Stroke Treatment and Ongoing Prevention Act

Mr. President, I have sought recognition to discuss my vote on July 28 against cloture--to end debate--on the motion to proceed to S. 3297, the so-called Reid omnibus bill or ``Coburn package.'' As I stated on the Senate floor Monday, July 28, it is my inclination that the majority leader called for a vote on cloture on proceeding to this bill in order to dislodge the pending legislation on oil speculation. By using his position of power, he seeks to force the Senate to prematurely move away from the No. 1 issue facing the people from my State and the Nation namely energy legislation.

I did not support cloture to move to the Reid omnibus bill not because I do not support many of its provisions, rather because I believe we should complete work on energy legislation before moving on to other matters. Further, I am seeking my right as a U.S. Senator to offer amendments to a bill in a fair and balanced legislative process.

For instance, Senator Kohl and I had a bipartisan amendment prepared to offer to the speculation bill that would have brought OPEC nations under U.S. antitrust laws to prohibit them from meeting in a room, lowering production and supply, and thus raising prices. Unfortunately, this effort was denied by the majority leader's blocking of amendments by filling the so-called amendment tree, disallowing mine and a number of other amendments that ought to be considered.

This procedure is nothing new for this majority leader who has filled the amendment tree on 15 occasions in the current 110th Congress, surpassing all other majority leaders in modern history. As a result of the majority leader's curtailing Senate procedure and amendments, I have been faced with voting against cloture on measures I would have ordinarily supported including this past Saturday's vote on LIHEAP. I have also opposed cloture in instances such as the Lieberman-Warner global warming bill which was considered the first week of June--2 to 6. In that case, the majority leader filled the amendment tree at the first opportunity and filed cloture on the bill without ever allowing consideration of amendments. The 5-day debate culminated in a fait accompli cloture vote that failed on June 6.

Most recently, I voted against cloture to move to the Reid omnibus bill that was a conglomeration of legislation that has been described as non-controversial and may benefit a wide variety of interests. As I stated on the Senate floor on Monday, July 28, I am supportive of most, if not all of the substance in this bill. In fact, I am a cosponsor of six of the items.

I support and have worked to pass a number of the Judiciary Committee-related bills in the proposed omnibus. For example, I am an original cosponsor of the Runaway and Homeless Youth Protection Act, S. 2982, which makes changes in the grant program for centers for runaway youths. I am also a cosponsor of the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act of 2008, S. 2304, which would provide grants for the improved mental health treatment and services provided to offenders with mental illness. In addition, I am a cosponsor of the Emmett Till Unsolved Civil Rights Crime Act, S. 535, which authorizes funding to solve pre-1970 civil rights crimes. Moreover, in committee, I supported a Federal commission to commemorate the bicentennial of the writing of the Star-Spangled Banner and the War of 1812, S. 1079.

Additionally, I voted in favor of the following child protection bills which were passed by the Judiciary Committee: The Combating Child Exploitation Act of 2008, S. 1738, which authorizes grants to combat child exploitation; and the Drug Endangered Children Act of 2007, S. 1210, which extends a grant program directed at drug-endangered children.

I directed my staff to work to clear the child exploitation bills from the omnibus package in the same manner I worked to pass the Adam Walsh Act without extraneous add-ons during the 109th Congress. To that end, my staff worked with Senator Coburn's staff to draft a proposed compromise child exploitation bill that includes the key provisions of the child pornography and exploitation legislation in the proposed omnibus, as well as important legislation to strengthen the powers of the National Center for Missing and Exploited Children, the SAFE Act, which was omitted from the omnibus bill.

My support is also invested in efforts to maintain the natural beauty of the Chesapeake Bay Watershed while simultaneously preserving its resources for the communities it serves. S. 2707, The Chesapeake Bay Gateways and Water Trails Network Continuing Authorization Act, will permanently authorize appropriations for these vital programs. I cosponsored this legislation because I believe it is a critical organization whose mission to protect the bay is vital for the communities affected by this watershed.

