A bill to amend title 38, United States Code, to establish a presumption of service-connection for certain veterans with hepatitis C, and for other purposes.

Mr. President, I rise today to reintroduce legislation I first introduced in the 105th Congress to address a serious health concern for veterans--specifically, the health threat posed by the Hepatitis C virus.

This legislation, the Veterans Hepatitis C Treatment bill, establishes a presumption of service connection for veterans with hepatitis C, provided that certain conditions are met. This bill will enable veterans who contracted Hepatitis C in military service to receive treatment for this condition by the Department of Veterans Affairs.

Under this legislation, veterans who received a transfusion of blood during a period of service before December 31, 1992; veterans who were exposed to blood during a period of service; veterans who underwent hemodialysis during a period of service; veterans diagnosed with unexplained liver disease during a period of service; or veterans working in a health care occupation during service, will be eligible for treatment for Hepatitis C at VA facilities.

I have reviewed medical research that suggests many veterans were exposed to Hepatitis C in service, and are now suffering from liver disease and other diseases caused by exposure to this virus. I am troubled that many ``Hepatitis C veterans'' are not being treated by the VA because they can't prove the virus was service connected, despite the fact that Hepatitis was not isolated until 1989 and could not be tested for until 1990.

Hepatitis C is a hidden infection with few symptoms. However, most of those infected with the virus will develop serious liver disease 10 to 30 years after contracting the virus. For many of those infected, Hepatitis C can lead to liver failure, transplants, liver cancer and death.

And yet, most people who have Hepatitis C don't even know it--and so they don't get treatment until it's too late. It has been estimated that up to 70 percent of the approximately four million Americans with Hepatitis C are unaware that they carry the virus. For those who know they're infected, the

prognosis is promising--some estimates indicate that 50 percent may have the virus eradicated.

Vietnam veterans in particular are just now starting to learn that they have liver disease likely caused by Hepatitis C. Early detection and treatment may help head off serious liver disease for many of them. However, many veterans with Hepatitis C will not be treated by the VA because they must first establish a service connection for their condition--a standard that is virtually impossible to meet.

My colleagues may be interested to know how veterans were likely exposed to this virus. Medical advances during the Vietnam War included rapid evacuation, improved transfusion and high rates of U.S. casualty survival in an era prior to Hepatitis C screening of the blood supply. Blood transfusion is one of the most common ways Hepatitis C is transmitted. Medical transmission of the virus through needles and other medical equipment is also possible in combat. Medical care providers who served in combat, where universal precautions and rubber glove use are often absent, were likely at increased risk as well, and may have, in turn, posed a risk to the service members they treated.

Researchers have discovered that some blood sent from the U.S. was infected with the virus. Researchers and veterans organizations, including the Vietnam Veterans of America, believe that many veterans were infected after being injured in combat and getting a transfusion or from working as a medic around combat injuries.

Yet, veterans cannot establish a service connection because frequently there were no symptoms when they were originally infected while in Vietnam. In addition, while medical records may show a short bout of Hepatitis, Hepatitis C was not known at the time and there was not a test available to detect the virus.

The Hepatitis C infected veteran is essentially in a catch-22 situation: the VA will not provide treatment unless a service connection has been established, but the veterans cannot prove that they contracted Hepatitis C in combat because the science to detect the virus didn't exist. Without legislative authority to treat these veterans, thousands of veterans infected with Hepatitis C while in the service will not receive VA health care testing or treatment.

I believe that in the long run we will actually save money by testing and treating this infection early on. The alternative is much more costly treatment of end-state liver disease and the associated complications, or other disorders.

Former Surgeon General C. Everett Koop, well respected both within and outside of the medical profession, has said: ``In some studies of veterans entering the Department of Veterans Affairs health facilities, half of the veterans have tested positive for [the Hepatitis C virus]. Some of those veterans may have left the military with the [Hepatitis C virus], while others may have developed it after their military service. In any event, we need to detect and treat [Hepatitis C] if we are to head off very high rates of liver disease and liver transplant in VA facilities over the next decade.''

Some may argue that further epidemiologic data is needed to resolve the issue of service connection. I agree that we have our work cut out for us, and further study should be done. However, there is already a substantial body of research which has firmly established that veterans have a higher incidence of Hepatitis C when compared to non-veterans. We should not ask those who have already sacrificed so much for this country to wait--perhaps for years--for the treatment they deserve while further research is being conducted.

