Medicare Long-Term Care Hospital Improvement Act of 2009

Mr. President, the Armed Forces have come a long way in addressing the bureaucratic hurdles that have long plagued wounded service members transitioning out of the Services. However, much more remains to be done to ensure that wounded service members do not go without income, due to injuries sustained in the line of duty. Currently, many are going without compensation of any kind because they are never told about the patchwork of programs designed to care for them as they transition back to civilian life and into the VA. This has been an issue of particular concern for members of the Reserve Components. Therefore, Sen. Murkowski and I are introducing the Wounded Warrior Transition Assistance Act to help ensure that wounded reservists and members of the Guard are informed of the various programs to compensate them for their injuries before they separate

from the military and to guarantee that there is no gap in income as they transition into the VA.

This bill was inspired by a young soldier from Wisconsin who came to me for assistance when he returned from Iraq with serious wounds. He had been separated from the Army without going through the medical discharge process even though he had sustained a serious injury that impaired his ability to work. No one had informed him that he may have been entitled to medical retirement, temporary disability retirement, combat-related special compensation or incapacitation pay due to the extent of his injuries. After his separation, it took several months for the VA to review all of his claims and begin compensating him for his injuries during which time his family struggled to get by. Now, nearly a year since he first contacted me, the Army has recognized its mistake and plans to evaluate him for medical retirement or placement on the temporary disability retirement list.

Unfortunately, this is a systemic issue. The Wisconsin National Guard has estimated that, in Wisconsin alone, there have been a dozen cases of wounded service members who were eligible for military compensation for their injuries who never received it and were instead sent home with nothing only to have to wait for the VA to process their claims. This has compromised their ability to focus on their recovery.

Members of my staff have been told by several officials within the Defense Department that they continue to see members of the Reserve Components given disparate and unequal treatment with regard to the medical discharge process. This legislation is urgently needed to ensure that wounded service members receive counseling about these issues before discharge so that they can make an educated decision about their treatment. Congress must act to convey the importance of this issue and to set a floor for how the Department will handle wounded members of the Reserve Components.

This bill would prohibit the discharge of wounded members of the Reserve Components until they have been evaluated for their eligibility for the various programs to assist wounded service members. The service member may elect to separate from the Armed Services after consulting with a JAG attorney. For those undergoing evaluation, the bill would ensure that they are returned to their home, if medically feasible, during the process. The Services currently have community-based wounded transition units established for this purpose.

If someone was prematurely discharged and cannot work due to his or her injury, the bill would require the relevant Service to return him or her to active duty, if the service member chooses to do so. It would also ensure that the Reserve Components have access to Defense Health Program funds. These measures will help ensure that future service members will not face the gap in income that created such a hardship for my constituent and his family. It is the least we can do.

In addition, this bill would ensure that wounded service members have trained advocates to help them navigate the entire medical discharge process. The fiscal year 2008 National Defense Authorization Act required the Defense Department to, among other things, provide service members with legal counsel during the physical disability evaluation process. In September 2008, the Government Accountability Office, GAO, found that only 5 of 35 Army treatment facilities had legal personnel dedicated to providing assistance during the disability evaluations process.

In addition, GAO has reported that there are still insufficient JAG attorneys to provide comprehensive legal support early in the evaluation process. According to Army staff, if attorneys counseled service members earlier in the discharge process, starting with the medical evaluation board process, service members could have a better understanding of what steps to take to ensure that they receive any compensation to which they may be entitled. Early outreach could also help to make the disability evaluation process proceed faster and more efficiently. This bill would require the Armed Services to hire sufficient personnel to provide comprehensive legal support early in the evaluation process.

At the same time, we should do everything possible to take advantage of veteran service officers who offer this counseling free of charge and at no cost to the federal government. Federal law requires commanders to make space available on base for chartered veteran service organizations that provide counseling to wounded service members. Therefore, I was extremely troubled to learn last year that several veteran service organizations that provide assistance to wounded service members, free of charge, including the Disabled American Veterans, the Veterans of Foreign Wars, the Paralyzed Veterans of America and the National Veterans Legal Services Project, were all having trouble accessing U.S. bases for the purpose of providing counseling to wounded service members.