Another environmental act I have fervently supported and of which I am an original cosponsor, is S. 496, the Appalachian Regional Development Act Amendments of 2008. The bill renews the Appalachian Regional Commission for 5 years--2007-2011--and authorizes $510 million to be appropriated over that timeframe for the Commission's economic development activities in distressed rural counties.

Numerous health care provisions I have worked hard for can also be found in this package, including S. 1382, which establishes a registry of those suffering from amyotrophic lateral sclerosis, ALS, better known as Lou Gehrig's disease. The registry will gather data about those who are diagnosed with the disease to better understand and research the illness. As Ranking Member of the Labor, Health and Human Services and Education--LHHS--Appropriations Subcommittee, I support research and an ALS registry. I worked to provide $39 million for NIH research of ALS in 2008 and $2.8 million to plan the ALS registry.

I am also a cosponsor of S. 1183, the Christopher and Dana Reeve Paralysis Act, to expand paralysis research at the National Institutes of Health, NIH, and set up a network to allow patients and their families to quickly learn the result of clinical trials on paralysis rehabilitation drugs. The LHHS fiscal year 2008 appropriations bill provided $64 million for NIH spinal cord research.

The package also included bills, H.R. 3112, S. 1810 intended to create a new Federal grant program to pay for information and support services regarding Down syndrome and other prenatally or postnatally diagnosed conditions. While awaiting these authorization bills, I have worked with Senator Harkin to get a jump start on these much-needed activities by including $1 million to establish the congenital disabilities program in the fiscal year 2009 Labor, HHS, and Education Appropriations bill. In addition, the Labor-HHS Subcommittee provided almost $1 million to the CDC in fiscal year 2009 for awareness activities related to Down syndrome.

One of the bills, H.R. 477, would permit the issuing of grants to states for stroke care systems. As ranking member of the Labor-HHS Appropriations Subcommittee, I have worked to increase CDC funding for heart disease and stroke activities in the States to over $50 million and NIH funding for stroke research to over $340 million in fiscal year 2008.

Another bill, S 1375, would establish a grant program for services to mothers suffering from postpartum depression. As ranking member of the Labor-HHS Appropriations Subcommittee, I have worked with Chairman Harkin to include $4.9 million for a first-time motherhood initiative within the maternal and child health block grant.

I also support S. 675, the Training for Realtime Writers Act of 2007. The Telecommunications Act of 1996 requires 100 percent closed captioning for all new English broadcast programming by January 1, 2006. That deadline has come and gone. There are not enough real time writers and captioners to meet this unfunded mandate out in the workforce. Furthermore, the Telecommunications Act of 1996 requires 100 percent closed captioning for all new Spanish broadcast programming by January 1, 2010. America is very far from achieving this goal. S. 675 will assist with training the workforce to provide closed captioning for the 30 million Americans who are deaf or hard-of-hearing.

I support H.R. 3320, the Support for the Museum of the History of Polish Jews Act of 2007, which requires assistance from the Department of State to support the development of a permanent collection at the Museum of the History of Polish Jews in Warsaw, Poland. It is in the national interest of the United States to encourage the preservation and protection of artifacts associated with the heritage of U.S. citizens who trace their forbearers to other countries and to encourage the collection and dissemination of knowledge about that heritage. Most recently, I traveled to Poland on August 27, 2007, and observed fist hand the importance of museums that examine Poland in WW II, specifically the Polish uprising and the Home Army. The Museum of the History of Polish Jews will complement the current museum facilities in Warsaw by preserving and presenting the history of the Jewish people in Poland, which had the largest Jewish population in Europe at the beginning of World War II.

