Small Business Health Information Technology Financing Act of 2009

Mr. President, as we move forward in modernizing our health care system, we must not forget the small businesses that simply cannot afford the upfront costs of installing new health information technology. That is why today I am introducing the Small Business Health Information Technology Financing Act. This bill will amend the Small Busis Act to allow the administrator of the Small Business Administration to guarantee up to 90 percent of the amount of a loan to small business health professionals to be used for the purchase and installation of health information technology. The loans can be used for computer hardware, software and other technology that will assist in the use of electronic health records and prescriptions.

A modernized health system using electronic prescribing and electronic health records will help improve patient care while reducing costs. Electronic prescribing not only saves money through improved efficiency, but more importantly, it reduces medical errors and saves lives. According to the Institute of Medicine, 1/3 of written prescriptions require follow-up clarification, with medication mistakes causing 7,000 deaths and 1.5 million injuries per year. The Medicare Improvements for Patients and Providers Act that was enacted into law in July 2008 included provisions from my electronic prescribing bill, providing incentive payments for medical professionals using electronic prescribing. Now we must take an additional step to make health IT accessible to small providers so they can afford to implement new technology such as e-prescribing and electronic health records.

Small businesses employ more than half of all private sector employees and have generated 64 percent of net new jobs in the past 15 years. Access to capital for small health providers not only benefits patients but also boosts small businesses in the medical field. Helping small businesses grow and succeed is critical as we look to create jobs and strengthen the economy.

It is my hope that we can move forward with this bill in a bi- partisan manner. I ask all of my colleagues to support this legislation.

Mr. President, each year an estimated 2,550 children in the U.S. are diagnosed with an inborn error of metabolism disorder. For the rest of their lives they will need modified foods that are void of the nutrients their body is incapable of processing. They may also require supplementation with pharmacological doses of vitamins and amino acids. The good news is that with treatment they can lead normal, productive lives. But without these foods and supplements, patients can become severely brain-damaged and hospitalized.

Newborn screening has made a tremendous difference in the early diagnosis of metabolic disorders, but affordable and accessible treatment options remain out of reach for too many Americans. Medical foods and supplements which are necessary for treatment may not be covered by insurance policies and can be prohibitively expensive for many families. For those with a metabolic disorder, medical foods are critical in treatment, just as other conditions are treated with pills or injections. The sporadic insurance coverage of treatment has already been recognized as a problem. Over 30 States have enacted laws to enforce coverage of medical foods, but too many loopholes Thmain and federal legislation is necessary to ensure that these individuals receive what they need to stay well.

The Medical Foods Equity Act follows the April 2009 recommendations of the U.S. Health and Human Services Secretary's Advisory Committee on Heritable Disorders in Newborns and Children. It will ensure coverage of medical foods and necessary supplements for individuals with disorders as recommended by the Advisory Committee and, most importantly, peace of mind for those families affected by inborn errors of metabolism.

The lack of medical food coverage available to families has a significant impact on their lives. With the current situation of varying regulations between States and insurance providers, even families with coverage find themselves living in fear that a change in insurance provider will lead to reduced or nonexistent coverage. Too many Americans across the country are struggling to access the treatment they need for this type of disorder.

Take the story of Donna from Wilmington, MA. Donna has two daughters with phenylketonuria and she speaks eloquently about the frustration she experienced after her employer switched insurance plans. Because medical foods are not listed along with other necessary medicines, Donna was forced to navigate a long list mostly made up of durable medical equipment providers unequipped to help her. Even when she finally found a pharmacy that could order the formula, she was told that they required an upfront payment because they were wary of not being reimbursed by insurance companies. In Donna's own words, she was dismayed at ``having that feeling like you're being held hostage every time a change may occur in your insurance or carrier.''