This bill would reiterate that the Armed Services are required by law to provide the space needed for wounded service members to receive counseling from trained advocates, especially during this time of war when so many are returning with serious wounds. Furthermore, it requires the Services to broadly disseminate information on the existence of the Wounded Warrior Resource Center, which, among other things, provides legal referrals.

This bill should not be costly. The Army has requested about 20 additional attorneys. The vast majority of the wounded service members will be medically discharged with retirement pay or other compensation and will not be in need of the assistance provided by this bill. Furthermore, the requirement that the Services retain wounded service members until they have been evaluated will sunset after five years, at which time it is my hope that the rate of deployments and subsequent injuries will be vastly lower.

Nonetheless, I have provided an ample offset to cover the costs of the bill. According to the Office of Management and Budget, the Defense Department recovered over $600 million in overpayments to contractors over the last 4 years. The Department identified but did not recover an additional $273 million. The funds needed to provide for these wounded service members during the evaluation process would come from the recoupment of these overpayments.

The National Guard Bureau has informed me that this legislation would go a long way to closing one of the remaining gaps in care for those transitioning from the Armed Forces to the VA. I am pleased that the legislation has been endorsed by the Disabled American Veterans, the Iraq and Afghanistan Veterans of America, Military Officers Association of America, the National Guard Association of the U.S. and the enlisted National Guard Association of the U.S.

Mr. President, I wish today to honor the extraordinary life of Robert M. La Follette Sr. This weekend, people around my home State of Wisconsin, the U.S. and the world will celebrate the 100th anniversary of the Progressive Magazine, which was founded by Bob La Follette and his wife Belle Case La Follette. The Progressive has been a powerful force for change and a leading advocate for civil rights, civil liberties, women's rights, clean Government, and many other priorities since its inception 100 years ago.

Throughout his life, La Follette was known for his diligent service to the people of Wisconsin and to the people of the U.S. His dogged, full-steam-ahead approach to his life's work earned him the nickname ``Fighting Bob.''

Robert Marion La Follette, Sr., was born on June 14, 1855, in Primrose, a small town southwest of Madison in Dane County. He graduated from the University of Wisconsin Law School in 1879 and, after being admitted to the State bar, began his long career in public service as Dane County district attorney.

La Follette was elected to the U.S. House of Representatives in 1884, and he served three terms as a member of that body, where he was a member of the Ways and Means Committee.

After losing his campaign for reelection in 1890, La Follette returned to Wisconsin and continued to serve the people of my State as a judge. Upon his exit from Washington DC, a reporter wrote, La Follette ``is popular at home, popular with his colleagues, and popular in the House. He is so good a fellow that even his enemies like him.''

He was elected the 20th Governor of Wisconsin in 1900. He served in that office until 1906, when he stepped down in order to serve the people of Wisconsin in the U.S. Senate, where he remained until his death in 1925.

A founder of the national progressive movement, La Follette championed progressive causes as governor of Wisconsin and in the U.S. Congress. As governor, he advanced an agenda that included the country's first workers compensation system, direct election of U.S. Senators, and railroad rate and tax reforms. Collectively, these reforms would become known as the ``Wisconsin Idea.'' As governor, La Follette also supported cooperation between the State and the University of Wisconsin.

His terms in the House of Representatives and the Senate were spent fighting for women's rights, working to limit the power of monopolies, and opposing pork barrel legislation. La Follette also advocated electoral reforms, and he brought his support for the direct election of U.S. Senators to this body. His efforts were brought to fruition with the ratification of the Seventeenth Amendment in 1913. Fighting Bob also worked tirelessly to hold the Government accountable, and was a key figure in exposing the Teapot Dome Scandal.