Having outlined a number of priorities and areas of support I have with this omnibus bill, let the record show that I support the package as a whole. However, as evidenced by my vote against cloture on the motion to proceed to the bill, I believe the energy situation is too important to set aside until we have completed or frankly even started our work on it by allowing amendments to be considered. It has been said on this floor that explaining opposition to this omnibus bill to our constituents will be difficult. While this premonition may have some merit,

I trust that the people of Pennsylvania and the Nation will support efforts to deal with high energy prices and encouraging the kind of open and fair debate that leads to better policies across the board.

I reinitiate my suggestion that the Senate stay in session during the month of August, if the majority leader would hold a legitimate session that provides the kind of deliberation that has led many to call the U.S. Senate ``the greatest deliberative body in the world.'' Members of this body should be prepared to work as long and hard as necessary in order to reach a solution to the energy crisis not based upon political appeasement, but results. It is time we allow debate and compromise to reverberate through this chamber as we find areas of agreement in the best tradition of the Senate.

Madam Speaker, I would like to thank my good friend, Mr. Cardoza, the gentleman from California, for the time; and I yield myself such time as I may consume.

Madam Speaker, on the opening day of this Congress, the distinguished chairwoman of the Rules Committee, Ms. Slaughter, came to the floor and said that the new majority would, `` . . . begin to return this Chamber to its rightful place as the home of democracy and deliberation in our great Nation.'' That pledge echoed a document by Speaker Pelosi titled A New Direction For America. That document said, ``bills should generally come to the floor under a procedure that allows open, full, and fair debate.''

Now as we approach the closing hours of the 110th Congress, I think it is appropriate for us to take a look at whether the majority has actually lived up to those promises.

Let us begin with closed rules. There really can be few, if any, parliamentary procedures that are more offensive to the essential spirit of democracy, the spirit of democracy, than a closed rule. A closed rule shuts off, blocks Members from both sides of the aisle from offering any amendments to legislation that is considered on the floor. As I said, no matter what their party affiliation, if and when Congress operates under a closed rule, all Members are shut out from the legislative process on the floor.

Even though the majority promised a more open Congress, as I referred to in the beginning of my remarks, they silenced the vote of every Member and thus all of every Member's constituents a record 63 times this Congress. Sixty-three times. No other Congress in the history of the Republic has ever brought forth so many closed rules. No other Congress in the history of the Republic has brought so many pieces of legislation to the floor under that legislative framework that prohibits every Member of this House from offering amendments to the legislation.

The consistent use of closed rules by the majority constitutes an affront to the democratic spirit as well as to their own promises. But that is not the only way that they have failed to live up to their promises. They have also systematically bypassed what is known as the conference process, effectively shutting out the minority from having a say on legislation that makes its way to the President's desk.

Madam Speaker, as you know, the conference process is the process by which the House and Senate work out differences, resolve their differences and achieve a final legislative product that is exact to be passed by the House and the Senate and sent to the President.

Now the majority has also used a technique known as ``ping-pong'' to avoid that conference process. They have used that technique in order to subvert the rights of the minority to offer motions to recommit and amendments. For comparison, in the 108th Congress and 109th Congress-- those Congresses combined--that technique known as ping-ponging was used three times during the 108th Congress and 109th Congress.

But that is not all. The majority has also considered 45 bills outside the regular order. They also blocked minority substitute amendments, allowing only 10 minority substitute amendments even though they promised a procedure that, and again I remind the majority of its own words, they promised that they would ``grant the minority the right to offer its alternatives, including a substitute.''

So here we are today with a rule that a distinguished senior member of the majority on the Rules Committee said, and I quote, is `` . . . outside the normal parameters of the way that the House should conduct its business . . . it effectively curtails our rights and responsibilities as serious legislators.''

Prior to becoming Speaker, Ms. Pelosi pledged, and I quote, ``to conduct our work with civility and bipartisanship and to act in partnership, not partisanship, with the President and the Republicans in Congress.''

Obviously, the record has been another story.

