Floor Statements

Mr. President, today I rise to introduce the Voluntary Medicare Quality Reporting Act of 2007. I thank my good friend, the gentleman from Pennsylvania, Mr. Specter, for joining me in this effort. This is an important bill for tens of millions of Medicare beneficiaries, for the physicians, nurse practitioners and allied health professionals who treat them, and for the future of the Medicare program.

At the end of this year, providers will again face the prospect of an across-the-board cut in their Medicare reimbursements. The scheduled cut for 2008 is the largest ever, 9.9 percent. These cuts are the result of a flawed reimbursement system created in 1997 that uses the Sustainable Growth Rate formula, or SGR, to determine an acceptable increase in the growth of provider expenditures.

Medicare reimbursements increase when the previous year's payments do not exceed a target level that is based on the growth of our economy. However, when the previous year's payments exceed that target level, reimbursements are cut. According to MedPAC, the SGR formula would reduce Medicare provider reimbursements by 40 percent over the next eight years if Congress does not act. MedPAC is also concerned that over the next several years these reductions ``would threaten beneficiary access to physician services over time, particularly those provided by primary care physicians.'' MedPAC recognizes the importance of provider participation in the Medicare program, particularly in our rural and underserved urban areas where the decision to not accept new Medicare patients can make all the difference in seniors' access to medical care.

Congress recognizes this as well, and so we have intervened to prevent scheduled cuts resulting from SGR from taking effect. For all except the newest members of this body, this process of enacting a ``physician fix'' is a familiar scenario. For the past four years, Congress has acted to prevent these cuts to providers, usually through a last-minute provision added to a must-pass bill.

In the 109th Congress, I introduced bipartisan legislation implementing MedPAC's recommendations and calling for Congress to repeal the SGR formula and update provider reimbursements by the cost of care. Replacing SGR will require a thoughtful and protracted process involving the input of lawmakers and the provider community, and it is costly, but it is something that we must do.

The most recent ``fix'' was made to the 2006 Tax Relief and Health Care Act, Public Law 109-432. That law froze payment rates, staving off an across-the-board cut of 5.1 percent. Congress also added a quality reporting system called the Physician Quality Reporting Initiative program PQRI, which made providers eligible for a bonus payment of 1.5 percent of their total allowed Medicare charges if they report to HHS on certain quality measures starting in July 2007.

This new system is also known as ``pay-for-reporting,'' and it is based on the concept that physicians should receive an increase in Medicare reimbursement only once they have participated in extensive quality reporting. Across my State, I have heard serious concerns that this will lead to a mandatory reporting system in the near future, and that we will soon see an untested ``pay-for-performance'' system in place.

Now, I think all my colleagues would agree that our seniors deserve the highest quality care. But in our quest for improved quality, we must answer two questions here: should we proceed with an untested system of reporting requirements just for the sake of reporting, and will we actually achieve better care for our seniors via the PQRI.

I am very concerned about implementing reporting requirements that have not been tested. I believe that we must have the right process in place for defining a quality reporting system for services provided to Medicare beneficiaries by health care professionals. We should not be establishing reporting requirements for health professionals just for the sake of reporting, and we should not be moving forward with this system until we have adequate time to evaluate each stage of its development.

Current law does not provide sufficient time to assess the appropriateness and effectiveness of this new system. Nor do they take into account the fact that most physicians and other health professionals have no experience in quality reporting and do not have in place the necessary health information technology and administrative infrastructures to participate in a reporting system.

The bill I am introducing today will assure that health professionals will be at the center of the process for defining areas where quality measures are needed, as well as for defining the relevant measures themselves. Why is this important? Health professionals must be actively engaged in developing and implementing an effective reporting system because they are on the front lines of health care delivery, and they best understand the nexus between care delivery and quality measurement. The development process for quality measures must be transparent and consistent for all health professionals because they are the ones who will determine its successful implementation.

Additionally, quality measures should be tested across a variety of specialties and practice settings before they are included in a reporting system because measures must be clinically valid to be relevant for defining quality, and because physicians and health professionals practice in a variety of settings, for example: small vs. large practices, urban vs. suburban vs. rural locations, office-based vs. hospital-base practices.

Most importantly, we should not be using hastily devised quality measures to justify reimbursement cuts. There are some who advocate pay-for-performance as a way to slow the growth of physician spending. They think we can accomplish lower physician expenditures by setting arbitrary standards and then cutting payments to physicians who fail to meet them. But across America, there are practices that would face tremendous obstacles in meeting such standards: they lack of the information technology necessary to document and report standards in a timely manner; they see patients with economic and language barriers that will result in higher noncompliance rates; they treat a patient population for whom ethnic and racial differences require different clinical interventions than for other patients. Ignoring these considerations will not only fail to dramatically improve quality, it will significantly penalize providers who treat traditionally underserved populations.

This bill provides an opportunity to thoughtfully and carefully develop effective quality measures that reflect differences in practice patterns, to share our findings, and to determine and encourage the most cost-effective methods of providing the highest quality care.

Rather than moving forward precipitously in 2008 with a permanent Medicare quality reporting system after a transitional 6-month period this year, as current law requires, our bill, the Voluntary Medicare Quality Reporting Act of 2007, instead would establish a more realistic timeline for quality measure reporting by health professionals. It does so by:

Requiring the Secretary first to evaluate the 6-month transitional reporting system and reporting findings to the Congress by June 1, 2008;

Requiring the Secretary to undertake demonstrations for defining appropriate mechanisms whereby health professionals may provide data on quality measures to the Secretary through an appropriate medical registry;

Allowing physicians and other eligible professionals to continue reporting to the Secretary quality measures developed for 2007, in order for the Secretary to refine systems for reporting quality measures;

After completion of the evaluation, phasing in a permanent Voluntary Medicare Quality Reporting Program, with implementation beginning January 1, 2010, based on a consistent set of rules that define an orderly and transparent process of quality measure development;

Requiring that the Physician Consortium for Performance Improvement of the American Medical Association be the beginning point for the designation of clinical areas where quality measures are needed;

Having the Consortium, in collaboration with physician specialty organizations and other eligible professional organizations, develop and propose quality measures to a consensus organization such as the National Quality Forum for endorsement; and

Prohibiting the Secretary from using any measures that have not been recommended by the Consortium and endorsed by the consensus organization.

I am confident that with all of these measures we will achieve a successful and effective quality reporting system that will truly make a difference in the quality of care that our Medicare beneficiaries receive. At the end of this year, as Congress moves forward to address the physician reimbursement issue, I urge my colleagues to support this rational approach to promoting quality and guaranteeing access to care.

