Traumatic Brain Injury Act of 2008

Mr. President, it's time we put a stop to wasteful, abusive, and fraudulent use of government credit cards. In fact, it's overdue. For several years, I have been working with the Government Accountability Office (GAO) to investigate misuse of government credit cards and the lack of internal controls in agencies that breeds such activity. We have found shockingly flagrant abuses like $2,443 in taxpayers' money going to pay for a down payment on a sapphire ring at a place called E-Z Pawn and $1,935 in taxpayers' money used to purchase two LA-Z-Boy reclining rocking chairs with full lumbar support and vibrator-massage features, all using government purchase cards. Government travel cards, which are only to be used for legitimate travel-related expenditures, have been used to pay for everything from women's lingerie from Frederick's of Hollywood to tickets to the Phantom of the Opera to a seven night Alaskan cruise for two. In each report it has issued, the GAO has made recommendations about what kind of controls need to be implemented to prevent such abuses from occurring in the future. Our oversight work has helped shine a light on this problem and has led to some improvements. Some agencies have moved to fix the specific shortcomings highlighted by the GAO, and the Office of Management and Budget has issued a circular to agencies that seeks to bring about an improved control environment. However, I believe a more comprehensive approach is needed. There is considerable commonality between the control breakdowns the GAO found in the agencies it investigated. The same controls were often missing or inadequate, and therefore the same recommendations are repeated in report after report. The OMB circular does not address many of these recommendations and it makes no sense for the GAO to visit every agency and bureau in the Federal Government to point out where they fall short. We know what is needed to prevent waste, fraud, and abuse of government credit cards and we must ensure that these internal controls are implemented consistently across the federal bureaucracy. That is why I am reintroducing the Government Credit Card Abuse Prevention Act, along with Senators Lieberman, Collins, and Coleman. I should also mention that Representative Joe Wilson will be reintroducing companion legislation in the House of Representatives and I appreciate his help and assistance as we've worked together on this legislation.

Based primarily on the recommendations of the GAO in numerous reports, as well the work of agency inspectors general and my own oversight work, my bill seeks to curtail waste, fraud, and abuse of government purchase cards, government travel cards, and centrally billed accounts. By way of background, government purchase cards are essentially credit cards held by an agency that authorized individuals use to purchase items necessary for the work of the agency. Since the agency pays the bills directly, the American taxpayer is on the hook when improper purchases slip through the cracks. That means hard working American citizens are paying for someone else's Christmas shopping, or at the very least items with little or no legitimate public interest. Just like the parents' credit card in the hands of an undisciplined teenager, government purchase cards in the hands of poorly trained bureaucrats with inadequate oversight can lead to rash and ill-considered impulse buys. Take for instance an incident uncovered by the GAO when an individual at the Air Force Academy found a dead deer alongside the road and decided to use a government purchase card to pay for mounting the mule deer head to hang on the wall at the office.

Centrally billed accounts are another credit product that federal agencies use, primarily for purchasing transportation services. Like purchase cards, the bill is sent to the government so it's the taxpayer who pays when the bureaucrats let things slip through the cracks. For instance, we've had repeated cases where government employees had airplane tickets purchased on their behalf directly from a centrally billed account, and then they sought and received reimbursement as though they had paid for the ticket. In other words, the ticket was paid for twice with the employee pocketing the cost the second time, and no one would be the wiser if it weren't for the GAO. The GAO has also found millions of dollars worth of fully refundable, unused airline tickets that no one bothered to cash in. I was pleased to work with Senator Coleman, then the Chairman of the Permanent Subcommittee on Investigations, to bring these issues with centrally billed accounts to light, as well as Senator Collins, who was at the time the Chairman of the Government Affairs Committee. In addition to being co-requesters of the GAO reports, they held hearings in their respective committees and were kind enough to invite me to testify about our work.

