National Guard and Reserve Mental Health Access Act of 2008

Mr. President, energy independence is no longer an option for our Nation. It is an imperative. The clock is ticking. If we do not break the ties, our children and grandchildren will have to clean up our mess. It is not too late.

Today I introduced legislation to help U.S. companies and U.S. workers chart a new course. This is an energy bill. It is a jobs bill. It is an environment bill. It will help companies turn green energy research into green energy products. It will help workers build careers around green energy development and production. It will help our Nation break free of foreign oil and grow our economy by growing green energy. It is an important step that, along with comprehensive climate change legislation, will put our country on a path to energy independence.

While the first oil well in the United States was in the Presiding Officer's State of Pennsylvania, just a year later oil was being produced in Ohio. Before long, derricks dotted the landscape in every corner of our State. My bill begins to address what Ohio and Pennsylvania have known for years about energy.

The history of my State is also rich in coal. Frontiersmen discovered large deposits of coal in Tuscarawas County in the mid-1700s, long before Ohio became a State. Today, coal power is more than 90 percent of Ohio's electricity production.

Oil and coal powered this Nation through two World Wars. They helped

the United States win the Cold War. And they made America the world's largest economy. But today our economic future depends on our ability to move toward alternative energy development. Green energy just will not restore our energy independence, it will secure our global leadership.

In my 15 months in the Senate, I have held nearly 100 roundtables across Ohio learning about Ohio's capabilities and potential in leading the way in the alternative energy industry. From Ralph Dahl's farm in northwest Montgomery County and the technology he has employed, to high-tech companies in Cleveland looking for financing but fearing the so-called valley of death, to eager entrepreneurs in Athens who are installing solar panels and wind turbines all over their part of the State, to the work of Stark State on fuel cells. But we haven't gone nearly far enough. It is only the beginning.

The Germans have long supported the development of solar power, and today they lead the world in that technology. Just last week, China announced plans to set up trade protection laws, not to increase wind energy in China but to corner the market on wind-energy-related products.

While we are debating whether to punch more holes in the ground to drill for oil, the rest of the world is about to pass us by. But it is not too late. American ingenuity and innovation can and will give our Nation an edge over the competition. My bill creates an investment corporation for that purpose lead by the best and brightest from the business, labor, and environmental worlds. It will be charged with supporting the development and commercialization of new energy products.

Great ideas are being left on the drawing board these days or, worse yet, getting produced overseas. Investments will be aimed with this legislation at communities with high levels of unemployment, with excess manufacturing capacity, and with brownfield industrial cleanup sites--communities with enormous potential and significant needs. My State, as is Pennsylvania, is dotted with dozens of those communities.

Our green energy manufacturing future should build on our great manufacturing past, revitalizing flagging industries, and reenergizing manufacturing hubs.

This bill creates the Green Redevelopment Opportunity and Workforce Program that provides grants to companies a little further from commercialization than those that receive loans in the Green Markets Program.

These companies have green energy ideas that are a few years away from the market. Without these grants, they would never make it into production.

We cannot pick, and we should not pick, winners in the fight for the future of green energy, so we must explore as many ideas and inventions that get to the market as possible.

My bill would also establish grant money for pilot programs for green energy communities, colleges, and National Guard bases even. These pilot programs will serve as important resources for business interested in commercializing green technologies, as well as models for other communities that are trying to transition their economies to green energy.

The corporation will run a green energy internship and apprenticeship program that will help innovate green energy companies, hire new talent, and help students earn valuable industry experience in this new industry as it begins to take off.

My bill establishes a Green Energy Efficiency Grant Program that is a dollar-for-dollar match for energy producers, including municipal power companies and rural electric co-ops.

This provision helps by ending the conflict that energy producers often face with protecting the environment and growing their businesses. These energy producers try to encourage people to conserve, but at the same time they are saying don't buy our product, which obviously is not a good business decision. This provision in this legislation will help answer that.

By meeting these companies halfway, by matching their investment in energy efficiency, the Government cannot do it all, but it can help these responsible companies do right by the consumers and the environment.

Today, most of Ohio's oil wells are dry, coal production is literally only half what it was in 1970, and Ohio's manufacturing centers from Steubenville to Lima, from Ravenna to Springfield, from Xenia to Findlay, are struggling to remain competitive. Our Nation's green future is more than using green energy or living in green houses or putting in green light bulbs. All those things are good, but we must build the green energy and its components in the United States. We know green energy is inevitable, but importing green energy from China and Germany, like we do today with oil from Saudi Arabia and Venezuela, need not be inevitable, and it is not in our Nation's best interests. We need to end our foreign energy dependence, whether it is today, too much with Saudi Arabia, or in the future, too much with Germany.

