Older Americans Sustainable Mobility Act of 2006

Mr. President, I rise today to introduce legislation aimed to address the disposal of chemical weapons by the military from World War II until 1970. A report titled, Off-Shore Disposal of Chemical Agents and Weapons Conducted by the United States, lists possible sites and types of munitions that may be found in Hawaii.

The Department of Defense has made tremendous strides in protecting the health and welfare of our citizens. However, it still is working on being better stewards of our environment. I am pleased the Army has taken preliminary steps to investigate these munition disposal sites in and around Hawaii. Given the health and safety threats that these munitions may pose, I am introducing legislation to ensure the Army will obtain a full accounting of the munitions found and the state of their condition. Furthermore, it requires the Army to monitor these areas for any health, safety, and environmental risks that these weapons may pose. Lastly, and more important, the Army will provide a report on remediation plans for these areas.

Sadly the issue of disposing hazardous ordnance and waste is not new to the State of Hawaii. Our citizens are keenly aware of the dangers that hazardous waste poses to the health and safety of the public and the environment. In fact, Departments of Defense installations are responsible for generating half of all hazardous waste in Hawaii. For these reasons, it is important for Congress to send the right message, specifically in this case, and ensure that the Army completes its survey, monitors the sites, and provides a plan for remediation. I urge my colleagues to join me in passing this important legislation to ensure that, if the Department of Defense is responsible for disposing of hazardous materials, wherever it may be, then it should be held accountable for monitoring and providing a plan for remediation.

Mr. President, I rise to introduce legislation to repeal a provision in the Deficit Reduction Act that will require people applying or reapplying for Medicaid to verify their citizenship with a U.S. passport or birth certificate. I thank my cosponsors of this legislation, Senators Obama, Bingaman, Inouye, Lautenberg, Jeffords, Kerry, and Lieberman for their support.

This provision must be repealed before it goes into effect July 1, 2006. We have arrived at this conclusion because it will create barriers to health care, and from information we have gathered from agencies, it is unnecessary and will be an administrative burden to implement. These are reasons for this legislation. The Center on Budget and Policy Priorities estimates that more than 51 million individuals in this country would be burdened by having to produce additional documentation. In 16 States--Arizona, California, Florida, Georgia, Illinois, Louisiana, Massachusetts, Michigan, Missouri, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, and Washington--more than a million Medicaid beneficiaries will be required to submit the additional documents to receive or stay on Medicaid. In Hawaii, an estimated 392,000 people who are enrolled in Medicaid will be required to produce the additional documentation.

The requirements will disproportionately impact low-income, racial and ethnic minorities, indigenous people, and individuals born in rural areas without access to hospitals. Due to discriminatory hospital admission policies, a significant number of African-Americans were prevented from being born in hospitals. One in five African Americans born during 1939-1940 do not have birth certificates.

We need to ensure that Medicaid beneficiaries are not discriminated against and do not lose access to care, simply because they do not have a passport or birth certificate. Data from a survey commissioned by the Center on Budget and Policy Priorities is helpful in trying to determine the impact of the legislation. One in 12 U.S.-born adults, who earn incomes less than $25,000, report they do not have a U.S. passport or birth certificate in their possession. Also, more than 10 percent of U.S.-born parents, who have incomes below $25,000, do not have a birth certificate or passport for at least one of their children. An estimated 3.2 to 4.6 million U.S. born citizens may have their Medicaid coverage threatened simply because they do not have a passport or birth certificate readily available.

Some groups are at a greater risk for losing their Medicaid coverage. Nine percent of African-American adults reported they did not have the needed documents. Seven percent of people over age 65 also report that they do not have birth certificates. Many others will also have difficulty in securing these documents, such as Native Americans born in home settings, Hurricane Katrina survivors, and homeless individuals.

It is difficult enough to get access to health care, let alone acquire a birth certificate or a passport before seeking treatment. Some beneficiaries may not be able to afford the financial cost or time investment associated with obtaining a birth certificate or passport. The Hawaii Department of Health charges $10 for duplicate birth certificates. The costs vary by State and can be as much as $23 to get a birth certificate or $87 to $97 for a passport. Taking the time and obtaining the necessary transportation to acquire the birth certificate or a passport, particularly in rural areas where public transportation may not exist, creates a hardship for Medicaid beneficiaries. Failure to produce the documents quickly may result in a loss of Medicaid eligibility.

Further compounding the hardship is the failure to provide an exemption for individuals suffering from mental or physical disabilities from the new requirements. I am really afraid that those suffering from diseases such as Alzheimer's may lose their Medicaid coverage because they may not have or be able to easily obtain a passport or birth certificate.

It is likely these documentation requirements will prevent beneficiaries who are otherwise eligible for Medicaid to enroll in the program. This will result in more uninsured Americans, an increased burden on our healthcare providers, and the delay of treatment for needed health care.

The hardships that will be imposed are unnecessary due to existing requirements that check immigration status. A 2005 study by the Health and Human Services Office of the Inspector General concluded there is no substantial evidence indicating that illegal immigrants claiming to be U.S. citizens are successfully enrolling in Medicaid.