Government travel cards, on the other hand, are not paid directly with taxpayers' money like purchase cards and centrally billed accounts, but they are only supposed to be used to pay for legitimate expense while on official government travel. Failure by employees to repay these cards results in the loss of millions of dollars in rebates to the Federal Government. Also, when credit card companies are forced to charge off bad debt, they raise interest rates and fees on everyone else. Nevertheless, government travel cards with high credit limits have been handed out like candy at a parade to individuals with abysmal credit ratings who ordinarily would never be issued that kind of credit. It's no surprise then when we learn that certain government employees have abused their government travel cards to buy jewelry, take in a New York Yankees game, or to fuel an internet gambling habit. Such abusive charges often occur when the cardholder is not even on travel at all. In fact, government travel cards have been used to provide cash advances in employees' hometowns. There are even examples of charges at so called ``gentleman's clubs'' like Cheetah's Lounge and Deja Vu Showgirls, and even at legalized brothels. Suffice it to say that the GAO was able to determine that these charges were not for food or other approved travel expenses. It also comes as no surprise when the GAO found that employees issued government travel cards despite bad credit often bounce checks when their bill comes due, sometimes repeatedly and fraudulently. Common sense then leads us to the same conclusion that the GAO came to through empirical analysis, namely that a significant relationship exists between potential travel card fraud, abuse, and delinquencies and individuals with substantial credit history problems. That is why my legislation requires agencies to perform credit checks for travel card holders and issue only restricted cards for those with poor or no credit to reduce the potential for misuse.

My bill would also require a series of common sense internal controls, which the GAO has found to be lacking in many cases, to be implemented in every federal agency. These include: maintaining a record of each cardholder, including single transaction limits and total credit limits so agencies can effectively manage their cardholders; implementing periodic reviews to determine if cardholders have a need for a card; properly recording rebates to the government based on prompt payment; providing training for cardholders and managers; utilizing available technologies to prevent or catch fraudulent purchases; establishing specific policies about the number of cards to be issued, the credit limits for certain categories of cardholders, and categories of employees eligible to be issued cards; invalidating cards when employees leave the agency or transfer; establishing an approving official other than the purchase card holder so employees cannot approve their own purchases; reconciling purchase card charges on the bill with receipts and supporting documentation; submitting disputed purchase card charges to the bank according to the proper procedure; making purchase card payments promptly to avoid interest penalties; retaining records of purchase card transactions in accordance with standard government record keeping polices; utilizing mandatory split disbursements when reimbursing employees for travel card purchases to ensure that travel card bills get paid; comparing items submitted on travel vouchers

with items already paid for with centrally billed accounts to avoid reimbursing employees for items already paid for by the agency; and submitting refund requests for unused airline tickets so the taxpayers don't pay for tickets that were not used.

My bill would also provide that each agency Inspector General periodically conduct risk assessments of agency purchase card and travel card programs and perform periodic audits to identify potentially fraudulent, improper, and abusive use of cards. We have had great success working with Inspectors General using techniques like data mining to reveal instances of improper use of government charge cards. Having this information on an ongoing basis will help maintain and strengthen a rigorous system of internal controls to prevent future instances of waste, fraud, and abuse with government charge cards.

In addition, my bill requires penalties so that employees who abuse government charge cards will not get away scot free. In fact, in cases of serious misuse or fraud, the bill provides that employees must be dismissed and suspected cases of fraud will also be referred to the appropriate U.S. Attorney for prosecution under federal anti-fraud laws. It is essential that we send a clear message that misuse and fraudulent use of government credit cards will not be tolerated. The lack of consistency in the past in applying punishments to those caught abusing government charge cards has sent the wrong message and led to an environment where misuse of government charge cards is more likely. My bill will change that.

The American people expect us to be good stewards of their money and their cynicism about government only builds when they read about bureaucrats saying, ``Just put it on plastic'' willy nilly with their hard earned dollars. Unfortunately, such incidents persist. In the wake of Hurricane Katrina, Congress hastily passed a supplemental spending bill containing an ill-advised provision to dramatically raise the micro-purchase threshold for purchase cards. I worked with Senators Collins and Lieberman, the leaders of the Homeland Security and Governmental Affairs Committee, to reverse what amounted to an invitation to misuse government purchase cards. Then, because of our concerns and the concerns of other members of Congress about the potential for fraud and abuse of purchase cards in the response to the hurricanes in the Gulf Coast region, the GAO conducted an investigation of purchase cards at the Department of Homeland Security. Just last September, the GAO issued its report finding instances of abusive or questionable government charge card transactions, including the purchase of a beer brewing kit, a 63-inch plasma television with a price tag of $8,000 that was found unused in its original box 6 months later, and tens of thousands of dollars for training at golf and tennis resorts. Clearly the abuse of government credit cards remains a problem and Congress needs to act. My bill will establish the discipline needed in government agencies to keep those credit cards in the wallet unless needed. I am particularly glad to be joined in introducing this bill by Chairman Lieberman and Ranking Member Collins as well as Senator Coleman. Their leadership on this issue will continue to be invaluable. I urge the rest of my colleagues to join us in this effort and put a stop to the bureaucratic shopping spree.

