Home Health Care Planning Improvement Act of 2007

Mr. President, I rise to introduce the Currency Reform and Financial Markets Access Act of 2007 on behalf of myself, Senator Shelby, Senator Bayh, Senator Carper, Senator Brown, and Senator Casey.

Nearly two decades ago, the Senate Banking Committee enacted legislation which required the Treasury Department to identify countries that manipulate their currency for purposes of gaining an unfair competitive trade advantage and to take prompt action to eliminate the unfair trade advantage when manipulation is found.

One of the very first actions that I undertook as chairman-elect of the Senate Banking Committee in December 2006 was to write a letter with then-Chairman Shelby to the Treasury Secretary about the report required under this legislation, the International Economic and Exchange Rate Policy Report and the inaugural U.S.-China strategic economic dialogue, SED. In that letter, we expressed our concern that the Treasury Department had not cited China, and potentially other nations, as currency manipulators.

At one of the very first hearings I held as chairman, in January 2007, Treasury Secretary Paulson provided his first congressional testimony since his confirmation, on the SED and the exchange rate report. At that hearing, Secretary Paulson testified that China did not meet the technical requirement for designation as a currency manipulator and that the SED is the ``best chance to get some progress [on the currency issue].''

Senator Shelby and I wrote to Secretary Paulson in advance of the most recent exchange rate report and the May SED urging him to consider steps beyond dialogue to eliminate the unfair trade advantage resulting from China's ongoing currency manipulation and discriminatory market access practices. But instead of taking action, the Treasury Department once again chose not to cite China as a currency manipulator in its latest report to the Senate Banking Committee, despite acknowledging ``heavy foreign exchange market intervention by China's central bank to manage the currency tightly.''

Secretary Paulson's efforts to engage the Chinese through dialogue are commendable, but after two meetings of the strategic economic dialogue, numerous congressional hearings, and the shortcomings of the most recent exchange rate reports, it is clear that dialogue alone is not enough to make progress and legislative action is needed.

Therefore, Senator Shelby and I are today introducing the Currency Reform and Financial Markets Access Act of 2007 which will provide the Treasury Department and Congress new, tough authority to recognize and remedy currency manipulation without ambiguity or delay.

Under current law, Treasury claims that no countries meet the technical finding of intent to manipulate their currencies. Treasury reiterated this point in its most recent exchange rate report, stating:

The Department of the Treasury concluded that, although the

Chinese currency is undervalued, China did not meet the

technical requirements for designation under the terms of

Section 3004 of the Act during the period under

consideration. Treasury was unable to determine that China's

exchange rate policy was carried out for the purpose of

preventing effective balance of payments adjustment or

gaining unfair competitive advantage in international trade.

The Currency Reform and Financial Markets Access Act of 2007 requires a Treasury designation of currency manipulation based on objective data, and without regard to subjective factors such as purpose or intent, removing a technicality that the Treasury Department has been using to defend its inaction.

Once currency manipulation is found, the bill requires the Treasury Department to submit a detailed plan of action to the Congress within 30 days of such finding. The plan of action sets specific timeframes and benchmarks, with the goal of remedying the manipulation. The bill also requires the Treasury to initiate both bilateral and multilateral negotiations, including immediate IMF consultations and to use the Treasury's voice and vote at the IMF to address the manipulation.

Our bill also provides new authority for the Treasury to file a WTO article XV case to remedy currency manipulation if the goals and benchmarks for progress are not met within 9 months of designation.

If the Treasury continues to avoid designating countries as currency manipulators, our bill creates a new process by which Congress, led by either the Senate Banking or House Financial Services Committee, can originate a joint resolution of disapproval of the Treasury's inaction and provides for an expedited process for such a motion through the floors of both Chambers.

Finally, the Currency Reform and Financial Markets Access Act of 2007 promotes market access for U.S. financial services firms to level the playing field for American businesses and to help develop the financial sector reform needed to support a freely floating currency in China. It also requires the Treasury Department to report on the progress of the SED, as well as on opening foreign markets to American financial services firms. It is time for American firms to be afforded the same open and fair treatment abroad that our country provides to foreign firms in the United States.

I am confident that in a free and fair environment American business and entrepreneurship will flourish. Our bill will require Treasury to assume its responsibility as a referee and will fight to level this playing field by identifying and addressing unfair practices and market access barriers.