Donna's story sharply illustrates the potential pitfalls even for those with insurance that offers some coverage. Too many families face a lack of coverage altogether. Take the case of Gwen of Waltham, Massachusetts. Her son Austen was 36 hours old when his heart stopped for over 20 minutes. Thankfully, he was stabilized but one doctor gave him only 6 months to live. A second opinion brought hope for Austen's family and a diagnosis of Glutaric Acidemia Type Two. Glutaric Acidemia Type Two is an inborn error of metabolism managed almost exclusively through diet. Because of the disorder, Austen cannot metabolize much fat or protein. He relies on supplements and specialty foods. MassHealth, Medicaid, covers most of the supplements but not the foods. Gwen pays for his food out of pocket, a significant strain on the family budget at a time when many families can least afford it. That strain is coupled with fears of job security and thoughts of what would happen if she could not pay for Austen's medical foods. No parent should have to see their child recover from a life-threatening trauma only to spend every day worrying about payment for their medical treatment--a treatment just as necessary as insulin for a diabetic or chemotherapy for a cancer patient.

As newborn screening and medical advances continue to improve the ability of those born with an inborn error of metabolism to lead full, healthy lives, we must make sure that the necessary treatments are available. The Medical Foods Equity Act will close existing loopholes in coverage and provide the parity in coverage these families deserve. It is my hope that we can move forward with this bill in a bi-partisan manner. I ask all of my colleagues to support this legislation.

Mr. President, today I am introducing the San Juan Mountains Wilderness Act of 2009. This bill is the Senate companion to the bill introduced by Representative John Salazar in the House of Representatives.

I want to thank Representative Salazar for all of his great work in bringing this bill forward. I am proud to sponsor this legislation in the Senate along with my Colorado colleague, Senator Bennet.

The San Juan Mountains Wilderness Act would designate about 33,383 acres in southwestern Colorado as wilderness, and about 21,697 acres as a special management area. It would also withdraw about 6,596 acres from mineral entry lands within the Naturita Canyon.

The bill is the result of the extensive work by many people to develop a collaborative approach to wilderness proposals and land protection designations. Representative Salazar and his staff worked with the affected Colorado county commissioners and interested stakeholders in developing this legislation. It is crafted to take into account the various ongoing uses of these lands, such as for water and recreation, while also providing strong managerial protection for these sensitive lands.

These lands are indeed worthy of this designation.

This region of Colorado is blessed with stunning beauty. Much of the land proposed for wilderness and other protections in this legislation are additions to existing wilderness. Those areas include the Mt. Sneffels Wilderness Area and the Lizard Head Wilderness--two areas that contain fourteen thousand foot peaks. They are defined

by their rugged beauty or rock and ice surrounded by forests that frame these peaks in summer's vibrant greens and brilliant fall colors.

The bill also establishes a new area called McKenna Peak. This peak presides over imposing sandstone cliffs which rise 2,000 feet above the plain that presents a remarkable opportunity to add a unique landform to the National Wilderness Preservation System. It also provides important winter wildlife habitat for large numbers of deer and elk. The Peak borders North Mountain, now considered to contain one of the largest deer and elk herds in all of Colorado. The Division of Wildlife places winter numbers of deer at 500 to 600, with up to 150 wintering elk. The favorable habitat for deer and elk naturally draws many hunters. Over 30,000 recreation user days are recorded annually during hunting season in the game management unit of which McKenna Peak is a part.

A wild horse herd numbering about 100 roams the western reaches of McKenna Peak within the designated Spring Creek Wild Horse Herd Management Area. Bald eagles winter in the lower reaches of the area, and peregrine falcons have been sighted as well. Mountain lions, bobcats, and black bear are also known to inhabit McKenna Peak. Other natural features of interest include rich fossil beds.

Moreover, the bill would establish the Sheep Mountain Special Management Area. This area is equally as striking as the surrounding mountains and valleys that are already protected or would be protected as wilderness in this legislation. However, since helicopter skiing currently exists in this area, the legislation designates this area in a way that protects its wilderness character, but still allows this use to continue. It is the sort of accommodation that is reflective of sound wilderness and land protection proposals, and I appreciate the compromises that are reflected in this approach.

As many of these lands are in high altitude areas, there should not be any issues related to water or other conflicts. As a result, the legislation does not exert a federally reserved water right, but allows access to existing water facilities and needs while also precluding any federal assistance for any new or expansion of existing water resource facility.

