Debbie Blanchard Access to Health Care for Individuals With Disabilities Act of 2010

Mr. President, I rise today to introduce the Strengthening Our Commitment to Legal Immigration and America's Security Act. Our immigration system is broken and needs reform. We can make progress by starting with the laws that already exist. My bill would enhance our core immigration and enforcement laws for both legal and illegal immigrants.

Much has been discussed this Congress on how to proceed on the very complex and, unfortunately at times, partisan issue of immigration reform. Some have introduced non-binding resolutions others have tried to attach

immigration-related measures to non-germane legislative vehicles. But, we're never going to get anywhere with these political stunts which do little to get to the root the problem.

Throughout my service, I have spent considerable time with my constituents and, quite frankly, have anguished with them on how to best address the considerable strain the illegal alien population is having on Utahns. Among other things, I have taken the initiative to increase immigration enforcement in Utah include bringing ICE Quick Response teams to our state, creating an immigration court, and establishing an ICE Field Office Director position to address Utah's immigration concerns. I also brought the 287(g) cross-deputizing program and just recently the Secure Communities program to Utah.

There is no question that more needs to be done. That is something everyone will agree on. Just recently legislation was enacted to enhance border security. I was pleased that this was a bipartisan effort. Some argue that the bill is sufficient to secure our border, but I disagree. There is much work to be done before the border is properly sealed. I continue to work with and support my colleagues whose states are located along the Southwest border. They know what resources we need to deploy to secure the border.

While Utah is not a border state, we still share the same concerns of our neighbors along the border. However, our problems result from a residual effect of a porous border and a breakdown of our immigration enforcement system.

For years, I have been saying most immigration problems could be solved if we would enforce the laws on the books. Unfortunately, the current Administration continues to explore ways to exploit current law and score political points.

During the past several months, the Obama administration has been holding behind-the-scenes talks to determine whether the Department of Homeland Security can unilaterally grant legal status, on a mass basis, to illegal immigrants via deferred action and parole. If the Administration is successful, it would be the equivalent of back-door amnesty for millions. For this reason, my bill specifies that an alien may only be paroled or granted deferred action on a case-by-case basis--not en mass--the way these laws were intended to be used.

The 287(g) and Secure Communities programs continue to be valuable tools to our law enforcement officials in detaining and deporting criminal aliens. For example, in Fiscal Year 2010, the 287(g) program was responsible for detaining 29,295 criminal aliens. What I don't understand is why some cities would choose to not participate in these effective programs. That is why my proposed legislation would require eligible states, counties, or cities to actively participate in the Secure Communities or 287(g) programs or forego compensation for incarceration expenses. Turning a blind eye to these law enforcement programs poses a serious risk to the public and creates sanctuary cities.

When I meet with my constituents, one of their top concerns is how we fix our visa programs. Many are concerned, and with good cause, about how some of these folks are getting into the country. Disturbingly, some visa holders are active participants in organized crime. They come to this country and infiltrate our communities, wreaking havoc in our neighborhoods.

In an effort to address this problem, my bill would provide our State Department consular officers the necessary legal authority to deny members of known gangs from coming into our country. It's not acceptable to allow these thugs to slip through the cracks.

After 9/11, many areas of our immigration system came under scrutiny. One of the top recommendations for reform to our system is to create an exit procedure for foreign visitors to the United States. Departure information is vital for determining whether foreign visitors are departing the U.S., maintaining their visa status, and evaluating future visa eligibility for these visitors. Not to mention, the ability to track departures goes to the heart of keeping America safe.

Without such exit procedures, however, the task of determining whether an alien has overstayed their visa in the United States is nearly impossible. Since 2004, the Department of Homeland Security has been testing exit programs and departure controls at U.S. airports for visa holders leaving the United States. As recently as July 2009, another pilot program was concluded by the Department of Homeland Security. To date, we still haven't seen any implementation of exit procedures for our country's visitors, nor have we seen any final conclusions made by the Department. It has been over 6 years since the first pilot program concluded. It is time to act.

Thus, my bill would require the Secretary of Homeland Security to create a mandatory exit procedure for foreign visitors to the United States. This should have been done years ago.

Additionally, the proposed legislation would eliminate the fraud- laden visa lottery, known as the Diversity Visa program. At present, applicants of the visa lottery program are open to being defrauded by so-called service providers who offer to assist them in obtaining Diversity Visa status. Unlike other immigrant visa categories, this is one of the few visas that allows people to immigrate to the United States without having any connection to the country. In other words, the applicants may not have any family, employment, or even provide an economic tie to the United States. And because of limited availability of verification, the program presents serious national security concerns.

Let me be clear: if anyone is a proponent of a diverse nation, one that enjoys the influence of many cultures, it is me. But what we have right now in the visa lottery program does not accomplish the intended goal.

After careful consultation with State Department officials, I have been advised that the Diversity Visa program needs serious reform, and some have even called for complete elimination of the program. In light of this guidance, I propose to sunset the Diversity Visa program, unless the State Department recommends to Congress how best to combat fraud and eliminate abuse currently in the program.

One of the most heated issues that is continually raised by my constituents, and many across the country, is the impact that illegal aliens are having upon our welfare programs. It came to my attention that Los Angeles County, California, actually tracks this information. Much to my amazement, L.A. County confirms that in 2009 alone, they distributed over $2.4 billion in Federal-State welfare and food stamp programs. Of that amount, $569 million was issued to households that include illegal aliens. Let me reiterate: the illegal alien population in L.A. County received over a half-billion dollars of welfare benefits in one year alone.

In order to have an honest discussion about the drain illegal aliens are having upon our welfare systems, we must be armed with state- specific information to understand the extent of this problem.

Thus, my bill would require the Secretary of Health and Human Services, in consultation with the Department of Homeland Security and any other appropriate Federal agency, to submit an annual report to Congress outlining the total dollar amount of Federal welfare benefits received by households of illegal aliens for each state and the District of Columbia. The annual report would also include the overall dollar amount each state spends on Federal welfare benefits.