Mr. President, today I am introducing legislation to help sustain the Federal Government's longstanding commitment to the Washington Metropolitan area's Metrorail system. The National Capital Transportation Amendments Act of 2007 authorizes a total of $1,500,000,000 in matching Federal funds over the next 10 years to maintain and improve America's public transit system. It is a companion to a measure introduced in the House by Representative Tom Davis, with strong regional and bipartisan support, and is nearly identical to the legislation which was approved by the House in the 109th Congress.

In March 2006, the Washington Metropolitan Area Transit Authority celebrated the 30th anniversary of passenger service on the Metrorail system. Since service first began in 1976, Metrorail has grown from a 4.6-mile, five-station, 22,000-passenger system into the Nation's second busiest rapid transit operation. Today the Metrorail system consists of 106.3 miles, 86 stations and carries more than 100 million passengers a year. The Metrorail system provides a unified and coordinated transportation system for the region, enhances mobility for the millions of residents, visitors and the Federal workforce in the region, promotes orderly growth and development of the region, enhances our environment, and preserves the beauty and dignity of our Nation's Capital. It is also an example of an unparalleled partnership that spans every level of government from city to State to Federal.

As the largest employer in this region, the Federal Government has had a longstanding and unique responsibility to support the Metro system. This special responsibility was recognized more than 40 years ago in the National Capital Transportation Act of 1960, when Congress found that ``an improved transportation system for the National Capital region is essential for the continued and effective performance of the functions of the Government of the United States.'' Today more than a third of Federal employees in this region rely on Metrorail to get to work, and at rush hour, more than 40 percent of Metro's riders are Federal employees. The service that WMATA provides is also a critical component of Federal emergency evacuation plans for the region. The Federal Government's interest in Metro is ``unique and enduring.''

It took extraordinary perseverance and effort to build the 106-mile Metorail system. From its origins in legislation first approved by the Congress during the Eisenhower Administration, three major statutes, the National Capital Transportation Act of 1969, the National Capital Transportation amendments of 1979, and the National Capital Transportation Amendments of 1990 were enacted to provide Federal and matching local funds for construction of the system. In addition, in ISTEA, TEA-21 and most-recently in SAFETEA-LU, we made the Metrorail eligible for millions of dollars in Federal funds annually to maintain and modernize the system, and provided an additional $104 million for WMATA's procurement of 52 rail cars and construction of upgrades to traction power equipment on 20 stations to allow the transit agency to expand many of its trains from 6 to 8 cars.

But the system is aging and has been experiencing increasing incidents of equipment breakdowns, delays in scheduled service, and unprecedented crowding on trains. In 2004, WMATA released a ``Metro Matters'' report which found a $1.5 billion shortfall in funding over 6 years to meet WMATA's capital and operating needs. A Blue Ribbon Panel, sponsored by the Metropolitan Washington Council of Governments, the Greater Washington Board of Trade and the Federal City Council published a report a year later which concluded that WMATA faces an average annual operating and capital shortfall of approximately $300 million between fiscal year 2006 and fiscal year 2015.

This legislation seeks to provide additional Federal funds to help close this gap. To be eligible for any Federals funds that may be appropriated annually under this legislation, the District of Columbia, the State of Maryland, and the Commonwealth of Virginia must first enact the required Compact amendments and either establish or use an existing dedicated funding source, such as Maryland's Transportation Trust fund, to provide the local matching funds. The legislation is still subject to the annual appropriations process and it is my hope that federal funding authorized under this Act will be forthcoming in future years. I urge my colleagues to join me in supporting this legislation.

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

Mr. President, today I am introducing legislation to help sustain the Federal Government's longstanding commitment to the Washington Metropolitan area's Metrorail system. The National Capital Transportation Amendments Act of 2007 authorizes a total of $1,500,000,000 in matching Federal funds over the next 10 years to maintain and improve America's public transit system. It is a companion to a measure introduced in the House by Representative Tom Davis, with strong regional and bipartisan support, and is nearly identical to the legislation which was approved by the House in the 109th Congress.

In March 2006, the Washington Metropolitan Area Transit Authority celebrated the 30th anniversary of passenger service on the Metrorail system. Since service first began in 1976, Metrorail has grown from a 4.6-mile, five-station, 22,000-passenger system into the Nation's second busiest rapid transit operation. Today the Metrorail system consists of 106.3 miles, 86 stations and carries more than 100 million passengers a year. The Metrorail system provides a unified and coordinated transportation system for the region, enhances mobility for the millions of residents, visitors and the Federal workforce in the region, promotes orderly growth and development of the region, enhances our environment, and preserves the beauty and dignity of our Nation's Capital. It is also an example of an unparalleled partnership that spans every level of government from city to State to Federal.

As the largest employer in this region, the Federal Government has had a longstanding and unique responsibility to support the Metro system. This special responsibility was recognized more than 40 years ago in the National Capital Transportation Act of 1960, when Congress found that ``an improved transportation system for the National Capital region is essential for the continued and effective performance of the functions of the Government of the United States.'' Today more than a third of Federal employees in this region rely on Metrorail to get to work, and at rush hour, more than 40 percent of Metro's riders are Federal employees. The service that WMATA provides is also a critical component of Federal emergency evacuation plans for the region. The Federal Government's interest in Metro is ``unique and enduring.''

It took extraordinary perseverance and effort to build the 106-mile Metorail system. From its origins in legislation first approved by the Congress during the Eisenhower Administration, three major statutes, the National Capital Transportation Act of 1969, the National Capital Transportation amendments of 1979, and the National Capital Transportation Amendments of 1990 were enacted to provide Federal and matching local funds for construction of the system. In addition, in ISTEA, TEA-21 and most-recently in SAFETEA-LU, we made the Metrorail eligible for millions of dollars in Federal funds annually to maintain and modernize the system, and provided an additional $104 million for WMATA's procurement of 52 rail cars and construction of upgrades to traction power equipment on 20 stations to allow the transit agency to expand many of its trains from 6 to 8 cars.

But the system is aging and has been experiencing increasing incidents of equipment breakdowns, delays in scheduled service, and unprecedented crowding on trains. In 2004, WMATA released a ``Metro Matters'' report which found a $1.5 billion shortfall in funding over 6 years to meet WMATA's capital and operating needs. A Blue Ribbon Panel, sponsored by the Metropolitan Washington Council of Governments, the Greater Washington Board of Trade and the Federal City Council published a report a year later which concluded that WMATA faces an average annual operating and capital shortfall of approximately $300 million between fiscal year 2006 and fiscal year 2015.