The next green energy company that can change the world is out there waiting to happen. It could be the National Composite Center in Dayton, could be the cutting-edge fuel cell research ongoing in Mount Vernon,

Mr. President, earlier this week, I spoke on the Senate floor about Cover the Uninsured Week and a bill I was introducing that would increase access to health coverage for small businesses and self- employed individuals.

I will formally introduce the Small Business Empowerment Act today, and I would like to discuss the bill in a bit more depth.

First, why is it necessary?

It is necessary because 82 percent of the uninsured are workers, and the overwhelming majority work in small firms.

In Ohio, 99 percent of firms with more than 50 workers sponsor health coverage. About 44 percent of firms with less than 50 do.

And small employers that do offer coverage are struggling under the weight of it. According to the well-respected Rand Corporation, small businesses saw the economic burden of health insurance rise by 30 percent between 2000 and 2005.

The situation is even worse for the self-employed, who must contend with staggeringly high premiums for individual coverage, if, that is, they can find an insurer willing to cover them.

In the meantime, health insurers have been living large, their profits increasing by more than a third over the last 5 years. That's not revenue, it's profits.

Middle class families are shouldering the burden of skyrocketing gas prices and ballooning food prices, even as the equity in their homes erodes and the cost of putting their children through college explodes.

It would be ideal if they could also afford to pay a king's ransom for health insurance.

They can't. They shouldn't have to.

With those realities staring us in the face, inaction is the same as indifference.

My legislation attacks the issue of health coverage access from several directions.

To ensure widespread access, the bill would establish a national insurance pool modeled after the successful Federal Employees Health Benefits program.

FEHB, which enables enrollees to choose from a variety of health plans whose rates and benefits are negotiated by the federal Office of Personnel Management, has served members of Congress and federal employees well for many years now.

Under my bill, an independent contractor would manage a program that looks like FEHB, with a few modifications to accommodate the market segment it would serve.

A few of those modifications are designed to hold down costs:

The bill would establish a reinsurance program to pay claims that fall between $5,000 and $75,000. This approach minimizes premium spikes and makes coverage affordable for companies regardless of the age and health of their employees.

The bill would also establish what is called a ``loss-ratio'' standard for insurers. Basically this means that insurers would be required to spend most of their premium income on claims, and hold down their administrative costs.

And the bill would identify and apply strategies to ensure that providers employ ``best practices'' in health care, which means that they are providing the right care in the right amounts.

Finally, the bill would target ``price-gouging'' by drug manufacturers and other manufacturers of medical products. Price gouging occurs in U.S. health care when a company exploits American consumers by charging them dramatically higher prices than consumers in other wealthy nations.

Other modifications are designed to ensure that health coverage is non-discriminatory.

Think about it: If you develop a mental illness like clinical depression and I develop a medical illness like heart disease, why should you be denied health benefits while I receive them? We both have paid premiums to cover health care costs and we both need health care. Why is my condition more worthy of coverage than yours?

My bill charges a group representing providers, businesses, consumers, economists, and health policy experts with rethinking health care coverage to eliminate arbitrary differences in the coverage of equally disruptive, disabling, or dangerous health conditions.

The bottom-line is this. We have an opportunity to expand access to health coverage in a way that advances fundamental goals:

We can reach populations who can't find a home in the current insurance system.

We stand up for American consumers who are paying ridiculous prices for essential health care.

We can demand spending discipline on the part of insurers--they have chosen to play a pivotal role in the health of our nation; they can live with reasonable limits on their administrative costs.

We can clean up duplication and random variation in the delivery of health care services; and we can end arbitrary coverage rules that turn health protection into a health care crapshoot.

For the sake of small employers and their employees, for the sake of self-employed entrepreneurs, and for the sake of every American who didn't request a particular health problem and shouldn't be penalized for having it, I hope Members on both sides of the aisle will support my bill.

Mr. President, today I am pleased to introduce a bill that will address a pressing need in our nation's child welfare system: improvements to the child welfare workforce. In 2006, the most recent year for which data are available, approximately 905,000 children were determined to be victims of abuse or neglect. Whether a child needs in- home support or foster care, family preservation or adoption, the child welfare workforce strives to meet the individual needs of children and families, so that safety and permanency are achieved as quickly as possible.