Without having this information, we will continue to dismiss the serious economic ramifications to our country's prosperity. We cannot afford to perpetuate this problem any longer.

My legislation also includes a provision which revisits the legal immigrant policy included in the Children's Health Insurance Program Reauthorization Act of 2009, P.L. 111-3. The CHIP Reauthorization law overturned language requiring a 5-year waiting period before legal immigrants may be eligible for federal health coverage. The 5-year waiting period was included in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, P.L. 104-193. As my colleagues will recall, the 1996 Welfare Reform Act required sponsors of legal immigrants to be responsible for individuals' expenses during the first 5 years of residency in our country. States had the option of offering legal immigrants CHIP and Medicaid coverage with State only dollars. In other words, States could not

receive Federal matching dollars for covering these legal immigrants.

The 2009 CHIP law overturned that policy. Today, States may still cover legal immigrant children and pregnant women who have been in the U.S. less than 5 years. However, the big difference is states now receive Federal matching dollars for covering those individuals.

The provision in the bill I am introducing today would permit states to continue receiving federal matching dollars for covering legal immigrant children and legal immigrant pregnant women but two conditions must be met. First, the state must demonstrate that it has covered 90 percent of its U.S. citizen children and pregnant women eligible for CHIP or Medicaid. These individuals' family income may not exceed 200 percent of the Federal poverty level. Second, the State must demonstrate that it is not supplanting state dollars which were being used to cover legal immigrants prior to passage of the 2009 CHIP reauthorization law with Federal dollars.

Another top concern I regularly hear about is identity theft--that of both adults and children who have to spend a great amount of their time and money to clear their good names and restore their credit history.

In 2006, parents of Utah 2-year old Tyler Lybbert realized their daughter's identity had been stolen by 38-year old Jose Tinoco. By the time the Lybberts became aware of the fraud, Mr. Tinoco had already taken out two loans and opened credit cards--saddling Tyler with over $15,000 in debt. Little Tyler was left holding the bag.

Fortunately, when Mr. Tinoco tried to obtain a loan from a local Utah bank, an employee spotted the discrepancy and alerted Tyler's parents. Mr. Tinoco was caught, but the Lybberts were left with countless hours of work to correct the fraud perpetrated against their child.

This past weekend, the Utah press reported on another identity theft case. A newly married radiology student at Weber State University has been battling to reclaim his identity for the last 15 years. When Cameron Noble was 7 years old his Social Security number was stolen by Mr. Jose Zavala of California--an over 60-year-old man.

Noble's parents thought they had corrected the error but when Cameron began working at the age of 16 he started receiving notices that his wages were being garnished to pay child support. The problem has continued to haunt him ever since--in the form of tax withholdings and credit report confusion. He is now nearing the end of the process to obtain a new Social Security number.

It is not a secret that many in the illegal immigrant community perpetuate identity theft with stolen or fabricated Social Security numbers, SSN. The identity theft they commit often affects the very young--who may not notice problems for years or decades until they are old enough to apply for their first job, car or school loan, or credit card.

As in little Tyler Lybbert's case, why did it take a bank employee to pick up on the theft? Because there is no formal system established to alert SSN holders when potential fraud or improper usage have occurred.

The federal agency that is best suited to track the use of mismatched SSN numbers is the Internal Revenue Service, IRS. That is why my bill requires the IRS to send a notice to an employer that an inaccurate SSN has been discovered for an employee. If the employer does not respond to the notice within 60-days to correct the inaccuracy, my legislation will require the IRS to notify the SSN holder or to parents and guardians of a minor, that a discrepancy has been detected and to do the following: if it is an actual mismatch to contact the IRS; if they suspect fraudulent use, the SSN holder is provided with contact information for the FTC and various credit bureaus to report the problem; and finally if no response is received by the SSN holder, the IRS would be required to refer the account number to appropriate Federal agencies for possible investigation.

Let me pause here to underscore a point. Currently, the original SSN holder never receives notice when a mismatch has occurred. Quite frankly, I do not have the assurances that the IRS is requiring much of the employer to correct or verify the submission. That is not acceptable. In this day and age, when at a click of a mouse, someone can apply for credit cards, mortgages, or even car loans, there is no excuse why SSN holders are left in the dark.

One can only imagine that if this simple notification step was taken in the case of little Tyler Lybbert or the Noble family that years of laborious efforts and countless hours of notifying credit bureaus, banks, and other authorities, could have been greatly reduced if not avoided all together.

To make matters more confusing in this area of the law, the Supreme Court has more or less tied the hands of prosecutors in going after these thieves and those who are involved in so-called document mills. The case of Flores-Figueroa v. United States undermined prosecutors' longstanding practice of using the aggravated identity theft statute by requiring them to also prove that a defendant knew that he or she was using a real person's identity information, as opposed to counterfeit information not connected to an actual person.

To clarify the Criminal Code and provide our prosecutors with the latitude they need to pursue these cases, my bill makes clear that defendants who possess or otherwise use identity information not their own, without lawful authority, and in the commission of another felony is still punishable for aggravated identity fraud, regardless of the defendants' ``knowledge'' of the victim.

Finally, my bill's identity theft would require the Secretary of the Treasury, the Chairman of the FTC, and the Commissioner of Social Security to conduct a study to determine the most feasible and cost- effective ways to protect the credit worthiness of individuals, especially that of children.

Mexican Cartel drug violence has been placed front and center by the media and members of this body. Some of my fellow colleagues have called for more resources directed to this problem. As additional federal law enforcement personnel and military units continue to be deployed to the southwest border the focus has been on weapons, drug interdiction and bulk cash smuggling. While I recognize the importance of these border enforcement activities, too little attention is being paid to outdoor marijuana cultivation by Mexican drug trafficking organizations.

Outdoor marijuana cultivation by Mexican drug trafficking organizations is causing increasing environmental damage, especially on publicly owned lands. From 2004-2009 more than 11 million marijuana plants have been eradicated from federal public lands. Outdoor marijuana cultivation is the chief source of revenue for Mexican drug trafficking organizations.