This legislation seeks to provide additional Federal funds to help close this gap. To be eligible for any Federals funds that may be appropriated annually under this legislation, the District of Columbia, the State of Maryland, and the Commonwealth of Virginia must first enact the required Compact amendments and either establish or use an existing dedicated funding source, such as Maryland's Transportation Trust fund, to provide the local matching funds. The legislation is still subject to the annual appropriations process and it is my hope that federal funding authorized under this Act will be forthcoming in future years. I urge my colleagues to join me in supporting this legislation.

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

Madam President, today I wish to recognize Janet Turcotte, of Bowie, MD, for her courageous efforts to raise awareness of colon cancer and promote screening. Janet was first diagnosed with Stage IV colorectal cancer 4 years ago at age 53, and she is currently battling her third recurrence of the disease. I met Janet in March when she came to my office on behalf of C3, the Colorectal Cancer Coalition. C3 is a national organization whose mission is to eliminate suffering and death due to colorectal cancer. Janet has joined the coalition in its push for ``more research to improve screening, diagnosis, and treatment of colorectal cancer; for policy decisions that make the most effective colorectal cancer prevention and treatment available for all; and for increased awareness that colorectal cancer is preventable, treatable, and beatable.''

Last year, Janet Turcotte brought her fight against colorectal cancer to a new venue, the Preakness Stakes at Pimlico Race Course. The Preakness is the second and shortest leg of horse racing's prestigious Triple Crown, being preceded by the Kentucky Derby and followed by the Belmont Stakes. The race was inaugurated in 1873 for 3 year-old thoroughbreds, and its l32nd running will be held this coming Saturday, May 19 in Baltimore, MD. Janet has embroidered the saddlecloths for thoroughbreds at the annual race for over 2 decades. Last May, she added the colorectal cancer ``Blue Star of Hope'' to the saddlecloths of the 11 contenders. Pimlico Race Course will again support Janet's efforts to fight colorectal cancer this coming weekend. More than 17 million people will view this weekend's race and her efforts will make a true difference in raising awareness. Of the millions of viewers, it's estimated that nearly 1 million of them are at risk for developing the disease. Janet, along with race course officials, hopes that this symbol will encourage early screening and detection of colorectal cancer.

Janet's message is an urgent and important one. In 2006 alone, according to the American Cancer Society, more than 150,000 new cases were diagnosed and more than 50,000 Americans died from colon cancer. In my own State of Maryland, nearly 1,000 people lost their lives to this disease last year. What many people are not as aware of is that colon, cancer is preventable with appropriate screening, highly detectable, and curable if found early.

This past April, I introduced the Colon Cancer Screen for Life Act of 2007 along with my colleagues, Senator Collins, Senator Lieberman, and Senator Graham. This bill would help eliminate the barriers that currently exist under Medicare for colorectal cancer screening and increase the number of seniors who receive this potentially lifesaving benefit. According to the Centers for Disease Control and Prevention, if everyone age 50 and older were screened regularly, as many as 60 percent of deaths from colorectal cancer could be prevented. When colorectal cancer is found early and treated, the 5-year survival rate is greater than 90 percent. With the number of lives at stake, the efforts of Janet Turcotte and other brave survivors deserve special recognition. As Janet has said, ``As the thoroughbreds carry this symbol in the race to the finish line, I can only hope that through awareness and prevention, we too can win the race against colorectal cancer.'' I wish Janet Turcotte all the best on Saturday and ask my colleagues to join me in commending her for this important effort.

Mr. President, I ask unanimous consent that the previous order be modified to provide that the amendment I intend to call up is amendment No. 1071.

I ask unanimous consent that the pending amendment be set aside, and I call up amendment No. 1071.

I ask unanimous consent that Senators Lieberman and Dodd be added as cosponsors of amendment No. 1071.

Mr. President, this amendment would restore the authority of State and local governments to protect the environment and public safety of the sitings of liquefied natural gas, LNG, terminals within their own State. The amendment is drafted to be an amendment to the Rivers and Harbors Act of 1899, which gives the Army Corps authority on section 10 permits. The current law on the siting of LNG plants basically allows the Federal Energy Regulatory Commission to site without the consultation or approval of State or local governments. This amendment is an effort to restore federalism to the process of siting LNG plants.

There are now dozens of proposals to site new LNG plants in the United States. Some are being suggested to be sited near population centers, which raises serious concern about public safety.

Let me point out that LNG plants and the tankers that bring in the natural gas are very much targets of terrorism. Richard Clarke, a former Bush administration counterterrorism official, said LNG plants and tankers are ``especially attractive targets'' to terrorists. The risks are great. We know LNG plants can spark pool fires, which are high-intensity fires, extremely difficult to extinguish. CRS has reported in the last six decades there have been 13 serious accidents involving LNG plants, including one in the State of Maryland in 1979 that had a fatality associated with it.

Maryland has one of the six LNG plants in our country, and there is a proposal to add another LNG plant in Maryland. AES Sparrows Point LNG and Mid-Atlantic Express intend to site a new LNG plant at Sparrows Point in the Baltimore metropolitan area. This is right in the middle of a population center. It is opposed by the congressional delegation. It is opposed by the Governor. It is opposed by the county executive in the jurisdiction in which the LNG plant is to be sited. It is unacceptable public safety, an economic and environmental risk. Yet there has been no consideration given by the individuals who want to site this plant to

the concerns of local government. It is totally up to FERC to make the decision, and that is wrong. State and local governments should have a meaningful opportunity to participate in decisions of siting LNG terminals. That is exactly what this amendment would do.

I see the distinguished chairman of the Environment and Public Works Committee on the Senate floor. I respect her judgment as to the importance of moving forward on this bill. This amendment, because it hasn't been cleared, could add some difficulty to that process. It is within the jurisdiction of the Environment and Public Works Committee on which I serve, and I hope our committee would hold hearings on this issue and consider another vehicle which may be more appropriate than the bill currently before us to deal with the appropriate input of State and local governments on the siting of LNG plants. We have a responsibility to do that. We have a responsibility to our communities. We have a responsibility for public safety. We have a responsibility to make sure it is done right. Allowing FERC to do that without the input of State and local government is wrong.

I hope there will be another opportunity that I will be able to either have a public hearing or an opportunity to discuss this amendment further.

I am pleased several of my colleagues have expressed interest in the amendment. This certainly will not be the last time I will have an opportunity to talk about it.

Amendment No. 1071 Withdrawn

With that, I ask unanimous consent to withdraw the amendment.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. President, I rise to support the Senate substitute for H.R. 1495, which I hope we will be getting to, the Water Resources Development Act. This legislation has been delayed for many years. I thank Senator Boxer and Senator Inhofe for bringing together a bill that is critically important to our future in regard to water infrastructure improvement and the ecosystem's restoration. I think this legislation is carefully balanced, it is responsible as far as its budget, but it is very important for us to move forward and consider this legislation and move it to, I hope, enactment and signature by the President.

