National Guard, Reserve, `Gray Area' Retiree, and Surviving Spouses Space-available Travel Equity Act of 2011

Mr. President, I rise today on behalf of myself and Senator Boxer to introduce the Buffalo Soldiers in the National Parks Study Act. This legislation is an important step in preserving the legacy of the Army's first all-black infantry and cavalry units and their unique role in the creation of our National Park system.

The Buffalo Soldiers served bravely in campaigns both at home and abroad before being stationed at the military Presidio in San Francisco and being given charge of patrolling the National Park system. Although first tasked with taming the frontier, these troops also took on the responsibility of preserving that wilderness for future generations. Each summer, Buffalo Soldier regiments traveled roughly 320 miles from San Francisco to either Sequoia or Yosemite National Park, where they patrolled the parks for poachers and loggers, built trails, and escorted visitors. They were, in essence if not in name, the nation's first park rangers.

In a time of segregation and adversity, these soldiers served their country bravely and the National Parks they worked to establish are part of the legacy they leave behind. Unfortunately, this unique aspect of their history is neither widely recognized nor remembered. This legislation would address that by authorizing a study to determine the most appropriate way to memorialize the Buffalo Soldiers. Money procured under the act would be used to determine the feasibility of establishing a national historic trail along the route traveled by the Buffalo Soldiers, scout for properties to add to the National Register of Historic Places, and develop educational initiatives and a public awareness campaign about the contribution of African-American soldiers after the Civil War.

Although the experiences of the Buffalo Soldiers are an important piece of our national history, we are in danger of losing their legacy to the passage of time unless we take conscious steps to preserve the memory. This legislation works to ensure that the contributions of the Buffalo Soldiers will be remembered and shared by all. I urge my colleagues to join me in their support for this measure.

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

Mr. President, I rise today with my friend and colleague from Vermont, Senator Leahy, and 20 co-sponsors to introduce the Cluster Munitions Civilian Protection Act of 2011.

Cluster munitions are large bombs, rockets, or artillery shells that contain up to hundreds of small submunitions, or individual ``bomblets.''

They are intended for attacking enemy troop formations and armor covering over a half mile radius.

But, in reality, they pose a deadly threat to innocent civilians. Before I discuss our legislation, I would like to share a few stories that show what these weapons can do.

Several months after the end of the Iraq war, Ahmed, 12 years old from Kebala, Iraq, was walking with his 9-year-old brother and picked up what he thought was just a shiny object, but was, in fact, a cluster bomb.

It exploded and Ahmed lost his right hand and three fingers off his left hand.

He also lost an eye and suffered shrapnel wounds to his torso and head.

A young shepherd, Akim, 13 years old, from Al-Radwaniya, Iraq, was playing on his parents' farm when it was hit by a cluster bomb attack.

He suffered burns to his lower limbs and multiple fractures to his right leg.

His wounds became infected and he developed pressure ulcers.

In 2003, 30 years after the Vietnam war, Dan, 9 years old from Phalanexay, Laos, was injured when he picked up and played with a cluster bomb. It exploded.

He suffered massive abdominal trauma, multiple shrapnel wounds, and a broken arm and leg.

Waleed Thamer, 10 years old, is from Iraq. In 2003, he was wounded by a cluster bomb on his way to the local market.

He lost his right hand and suffered shrapnel wounds to his eyes, neck, torso, and thighs.

These stories are deeply distressing. But they show us why our legislation is necessary.

Our legislation places commonsense restrictions on the use of cluster bombs. It prevents any funds from being spent to use cluster munitions that have a failure rate of more than 1 percent; and unless the rules of engagement specify the cluster munitions will only be used against clearly defined military targets; and will not be used where civilians are known to be

present or in areas normally inhabited by civilians.

Finally, our legislation includes a national security waiver that allows the President to waive the prohibition on the use of cluster bombs with a failure rate of more than 1 percent, if he determines it is vital to protect the security of the United States to do so.

If the President issues the waiver, he must issue a report to Congress within 30 days on the failure rate of the cluster bombs used and the steps taken to protect innocent civilians.