Twenty-eight of 47 Medicaid directors, surveyed by the Health and Human Services Inspector General, indicated that requiring documentary evidence of citizenship would delay eligibility determination. Twenty- five believe that providing additional evidence would result in increased eligibility personnel costs. State Medicaid Agencies would likely have to hire additional personnel to handle the increased workload with significant, additional administrative and financial costs. Twenty-one believe that it would be burdensome or expensive for applicants to obtain a birth certificate or other documentation.

In my home State, the Hawaii Primary Care Association estimates the administrative costs for our Department of Human Services will result in an increased cost of $640,000. Mr. John McComas, the Chief Executive Officer, of AlohaCare, stated, ``We anticipate that there will be significant administrative costs added to our already overburdened Medicaid programs. These

provisions are absolutely unnecessary and place an undue burden on the Medicaid beneficiary, to our entire Medicaid program, and ultimately to our entire state.''

I am frequently frustrated by the inability of the Congress to enact measures to improve health care for Americans. A misconceived provision to mandate these additional documentation requirements will cause real people real pain, and create public health and administrative difficulties. The provision in the Deficit Reduction Act will force every current and future Medicaid beneficiary to produce a passport or birth certificate. I look forward to my colleagues working with me to repeal this provision. I am hopeful that as my friends in the Senate go home during recess, they talk with their constituents at health centers, State Medicaid offices, and social service organizations, and hear how important it is to them for this legislation to be enacted to protect access to Medicaid.

Mr. President, I ask unanimous consent that the full text of the bill be printed in the Record, as well as letters of support and concern from AlohaCare, the Association of Asian Pacific Community Health Organizations, Maternal and Child Health Access, the Hawaii Primary Care Association, and Siren.

Thank you very much, Mr. President.

I hope we have the opportunity as soon as we get back to move forward on the pension conference. I hope we can do it even tonight. I don't want to see this pension bill, which is a matter that has been moved to this point on our legislative calendar on a very bipartisan basis, turned into a partisan issue. There has been too much work on a bipartisan basis to advance this bill, and it is very important to the American business community and to American workers. Billions and billions of dollars are at stake.

In fact, once the majority got serious about pension reform, consideration of this bill in the Senate has been a model of bipartisan cooperation. It would not have passed late last year without the Senate's Democratic caucus pushing for its consideration and working with Republicans to create a process by which a bipartisan consensus could be forged and acted upon by the Senate in a reasonable amount of time.

I agree that there have been unnecessary delays with regard to this legislation, and I regret that the full Senate could not act on this legislation until late last year. Consideration in the House and Senate was delayed last year for two reasons.

First of all, the administration pension proposal was narrowly focused on improving the solvency problems at the PBGC and failed to strike the necessary balance between improving pension funding and continuing the attractiveness of defined benefit pension plans to employers. It would have hastened the demise of defined pension plans, which today cover about one in five workers and provide workers greater retirement security because they provide a guaranteed stream of retirement income. The administration proposal generated little support among Republicans, but they weren't willing to buck the White House on policy grounds and instead deferred action on this legislation. That was unfortunate, but that is the way it is.

Consideration of the bill was also delayed by the decision of the House Republican leadership to hold pension reform hostage in order to advance their failed Social Security privatization plan. The House Republican leadership, as late as June of last year, was still delaying even committee consideration of the pension bill and wanted to couple pension reform with the proposal to privatize Social Security. It wasn't fair to hold this important bill hostage in order to advance the politically unpopular Social Security privatization plan. The political message to all those who cared about fixing the pension system was: Get behind our privatization plan for Social Security or you won't get your pension bill.

For example, the San Francisco Chronicle reported on April 30 of last year that ``House Republican leaders vowed Friday to push through Congress an overhaul not just of Social Security but `retirement security,' grabbing the baton President Bush handed them at his prime.'' In fact, Mr. President, not only prime time but at a news conference he held promising to run with it.

The prime is past.

The savvy legislative tactician who thrives on complex

issues, Thomas outlined a much broader legislative front than

President Bush has proposed. Thomas suggested changes to

private savings and pensions outside of Social Security as

well as to the 70-year-old program, saying he would deliver a

``retirement package for aging Americans.''

Chairman Thomas suggested this wide ranging proposal could

splinter the Democrats.

The Boston Globe reported months later in June:

Republicans in Congress want to turn aging baby boomer

fears of pension defaults heightened by the well-publicized

failure of the United Airlines plan to their advantage with

plans to link broad-based pension overhaul with elements of

President Bush's plan for personal Social Security accounts,

a move GOP leaders hope will break a logjam on Capitol Hill.

The strategy reflects a realization by GOP leaders that

their Democratic colleagues and even some Republicans are

steadfastly opposed to private accounts funded by a portion

of Social Security payroll tax.

Republican leaders hope to build on momentum generated by

the pension defaults and the shaky state of the federal

agency that insures pensions to make a case that retirement

security needs an across-the-board makeover and the type of

personal security accounts Bush has talked about should be

part of the solution.

Consequently, pension legislation languished in the Senate until the end of July. The inability of Senate Republicans on the Committee on Finance to produce a majority in favor of Social Security privatization, pressure by Senate Democrats to move ahead separately on pension reform, and high profile bankruptcies in the airline industry created enough pressure to break this logjam in the Senate.