Growing marijuana in the U.S. saves traffickers the risk and expense of smuggling their product across the border and allows gangs to produce their crops closer to local markets. Illegal alien workers are smuggled in from Mexico to serve as laborers and provide security to the grow plots. Mexican gang plots can often be distinguished from those of domestic-based growers based on their plant volume and security measures. Many of the plots are encircled with crude explosives and are patrolled by armed illegal aliens providing security for the crop.

In my home State of Utah, the Drug Enforcement Administration and local law enforcement have seized more than 110,000 marijuana plants this year. Each plant can yield one pound of marijuana with a street value of $1,000. These remote plots were on federal land and nestled under the cover in a national forest or hidden high in the rugged-yet- fertile tracts of federal land. All of the sites were far from the eyes of law enforcement, where growers can take the time needed to grow far more potent marijuana. Growers of these fields have even created irrigation systems to disrupt or divert water sources. They even use illegal fertilizers that damage the environment and the local eco- system.

In one recent incident in Garfield County, Utah an illegal alien grow worker was armed with a shotgun and confronted six teenage girls who inadvertently hiked into the marijuana field. The worker brandished a shotgun and demanded to use their cell phone. Fortunately, the group of girls were able to run away from this armed man

and prevented what could have been a very tragic outcome. The girls were quite traumatized and reported the incident to local police. The Drug Enforcement Administration and the local authorities apprehended the man a short time later.

So far this year in Utah, as a result of joint investigative efforts between Federal, State and local law enforcement, 20 arrests have been made in connection with the outdoor cultivation of marijuana on Federal lands. Out of the 20 arrests made, 19 were illegal aliens. This is not a problem that is unique to Utah. Other States with substantial federal lands are also seeing a spike in marijuana cultivation by Mexican drug trafficking organizations, including Colorado, California, Idaho, Nevada, Oregon and Michigan.

It is for this reason why my legislation would provide tougher penalties for cultivating marijuana on federal lands and destroying the environment. Provisions of this legislation would also require the Office of National Drug Control Policy to formulate a comprehensive and coordinated action plan to address marijuana cultivation on Federal lands. This plan will be a broad strategic approach to disrupt Mexican drug trafficking organizations' central source of revenue and a key reason for organized alien smuggling.

The fight to control the border is no longer isolated to just the physical boundary between the United States and Mexico. Securing the border now means addressing Mexican cartels; prohibiting mass deferral or parole; streamlining the visa process; requiring participation in key law enforcement programs; clamping down on identity theft; tracking the amount of welfare benefits being diverted by illegal immigrant households; ensuring that dollars are being used to cover newly eligible American children in CHIP and Medicaid; and keeping our great national parks and Federal lands safe and free from drug traffickers, drug cultivation, and environmental damage.

Let me conclude by saying this bill represents key issues that are important to my Utah constituents and Americans across the country. They are common sense solutions to strengthen our commitment to legal immigration and American's security. I urge my colleagues to put partisanship aside and support this bill.

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

Mr. President, I rise today to introduce S. 3919, an act to remove Endangered Species Act, ESA,

protections for gray wolves. Delisting of this species is long overdue.

Gray wolves are listed as endangered under the ESA in the United States, except in Minnesota where they are listed as threatened. The U.S. Fish and Wildlife Service removed ESA protection from these wolves in 2009, but subsequently reinstated protection under a court decision following a lawsuit.

Legislative action is the only solution to stop the endless cycle of litigation and return the sovereign ability of states to manage their wildlife. Gray wolves are the iconic species of the ESA. But we cannot let the preconceived and inaccurate perceptions surrounding this animal prevent us from doing our due diligence in providing protections and safeguards for other species including elk, deer, moose, and big horn sheep. With a population growth rate of 24 percent, gray wolf overpopulation is now doing significant damage to wildlife populations throughout the West and Midwest.

Gray wolf predation is erasing decades of effort and hundreds of millions invested in rebuilding healthy big game populations. Wolves do not know or care where recovery plan lines are drawn. They will roam wherever necessary to find adequate food and habitat. Research indicates that wolf and ungulate populations are generally inversely proportional and cyclical over relatively long periods of time.

Ill-advised experimentation and anti-management philosophy continues to be pushed by extreme animal rights and anti-sportsmen special interest groups. This war on the west threatens big game herds, proactive State wildlife management, use of renewable wildlife resources, and the western way of life. This bill, while viewed with suspicion and opposed with philosophical arguments by some environmental organizations, ensures that delicate wildlife populations are restored to healthy levels.

When Congress passed the ESA, it envisioned legislation to make certain that species would not become extinct. The key to success of the new law was finding a way to conserve and protect species truly in danger of becoming extinct. The gray wolf is not endangered as a species. There are thousands alive and well in North America. The ESA has become a vehicle by which some organizations and individuals seek to halt all activities on our public lands which they happen to oppose. I would submit to you that such use of the ESA was not envisioned nor would it have been condoned by a majority of those who originally crafted the law.

Some groups want to use the gray wolf as a surrogate for other agendas. Others have used it to raise a lot of money from citizens of this country truly concerned about the place of the wolf in our environment. Still others have used it for political purposes. What a shame that the laws of this great Nation can be subverted for purposes other than the reason the law was originally written.

The gray wolf has been protected by the ESA since 1973, the year the ESA was passed. The single exception to that classification is in the State of Minnesota where they are classified as threatened. The original recovery plan for the gray wolf in the Northern Rockies was written in 1974. The main States involved are owned largely by the Federal Government. Thirty percent of Montana, 50 percent of Wyoming, and 64 percent of Idaho is federally owned. Access to and use of the public lands and resources on them has a great deal to do with the economy of these sparsely populated States. When the economy suffers, so do these communities and these people.

The working men and women of our States have no alternative but to rely on continued access to and the use of grass, water, timber, and minerals from public lands to support their families. Those working people have mortgages to pay just like you and I; they have bills that are due each month; and they want to be able to feed and clothe their children just as you and I do.