The bill contains a number of provisions that are vital to Maryland, which relies heavily upon the Army Corps of Engineers for water resource programs. The bill contains an important project that protects Cumberland, MD, and Ridgeley, WV, against flooding. Like so many other projects contained in this bill, the Cumberland effort will have multiple benefits. In addition to the increased public safety that comes from flood control, this project will serve as an essential component of the restoration efforts underway in Cumberland, including the rewatering of the Chesapeake and Ohio Canal and the reconstruction of the turning basin there.

For the first time, the Army Corps will supplement the Environmental Protection Agency's efforts to repair and improve the wastewater treatment facility plants that benefit the Chesapeake Bay. The Corps will be able to support sewage treatment upgrades, such as the one at Blue Plains. That plant is the largest advanced treatment facility in America, serving customers in the District of Columbia, northern Virginia, and the Maryland jurisdictions of Prince George's County and Montgomery County.

The new EPA permit for Blue Plains requires that the nitrogen load from the plant be reduced by more than 4 million pounds annually. This bill will be the largest single nutrient-reduction project in the bay watershed in a decade. Slashing the nitrogen load to the bay is a key step in the Chesapeake restoration efforts, and this bill will help get it done. It takes the participation of the Federal Government in the Chesapeake Bay restoration to a new level. By allowing the Corps of Engineers to help us with the tremendous backlog of sewage treatment plant repairs and improvements, this bill takes us to a much stronger partnership in the Chesapeake Bay restoration efforts.

We have a geography and topography which make the Chesapeake Bay particularly susceptible to erosion. The bay shoreline and many of its historic islands are literally being washed away. The erosion contributes millions of cubic yards of sediment annually to the bay, adversely affecting water quality and clogging navigational channels.

The bill extends the authorization of the 50-foot dredging of the Baltimore harbor and its channels. This project has been vital to the economic strength of the Port of Baltimore.

The bill contains authorization for two important island environmental restoration efforts. Tiny Smith Island in Somerset County has lost over 3,300 acres of wetlands over the past 150 years, threatening the population that lives there and degrading the Chesapeake Bay in the process. The project authorized in this bill consists of constructing 2 miles of offshore sediment breakwaters to provide protection to over 2,100 acres of wetlands and underwater grass beds.

I am particularly pleased the bill we are considering now contains funding for the Poplar Island project. This is a model project. We have been able to restore an island that had been almost washed away. There used to be a hunting lodge there. People would use the island. It had eroded almost to being nonexistent. What we have been able to do at Poplar Island is have a site where we could take the dredge materials from the dredging of the harbor, put it on the island, restore the island from an environmental point of view, and it has been a win-win process.

The Port of Baltimore is one of the largest ports on the east coast and a vital engine of economic activity, contributing $2 billion to the State economy and employing 18,000 Marylanders directly and tens of thousands more indirectly. There are approximately 15 miles of channel leading to the Port of Baltimore. Each year, approximately 4 to 5 million cubic yards of material must be removed from the channels to keep them at the existing depth and width. Poplar Island allows us to comply with that dredging need.

We have been able to take the dredged materials and put them onto Poplar Island. It was once a home to residents and hunting lodges. Since the project's authorization in 1996, the Corps has restored over 1,100 acres of remote island habitat. Popular Island has risen again, Phoenix-like, from the waters of the Chesapeake Bay. Eight miles of dikes protect the island from severe wave action. There are over 570 acres of upland habitat at an elevation that sometimes exceeds 20 feet. An additional 570 acres of wetland habitat has been created.

Today, even as the project continues, the island is once again home to migratory shorebirds, mammals, reptiles, and even serves as a nesting area for Maryland's famous terrapins. The expansion of the project authorized in this bill will build upon this success. It will add an additional 575 acres, half uplands and half wetlands, to the restored island.

The Nation has become increasingly aware of the important role wetlands and barrier islands play. We all witnessed the increased devastation that struck the coast of Louisiana, due in part to loss of what I like to refer to as nature's speed bumps, the wetlands and coastal islands that help absorb the shock from these horrific storms.

The Poplar Island expansion project authorized in this bill is important to the Port of Baltimore and to the ecology of the Chesapeake Bay. It is also a model for the Nation, showing us how the Army Corps projects can be engines of economic success, while at the same time serving beneficial ecological functions.

This vital project points the way to the future of the Army Corps of Engineers. It is one of the main reasons I support this legislation. This is a well-balanced bill. It is a bill that, yes, will help Maryland, but also help Maryland with projects which I think are important to show the Nation what you can do in moving forward on the economic needs of our communities, such as the dredging of our ports, but also moving forward on the environmental issues such as restoring vital wetlands and islands that would have disappeared.

It is important as far as dealing with storm damage. It is important to the restoration of our wildlife. It is important in so many different areas. I urge us to move forward with this legislation. Let's move it forward to consider the amendments, let's get it done, let's take it to the other body, and let's get it to the President as soon as possible. It has been delayed for years, we all know that. Thanks to the hard work of our leadership on the Environment and Public Works Committee, we have been able now to come forward with a bill that I think has the best chance for enactment. I urge my colleagues to carefully consider this legislation, support this legislation, but, more importantly, let's get it moving.

It is well past time that we enact the WRDA bill.

I yield the floor.

The PRESIDING OFFICER (Mrs. McCaskill.) The Senator from Florida is recognized.

Mr. President, I ask unanimous consent that Mike Burke, a fellow in my office, be accorded the privileges of the floor for the duration of H.R. 1495.

Mr. President, as you know, teachers are the most valuable resource when it comes to educating our Nation's children. Under the No Child Left Behind Act, (NCLB), States are required to recruit highly qualified teachers, yet schools in rural or high poverty areas have trouble attracting and retaining these teachers. It is for this reason that Senator Snowe and I have joined together to introduce The Master Teacher Act of 2007.

We have an education problem in America. The schools that most need

experienced educators simply do not have the resources to attract and keep the best teachers. We must give our schools the tools they need to prepare our students to succeed.

As currently designated by NCLB, 100 percent of our Nation's schools must meet Adequate Yearly Progress, AYP, in reading/language arts and mathematics by the 2013/2014 school year. To date, almost 26 percent of schools in the U.S. are not making the grade. According to a report released by the National Education Association last year, fewer schools met AYP in the 2004/2005 school year than the prior school year. In my home State of Maryland, 311 out of 1,429 schools, or almost 22 percent, did not make Adequate Yearly Progress, as defined by the No Child Left Behind Act and the State targets. During the 2005-2006 school year, 79 schools, or about 6 percent of Maryland's elementary and secondary schools had missed Adequate Yearly Progress toward State achievement targets for 5 or more consecutive years. As a result they were placed in restructuring and were subject to a variety of major school-wide reform strategies. A large majority of these restructuring schools are urban schools, and more than half are in the Baltimore City Public School System.