Again, it was on a bipartisan basis. There was no filibuster, no obstruction, just inaction by the majority.

Despite these delays, Senators Grassley, Enzi, Boxer, and Kennedy, the chairman and ranking members of the Committees on Finance and HELP, worked through the committee and on the floor to draft and pass a bipartisan pension bill. The Committee on Finance reported its bill at the end of July. The HELP Committee reported its bill at the beginning of December. Committees agreed on a bipartisan basis to a compromise bill that merged the two approaches at the end of September.

The actual legislative work on this was relatively short, certainly, for something as complex as this. The bill passed the full Senate on November 16. At that time, I commended Members on both sides for the diligent work in hammering out a consensus bill, and again questioned why the Senate waited until November to address this important issue. In fact, I worked with the distinguished majority leader in making sure there were not a lot of extraneous amendments, and we could move forward.

There is no reason the Senate cannot move forward on this. We need to agree on a reasonable number of conferees. This is a bill, a very complex bill. What I am asking is there be three people from our HELP Committee who are Democrats, and four from the Committee on Finance, a total of seven. This is a very important bill. The reason we are not going to conference is the majority is not willing to give the Democrats another member--that is, they refuse to go with the ratio which the Republicans get, the best of that deal; they get two extra Senators. Now they say we have to do it with--I assume they want me to do two from HELP and three from the Committee on Finance. That is unfair.

I need, the country needs, a pension reform bill. That can only be done by going to conference. I plead with the majority, let's work this out. There is no reason we should not have a ratio of 8 to 6 that allows me to have three people from the HELP Committee who are experts in this field. They will move quickly. They are willing to work unending hours to resolve this matter.

A report in this morning's Congressional Quarterly suggests that outside interests are pushing for a very small conference, the smaller the better, in order to prevent some Senators who have positions on this most important issue, Senators who have worked on it for many years, from participating in the conference. That is too bad.

This legislation has reached this point and we are here today because of strong bipartisan support for moving forward. It has not been a partisan process thus far and I hope it will not become a partisan process. I expect the conference to be conducted in a bipartisan manner, no matter who gets appointed on what side. I am afraid the Republican majority has decided they want to create a political issue instead of trying to find a way around the impasse. The way around it is easy, 7 to 5 or 8 to 6. I hope we can continue working in a bipartisan way in order to get this bill to conference and enacted into law. It is an important piece of legislation.

It does not seem to me to be asking too much that the HELP Committee, which is so vitally important to the moving of this legislation, have three Democrats on the HELP Committee.

I yield the floor.

Mr. President, today, I am introducing legislation to overhaul the Mine Safety and Health Act to make this Nation's mines the safest in the world. The recent events at the Sago mine in Tallmansville and the Alma Mine in Mellville, WV, and the death of a miner of Pikeville, KY, demonstrates that improvements need to be made in all areas of mine safety. The West Virginia disasters remind us of the one at the Pennsylvania Quecreek mine where on July 24, 2002, a mining machine broke through an abandoned section of the mine, unleashing 60 million gallons of groundwater and trapping 9 miners. Some 78 hours after the accident, all 9 miners were pulled safely from the mine. Unfortunately, the 12 men at the Sago mine were not as lucky.

A recent article in the Pittsburgh Post Gazette stated: ``The rest of the world will move on. In the weeks and months to come, there will be other disasters, other wars, other political scandals. But for the families of the 12 men who died inside the mine in Tallmansville, WV, for the one who survived, for their relatives and friends, for the investigators searching for the cause of the mine explosion, for the people of these coal-rich hills 100 miles south of Pittsburgh, Sago will be a daily litany. Some questions about the January 2 accident may never be answered.''

Mining is a dangerous business. There have already been 4 coal mine accidents since the January 2, 2006, Sago disaster. One on January 10, when a miner was killed in Kentucky after a mine roof cave-in, another on January 19, when 2 miners became trapped at

the Alma mine in Melville, West Virginia, and two more accidents on February 1, 2006, where a miner was killed at an underground mine when a wall support popped loose, and a second fatality when a bulldozer struck a gas line at a surface mine sparking a fire and killing the operator. Last year, the safest year on record, there were 22 fatalities in underground coal mines, in 20 separate accidents with 4 men killed in my home State of Pennsylvania; 3 in West Virginia; 8 in Kentucky and 7 in other States.

The Sago mine had 208 citations, orders and safeguards issued against it in 2005, with nearly half of these violations cited as ``significant and substantial''. Eighteen of the violations were cited as ``withdrawal orders'', which shut down activity in specific areas of the mine until problems were corrected.

While the budget for mine safety and health has increased by 42 percent over the past 10 years, these increases barely keep pace with inflationary costs. This has forced the agency to reduce staffing by 183 positions over that same time period. In FY 2006, the final appropriation was $2.8 million below the budget request and $1.4 million below the FY 2005 appropriation due to the 1 percent across- the-board reduction that was required to stay within the budget resolution ceiling.

I chaired a hearing on January 23, 2006, that included testimony from Federal mining officials and mine safety experts from labor, business, and academia, which resulted in many of the proposals in my legislation.

