Brower Palisade Designation Act

Mr. President, I am pleased to introduce the Rural Hospital Act of 2008. Back in December, I stood before this body explaining that we were only passing a 6-month Medicare bill in order to provide the opportunity for us to address a number of priorities. One of the biggest priorities I identified was the need to ensure access to rural hospital services.

The type of rural hospitals that top the priority list are what are known as ``tweeners.'' These hospitals are too large to be critical access hospitals, but too small to be financially viable under the Medicare hospital prospective payment systems. It is absolutely imperative that these tweener hospitals get the assistance they need in order to keep their doors open. They are often not only the sole provider of health care in rural areas but are also significant employers and purchasers in the community. Also, the presence of a hospital is essential for purposes of economic development because businesses check to see if a hospital is in the community in which they might set up shop.

While the Medicare bill that Congress just enacted improves the situation for some tweeners, many more are left in financial peril. It is unfortunate that comprehensive payment reforms for tweener hospitals were not included in the bill that just passed. As you know, I have long proposed a number of tweener payment improvements in previous bills this Congress and they were included in the agreement that Senator Baucus and I reached for this year's Medicare bill. Unfortunately, the core tweener hospital payment improvements were dropped from the bill once the process became partisan.

It is for this reason that I am introducing this bill. We must improve the financial health of tweener hospitals and ensure that people have access to health care.

Most tweener hospitals are currently designated as Medicare Dependent Hospitals and Sole Community Hospitals under the Medicare program. While the bill that recently passed Congress improves payments for Sole Community Hospitals, there are no provisions that benefit Medicare Dependent Hospitals. This bill would benefit Medicare Dependent Hospitals by not adjusting their payments for area wages unless it would result in improved payments.

Also, a major driver of the financial difficulties that tweener hospitals face is the fact that many have relatively low volumes of inpatient admissions. Back when we passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, I made sure that this law included an add-on payment for low volume rural hospitals. This bill would improve the existing low-volume add-on payment for hospitals so that more rural facilities, both Medicare Dependent Hospitals and Sole Community Hospitals, with low volumes would receive the assistance they desperately need.

To offset the increases in spending from these tweener hospital payment improvements, this bill would address another priority that we wanted to include in a more comprehensive Medicare bill. Many know my position regarding physician owned hospitals and my concern about the effect these facilities have on health care access and costs as well as patient safety. There has been much debate regarding these facilities over the years, especially with physician owned limited service hospitals. This bill would eliminate the exceptions under the physician self-referral laws for physician-owned hospitals and provide a limited exception for existing facilities.

As you can see, we still have much to do when it comes to ensuring access to health care in rural America. I look forward to working with my colleagues on this urgent matter.

Mr. President, today I am introducing along with Senators Leahy, Lieberman, Feinstein, Inouye, Kennedy, Boxer, and Biden, an important bill, with provisions in a variety of areas--from advancing medical research in critical areas, to cracking down on child exploitation, to promoting important U.S. foreign policy goals, to helping improve America's understanding about the oceans. What unites this diverse package of bills? One thing--unprecedented obstructionism.

The bills in this package include initiatives that have broad bipartisan support. Initiatives that have passed the House by 411 to 3; by 422 to 2; by 416 to 0. Many of these initiatives had such strong bipartisan support that they passed the House and Senate Committee by voice vote or even by unanimous consent.

Under normal circumstances, they would have passed the Senate through a simplified and expedited unanimous consent process and become law. Maybe some would have required a period of brief debate before passing the Senate.

But, instead of allowing the will of the Congress and the American people to be heard, Republicans have obstructed one bill after another. Here are just a few examples of the legislation that this bill includes--and that Republicans are preventing from becoming law:

The Emmitt Till Unsolved Crimes bill: Would help heal old wounds and solve crimes that have continued to be unsolved and unpunished since the Civil Rights era.

The Runaway and Homeless Youth bill: Would provide grants for health care, education and workforce programs, and housing programs for runaways and homeless youth.