Today is Veteran's Day and we will all take time to honor the sacrifices that these brave men and women have made to defend the freedom of this country and ensure others could live in peace. These veterans shouldn't be asked to fight another battle for the benefits and respect that they have earned.

I hope this legislation will be a constructive step in addressing the health concerns of this Nation's veterans, and I look forward to working with the Veterans Affairs Committee, the VA-HUD appropriators, and veterans groups to meet this emerging challenge.

Mr. President, I rise today to reintroduce legislation I first introduced in the 105th Congress to address a serious health concern for veterans--specifically, the health threat posed by the Hepatitis C virus.

This legislation, the Veterans Hepatitis C Treatment bill, establishes a presumption of service connection for veterans with hepatitis C, provided that certain conditions are met. This bill will enable veterans who contracted Hepatitis C in military service to receive treatment for this condition by the Department of Veterans Affairs.

Under this legislation, veterans who received a transfusion of blood during a period of service before December 31, 1992; veterans who were exposed to blood during a period of service; veterans who underwent hemodialysis during a period of service; veterans diagnosed with unexplained liver disease during a period of service; or veterans working in a health care occupation during service, will be eligible for treatment for Hepatitis C at VA facilities.

I have reviewed medical research that suggests many veterans were exposed to Hepatitis C in service, and are now suffering from liver disease and other diseases caused by exposure to this virus. I am troubled that many ``Hepatitis C veterans'' are not being treated by the VA because they can't prove the virus was service connected, despite the fact that Hepatitis was not isolated until 1989 and could not be tested for until 1990.

Hepatitis C is a hidden infection with few symptoms. However, most of those infected with the virus will develop serious liver disease 10 to 30 years after contracting the virus. For many of those infected, Hepatitis C can lead to liver failure, transplants, liver cancer and death.

And yet, most people who have Hepatitis C don't even know it--and so they don't get treatment until it's too late. It has been estimated that up to 70 percent of the approximately four million Americans with Hepatitis C are unaware that they carry the virus. For those who know they're infected, the

prognosis is promising--some estimates indicate that 50 percent may have the virus eradicated.

Vietnam veterans in particular are just now starting to learn that they have liver disease likely caused by Hepatitis C. Early detection and treatment may help head off serious liver disease for many of them. However, many veterans with Hepatitis C will not be treated by the VA because they must first establish a service connection for their condition--a standard that is virtually impossible to meet.

My colleagues may be interested to know how veterans were likely exposed to this virus. Medical advances during the Vietnam War included rapid evacuation, improved transfusion and high rates of U.S. casualty survival in an era prior to Hepatitis C screening of the blood supply. Blood transfusion is one of the most common ways Hepatitis C is transmitted. Medical transmission of the virus through needles and other medical equipment is also possible in combat. Medical care providers who served in combat, where universal precautions and rubber glove use are often absent, were likely at increased risk as well, and may have, in turn, posed a risk to the service members they treated.

Researchers have discovered that some blood sent from the U.S. was infected with the virus. Researchers and veterans organizations, including the Vietnam Veterans of America, believe that many veterans were infected after being injured in combat and getting a transfusion or from working as a medic around combat injuries.

Yet, veterans cannot establish a service connection because frequently there were no symptoms when they were originally infected while in Vietnam. In addition, while medical records may show a short bout of Hepatitis, Hepatitis C was not known at the time and there was not a test available to detect the virus.

The Hepatitis C infected veteran is essentially in a catch-22 situation: the VA will not provide treatment unless a service connection has been established, but the veterans cannot prove that they contracted Hepatitis C in combat because the science to detect the virus didn't exist. Without legislative authority to treat these veterans, thousands of veterans infected with Hepatitis C while in the service will not receive VA health care testing or treatment.

I believe that in the long run we will actually save money by testing and treating this infection early on. The alternative is much more costly treatment of end-state liver disease and the associated complications, or other disorders.

Former Surgeon General C. Everett Koop, well respected both within and outside of the medical profession, has said: ``In some studies of veterans entering the Department of Veterans Affairs health facilities, half of the veterans have tested positive for [the Hepatitis C virus]. Some of those veterans may have left the military with the [Hepatitis C virus], while others may have developed it after their military service. In any event, we need to detect and treat [Hepatitis C] if we are to head off very high rates of liver disease and liver transplant in VA facilities over the next decade.''