According to research, teacher quality is the schooling factor with the most profound effect on student achievement. Good teachers can make up to a full year's difference in learning growth for students and overwhelm the impact of any other educational investment, including smaller class sizes.

Unfortunately, our educational system pairs the children most behind with teachers who, on average, have less experience, less education, and less skill than those who teach other children. Certainly, there are exceptions, excellent and experienced teachers who have devoted their lives to at-risk students. But the overall patterns are clear.

Despite evidence that teachers become more effective after several years experience, students in high-poverty and high-minority schools are assigned to novice teachers almost twice as often as children in low-poverty schools. Classes in high-poverty and high-minority schools are much more likely to be taught by teachers without a major or minor in the subject they teach. Certainly, there are excellent first-year teachers and ineffective veterans. Indeed, mastery of a subject matter does not necessarily translate into effective teaching. But these proxies for teacher effectiveness are backed by substantial bodies of research. Studies of effective teachers reveal they are distributed among our Nation's schools in a manner that actually enlarges achievement gaps.

We will only close student achievement gaps when we improve teacher quality and experience. We must make obtaining advanced training and experience in teaching more accessible and teaching at-risk students more desirable. In short, we must establish a class of ``master teachers'' with extensive experience and training who are willing to teach for an extended period of time in the schools that need them the most.

Fortunately, research also shows even modest monetary incentives lower teacher attrition, especially in high-risk school districts. Our legislation will reward master teachers with a 25 percent Federal tax exemption on their salary for four years if they agree to teach in a school that is not meeting AYP. A master teacher is a teacher that has at least 5 years of teaching experience in a public elementary or secondary school, holds a master's degree, meets the definition of highly qualified as defined by the NCLB, and has obtained advanced certification in their state licensing system. Each State would have a cap of 10 percent of public school teachers eligible to receive master teacher tax treatment at a time. This program would go into effect in 2007 and end with the 2013/2014 school year, when NCLB requires that 100 percent of students perform at the proficient level.

Good teachers are essential to a successful education system; they are the profession charged with educating our future work force. The Master Teacher Act of 2007 will provide our children access to the best possible teachers and our teachers much needed financial support.

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

Mr. President, as you know, teachers are the most valuable resource when it comes to educating our Nation's children. Under the No Child Left Behind Act, (NCLB), States are required to recruit highly qualified teachers, yet schools in rural or high poverty areas have trouble attracting and retaining these teachers. It is for this reason that Senator Snowe and I have joined together to introduce The Master Teacher Act of 2007.

We have an education problem in America. The schools that most need

experienced educators simply do not have the resources to attract and keep the best teachers. We must give our schools the tools they need to prepare our students to succeed.

As currently designated by NCLB, 100 percent of our Nation's schools must meet Adequate Yearly Progress, AYP, in reading/language arts and mathematics by the 2013/2014 school year. To date, almost 26 percent of schools in the U.S. are not making the grade. According to a report released by the National Education Association last year, fewer schools met AYP in the 2004/2005 school year than the prior school year. In my home State of Maryland, 311 out of 1,429 schools, or almost 22 percent, did not make Adequate Yearly Progress, as defined by the No Child Left Behind Act and the State targets. During the 2005-2006 school year, 79 schools, or about 6 percent of Maryland's elementary and secondary schools had missed Adequate Yearly Progress toward State achievement targets for 5 or more consecutive years. As a result they were placed in restructuring and were subject to a variety of major school-wide reform strategies. A large majority of these restructuring schools are urban schools, and more than half are in the Baltimore City Public School System.

According to research, teacher quality is the schooling factor with the most profound effect on student achievement. Good teachers can make up to a full year's difference in learning growth for students and overwhelm the impact of any other educational investment, including smaller class sizes.

Unfortunately, our educational system pairs the children most behind with teachers who, on average, have less experience, less education, and less skill than those who teach other children. Certainly, there are exceptions, excellent and experienced teachers who have devoted their lives to at-risk students. But the overall patterns are clear.

Despite evidence that teachers become more effective after several years experience, students in high-poverty and high-minority schools are assigned to novice teachers almost twice as often as children in low-poverty schools. Classes in high-poverty and high-minority schools are much more likely to be taught by teachers without a major or minor in the subject they teach. Certainly, there are excellent first-year teachers and ineffective veterans. Indeed, mastery of a subject matter does not necessarily translate into effective teaching. But these proxies for teacher effectiveness are backed by substantial bodies of research. Studies of effective teachers reveal they are distributed among our Nation's schools in a manner that actually enlarges achievement gaps.

We will only close student achievement gaps when we improve teacher quality and experience. We must make obtaining advanced training and experience in teaching more accessible and teaching at-risk students more desirable. In short, we must establish a class of ``master teachers'' with extensive experience and training who are willing to teach for an extended period of time in the schools that need them the most.

Fortunately, research also shows even modest monetary incentives lower teacher attrition, especially in high-risk school districts. Our legislation will reward master teachers with a 25 percent Federal tax exemption on their salary for four years if they agree to teach in a school that is not meeting AYP. A master teacher is a teacher that has at least 5 years of teaching experience in a public elementary or secondary school, holds a master's degree, meets the definition of highly qualified as defined by the NCLB, and has obtained advanced certification in their state licensing system. Each State would have a cap of 10 percent of public school teachers eligible to receive master teacher tax treatment at a time. This program would go into effect in 2007 and end with the 2013/2014 school year, when NCLB requires that 100 percent of students perform at the proficient level.

Good teachers are essential to a successful education system; they are the profession charged with educating our future work force. The Master Teacher Act of 2007 will provide our children access to the best possible teachers and our teachers much needed financial support.

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

Mr. President, 2\1/2\ hours ago, along with Senator Mikulski, I attended a mobilization ceremony for members of the Maryland National Guard who are being deployed to Iraq. All Marylanders are proud of the service of our members of the National Guard who have been called up and have served in Iraq and Afghanistan and are now being called up. It was an emotional morning as these soldiers said goodbye to their families.

I can tell you, they are ready. They are ready to serve our country. They will serve with great distinction. I told our soldiers and their families I would do everything I could as a Senator to make sure they had all of the resources so they can carry out the mission that has been assigned to them as safely and as effectively as possible. That is one reason I will vote for this conference report. I told their families I would do everything I could to help support their needs and to support the needs of military families around this Nation and to support the needs of veterans around this Nation, to take care of their support services, including their health care needs. That is another reason I will be voting for this conference report.