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

Mr. President, if I may just review for our colleagues, that is 30 amendments that were just cleared. We now go to an amendment by Senator Boxer.

Mr. President, did we move to reconsider and table?

Mr. President, can we have order in the Chamber.

We need to ask people to hold it down so we can conduct business. It will go much faster if we do that and respect the rights of Senators to be heard.

We now go to Senator Ensign for an amendment.

Mr. President, the next amendment ready to go is an amendment by the Senator from South Carolina, Mr. DeMint.

Mr. President, might I ask a series of questions, through the Chair, to the Parliamentarian?

Mr. President, I ask the Chair if the amendment by the Senator from South Carolina is germane to the budget resolution?

The second question is, If this amendment is adopted, is it corrosive to the privileged standing of budget resolutions?

No. 3, if this amendment were adopted and went to conference and if it came back from conference, would it be fatal to the budget resolution's privileged status?

This amendment is simply not in the jurisdiction of the Budget Committee. It is in the jurisdiction of the Energy Committee.

I raise a point of order that the amendment violates section 305(b)(2) of the Congressional Budget Act of 1974. It is not germane.

The next amendment in order is the amendment of the Senator from Texas, Mr. Cornyn.

Does the Senator yield back his time?

Mr. President, I will ask a series of questions of the Parliamentarian through the Chair.

Is the amendment by the Senator from Texas germane?

Would it be corrosive to the privileged status of the budget resolution if this amendment were adopted?

Would it be fatal to the privileged status of the budget resolution if it came back from conference?

Mr. President, so the challenge of this amendment is it is not germane. I, therefore, raise a point of order that the amendment violates section 305(b)(2) of the Congressional Budget Act of 1974.

Mr. President, let me just help people understand where we are. We have what conceivably could be 9 or 10 more rollcall votes but dozens of additional amendments that are out there pending--as many as a total of 50. So that is the circumstance we face. The only way that Senator Gregg and I can see to reach conclusion tonight is if we devise another managers' package, put together amendments that can be cleared on both sides and deal with these other votes that require rollcalls, starting with Senator Kyl on his extenders.

Or do we want to go to Senator DeMint?

Senator Kyl.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, let me thank all colleagues for their extraordinary patience. This will be, before the end of the day, I think, a record number of votes on a budget resolution in 1 day. I don't think that is anything particularly to be proud of, but it is the reality of what we are confronting.

We can go now to the Kyl amendment?

We thank the leaders of both sides, and I especially thank our leader, Senator Reid, for pushing to get a final definitive list.

With that, we go to Senator Kyl.

Mr. President, I am having a hard time hearing. I think the Senator deserves to be heard. This is a serious amendment.

Mr. President, the budget resolution already provides for a 1-year package of extenders that is fully paid for. The Kyl amendment would add a second year without paying for it. Consequently, the Kyl amendment would drive us $28.6 billion into debt, driving us further away from the balance that we are seeking to achieve by the fourth year.

We anticipate that tax extenders will be dealt with in the regular order, and our resolution provides for longer term extensions, as long as they are paid for.

I ask colleagues to resist the Kyl amendment.

Mr. President, I ask for the yeas and nays.

I move to lay that motion on the table.

Mr. President, while that matter is being resolved, could we go to the next amendment?

And the next amendment in order is Senator DeMint's.

Amendment No. 4347

Mr. President, I ask, through the Chair, a question to the Parliamentarian.

Is this amendment germane to the budget resolution?

The amendment is not germane.

Mr. President, if this amendment were adopted, is it corrosive to the privileged status of the budget resolution?

Mr. President, if this amendment were adopted and came back from conference, would it be fatal to the privileged nature of the budget resolution?