During the SED events in Beijing, Federal Reserve Chairman Bernanke talked about the market distortions that result from ``an effective subsidy that an undervalued currency provides for Chinese firms that focus on exporting.'' I agree with Chairman Bernanke that undervalued currency is an export subsidy causing market disruptions and fully dealing with such subsidies can involve some trade remedies that are not within the Banking Committee's jurisdiction and hence not within the scope of this bill. But, remedying countervailable export subsidies is a policy that could be fully appropriate and supported by myself and my colleagues through other legislative proposals.

I ask unanimous consent that the text of the bill, a one page summary of the bill, and letters of support be printed in the Record.

Mr. President, I am pleased to introduce the Family Leave Insurance Act of 2007 and especially pleased to be joined by my colleague Senator Stevens. This bill, which would provide 8 weeks of paid benefits to workers who take time off for reasons allowed under the Family and Medical Leave Act, FMLA, is an important step in continuing to help our Nation's workers to be both productive employees and responsible family members.

Before the FMLA, workers had no guarantee that their jobs would still be there if they took time off to care for loved ones or recover from illness themselves. Millions of Americans were forced into a challenging dilemma: care for their families, or provide for them.

That is why I worked to create the FMLA in 1985, and that is why I fought for its passage through 7 years of obstruction and two presidential vetoes, pointing out that its denial of guaranteed leave put America virtually alone among nations, industrialized or otherwise.

Finally, on February 5, 1993, the Family and Medical Leave Act was signed into law. Under its protection, eligible workers receive 12 weeks of leave every year, so that they can watch over a newborn or adopted baby, or help a parent through an illness, or get better themselves, knowing that their job will be there when they return. To date, more than 50 million Americans have taken that opportunity. The FMLA isn't just good for American workers, it is good for American business. Ninety percent of employers have reported that the FMLA had a neutral or positive effect on profits.

Today, the idea of guaranteed leave seems obvious; but now, it is time to take another step in making that hard-won leave a possibility for even more Americans. In the 21st century, working families should not have to give up the leave they earned because they cannot afford it, they deserve paid leave.

Why do we offer nothing, when the European standard is 14 paid weeks? Why are we one of only four countries in the world to deny paid maternity leave, leaving us in the company of Swaziland, Liberia, and Papua New Guinea?

For every worker who can weather a day without pay, three more can't afford the loss. To these workers, unpaid leave is a hollow promise, an impossible choice between the family they love and the job they need.

I believe it is a choice that no American should ever again be forced to make. When Congress passed and President Clinton signed the FMLA, we affirmed that health and family should never have to suffer because of the demands of work. I fail to see why that right should only be afforded to Americans in a certain income bracket.

With the introduction of the Family Leave Insurance Act, we take a huge step toward making family leave a possibility for all Americans. Its 8 weeks of paid leave per year will apply to employees who need time off for any of the reasons included in the FMLA: birth of a child; placement of an adopted or foster child; the care for a child, parent, or spouse with a serious medical condition; or recovery from a serious personal medical condition. Benefits will be tiered on the basis of wages, with the tiers themselves indexed to inflation. This structure will provide the greatest benefit to those with the lowest salaries. And workers who are covered by the FMLA will retain their health insurance and will be guaranteed a return to their job, or a comparable position, on their return.

The act creates a new Family Leave Insurance Fund into which premiums are paid, to finance benefit payments, allowing stakeholders to pool risk and lower costs, and funded through small, shared premiums. Those costs will be shared by employees and employers; the Federal Government will pay for administrative costs. Participation will be mandatory for all businesses with 50 employees or more; those with fewer employees can choose to participate and receive a discount on premium payments. To reduce administrative burdens for employers and employees, employers will pay leave benefits to employees through their regular payroll, with prompt reimbursement from the Family Leave Insurance Fund.

We know that many employers, both large and small, offer very generous leave policies, exemplifying best business practices. Through this legislation, we seek to support companies who offer paid leave so they continue to do so, and to create an incentive for smaller companies to offer paid leave. A provision in the bill allows employers to maintain their own paid leave plan, if it is certified to be equivalent or better to the plan in this legislation.

Our bill will also allow States flexibility in maintaining their existing programs. Several States already have systems to provide paid family and medical leave, and several more have legislation pending to create such systems. In recent years, more than 25 States have introduced legislation to create paid leave programs. The landscape in the States is changing quickly on policies for working families and there are complex issues around the interaction between this legislation, State programs and employers within States. We look forward to collaborating with States so they can maintain maximum flexibility, and provide the best leave policy, as the bill moves forward.

