FACT Act

Mr. President, those amendments have all been cleared by both sides. I have no objection.

Mr. President, I suggest the absence of a quorum.

Mr. President, we are on the Interior appropriations bill, waiting for additional debate. All amendments have been offered, but we are waiting for additional debate on some amendments. I am going to seek to speak in morning business.

Yes.

Mr. President, I ask unanimous consent to speak in morning business for 10 minutes.

Mr. President, to follow up on an issue I raised yesterday, I have not yet received a return call from the State Department. As I indicated, Karl Rove and the chief of staff at the White House had sent word to me following my discussion with Karl Rove last Friday that Mr. Zoellick at the State Department would be handling this issue. The issue is Mr. Carlos Lazo, a marine who fought in Iraq and won the Bronze Star for bravery and courage, came back to this country. He is a fellow who fled Cuba on a raft in 1992. His wife and children remain in Cuba unable to leave. He went to fight in the National Guard, went to Iraq to fight for this country, earned a Bronze Star last November in Iraq. He came back to this country to find out that his son was quite ill in Cuba. He wanted to go visit his son and was told he can't travel to Cuba because the President's current regulations and rules say you can only visit once every 3 years.

This young man who fled Cuba, came to this country, put on America's uniform, fought for this country in Iraq, won a Bronze Star fighting for freedom, comes back to this country. He doesn't have the freedom to go to see his sick child in Cuba. That is unbelievable to me. Why? Because there is no humanitarian exemption in the travel to Cuba regulation the President proposed several years ago.

I have asked all the folks involved: Do you mean there is no flexibility at all in this regulation proposed by the President?

None at all, they said. We have people calling. Their mothers are dying in Cuba, and we won't let them go. You can only go once every 3 years.

So Mr. Zoellick did tell me he is looking into it. I haven't heard back from him. Sergeant Lazo, who is walking around with a Bronze Star awarded by this country for his heroism on the battlefield, does not apparently have the freedom to go see his sick son. I will continue to ask these questions of the administration.

Incidentally, I have offered an amendment on this legislation. I agree it is going to take a two-thirds vote, but I want to see the people in the Senate who want to vote against giving this marine the opportunity to go see his sick child. It is not just him. It is all the other people caught in the web of this bizarre travel restriction. In an attempt to slap around Fidel Castro, we have decided to restrict the freedom of the American people to travel to Cuba. What a strange thing that is. We can travel to Communist China, Vietnam, but you can't go see your sick child in Cuba. You can't take your father's ashes to distribute on the church grounds of the church he ministered at in Cuba, after your dad died and his last wishes were to have his ashes distributed on the church property in Cuba. When you do that, you get hit with a big fine. It is unbelievable.

I won't go on except to say that I continue to wait by the phone for a call back from Mr. Zoellick who apparently is handling this. My hope is they will find a way to do the right thing. My hope is the Senate will be able to vote on this in the next day, and maybe the Senate will decide what the right thing is. The right thing is for humanitarian reasons to allow this courageous soldier who fought for freedom to have the freedom to go see his sick child.

Halliburton

Mr. President, let me describe a hearing I chaired yesterday morning. It was a hearing on the subject of Halliburton. Typically, Halliburton has put out a statement saying that it was political. They have been saying this is political for a long while. I held a hearing because the authorizing committee won't. This is the fifth hearing I have held.

The highest civilian official in the Department of Defense, working with the Corps of Engineers, testified at that hearing. She was describing the meetings during which Halliburton was awarded no-bid contracts worth billions of dollars.

She said:

I can unequivocally state that the abuse related to

contracts awarded to KBR [the subsidiary of Halliburton]

represents the most blatant and improper contract abuse I

have witnessed during the course of my professional career.

She insisted these things be done right. They weren't done right. These were sweetheart deals, worth billions of dollars, given to a company without competition for the bid, companies that had an inside track to get the money, get the bid, and they did.

Let me describe one more piece of testimony from an employee of this company. We have had testimony from many others who worked for this company in the country of Iraq under the contract given to Halliburton. This is from an employee of Halliburton who testified yesterday. He was involved in food service, providing food to our troops:

Food items were being brought into the base that were

outdated or expired as much as a year. We were told by the

[Halliburton] food service managers to use these items

anyway.

They are feeding the American troops, and they are receiving food that has an expired date on it; some as much as a year ago have expired. They said give it to the troops anyway. This food was fed to the troops. Continuing to quote:

A lot of these were frozen foods: Chicken, beef, fish, and

ice cream. For trucks that were hit by convoy fire and

bombings [during delivery], we were told to go into the

trucks and remove the food items and use them after removing

the bullets and any shrapnel from the bad food that was hit.

I will say that again:

We were told to go into the trucks and remove the food

items and use them after removing the bullets and any

shrapnel from the bad food that was hit. We were told to turn

the removed bullets over to the managers for souvenirs. When

I had the military check some of the food shipments, they

would turn the food items away. But there wasn't any making

of the record, so KBR [Halliburton] just sent the food to

another base for use.

It is unbelievable. We are talking about feeding soldiers here, and this is an employee of the company that was receiving billions of dollars to feed soldiers. In fact, what caught my attention about this issue is that Halliburton was charging us to feed 42,000 soldiers a day, and it turns out they were only feeding 14,000 soldiers. They were billing the Government for 42,000 soldiers and feeding 14,000. I didn't know they were feeding soldiers food that had expired on its label, food that had come in trucks that had been attacked with bullets and shrapnel embedded in the food to be removed first and then provided to the superiors for souvenirs. This is unbelievable.

Everybody here talks about honoring America's soldiers. What kind of honor exists in providing a sole-source, no-bid contract worth billions of dollars to a company that is feeding food to our soldiers that is outdated or expired on

its label? They say do it any way, it doesn't matter, it is just soldiers. This is just one more example. Every time we hear this sort of thing, we get Halliburton putting out a statement that says this is just politics because the Vice President used to run Halliburton. We didn't talk about the Vice President yesterday. This is a company that got a sweetheart deal at the Pentagon and there are stories after stories of abuse. There was one about the guy who came to our hearing some while ago, and he held up a hand towel. He was in charge of buying supplies such as hand towels. Well, the hand towels he would have bought for the soldiers weren't what his boss wanted. He bought the ones his bosses wanted to buy; they were almost double the price. Why? They wanted the company logo on the hand towel. The taxpayers get bilked, and it increased the price of the hand towels used by soldiers.