Some may argue that further epidemiologic data is needed to resolve the issue of service connection. I agree that we have our work cut out for us, and further study should be done. However, there is already a substantial body of research which has firmly established that veterans have a higher incidence of Hepatitis C when compared to non-veterans. We should not ask those who have already sacrificed so much for this country to wait--perhaps for years--for the treatment they deserve while further research is being conducted.

Today is Veteran's Day and we will all take time to honor the sacrifices that these brave men and women have made to defend the freedom of this country and ensure others could live in peace. These veterans shouldn't be asked to fight another battle for the benefits and respect that they have earned.

I hope this legislation will be a constructive step in addressing the health concerns of this Nation's veterans, and I look forward to working with the Veterans Affairs Committee, the VA-HUD appropriators, and veterans groups to meet this emerging challenge.

Mr. President, I rise today on Veterans Day to introduce the Veterans Comprehensive Hepatitis C Health Care Act. This bill would fundamentally change the way the Department of Veterans Affairs is addressing the growing Hepatitis C epidemic, and would create a national standard for testing and treating veterans with the virus.

Hepatitis C is a disease of the liver caused by contact with the Hepatitis C virus. It is primarily spread by contact with infected blood. The CDC estimates that 1.8 percent of the population is infected with the Hepatitis C virus, and that number is much higher among veterans. Vietnam-era veterans are considered to be at greater risk because many were exposed to Hepatitis C-infected blood as a result of combat-related surgical care during the Vietnam War. In fact, data from the Veterans Administration suggests that as many as 18 percent of all veterans and 64 percent of Vietnam veterans are infected with the Hepatitis C Virus (HCV). For many of those infected, Hepatitis C can lead to liver failure, transplants, liver cancer, and death.

And yet, most veterans who have Hepatitis C don't even know it--and often do not get treatment until it's too late. Despite recent advances in treating Hepatitis C, the VA still lacks a comprehensive, consistent, uniform approach to testing and treating veterans for the virus. Only a fraction of the 3.5 million veterans enrolled nationally with the VA Health Care System have been tested to date. Part of the problem stems from a lack of qualified, full-time medical personnel to administer and analyze the tests. Most of the 172 VA hospitals in this country have only one doctor, working a half day a week, to conduct and analyze all the tests. At this rate, it will take years to test the entire enrolled population--years that many of these veterans may not have.

To address this growing problem, I am introducing the Veterans Comprehensive Hepatitis C Health Care Act. This legislation will improve access to Hepatitis C testing and treatment for all veterans, ensure that the VA spends all allocated Hepatitis C funds on testing and treatment, and sets new, national policies for Hepatitis C care. Congressman Rodney Frelinghuysen from New Jersey has introduced companion legislation in the House of Representatives.

The bill would improve testing and treatment for veterans by requiring annual screening tests for Vietnam-era veterans enrolled in the VA system, and providing annual tests, upon request, to other veterans enrolled in the VA system. Further, it would require the VA to treat any enrolled veteran who tests positive for the Hepatitis C virus, regardless of service-connected disability status or priority group categorization. The VA would be required to provide at least one dedicated health care professional--a doctor and a nurse--at each VA Hospital for testing and treatment of this disease.

This bill would also increase the amount of money dedicated to Hepatitis C testing and treatment, and would make sure these funds are spent where they are needed most. Beginning in FY04, Hepatitis C funding would be shifted to the Specific Purpose account under the Veterans Health Administration, and would be dedicated solely for the purpose of paying for the costs associated with treating veterans with the Hepatitis C virus. The bill would allocate these funds to the 22 Veterans Integrated Service Networks (VISN) based on each VISN's Hepatitis C incidence rate, or the number of veterans infected with the virus.

In addition, this bill will end the confusing patchwork of policies governing the care of veterans with Hepatitis C throughout the nation. This legislation directs the VA to develop and implement a standardized, national Hepatitis C policy for its testing protocol, treatment options and education and notification efforts. The bill further directs the VA to develop an outreach program to notify veterans who have

not been tested for the Hepatitis C virus of the need for such testing and the availability of such testing through the VA. And finally, this legislation would establish Hepatitis C Centers of Excellence in geographic areas with high incidence of Hepatitis C infection.