As the FMLA has demonstrated so strongly, family leave benefits both workers and businesses, and that is certainly the case for paid family leave. Paid leave cuts down on employee turnover and the high costs of training replacements; it has been shown to raise morale and productivity; and it levels the playing field by allowing small businesses to adopt a benefit that many of their larger competitors have been offering for years.

Our changing workforce demonstrates the strong need for paid family and medical leave. Almost 80 percent of the workforce is made up of

dual earner couples, who struggle to find time to care for their sick children or their own illnesses. In addition, approximately 40 percent of the workforce will be caring for older parents by 2010. For these and many other reasons, this bill is the right policy.

The FMLA established the principle, and now the Family Leave Insurance Act puts it into practice and into reach for more Americans. Its passage will bring America closer to the world's standards, help our businesses, and protect our workforce. In the lives of millions of Americans, it will help reduce the dilemma of balancing work and family. Let us continue to work together: Government, business and employees need to continue this conversation and improve our policies for working families and individual employees who need paid leave. I strongly urge my colleagues to support this bill.

Mr. President, the Izembek and Alaska Peninsula Wildlife Refuge and Wilderness Enhancement Act authorizes a land exchange among the U.S. Department of the Interior, the State of Alaska, and the people of King Cove. King Cove is an Alaska Native village and many of its present day residents descend from the indigenous Aleut people who have lived and thrived in this isolated area of the Alaska Peninsula for over 4,000 years.

This bill provides the land for a road on which to travel to the nearest all-weather airport which is located in Cold Bay. The people of King Cove do not have a road to their airport today because a National Wildlife Refuge wilderness sits between their village and Cold Bay.

World War II prompted the construction of a major air facility at Cold Bay, which is about 25 miles north of King Cove. Today, the Cold Bay Airport with a 10,000 foot main runway and a 6,500 foot crosswind runway is one of the largest airport facilities in Alaska and is accessible 365 days a year. However, the problem for King Cove residents has always been their inability to get to the airport on a predictable basis due to constant, ever changing weather conditions, combined with King Cove's topographic constraints.

These topographic constraints are directly related to the location of King Cove's small gravel airstrip nestled between 3,000 foot volcanic peaks. To access the airstrip in King Cove, pilots must navigate a narrow opening in the mountains.

Over the past 30 years, efforts by King Cove residents attempting to reach the Cold Bay Airport have resulted in numerous small plane crashes, some fatal. Neither King Cove nor Cold Bay have the sort of hospital facilities that are found in Anchorage. When King Cove people have a serious medical condition, they need to be ``medevaced'' to Anchorage from Cold Bay. That assumes that they can reach the airport at Cold Bay.

This legislation accomplishes the goal of providing the King Cove people with a road to the airport. It accomplishes this goal in a way that provides a net gain, rather than a net loss, to wilderness. The exchange provided for in this bill will add 61,723 acres to the Izembek and Alaska Peninsula National Wildlife Refuges. It adds 45,456 acres of wilderness, the first new wilderness areas designated by the Congress in Alaska in a generation. Not since the passage of the Alaska National Interest Lands Conservation Act, ANILCA, has new wilderness been designated in Alaska.

More importantly, this bill will add key areas of wildlife habitat to these two world-class wildlife refuges. Habitat for some of the largest and wildest brown bears in the world will transfer from private to public ownership. Other areas include key habitat for internationally valued waterfowl such as stellar eiders and brants.

I am sad to say that this is not a new issue for this body. The people of King Cove have been seeking justice in the form of a simple road to Cold Bay for decades. Congress attempted to make things right for the people of King Cove about a decade ago and came up with an imperfect solution.

This imperfect solution involved the construction of a 17-mile road from King Cove to a point near the border of the Izembek Refuge wilderness and a very expensive hovercraft to ferry King Cove residents across the rough waters of Cold Bay. The community has concluded that it cannot afford the cost of the hovercraft solution.

This bill will finish the job started by the Congress a few years ago. This bill provides a wonderful combination of wilderness additions in return for a small road corridor within the Izembek Wildlife Refuge to permit the current 17-mile road to be completed all the way to Cold Bay. This is the fairest and most logical process by which the King Cove residents and the nation can all benefit.