Specifically, the legislation that I am introducing today amends the Mine Safety and Health Act by requiring: 1. MSHA to release the internal review and accident investigation reports to the House and Senate authorizing and appropriating committees, within 30 days of completing their investigation of a mine disaster. 2. MSHA to publish formal rules for conducting accident investigations and hearing procedures. 3. That fines for a flagrant violation be increased from $60,000 to $500,000; defining that violation as a reckless or repeated failure to make reasonable efforts to eliminate a known violation of a standard that substantially and proximately caused, or reasonably could have been expected to cause death or serious bodily injury; and prohibiting the reduction of penalties by an administrative law judge for any violation termed as ``flagrant or habitual''. 4. That no fine less than $10,000 can be assessed for a safety violation that could cause serious illness or injury, and no less than $20,000 can be assessed to a habitual violator for a violation that could significantly and substantially contribute to a safety or health hazard. 5. MSHA inspectors to follow-up on all violations no later than 24 hours. 6. MSHA to ensure that the ventilation and roof control plans are reviewed on a quarterly basis. 7. That mining companies be subject to a fine of no less than $100,000 if MSHA officials are not informed of a disaster within 15 minutes of an accident. The MSHA Director may waive the penalty if it is found that failure to give notice was caused by circumstances outside the control of the mine operator. 8. That mine representatives not be present during accident investigation interviews with miners. 9. MSHA to train all mine personnel in the proper usage of wireless devices and do refresher training courses during each calendar year. 10. That rescue teams do training exercises twice a year and conduct emergency rescue drills at operating mines--on a surprise, unannounced basis. 11. That communications between rescue teams be strictly confined between the command center and the team members. 12. MSHA to have a central communications Emergency Call Center--which includes manned telephone operation with all calls answered by a live operator, 24 hours a day, seven days a week. This provision will apply to all types of mining operations. To assist in implementing and operating the Emergency Call Center, MSHA shall--on a quarterly basis-- provide the Center with a mine emergency contact list. 13. That wireless Emergency Tracking Devices be made available to each miner by the operator which will enable rescuers to locate miners in case of an accident. 14. That wireless text messaging or other wireless communications devices be made by the operator and shall be worn by underground personnel to enable rescuers or mine operators to communicate with underground personnel. 15. MSHA to place secondary telephone lines in a separate entry in order to increase the likelihood that communications could be maintained between miners and those on the surface in the event of an emergency. 16. That strategically placed oxygen stations be provided to miners with four days of oxygen--in the section of the mine where miners are working. 17. That fines will be increased from $5,500 to $55,000 for operators who fail to correct a violation. 18. That an operator who knowingly exposes workers to situations likely to cause death or serious bodily injury or willfully violates a mandatory health or safety standard will have fines increased from $25,000 to $250,000. 19. That if any person gives advance notice of the mine inspection the fine will be increased from not more than $1,000 to not more than $20,000. 20. That if any person makes a false statement regarding complying with the MSHA Act the fine will be increased from $10,000 to $100,000.

All metal, non-metal and coal mines as defined in section 3 of the Act, shall be subject to a user fee of $100.00 for each penalty assessed, to be collected by MSHA and deposited into its account to augment funding above fiscal year 2006 enacted appropriations, for the following activities: reimburse operators for the costs of training, research and development, rescue teams, safe rooms, and other miner safety supplies and equipment, and supplement MSHA funding of technical support, educational policy and development, and program evaluation and information activities.

These amendments that I have proposed to the Mine Safety and Health Act will improve the conditions in this Nation's mines. The provisions set forth in this legislation will provide increased protections for miners; put in place new equipment and technology to locate miners working underground; increase their oxygen supplies and speed up rescue operations so that the tragedy of the last few months will be not be repeated. I ask that you join me in cosponsoring this legislation.

Mr. President, in recent years, we have become increasingly aware of the great challenges facing our Nation as our population ages. While much discussion revolves around health care, social security, and pension systems, there is another daunting challenge that is rarely addressed in a comprehensive way.

I am referring to the challenge of senior transportation.

We Americans love our automobiles. From the time most of us were old enough to drive, we have been behind the wheel. Cars mean freedom--not in some grand philosophical sense--but in the real and practical sense that matters to us in our everyday lives. Having a car, and being able to drive it, means the freedom to go where we want, when we want.

But as we age, we will find it harder and harder to use the freedom given to us by automobiles. Because as we age, our abilities decline, and driving becomes less and less simple. And then the day comes when we wonder whether we should keep driving at all, and if we don't, how we will get about our daily lives.

That day has already come for millions of our senior citizens.

All around the Nation, older Americans are struggling to stay active and independent while their ability to drive themselves declines. A few live in communities with well-developed public transportation services geared to our senior citizens, but most do not. Many seniors drive as long as they can, perhaps longer than they think they should, simply because they feel they have no alternative.

That is why I am today introducing the Older Americans Sustainable Mobility Act of 2006. Despite its rather

awkward name, this legislation has a great purpose. It would create a 5-year demonstration project, overseen by the Administration on Aging, to establish a national, nonprofit senior transportation network to help provide some transportation alternatives to our aging population. The goal of this network is to build upon creative, successful models that are already showing how the transportation needs of older Americans can be met in a manner that is economically sustainable.

