A bill to repeal the excise tax on medical device manufacturers.

Mr. President, fighting fires is very serious business in my home State of Colorado. Just a few months ago, we experienced the most expensive fire in our history--the Fourmile Fire, near Boulder. This fire destroyed more than 150 homes and burned over 6,000 acres.

We could not have stopped this fire without the dedicated efforts of hundreds of public servants, including volunteer firefighters from local fire districts. These individuals saved lives and property, often risking their own lives. That is, in part, why I believe we should do everything we can to help these fire districts and the volunteers who serve them.

One fire district involved in the Fourmile Fire--the Sugar Loaf Fire District--lost 17 homes in the fire. The Sugar Loaf Fire District is critical to protecting thousands of Coloradans, but instead of being able to focus on fighting fires this District has been wrapped up trying to resolve a land issue with the Forest Service for many years now. It is a very simple land exchange to make sure that the Fire District owns the land under two of its three fire stations.

The Fire District has occupied and operated the fire stations on these properties for nearly 40 years. If they can secure ownership, the lands will continue to be used as sites for fire stations and training. The Fire District is willing to trade the property it owns, an undeveloped inholding in Forest Service land, for the property under the stations. This is a simple and fair exchange that will serve the public good and help protect the local area from growing wildfire threats.

The Fire District has made a strong, persistent, and good faith effort to acquire the land under the stations through administrative means by working with the Forest Service. Furthermore, the Fire District has demonstrated its sincere commitment to this project by expending its monetary resources and the time of its staff to satisfy the requirements set forth by the Forest Service.

However, those efforts have not succeeded and it has become evident that legislation is required to resolve the situation.

To help facilitate this land exchange, I am introducing the Sugar Loaf Fire Station Land Exchange Act of 2011 today. This language is the same as what passed the Senate Energy and Natural Resources Committee in the last Congress.

Under the bill, the land exchange will proceed if the Fire District offers to convey acceptable title to a specified parcel of land amounting to about 5.17 acres. This land resides between the communities of Boulder and Nederland in an unincorporated part of Boulder County within the boundaries of the Arapaho-Roosevelt National Forest. In return, the land--about 5.08 acres--where the two fire stations are located will be transferred to the Fire District.

The lands transferred to the Federal Government will become part of the Arapaho-Roosevelt National Forest and managed accordingly.

This is a relatively minor bill but one that is important to the Sugar Loaf Fire District and the people it serves. As public lands bills pile up in Congress because of ideological obstruction, this fire district is being forced into wasting time and money trying to resolve an otherwise commonsense and technical public lands fix. I think this bill deserves enactment without unnecessary delay.

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

Mr. President, today I am introducing the Camp Hale Study Act of 2011, which would direct the Secretary of the Interior to study the feasibility and suitability of establishing Camp Hale, near Leadville, CO, as a national historic district. Camp Hale is an important part of our Nation's proud national defense legacy, and it deserves to be recognized and protected.

This bill concerns an important military legacy from the World War II and Cold War eras. Camp Hale, located in the mountains of central Colorado, was a training facility for combat in high alpine and mountainous conditions. Principally, it was a training venue for the Army's 10th Mountain Division and other elements of the U.S. Armed Forces. The geography of the area was ideal for winter and high- altitude training, with steep mountains surrounding a level valley suitable for housing and other facilities. The facility itself was located in Eagle County along the Eagle River, and its training boundary included lands in Eagle, Summit, Lake, and Pitkin Counties.

In addition to the 10th Mountain Division, the 38th Regimental Combat Team, 99th Infantry Battalion, and soldiers from Fort Carson were trained at Camp Hale from 1942 to 1965. Throughout this time, the Army tested a variety of weapons and equipment at Camp Hale.

Between 1956 and 1965, the camp was also used by the Central Intelligence Agency as a secret center for training Tibetan refugees in guerilla warfare to resist the Chinese occupation of their mountainous country. Just last year, at my urging, the Forest Service put in place a plaque honoring these Tibetan Freedom Fighters. I joined many of those brave Tibetans, their CIA trainers, and their families in a moving ceremony to honor those who trained at Camp Hale.