We must recognize the legitimate concerns of the hundreds of honest, hardworking citizens who are being directly affected by the continued listing of the gray wolf on the ESA. In my opinion, we have a responsibility to protect their right to make an honest living and to live the lifestyle they have chosen.

I hope my colleagues will join me in this attempt to resolve this important issue.

Mr. President, I rise today to introduce the Keeping All Students Safe Act to create a safe environment for students and school personnel by creating minimum standards around the use of seclusion and restraint in schools. In December, I introduced a similar bill. But today, I come to the floor with my good friend and colleague Senator Burr, with a revised act that incorporates additional protections for students.

In 1998, the Hartford Courant ran an award-winning series of stories about the use of seclusion and restraint in hospitals, residential facilities, and group homes for individuals with psychiatric and developmental disabilities. The Courant uncovered a hidden epidemic, confirming 142 deaths occurring during or after the use of seclusion or restraint.

One of those 142 cases was an 11-year-old boy from my home State of Connecticut. He was restrained face-down in a position that restricted his air flow. He died as a result.

In response, I led the charge to establish Federal standards to prevent the misuse of these practices. I helped pass The Children's Health Act of 2000, which included the Compassionate Care Act that I originally drafted to put these standards in place in certain hospitals and residential facilities. We

wanted to include schools in this legislation, but were unable to do so. Sadly, the need could not have been greater.

Over the past year, reports from the National Disability Rights Network, NDRN, the Alliance to Prevent Restraint, Aversive Interventions, and Seclusion, APRAIS, the Council of Parent Attorneys and Advocates, Inc., COPAA, and the Government Accountability Office, GAO, have painted a picture disturbingly similar to the one the Hartford Courant discovered more than a decade ago.

The statistics are chilling--hundreds of incidents of physical injury, psychological trauma, even death--but the stories are even more devastating.

The GAO found many examples of the inappropriate use of seclusion and restraint in the report it released on May 19, 2009.

A 14 year-old boy was restrained face-down by a teacher because he would not stay seated in class. The 230 lb. teacher sat on the 129 lb. boy, restricting his airflow and resulting in the boy's death.

A 4 year-old girl with cerebral palsy and autism was restrained in a wooden chair with leather straps for being ``uncooperative.''

In one school district, children with disabilities as young as six years old were allegedly placed in strangleholds, restrained for extended periods of time, confined to dark rooms, and tethered to ropes and prevented from using the restroom until they urinated on themselves.

To be clear, school personnel go to work every day with the goal of educating children, not harming them. I have the utmost respect and appreciation for the difficult job they do and want to make it clear that my concern signifies no disrespect for their challenging jobs, or the dangers they sometimes face.

However, these tragic stories reflect inadequate training and a lack of resources on the state and local levels to implement effective interventions, such as school-wide positive behavioral interventions and supports. According to a report by COPPA, over 71 percent of the 185 incidents they identified occurred in schools with no positive behavioral interventions or supports. If school personnel are provided with the necessary tools to prevent dangerous situations, the number of incidents requiring restraint and seclusion will decrease.

Just as students have a right to learn in a safe environment, educators have a right to work in a safe environment. They should be provided with the proper training and support to prevent injury to themselves and others.

In some states, parents have successfully advocated for laws that provide these resources, as well as guidelines to ensure that they are used effectively.

But the patchwork of state laws and regulations is confusing and especially troublesome for transient students.

According to the GAO study, 19 states have no law or regulations concerning seclusion and restraint in schools. Some laws apply to only certain schools or situations, and some apply to restraint but not seclusion. Only 19 states require parental notification, only 17 states require staff training, and only eight specifically prohibit restraints that restrict air flow.

Therefore, Senator Burr and I will today introduce the Keeping All Students Safe Act, a bill that will address these issues.

Our bill will establish clear minimum standards for the use of restraint and seclusion in schools, closely based on the Children's Health Act of 2000. It will also provide resources to assist with policy implementation and provide school personnel with necessary tools, training, and support.

It will improve data collection, analysis, and identification of effective practices to prevent and reduce seclusion and restraint in schools, so we may better understand the scope of the problem and the effectiveness of our solutions.

Specifically, the legislation will prohibit the use of seclusion and restraint in schools unless a student's behavior poses an immediate danger of serious physical injury and less restrictive interventions would be ineffective.

It will prohibit the use of mechanical, chemical, and physical restraints that restrict air flow to the lungs.

This legislation will require adequate training and state certification of school personnel imposing seclusion or restraint, immediate parental notification when such an incident occurs, and a debriefing session to prevent future incidents.

As a result of this act, the Department of Education will conduct, and provide to Congress, a national assessment that analyzes data on seclusion and restraint and determines effective practices in preventing and reducing the number of incidents. This assessment will provide us with a more accurate picture of the extent of seclusion and restraint in schools, and will help direct additional future efforts to ensure that our children and those who educate them are safe.

The Keeping All Students Safe Act includes language that solidifies Protection and Advocacy agencies', P&A, abilities to serve the students who are in need of protection. This legislation is meant to ensure that these P&As are spending their time and resources protecting our Nation's children in schools, and not in court about this already settled issue.

Finally, this legislation will amend the Elementary and Secondary Education Act, as well as the Higher Education Act, to provide additional planning for and training on the use of positive behavioral interventions and supports.

I want to thank the many organizations representing individuals with disabilities, students, teachers, and schools that all came to the table with recommendations. Their time, energy, and input made this a much stronger and more effective bill, and I truly appreciate their hard work and support. I am especially thankful for Senator Burr's commitment to this issue and his insights that have strengthened the bill. I am also grateful to Secretary Duncan for his leadership on this issue at the Department of Education. Finally, I want to thank my colleague and good friend, Chairman George Miller in the House of Representatives. Earlier this year, he introduced companion legislation that passed the House in March. Senator Burr and I look forward to working with him to pass this into law.

Every child has a right to be safe in the place where he or she goes to learn and grow. Every educator deserves the training and support he or she needs to do his or her job safely and effectively. The Keeping All Students Safe Act will help to prevent tragedies in our schools. I am proud to introduce it today, and I urge my colleagues to join me.