Unfortunately, the members of the child welfare workforce face a variety of barriers to their execution of this critically important work. Due to high caseloads and workloads, caseworkers have insufficient time to interact with children and families, prepare individualized plans, and provide services. Burnout and turnover are endemic to the child welfare system. The average tenure of a child welfare worker is just under 2 years, with staff citing high caseloads, a need for greater supervision, and few training opportunities as reasons for leaving their positions. This turnover leads to discontinuity of services, children's multiple placements in foster care, longer stays of children in care, and lower rates of finding permanent homes for children. There is evidence that turnover is lower among child welfare workers holding a degree in social work than among those who do not; yet, fewer than a third of child welfare workers hold these degrees.

Turnover is also expensive. The U.S. Department of Labor has estimated that the cost of worker turnover is equivalent to approximately one-third of the worker's annual salary. Therefore, it may cost agencies between $10,000 and $20,000 each time a worker leaves his or her position. Additionally, costs increase when turnover leads to children's extended stays in foster care, as maintaining children in foster care is more expensive than establishing permanency through reunification, adoption, or guardianship.

In addition to these obstacles, Federal support for training of child welfare workers is restricted. Title IV-E of the Social Security Act, the primary Federal source for child welfare training funds, is linked to an outdated income requirement. As a result, States may only access these dollars on behalf of a portion of the children in their care. Currently, Title IV-E funds may not be used to train child welfare staff employed by contracted nonprofit child welfare agencies, a huge barrier given the fact that many states rely on these agencies for providing necessary services. The Title IV-E training program does not address the essential role of non-child welfare professionals, such as substance abuse and domestic violence counselors, educators, and mental health providers, who work with children and families involved in the child welfare system. We must improve States' access to these funds in order to attract and maintain a trained and committed child welfare workforce.

Finally, Federal regulations limit the extent to which public child welfare agencies can partner with educational institutions to provide training to prospective and currently employed child welfare staff. Training programs implemented using Title IV-E university partnerships have shown great success. States running such programs show up to 90 percent retention of graduates in child welfare positions, even after their employment obligation period has expired. Unfortunately, because regulations prohibit private institutions from providing the state match for IV-E funded university training programs, state child welfare agencies are limited in the university partnerships they can create. As such, regions that have ready and willing private schools of social work, but few nearby public schools, are often unable to create these useful programs.

The Child Welfare Workforce Improvement Act tackles these challenges head on. This legislation calls on the National Academy of Sciences to conduct a study that assesses the child welfare workforce nationwide; makes recommendations regarding appropriate levels of caseload, workload, training, and supervision; and makes recommendations for linking workforce data to data on child outcomes. The bill requires the Department of Health and Human Services to devise a method for regularly collecting data on the child welfare workforce so that it can be linked to existing databases of child outcomes.

Additionally, the bill amends Title IV-E so that federal funds for training can be accessed by the full breadth of professionals responsible for children and families in the child welfare system. The legislation eliminates the 1996 AFDC ``look-back'' for IV-E training dollars so that a state can access training funds based on all of its children in foster care. It removes limitations so that funds may be used to train staff who provide support, preservation, or reunification services as well as foster care and adoption services. The bill allows related professionals access to short-term IV-E training in order to enhance their work with children and families in the child welfare system. Finally, the bill permits private nonprofit institutions of higher education to contribute matching dollars for IV-E funded training programs. This provision will allow State child welfare systems to set up university partnerships with a broader range of schools, thereby enhancing program quality, and helping to generate a cadre of professionally trained and committed child welfare workers.

We absolutely must support the members of the child welfare workforce if we want high quality services for our Nation's vulnerable children and families. I hope that my colleagues in the Senate will join me in this important effort.

Today, I introduce the National Guard and Reserve Mental Health Access Act, which provides greater access to mental health services for our members of the National Guard and Reserve.

The wars in Iraq and Afghanistan are taking an excruciatingly high toll on veterans and their families and the Nation obviously needs to give greater priority to their mental health needs, including the National Guard and the Reserve.

As of April 29, 2008, 31,848 servicemembers have been wounded in Iraq and Afghanistan. Thirty percent of our soldiers struggle with brain injuries, mental illnesses, including post-traumatic stress disorder and depression, or a combination of these physical and mental wounds.