In July 1965, Camp Hale was deactivated, and in 1966, control of the lands was returned to the Forest Service. Today the site is part of the White River and San Isabel National Forests. The U.S. Army Corps of Engineers is working to clean up potentially hazardous munitions left over from weapons testing at the site, particularly in the East Fork.

Camp Hale was placed on the National Register of Historic Places in 1992, but this bill would direct the Secretary of the Interior to complete a special resource study of Camp Hale to determine the suitability and feasibility of designating Camp Hale as a separate unit of the National Park System. That would include an analysis of the significance of Camp Hale in relation to the defense of our Nation during World War II and the Cold War, including the use of Camp Hale for training of the 10th Mountain Division and for training by the Central Intelligence Agency of Tibetan refugees seeking to resist the Chinese occupation of Tibet.

I have worked with Representative Lamborn on this bill since he first introduced it in the House in the 110th Congress, when I proudly cosponsored it. I introduced this bill in the Senate in the last Congress and shepherded it through the Senate Energy and Natural Resources Committee. However, because of opposition from a few Senators to all public lands bills, we could not pass this bipartisan bill on the Senate floor.

Camp Hale should be recognized for the role it played in our country's national security. The people who trained there are proud of their accomplishments, and I am proud to join Representative Lamborn in supporting this legislation. I am confident that we will have more success in passing this legislation in this Congress.

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

Mr. President, I rise today to introduce the No Child Left Behind Flexibility and Improvements Act. I am pleased to be joined in this effort by my colleague from Maine, Senator Snowe. Our legislation would give greater local control and flexibility to Maine and other states in their efforts to implement the No Child Left Behind Act, NCLB. It provides common sense reforms in the statute while retaining elements to help ensure transparency and accountability.

Since the enactment of NCLB 9 years ago, I have had the opportunity to meet with numerous Maine educators to discuss their concerns with the law. In response to their concerns, Senator Snowe and I commissioned the Maine NCLB Task Force to examine the implementation issues facing Maine under both NCLB and the Maine Learning Results. Our task force included members from every county in our State, and had superintendents, teachers, principals, school board members, parents, business leaders, former State legislators, special education specialists, assessment experts, officials from the Maine Department of Education, and was chaired by a former Maine commissioner of education and a dean from the University of Maine's College of Education and Human Development. In other words, it was a broad-based commission that brought a great deal of expertise, experience, and perspective to the task force's work.

After a year of study, the task force presented us with its final report outlining recommendations for possible statutory and regulatory changes to the act. The task force recommendations highlighted the need for greater flexibility for the Maine Department of Education and local schools in order to address various implementation concerns facing Maine. The legislation we are introducing today would make significant statutory changes designed to provide greater local control to Maine and greater flexibility to all States in their implementation efforts, not just Maine.

First, our legislation would provide greater flexibility to states in the ways that they measure student progress in meeting state education standards. Current NCLB law has proven to be too restrictive. Our legislation would permit states to use additional models to more accurately track the progress of all students over time. Specifically, it would allow States to use a cohort growth model, which tracks the progress of the same group of students over time. It would also permit the use of an ``indexing'' model, where progress is measured based on the number of students whose scores improve from, for example, a ``below-basic'' to a ``basic'' level, and not simply on the number of students who cross the ``proficient'' line. Even if a school is unable to meet the trajectory targets set by the NCLB time-line, a school would not be identified as failing to make AYP provided it demonstrates improved student achievement according to these additional models. We would also require the Secretary to provide examples of these models to give practical assistance to States in the design of these systems. While the trajectory goals set in the statute are certainly valuable, our legislation seeks to clarify that States should be granted greater flexibility in the design of different accountability systems provided that they are consistent with the principle of improved student performance.

Second, our legislation would provide schools with better notice regarding possible performance issues, allowing schools a chance to identify and work with a particular group of students before being identified. It would expand the existing ``safe-harbor'' provisions to allow more schools to qualify for this important protection. The changes made in our bill are in keeping with what assessment experts and teachers know--that significant gains in academic achievement tend to occur gradually and over time. In addition, the legislation addresses my concern about the statute's current requirement that all schools reach 100 percent proficiency by 2013-2014 by requiring the Secretary of Education to review progress by the States toward meeting this goal every three years, and allowing him to modify the time-line as necessary.