Mr. President, I rise today to discuss a very serious issue that affects many Americans, and that is premature births. More than half a million babies will be born preterm this year and approximately 28,000 babies will die before they turn 1 year old.

In my home State of Connecticut, there were more than 4,000 preterm births in 2007, representing approximately 11 percent of all live births in the State. Between 1997 and 2007, the rate of infants born preterm in Connecticut increased 3 percent.

The incidence of preterm birth represents a huge disconnect between our scientific knowledge and our capacity to meet basic and critical needs in maternal-child health. According to the Centers for Disease Control and Prevention, CDC, babies who died from preterm birth-related causes accounted for more than 36 percent of infant deaths in 2006. For newborns, prematurity is the leading cause of death.

Of the surviving preemies, approximately one-fourth will have serious health complications including hearing loss, cerebral palsy, intellectual disabilities, acute respiratory diseases, and other maladies. These health problems not only affect the child, but also place a financial and emotional burden on many families. According to the Institute of Medicine, the annual societal costs associated with preterm birth were $26.2 billion in 2005 or $51,600 per infant born preterm. Nearly two-thirds of this cost was for medical care. More importantly, the $26.2 billion estimate does not include the cost of medical care beyond early childhood or caretaker costs such as lost wages.

In nearly half of all cases, physicians and scientists cannot pinpoint a cause for preterm labor and delivery. However, research has shown that causes of preterm birth may include neighborhood characteristics, environmental exposures, biological factors, and medical conditions. Many of these factors can occur in combination, particularly for those who are socioeconomically disadvantaged and minority groups. Accordingly, there are significant disparities in the rates of preterm birth across these groups, with the highest rate of preterm births for non-Hispanic African Americans at 17.5 percent in 2008, according to the National Center for Health Statistics. It is clear that a greater commitment to eliminating these inequalities is needed. As the chairman of the U.S. Senate's Health, Education, Labor, and Pensions' Subcommittee on Children and Families, ensuring the health of America's children has been my life's work, making the correction of these inequalities an issue of great importance.

In 2006, my colleague Senator Alexander and I worked to pass the Prematurity Research Expansion and Education for Mothers who deliver Infants Early Act or PREEMIE Act, Public Law 109-450, which authorized finding to enhance Federal research related to preterm labor and delivery and increased public and provider education and support services. Among the results of the PREEMIE Act were the 2008 Surgeon General's Conference on Preterm Birth and expanded research activities at CDC. The most notable accomplishment to date is a 3 percent decline in the preterm birth rate from 2007 to 2008. But there is still much work to be done. We must build on the progress recently achieved and use both public and private efforts to accelerate this decrease in the rate of preterm birth.

For these reasons, I rise today to join my colleague from Tennessee to introduce the PREEMIE Act to reauthorize these vital activities. It is my hope that this legislation will complement many of the efforts being conducted by the private sector, such as the March of Dimes campaign to raise public awareness and reduce the rate of preterm births. I urge my colleagues to join me in promoting a healthy start for America's children by supporting this legislation.

Mr. President, as a co-chair of the Congressional Spina Bifida Caucus, I rise today to introduce the Debbie Blanchard Access to Health Care for Individuals with Disabilities Act of 2010 with my colleague, Senator Sherrod Brown. This legislation provides an excellent opportunity to address a critical disparity that exists in our Nation's health care system.

Individuals with disabilities can face a myriad of challenges in accessing the health care they need and deserve. Such was the case for Debbie Blanchard, a woman who lived with Spina Bifida for nearly 56 years, and who passed away in August 2008 from cervical cancer. Due to the challenges she faced in finding a physician whose office and examination tables were accessible for individuals with disabilities, Debbie was not able to seek regular well-woman exams, including cervical cancer screenings. The barriers Debbie faced in physically accessing the regular preventive care she needed unfortunately contributed to her cervical cancer going undetected until it was too late. The lack of accessible care clearly contributed to her untimely death.

The Spina Bifida community is devastated by Debbie Blanchard's tragic passing, and we in the Congressional Spina Bifida Caucus wish to help ensure that the challenges and barriers that contributed to her illness and death are eliminated. To that end, we have developed the Debbie Blanchard Access to Health Care for Individuals with Disabilities Act in an effort to help facilitate access to health care by individuals with disabilities, including, but not limited to, those with Spina Bifida, and help them to identify providers whose offices and examination rooms are accessible for individuals with disabilities.

Before I discuss the details of this bill, I believe it is important to recognize the scope of the problem we are dealing with. According to the U.S. Census, more than 54 million Americans, about one out of every five, live with some level of disability. Approximately 34 million of those are classified as having a severe disability. In Connecticut, more than 540,000 individuals are living with some level of disability. Of those individuals, close to 22,000 have physical disabilities.

Studies conducted by the Centers for Disease Control and Prevention have found that individuals with disabilities have difficulty in accessing routine and specialized health care. Numerous barriers exist for these patients, including the inability to find a health care provider who understands how to treat individuals with disabilities and is willing to have those individuals as patients. According to a survey commissioned by the National Organization on Disability, 19 percent of persons with disabilities reported they needed medical care within the previous year and did not get it. This is a number more than three times the percentage for those without disabilities.

Women with disabilities are particularly vulnerable. A study by the Center for Research on Women with Disabilities showed that nearly one- third of women with disabilities surveyed reported being denied services at a physician's office solely because of their disability, and 56 percent described their physicians' offices and hospitals as ill-prepared to accommodate their specific needs. Research by the National Institute on Disability and Rehabilitation Research shows that women with disabilities are less likely to have Pap smears and mammograms and are more likely to be diagnosed at a later stage of breast cancer. These women are less likely to receive standard treatments and more likely to have poor outcomes.