Mr. President, I suggest the pending amendment is not germane; therefore, I raise a point of order that the amendment violates section 305(b)(2) of the Congressional Budget Act of 1974.

I would be constrained to object.

I move to reconsider the vote.

Mr. President, the next amendment in order is an amendment by Senator Landrieu. It is a side-by-side to Senator Kyl. This is on the estate tax. Obviously, these are important amendments. We would ask for the attention of our colleagues.

Mr. President, next up is the Kyl amendment.

Amendment No. 4372

Mr. President, I thank my colleague, Senator Kyl, for his courtesy during all of the debates today.

I urge my colleagues to oppose the Kyl amendment because it is not paid for. It goes onto the debt some $200 billion over 10 years. This would knock us out of balance in 2012 and in 2013. The previous amendment that had the same more generous exemptions was paid for. It didn't add to the debt, didn't add to the deficits, and it kept us in balance.

So I would urge my colleagues to vote no on the Kyl amendment.

Mr. President, I move to reconsider the vote, and I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Mr. President, the next amendment is from the ranking member of the Finance Committee, Senator Grassley.

Mr. President, if you want to blow a hole in the budget as big as all outdoors, here is your opportunity--a trillion dollars not paid for, a trillion dollars that we are going to go out and borrow from the Chinese and Japanese. That makes absolutely no sense. I urge my colleagues to vote no.

That is correct.

That is correct. That is a Dorgan amendment. That is correct. It should have been read as amendment No. 4249.

Mr. President, we have a list now of additional amendments in a managers' package we can approve: amendment No. 4252, Senator Brown; amendment No. 4230, Senator Chambliss; amendment No. 4330, Senator Obama; amendment No. 4268, as modified, Senator Thune; amendment No. 4186, Senator Bunning; amendment No. 4311, Senator Alexander; amendment No. 4357, Senator Gregg; amendment No. 4361, Senator Clinton; amendment No. 4370, Senator Bingaman; amendment No. 4200, Senator Dorgan; amendment No. 4334, Senator Smith; amendment No. 4376, as modified, Senator Snowe; amendment No. 4159, Senator Allard, as well as amendment No. 4333, Senator Baucus; amendment No. 4255, Senator Kohl; amendment No. 4283, Senator Hatch; amendment No. 4345, Senator DeMint; and amendment No. 4220, Senator Cardin.

Mr. President, if Senator Snowe's staff is in the Chamber, we need the modification to Senator Snowe's amendment sent to the desk.

Senator DeMint has an amendment on deductibility. If the Senator can describe that amendment and if he would be willing to take that amendment on a voice vote, we can accept it at this point.

Amendment No. 4339

Mr. President, the ranking member tells me we need to defer on this DeMint amendment because it involves another amendment, it affects another amendment, and the other amendment is still in the clearing process. So we need to defer on this amendment.

Senator DeMint has another amendment on Semper Fi; is that correct?

I ask the Senator from South Carolina if he can describe the amendment briefly, and if he will accept a voice vote, we can proceed to that amendment. We can accept that amendment.

Mr. President, we were told that amendment had been cleared. It appears it has not.

Mr. President, we have to return to regular order if we can. Perhaps the best way to unwind this situation, as I understand, Senator DeMint's amendment then will require a vote; is that the case? Then I think what we should do is ask Senator DeMint to take his 1 minute to explain the amendment. Then we will ask for 1 minute in opposition by perhaps the two Senators from California, vote on the DeMint amendment, and then perhaps we can go to Senator Vitter's amendment, if that is OK.

No, no, that is fair. I think we need to agree to that request. That has to be done. That is fair.

Mr. President, I suggest the absence of a quorum. At this moment we have, unfortunately, not yet seen the amendment of the Senator. We do need to take a moment to review it, and I suggest the absence of a quorum.

Mr. President, for the purpose of helping us move along effectively, in order to get this done it is very important that both sides have copies of the amendments that are offered. We can't do business efficiently if we don't--both sides--have copies of the amendments.

I say this because both of us are in such a rush to conclusion that sometimes we neglect to make sure the other side--we have done it, which we apologize for, and it is very easy to happen in this hectic ending.

I suggest the absence of a quorum.