Furthermore, the Task Force report raised important concerns that in some schools, special education students fear that they are being blamed for their school not making adequate yearly progress. Our legislation would allow the members of a special education student's Individual Education Plan, IEP, team to determine the best assessment for that individual student, and would permit the student's performance on that assessment to count for all NCLB purposes. This legislative change is also based on principles of fairness and common sense. Many times, it simply does not make sense to require a special needs student to take a grade-level assessment that educators and parents know he or she is not ready to take. Many special education students are referred for special education services precisely because they cannot meet grade-level expectations. Allowing the IEP team to determine the best test for each special needs student will bring an important improvement to the act while still ensuring accountability.

Finally, our legislation would provide new flexibility for teachers of multiple subjects at the secondary school level to help them meet the ``highly qualified teacher'' requirements. Unfortunately, the current regulations place undue burdens on teachers at small and rural schools who often teach multiple subjects due to staffing needs, and on special education teachers who work with students on a variety of subjects throughout the day. Under the bill, provided these teachers are highly qualified for one subject they teach, they will be provided additional time and less burdensome avenues to satisfy the remaining requirements.

While it has been some time since Maine's Task Force issued its report, its findings and recommendations remain valid. Our legislation is still necessary to provide greater flexibility and common sense modifications to address those key NCLB challenges identified in Maine. Our goals remain the same as those in NCLB: a good education for each and every child; well- qualified, committed teachers in every classroom; and increased transparency and accountability for every school. I look forward to working with my colleagues on both sides of the aisle on these issues during the upcoming NCLB reauthorization process.

Mr. President, today I am pleased to introduce two bills that will provide two important communities in rural Oregon with the means to promote their cultural history and their economic development opportunities. These are bills that I introduced in the last Congress and were reported out of the Energy and Natural Resources Committee, but were unfortunately not passed in the Senate. I am pleased to be joined by Senator Merkley in this effort.

These bills both are intended to help leaders in rural communities in my State continue to grow their economies and make the most of the abundant resources surrounding their communities. As in many rural communities in my State and in many places in the Western United States, not much happens without the Federal Government's involvement. In fact, the Federal Government owns much of the land surrounding these small communities. While many of these lands are treasures, this high percentage of Federal land ownership sometimes limits the ability of local governments and civic leaders to solve problems and serve the public. I firmly believe the Federal Government can and should be an active partner in strengthening communities and improving a region's quality of life.

That is why I am re-introducing these two pieces of legislation today. These bills--both passed out of the Senate Energy and Natural Resources Committee in the last Congress with minor modifications-- demonstrate the possibilities that can come when the Federal Government partners with proactive, innovative communities to tackle challenging economic conditions and the pattern of Federal land ownership.

My first bill, the La Pine Land Conveyance Act, would convey two parcels of property to Deschutes County, Oregon and a third parcel to the City of La Pine. The bill directs the transfer of Bureau of Land Management, BLM, lands to Deschutes County and the City of La Pine to enable the small town of La Pine to develop rodeo and equestrian facilities, expand a sewage treatment site, and develop the library or other public facilities.

La Pine has a set of unique challenges but the town's incorporation has brought a feeling in the community that good things can happen if they work together to make their town as good as it can possibly be.

My bill proposes the transfer of 150 acres of BLM land contiguous to the La Pine city limit to enable construction of public equestrian and rodeo facilities that have become increasingly important in La Pine. In addition, the land will provide a location for development of ball fields, parks, and recreation facilities, which can be developed as the town grows and budgets allow.

My bill also directs the transfer of approximately 750 acres of BLM lands to Deschutes County for the purpose of expanding the town's wastewater treatment operation. For several years this has been the City's top priority for a land transfer under the Recreation and Public Purposes Act. Although the BLM began an administrative transfer it was not completed, limiting this small community's ability to be competitive for state and federal economic stimulus funds. This project is too important to let languish.