This bill has been carefully crafted and narrowly tailored to apply deserving protections to these lands. I look forward to working with my colleagues in seeing it passed.

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

Mr. President, tomorrow we will observe Veterans Day, a day to honor the millions of men and women who put on the uniform to defend our Nation. In communities across the Nation, we will gather to thank all veterans for their service, for their having risked their lives so that the rest of us could enjoy freedom.

I rise to offer legislation that is meant to honor veterans who are too often forgotten. Tonight, on the eve of the day meant to highlight their heroism, more than 130,000 veterans will be homeless, left without a home and without a warm meal. For many, they are on the streets with their families--husbands and wives and children left without any safety net. Perhaps they recently lost their job. Perhaps they recently lost their home to foreclosure. Why they are on the streets matters less than why we have left them on their own.

When coming into office, President Obama set a goal of ending homelessness among veterans within 5 years. This is a goal that I strongly support. VA Secretary Shinseki, himself a decorated veteran, has aggressively taken on this challenge, focusing efforts and funding toward eradicating homelessness.

Last Friday, I rose on this floor to increase funding for the homelessness and grant per diem program to the fully authorized amount of $150 million. This vital program has produced real results, offering transitional housing to veterans and their families and allowing organizations to construct and renovate facilities that can provide a multitude of services. I am hopeful that we will see this amendment pass and this level of funding included in the final bill.

However, if we are going to reach the President's goal of ending veterans' homelessness in five years, more will be needed. For that reason, I am joined today by Senator Bond in introducing S. 2760, legislation to increase the authorization of the grant and per diem program to $200 million. This increased funding can provide hundreds, perhaps thousands, of new beds and facilities for veterans in all 50 States.

Congressman Harry Teague introduced similar legislation earlier this year in the House where it has been marked up in subcommittee and is awaiting further action. I am hopeful that we will see Congress stand up to this moral obligation and provide the full resources needed for the thousands of veterans who have no home, who have no hope.

Last week, as I offered my amendment, I read a letter from a 15-year- old Boy Scout from Albuquerque. His father and grandfather are veterans and he is planning to follow in their footsteps and join the military himself when he is old enough. This young man wrote to say how angry he is that we are not doing enough to help our homeless veterans. ``These men and women are doing what they were called to do by our government,'' he wrote, ``but then they come back and are treated so poorly by everyone. We, as a Nation, need to do more to help our veterans.''

To the smart young man who wrote me that letter and to all of America's veterans, this bill builds on efforts to meet our country's moral obligations to the men and women who so bravely served our country. I thank Senator Bond for his support and I urge fast action to move this legislation forward.

Mr. President, as we move forward in modernizing our health care system, we must not forget the small businesses that simply cannot afford the upfront costs of installing new health information technology. That is why today I am introducing the Small Business Health Information Technology Financing Act. This bill will amend the Small Busis Act to allow the administrator of the Small Business Administration to guarantee up to 90 percent of the amount of a loan to small business health professionals to be used for the purchase and installation of health information technology. The loans can be used for computer hardware, software and other technology that will assist in the use of electronic health records and prescriptions.

A modernized health system using electronic prescribing and electronic health records will help improve patient care while reducing costs. Electronic prescribing not only saves money through improved efficiency, but more importantly, it reduces medical errors and saves lives. According to the Institute of Medicine, 1/3 of written prescriptions require follow-up clarification, with medication mistakes causing 7,000 deaths and 1.5 million injuries per year. The Medicare Improvements for Patients and Providers Act that was enacted into law in July 2008 included provisions from my electronic prescribing bill, providing incentive payments for medical professionals using electronic prescribing. Now we must take an additional step to make health IT accessible to small providers so they can afford to implement new technology such as e-prescribing and electronic health records.

Small businesses employ more than half of all private sector employees and have generated 64 percent of net new jobs in the past 15 years. Access to capital for small health providers not only benefits patients but also boosts small businesses in the medical field. Helping small businesses grow and succeed is critical as we look to create jobs and strengthen the economy.

It is my hope that we can move forward with this bill in a bi- partisan manner. I ask all of my colleagues to support this legislation.