Earlier this month, the RAND Corporation released a report documenting the alarmingly high numbers of veterans who struggle with mental health problems and brain injuries. One in 5 of these brave men and women report mental health problems.

These mental health problems take various forms, including post- traumatic stress disorder, depression, suicidal tendencies and substance abuse, and they can persist for months or even years after their service. Some will never be the same again.

It is our duty to give our National Guard and Reserves the best possible treatment, whatever their injury. Mental conditions should be treated with the same care and concern as physical conditions.

This bill calls for the implementation of the Yellow Ribbon Reintegration Program, which provides counseling, education and family services to returning members of the Guard and reservists. It establishes a Joint Psychological Health Program in the National Guard Bureau to oversee and coordinate support for Guard members with mental illness or brain injuries, and it creates a pilot project for providing new applications of technology in tele-mental health and anti-stigma treatment.

The National Guard and Reserve Mental Health Access Act is a three- part approach to targeting these mental health needs, which require specialized access to care and services.

Our National Guard and Reserves make incredible sacrifices for our country and we owe them the very best access to care possible.

Mr. President, my home State of Washington, and the Pacific Northwest in general, is home to some of the most pristine nature and breathtaking scenery this country has to offer. I rise today to recognize a well known local treasure that puts the priceless gems of our region within reach. The Pacific Northwest Trail, running from the Continental Divide to the Pacific Coast, is 1,200 miles long and ranks among the most scenic trails in the world. This carefully chosen path runs through the Rocky Mountains, Selkirk Mountains, Pasayten Wilderness, North Cascades, Olympic Mountains, and Wilderness Coast. From beginning to end it passes through three States, crosses three National Parks, and winds through seven National Forests. This trail is a national prize and should be recognized as such. That is why, today, I am introducing the Pacific Northwest National Scenic Trail Act of 2008 with my colleague from Washington State, Senator Murray.

The National Trails System was created in 1968 by the National Trails System Act. This act authorized a national system of trails to provide additional outdoor recreation opportunities and to promote the preservation of access to the outdoor areas and historic resources of the nation. Today there are eight National Scenic Trails that provide recreation, conservation, and enjoyment of significant scenic, historic, natural, or cultural qualities. Designating the Pacific Northwest Trail a National Scenic Trail will give it the proper recognition, bring benefits to countless neighboring communities, and promote its protection, development, and maintenance.

Adding the Pacific Northwest Trail to the National Trail System has gained the support of Commissioners in Clallam, Jefferson. Island, Skagit, Whatcom, Okanogan, Ferry, Stevens, and Pend Oreille Counties in Washington and Boundary County in Idaho. Mayors in numerous cities along the trail support the economic impact the trail has had on their communities

I urge my colleagues to support this bill and to come hike the Pacific Northwest Trail if ever given the opportunity.

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

Today, I introduce the National Guard and Reserve Mental Health Access Act, which provides greater access to mental health services for our members of the National Guard and Reserve.

The wars in Iraq and Afghanistan are taking an excruciatingly high toll on veterans and their families and the Nation obviously needs to give greater priority to their mental health needs, including the National Guard and the Reserve.

As of April 29, 2008, 31,848 servicemembers have been wounded in Iraq and Afghanistan. Thirty percent of our soldiers struggle with brain injuries, mental illnesses, including post-traumatic stress disorder and depression, or a combination of these physical and mental wounds.

Earlier this month, the RAND Corporation released a report documenting the alarmingly high numbers of veterans who struggle with mental health problems and brain injuries. One in 5 of these brave men and women report mental health problems.

These mental health problems take various forms, including post- traumatic stress disorder, depression, suicidal tendencies and substance abuse, and they can persist for months or even years after their service. Some will never be the same again.

It is our duty to give our National Guard and Reserves the best possible treatment, whatever their injury. Mental conditions should be treated with the same care and concern as physical conditions.

This bill calls for the implementation of the Yellow Ribbon Reintegration Program, which provides counseling, education and family services to returning members of the Guard and reservists. It establishes a Joint Psychological Health Program in the National Guard Bureau to oversee and coordinate support for Guard members with mental illness or brain injuries, and it creates a pilot project for providing new applications of technology in tele-mental health and anti-stigma treatment.

The National Guard and Reserve Mental Health Access Act is a three- part approach to targeting these mental health needs, which require specialized access to care and services.

Our National Guard and Reserves make incredible sacrifices for our country and we owe them the very best access to care possible.