Perhaps the most important issue affecting water quality in Deschutes County involves the threat to groundwater and the Deschutes River from household septic systems in southern Deschutes County, the region around La Pine. This project directly reduces nitrate loading into south county groundwater in two ways. First, by enabling expansion of the District service boundary to residential areas where septic systems are generating elevated groundwater nitrate levels; and second, by closing the current location for spreading treated effluent, over a relatively high groundwater area, to this new location which is judged not to threaten groundwater. That is why I am introducing legislation today to make sure this transfer moves forward.

The third parcel that would be transferred under this legislation would convey approximately 10 acres to the City of La Pine. This is a parcel right in the heart of downtown La Pine. The City is exploring its use for expansion of library space or using it as an open space.

My second bill, S. 271, the Wallowa Forest Service Compound Conveyance Act would convey an old Forest Service Ranger Station compound to the City of Wallowa, OR. In Wallowa County, this Forest Service compound was built by the Civilian Conservation Corps in the 1930's. For many years it was the center of town and this site continues to represent the natural and cultural history of one of Eastern Oregon's most beautiful communities. The City of Wallowa, along with County Commissioners, the local arts organizations, and a broad group of community leaders intend to restore this important example of Pacific Northwest rustic architecture and tribute to bygone times, making a valuable community interpretive center at this site. The conveyance of this property will allow the community to move forward with this project. The community worked hard to list the Ranger Station on the National Register of Historic Places, and ownership by the City will allow this coalition to restore the buildings and again develop a vibrant community center. Oregon Public Broadcasting aired a segment depicting an early 20th century railroad logging community--a significant part of the rich and diverse history and traditions that will be preserved and celebrated as this Forest Service Compound is developed as an interpretive center.

I want to express my thanks to all the citizens and community leaders who have worked to build their communities and develop these projects. They represent the pioneering spirit and vision that defines my State.

Mr. President, today, I am proud to reintroduce the Medication Therapy Management, MTM, Empowerment Act of 2011, with my colleagues from Minnesota, Senator Franken, from Ohio, Senator Brown, and from South Dakota, Senator Johnson.

A recent analysis conducted by the New England Healthcare Institute estimates that the overall cost of medication nonadherence is as much as $290 billion per year. According to a recent article published in the New England Journal of Medicine, over $100 billion is spent annually on avoidable hospitalizations because patients do not take their medications correctly.

Not only does nonadherence cost our system billions of dollars, nonadherence to medication regimens also affects the quality of life for seniors and may lead to early death. The elderly typically take many more prescription medicines than the general population and therefore are at greater risk for problems associated with improper use of medications. For example, the same New England Journal of Medicine article I just referenced found that better adherence to antihypertensive treatment alone could prevent 89,000 premature deaths in the U.S. annually.

With as much as one half of all patients in the U.S. not following their doctors' orders regarding their medications, medication therapy management could help reduce some of the wasted health care costs in our system.

North Carolina has implemented some very successful MTM programs.

The Asheville Project, which focuses on diabetes, asthma, and cardiovascular disease, has seen improved

health outcomes and significant savings among city employees since it began in 1997. For example, in the Asheville Project's diabetes MTM Project, they have seen a decrease in medical costs of between $1,622 to $3,356 per patient per year; a decrease in insurance claims of $2,704 per patient in year one and a $6,502 decrease in year five; a 50 percent decrease in use of sick days; and increased productivity gains estimated at $18,000 annually.

In 2007, the North Carolina Health and Wellness Trust Fund Commission launched an innovative statewide program, Checkmeds NC, to provide MTM services to North Carolina seniors. During the program's first year, more than 15,000 North Carolina seniors and 285 pharmacists participated. A total of 31,000 seniors have participated since 2007. The seniors bring all of their prescriptions, over-the-counter medicines, vitamins and supplements to the pharmacy to be thoroughly reviewed in a one-on-one session. The pharmacist follows up and educates the patient about his or her medication regimen. The program has saved an estimated $34 million to date, and countless health problems have been avoided.

During consideration of health care reform, I was pleased to have successfully secured language in the bill that built off these North Carolina models and implemented MTM nationally for seniors suffering from two or more chronic conditions.

The bill I am reintroducing today takes MTM one step further. Specifically, this bill would expand MTM eligibility to seniors with any chronic condition that accounts for high spending in our health care system, such as heart failure and diabetes. Currently, only 12.9 percent of Part D beneficiaries are eligible under the MTM criteria for multiple chronic conditions. However, of those, more than 85 percent have chosen to participate in the benefit. Clearly this program is very popular and widely utilized by those who are already eligible. By expanding eligibility to more seniors, MTM will certainly result in Medicare savings.