If our bill is enacted, it will have an immediate impact.

Out of the 728.5 million cluster submunitions in the U.S. arsenal, only 30,900 have self-destruct devices that would ensure a less than 1 percent dud rate.

Those submunitions account for only 0.00004 percent of the U.S. total.

So, the technology exists for the U.S. to meet the 1 percent standard but our arsenal consists overwhelmingly of cluster bombs with high failure rates.

Simply put, our bill will help save lives.

As the above stories demonstrate, cluster bombs pose a real threat to the safety of civilians when used in populated areas because they leave hundreds of unexploded bombs over a very large area and they are often inaccurate.

Indeed, the human toll of these weapons has been terrible:

In Laos, approximately 11,000 people, 30 percent of them children, have been killed or injured by U.S. cluster munitions since the Vietnam war ended.

In Afghanistan, between October 2001 and November 2002, 127 civilians lost their lives due to cluster munitions, 70 percent of them under the age of 18.

An estimated 1,220 Kuwaitis and 400 Iraqi civilians have been killed by cluster munitions since 1991.

In the 2006 war in Lebanon, Israeli cluster munitions, many of them manufactured in the U.S., injured and killed 343 civilians.

During the 2003 invasion of Baghdad, the last time the U.S. used cluster munitions, these weapons killed more civilians than any other type of U.S. weapon.

The U.S. 3rd Infantry Division described cluster munitions as ``battlefield losers'' in Iraq, because they were often forced to advance through areas contaminated with unexploded duds.

During the 1991 Gulf War, U.S. cluster munitions caused more U.S. troop casualties than any single Iraqi weapon system, killing 22 U.S. servicemen.

Yet we have seen significant progress in the effort to protect innocent civilians from these deadly weapons since we first introduced this legislation in the 110th Congress.

In December 2008, 95 countries came together to sign the Oslo Convention on Cluster Munitions which would prohibit the production, use, and export of cluster bombs and requires signatories to eliminate their arsenals within 8 years.

This group includes key NATO allies such as Canada, the United Kingdom, France, and Germany, who are fighting alongside our troops in Afghanistan.

It includes 33 countries that have produced and used cluster munitions.

To date, 108 countries have signed the convention and 48 have ratified it.

It formally came into force on August 1, 2010.

In 2007, Congress passed and President Bush signed into law a provision from our legislation contained in the fiscal year 2008 Consolidated Appropriations Act prohibiting the sale and transfer of cluster bombs with a failure rate of more than 1 percent.

Congress extended this ban as a part of the Omnibus Appropriations Act for fiscal year 2009 and the Consolidated Appropriations Act of 2010.

These actions will help save lives. But much more work remains to be done and significant obstacles remain.

For one, the United States chose not to participate in the Oslo process or sign the treaty.

The Pentagon continues to believe that cluster munitions are ``legitimate weapons with clear military utility in combat.''

It would prefer that the United States work within the Geneva-based Convention on Certain Conventional Weapons, CCW, to negotiate limits on the use of cluster munitions.

Yet these efforts have been going on since 2001 and it was the inability of the CCW to come to any meaningful agreement which prompted other countries, led by Norway, to pursue an alternative treaty through the Oslo process.

A lack of U.S. leadership in this area has given cover to other major cluster munitions producing nations--China, Russia, India, Pakistan, Israel, and Egypt--who have refused to sign the Oslo Convention as well.

Recognizing the United States could not remain silent in the face of international efforts to restrict the use of cluster bombs, Secretary of Defense Robert Gates issued a new policy on cluster munitions in June 2008 stating that after 2018, the use, sale and transfer of cluster munitions with a failure rate of more than 1 percent would be prohibited.

The policy is a step in the right direction, but under the terms of this new policy, the Pentagon will still have the authority to use cluster bombs with high failure rates for the next 10 years.

That is unacceptable and runs counter to our values. The administration should take another look at this policy.