Unbelievable. The stories we have heard are hard to believe. They ordered 50,000 pounds of nails, but they came in the wrong size. They are now dumped in the desert in Iraq. It is just a mistake. How about driving $85,000 trucks and when you get a flat tire, you leave the truck. An $85,000 new truck gets a flat tire or has a plugged fuel pump--just trash the truck, leave it beside the road and somebody torches it.

The stories are astounding every time we hear them. Mr. President, every time we hold a hearing, we have the same response. I am not interested in holding any more hearings. I have held five. The only reason we will hold hearings is the authorizing committee won't. You would think somebody would be halfway interested in this kind of fraud. Some of it is abuse or recklessness.

I will tell you one other thing. This is Mr. Rory Mayberry, former food production manager at KBR, a subsidiary of Halliburton. He happens to be in Baghdad at this minute, but he is not working for Halliburton. He is working for another contractor. Here is what Mr. Mayberry said. He said: When the Government auditors came to try to determine what they were doing, I was told all of the employees were told don't you dare talk to a Government auditor. Don't you speak to them. If you do, one of two things will happen. No. 1, you are either going to be transferred to an area where there is hostile activity, in a fire zone, or you are going to be fired. He talked to an auditor at one point, and he was sent to Fallujah during the fighting. That is the way they handled him. Then he quit.

It is unbelievable. They are telling employees you may not speak to auditors under the threat of being fired. You cannot talk or cooperate with Government auditors. Why? I suppose the reason is because this sort of nonsense is going on. They have a sole-source contract, a noncompetitive contract, with billions of dollars going out the door. There is massive waste, abuse and, yes, I believe, fraud. Now, we know there is, at this point, slightly more than $1 billion in billing to the Federal Government by Halliburton, which has a sole-source contract worth billions. We know there is $1 billion that has been formally objected to by the Pentagon. There is about $440 million above that for which there is not sufficient documentation. Yet, this Congress seems to be willing to snore through all of this.

In 1941, right on the edge of the Second World War, Harry Truman was a Democrat and here on the floor of the Senate. There was a Democrat in the White House. Maybe it was uncomfortable to have a Democratic Senator going after waste, fraud, and abuse in the military in contracting, but he did. They went after it for 6 years. I am sure Franklin Delano Roosevelt didn't like it, but the Truman committee, as it was known, held hundreds of hearings and, in 1940 dollars, saved $16 billion. Would that, could that, should that happen now? The answer is yes. Would it or could it? Probably not because no one is interested in having these hearings--no one. Is the White House interested in having hearings like this? Absolutely not. Is anybody going to respond to the question of whether expired food is being fed to soldiers? Will one person stand up downtown at the White House or at the Pentagon and demand answers now? Will there be one hearing by the authorizing committee? Will one person be angry enough to decide this should not happen any longer? I doubt it.

Month after month after month, through five hearings, nobody seems to give a damn about this. We have soldiers eating bad food, taxpayers being bilked, and nobody seems to care. Somebody should. This Congress has little reason to hold its head high when it decides to ignore these kinds of things. It is not of great interest to me to continue to hold hearings through our policy committee, but I will do it if the authorizing committees will not. I don't have the foggiest idea why somebody would want to have an authorizing committee if they weren't interested in following the trail of wrongdoing. Look, this doesn't take an ``Inspector Clouseau.'' You don't need a funny looking hat to track this down. It is all out in front of you. The whole case is laid out. Yet, nobody seems to care.

We don't honor these soldiers, such as Sergeant Lazo, by saying you can fight for freedom and earn a Bronze Star, but you don't have the liberty or the freedom to go see your sick child. We don't honor our soldiers by deciding it is OK for someone to feed them bad food or expired food. I hope perhaps all those who talk about honoring soldiers will decide that honor means a responsibility to follow up. We have had these discussions on the floor of the Senate before about uparmoring humvees and other things. Every time it is raised, it is political, we are told. Perhaps sometimes we should understand there are areas of serious policy, serious concern that ought to embrace the time of this Congress. We spend so much time on things that have so little importance.

I said yesterday that this is a Congress that has tended to treat the light too seriously and the serious too lightly and important things that really matter and really make a difference in people's lives are largely not the center of debate here in the Congress. I regret that. We can, and should, do much better.

I ask unanimous consent to have printed in the Record, following my presentation, the entire testimony of Rory Mayberry, former food production manager at Halliburton's KBR.

Mr. President, I ask unanimous consent to have printed in the Record, following my remarks, the formal statements presented yesterday by the highest ranking civilian official in the Corps of Engineers at the Pentagon, Bunnatine Greenhouse.

She is a woman who had a wonderful career for a long time, was given high marks always, clearly someone with a sterling reputation and a great career, who ran afoul of the ``old boy's network,'' it appears to me, in the Pentagon when they decided they wanted to steer certain contracts in certain ways. She said: You are not following regulations. That is the wrong thing to do, and we are going to see waste, fraud, and abuse as a result of it. She would not go along with it all. Guess what. They decided to tell her that, despite all those glowing performance evaluations, they are changing their mind on her if she would not go along, so she was either going to be demoted or fired. She testified yesterday, when she was told by the acting general counsel of the Corps of Engineers that it would not be in her best interest to speak publicly about these things. Oh, really? I thank her for the courage and the others for their courage. I also thank Rory for the courage to speak out. I suppose it would be easier not to speak out.

I will read the last sentence of the second paragraph of the statement of Bunnatine Greenhouse:

I can unequivocally state that the abuse related to

contracts awarded to KBR [Halliburton] represents the most

blatant and improper contract abuse I have witnessed during

the course of my professional career.