Mr. President, since we have had argument on both sides, I wonder if it would be fair now to have 2 minutes for those in opposition, 1

minute by each of the Senators from California.

I think we have to cut this off at this point, if I can say that to my colleague.

So Senator Feinstein.

Time for the vote. I ask for the yeas and nays.

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Mr. President, in the previous list sent to the desk, we need to show amendment No. 4268, by Senator Thune, as having been modified.

Mr. President, we are about to move. We are awaiting some additional amendments to clear. While we are doing that, we could go to the next amendments, which are on the unborn child. Senator Boxer has a side-by-side, followed by Senator Allard. These will require votes.

Senator Boxer.

Amendment No. 4379

Mr. President, I rise today to introduce legislation to reauthorize the Traumatic Brain Injury Act. It is my pleasure to be joined in this effort by the Chairman of the Senate Health, Education, Labor and Pension Committee, Senator Ted Kennedy, with whom I worked on the original legislation over 10 years ago.

Sustaining a traumatic brain injury--or TBI--can be both catastrophic and devastating. The financial and emotional costs to the individual, family, and community are enormous. Traumatic brain injuries contribute to a substantial number of deaths and cases of permanent disability annually.

Individuals with TBI and their families are often faced with challenges, such as improper diagnosis, inability to access support or rehabilitation services, institutional segregation, unemployment, and being forced to navigate complicated and cumbersome service and support systems.

Of the 1.4 million who sustain a TBI each year in the United States: 50,000 die; 235,000 are hospitalized; and 1.1 million are treated and released from an emergency department. Brain injuries are the most frequent reasons for visits to physicians and emergency rooms.

These statistics are more revealing when one considers that every 16 seconds someone in the U.S. sustains a head injury; and every 12 minutes, one of these people will die and another will become permanently disabled. Of those who survive, each year, an estimated 80,000 to 90,000 people experience the onset of long-term disability associated with a TBI. An additional 2,000 will exist in a persistent vegetative state.

Even more startling is the fact that brain injury kills more Americans under the age of 34 than all other causes combined and has claimed more lives since the turn of the century than all United States wars combined.

Recent publicity about brain injuries Americans have sustained in Iraq points out that TBI is an everyday threat to our servicemen and servicewomen--68 percent of war veterans are returning home with sustained brain injuries. According to the Defense and Veterans Brain Injury Center, which serves active duty military, their dependents and veterans with TBI, traumatic brain injury is one of the leading causes of death and disability on today's battlefield. While not specifically addressed by this bill, the Federal TBI program helps to provide resources that supplement the networks which serve our returning soldiers.

The distress of TBI is not limited to diagnosis. A survivor of a severe brain injury typically faces 5 to 10 years of intensive services and estimated lifetime costs can exceed $4 million. Direct medical costs and indirect costs such as lost productivity of TBI totaled an estimated $60 billion in the United States in 2000.

To recognize the large number of individuals and families struggling to access appropriate and community-based services, Senator Kennedy and I wrote the TBI Act of 1996, PL 104-166.

The TBI Act of 1996 launched an effort to conduct expanded studies and to establish innovative programs for TBI. It gave the Health Resources and Services Administration (HRSA) authority to establish a grant program for States to assist it in addressing the needs of individuals with TBI and their families. It also delegated responsibilities in the areas of research, prevention, and surveillance to the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), respectively.

Title XIII of the Children's Health Act of 2000, PL 106-310, reauthorized the programs of the TBI Act of 1996. This reauthorization also added a provision on protection and advocacy, P&A, services for individuals with TBI and their families by authorizing HRSA to make grants to State P&A Systems.

The Traumatic Brain Injury Act is the only Federal legislation that specifically addresses issues faced by 5.3 million American children and adults who live with a long-term disability as a result of traumatic brain injury. Reauthorization of the Traumatic Brain Injury Act will provide for the continuation of research, not only for the treatment of TBI, but also for prevention and awareness programs which will help decrease the occurrence of traumatic brain injury and improve the long-term outcome.

This legislation authorizes the Health Resources and Services Administration, HRSA, to make grants for projects of national significance that improve individual and family access to service systems; assist States in developing service capacity; improve monitoring and evaluation of rehabilitation services and supports; and address emerging needs of servicemen and women, veterans, and individuals and families who have experienced

brain injury through service delivery demonstration projects.