The Patient Protection and Affordable Care Act, PL 111-l48, includes an important component to establish standards for medical diagnostic equipment such as examination tables and chairs to improve access to health care for individuals with disabilities and I applaud Senator Harkin for his leadership on that provision. As such, the legislation I propose today seeks to complement existing programs and other pending proposals. The Debbie Blanchard Access to Health Care for Individuals with Disabilities Act would empower individuals with disabilities with the information and tools they need to identify accessible providers. It would also increase awareness among health professionals of the need to provide an accessible environment. The bill provides for four key programs to achieve these goals.

First, this bill authorizes the Secretary of the Department of Health and Human Services to provide formula-based grants to States to create on-line directories of health care providers accessible to individuals with disabilities. States would not be required to engage in this activity, and the grants are strictly voluntary.

Second, it authorizes HHS to develop a pilot program to increase health care provider awareness of the need to provide accessible environments, examination rooms, and examination tables for individuals with disabilities.

Third, it authorizes the HHS Office on Disability, with the help of national organizations representing individuals with disabilities, to develop resources to support individuals with disabilities in their efforts to find accessible providers. Such resources include ``tips cards'' and questions to ask when calling a provider for the first time to make an appointment.

Finally, the bill authorizes HHS to create a National Advisory Committee on Access to Health Care for Individuals with Disabilities to ensure intra-agency coordination of efforts to improve access to care for individuals with disabilities.

The Debbie Blanchard Access to Health Care for Individuals with Disabilities Act would be a significant step in ensuring health care equity for the more than 50 million Americans who live with a disability. Debbie Blanchard's tragic passing should serve as a lesson on the barriers that exist for individuals with disabilities in accessing basic quality health care. We should take action to ensure that these barriers are eliminated to prevent Debbie's story from being repeated. I urge my colleagues to cosponsor this important legislation.

Mr. President, I come to the floor today to introduce legislation with Senator Alexander of Tennessee that I believe will have a dramatic impact on the safety of our Nation's highways and interstates, called the Commercial Driver Compliance Improvement Act. This bill will require the Department of Transportation's Federal Motor Carrier Safety Administration, FMCSA, to implement regulations requiring the use of electronic on-board recording devices, EOBRs, for motor carriers in order to improve compliance with Hours-of-Service, HOS, regulations. Requiring the use of these technologies in motor carriers will not only improve compliance with HOS regulations, but it will also reduce the number of fatigued commercial motor vehicle drivers on the road. This will have a profound impact on highway safety and reduce accidents and fatalities on our highways and interstates.

Hours-of-Service regulations place limits on when and how long commercial motor vehicle drivers may drive. These regulations are based on an exhaustive scientific review and are designed to ensure truck drivers get the necessary rest to drive safely. In developing HOS rules the FMCSA reviewed existing fatigue research and worked with nongovernmental organizations like the Transportation Research Board of the National Academies and the National Institute for Occupational Safety. HOS regulations are designed to continue the downward trend in truck driving fatalities and maintain motor carrier operational efficiencies.

Unfortunately, compliance with HOS regulations is often spotty due to inaccurate reporting by drivers as they are

only required to fill out a paper log, a tracking method that dates back to the 1930s. Inaccurate reporting may result from an honest mistake or an intentional error by a driver seeking to extend his work day. These inaccuracies can lead to too much time on the road leaving the driver fatigued and placing other drivers at risk. After listening to the many interest groups and experts on this issue in meetings and Commerce, Science and Transportation Committee hearings, I have come to learn that there is an available and affordable 21st century technology that can ensure accurate logs, enhance compliance, and reduce the number of fatigued drivers on the road. They are being used today, and they are producing results. I believe that widespread utilization of these devices as soon as possible will significantly reduce further loss of life resulting from driver fatigue.

Our legislation will require motor carriers to install in their trucks an electronic device that performs multiple tasks to ensure compliance with HOS regulations. These devices must be engaged to the truck engine control module and capable of identifying the driver operating the truck, recording a driver's duty status, and monitoring the location and movement of the vehicle. Requiring electronic log books that are integrally connected to the vehicle engine as this bill requires will dramatically increase the accuracy of information submitted for hours of service compliance. Our bill will also require these recording devices to be tamper resistant and fully accessible by law enforcement personnel and federal safety regulators only for purposes of enforcement and compliance reviews.

While I understand that some drivers may be reluctant to transition to electronic logging devices, I strongly believe that the safety benefits of the use of these devices far outweigh the costs. I don't want to see more lives lost due to driver fatigue resulting from log book manipulation. I also believe that with the rapid development of electronic technology, especially in the wireless telecommunications area, we will see strong competition among EOBR manufacturers and reduced costs for these technologies. In addition, the price of these products should go down as the demand increases through regulatory requirement to utilize this equipment.

In order to protect the privacy of the driver, an issue which I know is a major concern among truck drivers, this legislation would explicitly provide privacy protections for use of information beyond enforcement and compliance monitoring. Ownership of data is protected for the owner of the vehicle or the person entitled to possession of the vehicle as the lessee.

Senator Alexander and I are not alone in calling for this technology to be more widely used by commercial vehicles. There are a number of Senators, including Senator Lautenberg, who have long been strong proponents of implementing the use of this technology. In addition, multiple federal agencies and nongovernmental organizations have recognized the benefits of this technology and called for its widespread use.

For example, Mr. Francis France of the Commercial Vehicle Safety Alliance witness stated at the April 28, 2010, Senate Committee on Commerce, Science, and Transportation hearing on Oversight of Motor Carrier Safety Efforts that:

All motor vehicles should be equipped with EOBRs to better

comply with Hours of Service laws . . . CVSA has been working

with a broad partnership to help provide guidance to achieve

uniform performance standards for EOBRs.

Similarly, the Chairman of the National Transportation Safety Board, the Honorable Deborah Hersman, stated at the same hearing that:

For the past 30 years, the NTSB has advocated the use of

onboard data recorders to increase Hours of Service

compliance . . . the NTSB recommended that they be required

on all commercial vehicles.

During the same hearing, Ms. Jacqueline S. Gillan, with the Advocates for Highway and Auto Safety stated that:

We regard the mandatory, universal installation and use of

EOBRs as crucial to stopping the epidemic of hours of service

violations that produce fatigued, sleep-deprived commercial

drivers . . . at very high risk of serious injury and fatal

crashes.

