states, to transfer to other States a percentage of the revenue from Federal highway user fees. Several of these donor States transfer more than 10 percent of every Federal highway user fee dollar to other States. As a result, donor States receive a significantly lower rate- of-return on their transportation tax dollar being sent to Washington, Currently, over 25 States, including my State of Ohio, contribute more money to the Highway Trust Fund than they receive back.

My State of Ohio has the Nation's 10th largest highway network, the 5th highest volume of traffic, the 4th largest interstate highway network, and the 2nd largest inventory of bridges in the country. Ohio is a major manufacturing State and is within 600 miles of 50 percent of the population of North America. The interstate highways throughout Ohio and all the donor States provide a vital link to suppliers, manufacturers, distributors, and consumers.

Maintaining our Nation's highway infrastructure is essential to a robust economy and increasing Ohio's share of Federal highway dollars has been a longtime battle of mine. One of my goals when I became governor 12 years ago was to increase our rate-of-return from 79 percent to 87 percent in the Intermodal Surface Transportation Efficiency Act of 1991, ISTEA. Then, in 1998, as Chairman of the National Governors Association, I lobbied Congress to increase the minimum rate-of-return to 90.5 percent. The goal of the Highway Funding Equity Act of 2003 is to increase the minimum guaranteed rate-of-return to 95 percent.

The Highway Funding Equity Act of 2003 has two components. First, the bill would increase the minimum guaranteed rate-of-return in TEA-21 from 90.5 percent of a State's share of contributions to the Highway Trust Fund to 95 percent. The Minimum Guarantee under TEA-21 includes all major Core highway programs: Interstate Maintenance, National Highway System, Bridge, Surface Transportation Program, Congestion Mitigation and Air Quality, Metropolitan Planning, Recreational Trails, and any funds provided by the Minimum Guarantee itself.

Second, the bill uses the table of percentages now in Section 105 of Title 23 to guarantee States with a population density of less the 50 people per square mile a minimum rate-of-return that may exceed 95 percent of that State's share of Highway Account contributions. This provision is intended to ensure that every State is able to provide the quality of road systems needed for national mobility, economic prosperity, and national defense. Under the 2000 Census, this provision would benefit 15 states: Alaska, Arizona, Colorado, Idaho, Kansas, Maine, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Utah, and Wyoming.

Increasing donor States' rate of return to 95 percent will send more than $60 million back to Ohio for road improvements we sorely need. The interstate system was built in the 1950s to serve the demands and traffic of the 1980s. Today, Ohio's infrastructure is functionally obsolete. Nearly every central urban interstate in Ohio is over capacity and plagued with accidents and congestion. Ohio's critical roadways are unable to meet today's traffic demands, much less future traffic which is expected to grow nearly 70 percent in the next 20 years. Like all the donor States, we need these funds in Ohio.

States can no longer afford to support others that are already self- sufficient. Each State has its own needs that far outweigh total available funding, especially in light of the so-called ``mega projects'' coming due in the next decade. For example, the Brent Spence Bridge that carries Interstates 71 and 75 across the Ohio River into Kentucky is in need of replacement within the next 10 years at a cost of about $500 million. With the inclusion of the approach work, the total project could cost close to $1 billion.

The goal of this legislation is to improve the rate-of-return on donor states' dollars to guarantee that federal highway program funding is more equitable for all states. Donor States seek only their fair share, and I look forward to working with my colleagues to improve highway funding equity during the upcoming surface transportation reauthorization process.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, today I introduce legislation, the National War Permanent Tribute Historical Database Act, which would establish a permanent database to catalogue, identify, and locate the thousands of permanent veterans' memorials on public land.

Right now, an individual can go online and access a network of all railway mainlines, railroad yards, and major sidings in the continental U.S. through the Bureau of Transportation Statistics. If someone wants to search all scenic byways--by location or keyword--he or she can easily access this database through the Federal Highway Administration. Through the National Park Service, one can access the inventory of historic light stations and publicly accessible lighthouses.

But if one of my constituents, a veteran, or a young person working on a school project, wants to access a comprehensive list of veterans' memorials, they can't.

Currently, there is no central catalogue of information on structures commemorating an individual or group in the Armed Forces available to the public--maintained either by the Federal Government or by a non- governmental entity. Unfortunately, many of these structures are in a terrible state of disrepair and rest in unknown storage facilities around the country. Through the Department of Veterans' Affairs, an individual can look up a list of all State cemeteries and their contact information. But, as I understand it, that's the extent of the database. And that's simply not enough.

Admittedly, I am not an expert on navigating through the Internet, but I know that many of my constituents are. The ultimate purpose of this bill is to compile and classify the myriad of information that exists and make it available for anyone to access. Even those not proficient on a computer will benefit from a standardized database, because hopefully it will be operative from a number of means.