This bill also authorizes HRSA to include the American Indian Consortium as an eligible recipient of competitive grants awarded to States, Territories, and the District of Columbia to develop comprehensive system of services and supports nationwide.

Furthermore, this bill instructs HRSA and the Administration on Developmental Disabilities to coordinate data collection regarding protection and advocacy services.

Also funded by the TBI program, the CDC supports multiple projects and programs, including those that monitor TBI, link people with TBI to information about services, and prevent TBI-related disabilities. These projects comprise initiatives such as generating national estimates for TBI deaths, hospitalizations, and emergency department visits; planning the future of TBI registries and data systems; and educating health care professionals about TBI. In addition, the CDC funds TBI research in various academic institutions to investigate TBI in children and adolescents.

This year, Congress has an opportunity to strengthen the TBI Act by authorizing the Centers for Disease Control and Prevention, CDC, to determine the incidence and prevalence of traumatic brain injury in the general population of the United States, including all age groups and persons in institutional settings such as nursing homes, correctional facilities, psychiatric hospitals, child care facilities, and residential institutes for people with developmental disabilities.

Brain injury is a complex issue and there is still much unknown. With Federal funds provided within the TBI program, researchers at the NIH are studying many issues related to the special cognitive and communication problems experienced by individuals who have traumatic brain injuries. Scientists are designing new evaluation tools to assess the special problems that children who have suffered traumatic brain injuries encounter. Because the brain of a child is vastly different from the brain of an adult, scientists are also examining the effects of various treatment methods that have been developed specifically for children. In addition, research is examining the effects of some medications on the recovery of speech, language, and cognitive abilities following traumatic brain injury. Reauthorization of the TBI program will enable this important research to continue and expand.

As I have mentioned, there is still a lot of unknown surrounding the issue of TBI; however, one aspect is definite, and that is that people are never the same after TBI. Not only are their lives forever changed, but they must face these changes in a compromised state. The TBI program offers balanced and coordinated public policy in brain injury prevention, research, education, and community-based services and supports for individuals living with traumatic brain injury and their families.

Reauthorization of the Traumatic Brain Injury Act will further provide mechanisms for the research, prevention, and treatment of TBI and the improvement of the quality of life for those Americans and their families who may sustain such a devastating disability. I ask my colleagues' support in promptly reauthorizing the Traumatic Brain Injury Act.

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

Mr. President, I rise today to introduce legislation to reauthorize the Traumatic Brain Injury Act. It is my pleasure to be joined in this effort by the Chairman of the Senate Health, Education, Labor and Pension Committee, Senator Ted Kennedy, with whom I worked on the original legislation over 10 years ago.

Sustaining a traumatic brain injury--or TBI--can be both catastrophic and devastating. The financial and emotional costs to the individual, family, and community are enormous. Traumatic brain injuries contribute to a substantial number of deaths and cases of permanent disability annually.

Individuals with TBI and their families are often faced with challenges, such as improper diagnosis, inability to access support or rehabilitation services, institutional segregation, unemployment, and being forced to navigate complicated and cumbersome service and support systems.

Of the 1.4 million who sustain a TBI each year in the United States: 50,000 die; 235,000 are hospitalized; and 1.1 million are treated and released from an emergency department. Brain injuries are the most frequent reasons for visits to physicians and emergency rooms.

These statistics are more revealing when one considers that every 16 seconds someone in the U.S. sustains a head injury; and every 12 minutes, one of these people will die and another will become permanently disabled. Of those who survive, each year, an estimated 80,000 to 90,000 people experience the onset of long-term disability associated with a TBI. An additional 2,000 will exist in a persistent vegetative state.

Even more startling is the fact that brain injury kills more Americans under the age of 34 than all other causes combined and has claimed more lives since the turn of the century than all United States wars combined.

Recent publicity about brain injuries Americans have sustained in Iraq points out that TBI is an everyday threat to our servicemen and servicewomen--68 percent of war veterans are returning home with sustained brain injuries. According to the Defense and Veterans Brain Injury Center, which serves active duty military, their dependents and veterans with TBI, traumatic brain injury is one of the leading causes of death and disability on today's battlefield. While not specifically addressed by this bill, the Federal TBI program helps to provide resources that supplement the networks which serve our returning soldiers.