La Follette earned the respect of such notable Americans as Frederick Douglass, Booker T. Washington and Harriet Tubman Upton for making civil rights one of his trademark issues. At a speech before the 1886 graduating class of Howard University, La Follette said, ``We are one people, one by truth, one almost by blood. Our lives run side by side, our ashes rest in the same soil. [Seize] the waiting world of opportunity. Separatism is snobbish stupidity, it is supreme folly, to talk of non-contact, or exclusion!''

La Follette ran for President three times, twice as a Republican and once on the Progressive ticket. In 1924, as the Progressive candidate for president, La Follette garnered approximately 17 percent of the popular vote and carried the State of Wisconsin.

La Follette's years of public service were not without controversy. In 1917, he filibustered a bill to allow the arming of U.S. merchant ships in response to a series of German submarine attacks. His filibuster was successful in blocking passage of this bill in the closing hours of the 64th Congress. Soon after, La Follette was one of only 6 Senators who voted against U.S. entry into World War I.

Fighting Bob was outspoken in his belief that the right to free speech did not end when war began. In the fall of 1917, La Follette gave a speech about the war in Minnesota, and he was misquoted in press reports as saying that he supported the sinking of the Lusitania. The Wisconsin State Legislature condemned his supposed statement as treason, and some of La Follette's Senate colleagues introduced a resolution to expel him. In response to this action, he delivered his seminal floor address, ``Free Speech in Wartime,'' on October 6, 1917. If you listen closely, you can almost hear his strong voice echoing through this chamber as he said: ``Mr. President, our government, above all others, is founded on the right of the people freely to discuss all matters pertaining to their government, in war not less than in peace, for in this government, the people are the rulers in war no less than in peace.''

Of the expulsion petition filed against him, La Follette said:

I am aware, Mr. President, that in pursuance of this

general campaign of vilification and attempted intimidation,

requests from various individuals and certain organizations

have been submitted to the Senate for my expulsion from this

body, and that such requests have been referred to and

considered by one of the Committees of the Senate.

If I alone had been made the victim of these attacks, I

should not take one moment of the Senate's time for their

consideration, and I believe that other Senators who have

been unjustly and unfairly assailed, as I have been, hold the

same attitude upon this that I do. Neither the clamor of the

mob nor the voice of power will ever turn me by the breadth

of a hair from the course I mark out for myself, guided by

such knowledge as I can obtain and controlled and directed by

a solemn conviction of right and duty.

This powerful speech led to a Senate investigation of whether La Follette's conduct constituted treason. In 1919, following the end of World War I, the Senate dropped its investigation and reimbursed La Follette for the legal fees he incurred as a result of the expulsion petition and corresponding investigation. This incident is indicative of Fighting Bob's commitment to his ideals and of his tenacious spirit.

La Follette died on June 18, 1925, in Washington, DC, while serving Wisconsin in this body. His daughter noted, ``His passing was mysteriously peaceful for one who had stood so long on the battle line.'' Mourners visited the Wisconsin Capitol to view his body, and paid respects in a crowd nearing 50,000 people. La Follette's son, Robert M. La Follette, Jr., was elected to serve in the U.S. Senate after his father's death and served in this body for more than 20 years, following the progressive path blazed by his father.

La Follette has been honored a number of times for his unwavering commitment to his ideals and for his service to the people of Wisconsin and of the United States.

During the 109th Congress, I was proud to support Senate passage of a bill introduced in the House of Representatives by Congresswoman Tammy Baldwin that named the post office at 215 Martin Luther King, Jr., Boulevard in Madison in La Follette's honor. I commend Congresswomen Baldwin for her efforts to pass that bill and I am pleased she is introducing House companion measures of the legislation I am introducing today in the Senate.