The Combating Child Exploitation bill: Would provide grants to train law enforcement to use technology to track individuals who trade child pornography. Establishes an Internet Crimes Against Children Task Force within the Office of Justice Programs.

The ALS Registry bill: WouId create a centralized database to help doctors and scientists treat and hopefully find a cure for ALS/Lou Gehrig's Disease, which afflicts 5,600 Americans every year.

The Christopher and Dana Reeve Paralysis Act: Would enhance cooperation in research, rehabilitation and quality of life for people who suffer from paralysis. Not only will this bill accelerate the discovery of better treatments and cures, but help improve the daily lives of the 2 million Americans who await a cure.

This is just the tip of the iceberg. These bills address important American priorities, have broad--virtually unanimous--bipartisan support, yet, all have fallen victim to just one or two Republicans.

Senate Democrats are not willing to allow this obstruction of a few to block the will of the Congress and the American people any longer. Republicans will have a choice: Will they join the side of the American people, or continue to stand beside one or two colleagues intent on blocking progress? I hope Republicans will end their obstruction and work with Democrats this week to pass this crucial and long-overdue legislation.

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

Mr. President, I rise today on behalf of myself and my colleague Senator Boxer to introduce the Brower Palisade Designation Act and honor the life of one of our Nation's most influential environmental stewards, the late David Brower.

The Brower Palisade Designation Act renames the North Palisade--a prominent peak in the Sierra Nevada--``Brower Palisade'' in his honor.

David Brower dedicated his life to environmental advocacy and helped shape the conservation movement in California and across the Nation.

His efforts raised public awareness about the environment and the need to preserve our resources for future generations.

Former Secretary of the Interior Stewart Udall once referred to David Brower as the ``giant of 20th Century conservation in the United States.''

In 1952, David Brower was named the first executive director of the Sierra Club, one of the most prominent environmental and conservation organizations in the U.S. He held this position for nearly 2 decades.

David Brower's leadership led to the creation of many units of the National Park System, including North Cascades National Park, Redwood National Park and Point Reyes National Seashore.

He also played a significant role in helping to draft the Wilderness Act, which has preserved much of the Sierra Nevada, including his favorite group peaks, the Palisades.

Renaming the North Palisade peak ``Brower Palisade'' will be a lasting reminder of David Brower's leadership and invaluable contributions to the environmental community for generations to come.

I encourage my colleagues to support the Brower Palisade Designation Act and join me in honoring the achievements of one of our most notable environmental advocates, David Brower.

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

Mr. President, I rise today on behalf of myself and my colleague Senator Boxer to introduce the Brower Palisade Designation Act and honor the life of one of our Nation's most influential environmental stewards, the late David Brower.

The Brower Palisade Designation Act renames the North Palisade--a prominent peak in the Sierra Nevada--``Brower Palisade'' in his honor.

David Brower dedicated his life to environmental advocacy and helped shape the conservation movement in California and across the Nation.

His efforts raised public awareness about the environment and the need to preserve our resources for future generations.

Former Secretary of the Interior Stewart Udall once referred to David Brower as the ``giant of 20th Century conservation in the United States.''

In 1952, David Brower was named the first executive director of the Sierra Club, one of the most prominent environmental and conservation organizations in the U.S. He held this position for nearly 2 decades.

David Brower's leadership led to the creation of many units of the National Park System, including North Cascades National Park, Redwood National Park and Point Reyes National Seashore.

He also played a significant role in helping to draft the Wilderness Act, which has preserved much of the Sierra Nevada, including his favorite group peaks, the Palisades.

Renaming the North Palisade peak ``Brower Palisade'' will be a lasting reminder of David Brower's leadership and invaluable contributions to the environmental community for generations to come.

I encourage my colleagues to support the Brower Palisade Designation Act and join me in honoring the achievements of one of our most notable environmental advocates, David Brower.

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