We need a change in our mission in Iraq so our soldiers can achieve a mission that is in the best interest of this country. That is another reason I am supporting this conference report. It spells out a mission that is in the best interest of this Nation and can be achieved. We need to change our role in Iraq. We need to get our soldiers out of the middle of a civil war, to focus on the war against terror, to help the Iraqi people take care of their own needs, to bring our troops home. That is another reason I will be supporting this conference report.

We need measurable and achievable benchmarks for the Iraqi Government so they can secure their own country to undertake political reconciliation and to provide basic needs for ordinary Iraqi citizens, another reason I will be supporting this conference report.

We need a political framework to include all the Iraqi stakeholders in order to provide a political answer to the problems of that country, another reason I support this conference report.

The President of the United States has threatened a veto. That would only delay the delivery of much needed funds to our forces, delay a change in direction in Iraq, and undermine the need for political reform in Iraq itself. We have our responsibility. Our first responsibility is to act and to pass this supplemental appropriations bill.

I urge colleagues to support this appropriation. It is in the best interest of the country.

I yield the floor.

Mr. President, today I am introducing legislation that will improve mutual aid agreements for the National Capitol Region. Senators Mikulski and Warner are original co-sponsors of my bill.

The Intelligence Reform and Terrorism Prevention Act of 2004 contains provisions for cooperation among the National Capital Region's jurisdictions in the event of a regional or national emergency. Since that time, a model mutual aid agreement has been approved by 20 of the 21 jurisdictions in the Washington Council of Governments, the State of Maryland, the Commonwealth of Virginia, the Metropolitan Washington Airports Authority, and the Washington Metropolitan Area Transit Authority. The model mutual aid agreement is designed to append operational plans across the spectrum of public safety disciplines, including police, fire and rescue, public health, water supply, and debris removal, among others. This has opened the way for the region's governments to begin hammering out the details of how emergency responses will actually be executed.

As the jurisdictions began working on the mutual aid agreements, concern arose that drinking water and wastewater utilities were not included in the original language. The Metropolitan Washington Council of Governments brought this issue to my attention. Today's legislation will remedy the situation by providing a commonsense solution that will allow our drinking water and wastewater facilities' staffs to participate as appropriate in the mutual aid agreements.

Current law allows the jurisdictions in the Washington metropolitan area to share their personnel freely in the event of a national emergency. Firefighters in Fairfax County, for example, could be enlisted to support their counterparts in the District of Columbia or in Maryland in the event of a national or regional emergency. Similarly, emergency responders in Montgomery and Prince George's counties could support their counterparts in Alexandria or Arlington.

This legislation simply extends that same commonsense approach to drinking water and wastewater treatment authorities. If a drinking water plant were to become disabled because of a natural disaster or terrorist attack, this bill would allow licensed engineers to cross jurisdictional boundaries to come to the aid of the disabled system and the thousands of regional residents who depend on these vital systems for safe drinking water.

This legislation has the support of the Metropolitan Washington Council of Governments and the National Capital Region Water Security Workgroup, chaired by the Fairfax County Water Authority.

One section of the legislation requires some explanation. That section relates to the terms ``agent'' and ``volunteer.'' It is anticipated that the region's localities will rely on a variety of authorized agents and volunteers to assist in fulfilling their mutual aid response obligations. The act currently includes agents and volunteers in the definition of ``employee'' and requires that all agents and volunteers be ``committed in a mutual aid agreement'' to prepare for or respond to an emergency. It has become apparent in developing operational plans, however, that it is not likely that a complete list of agents and volunteers will be identified and become parties to a mutual aid agreement with one or more of the region's localities. Instead, it is more likely that agents and volunteers will be associated with a locality through a mechanism other than an actual mutual aid agreement. Moreover, it is probable that the association with an agent or volunteer will arise only in direct response to a particular emergency. For example, a locality may find it necessary to call upon volunteer fire companies to respond to a particular fire- related event that threatens to overwhelm the localities' resources. In such an instance, the agent and volunteers, as well as the locality that has called upon them, should be accorded the liability protections of the act. Perhaps more importantly, it is preferred by the region's localities that a list of agents and volunteers not be brought within the scope of the act prospectively and on a continuous basis, but only as the need arises on a case-by-case basis.

The legislation I am introducing today simply strikes ``agents and volunteers'' from the definition of ``employee'' and expressly extends the liability protections of the act to agents. This term, consistent with common dictionary usage, would encompass authorized volunteers. The proposed language was drafted and approved by members of the Council of Governments' Attorneys Committee, consisting of the lead counsel of all 21 COG jurisdictions, with participation by the two State's Attorneys General offices.

In short, this legislation will give local jurisdictions the ability to respond fully and appropriately to the full range of emergencies that they may face. I urge the Senate to pass this bill as expeditiously as possible so that we can give these local and State governments the tools they need to meet the challenges that the future may present.

Mr. President, I ask unanimous consent that the text of the legislation be printed in the Record following my remarks.

Mr. President, today I am introducing legislation that will improve mutual aid agreements for the National Capitol Region. Senators Mikulski and Warner are original co-sponsors of my bill.

The Intelligence Reform and Terrorism Prevention Act of 2004 contains provisions for cooperation among the National Capital Region's jurisdictions in the event of a regional or national emergency. Since that time, a model mutual aid agreement has been approved by 20 of the 21 jurisdictions in the Washington Council of Governments, the State of Maryland, the Commonwealth of Virginia, the Metropolitan Washington Airports Authority, and the Washington Metropolitan Area Transit Authority. The model mutual aid agreement is designed to append operational plans across the spectrum of public safety disciplines, including police, fire and rescue, public health, water supply, and debris removal, among others. This has opened the way for the region's governments to begin hammering out the details of how emergency responses will actually be executed.

As the jurisdictions began working on the mutual aid agreements, concern arose that drinking water and wastewater utilities were not included in the original language. The Metropolitan Washington Council of Governments brought this issue to my attention. Today's legislation will remedy the situation by providing a commonsense solution that will allow our drinking water and wastewater facilities' staffs to participate as appropriate in the mutual aid agreements.

Current law allows the jurisdictions in the Washington metropolitan area to share their personnel freely in the event of a national emergency. Firefighters in Fairfax County, for example, could be enlisted to support their counterparts in the District of Columbia or in Maryland in the event of a national or regional emergency. Similarly, emergency responders in Montgomery and Prince George's counties could support their counterparts in Alexandria or Arlington.