The Library of Congress recognized La Follette in 1985 by naming the Congressional Research Service reading room in the Madison Building in honor of both Fighting Bob and his son, Robert M. La Follette, Jr., for their shared commitment to the development of a legislative research service to support the U.S. Congress. In his autobiography, Fighting Bob noted that, as governor of Wisconsin, he ``made it a . . . policy to bring all the reserves of knowledge and inspiration of the university more fully to the service of the people. . . . Many of the university staff are now in state service, and a bureau of investigation and research established as a legislative reference library . . . has proved of the greatest assistance to the legislature in furnishing the latest and best thought of the advanced students of government in this and other countries.'' He went on to call this service ``a model which the federal government and ultimately every state in the union will follow.'' Thus, the legislative reference service that La Follette created in Madison served as the basis for his work to create the Congressional Research Service at the Library of Congress.

The La Follette Reading Room was dedicated on March 5, 1985, the 100th anniversary of Fighting Bob being sworn in for his first term as a Member of Congress.

Across the magnificent Capitol in National Statuary Hall, Fighting Bob is forever immortalized in white marble, still proudly representing the state of Wisconsin. His statue resides in the Old House Chamber, now known as National Statuary Hall, among those of other notable figures who have made their marks in American history. One of the few seated statues is that of Fighting Bob. Though he is sitting, he is shown with one foot forward, and one hand on the arm of his chair, as if he is about to leap to his feet and begin a robust speech.

When then-Senator John F. Kennedy's 5-member Special Committee on the Senate Reception Room chose La Follette as one of the ``Five Outstanding Senators'' whose portraits would hang outside of this chamber in the Senate reception room, he was described as being a ``ceaseless battler for the underprivileged'' and a ``courageous independent.'' Today, his painting still hangs just outside this chamber, where it bears witness to the proceedings of this body--and, perhaps, challenges his successors here to continue fighting for the social and government reforms he championed.

To honor Robert M. La Follette, Sr., during the week of the anniversary of

the Progressive Magazine, today I am introducing two pieces of legislation. I am pleased to be joined in this effort by the senior Senator from Wisconsin, Senator Kohl and the senior Senator from Massachusetts, Senator Kennedy.

I am introducing a bill that would direct the Secretary of the Treasury to mint coins to commemorate Fighting Bob's life and legacy. The second bill that I am introducing today would authorize the President to posthumously award a gold medal on behalf of Congress to Robert M. La Follette, Sr. The minting of a commemorative coin and the awarding of the Congressional Gold Medal would be fitting tributes to the memory of Robert M. La Follette, Sr., and to his deeply held beliefs and long record of service to his State and to his country. I hope that my colleagues will support these proposals.

Let us never forget Robert M. La Follette, Sr.'s character, his integrity, his deep commitment to Progressive causes, and his unwillingness to waver from doing what he thought was right. The Senate has known no greater champion of the common man and woman, no greater enemy of corruption and cronyism, than ``Fighting Bob'' La Follette, and it is an honor to speak in the same chamber, and serve the same great State, as he did.

Mr. President, I rise today to introduce a resolution that in many ways is long overdue, a resolution to officially apologize for the past ill-conceived policies by the US Government toward the Native Peoples of this land and re-affirm our commitment toward healing our nation's wounds and working toward establishing better relationships rooted in reconciliation.

Apologies are often-times difficult, but like treaties, go beyond mere words and usher in a true spirit of reconciling past difficulties and help to pave the way toward a united future. Perhaps Dr. King said it best when he stated, ``The end is reconciliation, the end is redemption, the end is the creation of the beloved community.'' This is our goal, with this resolution today.

Native Americans have a vast and proud legacy on this continent. Long before 1776 and the establishment of the United States of America, Native peoples inhabited this land and maintained a powerful physical and spiritual connection to it. In service to the Creator, Native peoples sowed the land, journeyed it, and protected it. The people from my State of Kansas have a similar strong attachment to the land.