In fact, on September 29, 2009, Senator Leahy and I were joined by 14 of our colleagues in sending a letter to President Obama urging him to conduct a thorough review of U.S. policy on cluster munitions.

On April 14, 2010, we received a response from then National Security Advisor Jim Jones stating that the administration will undertake this review following the policy review on U.S. landmines policy.

The administration should complete this review without delay.

Let us not forget that the United States maintains an arsenal of an estimated 5.5 million cluster munitions containing 728 million submunitions which have an estimated failure rate of between 5 and 15 percent.

What does that say about us, that we are still prepared to use, sell and transfer these weapons with well-known failure rates?

The fact is, cluster munition technologies already exist, that meet the 1 percent standard. Why do we need to wait 10 years?

This delay is especially troubling given that in 2001, former Secretary of Defense William Cohen issued his own policy on cluster munitions stating that, beginning in fiscal year 2005, all new cluster munitions must have a failure rate of less than 1 percent.

Unfortunately, the Pentagon was unable to meet this deadline and Secretary Gates' new policy essentially postpones any meaningful action for another 10 years.

That means if we do nothing, by 2018 close to 20 years will have passed since the Pentagon first recognized the threat these deadly weapons pose to innocent civilians.

We can do better.

Our legislation simply moves up the Gates policy by 7 years.

For those of my colleagues who are concerned that it may be too soon to enact a ban on the use of cluster bombs with failure rates of more than 1 percent, I point out again that our bill allows the President to waive this restriction if he determines it is vital to protect the security of the United States to do so.

I would also remind my colleagues that the United States has not used cluster bombs in Iraq since 2003 and has observed a moratorium on their use in Afghanistan since 2002.

We introduce this legislation to make this moratorium permanent for the entire U.S. arsenal of cluster munitions.

We introduce this legislation for children like Hassan Hammade.

A 13-year-old Lebanese boy, Hassan lost four fingers and sustained injuries to his stomach and shoulder after he picked up an unexploded cluster bomb in front of an orange tree.

He said:

I started playing with it and it blew up. I didn't know it

was a cluster bomb--it just looked like a burned out piece of

metal.

All the children are too scared to go out now, we just play

on the main roads or in our homes.

I urge my colleagues to support this legislation. We should do whatever we can to protect more innocent children and other civilians from these dangerous weapons.

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

Mr. President, I will try to bring this budget debate down to Earth and talk a little bit about the reality of what is happening and go beyond the amount of numbers that are out there.

My good friend from Alabama who sits with me on the Budget Committee makes the point that this country has a severe budget crisis. He is right. The question is, How did we get to where we are today and how do we go forward in a way that is fair and responsible to address it? In that regard, the Senator from Alabama and I have very strong disagreements.

How did we get to where we are today when not so many years ago, the day George W. Bush became President, we had a significant surplus? We had a surplus when Clinton left office. Now we have a major deficit crisis. There are a number of reasons:

No. 1, against my vote, we are fighting a war in Iraq which, by the time we take care of our last veteran, is going to cost us some $3 trillion. I didn't hear any of my Republican friends saying we can't go to war unless we figure out a way to pay for it.

No. 2, my Republican friends for years have been pushing huge tax breaks for the very wealthiest people. I didn't hear them ask how that was going to be paid for.

No. 3, under President Bush, with strong Republican support and against my vote, Congress passed a $400 billion-plus Medicare Part D prescription drug program, written by the insurance companies and the drug companies. It drove up the deficit.

No. 4, against my vote, Congress voted for a massive bailout of Wall Street. I didn't hear too many people talking about how we would pay for that, $700 billion to bail out Wall Street. I didn't hear them arguing that it was too much money and it would drive up the deficit.

Yesterday, the Republicans brought forth and voted on H.R. 1. Almost all of them voted for it. Those who did not actually wanted to go further.

The main point I wish to make is, A, we do have to address the deficit crisis, but, B, we have to address it in a way that is fair and responsible and not solely on the backs of working families, the middle class, the elderly, the sick, and the poor. That is immoral. That is wrong. That is bad economics.