I continue to ask the question: Is there somebody here who cares? Is there somebody who has the reins of an authorizing committee that cares enough to begin a real investigation or shall we continue to hold hearings in the Policy Committee only because nobody else will?

I yield the floor.

Exhibit I

transcript of the testimony of rory mayberry, former food production

manager, kbr, senate democratic policy committee, june 27, 2005

My name is Rory Mayberry. I'm sorry that I'm not able to be

there in person to testify to the Committee, but I returned

to Iraq on June 14. I am working as a Medical Examiner and

Medic Supervisor for a company called Emergent Services.

I wanted to testify today about my experience working with

Halliburton in Iraq. I was hired by Halliburton subsidiary

KBR in January 2004 as the Food Production Manager for a

dining hall at Camp Anaconda, Iraq. I worked under the

Halliburton's LOGCAP contract from February 2004 until Apri1

2004.

When I was assigned to the dining facility, KBR managers

informed me that there were KBR practices that were to be

followed everyday. These practices led to major overcharges.

First, KBR was supposed to feed 600 Turkish and Filipino

workers meals according to their custom. Although KBR charged

the government for this service, it didn't prepare the meals.

Instead, these workers were given leftover food in boxes and

garbage bags after the troops ate. Sometimes there were no

leftovers to give them.

Second, KBR charged the government for meals it never

served to the troops. Until late 2003, anaconda was a

transition site for army personnel. Because there could be

large numbers of extra personnel passing through everyday,

KBR would charge for a surge capacity of 5,000 troops per

meal. However, KBR continued to charge for the extra

headcount even after Anaconda was no longer a transition

site.

When I questioned these practices, the managers told me

that this needed to be done because KBR lost money in prior

months, when the government suspended some of the dining hall

payments to the company. The managers said that they were

adjusting the numbers to make up for the suspended payments.

I would prepare food orders each week in order to get the

food we needed at the camp in the coming week. The KBR

managers would triple the order every week to bring in much

more food than we needed. They did this because they were

charging an extra 5,000 troops they weren't actually feeding.

Most of this food went to waste though.

Third, KBR paid too much for the food itself. Initially, a

company called Tamimi Catering was KBR's sub-contractor for

the food. Tamimi paid local prices for the food products in

the towns and cities around the base in addition to orders

sent to their main office. Tamimi's pricing was fair for the

condition of the country. Then, KBR switched to a new

supplier, PWC. PWC's prices were almost triple what Tamimi's

were.

For example, tomatoes cost about $5 a box locally, but the

PWC price was $13 to $15 per box. The local price for a 15-

pound box of bacon was $12, compared to PWC's price of $80

per box. PWC charged a lot for transportation because they

brought the food from Philadelphia. KBR switched from Tamimi

to PWC because Tamimi complained about KBR's poor treatment

of its staff; they were living in tents with sand floors and

no beds.

There were other problems that were not related to KBR's

costs:

Food items were being brought into the base that were

outdated or expired as much as a year. We were told by the

KBR food service managers to use these items anyway. This

food was fed to the troops. A lot of these were frozen foods:

chicken, beef, fish, and ice cream. For trucks that were hit

by convoy fire and bombings, we were told to go into the

trucks and remove the food items and use them after removing

the bullets and any shrapnel from the bad food that was hit.

We were told to turn the removed bullets over to the managers

for souvenirs. When I had the military check some of the food

shipments, they would turn the food items away. But there

wasn't any marking of the record, so KBR just sent the food

to another base for use. The problem with expired food was

actually worsened with the switch to PWC because it took

longer for the food items to get to the base as they were

shipped from the U.S. to a warehouse in Kuwait.

KBR also paid for spoiled food. When Tamimi dropped off

food, there was often no place to put it in to the freezers

or refrigeration. Food would stay in the refrigeration and

freezer trucks until they ran out of fuel. KBR wouldn't

refuel the trucks so the food would spoil. This happened

quite a bit.

In addition, KBR would cater events for KBR employees, like

management parties and barbecues. This happened about 3 times

a week. As a result, there were shortages of certain food

items, such as beef, chicken, pork, salads, dressings, and

sodas for the troops.

The food service personnel were given sanitation rules from

the Military Preventive Medicine information programs and

rules to follow by the Armed Forces, but KBR managers

informed us that the information was not to be followed, that

they knew best, and to keep following their instructions. So

our employees weren't following sanitation rules as set

forth.

Also, the Iraqi subcontract drivers of food convoys that

arrived on the base were not fed. They were given MREs, or

meals ready to eat, with pork, which they couldn't because of

religious reasons. As a result, the drivers would raid the

trucks for food.

Government auditors would have caught and fixed many of the

problems. But KBR managers told us not to speak with

auditors. The managers themselves would leave the base or

hide from the auditors when they were on the base and not

answer the radios when we called for them. We were told to

follow instructions or get off the base. The threat of being

sent to a camp under fire was their way of keeping us quiet.

The employees that talked to the auditors were moved to the

other bases that were under more fire then Anaconda. If they

refused to move, they were fired and sent home.

I personally was sent to Fallujah for 3 weeks. The manager

told me I was being sent away until the auditors were gone

because I had opened my mouth to the auditors. When I

returned from Fallujah, the convoy was attacked. I was put in

danger because the KBR managers didn't want me to talk with

U.S. government auditors.

When KBR wanted me to go to Tikrit, I headed home on

rotation. I wasn't officially fired and I didn't formally

quit.

I am happy to answer any questions the Committee may have

for me.

Mr. Mayberry, representatives of the Senate Democratic

Policy Committee have provided me with several questions that

they would like me to ask you now. Can I begin asking you

those questions?

Q: Are you saying that Halliburton deliberately falsified

the number of meals they prepared, and then submitted false

claims for reimbursement, and that they did this to make up

for past amounts auditors had disallowed?

A: Yes.

Q: So, when they couldn't get reimbursed legitimately, they

committed fraud by submitting these false bills?

A: Yes.

Q: How many meals were served at the dining hall each day?

A: 2,500 meals, per meal, times four. There were four

meals, breakfast, lunch, dinner and a midnight meal.

Q: So, every day, Halliburton was charging for 20,000 meals

it never served?