Like many in my State, I was raised on the land. I grew up farming and caring for the land. I and many in my State established a connection to this land as well. We care for our Nation and the land of our forefathers so greatly that we too are willing to serve and protect it, as faithful stewards of the creation with which God has blessed us. I believe without a doubt citizens across this great Nation share this sentiment and know its unifying power. Americans have stood side by side for centuries to defend this land we love.

Both the Founding Fathers of the United States, it and the indigenous tribes that lived here were attached to this land. Both sought to steward and protect it. There were several instances of collegiality and cooperation between our forbears--for example, in Jamestown, VA, Plymouth, MA, and in aid to explorers Lewis and Clark. Yet, sadly, since the formation of the American Republic, numerous conflicts have ensued between our Government, the Federal Government, and many of these tribes, conflicts in which warriors on all sides fought courageously and which all sides suffered. Even from the earliest days of our Republic there existed a sentiment that honorable dealings and a peaceful coexistence were clearly preferable to bloodshed. Indeed, our predecessors in Congress in 1787 stated in the Northwest Ordinance:

``The utmost good faith shall always be observed toward the Indians.''

Many treaties were made between the U.S. Government and Native peoples, but treaties are far more than just words on a page. Treaties represent our word, and they represent our bond. Treaties with other governments are not to be regarded lightly. Unfortunately, again, too often the United States did not uphold its responsibilities as stated in its covenants with Native tribes.

I have read all of the treaties in my State between the tribes and the Federal Government that apply to Kansas. They generally came in tranches of three. First, there would be a big land grant to the tribe. Then there would be a much smaller one associated with some equipment and livestock, and then a much smaller one after that.

Too often, our Government broke its solemn oath to Native Americans. For too long, relations between the U.S. and Native people of this land have been in disrepair. For too much of our history, Federal tribal relations have been marked by broken treaties, mistreatment, and dishonorable dealings.

I believe it is time to work to restore these relationships to good health. While the record of the past cannot be and should not be erased, I am confident the United States can acknowledge its past failures, express sincere regrets, and work toward establishing a brighter future for all Americans. It is in this spirit of hope for our land that I and my Senate colleagues, Senators Inouye, Baucus, Boxer, Crapo, Cantwell, Coburn, Harkin, Lieberman, and Tester, are offering this Senate Joint Resolution, the Native American Apology Resolution. I am also pleased to be in partnership with Representative Dan Boren who is offering the companion Joint Resolution in the House of Representatives today as well.

This resolution will extend a formal apology from the U.S. to tribal governments and Native peoples nationwide--something we have never done; something we should have done years and years ago.

I am proud that this Joint Resolution, which I have introduced since the 107th Congress, has passed the Indian Affairs Committee unanimously in the 108th, 109th and 110th Congresses and passed the Senate in the 110th Congress.

Additionally, I want my fellow Senators to note this resolution does not--does not--dismiss the valiance of our American soldiers who fought bravely for their families in wars between the United States and a number of the Indian tribes, nor does this resolution cast all the blame for the various battles on one side or another.

Further, this resolution will not resolve the many challenges still facing Native Americans, nor will it authorize, support or settle any claims against the United States. It doesn't have anything to do with any property claims against the United States. That is specifically set aside and not in this bill. What this resolution does do is recognize and honor the importance of Native Americans to this land and to the U.S. in the past and today and offers an official apology for the poor and painful path the U.S. Government sometimes made in relation to our Native brothers and sisters by disregarding our solemn word to Native peoples. It recognizes the negative impact of numerous destructive Federal acts and policies on Native Americans and their culture, and it begins--begins--the effort of reconciliation.

President Ronald Reagan spoke of the importance of reconciliation many times throughout his Presidency. In a 1984 speech to mark the 40th anniversary of the day when the Allied armies joined in battle to free the European Continent from the grip of the Axis powers, Reagan implored the United States and Europe to ``prepare to reach out in the spirit of reconciliation.''

This resolution is not a panacea of course, but perhaps it signals the beginning of the end of division and a faint first light and first fruits of reconciliation and the creation of beloved community Dr. King so eloquently described.