I want to commend the parties who have worked on this bill. The State of Alaska, has brought nearly 43,000 acres to this exchange. Without this land, the exchange would not be possible. The King Cove Native Corporation, which is a Village Corporation created

by the Alaska Native Claim Settlement Act, ANCSA, is donating approximately 2,500 acres of high value wetland habitat in Kinzaroff Lagoon. This lagoon is part of the Izembek National Wildlife Refuge and will be designated as wilderness, so that the mouth of this lagoon will be in public ownership. The corporation is also offering another 10,500 acres, which will be made part of the Alaska Peninsula Wildlife Refuge while relinquishing another 5,400 acres of their ANCSA land in the Refuge.

The only land, which will leave Federal ownership in the area, is approximately 206 acres for a narrow road to connect the existing road from King Cove to the Cold Bay Airport. The route and alignment of the road, within the corridor established by the bill, will be determined through an inclusive, cooperative planning process.

It has been suggested by some that we should not reopen this issue-- it has always been so controversial. People who fought this battle before, and still have the scars to prove it, were told that putting a road in a national wildlife refuge creates a bad precedent. I have been warned that every environmental group in the Nation will line up against me if I pursue the exchange.

That may be true but this is how I see it. In the 25 years that have passed since the Alaska National Interest Lands Conservation Act, ANILCA, became law, I think most Alaskans have come to appreciate the value of setting aside land in Alaska for preservation. That appreciation took time. Many Alaskans, as you know, resisted ANILCA.

In return, it is appropriate for Alaskans to expect the conservation system units to be good neighbors to the aboriginal communities that they border. That hasn't always been the case. The Aleut people of King Cove inhabited their lands long before there was an Izembek National Wildlife Refuge. The King Cove people steadfastly maintain that they were not consulted before the decision was made to make the land that stands between their community and the airport a wilderness. It is their contention that thousands of others across the United States, Canada, and Europe were invited by the Federal Govermment to make their views known in this process, yet they were denied a voice in this most crucial decision affecting their native homeland.

To me the King Cove road isn't just a matter of transportation. It is a matter of respect for Native people. That is why I am willing to take up this cause on behalf of the Native people of King Cove. I ask my colleagues to join with me and with the Aleut people of King Cove to make their dream of a road to the airport, something that those in the Lower 48 take for granted, a reality.

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

Mr. President, today I am proud to introduce legislation with Senator Mike Crapo, House Ways and Means Chairman Charlie Rangel, and Congresswoman Jo Ann Emerson to help open a promising market to American exports. That market is Cuba.

For too long, we have maintained ideologically driven restrictions that have undermined our export competitiveness in a market 90 miles away from us.

Just beyond our shoreline, our trading partners--especially Canada and China--are making multi billion-dollar investments in a Cuban economy that is growing at a rate of 7 to 12 percent per year. But the United States just stands by while these and other countries capitalize on opportunities in our own backyard.

Our economic policy toward Cuba simply is not working. This bill changes that.

The greatest opportunities exist in Cuba's agriculture sector. When Congress passed legislation allowing food and medicine sales to Cuba in 2000, some people said Cuba would never buy. Fidel Castro himself predicted that Cuba would buy ``not one grain'' from the United States.

But Mr. Castro was wrong. Agricultural sales happened. In 2004 alone, Cubans bought more than $375 million in American agricultural products. And, today, nearly every state in the union wants to get into the largest agriculture market in the Caribbean.

I have worked tirelessly to market Montana's high quality agriculture products, and it has paid off. In 2003, I inked a $10 million deal with Cuba. After we completed that deal, I went back to Havana and signed another deal--for $15 million. We have sent Montana wheat, beans and peas to Cuba, and that is just the beginning.

But it has not been easy. In 2005, the Treasury Department issued a rule to undermine the will of Congress. In landmark legislation, Congress in 2000 facilitated agriculture exports to Cuba by authorizing the use of cash basis sales. But the Treasury rule made such transactions impossible. Instead, sellers had to resort to foreign letters of credit, which are time-consuming, complicated, and expensive, especially for smaller exporters.

The Treasury rule stunted what had been meteoric growth in American agriculture exports to Cuba. This rule flies in the face of the law, and it will not stand.

Today's bill overturns the Treasury rule. It clarifies that not only do we intend to let these cash basis sales go forward, we mean to expand and promote them. This bill also ensures that exporters and commodity groups looking to get into the Cuban market get help from the Department of Agriculture. And it would require our Agriculture Department to promote American agricultural exports for Cuba.