A: Correct. They were charging for 20,000 meals, and they

were only serving 10,000 meals.

Q: Was it rare for expired food to be served to the troops?

A: No. It was an everyday occurrence, sometimes every meal.

Q: You've described routine overcharging and unsanitary

practices by Halliburton, as well as shortages of food items

for troops because of private Halliburton parties.

Halliburton managers were not only aware of these practices,

they ordered them, is that correct?

A: Correct.

Q: How senior were these managers?

A: The managers, the main manager was a manager of all of

Iraq, assigned by KBR.

Q: So these practices may have been ordered at other dining

halls in Iraq?

A: Most likely, yes.

Q: When government auditors arrived, these senior managers

deliberately avoided them?

A: Yes.

Q: And these senior managers ordered you and other

employees not to discuss your concerns with the auditors?

A: Yes. We were informed if we talked, we would be rotated

out to other camps that were under fire.

Q: Is it fair to say that the managers used the threat of

transfer to a more dangerous base to intimidate employees

into keeping quiet?

A: Yes.

Q: When employees did talk to auditors, what happened?

A: All the employees that did talk to the auditors were

switched out to other camps or fired because they refused to

go to the other camps.

Q: Is there anything else you'd like us to know?

A: Not at this time.

Thank you for your testimony, Mr. Mayberry.

Mr. President, the well-being of the U.S. population depends to a considerable extent on having access to high quality health care which, in turn, requires the presence of an adequate supply of health care professionals. The Congress and the President recognized this need when we passed, and President Bush signed, the Nurse Reinvestment Act in the 107th Congress. Just as with nurses, we must also insure an adequate supply of well-prepared allied health professionals. That is why, today, I am introducing the Allied Health Reinvestment Act with my good colleagues, Senator Bingaman of New Mexico and Senator Lieberman of Connecticut.

The allied health professions are many. Those recognized in the act include professionals in the areas of: dental hygiene, dietetics/ nutrition, emergency medical services, health information management, clinical laboratory sciences/medical technology, cytotechnology, occupational therapy, physical therapy, radiologic technology, nuclear medical technology, rehabilitation counseling, respiratory therapy, and speech-language pathology/audiology. This is not an exhaustive list, as the act will leave to the discretion of the Secretary of HHS additional professions deemed eligible.

Today, many allied health professions are characterized by existing workforce shortages, declining enrollments in academic institutions, or a combination of both factors. The American Hospital Association, AHA, reports vacancy rates of 18 percent among radiology technicians, 10 percent among laboratory technologists, 15.3 percent among imaging technicians, and 12.7 percent among pharmacy technicians. In addition, the AHA indicates that hospitals are having increasing difficulties recruiting these same professionals over the preceding 2-year period.

In my own State of Washington, the Washington State Hospital Association reports vacancy rates of 14.3 percent among ultrasound technologists, 11.3 percent among radiology technicians, and 10.9 percent among nuclear medicine technologists. These vacancy rates have a real effect on the hospitals in my State. When I meet with hospital officials back home, they always tell me how the lack of technicians affects patient care.

The Bureau of Labor Statistics projected that in the period 1998- 2008, the United States would need a total of 93,000 new professionals in clinical laboratory science by creating 53,000 new positions and filling the 40,000 existing vacancies. That averages 9,000 openings per year for technicians, and yet academic institutions are producing only 4,990 graduates annually. If these numbers stay constant, we will be short by 43,100 needed technicians in 2008.

According to the American Hospital Association, declining enrollment in health education programs contributes to the critical shortages of health care professionals. Similarly, data from a November 2002 study of 90 institutions by the Association of Schools of Allied Health Professions, ASAHP, shows a 3-year period of decline in enrollment in cardiovascular perfusion technology, cytotechnology, dietetics, emergency medical sciences, health administration, health information management, medical technology, occupational therapy, rehabilitation counseling, respiratory therapy, and respiratory therapy technician programs. As an indication of a worsening situation, data from the 2002-2003 academic year, alone, show that dental hygiene, physician assistant, and speech-language pathology and audiology should be added to this list.

While having an adequate number of health professionals in our country is key to ensuring access to health care for all of us, certainly one of the key populations for whom a healthy supply of health professionals is vitally important for is our senior population.

The U.S. Census Bureau reports that rapid growth of the population age 65 and over will begin in 2011 when the first of the baby boom generation reaches age 65 and will continue for many years. From 1900 to 2000, the proportion of persons 65 and over tripled, going from 4.1 percent to 12.4 percent.

The baby-boom generation's movement into middle age, a period when the incidence of heart attack and stroke increases, will produce a higher demand for therapeutic services. Medical advances now enable more patients with critical problems to survive, but in order to do so and maintain a high quality of life, these patients may need extensive therapy.

Along with the aging of the population came an increase in the number of Americans living with one, and often more than one, chronic condition. Today, it is estimated that 125 million Americans live with a chronic condition, and by 2020 as the population ages, that number will increase to an estimated 157 million, with 81 million of them having two or more chronic conditions. Twenty-five percent of individuals with chronic conditions have some type of activity limitations. Two-thirds of Medicare spending is for beneficiaries with five or more chronic conditions.

Many individuals with chronic conditions rely on family caregivers. Approximately 9 million Americans provide such services, and on the average, they spend 24 hours a week doing so. Caregivers aged 65-74 provide an average of 30.7 hours of care per week and individuals aged 75 and older provide an average of 34.5 hours per week.

Women are more likely than men to have chronic conditions, in part because they have longer life expectancies. These same women are caregivers to other chronically ill persons. In addition, 65 percent of caregivers are female, and of all caregivers, nearly 40 percent are 55 years of age and older.

Physicians report that their training does not adequately prepare them to care for this type of patient by providing education and offering effective nutritional guidance. Those aspects of care can be provided by allied health professionals, but many of them need better preparation to treat and coordinate care for patients with chronic conditions. While much emphasis is placed on curative forms of care, additional efforts must be devoted to slowing the progression of disease and its effects.