To my mind, it is absolutely absurd that when my Republican friends talk about deficit reduction, they forget to talk about the reality that the wealthiest people have never had it so good; that the effective, the real tax rate for the richest people is the lowest on record; and that the wealthiest people, the top 2 percent, have received many hundreds of billions of dollars in tax breaks.

I ask my Republican friends, why do they want to balance the budget on the backs of low-income children, low-income senior citizens, those who are sick, those who are vulnerable, without asking the wealthiest people who have never had it so good to put one penny into deficit reduction? I think that is wrong, and the American people think that is wrong. When we talk about deficit reduction, we have to talk about shared sacrifice, everybody playing a role, not just little kids, not just the elderly, not just the sick, but even--dare I say it--people who have a whole lot of money and who have never done so well.

I have not been impressed at how the media has been covering this issue. They have not made it clear to the American people how devastating the cuts are that Republicans want to impose on working families. Let me briefly tick off some of them.

The Republicans want to throw over 200,000 children off of the Head Start Program. Every working family in America knows how hard it is today to come up with affordable childcare, early childhood education. We have the highest rate of childhood poverty in the industrialized world. The Republican solution is to slash Head Start by 20 percent, cut 218,000 kids off of Head Start, and lay off 55,000 Head Start instructors.

The cost of college education today is so high that many young people are giving up their dream of going to college, while many others are graduating deeply in debt. Republican solution: Slash Pell grants by $5.7 billion and reduce or eliminate Pell grants for 9.4 million low- income college students. Middle-class families, working-class families, do they hear that? We are going to balance the budget by either eliminating or lowering Pell grants--the ability of young people to go to college--for over 9 million college students.

I know in my office we get calls every week from senior citizens, people with disabilities, widows who are having a hard time getting a timely response toward their Social Security claims. It takes too long to process the paperwork. What the Republicans want to do is slash the Social Security Administration, the people who administer Social Security for seniors and the disabled, widows and orphans, by $1.7 billion. That means half a million Americans who are legally entitled to Social Security benefits will have to wait significantly longer times in order to receive them.

We have 50 million Americans with no health insurance today, and 45,000 Americans die because they don't get to a doctor in time. Last year, as part of health care reform, I worked very hard with many Members to expand community health centers so that more and more low- and moderate-income people could walk into a doctor's office, get health care, dental care, low-cost prescription drugs, mental health counseling. In H.R. 1, the bill they voted for yesterday, Republicans want to deny primary health care to 11 million Americans at a time when State after State is cutting back on Medicaid. What are you supposed to do if you are 50 years old, you have a pain in your chest, and you don't have any health insurance? Where do you go? Republicans want to deny health care to another 11 million Americans.

For the poorest people, community services block grants provide the infrastructure, the ability to get out emergency food help, emergency help to pay the electric bill, LIHEAP. They are the infrastructure of this country that protects the poorest and most vulnerable. Republicans want to slash $405 million from the Community Services Block Grant Program. That is wrong. And the President's proposed cut to the community services block grant is also wrong.

In real terms, 16 percent of our population today is really unemployed, if we add together the official unemployment--those people who have given up looking for work, those people who work part time and want to work full time. Republicans want to slash $2 billion in Federal job-training programs.

Republicans want to slash $400 million in LIHEAP. That is the program that in my State and all over the country enables people to stay warm in the winter. We have a lot of senior citizens in Vermont getting by on $13,000 or $14,000 a year in income. They need help. It gets cold in Vermont. It gets 20 below zero. People don't have the income. LIHEAP is a very valuable tool. Republicans want to slash $100 million for

Mr. President, today Senators Collins, Carper, Brown, and I are pleased to introduce the Fire Grants Reauthorization Act of 2011 to ensure that firefighters and emergency medical service personnel serving communities across the nation are repaid for the sacrifices they make every day with the best possible training and equipment--particularly given the budget cuts many communities have been forced to make in these economically uncertain times.