Now with regard to what the majority is doing today, the majority is bringing forth 44 bills for consideration under what is known as suspension of the rules. It's a process by which usually noncontroversial bills, as my friend described them, bills that generally have bipartisan support because they require two-thirds of the House in order to pass, under the rule being brought forth today, we will be authorizing under this rule 44 bills for consideration under suspension of the rules. At least they're telling us what the 44 bills are. That's why it took some time for the Clerk to read them, because there are 44 bills to read the titles. So at least I think the majority should be commended for telling us what the 44 bills are.

Now, unfortunately, we're informed that the Rules Committee is meeting at this time, as we speak, to pass a rule to authorize more suspensions, but not telling us what they are; in other words, a blanket authority. So, obviously everything has to be put in perspective.

Compared to what the Rules Committee is doing now for the rest of the session, this is a commendable rule because at least it is informing us and the American people what we will be considering. At least the titles have been brought forth. So that is something that, when we consider how the majority has acted procedurally in this Congress, we have to be grateful that we're being informed at least what bills are being authorized for consideration under the rule today.

Madam Speaker, as we look back at this 110th Congress that is nearing its end, I think it would be fair to say that when one considers the promises for openness and fairness and transparency made by the majority at the beginning of this Congress and in their campaign before this Congress began, when one compares that with their record of having broken all precedent in terms of the number, the number, having broken the record in terms of the number of pieces of legislation brought to this floor authorizing no amendments, in other words, closed rules, there is an extraordinary difference between the promise and the reality by our friends on the other side of the aisle.

I reserve the balance of my time.

No, I would inform my friend that we have no other speakers. So at this time I yield back the balance of my time.

Mr. Speaker, I am pleased to rise in support of H.R. 477, the STOP Stroke Act. By passing this legislation, we are drawing attention to the dangers of stroke and heart disease. As we have already heard, stroke is the third leading cause of death in this country, preceded by cardiovascular disease and cancer, but clearly an important cause of death in this country. It is the most common cause of adult disability. As we have already heard, each year, more than 700,000 Americans suffer stroke, and 160,000 die from stroke-related causes.

It is important to increase awareness and knowledge about stroke and stroke prevention. One of the key components of this legislation is that it allows the Secretary of HHS to establish programs for education about stroke prevention.

Additionally, the STOP Stroke Act provides federally funded grants to health care professionals at qualified entities to help educate them about the need for prevention, diagnosis, treatment and rehabilitation.

Lastly, the legislation before us today includes a 5-year pilot program that provides grants to States and public-private entities for coordination of health care through telehealth networks.

I want to thank Congresswoman Capps and Congressman Pickering for their work in bringing this legislation to the floor tonight. I urge my colleagues to support the STOP Stroke Act.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, through the course of these three bills being brought by the Energy and Commerce Committee tonight, we have heard a number of stories. People have shared with us their personal stories.

I saw on the news wires just this evening where a good friend of our committee, Jack Valenti, had been hospitalized with a stroke earlier this week.

My own father suffered a stroke, May 23 of 1989. He, unfortunately, died 2 years ago this week. He spent the last 16 years of his life living with a disability as a result of that stroke. The day that it happened, he lost the ability to speak and never regained it prior to his death.

Stroke treatment is so important and it has evolved over time. It wasn't too many years ago where it was just simply a question of being certain about the diagnosis, making certain the stroke patient was stable, and then making arrangements for their rehabilitation. But so much more can be done now.

And we heard about the golden hour when talking about the trauma bill. Actually, for stroke victims, if treatment is rendered within the first 3 hours of a clot occurring, anti-clot medications, clot-busting medications, thrombolytic agents can be administered to restore significant function to that and prevent injury to that part of the brain that has been injured by, or been placed in jeopardy by, the presence of a clot.

Other strokes are caused by bleeding and blood vessel malformations within the brain; and one of our colleagues in the other body, indeed, suffered such an injury earlier this year. The treatment is vastly different. Clearly, those patients should not be treated with clot- inhibiting agents because they would be placed at greater risk.