One example of the effectiveness of allied health interventions may be illustrated by a study funded by the National Institute on Aging, the National Center for Medical Rehabilitation Research, and the Agency for Health Care Policy and Research--since renamed the Agency for Healthcare Research and Quality. The investigation showed that significant benefits resulted from a 9-month occupational therapy intervention intended to reduce health-related declines urban, multiethnic, independent-living older adults. The majority of study participants, 73 percent, lived alone and 26 percent reported at least one disability. Important health-related benefits attributable to the intervention continued over a 6-month interval in the absence of further treatment.

The bill my colleagues and I introduce today, like the Nurse Reinvestment Act in the 107th Congress, is intended to provide incentives for individuals to seek and complete high quality allied health education and training. Furthermore, the bill will provide additional funding to ensure that such education and training can be provided to allied health students so that the U.S. healthcare industry with have a supply of allied health professionals needed to support the Nation's health care system in this decade and beyond.

The bill offers allied health education, practice, and retention grants. Education grants will be used to expand the enrollment in allied health education programs, especially by underrepresented racial and ethnic minority students, and provide educational opportunities through new technologies and methods, including distance-learning. Practice grants are intended to establish or expand allied health practice arrangements in noninstitutional settings to demonstrate methods that will improve access to primary health care in rural areas and other medically underserved communities. Retention grants are intended to promote career advancement for allied health personnel.

Grants will also be made available to health care facilities to enable them to

carry out demonstrations of models and best practices in allied health for the purpose of developing innovative strategies or approaches for retention of allied health professionals. These grants will be awarded to a variety of geographic regions, and to a range of different types and sizes of facilities, including facilities located in rural, urban, and suburban areas.

Furthermore, this bill will give the Secretary of HHS, acting through the Administrator of HRSA, the authority to enter into an agreement with any institution that offers an eligible allied health education program to establish and operate a faculty loan fund to increase the number of qualified allied health faculty. Loans may be granted to faculty who are pursuing a full-time course of study or, at the discretion of the Secretary, a part-time course of study in an advanced degree program.

I am especially proud of the provisions of this legislation regarding the National Health Service Corps program, the brain child of Senator Warren Magnuson of Washington. The NHSC program, of course, encourages students in the health professions such as doctors and dentists to serve in underserved areas throughout our nation in return for loan repayment assistance. And, like the NHSC program, this Allied Health Reinvestment Act will establish a scholarship program that provides scholarships to individuals seeking allied health education in exchange for service by those individuals in rural and other medically underserved areas with allied health personnel shortages.

There are a number of organizations supporting this bill, and I thank them for that support. Among them, the list includes, but is not limited to:

Washington State Hospital Association

Health Work Force Institute (Seattle, WA)

American Association for Respiratory Care

American Association of Community Colleges

American Clinical Laboratory Association

American Dental Hygienists' Association

American Dietetic Association

American Health Information Management Association

American Hospital Association

American Physical Therapy Association

American Society for Clinical Laboratory Science

American Society for Clinical Pathology

American Society of Radiologic Technologists

Association of Academic Health Centers

College of Health Deans

Midwest Regional Deans Group

Myositis Association

National Association of EMS Educators

National Cancer Registrars Association

National Network of Health Career Programs in Two-Year

Colleges

Northeast Regional Deans Group

In addition to these organizations, I would also like to express my appreciation to the Association of Schools of Allied Health Professions, ASAHP, for its support of the legislation as well as its ongoing efforts to address the need for allied health professionals and allied health faculty.

ASAHP, founded in 1967, has a membership that includes 108 institutions of higher learning throughout the United States, as well as several hundred individual members. ASAHP publishes a quarterly journal and also conducts an annual survey of member institutions. This annual survey, called the ``Institutional Profile Survey,'' is used for, among other purposes, collecting student application and enrollment data. These data substantiate that there is a pressing need to address existing allied health workforce shortages, which have been further exacerbated by declines in enrollment that have occurred for 4 straight years.

In the survey conducted during the period September-November 2004 for the 2004-2005 class starting in fall 2004, the results from 90 academic institutions indicate that in 16 of the 20 professions studied, available classroom seats were not filled. For example, only 33 percent of enrollment capacity was reached for health information management programs in these schools. Given the emphasis on increasing the use of information technology in health care such as conversion to electronic patient records, that figure is disturbingly low.

Similarly, the survey shows that enrollment levels were low in the following professions: rehabilitation counseling, 44 percent, emergency medical sciences, 66 percent, cytotechnology, 69 percent, and medical technology, 77 percent. Severe workforce shortages already exist in the two laboratory professions and emergency medical personnel will play a key role as first responders in dealing with any bioterrorism incident that might occur.

Using data from the Institutional Profile Survey, as well as the General Accounting Office, U.S. Census Bureau, and other sources, ASAHP has compiled what I believe to be a compelling rationale in its support for the Allied Health Reinvestment Act that Senators Bingaman, Lieberman, and I introduce today. I ask unanimous consent that the text of this Rationale for an Allied Health Reinvestment Act from the Association of Schools of Allied Health Professions be printed in the Record.

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

Mr. President, I rise today to introduce the Fair Access to Clinical Trials, FACT, Act. I want to begin by thanking Senator Grassley, Senator Johnson, and Senator Wyden for joining me in introducing this legislation. Our bill will create an electronic databanks for clinical trials of drugs, biological products, and medical devices. Such a databank will ensure that physicians, researchers, the general public, and patients seeking to enroll in clinical trials have access to basic information about those trials. It will require manufacturers and other researchers to reveal the results of clinical trials so that clinically important information will be available to all Americans, and physicians will have all the necessary information to make appropriate treatment decisions for their patients.

Events of the past year have made it clear that such a databank is needed. First, serious questions were raised about the effectiveness and safety of antidepressants when used in children and youth. It has now become clear that the existing data indicates that these drugs may very well put children at risk. However, because the data from antidepressant clinical trials was not publicly available, it took years for this risk to be realized. In the meantime, millions of children have been prescribed antidepressants by well-meaning physicians. While these drugs undoubtedly helped many of these children, they also led to greater suffering for others. Recently, it has been suggested that the risk of antidepressants might even extend beyond children.