Increased agriculture sales will allow Cubans to become familiar with more and more American branded food products. But a little-known provision of U.S. law--known as section 211--invites Cuba to withhold trademark protection from these and other American food exports. Today's bill also addresses that problem.

Section 211 bars U.S. courts from hearing claims of foreign nationals to trademarks similar to or associated with expropriated properties. It also forbids the United States from allowing foreign nationals to register or renew such trademark rights. In other words, it denies trademark protection to Cuban assets. If we are not going to recognize Cuban brands, why should Cuba, in the future, recognize American brands?

The World Trade Organization has already struck down section 211 as inconsistent with U.S. international trade obligations. It is time for this Congress to do the same. My bill repeals this wrong-headed and WTO-inconsistent provision. It ensures the continued security of thousands of American-owned trademarks already registered in Cuba.

I am a big proponent of getting American food products into Cuba. But I also fundamentally believe that we should never use food and medicine as a weapon against a people, no matter what we think of their government.

Many of my colleagues agree with me on this. This is why Congress, in the 1992 Cuban Democracy Act, authorized medicine and medical supplies sales to Cuba. But, at that time, we didn't get it quite right. We passed a law with good intent but loaded it up with so many restrictions that we have made medical sales to Cuba more difficult than medical sales to Iran or North Korea.

My bill will correct this lopsided and inhumane policy. It will allow Cubans access to our medicines and medical products--which are the best money can buy--on the same terms that we offer to other regimes. There is no sound reason to deny our products to our Cuban neighbors but allow such sales to Iran and North Korea.

I have taken Montana farmers and ranchers to Cuba to explore export opportunities. But such opportunities are rare because our government, with limited exceptions, does not permit travel to Cuba. And those exceptions are so riddled with red tape as to discourage applicants from making use of them.

Many Americans are ready and willing to travel to Cuba, and not just to make agriculture sales. Religious organizations have deep roots on the island--since before the Castro government. They are a lifeline, bringing hope, help, and brotherhood to their counterparts in Cuba. American academics and professionals engage in thoughtful exchanges of research and ideas. American students visit with Cuban students, and they learn lessons a teacher cannot imbue.

Nearly everyone in Cuba has a dear friend or relative living in the United States. Tens of thousands of Cubans who found their way to America save their hard earned dollars on frequent trips home, their bags packed with medicine, vitamins, and clothing.

Rather than encourage these meaningful contacts between Cubans and Americans, our government stifles our interaction. Rather than unite the Cuban family, our government seeks to divide it further.

Americans do not benefit from this policy. The Cuban people do not benefit from this policy. Only those who seek to keep Americans and Cubans apart benefit from our misguided policy of isolation.

It is time to reach out to the Cuban people. It is time to restore Americans' fundamental right to travel anywhere they want. It is time to lift the travel ban.

I am proud of our bill. It spells out the right policy during this fundamental transition in Cuba. It helps farmers and ranchers in Montana and elsewhere seek opportunities in a nearby market. And it affords our citizens the opportunity to spread American generosity, assistance, and values to Cuba.

I look forward to working with Senator Crapo, Chairman Rangel, Congresswoman Emerson, and others to put our trade relationship with Cuba on the right path.

Mr. President, I rise today on behalf of myself, Senator Conrad, Senator Smith, Senator Mikulski, and Senator Inouye, to introduce legislation to ensure that our seniors and disabled citizens have timely access to home health services under the Medicare Program.

Nurse practitioners, physician assistants, certified nurse midwives, and clinical nurse specialists are all playing increasingly important roles in the delivery of health care services, particularly in rural and medically underserved areas of our country where physicians may be in scarce supply. In recognition of their growing role, Congress, in 1997, authorized Medicare to begin paying for physician services provided by these health professionals as long as those services are within their scope of practice under State law.

Despite their expanded role, these advanced practice registered nurses and physician assistants are currently unable to order home health services for their Medicare patients. Under current law, only physicians are allowed to certify or initiate home health care for Medicare patients, even though they may not be as familiar with the patient's case as the non-physician provider. In fact, in many cases, the certifying physician may not even have a relationship with the patient and must rely upon the input of the nurse practitioner, physician assistant, clinical nurse specialist or certified nurse midwife to order the medically necessary home health care. At best, this requirement adds more paperwork and a number of unnecessary steps to the process before home health care can be provided. At worst, it can lead to needless delays in getting Medicare patients the home health care they need simply because a physician is not readily available to sign the form.