So the diagnosis of the type of stroke at the time of the stroke becomes critical, and that is where the funding placed for the education and the medical research becomes so important. Further, it is my feeling that, as time goes forward, we will indeed improve the ability to help individuals who have been afflicted by a stroke.

Additionally, the bill calls for the Secretary of Health and Human Services to establish programs educating the public about stroke prevention. And thanks to my good friends at mayoclinic.com, I would like to take just a moment to run through, to enumerate those things that should be done for stroke prevention. And the number one issue is, if a person has hypertension, that hypertension needs to be controlled. If a person has high cholesterol, that needs to be lowered, either by modifying diet, a diet low in fat or a cholesterol lowering medication such as a statin. No one should smoke in the United States today. If you are diabetic, control your blood sugar. Maintain a healthy weight. Exercise regularly. Avoid stress. Don't serve in Congress. Oh, that wasn't on the list. Avoid stress. And if you do use alcohol or illicit drugs, perhaps you ought to think of another activity.

These are very commonsense recommendations. They have been developed by, again, our good friends at Mayo Clinic. And I urge all Americans to consider incorporating those into their lifestyle.

This is important legislation. I urge my colleagues to support the legislation.

Mr. Speaker, I yield back the balance of my time.

Mr. Speaker, I rise today in support of the Stroke Treatment and Ongoing Prevention Act.

As the original cosponsor of the STOP Stroke Act, I would like to extend a special thanks to my colleague and the bill's sponsor, Congresswoman Capps for her tireless efforts to move this important legislation.

Despite significant advances in its diagnosis, treatment, and prevention, stroke remains the nation's number three killer and a leading cause of long-term disability. An estimated 700,000 U.S. residents have a new or recurrent stroke each year, and about 160,000 of them die, according to statistics compiled by the American Heart Association. On average, every 45 seconds, someone in the United States has a stroke, and someone dies of a stroke every 3 to 4 minutes. Stroke is the number four killer in my home state of Mississippi. In 2004, 1,651 people in Mississippi died of stroke. Mississippi ranks first in the nation for the highest death rate from heart disease, stroke, and other cardiovascular diseases.

Today 5.7 million Americans are stroke survivors. As many as 30 percent of them are permanently disabled, requiring extensive and costly care. It is expected that stroke will cost the nation $62.7 billion in 2007.

Prompt treatment of patients experiencing stroke can save lives and reduce disability, yet thousands of stroke patients do not receive the care they need. Additionally, most Americans cannot identify the signs of stroke, and even emergency medical technicians are often not taught how to recognize and manage its symptoms. Even in hospitals, stroke patients often do not receive the care that could save their lives. Rapid administration of clot-dissolving drugs dramatically improves the outcome of stroke, yet fewer than 3 percent of stroke patients now receive such medication.

The STOP Stroke Act is a first step toward removing these barriers to quality stroke care, thereby saving lives and reducing disability. The legislation addresses a number of significant hindrances to quality stroke care including low public awareness, lack of necessary infrastructure, low awareness among medical professionals, and lack of adequate data collection.

The legislation will coordinate these various components. According to the American Heart Association, developing coordinated systems of care is essential to improving prevention, treatment, and rehabilitation for stroke patients.

The STOP Stroke Act authorizes a national public information campaign to educate the public about stroke, including how to reduce risk, recognize the warning signs, and seek emergency treatment as soon as symptoms occur.

This legislation also authorizes the Paul Coverdell Stroke Registry and Clearinghouse to collect data about the care of acute stroke patients and foster the development of effective stroke care systems. The clearinghouse will serve as a resource for States seeking to design and implement their own stroke care systems by collecting, analyzing and disseminating information on the efforts of other communities to establish similar systems.

The STOP Stroke Act also provides grants for public and non-profit entities to develop and implement continuing education programs in the use of new diagnostic approaches, technologies, and therapies for the prevention and treatment of stroke. Stroke support can be delivered to smaller, underserved facilities by relying more heavily on innovative telemedicine approaches that overcome the boundaries of time and distance to help rural hospitals tap into otherwise unattainable resources.