As I've said, many veterans do not even realize that they may be infected with the Hepatitis C virus, and the VA is doing little to encourage them to get the critical testing they need. The VA currently lacks a comprehensive national strategy for combating this deadly disease. With the passage of the Veterans Comprehensive Hepatitis C Health Care Act, veterans will finally be provided with the access to testing and treatment that they have more than earned and deserve. Additionally, the Federal Government will actually save money in the long run by testing and treating this infection early on. The alternative is much more costly treatment of end-stage liver disease and the associated complications, or other disorders.

The VA has known about the problem of Hepatitis C among veterans since 1992, but they have not acted. We must address this critical issue for the brave men and women who have placed their lives in danger to protect the United States. I urge my colleagues to join me in supporting this crucial legislation.

Mr. President, today I am introducing a bill, with my friend and colleague Senator Smith of Oregon, to amend the Bend Pine Nursery Land Conveyance Act, enacted three years ago, authorizing the sale of the U.S. Forest Service Bend Pine Nursery to the community of Bend, OR, for use as a public park and recreation facility.

In the original bill, Senator Smith, Congressman Walden and I sought to achieve some very basic objectives. We wanted the community of Bend to take title to a property which for many years had been a federally owned plantation for growing pine seedlings, and which will now make a superb park and ball field complex for the use of the community. At the same time, the bill authorized the sale of several other properties in order to raise an account enabling the Forest Service to acquire a new headquarters for the Deschutes National Forest.

In 1999, we drafted the original legislation in very close consultation with the U.S. Forest Service based on the assumption that in so doing, the agency would have the necessary tools and direction to move swiftly to implement the legislation. The intent of the legislation was to have the Forest Service sell the property to the Bend Parks District within a year of its enactment at the estimated value of the property at that time, $3 million.

Unfortunately, the goodwill built up throughout the drafting process was squandered by the Forest Service. Two years of delays in the implementation of the original legislation resulted in an appraised price of $5.8 million as opposed to the $3 million this property was assumed to be worth when the original Bend Pine Nursery Land Conveyance was enacted in 2000. This delay has been inconsistent with the intent

of the original legislation and runs entirely contrary to the interest of Bend taxpayers.

The community has always been more than willing to pay fair value for this property, and their goodwill and their tax dollars should not be wasted any longer.

The bill I introduce today resolves the issues that stand in the way of implementation of this simple land sale in a fair manner, directing the sale to move forward expeditiously for $3.5 million. That figure is arrived at by assuming the $3 million value of the property on the day the original Act was passed, allowing for inflation per the Forest Service's calculations, and then deducting the value of acreage that the Forest Service has decided not to sell and 15 acres the Forest Service has the ability to transfer to the local school district at no cost.

I look forward to the expeditious resolution to this issue.

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

Mr. President, today is Veterans Day--a day to honor the service of those brave men and women who have fought for and defended our country.

This Veterans Day has special meaning as 130,000 Americans are serving in Iraq, and many in this country have lost loved ones in Iraq in the past year.

Americans can be proud of the soldiers, sailors, airmen, and marines who are serving today. They are continuing to show the courage, dignity, and bravery with which our veterans, who we honor today, have served in the past.

That rich tradition includes those Americans who serve in the Guard and Reserves. In the 12 years since the first war in Iraq, more than 525,000 members of the Guard and Reserves have been mobilized--more than twice the number that were mobilized in the previous 36 years.

When they are called up to active duty, they leave their civilian jobs--and their civilian salaries--behind. Most take a pay cut--and are glad to do so to serve our country. But when that active duty service becomes an extended tour of duty, the financial strain on the families left behind can be enormous.

To close this pay gap, some State and local governments make up the different between military and civilian pay for their employees who have been activated. Unfortunately, with strains on State and local budgets across the country--as well as the increased demand for more police and firefighters to help fight terrorism and enhance our homeland security--such payments to our Guards and Reservists are a financially difficult option--or not an option at all--for most State and local governments.

That is why I am today introducing the Service to the Country Reimbursement Act. Under my bill, the Federal Government would reimburse State and local governments for the costs of paying the different between the civilian salary and the military pay of a Guard or Reserves member who is activated for more than 30 days.

This legislation will encourage State and local governments to make those payments in order to keep the families financially whole, ensuring that the families of those who serve our country in the Guards and Reserves will not be financially penalized because of the service being made to our country.

I encourage my colleagues to join me in this effort. And I ask unanimous consent that the text of the bill be printed in the Record.