This is a resolution of apology and a resolution of reconciliation. It is a step toward healing the wounds that have divided our country for so long--a potential foundation for a new era of positive relations between tribal governments and the Federal Government.

It is time, as I have stated, for us to heal our land of division, all divisions, and bring us together. I hope a number

of my colleagues in the Senate will join me and support this resolution and begin a much needed healing process in this Nation.

Mr. President, I ask that the text of the joint resolution be printed in the Record.

Mr. President, today, I am reintroducing the Government Charge Card Abuse Prevention Act to ensure that federal departments and agencies do not take the eye off the ball when it comes to spending the taxpayers' money. I have put in a lot of time and effort to call attention to instances of waste, fraud, and abuse using government charge cards while agencies were looking the other way. Now I want to make sure that they stay on top of this issue.

In 1998, the General Service Administration's, GSA, entered into a contract with a set of commercial banks to utilize charge cards, not unlike those used by businesses large and small and millions of consumers worldwide. This is called the SmartPay' program. These Government charge cards include government purchase cards, which are used for acquisition of commercial goods and services by agencies and paid directly by the agency, and Government travel cards, which are used to pay for individual Government travel expenses and issued in the name of individual government employees.

Government charge cards were intended as a low cost method to streamline government acquisition and travel processes. The whole idea was to adopt the best practices of the commercial sector. In the business sector, charge cards have been a success. They save time and money. The main reason they work so well is because the control environment in the private sector is rock solid and accountability is a fact of life. When a business is spending its own money, it is going to be sure that it accounts for every penny or it would not stay in business. As a result, in corporate America, if an employee is caught abusing a card, they'll lose it or get fired.

This was not the case when the Federal Government began using charge cards. Federal agencies did not put in place the necessary controls to make sure that all spending on charge cards was legitimate. When I started looking into this with the Government Accountability Office, GAO, we uncovered blatant examples of wasteful spending like LA-Z-Boy reclining rocking chairs, kitchen appliances, and even a sapphire ring being paid for with Government purchase cards, with the American taxpayer paying the bill.

Government travel cards have been used for gambling, sporting events, concerts, cruises, and even gentlemen's clubs and legalized brothels! While travel cards are not paid directly with taxpayers' money like purchase cards, 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.

A series of GAO reports over the last decade have identified an inadequate and inconsistent control environment across numerous federal agencies with respect to both government purchase cards and Government travel cards. This has led to millions of dollars in taxpayers' money wasted. In some cases purchases were outright fraudulent, and others were of questionable need or were unnecessarily expensive. 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. In many cases, the same controls were often missing or inadequate, and therefore the same recommendations are repeated in report after report. One agency would promise to clean up its act, but then we would find the exact same problems with another. That is why I worked to develop legislation that would incorporate GAO's recommendations regarding some of the most basic controls needed in every agency to prevent abuse of government charge cards.

As a result of the pressure applied by the relentless oversight of Congress, the GAO, and agency Inspectors General, we have seen some progress toward establishing a better control environment. In fact, the Office of Management and Budget has issued a circular to agencies that seeks to bring about many of the controls we identified. However, this progress would not have been possible without the continual spotlight being shone on the problem and the threat of congressional action. It is also clear that we still have a way to go in stamping out abuse of government charge cards as evidenced by a GAO report on the internal controls for purchase cards governmentwide that came out just last year.

That report found that a weak control environment led to government purchase cards being used for items like iPods at NASA, internet dating and pornographic sites at the Postal Service, women's lingerie from a place called ``Seduction Boutique'' at the State Department that was supposedly for use during jungle training'', and over $642,000 over six years in fraudulent payments at the USDA for the cardholder's live-in boyfriend. These funds went for personal expenditures like gambling, car loan and mortgage payments, and other retail purchases. Clearly we still have a problem and that's why I'm determined to make sure this situation is fixed once and for all.