This last point is important. Senior transportation is a complex and expensive logistical problem. We cannot expect to address this problem by creating a brand new, expansive, Federal Government program that requires the commitment of vast sums year after year in order to succeed. We can't afford that, and that really isn't what older Americans want.

What older Americans want is what most of us have and take for granted--the freedom and mobility that our automobiles provide.

My legislation would build upon models that have demonstrated how senior citizens can stay active and mobile even after they stop driving. One such model is ITNAmerica, which has been operating in my home State of Maine since the mid-1990s and has since branched out to communities across the Nation. ITNAmerica uses private automobiles to provide rides to senior citizens whenever they want, almost like a taxi service. Riders open an account which is automatically charged when the service is used. Riders can get credits for rides through volunteer services, through donations--and this is what I think is most intriguing--by donating their private car to the program after they have decided that they should no longer drive.

Kathy Freund, the founder of ITNAmerica, sees this as a way of taking something people see as a liability, and turning it into an asset. Through Kathy's extraordinary vision and hard work, ITNAmerica has developed a model that works because it allows older Americans to make the transition away from driving themselves without asking them to sacrifice their independence, or to learn at an older age how to navigate public transportation systems that may simply be inappropriate for their needs, or widely unavailable in many parts of the country. They can still be mobile, they can still go where they want and when they want, and they can go by car.

Senior citizens will often keep their vehicles long after they have stopped driving. I am sure you have seen these vehicles in your State as I have in mine. You will see them sitting in driveways--unattended and poorly maintained, sometimes not driven for many months at a time. In this form, these cars are ``wasting'' assets. But ITNAmerica has found that the value of these cars can be unlocked by allowing seniors to exchange them for rides. That is why my bill calls for the creation of a once-in-a-lifetime tax benefit for seniors who exchange their cars for rides, valued at the amount of the ride-credit they are provided.

One of my senior citizen constituents, June Snow from Falmouth, ME, has been using the system that I described--the ITNAmerica system-- since 1995, when her eyesight began to fail. At first, she used the program only to get into the city, Portland, and only after dark, when she found it more difficult to drive. But more recently she has traded her car for rides, and now she depends on the system to go everywhere she needs to go. She finds that the program allows her to get around town, to run errands, and do the things she has to do and wants to do without worrying about whether she will be able to get safely from one place to another. She told me: It's not like riding a bus, where you have to work with their schedules, and they won't stop and help you with your groceries. They won't make you get your feet wet walking through the snow to the bus stop.

But what she loves most is the personal attention she gets from the drivers, most of whom are volunteers. ``They help you to the door, and they even carry your bundles and put them in the trunk,'' she says.

My bill also creates a limited-time matching grant program to help communities establish sustainable transportation alternatives for seniors as part of a national network. Programs that wish to compete for these matching grants must be able to show that they can become self-sustaining after 5 years, and that they can operate after that period without reliance on public funds. So what I am proposing, is that we just provide some seed money as a catalyst, to get these programs going, with the full expectation--indeed the requirement--that they become self-sustaining without any public funds after the initial period. My bill also provides smaller grants to help transportation providers acquire the technology they need to connect to this network, and grants to encourage efforts to get the baby boomers more involved in supporting transportation alternatives in their communities. The total cost of these grant programs would be only $25 million over the full 5 year period. Then the program sunsets, and these wonderful transportation programs that would be created all over the country would be sustainable on their own without public funding.

The challenge of providing transportation alternatives to our Nation's senior citizens is literally growing by the day. The bill I am offering is one step toward a reasonable, practical, solution to this important challenge. I think all of us know of neighbors and family members who reach their senior years and really shouldn't be driving anymore but are very reluctant to give up those car keys because there are simply no workable alternatives for them. This bill would provide those alternatives, and I urge my colleagues to support the legislation.

Mr. President, in recent years, we have become increasingly aware of the great challenges facing our Nation as our population ages. While much discussion revolves around health care, social security, and pension systems, there is another daunting challenge that is rarely addressed in a comprehensive way.

I am referring to the challenge of senior transportation.

We Americans love our automobiles. From the time most of us were old enough to drive, we have been behind the wheel. Cars mean freedom--not in some grand philosophical sense--but in the real and practical sense that matters to us in our everyday lives. Having a car, and being able to drive it, means the freedom to go where we want, when we want.

But as we age, we will find it harder and harder to use the freedom given to us by automobiles. Because as we age, our abilities decline, and driving becomes less and less simple. And then the day comes when we wonder whether we should keep driving at all, and if we don't, how we will get about our daily lives.

That day has already come for millions of our senior citizens.

All around the Nation, older Americans are struggling to stay active and independent while their ability to drive themselves declines. A few live in communities with well-developed public transportation services geared to our senior citizens, but most do not. Many seniors drive as long as they can, perhaps longer than they think they should, simply because they feel they have no alternative.

That is why I am today introducing the Older Americans Sustainable Mobility Act of 2006. Despite its rather

awkward name, this legislation has a great purpose. It would create a 5-year demonstration project, overseen by the Administration on Aging, to establish a national, nonprofit senior transportation network to help provide some transportation alternatives to our aging population. The goal of this network is to build upon creative, successful models that are already showing how the transportation needs of older Americans can be met in a manner that is economically sustainable.