The bill we present to the Senate reauthorizes the Assistance to Firefighters, AFG, program and the Staffing for Adequate Fire and Emergency Response program, SAFER, two highly successful programs I worked to establish in 2000 and 2003. This is bipartisan legislation that has won overwhelming Senate support in previous years. As we all know, our first responders make great sacrifices for us. Firefighters in communities of all shapes and sizes have assumed a greater role in overall national emergency preparedness since September 11 and the Hurricane Katrina catastrophe. They now serve as the frontline of defense in many communities for disasters of all types. More than ever, firefighters need the training and equipment to deal not only with fires but also with hazardous materials; nuclear, radioactive, and explosive devices; and other potential threats.

The responsibilities placed on firefighters have only grown more demanding. Firefighters respond more and more to medical emergencies-- 15.8 million in 2008, a 213 percent increase from 1980. Right here in Washington, D.C., at Fire Engine Company 10--known as the ``House of Pain'' for its grueling schedule--80 percent of the calls are for medical emergencies. Our nation's firefighters--like other first responders--are the first to arrive and the last to leave whenever trouble hits. They deserve all the support we can give them.

Unfortunately, they do not always get it. Firefighters often lack the equipment and vehicles they need to do their jobs safely and effectively. In 2006 the U.S. Fire Administration reported that 60 percent of fire departments did not have enough breathing apparatuses to equip all firefighters on a shift, 65 percent did not have enough portable radios, and 49 percent of all fire engines were at least 15 years old.

We can and must do more for these brave men and women. We must make sure they have what they need to protect their communities and themselves as they perform a very dangerous job. Our bill takes much- needed steps to ensure that they do.

To start with, because career, volunteer, and combination fire departments all suffer from shortages in equipment, vehicles, and training, our bill requires that each type receives at least 25 percent of the available AFG grant funding. The remaining funds will be allocated based on factors such as risk and the needs of individual communities and the country as a whole. This creates an appropriate balance, ensuring that funds are directed at departments facing the most significant risks while guaranteeing that no department is left out.

We have also taken a number of steps in our bill to help fire departments in communities struggling with economic difficulties. In many cases, local governments have reduced spending on vital services, including fire departments. Among other things, these cuts have prevented many departments from replacing old equipment and forced them to lay off needed firefighters. To help departments rebuild, we have lowered the matching requirements for AFG and SAFER. Departments are still required to match some of their grant awards with funds of their own--ensuring they have some skin in the game--but the reduced amount will make it easier for them to accept awards.

We have similarly created an economic hardship waiver for both grant programs that will allow FEMA to waive certain requirements, such as requiring that grantees provide matching funds, for departments in communities that have been especially hard hit by tough economic times.

Our bill contains a number of other important provisions. It raises the maximum grant amounts available under AFG. As commonsense would suggest, large communities often require a substantial amount of equipment, and they will now be able to apply for funding in amounts more in line with what they need.

Our bill would provide funding for national fire safety organizations and institutions of higher education that wish to create joint programs establishing fire safety research centers. There is a great need for research devoted to fire safety and prevention and improved technology. The work these centers do will help us reduce fire casualties among firefighters and civilians and make communities safer.

But as important as it is to help our firefighters, we must also demand accountability when we spend taxpayer dollars. For this reason, we require that FEMA create performance management systems for these programs, complete with quantifiable metrics that will allow us to see how well they perform. Going forward, this will allow us to see what works in these programs and what does not so that we can make needed improvements when required.

We have also included provisions to prevent earmarks from being attached to these programs. AFG and SAFER have never been earmarked--an impressive accomplishment--and we want to keep it that way. The funding for these programs needs to go to firefighters, not pet projects.

Finally, this legislation authorizes $950 million each for these vital programs. This is actually less than what was authorized in the past. We believe that supporting our Nation's firefighters and emergency medical service responders ought to be a priority, but we recognize that these tough fiscal times require some belt-tightening. Authorizing funding for AFG and SAFER at these amounts sends the message that Congress can direct funding where it is needed while also showing discipline.