Finally, this bill authorizes a telehealth stroke treatment pilot project to support states' efforts to develop comprehensive networks to improve stroke prevention, treatment, and rehabilitation. These grants will allow states to identify stroke centers, improve communication networks that bring stroke care to rural areas, and decease response time.

The time has come for a bill such as the STOP Stroke Act. In fact, the time is past due. We are in a situation where stroke rates are on the rise, and we must address the issues that are going to help us match resources with the growing need to prevent and treat this devastating illness.

I look forward to working with my colleagues in both Chambers to promptly move this legislation that has actually passed previously in both the House and the Senate.

Madam Speaker, by direction of the Committee on Rules, I call up House Resolution 1491 and ask for its immediate consideration.

Madam Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Florida (Mr. Lincoln Diaz-Balart). All time yielded during consideration of the rule is for debate only.

General Leave

Madam Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks on House Resolution 1491.

Madam Speaker, I yield myself such time as I may consume.

Madam Speaker, H. Res. 1491 authorizes the Speaker to entertain motions that the House suspend the rules at any time on the legislative day of Thursday, September 25, 2008, on 44 separate measures. This rule is necessary because under clause 1(a) of rule XV, the Speaker may entertain motions to suspend the rules only on Monday, Tuesday or Wednesday of each week. In order for suspensions to be considered on other days, the Rules Committee must authorize consideration of these motions.

This is not unusual. In fact, in the 109th Congress, my friends on the other side of the aisle reported at least six rules that provided for additional suspension days. This bill limits the suspension of rules only to those measures listed in the rule itself so Members on both sides of the aisle are aware of exactly what bills may be considered under this suspension of the rules.

This is standard procedure at the end of the legislative session and includes both House bills that we will send to the Senate for consideration and Senate-passed bills that are ready to become law once they pass the House.

I would remind my colleagues on both sides of the aisle that bills considered under suspension of the rules must receive strong bipartisan support in order to pass the House.

I urge my colleagues to join me in supporting this rule which will simply help us move important, noncontroversial legislation before we adjourn that is important to our constituents and

that will receive overwhelmingly bipartisan support and that will hopefully become law.

I reserve the balance of my time.

Madam Speaker, I would like to inquire of the gentleman from Florida if he has any additional speakers. I am the last speaker on my side.

Madam Speaker, my friend from Florida has raised several issues with regard to the procedures of the House for the last 2 years. The gentleman is correct that there have been a number of closed rules this year. But I would like to just say, in response to that, that we have had to try and manage this House with a very obstinate Republican minority in the Senate.

There has been a record number of filibusters that have been put forward this year to try and stop everything that we have tried to accomplish in this body. In fact, there has been an absolute stonewalling on the number of conference committees, breaking down the bipartisan process, breaking down the comity that engages both Houses, so that we can get something done for the American people. By refusing to go to conference, this has gummed up the arteries of this body, and it, frankly, is the Republican minority in the other body that has really made this a very difficult House and institution to manage.

Madam Speaker, I would also say that the gentleman mentioned that this is--well, first of all, he acknowledged that we are telling everyone today the 44 bills that we are, in fact, bringing forward in this rule. Six times the gentleman's party, in the last Congress, did not tell us what they were bringing forward in a rule. And I can cite the dates. We have the information.

The reality is that this is not an uncommon practice at the end of the session. We would like to, as we are doing in this rule, do it every time, but sometimes it's possible at the end of the session we're simply running out of time.

So, Madam Speaker, as I said, this is a standard procedure at the end of the legislative session that will simply

help us move important, noncontroversial legislation before we adjourn that will receive overwhelming bipartisan support.

I urge a ``yes'' vote on the rule and on the previous question, Madam Speaker.

I yield back the balance of my time, and I move the previous question on the resolution.

The previous question was ordered.