This last point is important. Senior transportation is a complex and expensive logistical problem. We cannot expect to address this problem by creating a brand new, expansive, Federal Government program that requires the commitment of vast sums year after year in order to succeed. We can't afford that, and that really isn't what older Americans want.

What older Americans want is what most of us have and take for granted--the freedom and mobility that our automobiles provide.

My legislation would build upon models that have demonstrated how senior citizens can stay active and mobile even after they stop driving. One such model is ITNAmerica, which has been operating in my home State of Maine since the mid-1990s and has since branched out to communities across the Nation. ITNAmerica uses private automobiles to provide rides to senior citizens whenever they want, almost like a taxi service. Riders open an account which is automatically charged when the service is used. Riders can get credits for rides through volunteer services, through donations--and this is what I think is most intriguing--by donating their private car to the program after they have decided that they should no longer drive.

Kathy Freund, the founder of ITNAmerica, sees this as a way of taking something people see as a liability, and turning it into an asset. Through Kathy's extraordinary vision and hard work, ITNAmerica has developed a model that works because it allows older Americans to make the transition away from driving themselves without asking them to sacrifice their independence, or to learn at an older age how to navigate public transportation systems that may simply be inappropriate for their needs, or widely unavailable in many parts of the country. They can still be mobile, they can still go where they want and when they want, and they can go by car.

Senior citizens will often keep their vehicles long after they have stopped driving. I am sure you have seen these vehicles in your State as I have in mine. You will see them sitting in driveways--unattended and poorly maintained, sometimes not driven for many months at a time. In this form, these cars are ``wasting'' assets. But ITNAmerica has found that the value of these cars can be unlocked by allowing seniors to exchange them for rides. That is why my bill calls for the creation of a once-in-a-lifetime tax benefit for seniors who exchange their cars for rides, valued at the amount of the ride-credit they are provided.

One of my senior citizen constituents, June Snow from Falmouth, ME, has been using the system that I described--the ITNAmerica system-- since 1995, when her eyesight began to fail. At first, she used the program only to get into the city, Portland, and only after dark, when she found it more difficult to drive. But more recently she has traded her car for rides, and now she depends on the system to go everywhere she needs to go. She finds that the program allows her to get around town, to run errands, and do the things she has to do and wants to do without worrying about whether she will be able to get safely from one place to another. She told me: It's not like riding a bus, where you have to work with their schedules, and they won't stop and help you with your groceries. They won't make you get your feet wet walking through the snow to the bus stop.

But what she loves most is the personal attention she gets from the drivers, most of whom are volunteers. ``They help you to the door, and they even carry your bundles and put them in the trunk,'' she says.

My bill also creates a limited-time matching grant program to help communities establish sustainable transportation alternatives for seniors as part of a national network. Programs that wish to compete for these matching grants must be able to show that they can become self-sustaining after 5 years, and that they can operate after that period without reliance on public funds. So what I am proposing, is that we just provide some seed money as a catalyst, to get these programs going, with the full expectation--indeed the requirement--that they become self-sustaining without any public funds after the initial period. My bill also provides smaller grants to help transportation providers acquire the technology they need to connect to this network, and grants to encourage efforts to get the baby boomers more involved in supporting transportation alternatives in their communities. The total cost of these grant programs would be only $25 million over the full 5 year period. Then the program sunsets, and these wonderful transportation programs that would be created all over the country would be sustainable on their own without public funding.

The challenge of providing transportation alternatives to our Nation's senior citizens is literally growing by the day. The bill I am offering is one step toward a reasonable, practical, solution to this important challenge. I think all of us know of neighbors and family members who reach their senior years and really shouldn't be driving anymore but are very reluctant to give up those car keys because there are simply no workable alternatives for them. This bill would provide those alternatives, and I urge my colleagues to support the legislation.

Mr. President, I am pleased today to be joined by Senators DeWine, Dorgan and Bond in introducing legislation that will save lives by increasing the number of kidneys available for transplantation. Our bill addresses relatively new procedures that did not exist when the National Organ Transplant Act--NOTA--was passed more than two decades ago. No Federal dollars will be needed to implement it. More importantly, it will make it possible for thousands of people who wish to donate a kidney to a spouse, family member or friend, but find that they are medically incompatible, still to become living kidney donors.

Kidney paired donations involve two living donors and two recipients--the intended recipient of each donor is incompatible with the intended donor but compatible with the other donor in the arrangement. For example, person A wants to donate her kidney to her husband, person B, but cannot because of a biological incompatibility. Likewise, person C wants to donate to his wife, person D, and cannot because of a biological incompatibility. However, testing reveals that A and D are biologically compatible, and C and B are biologically compatible. Therefore, a paired kidney donation can be made whereby A donates to D and C donates to B. Every paired donation transplant avoids burdening the kidney waiting list and increases access to organs for all kidney transplant candidates.