This legislation ensures that fire departments get the support they need to protect their communities while also protecting taxpayer dollars. It addresses a vital national need while increasing accountability to the public. I urge my colleagues to join me in supporting the reauthorization of these important programs.

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

Mr. President, I wish to tell you about a teenager whom I think you know about--Justin Aaberg--from our home State of Minnesota. Yesterday should have been Justin's 16th birthday. Justin was a kind young man, friendly and cheerful, a budding composer, but he was also the target for bullies at his high school, who targeted him because he was different--because he was gay.

I never had the opportunity to meet Justin. His family lost him to suicide last summer. The Presiding Officer knows that. But you and I have been privileged to meet his mother Tammy. I have been privileged to meet her a few times. She is incredible. She has been speaking out to protect other kids. Because, unfortunately, there are a lot of other kids out there struggling to get through school as they suffer from bullying and harassment and discrimination at their public schools. Nine out of ten LGBT students are harassed or bullied or taunted in school. This harassment deprives them of an equal education. They are more likely to skip school, they are less likely to perform well academically, and they are more likely to drop out before they graduate from high school.

In some tragic cases, such as Justin's, the harassment of LGBT students can even lead to suicide. We have seen this in all too many cases all over the country, because, sadly, this problem is so much broader than Justin. More than a third--more than a third--of lesbian, gay, and bisexual youth have made a suicide attempt. More than a third. That is horrifying beyond belief to me.

We are failing these kids. That is why I, along with 29 of my Senate colleagues, including the Presiding Officer, have reintroduced the Student Nondiscrimination Act today. While Federal civil rights laws prohibit discrimination on the basis of race, color, sex, religion, disability, and national origin, they do not expressly cover sexual origin or gender identity. As a result, parents of LGBT students have limited legal recourse when schools fail to protect their children from harassment and bullying.

You might be wondering why I am mentioning bullying and discrimination in the same breath. It is simple: When a school acts to protect kids with disabilities from bullying but looks the other way when LGBT kids are harassed by their peers, that is discrimination. When school staff members participate in or encourage bullying of LGBT youth, that is discrimination. When a principal excuses a bully who torments an LGBT kid with ``boys will be boys,'' this is discrimination and needs to stop. It needs to stop before more kids are hurt.

The Student Nondiscrimination Act would prohibit discrimination and harassment in public schools based on sexual orientation and gender identity. It would give LGBT students similar civil rights protections against bullying and harassment as those that currently apply to students based on characteristics such as race and gender.

This legislation would also provide meaningful remedies for discrimination in public schools based on sexual orientation or gender identity, modeled on Title IX's protection against discrimination and harassment based on gender. Fifty years of civil rights history shows that similar laws that contain such remedies are often most effective in preventing discrimination from occurring in the first place. Like other civil rights laws, the one we introduce today would prompt schools to

avoid liability by taking proactive steps to prevent the discrimination and bullying of students protected by the bill.

I guarantee you that when this bill is passed, nearly every school district in this country is going to go to its lawyer and ask, ``How do we come into compliance?'' I guarantee you that the U.S. Department of Education will issue regulations, as it has under Title IX, so that schools have guidance in how to protect these kids. The goal isn't for any school to be sued for failing to protect kids from bullying and harassment. The goal isn't for any school to come under Department of Education scrutiny. The goal is for schools to do all they can to ensure these incidents never happen in the first place.

Parents in Minnesota and across the country entrust their children to public schools with the understanding that these schools will do everything in their power to keep their children safe. When 9 in 10 LGBT kids are bullied at school, when they are three times more likely than straight kids to feel unsafe at school, when one third of LGBT kids say they have skipped a day of school in the last month because of feeling unsafe, then we know that our public education system is not fulfilling its most basic obligation to parents to keep children safe. We have an obligation to do something about it.

Yesterday, Justin Aaberg from Minnesota should have celebrated his 16th birthday with family and friends. But instead, I know that his family and friends were missing him terribly--are still missing him terribly.