The distress of TBI is not limited to diagnosis. A survivor of a severe brain injury typically faces 5 to 10 years of intensive services and estimated lifetime costs can exceed $4 million. Direct medical costs and indirect costs such as lost productivity of TBI totaled an estimated $60 billion in the United States in 2000.

To recognize the large number of individuals and families struggling to access appropriate and community-based services, Senator Kennedy and I wrote the TBI Act of 1996, PL 104-166.

The TBI Act of 1996 launched an effort to conduct expanded studies and to establish innovative programs for TBI. It gave the Health Resources and Services Administration (HRSA) authority to establish a grant program for States to assist it in addressing the needs of individuals with TBI and their families. It also delegated responsibilities in the areas of research, prevention, and surveillance to the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), respectively.

Title XIII of the Children's Health Act of 2000, PL 106-310, reauthorized the programs of the TBI Act of 1996. This reauthorization also added a provision on protection and advocacy, P&A, services for individuals with TBI and their families by authorizing HRSA to make grants to State P&A Systems.

The Traumatic Brain Injury Act is the only Federal legislation that specifically addresses issues faced by 5.3 million American children and adults who live with a long-term disability as a result of traumatic brain injury. Reauthorization of the Traumatic Brain Injury Act will provide for the continuation of research, not only for the treatment of TBI, but also for prevention and awareness programs which will help decrease the occurrence of traumatic brain injury and improve the long-term outcome.

This legislation authorizes the Health Resources and Services Administration, HRSA, to make grants for projects of national significance that improve individual and family access to service systems; assist States in developing service capacity; improve monitoring and evaluation of rehabilitation services and supports; and address emerging needs of servicemen and women, veterans, and individuals and families who have experienced

brain injury through service delivery demonstration projects.

This bill also authorizes HRSA to include the American Indian Consortium as an eligible recipient of competitive grants awarded to States, Territories, and the District of Columbia to develop comprehensive system of services and supports nationwide.

Furthermore, this bill instructs HRSA and the Administration on Developmental Disabilities to coordinate data collection regarding protection and advocacy services.

Also funded by the TBI program, the CDC supports multiple projects and programs, including those that monitor TBI, link people with TBI to information about services, and prevent TBI-related disabilities. These projects comprise initiatives such as generating national estimates for TBI deaths, hospitalizations, and emergency department visits; planning the future of TBI registries and data systems; and educating health care professionals about TBI. In addition, the CDC funds TBI research in various academic institutions to investigate TBI in children and adolescents.

This year, Congress has an opportunity to strengthen the TBI Act by authorizing the Centers for Disease Control and Prevention, CDC, to determine the incidence and prevalence of traumatic brain injury in the general population of the United States, including all age groups and persons in institutional settings such as nursing homes, correctional facilities, psychiatric hospitals, child care facilities, and residential institutes for people with developmental disabilities.

Brain injury is a complex issue and there is still much unknown. With Federal funds provided within the TBI program, researchers at the NIH are studying many issues related to the special cognitive and communication problems experienced by individuals who have traumatic brain injuries. Scientists are designing new evaluation tools to assess the special problems that children who have suffered traumatic brain injuries encounter. Because the brain of a child is vastly different from the brain of an adult, scientists are also examining the effects of various treatment methods that have been developed specifically for children. In addition, research is examining the effects of some medications on the recovery of speech, language, and cognitive abilities following traumatic brain injury. Reauthorization of the TBI program will enable this important research to continue and expand.

As I have mentioned, there is still a lot of unknown surrounding the issue of TBI; however, one aspect is definite, and that is that people are never the same after TBI. Not only are their lives forever changed, but they must face these changes in a compromised state. The TBI program offers balanced and coordinated public policy in brain injury prevention, research, education, and community-based services and supports for individuals living with traumatic brain injury and their families.

Reauthorization of the Traumatic Brain Injury Act will further provide mechanisms for the research, prevention, and treatment of TBI and the improvement of the quality of life for those Americans and their families who may sustain such a devastating disability. I ask my colleagues' support in promptly reauthorizing the Traumatic Brain Injury Act.