Kidney list donations involve three individuals: a living donor; the recipient of the living donor's kidney, who is allocated the organ through the waiting list; and the donor's intended recipient who receives an allocation priority on the kidney waiting list. In this circumstance, a person intends to donate a kidney to a recipient but is found to be medically incompatible, and there are no other donor- recipient pairs available for a simultaneous paired donation. The person donates his or her kidney, and the kidney is allocated to a medically suitable patient on the national Organ Procurement and Transplantation Network--OPTN--waiting list according to OPTN organ allocation policy. The donor's originally intended recipient then receives allocation priority through the national system to receive a deceased donor kidney, thus fulfilling the donor's original intent to donate to a particular person. It is estimated that clearing the way for these procedures will not only save lives, it would save Medicare tens of millions of dollars each year in avoided costs for renal dialyses of these patients. By permitting living paired donations, this bill will also have the effect of increasing the number of kidneys available to patients already on the kidney waiting list.

The legislation we are introducing removes an unintended impediment to kidney donations by clarifying ambiguous language in Section 301 of the National Organ Transplant Act--NOTA. That section has been interpreted by a number of transplant centers to prohibit such donations. In Section 301 of NOTA, Congress prohibited the buying and selling of organs. Subsection (a), titled ``Prohibition of organ purchases,'' says: ``It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration. . . . '' The legislation we are introducing does not remove or alter any current provision of NOTA, but simply adds a line to Section 301 which states that paired donations do not violate it. When we originally enacted NOTA we expressly exempted several other actions from the valuable consideration provision, such as expressly permitting reimbursement of travel and subsistence costs for living donors, and for reimbursement of their lost wages. We did not know to include paired kidney donation events with these exceptions because they were not being performed then.

Congress surely never intended that the living donation arrangements that permit either a kidney paired donation or a kidney list donation be impeded by NOTA. Our bill simply makes that clear. A number of transplant professionals involved in these and other innovative living kidney donation arrangements have proceeded in the reasonable belief that these arrangements do not violate Section 301 of NOTA, and they are being performed in many states already. This legislation is necessary because some have questioned whether these paired donation situations might somehow involve valuable consideration in that the mutual promises to donate could be considered a thing of value being given in exchange for an organ. We do not believe that this is the case. Certainly, Congress never intended to impede paired donation when it outlawed buying and selling of organs.

There is no known opposition to this legislation. It is supported by numerous medical organizations, including the United Network for Organ Sharing, the American Society of Transplant Surgeons, the American Society of Transplantation, the National Kidney Foundation and the American Society of Pediatric Nephrology.

It is important that we make the intent of Congress explicit so that transplant centers which have hesitated to implement paired donation programs can feel free to do so; and in order that the Organ Procurement and Transplant Network, which is operated by UNOS under contract with the U.S. Department of Health and Human Services, may implement a national registry of pairs who need to find other compatible pairs so that their loved ones can get the transplant they so desperately need.

The experts in the field of organ donation and transplantation estimate that our legislation will result in well over 2,000 additional transplants annually and that Medicare would save millions in kidney dialysis costs. By its own estimate, Medicare spends more than $55,000 annually for each dialysis patient, which equates to more than $3.6 billion per year. Savings to Medicare due to removal of an additional 2,000 patients from the dialysis program through living kidney donation would exceed $110 million. Since the median waiting time for each patient is four years, removal of each patient translates into a total Medicare savings of $220,000.

It is our hope that the Senate will promptly act on this necessary legislation.

Mr. President, as our Nation faces staggering healthcare costs, rising rates of chronic conditions, and a growing wage gap between the haves and the have-nots, we must acknowledge the vital importance of this Nation's safety net--the Medicaid program. The Medicaid program is the provider of healthcare for more than 50 million Americans--young and old, black and white, and the disabled.

As many of us would argue, and as stated by the President in this year's State of the Union Address, the government has a responsibility to help provide healthcare for the poor and the elderly. I ask you to question whether we meet that responsibility with section 6036 of the Deficit Reduction Act that requires citizenship documentation for individuals seeking Medicaid. In order for our country to have healthy children, a healthy workforce and healthy communities, we must not deter Americans from seeking medical care, and yet this provision would do just that.

Much of the public scrutiny on Medicaid spending has focused on the costs of providing care to undocumented immigrant populations. Some believe that requirements for documentation of citizenship will curtail alleged abuse of the Medicaid program by illegal immigrants. Yet, a study conducted by the HHS Inspector General failed to find any substantial evidence that illegal immigrants are fraudulently getting Medicaid coverage by claiming they are citizens, and he did not recommend any new requirements for documentation of citizenship.

If the requirement to document citizenship will not affect illegal immigrants, who are in fact not using the Medicaid program, than we must ask ourselves who will be affected by this requirement?

Let's think about the senior with Alzheimer's disease and the difficulty she experiences in remembering the name of her daughter, let alone where she placed her birth certificate. Let us think about the families who survived Hurricane Katrina, who lost their homes with all their possessions, including their passports. Let us think about the children being raised by cash-strapped grandparents and other relatives, who will incur additional costs for obtaining required documents.

About one out of every twelve U.S.-born adults, or 1.7 million Americans, who have incomes below $25,000 report that they do not have a U.S. passport or birth certificate in their possession. In addition, studies have shown that there are up to 2.9 million Medicaid-eligible children without such documentation.