No child should have to go through the pain that Justin went through at school. No mom or dad should have to go through the heartbreaking pain that Justin's family has gone through. It is time. It is time that we extend equal rights to LGBT students. We have the opportunity now, as we reform No Child Left Behind--the ESEA, the Elementary and Secondary Education Act--to include this legislation. Our children cannot afford for us to squander this opportunity. I urge my colleagues to join me today in supporting the Student Non-Discrimination Act and demanding protection for all of our children under the law.

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

Mr. President, today I am proud to introduce the Violence Against Women Health Initiative. October is Domestic Violence Awareness month, and this bill will raise awareness of domestic violence among health care providers and allow them to better assess and treat survivors of domestic violence.

The rates of violence and abuse in this country are astounding. Nearly one in four women in the U.S. has reported experiencing domestic violence at some point in her life. In 2007, there were 248,300 reported incidents of sexual assault in the U.S. Young women experience the highest rates of sexual assault and stalking. Sadly, 15.5 million children in the U.S. live in families in which partner violence has occurred in the past year, and 7 million children live in families in which severe partner violence has occurred.

Domestic violence has a significant impact on our country's health. According to the Centers for Disease Control and Prevention, CDC, intimate partner violence costs the health care system over $8.3 billion annually.

In addition to injuries sustained during violent episodes, survivors suffer lifelong health complications. Research published in the journal of Women's Health in 2007 found that women who are victimized by violence have 17 percent more primary care doctor visits, 14 percent more specialist visits, and 27 percent more prescription refills than non-abused women.

Physical and psychological abuse are linked to a number of adverse physical health effects. A study released in 2010 that compared victims with never-abused women found abuse victims had an approximately six- fold increase in clinically-identified substance abuse, a more than three-fold increase in depression diagnoses, a three-fold increase in sexually transmitted diseases, and a two-fold increase in lacerations.

But it is not just the spouse who suffers these lifelong consequences. It is their children, too. Children who witness domestic violence are more likely to exhibit behavioral and physical health problems, including depression, anxiety, and violence towards peers. They are also more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution, and commit sexual assault crimes. Fifty percent of men who frequently assault their wives also frequently assault their children, and the U.S. Advisory Board on Child Abuse and Neglect suggests that domestic violence may be the single major precursor to child abuse and neglect fatalities in this country.

Without question, we must tackle the underlying causes of domestic violence and abuse in this country. At the same time, we must strengthen our health care response to this abuse.

Despite the commitment of health care providers to help domestic violence victims, a critical gap remains in the delivery of health care to victims. Health care providers often only address immediate injuries, without tackling the underlying cause of those injuries. For example, each year, about 324,000 pregnant women in this country are battered by their intimate partners. However, few physicians screen pregnant patients for abuse. This highlights the need to ensure that health care providers have the necessary training and support in order to assess, refer, and support victims of domestic and sexual violence.

Victims know and trust their health care providers. Almost 3/4 of survivors say that they would like their health care providers to ask them about violence and abuse.

Multiple clinical studies have shown that short interventions in the medical environment protect the health and safety of women. These interventions are short between 2 and 10 minutes, and effective. In repeated clinical trials, violence decreased and health status improved following simple assessment and referral protocols. Integrating these effective protocols into our health care system will save lives.

This is why routine assessments for intimate partner violence have been recommended for health care settings by the American Medical Association, American Psychological Association, American Nurses Association, American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and the Joint Commission on the Accreditation of Health Care Organizations.

Since its passage in 1994, the Violence Against Women Act, VAWA, has transformed our criminal justice system and social service system, helping to prevent and respond to domestic violence. The last reauthorization of VAWA, set to expire this year, included a new title authorizing three programs that support the health system's efforts to help victims, preventing further abuse and improving the health status of women. The bill I am introducing today will continue those important efforts.

This bill would consolidate the three existing health programs into one program, while increasing evaluation and accountability. Specifically, this bill would foster public health responses to intimate partner violence and sexual violence; provide training and education of health professionals to respond to violence and abuse; and support research on effective public health approaches to end violence against women.

I urge my colleagues to join us in supporting this important bill.