The news is similarly disturbing for a popular class of painkillers known as Cox-2 inhibitors. These medicines, taken by millions of Americans, have been associated with an increased risk of cardiovascular adverse events, such as heart attack and stroke. It has been suggested that one of these medicines, which has since been pulled from the market, may be responsible for tens of thousands of deaths.

Unfortunately, antidepressants and Cox-2 inhibitors are just two examples of a story that has become all too common. It has been suggested that negative data might actually have been suppressed; and if this is discovered to be the case, those responsible should be dealt with harshly. However, because of what is known as ``publication bias,'' the information available to the public and physicians can be misleading even without nefarious motives. The simple fact is that a study with a positive result is far more likely to be published, and thus publicly available, than a study with a negative result. Physicians and patients hear the good news, but rarely the bad news. In the end, the imbalance of available information hurts patients.

Our bill would correct the imbalance of information, and prevent manufacturers from suppressing negative data. It would do so by creating a two-part databank, consisting of an expansion of clinicaltrials.gov--an existing registry that is operated by the National Library of Medicine, NLM--and a new database for clinical trial results.

Under the FACT Act, the registry would continue to operate as a resource for patients seeking to enroll in clinical trials for drugs and biological products intended to treat serious or life-threatening conditions--and for the first time, it would also include medical device trials. The new results database would include all trials, except for preliminary safety trials, and would require the submission of results data.

Our legislation would enforce the requirement to submit information to the databank in two ways. First, by requiring registration as a condition of Institutional Review Board, IRB, approval, no trial could begin without submitting preliminary information to the registry and database. This information would include the purpose of the trial, the estimated date of trial completion, as well as all of the information necessary to help patients to enroll in the trial.

Once the trial is completed, the researcher or manufacturer would be required to submit the results to the database. If they refuse to do so, they would be subject to monetary penalties or, in the case of federally funded research, a restriction on future funding. It is my belief that these enforcement mechanisms will ensure broad compliance. However, in the rare case where a manufacturer does not comply, this legislation also gives the Food and Drug Administration, FDA, the authority to publicize the required information.

Let me also say that any time you are collecting large amounts of data and making it public, protecting patient privacy and confidentiality must be paramount. Our legislation would in no way threaten that privacy. The simple fact is that under this bill, no individually identifiable information would be available to the public.

I believe that the establishment of a clinical trials databank is absolutely necessary for the health and well-being of the American public. But I would also like to highlight two other benefits that such a databank will have. First, it has the potential to reduce health care costs. Studies have shown that publication bias also leads to a bias toward new and more expensive treatment options. A databank could help make it clear that, in some cases, less expensive treatments are just as effective for patients.

In addition, a databank will ensure that the sacrifice made by patients who enroll in clinical trials is not squandered. Many patients would be less willing to participate in trials if they understood that the data are unlikely to be made public if the results of the trial are negative. We owe it to patients to make sure that their participation in a trial will benefit other individuals suffering from the same illness or condition.

The problems associated with publication bias have recently drawn more attention from the medical community, and there is broad consensus that a clinical trials registry is one of the best ways to address the issue. Accordingly, the American Medical Association, AMA, has recommended the creation of such a databank, and the major medical journals have established a policy that they will only publish the results of trials that were registered in a public database before the trial began. Our legislation meets all of the minimum criteria for a trial registry set out by the International Committee of Medical Journal Editors.

To its credit, the pharmaceutical industry has also acknowledged the problem, and has created a database to which manufacturers can voluntarily submit clinical trials data. I applaud this step. However, if our objective is to provide the public with a complete and consistent supply of information, a voluntary database is unlikely to achieve that goal. Some companies will provide information, but others may decide not to participate. We need a clinical trials framework that is not just fair to all companies, but provides patients with peace of mind that they will receive complete information about the medicines they rely on.

The American drug industry is an extraordinary success story. As a result of the innovations that this industry has spawned, millions of lives have been improved and saved in our country and around the globe. Because of the importance of these medicines to our health and well- being, I have consistently supported sound public policies to help the industry to succeed. This legislation aims to build upon the successes of this industry, and help ensure that the positive changes to our health care system that prescription drugs have brought are not undermined by controversies such as the ones now surrounding antidepressants and Cox-2 inhibitors, which are at least in part based on a lack of public information. This bill will help ensure that well- informed patients will use new and innovative medicines.

I look forward to working with industry, physicians, the medical journals, patient groups, and my colleagues--including the Chairman and the Ranking Member of the Health, Education, Labor, and Pensions Committee, Senator Enzi and Senator Kennedy--to move this legislation forward. This bill has already been endorsed by the National Organization for Rare Disorders, Consumers Union, the Elizabeth Glaser Pediatric AIDS Foundation, the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, the New England Journal of Medicine, and the National Women's Health Network. I thank these organizations for lending their expertise as we crafted this legislation.

The creation of a clinical trials databank is a critical step toward ensuring the safety of drugs, biological products, and devices in this country--but it should not be the end of our efforts. I believe that other steps are necessary to fully restore patient confidence in the safety of the medicines they rely on. I have already announced my intention to introduce another piece of legislation that will create an Office of Patient Protection within the FDA, which will be responsible for ensuring the safety of prescription drugs once they are on the market. I look forward to introducing this bill in the coming weeks.

Clinical trials are critical to protecting the safety and health of the American public, and for this reason, trial results must not be treated as information that can be hidden from scrutiny. Recent events have made it clear that a clinical trials databank is needed. Patients and physicians agree that such a databank is in the interest of the public health. I urge my colleagues to support this legislation, and I am hopeful that it will become law as soon as possible.

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

Mr. President, I rise today to introduce the Fair Access to Clinical Trials, FACT, Act. I want to begin by thanking Senator Grassley, Senator Johnson, and Senator Wyden for joining me in introducing this legislation. Our bill will create an electronic databanks for clinical trials of drugs, biological products, and medical devices. Such a databank will ensure that physicians, researchers, the general public, and patients seeking to enroll in clinical trials have access to basic information about those trials. It will require manufacturers and other researchers to reveal the results of clinical trials so that clinically important information will be available to all Americans, and physicians will have all the necessary information to make appropriate treatment decisions for their patients.