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

Mr. President, in just five years, our Nation will observe the bicentennial of a defining moment in our Nation's history-- the war of 1812. Sometimes referred to as America's ``Second War of Independence,'' the War of 1812 played a critical role in shaping our national heritage and identity. To ensure that this anniversary will be commemorated properly and in a timely manner, I am today re-introducing legislation to establish the Star Spangled Banner National Historic Trail and the Star-Spangled Banner and War of 1812 Bicentennial Commission. Joining me in co-sponsoring one or more of these measures are my colleagues Senators Mikulski, Warner, Webb, Levin, and Clinton. I spoke during the 109th Congress about the significance of the War of 1812, its impact on our Nation's history and culture and the rationale for these two measures. I want to highlight some of those principal points today.

The United States declared war on Britain in June 1812, after enduring years of naval blockades, trade restrictions with the European continent, and seizure of American ships and sailors in the ongoing war between Britain and France. With only a small army and practically no navy, our young Nation was ill-prepared to face Britain--then the world's preeminent naval power. By the summer of 1814 defeat seemed certain, with the British combined land and sea invasion of the Chesapeake region and the burning of the Capitol, the White House and much of the federal city. But in their attack on Baltimore, the British met stiff resistance. American patriots successfully defended Fort McHenry and the British invasion was repelled. It was during this battle that Francis Scott Key witnessed our flag flying intact, despite the continuous bombardment, and wrote the words which were to become our National Anthem. Today, many historians see the War of 1812 as the definitive end of the American Revolution--a war which preserved and strengthened our democracy, brought America to the international stage, and helped forge our national identity through the symbols of the National Anthem and the Star Spangled Banner.

To commemorate the historic events associated with the War of 1812, eight years ago I joined with my predecessor, Senator Paul Sarbanes, in sponsoring legislation directing the National Park Service to conduct a study of the feasibility and desirability of designating the routes used by the British and Americans during the Chesapeake Campaign of the War of 1812 as a National Historic Trail. That study was completed in March 2004 and recommended that the proposed Star Spangled Banner National Historic Trail ``. . . be established by the Congress as a national historic trail with commemorative recreation and driving routes and water trails.'' The study found that the proposed series of land and water trails fully meet the eligibility criteria for designation as a National Historic Trail--they retain historic integrity, are nationally significant, and have significant potential for public recreational use and historic interpretation. The study recommended that the trail be managed through a partnership between the National Park Service, a trail organization and state and local authorities and concluded that the costs of implementing the proposed trail would be minimal. The study also recommended that the Congress''. . . establish a War of 1812 Bicentennial Commission to coordinate the 200th anniversary of the War of 1812.''

The two pieces of legislation I am reintroducing today would implement

these two recommendations of the National Park Service. The first measure would authorize the establishment of the Star Spangled Banner National Historic Trail, an approximately 290-mile series of land and water trails tracing the story of the only combined naval and land attack on the United States and the events leading up to the writing of the Star Spangled Banner. Sites along the National Historic Trail would mark some of the most important events of the War of 1812 including battles between the British Navy and the American Chesapeake Flotilla in St. Leonard's Creek in Calvert County; the British landing at Benedict; the Battle of Bladensburg; the burning of the Nation's Capitol, White House and Washington Navy Yard; the British naval feints up the Potomac River to Alexandria and on the upper Chesapeake Bay; the Battle of North Point; and the successful American defense of Fort McHenry on September 14, 1814, which inspired the poem that became our National Anthem. The second measure would authorize the establishment of a ``Star Spangled Banner and War of 1812 Bicentennial Commission'' to plan, coordinate and facilitate programs and other efforts to commemorate the historic events associated with the War of 1812. Made up, in part, by citizens from the thirty states involved in the War, the Commission is tasked with planning, encouraging, developing, executing and coordinating programs to ensure a suitable national observance of the War of 1812. Both these measures were approved by the full Senate during the 109th Congress, but unfortunately were not acted upon by the House Committees of jurisdiction.

With the bicentennial of the War of 1812 quickly approaching, it is vital that the Congress move swiftly to approve these measures and enable the proper commemoration of this important period in our nation's history. The legislation will help provide Americans and visitors alike with a better understanding and appreciation of our heritage.

I ask unanimous consent that the text of the two measures I am introducing be printed in the Record.