This legislation simply extends that same commonsense approach to drinking water and wastewater treatment authorities. If a drinking water plant were to become disabled because of a natural disaster or terrorist attack, this bill would allow licensed engineers to cross jurisdictional boundaries to come to the aid of the disabled system and the thousands of regional residents who depend on these vital systems for safe drinking water.

This legislation has the support of the Metropolitan Washington Council of Governments and the National Capital Region Water Security Workgroup, chaired by the Fairfax County Water Authority.

One section of the legislation requires some explanation. That section relates to the terms ``agent'' and ``volunteer.'' It is anticipated that the region's localities will rely on a variety of authorized agents and volunteers to assist in fulfilling their mutual aid response obligations. The act currently includes agents and volunteers in the definition of ``employee'' and requires that all agents and volunteers be ``committed in a mutual aid agreement'' to prepare for or respond to an emergency. It has become apparent in developing operational plans, however, that it is not likely that a complete list of agents and volunteers will be identified and become parties to a mutual aid agreement with one or more of the region's localities. Instead, it is more likely that agents and volunteers will be associated with a locality through a mechanism other than an actual mutual aid agreement. Moreover, it is probable that the association with an agent or volunteer will arise only in direct response to a particular emergency. For example, a locality may find it necessary to call upon volunteer fire companies to respond to a particular fire- related event that threatens to overwhelm the localities' resources. In such an instance, the agent and volunteers, as well as the locality that has called upon them, should be accorded the liability protections of the act. Perhaps more importantly, it is preferred by the region's localities that a list of agents and volunteers not be brought within the scope of the act prospectively and on a continuous basis, but only as the need arises on a case-by-case basis.

The legislation I am introducing today simply strikes ``agents and volunteers'' from the definition of ``employee'' and expressly extends the liability protections of the act to agents. This term, consistent with common dictionary usage, would encompass authorized volunteers. The proposed language was drafted and approved by members of the Council of Governments' Attorneys Committee, consisting of the lead counsel of all 21 COG jurisdictions, with participation by the two State's Attorneys General offices.

In short, this legislation will give local jurisdictions the ability to respond fully and appropriately to the full range of emergencies that they may face. I urge the Senate to pass this bill as expeditiously as possible so that we can give these local and State governments the tools they need to meet the challenges that the future may present.

Mr. President, I ask unanimous consent that the text of the legislation be printed in the Record following my remarks.

Mr. President, I rise today in strong support of S. 761, the America COMPETES Act of 2007. If we consider the people who have given us the light bulb, the blood bank, the artificial heart, the microchip processor, and Microsoft, we must acknowledge that access to quality education and openness to innovation in America have nurtured many of the most influential inventors and the best trained workforce in modern history.

But while technological progress has revolutionized the workplace, our education system has failed to keep pace; now, many of our Nation's schools are unable to provide their students with the scientific, technological, engineering, and mathematical knowledge and skills the 21st century economy demands. Without sufficient numbers of well- trained people and the scientific and technical innovations they produce, the United States is in jeopardy of losing its place as the center for the high-quality jobs and innovative enterprise that have been part of our national heritage.

I applaud Senators Bingaman and Alexander and the other leading sponsors of the bill for taking action to ensure that this Nation remains a leader for innovation, and I am proud to join them as a cosponsor of this bill. I am grateful to the academic and business leaders, including Nancy Grasmick, the Maryland State superintendent of schools, and Dr. C.D. Mote, Jr., president of the University of Maryland, who produced both the National Academies' ``Rising Above the Gathering Storm'' and the Council on Competitiveness' ``Innovative America'' reports and recommendations that serve as the foundation for this legislation. I am proud of the legislation the Senate is considering: it takes significant steps to stimulate and support innovation in our Nation.

When I ask young scientists and engineers what triggered their interest, they cite--almost without exception--a teacher, mentor, or internship as the inspiration for their love of science, math, and innovation. I am pleased, therefore, that this bill includes several measures to improve teacher recruitment and training, develop partnerships between schools and laboratories, and encourage internship programs. All of these provisions will increase students' exposure to inspirational teaching, talented scientists, and real-world experience.

Education research and the anecdotal evidence I mentioned above indicate that teacher quality is the most important factor influencing student achievement. Yet our best teachers are not evenly distributed among our Nations communities. Far too many of our highest need school districts are struggling to recruit and retain experienced teachers. To address this inequity, S. 761 includes important measures to recruit and train high-quality math and science teachers for high-need school districts. The legislation also creates mentorship and apprenticeship programs for women, who are underrepresented in science, technology, engineering, and mathematics careers.

The growing gap between what is taught in elementary and secondary schools and the skills necessary to succeed in college, graduate school, and today's workforce threatens the implicit promise we have each made to our own children and those whom we represent: get good grades in school and you will succeed in life. S. 761 contains competitive grants to States that will encourage better alignment of elementary and secondary curricula with the knowledge and skills required by colleges and universities, 21st century employers, and the Armed Forces, so that high school graduates will be prepared to succeed in the world.

Those students who choose to pursue high-tech careers require Federal funding to conduct research. Many scientists and mathematicians make their greatest discoveries early in their careers, before they have developed the track records and reputations often required to secure research grants. The leaders of Johns Hopkins and other great Maryland research institutions have told me that it is difficult for their young and most daring researchers to secure necessary research funding.

S. 761 would significantly increase America's investment in research, doubling funding for the National Science Foundation and the Department of Energy's Office of Science over the next 4 years and authorizing a significant increase in funding for the National Institute of Standards and Technology. But the legislation goes further by also targeting more funds to young researchers and high-risk frontier research. S. 761 would increase the number of research fellowships and traineeships that provide critical support for science, technology, engineering, and mathematics graduate students and would require NIST to set aside at least 8 percent of its annual funding for high-risk, high-reward innovation acceleration research.

Today, we face enormous technological challenges, which include halting global climate change, achieving energy independence, and finding cures for AIDS, malaria, diabetes, and other devastating diseases. We must equip ourselves with skills and resources to tackle these problems so that our children and grandchildren may inherit a world rich with economic opportunities. Therefore, I am urging my colleagues to join me in support of this critical legislation.

Madam President, I commemorate April 22--Earth Day 2007, a day set aside to celebrate gains we have made in improving the environment and to renew our commitment to protect our planet.

Earth Day was established by Senator Gaylord Nelson of Wisconsin and was first celebrated in 1970. Senator Nelson firmly believed that education was the key to changing people's attitude about the environment. Since then, the Earth Day celebration has spread throughout the nation and to the rest of the world, with more and more people getting involved in efforts to clean and nurture the environment.