Events of the past year have made it clear that such a databank is needed. First, serious questions were raised about the effectiveness and safety of antidepressants when used in children and youth. It has now become clear that the existing data indicates that these drugs may very well put children at risk. However, because the data from antidepressant clinical trials was not publicly available, it took years for this risk to be realized. In the meantime, millions of children have been prescribed antidepressants by well-meaning physicians. While these drugs undoubtedly helped many of these children, they also led to greater suffering for others. Recently, it has been suggested that the risk of antidepressants might even extend beyond children.

The news is similarly disturbing for a popular class of painkillers known as Cox-2 inhibitors. These medicines, taken by millions of Americans, have been associated with an increased risk of cardiovascular adverse events, such as heart attack and stroke. It has been suggested that one of these medicines, which has since been pulled from the market, may be responsible for tens of thousands of deaths.

Unfortunately, antidepressants and Cox-2 inhibitors are just two examples of a story that has become all too common. It has been suggested that negative data might actually have been suppressed; and if this is discovered to be the case, those responsible should be dealt with harshly. However, because of what is known as ``publication bias,'' the information available to the public and physicians can be misleading even without nefarious motives. The simple fact is that a study with a positive result is far more likely to be published, and thus publicly available, than a study with a negative result. Physicians and patients hear the good news, but rarely the bad news. In the end, the imbalance of available information hurts patients.

Our bill would correct the imbalance of information, and prevent manufacturers from suppressing negative data. It would do so by creating a two-part databank, consisting of an expansion of clinicaltrials.gov--an existing registry that is operated by the National Library of Medicine, NLM--and a new database for clinical trial results.

Under the FACT Act, the registry would continue to operate as a resource for patients seeking to enroll in clinical trials for drugs and biological products intended to treat serious or life-threatening conditions--and for the first time, it would also include medical device trials. The new results database would include all trials, except for preliminary safety trials, and would require the submission of results data.

Our legislation would enforce the requirement to submit information to the databank in two ways. First, by requiring registration as a condition of Institutional Review Board, IRB, approval, no trial could begin without submitting preliminary information to the registry and database. This information would include the purpose of the trial, the estimated date of trial completion, as well as all of the information necessary to help patients to enroll in the trial.

Once the trial is completed, the researcher or manufacturer would be required to submit the results to the database. If they refuse to do so, they would be subject to monetary penalties or, in the case of federally funded research, a restriction on future funding. It is my belief that these enforcement mechanisms will ensure broad compliance. However, in the rare case where a manufacturer does not comply, this legislation also gives the Food and Drug Administration, FDA, the authority to publicize the required information.

Let me also say that any time you are collecting large amounts of data and making it public, protecting patient privacy and confidentiality must be paramount. Our legislation would in no way threaten that privacy. The simple fact is that under this bill, no individually identifiable information would be available to the public.

I believe that the establishment of a clinical trials databank is absolutely necessary for the health and well-being of the American public. But I would also like to highlight two other benefits that such a databank will have. First, it has the potential to reduce health care costs. Studies have shown that publication bias also leads to a bias toward new and more expensive treatment options. A databank could help make it clear that, in some cases, less expensive treatments are just as effective for patients.

In addition, a databank will ensure that the sacrifice made by patients who enroll in clinical trials is not squandered. Many patients would be less willing to participate in trials if they understood that the data are unlikely to be made public if the results of the trial are negative. We owe it to patients to make sure that their participation in a trial will benefit other individuals suffering from the same illness or condition.

The problems associated with publication bias have recently drawn more attention from the medical community, and there is broad consensus that a clinical trials registry is one of the best ways to address the issue. Accordingly, the American Medical Association, AMA, has recommended the creation of such a databank, and the major medical journals have established a policy that they will only publish the results of trials that were registered in a public database before the trial began. Our legislation meets all of the minimum criteria for a trial registry set out by the International Committee of Medical Journal Editors.

To its credit, the pharmaceutical industry has also acknowledged the problem, and has created a database to which manufacturers can voluntarily submit clinical trials data. I applaud this step. However, if our objective is to provide the public with a complete and consistent supply of information, a voluntary database is unlikely to achieve that goal. Some companies will provide information, but others may decide not to participate. We need a clinical trials framework that is not just fair to all companies, but provides patients with peace of mind that they will receive complete information about the medicines they rely on.

The American drug industry is an extraordinary success story. As a result of the innovations that this industry has spawned, millions of lives have been improved and saved in our country and around the globe. Because of the importance of these medicines to our health and well- being, I have consistently supported sound public policies to help the industry to succeed. This legislation aims to build upon the successes of this industry, and help ensure that the positive changes to our health care system that prescription drugs have brought are not undermined by controversies such as the ones now surrounding antidepressants and Cox-2 inhibitors, which are at least in part based on a lack of public information. This bill will help ensure that well- informed patients will use new and innovative medicines.

I look forward to working with industry, physicians, the medical journals, patient groups, and my colleagues--including the Chairman and the Ranking Member of the Health, Education, Labor, and Pensions Committee, Senator Enzi and Senator Kennedy--to move this legislation forward. This bill has already been endorsed by the National Organization for Rare Disorders, Consumers Union, the Elizabeth Glaser Pediatric AIDS Foundation, the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, the New England Journal of Medicine, and the National Women's Health Network. I thank these organizations for lending their expertise as we crafted this legislation.

The creation of a clinical trials databank is a critical step toward ensuring the safety of drugs, biological products, and devices in this country--but it should not be the end of our efforts. I believe that other steps are necessary to fully restore patient confidence in the safety of the medicines they rely on. I have already announced my intention to introduce another piece of legislation that will create an Office of Patient Protection within the FDA, which will be responsible for ensuring the safety of prescription drugs once they are on the market. I look forward to introducing this bill in the coming weeks.