These figures are even higher for other populations. While 5.7 percent of all adults at all income levels report they lack birth certificates or passports, this percentage rises to 7 percent for senior citizens age 65 or older, and 9 percent each for African American adults, adults without a high school diploma and adults living in rural areas. Notably, these figures do not include many other groups who would also experience difficulty in securing these documents, such as Native Americans born in home settings, nursing-home residents, Hurricane Katrina survivors, and homeless individuals. The documentation requirements in section 6036 would apply to all current beneficiaries and future applicants, allowing for no exceptions, even for those with serious mental or physical disabilities such as Alzheimer's disease or those who lack documents due to homelessness or a disaster such as Hurricane Katrina.

The costs to individuals applying for Medicaid coverage is matched by the overwhelming administrative costs associated with the documentation requirements. If birth certificates or passports are required for Medicaid enrollment, approximately 50 percent of

state officials have reported that they would have to hire additional personnel to handle the increased workload with significant, additional administrative and financial costs. The National Association for Public Health Statistics and Information Systems predicts a 50 percent increase in the volume of birth certificate requests if requirements for birth certificates or passports for Medicaid applications are imposed, resulting in significant delays in processing all birth certificate applications. State resources are already stretched too thin, and we should not impose additional and unnecessary burdens.

At a time when this administration is touting health care tax breaks, which will benefit those who need the least help, it is critical that members of Congress remember the worst off and the most vulnerable members of our society. Medicaid is their lifeline to a healthy and productive future, and we should not obstruct access to this program.

Senator Akaka, Senator Bingaman and I have introduced this bill to eliminate requirements for citizenship documentation from Medicaid, and I urge all of my colleagues to support us in passing this critical act.

Mr. President, I rise today to introduce an important piece of legislation related to our Navy and National Security.

The Department of Defense has submitted its report to the Congress on the Quadrennial Defense Review for 2005 and, as we are all well aware, in the 4 years since the previous Quadrennial Defense Review.

The global war on terror has dramatically broadened the demands on our naval combat forces. In response, the Navy has implemented fundamental changes to fleet maintenance and deployment practices that have increased total force availability, and it has fielded advances in ship systems, aircraft, and precision weapons that have provided appreciably greater combat power than 4 years ago.

These commendable efforts reflect the superb skills, resolve, and dedication of the men and women of our Armed Forces, as they adapt to the added dimension of international terror while providing for the security of our Nation.

However, we must consider that the Navy is at its smallest size in decades, and the threat of emerging naval powers superimposed upon the Navy's broader mission of maintaining global maritime security, requires that we modernize and expand our Navy.

The longer view dictated by naval force structure planning requires that we invest today to ensure maritime dominance 15 years and further in the future; investment to modernize our aircraft carrier force with 21st century capabilities, to increase our expeditionary capability, to maintain our undersea superiority, and to develop the ability to penetrate the littorals with the same command we possess today in the open seas.

The 2005 Quadrennial Defense Review impresses these critical requirements against the backdrop of the national defense strategy and concludes that the Navy must build a larger fleet. The Navy, in its evaluation of the future threat, has determined that a force level of 313 ships, 32 ships greater than today's operational fleet, is required to maintain decisive maritime superiority.

These findings are in whole agreement with previous concerns raised by Congress as the rate of shipbuilding declined over the past 15 years. Now we must finance this critical modernization, and in doing so we must strike an affordable balance between existing and future force structure.

The centerpiece of the Navy's force structure is the carrier strike group, and the evaluation of current and future aircraft carrier capabilities by the Quadrennial Defense Review has concluded that 11 carrier strike groups provide the decisively superior combat capability required by the national defense strategy. Carefully considering this conclusion, we must weigh the risk of reducing the naval force from 12 to 11 aircraft carriers against the risk of failing to modernize the naval force.

Maintaining 12 aircraft carriers would require extending the service life and continuing to operate the USS John F. Kennedy (CV-67). The compelling reality is that today the 38-year-old USS John F. Kennedy (CV-67) is not deployable without a significant investment of resources. Recognizing the great complexity and risks inherent to naval aviation, there are real concerns regarding the ability to maintain the Kennedy in an operationally safe condition for our sailors at sea. In the final assessment, the costs to extend the service life and to make the necessary investments to deploy this aging aircraft carrier in the future prove prohibitive when measured against the critical need to invest in modernizing the carrier force, the submarine force, and the surface combatant force.

We in the Congress have an obligation to ensure that our brave men and women in uniform are armed with the right capability when and where called upon to perform their mission in defense of freedom around the world. Previously, we have questioned the steady decline in naval force structure, raising concerns with regard to long term impacts on operations, force readiness, and the viability of the industrial base that we rely upon to build our Nation's Navy. Accordingly, I am encouraged by and strongly endorse the Navy's vision for a larger, modernized fleet, sized and shaped to remain the world's dominant seapower through the 21st century.

However, to achieve this expansion while managing limited resources, it is necessary to retire the aging conventional carriers that have served this country for so long. To this end, Mr. President, I offer this legislation which would amend section 5062 of Title 10, United States Code to eliminate the requirement for the naval combat forces of the Navy to include not less than 12 operational aircraft carriers.