The bill also ensures access to MTM for seniors at a pharmacy or with a qualified health care provider of their choice.

To ensure pharmacists and health care providers are able to provide MTM to seniors, this bill requires that they are appropriately reimbursed for their time and service. This provision will permit pharmacies and other health care providers to spend considerable time and resources evaluating a person's drug routine and educating them on proper usage--all critical components of a successful MTM program.

Finally, this bill would establish standards for data collection to evaluate and improve the Part D MTM benefit.

The value of MTM is widely known and discussed. I am proud that North Carolina is a leader in this arena. Expansion of MTM to more seniors will no doubt improve their overall health, while at the same time reducing waste in our health care system.

I urge my collegues to support this bill.

Mr. President, I rise today to introduce legislation to repeal the tax imposed on medical device manufacturers.

As my colleagues know, this 2.3 percent sales tax imposed on medical device manufacturers--a tax that will ultimately be passed on to consumers--is part-and-parcel of the Federal health care reform bill that passed last Congress.

Like others in this chamber, I am extremely concerned that this tax could threaten jobs in my State, reduce domestic investment in research and development and ultimately diminish access to life-saving medical devices for patients.

Medical technology companies employ more than 375,000 workers in the United States. In Massachusetts alone, we have more than 225 medical device firms, which employ more than 20,000 workers, and contribute nearly $1 billion in payroll. Medical devices are one of our State's top exports, contributing $6 billion to our State's economy.

These are powerfully good numbers. These are the numbers that make my State tick, help drive our economy, and keep people working. I want to make certain that what happens in Washington does not reverse these numbers, does not undermine my State's ability to compete, and does not hamper our chances to grow and hire workers.

Massachusetts' position as an industry leader, a hub of innovation and entrepreneurship must be preserved. That has been and will continue to be my focus in the U.S. Senate.

So how do I intend to accomplish this?

For starters it means working to eliminate the medical device tax, which I believe will diminish our ability to compete, will increase costs for consumers, and could result in our medical device and technology jobs being sent overseas, where the costs of labor and production are cheaper.

The effort that I am spearheading--and that I ask my colleagues to join--eliminates the medical device tax in a way that does not add to the deficit. I propose eliminating this harmful tax--a tax that will stifle innovation, be passed on to consumers, and increase the cost of care--and propose that we offset the cost by using unobligated discretionary dollars. This is the same source of funding, the same offset, that 81 of my colleagues supported yesterday.

As my colleagues know, I worked on an amendment that would repeal the medical device tax last Congress. I will continue this work because the harmful effects of this tax are the last thing Massachusetts needs-- more industry jobs lost, our workers at a competitive disadvantage.

But the medical device tax doesn't just lead to job uncertainty, it leads to investment uncertainty as well, which results in private capital staying on the sidelines rather than being invested in Massachusetts based companies and their workers.

The medical device tax, coupled with other provisions in the Federal health reform bill, increases the level of uncertainty at a time when businesses, consumers and investors are craving the exact opposite.

For example, some medical devices are approved as combination products, both as medical devices and drugs and/or biologics. The Secretary has yet to determine how these medical devices will be captured under the law, how they will be taxed.

I pledge to work with my Senate colleagues--and during the Medical Device User Fee Modernization Act reauthorization slated for next year--to ensure that the medical device companies whose products are approved as combination products by the FDA are not double-taxed by way of the medical device tax and the pharmaceutical tax.

With the rolling implementation of the Federal health care reform bill, this Congress will provide many opportunities for me to protect the interests of and work on behalf of Massachusetts families, Massachusetts taxpayers,

Massachusetts workers, and Massachusetts businesses.

I hope my colleagues will join my efforts to find opportunities to correct what is wrong with the Federal health reform law--to protect innovation, the jobs, and the development and growth that can occur in a sector that is vitally important to our Nation's health.

I know that a robust medical device sector translates into a healthier America--physically, economically, and socially. The same is true for Massachusetts.