Clinical trials are critical to protecting the safety and health of the American public, and for this reason, trial results must not be treated as information that can be hidden from scrutiny. Recent events have made it clear that a clinical trials databank is needed. Patients and physicians agree that such a databank is in the interest of the public health. I urge my colleagues to support this legislation, and I am hopeful that it will become law as soon as possible.

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

Mr. President, I rise to reintroduce comprehensive legislation aimed at addressing the issue of economic and financial illiteracy on college campuses. I am referring to the worrisome problems of skyrocketing debt levels, low rates of saving, and the proliferation of unchecked predatory practices by unscrupulous financial institutions among young adults who hold our country's future in their hands. Entitled the College LIFE or College Literacy In Finance and Economics Act, this bill has the support of Senators Sarbanes and Corzine. I thank my colleagues from Maryland and New Jersey for joining me as original cosponsors of this measure. I also thank Senator Enzi, the Chairman of the Health, Education, Labor, and Pensions Committee, for working with me on financial literacy as it affects all constituencies, including college students.

The problem we are working to address with the College LIFE Act is simple. Our college students are many of America's best and the brightest and will go on to become leaders--in business, education, politics, the military, the community--any area you can name. I find it wonderful that many young people are fulfilling their dreams of higher education in numbers that I did not imagine when I was in college. In fact, as reported by the Census Bureau, college enrollment was estimated at 15.9 million for the current school year, compared to 5.7 million in 1965 when the Higher Education Act was enacted. However, I am gravely concerned, both as a member of this body and particularly as a grandparent and great-grandparent, that our young people are entering college without proper direction or good skills for money management or economic decisionmaking.

As we work on increasing access to higher education, we must give students access to tools needed to make sound economic and financial decisions once they are on campus; however, the lack of personal finance and economics standards or implementation of existing standards in elementary and secondary education in a number of States results in many students arriving at college with little understanding of economic concepts like supply and demand or benefits versus costs, or personal finance concepts such as household money management or the importance of maintaining good credit history. Without this basic understanding, college students are not effectively evaluating credit alternatives, managing their debt, and preparing for long-term financial goals, such as saving for a home or retirement.

Imagine life from the point of view of a college student. A young adult leaves his home and travels many miles--thousands of miles in the case of Hawaii students attending mainland colleges--to the campus that holds his hopes and dreams. Perhaps he is not being mindful of how much money he needs for textbooks, school supplies, or student fees. He visits the campus bookstore and walks out with a bag that includes a preapproved credit card application, which he immediately completes and sends. Months later, he has joined other credit card-holding college students who, on average, have credit card balances above $3,000. Sophomore year rolls around and, instead of conferring with his parents about the details of his renewal FAFSA for student financial aid or master promissory note, he is saddled with another $20,000 loan. According to the Census Bureau, average college tuition, room, and board have increased to $29,119 for a four-year private institution and to $9,953 for a four-year public institution. The same scenario repeats itself in junior and senior year. Finally, after completing all coursework, he graduates, finds an entry-level job, and realizes that, after servicing his debt, he has little left to spend on basics such as food, transportation, and rent, much less career clothing or a new briefcase. His lack of knowledge about how to properly use credit has led him to anxiety-causing financial missteps. With appropriate financial and economic literacy, he may have known what debt load to anticipate and made wiser financing and spending decisions while in school.

Instead, she may be on the road to true financial trouble. A U.S. Public Interest Research Group and Consumer Federation of America analysis of Federal Reserve data indicates that the average household with debt carries approximately $10,000 to $12,000 in total revolving debt and has nine credit cards. From January through September of 2004, approximately 1.2 million consumers filed for bankruptcy, keeping pace with last year's record level, which is almost half of the number of college diplomas expected to be conferred this year at 2.5 million. Furthermore, the Federal Reserve Board reports that Americans currently pay more than 13 percent of after-tax income to service their debts. We must ensure that our youth make the right decisions to follow a better financial path. This is especially in light of a report cited by Dan Iannicola, Jr., Deputy Assistant Secretary of the Treasury for Financial Education, at a House hearing last Congress, noting that youths spent more than $172 billion in a recent year, and figures from MarketResearch.com noting that typical 8- to 14-year-olds spend--from allowances, jobs, and gifts--nearly $1,300 a year or $25 a week.

The College LIFE Act represents a comprehensive approach to assist upcoming generations of Americans. It proposes four new grant programs that provide resources to encourage experimentation with delivery systems--innovative methods used in or out of the classroom to increase college students'

financial literacy. Another grant would allow higher education institutions to share best practices about or create personal finance courses where none exist. A third grant would assist efforts that are looking at the best ways to integrate personal finance and economic education into basic educational subjects, which is especially important as schools are facing challenges under the No Child Left Behind Act and are tempted to focus on subjects being tested for Adequate Yearly Progress. The final grant would train teachers and high school counselors toward increasing financial and economic literacy in grades K-12 so that our college students are prepared when they arrive at college campuses.

The bill also proposes a pilot program for five higher education institutions to encourage students to take a personal finance course and participate in preventive annual credit counseling, working in conjunction with State or local public, private, and nonprofit entities selected by the local education agency or the school, and measuring the effectiveness of efforts in any behavioral changes that may result. It promotes greater collaboration with and support from Federal agencies in the form of the Financial Literacy and Education Commission. Finally, the measure emphasizes the importance of personal finance and economic education and counseling by authorizing these activities as allowable uses in existing Higher Education Act programs, such as TRIO, GEAR UP, and Title III and Title V Serving Institutions.

Furthermore, I intend the reach of this bill to be beyond the traditional college student. Our returning college students are a vital part of society--many who are already community leaders and breadwinners for their families who have already gained valuable work experience that they may use as they learn a new field or continue their undergraduate study in the pursuit of a graduate or doctoral degree. In addition, older adults who are entering higher education for the first time can also be lauded for their enterprising spirit in wanting to better their lives by earning an associates or bachelors degree. I anticipate that the assistance provided through the College LIFE Act will work to provided needed help to many of these students as well.

I am looking forward to continuing to work with my colleagues to have the College LIFE Act passed or included in the upcoming Higher Education Act reauthorization. I encourage my colleagues' support for this bill.