In fact, under my bill, this database would be established by the Department of the Interior with the assistance of other agencies, non- profits, tribal governments, and any other entities the Secretary of the Interior deem appropriate. Since the Department of the Interior already maintains several databases, I believe it already has the infrastructure and the proven capability to maintain a catalogue of veterans' memorials. The Secretary would also have to report back to Congress three years after enactment to assess the feasibility of establishing a permanent fund to repair, maintain, and restore memorials that need help.

Several years ago, Congress passed a law which expressed the need for cataloguing and maintaining these public veterans' memorials. When similar legislation, upon which this bill is based, was reported favorably out of the House Committee on Resources last Congress, staff from the Congressional Budget Office estimated that enacting this bill would not have a significant impact on the budgets of State, local, or tribal governments. It would also not preempt authority of State, local, or tribal law. Let's work together to get this common-sense, low cost effort off the ground and working for the millions of people who have so courageously defended our freedom.

I have said this before, but I truly believe that veterans' memorials often serve as the only tangible reminders we have of their service to this country. Not only have we lost many of these brave men and women during conflict, we are losing thousands of them forever, each year, as the veteran population ages. A common-sense first step to making sure that the sites and structures honoring them are properly maintained is also making sure we know where each of them is. Future generations depend on it.

Yesterday, the House of Representatives passed another veterans' bill of mine, the Veterans' Memorial Preservation and Recognition Act of 2003, which is on its way to the President's desk. This bill, S. 330, would make a Federal crime, the destruction of veterans' memorials and would permit guide signs to veterans' cemeteries on Federal-aid highways. I cannot think of a better way to make this law more effective than to have a national database to identify these veterans' memorials.

Having said that, it is my hope that we can work swiftly together to move this legislation introduced today. This weekend, we will be commemorating our veterans with festive celebrations and somber vigils. Let us honor what they have done to preserve our freedom by protecting and recognizing the sites which commemorate them.

I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, today I join Senator Voinovich in introducing the Highway Funding Equity Act of 2003.

Our bill will allow States to get back more of what they contribute in gas taxes to the highway trust fund. We do this by increasing the Federal minimum guaranteed funding level for highways from the current 90.5 percent of a State's share of contributions made to the Federal Highway Trust Fund in gas tax payments to 95 percent.

Increasing this minimum guarantee to 95 percent will bring us one step closer to achieving fairness in the distribution of Federal highway funds to States.

Historically about 20 States, including Michigan, known as ``donor'' States, have sent more gas tax dollars to the Highway Trust Fund in Washington than were returned in transportation infrastructure spending. The remaining 30 States, known as ``donee'' States, have received more transportation funding than they paid into the Highway Trust Fund.

This came about in 1956 when a number of small States and large Western States banded together to develop a formula to distribute Federal highway dollars that advantaged themselves over the remaining States. They formed a coalition of about 30 States that would benefit from the formula and, once that formula was in place, have tenaciously defended it.

At the beginning there was some legitimacy to the large low- population predominately Western States getting more funds than they contributed to the system in order to build a national interstate highway system. Some arguments remain for providing additional funds to those States to maintain the national system and our bill will do that. However, there is no justification for any state getting more than its fair share.

Each time the highway bill is reauthorized the donor States that have traditionally subsidized other States' road and bridge projects have fought to correct this inequity in highway funding. It has been a long struggle to change these outdated formulas. Through these battles, some progress has been made. For instance, in 1978, Michigan was getting around 75 cents on our gas tax dollar. The 1991 bill brought us up to approximately 80 cents per dollar and the 1998 bill guaranteed a 90.5 cent minimum return for each State.

We still have a long way to go to achieve fairness for Michigan and other States on the return on our Highway Trust Fund contributions. At stake are tens of millions of dollars a year in additional funding to pay for badly needed transportation improvements in Michigan and the jobs that go with it. According to Federal Highway Administration calculations, Michigan would have received an additional $42 million in FY 02 under the Voinovich-Levin 95 percent minimum guarantee bill. That's a critically important difference for Michigan each year. The same is true for other donor States that stand to get back millions more of their gas tax dollars currently being sent to other States. There is no logical reason for some States to continue to send that money to other States to subsidize their road and bridge projects and to perpetuate this imbalance is simply unfair.

With the national interstate system completed, the formulas used to determine how much a State will receive from the Highway Trust Fund are antiquated and do not relate to what a State's real needs or contributions are.

The Voinovich-Levin bill is consensus bill developed with the help of donor State Department of Transportation agencies and their coalition working group. This legislation would increase the minimum guarantee from 90.5 percent to 95 percent for all States. A companion bill is being introduced in the House today by majority leader Tom DeLay and Representative Barron Hill. With this legislation, we intend to send a strong message to the authorizing committees that they should address the equity issue in the Senate and House highway reauthorization bills. We are determined to make progress in this bill to redistribute the highway funds in a more equitable manner so that every State gets its fair share.

This is an issue of equity and we will not be satisfied until we achieve it.