The inability of advanced practice registered nurses and physician assistants to order home health care is particularly burdensome for Medicare beneficiaries in medically underserved areas, where these providers may be the only health care professionals available. For example, needed home health care was delayed by more than a week for a Medicare patient in Nevada because the physician assistant was the only health care professional

serving the patient's small rural town, and the supervising physician was located 60 miles away.

A nurse practitioner told me about another case in which her collaborating physician had just lost her father and was not available. As a consequence, the patient experienced a 2-day delay in getting needed care while they waited to get the paperwork signed by another physician. Another nurse practitioner pointed out that it is ridiculous that she can order physical and occupational therapy in a subacute facility but cannot order home health care. One of her patients had to wait 11 days after being discharged before his physical and occupational therapy could continue simply because the home health agency had difficulty finding a physician to certify the continuation of the same therapy that the nurse practitioner had been able to authorize when the patient was in the facility.

The Home Health Care Planning Improvement Act will help to ensure that our Medicare beneficiaries get the home health care they need when they need it by allowing physician assistants, nurse practitioners, clinical nurse specialists and certified nurse midwives to order home health services. Our legislation is supported by the National Association for Home Care and Hospice, the American Nurses Association, the American Academy of Physician Assistants, the American College of Nurse Practitioners, the American College of Nurse Midwives, the American Academy of Nurse Practitioners, and the Visiting Nurse Associations of America.

I urge my colleagues to sign onto this legislation as cosponsors. I ask unanimous consent that letters of support be printed in the Record.

Mr. President, I rise today on behalf of myself, Senator Conrad, Senator Smith, Senator Mikulski, and Senator Inouye, to introduce legislation to ensure that our seniors and disabled citizens have timely access to home health services under the Medicare Program.

Nurse practitioners, physician assistants, certified nurse midwives, and clinical nurse specialists are all playing increasingly important roles in the delivery of health care services, particularly in rural and medically underserved areas of our country where physicians may be in scarce supply. In recognition of their growing role, Congress, in 1997, authorized Medicare to begin paying for physician services provided by these health professionals as long as those services are within their scope of practice under State law.

Despite their expanded role, these advanced practice registered nurses and physician assistants are currently unable to order home health services for their Medicare patients. Under current law, only physicians are allowed to certify or initiate home health care for Medicare patients, even though they may not be as familiar with the patient's case as the non-physician provider. In fact, in many cases, the certifying physician may not even have a relationship with the patient and must rely upon the input of the nurse practitioner, physician assistant, clinical nurse specialist or certified nurse midwife to order the medically necessary home health care. At best, this requirement adds more paperwork and a number of unnecessary steps to the process before home health care can be provided. At worst, it can lead to needless delays in getting Medicare patients the home health care they need simply because a physician is not readily available to sign the form.

The inability of advanced practice registered nurses and physician assistants to order home health care is particularly burdensome for Medicare beneficiaries in medically underserved areas, where these providers may be the only health care professionals available. For example, needed home health care was delayed by more than a week for a Medicare patient in Nevada because the physician assistant was the only health care professional

serving the patient's small rural town, and the supervising physician was located 60 miles away.

A nurse practitioner told me about another case in which her collaborating physician had just lost her father and was not available. As a consequence, the patient experienced a 2-day delay in getting needed care while they waited to get the paperwork signed by another physician. Another nurse practitioner pointed out that it is ridiculous that she can order physical and occupational therapy in a subacute facility but cannot order home health care. One of her patients had to wait 11 days after being discharged before his physical and occupational therapy could continue simply because the home health agency had difficulty finding a physician to certify the continuation of the same therapy that the nurse practitioner had been able to authorize when the patient was in the facility.

The Home Health Care Planning Improvement Act will help to ensure that our Medicare beneficiaries get the home health care they need when they need it by allowing physician assistants, nurse practitioners, clinical nurse specialists and certified nurse midwives to order home health services. Our legislation is supported by the National Association for Home Care and Hospice, the American Nurses Association, the American Academy of Physician Assistants, the American College of Nurse Practitioners, the American College of Nurse Midwives, the American Academy of Nurse Practitioners, and the Visiting Nurse Associations of America.

I urge my colleagues to sign onto this legislation as cosponsors. I ask unanimous consent that letters of support be printed in the Record.