In addition to requiring federal agencies to establish a series of basic and vital internal controls that the GAO has found lacking in many cases, 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.

My bill also requires agencies to establish penalties so that employees who abuse government charge cards will face real and consistent consequences. This is necessary not only so that taxpayers know that those who would squander their money are held accountable, but also to send a message to other government employees that such behavior will not be tolerated. In fact, these penalties must include dismissal in serious circumstances.

This legislation has been revised a number of times with considerable input from the GAO as well as the Inspector General community and other stakeholders. I am also glad to have Chairman Lieberman and Ranking Member Collins as original cosponsors of this bill. Their help, assistance, and support has been very much appreciated as this legislation has developed. The result is a carefully considered and targeted piece of legislation that I look forward to seeing become law. I know that will give me and a great many American taxpayers more peace of mind about how their money is being spent.

Mr. President, I rise today with my good friend Senator Ensign to introduce the Southern Nevada Higher Education Land Act of 2009. This bill will expand opportunities for higher education in one of the nation's fastest growing areas, southern Nevada.

In July 1862, President Abraham Lincoln signed the Land Grant College Act into law, creating a higher education legacy that continues to benefit our country today. That bill, now referred to as the Morrill Act, provided 30,000 acres of Federal land per Member of Congress to establish institutions of higher education in each State. Today, thanks in large part to the foresight of Senator Justin Smith Morrill from Vermont and others from his time, this Nation has one of the finest public university systems in the world.

Among the many universities established as a result of this forward- looking legislation was the University of Nevada. The State's first university was originally founded in Elko in 1874. Two years later, Nevada's state legislature voted to move the university to its current home in Reno. The University of Nevada remained the State's only higher education institution for 75 years.

From these humble beginnings, the State of Nevada has expanded its higher education system to now include two research universities, one State college, one research institution, and four community colleges. The Nevada System of Higher Education, which was formed in 1968 and encompasses all eight institutions, has grown to serve roughly 98,000 degree-seeking students.

As the State of Nevada continues to grow, so too must its university system. With over 2 million residents in 2007, greater Las Vegas is the fourth-largest metropolitan area in the Mountain West. In this decade alone, the area's population has grown by 31 percent, five times faster than the Nation as a whole. We must expand higher education opportunities to meet the demands of this growing region.

Consider the following--bthe University of Nevada, Las Vegas, with 28,000 students and 3,300 faculty and staff, is the fourth fastest- growing research university in the Nation. The College of Southern Nevada, also in Las Vegas, serves 41,000 students and its three urban campuses are at near capacity. The town of Pahrump, 60 miles from Las Vegas in rural Nye County, has grown by 20 percent since 2000. Great Basin College's small branch campus in Pahrump uses high school classrooms at night to serve the city's 41,000 residents.

Our legislation will make selected parcels of Federal lands available for the future growth of the university system. Land will be provided for new campuses for the University of Nevada, Las Vegas; the College of Southern Nevada; and a Pahrump campus of Great Basin College. The current campuses for these three institutions comprise 1,150 acres in southern Nevada. With the passage of this legislation, an additional 2,400 acres will be available for new classroom, research, and residential facilities to help further the missions of these three fine institutions.

To establish these new campuses, three parcels of land would be conveyed from the Bureau of Land Management, BLM, to the Nevada System of Higher Education. Two of the parcels are located in Clark County, within the Southern Nevada Public Land Management Act, SNPLMA, disposal boundary. The third parcel is located in Pahrump, west of Las Vegas, in Nye County. BLM has designated all of these parcels for disposal because they are surrounded by development and are difficult to manage.

It is important to point out that the land our legislation conveys for the University of Nevada, Las Vegas borders Nellis Air Force Base. Nellis was once on the outskirts of town, but now development is on its doorstep. In order to protect the mission of the Nellis Air Force base, we have put a special provision in the legislation requiring that the university system and Air Force sign a binding agreement regarding development plans for the campus. The university system and the Air Force worked together on this issue for the last 3 years and have found a middle ground that will serve the interests of both parties. We greatly appreciate the efforts of the university system and the Air Force to make this work.