I have also heard from Administrator Ferro of the FMCSA on her thoughts of how EOBRs would enhance compliance and improve highway safety. The FMCSA recently implemented a rule to require that these devices be mandated for truck drivers and trucking companies that have been found to be noncompliant with FMCSA rules. These rules will be effective in June 2012. It is my understanding that they are looking to expand these requirements to include more motor carriers, and I support those efforts as they reflect the qualities and intent of this legislation.

Finally, in addition to the support from safety advocates and Federal transportation safety officials, I have also heard from a number of Arkansas trucking companies currently utilizing this technology. These companies have experienced reductions in driver fatigue, increases in compliance, and reductions in insurance premiums. The executives of these companies, which include J.B. Hunt and Maverick U.S.A. among others, support the expanded use of these devices to increase compliance, improve highway safety, and level the playing field among the industry. I agree with their views on the importance of widespread utilization of this safety and compliance device.

The Commercial Driver Compliance Improvement Act, if enacted, will require the Department of Transportation to issue regulations within 18 months from enactment to require commercial motor vehicles used in interstate commerce to be equipped with electronic onboard recorders for purposes of improving compliance with hours of service regulations. The regulation will apply to commercial motor carriers, commercial motor vehicles, and vehicle operators subject to both hours of service and record of duty status requirements three years after the date of enactment of this act. This population represents a vast majority of drivers and carriers who operate trucks weighing 10,001 pounds or more involved in interstate commerce. It will cover one hundred percent of over-the-road, long-haul truck drivers.

I urge my colleagues in the Senate to recognize the importance of this technology in saving lives on our nation's highways and interstates. I also ask for their support for this legislation and help in moving it to the President as quickly as possible. While I understand our time in the 111th Congress is quickly shrinking as the number of legislative days are limited, it is my hope that we move this legislation through the Senate no later than the Surface Transportation Reauthorization legislation that the Senate will take up in the near future.

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

Mr. President, I rise today to discuss an issue that I believe does cross the political divide; and that issue is, protecting children from needless pain. Forty years ago, when Roe v. Wade became the law of the land, it was believed that babies simply did not feel pain. At that time, the medical community thought a baby's nervous system was not yet developed enough to have a sense of pain, so surgeries were literally performed with no anesthesia. Parents were told not to worry if it appeared their child was in pain.

We found out the medical community was wrong.

Twenty-five years ago, a doctor at Oxford University proved that newborn babies do, in fact, feel pain. His groundbreaking research was inspired by his own recognition of the signs of pain.

Dr. Anand noticed preterm babies returning from operations with weak pulses, with rapid heart rates, and other signs of stress that would typically be associated with the feeling of pain.

As a result, he studied two groups of babies. One went through surgery without anesthesia, as was the practice at that time. A second group was given anesthesia before the surgery took place.

The results were remarkable. Most of the babies who were given pain medicine sailed through the procedures while the babies who were given no pain medicine suffered significant stress. This study opened the eyes of the medical community, shifting both medical opinion and common practice.

Today, pain relief for infants is now the standard of care. If my child needed surgery today, and a doctor told us it would be done without anesthesia, without pain medicine for the baby, we would walk straight out of the door; and any parent would.

Performing surgery on an infant without pain medicine is unimaginable today, despite having been common practice, the accepted standard of care 40 years ago. Medical research shattered a commonly held belief, and it changed medicine forever.

I stand before you today in recognition that medical research has again advanced. Again, it should shatter a misguided assumption. You see, doctors now perform surgery on unborn babies. They can go into the womb and save a baby as young as 20 weeks old.

This has allowed researchers to study reactions to pain by these unborn babies. The eye-opening results simply cannot be denied. Much like the original groundbreaking study of newborns,

the research involving unborn babies presented evidence that they feel pain.

When pain medicine was administered during surgery involving unborn children, their blood flow, their heart rate remained normal. But without pain medicine, blood flow and heart rate were affected, as unborn babies endured the pain.

The medical evidence is so compelling it alone should inspire us to act. But we do not have to rely upon a doctor's research. All of my colleagues have surely seen with their own eyes the breathtaking images from ultrasounds. Perhaps it was the picture of a child or a grandchild that showed a face and fingers and toes. Some might have been lucky enough to be in the room for a checkup and actually listened to that heartbeat.

There is no denying that those fingers and toes--that face, that heartbeat--is about a baby, a tiny, little miracle that can feel pain. Pretending there is some magical line that is crossed at the moment of birth that allows a baby to feel pain is literally absurd. There is no such line. There is no difference in the pain a baby begins feeling about halfway through pregnancy and the pain a newborn baby feels.

Just as the medical community now admits it was wrong to assert that newborns feel no pain, we know it is wrong to say unborn children feel no pain. But while medical science has moved forward and taken this step, our laws and our practices still rely on decades-old information and mistaken beliefs.

So it is time for us to acknowledge in law and in practice the realities revealed by these advancements in medical science. We must be willing to change our mindset based upon this evidence, and I would suggest we have an obligation to do so.

Mothers have a right to know that their unborn babies feel pain. Respected doctors are on record saying that abortions in the second and third trimester likely cause unborn babies ``intense pain.'' How can we claim to be compassionate, yet look the other way in denial of this pain? I would suggest we cannot. We can see these precious faces. We can hear their hearts beat.

That is why the legislation I am introducing today is so critically important. The Unborn Child Pain Awareness Act would merely require those who perform abortions 20 weeks into a pregnancy or later to inform the mother that her unborn child feels pain. And the mother may request anesthesia for that child to lessen the pain if she does not choose life.

Women should not be kept in the dark. They have the right to know what their unborn child will feel during an abortion. And those who provide abortions should not dismiss the reality of the anguish. The Unborn Child Pain Awareness Act says: At the very least, let's provide mothers with the complete medical and scientific research we have at our disposal today. Let's simply provide the truth before they make a life-changing decision. We cannot in good conscience know of this medical reality and fail to share it with mothers who are contemplating the most difficult and consequential decision of their entire lives.