This same land bordering Nellis was once used as a small arms range during World War II and will need to be cleaned up before it can be conveyed to the university system. Because it will take time to accomplish this, our legislation allows the land to be conveyed in phases, as the remediation is completed.

This proposal to expand higher education opportunities in southern Nevada has been welcomed by area leaders. City and county officials have worked closely with the Nevada System of Higher Education to plan the development of world-class facilities in their communities. These facilities are critical to meeting the challenge of diversifying their economies and attracting and growing knowledge industries in the area.

I also want to note that a long-time champion of this legislation, and especially the Pahrump campus, passed away recently. Bob Swadell lived a life of service. He saw action in Korea where he earned a Bronze Star and later worked for the Central Intelligence Agency. More recently, Mr. Swadell devoted a great deal of his time to looking out for the future of

Pahrump. I regret that he will not be with us to see this legislation move forward, but we will certainly keep his vision and spirit with us as we work on this important bill.

Just as the Morrill Act opened up Federal land to expand higher education across the Nation, I am hopeful that this important, though much more modest effort can do the same for the residents of southern Nevada. We look forward to working with Chairman Bingaman, Ranking Member Murkowski and the other distinguished Members of the Energy and Natural Resources Committee to move this legislation in an expeditious manner.

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

Mr. President, I am pleased to join my friend, Senator Kent Conrad, and others in introducing the Medicare Long-Term Care Hospital Improvement Act of 2009. This legislation would help ensure that Medicare beneficiaries continue to have access to long-term, acute-care,

LTAC, hospitals. These hospitals provide inpatient care to Medicare beneficiaries who spend at least 25 days in the hospital. Typically, the average patient stay in an acute care hospital is only six days. We have several LTAC hospitals and facilities in Salt Lake, Provo, and Bountiful, UT.

Our bill would extend for two more years the LTAC hospital moratorium included in the Medicare, Medicaid, and SCHIP Extension Act of 2007, MMSEA, P.L. 110-173. While MMSEA's LTAC hospital provisions helped the LTAC hospitals, they also addressed important issues raised by the Centers for Medicare and Medicaid Services, CMS, regarding these hospitals. Under MMSEA, new LTAC hospitals would not be allowed to open until the three year moratorium ends in 2010--the intent was to give CMS time to develop new federal standards on LTAC patient criteria. The bill that we are introducing today would extend the MMSEA moratorium for another 2 years.

To my friends in the hospital community and to those responsible for issuing federal regulations impacting the hospital community, I urge you to work together to address some of the valid concerns that have been raised with regard to LTAC hospitals. But I want these concerns addressed fairly so that beneficiaries will continue to have access to quality care and choice of long-term care coverage.

I also believe that while most LTAC hospitals provide good care in many parts of the country, the industry must do a better job convincing Congress and Federal agencies that the type of care you provide is valuable and necessary. Only truly sick patients should go to LTAC hospitals. Less medically-complex patients should be seen at less intensive facilities.

It is my hope that Federal officials making important decisions regarding LTACs get the job done. Five years ago, LTAC hospitals were told that they needed new standards and yet, we have made limited progress in this area. You need to finish this important job once and for all! It needs to be done in partnership with the LTAC community. Hopefully, the introduction of this bill will get the ball rolling in this area.

Finally, President Obama's budget guidelines for fiscal year 2010 has a bundling proposal that would include the payment of post-acute care with the hospital payment system. The Senate Finance Committee is considering a similar proposal. Therefore, I do not want to leave the impression with anyone that the introduction of this legislation is meant to delay such a proposal from moving forward. However, I do believe that should bundling be seriously considered by Congress, all stakeholders should be included in those discussions, including the LTACH hospitals.

I look forward to working with my Senate colleagues on this important bill.