Our country is awakening to the reality of the pain felt by unborn children but slowly, just as we were slow to accept that newborn babies, yes, in fact, do feel pain so many years ago. Thankfully, our States are leading the way when Congress has failed to act. Arkansas, Georgia, Louisiana, Minnesota, Oklahoma, and Utah have passed similar legislation. Several other States include information about the pain an unborn child experiences in their counseling materials. In fact, in my home State of Nebraska, we became the first State to ban abortions after 20 weeks on the basis that an unborn child can, in fact, feel pain.

Unborn children cannot tell us what they feel, but medical research cries out on their behalf. They deserve the same human compassion we show newborns, 2-year-olds, and children of every age. They all feel pain.

So I encourage my colleagues to join me in cosponsoring this legislation. Thus far, 18 Senators have signed on, and I hope more will follow. I would suggest that this legislation has little to do with whether you call yourself pro-life or pro-choice. It is about basic human decency and concern for human suffering. I hope my colleagues will review the medical research, look to their conscience, and follow what is right. I hope they join me in cosponsoring this legislation.

Mr. President, I rise on behalf of myself and Senator Boxer to introduce legislation to establish a National Heritage Area in the California Sacramento-San Joaquin Delta. This legislation will create the first Heritage Area in California. I am pleased that I have had the opportunity to work with Senator Boxer, Representatives John Garamendi, George Miller, Mike Thompson, Doris Matsui, Jerry McNerney and the County Supervisors from the five Delta Counties to prepare this legislation and support their efforts to fully partner with the State, the Federal agencies, and other local governments to improve and care for the Delta.

This bill will establish the Sacramento-San Joaquin Delta as a National Heritage Area.

The Delta Protection Commission, created by California law and responsible to the citizens of the Delta and California, will manage the Heritage Area. It will ensure an open and public process, working with all levels of Federal, State, and local government, tribes, local stakeholders, and private property owners as it develops and implements the management plan for the Heritage Area. The goal is to conserve and protect the Delta, its communities, its resources, and its history.

This bill does not create any new layers of government.

It does not infringe on private property rights. Nothing in this bill gives any governmental agency any more regulatory power than it already has.

In short, this bill provides no additional burden on local government or residents. Instead, it authorizes Federal assistance to a local process already required by State law that will elevate the Delta, providing a means to conserve and protect its valued communities, resources, and history.

The Sacramento-San Joaquin Delta is the largest estuary on the West Coast. It is the most extensive inland delta in the world, and a unique national treasure.

Today, it is a labyrinth of sloughs, wetlands, and deepwater channels that connect the waters of the high Sierra mountain streams to the Pacific Ocean through the San Francisco Bay. Its approximately 60 islands are protected by 1,100 miles of levees, and are home to 3,500,000 residents, including 2,500 family farmers. The Delta and its farmers produce some of the highest quality specialty crops in the United States.

The Delta offers recreational opportunities to the two million Californians that visit the Delta each year for boating, fishing, hunting, visiting historic sites, and viewing wildlife. It provides habitat for more than 750 species of plants and wildlife. These include sand hill cranes that migrate to the Delta wetland from places as far away as Siberia. The Delta also provides habitat for 55 species of fish, including Chinook salmon--some as large as 60 pounds- that return each year to travel through the Delta to spawn in the tributaries.

These same waterways also channel fresh water to the Federal and State-owned pumps in the South Delta that provide water to 23 million Californians and three million acres of irrigated agricultural land elsewhere in the State.

Before the Delta was reclaimed for farmland in the 19th Century, the Delta flooded regularly with snow melt each spring, and provided the rich environment that, by 1492, supported the

largest settlement of Native Americans in North America.

The Delta was the gateway to the gold fields in 1849, after which Chinese workers built hundreds of miles of levees throughout the waterways of the Delta to make its rich peat soils available for farming and to control flooding.

Japanese, Italians, German, Portuguese, Dutch, Greeks, South Asians and other immigrants began the farming legacy, and developed technologies specifically adapted to the unique environment, including the Caterpillar Tractor, which later contributed to agriculture and transportation internationally.

Delta communities created a river culture befitting their dependence on water transport, a culture which has attracted the attention of authors from Mark Twain and Jack London to Joan Didion.

The Delta is in crisis due to many factors, including invasive species, urban and agricultural run-off, wastewater discharges, channelization, dredging, water export operations, and other stressors.

Many of the islands of the Delta are between 10 and 20 feet below sea level, and the levee system is presently inadequate to provide reliable flood protection for historic communities, significant habitats, agricultural enterprises, water resources, transportation and other infrastructure.

Existing levees have not been engineered to withstand earthquakes. Should levees fail for any reason, a rush of seawater into the interior of the Delta could damage the already fragile ecosystem, contaminate drinking water for many Californians, flood agricultural land, inundate towns, and damage roads, power lines, and water project infrastructure.

The State of California has been working for decades on a resolution to the water supply and ecosystem crisis in the State, and has a long history of partnerships with Federal agencies, working together to resolve challenges to the Delta's historic communities, ecosystem and the water it supplies so many Californians.

The Delta Protection Commission, established under state law, has been tasked by the California State Legislature with providing a forum for Delta residents to engage in decisions regarding actions to recognize and enhance the unique cultural, recreational, agricultural resources, infrastructure and legacy communities of the Delta and to serve as the facilitating agency for the implementation of a National Heritage Area in the Delta.

This legislation authorizes the creation of the Delta Heritage Area and federal assistance to the Delta Protection Commission in implementing the Area. This legislation is just a small part of the commitment the Federal government must make to the Delta and to California's ecosystem and water supply. I look forward to continuing to work with my colleagues at every level of government to restore and sustain the ecosystem in the Delta, to provide for reliable water supply in the State of California, to recover the native species of the Delta, protect communities in the Delta from flood risk, ensure economic sustainability in the Delta, improve water quality in the Delta, and; sustain the unique cultural, historical, recreational, agricultural and economic values of the Delta.

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