Despite Earth Day's popularity and the many programs that were created to improve the health of the planet, our world is still wrought with environmental problems. We still face many pressing issues such as global warming, protecting our coastal waters from over-fishing, and preserving America's most precious resource lands from the Alaskan Tongass Rainforest to the Redrock lands in Utah, to our own Chesapeake Bay.

Today, we face a serious and growing threat from global warming. Recently I told the Senate Environment and Public Works Committee about the immediate threats that global warming poses to Maryland. A significant part of Maryland is in low-lying areas that would be inundated if global temperatures keep rising. The National Flood Insurance Program has designated more than 12 percent of Maryland as a special flood hazard area, and an estimated 68,000 Maryland homes and buildings are located within a flood plain.

We are already seeing the effects. About a third of Blackwater National Wildlife Refuge on the Eastern Shore has been lost to sea level rise in the past 70 years. Smith Island, situated in the Chesapeake Bay, has lost 30 percent of its land to rising sea levels since 1850.

I have long supported a comprehensive, environmentally friendly energy policy that emphasizes increasing the availability and use of renewable energy, as well as promoting greater energy efficiency. Energy efficiency and renewable energy will reduce America's dangerous dependency on foreign oil while also dramatically reducing greenhouse gases.

Closer to home, we must continue to focus our efforts on restoring the Chesapeake Bay. The Bush administration's budget proposes drastic cuts to vital initiatives, including environmental education, funds to upgrade wastewater treatment plants, and several farm bill conservation programs that help farmers reduce nutrient runoff from entering the Bay. The budget resolution that I helped draft and the Senate passed last month restores many of those dangerous cuts, but we still have much work ahead of us to assure that these critical Federal programs are fully funded.

Earth Day celebrations serve as important reminders that we cannot take our natural resources for granted. I urge all Americans to join together to protect, preserve, and restore the planet's natural treasures.

Mr. President, today I introduce the Colon Cancer Screen for Life Act of 2007 along with my colleagues, Senator Collins, Senator Lieberman, and Senator Graham. Many people are aware that colon cancer is the second most deadly cancer in the United States. In 2006 alone, according to the American Cancer Society, more than 150,000 new cases were diagnosed and more than 50,000 Americans died from colon cancer. In my own State of Maryland, nearly 1,000 people lost their lives to this disease last year. What people are not as aware of, however, is that colon cancer is preventable with appropriate screening, highly detectable, and curable if found early. The purpose of our bill is to increase the rate of participation in colon cancer screening and ensure that we are saving every life that we can from this deadly disease.

Medicare coverage for colorectal cancer screening through colonoscopy was authorized in the Balanced Budget Act of 1997 and further expanded in 2000 when the colonoscopy benefit was added for high risk beneficiaries. Under this Medicare benefit, a low risk beneficiary is entitled to receive a colonoscopy once every ten years and a high risk beneficiary is entitled to a colonoscopy every two years. Despite this, recent studies have shown that patients are not utilizing coverage of CRC preventive screenings. According to the Government Accountability Office, since the implementation of the benefit in 1998, the percentage of Medicare beneficiaries receiving either a screening or a diagnostic colonoscopy has increased by 1 percent.

Since providing coverage for this lifesaving service, Congress has discovered many barriers that stand in the way of patients having access to the colonoscopy benefit. One reason for such low utilization is that the physician reimbursement has been cut by 33 percent since this benefit was enacted. In 1997, a colonoscopy performed in a hospital outpatient department or an ambulatory surgery center was reimbursed at approximately $301. Now, in 2007, that reimbursement is only $198.20.

Some may argue that reductions in Medicare payments are necessary to keep the Medicare Program financially viable. While I strongly support efforts to eliminate wasteful spending in Medicare, I can assure my colleagues that is not the case here. To the contrary, providing adequate reimbursement for screening will result in Medicare savings and better health outcomes. Let me explain. Our health care system spends an estimated $8.3 billion annually to treat newly diagnosed cases of colon cancer. The average cost of direct medical care for each cancer episode is estimated to be between $35,000 for early stage detection and $80,000 for later stage detection. So each time that cancer is not detected early, that individual faces an increased risk of developing the disease and needing treatment that costs Medicare Program tens of thousands of dollars.

Patient participation has also been is that currently Medicare does not cover a preoperative visit with a physician prior to screening. While it is true that a colonoscopy is a minimally invasive procedure, an anesthetic is used to sedate the patient to make the colonoscopy less uncomfortable. Because the patient is going to be sedated, medical standards require doctors to visit with the patient before surgery to determine and protect against any risks, such as drug interaction, and to give them preoperative instructions. Recognizing the importance of these visits, Medicare does reimburse for a consultation prior to a diagnostic colonoscopy. A preoperative visit is no less medically necessary before a preventive screening, and therefore should be reimbursed in the same manner.

Finally, some beneficiaries may delay seeking colorectal cancer screening because they cannot afford Medicare's Part B deductible. Recognizing this, Congress recently took an important step by waiving the Part B deductible for preventive colon cancer screenings, effective January 1, 2007. However, gastroenterologists are now reporting that, if polyps or other signs of cancer are discovered in the course of a preventive colonoscopy, the procedure is then considered to be diagnostic and Medicare requires that the beneficiary pay a deductible. Congress needs to ensure that beneficiaries are not dissuaded from getting this lifesaving procedure by the concern that they might have to pay a deductible if a polyp is discovered. Our legislation clarifies congressional intent to ensure that CMS will waive the deductible in all screenings so that Medicare beneficiaries are not confronted with an unexpected additional expense, should the procedure's coding change.

The Colon Cancer Screen for Life Act would eliminate every one of these barriers, and in doing so, save lives. First, this legislation would increase reimbursement for colorectal cancer related procedures to ensure that physicians are able to continue to perform these valuable services. Reimbursement for procedures performed in a physician's office would be increased by up to 10 percent and reimbursement for procedures performed in Hospital Outpatient Department, HOPD, or Ambulatory Surgery Center, ASC, would be increased by up to 30 percent. The bill would also provide Medicare coverage for the preoperative doctor's visit conducted prior to a screening colonoscopy. Finally, the bill contains a technical provision to require that the deductible is waived whether or not the beneficiary's screening was clean or results in a biopsy or lesion removal.

More than 50,000 Americans will die from colon cancer this year alone. Ninety percent of these cases might have been prevented. We cannot afford to wait another moment before doing something to eliminate these and other barriers that are standing in the way of preventing colon cancer.

I urge my colleagues to join me in support of this important legislation and enact it this year.

Mr. President, we need to make this country energy independent, and to enact a comprehensive, long-term energy policy that will give Americans the energy they need, while protecting our environment and our national security.

As one step in this direction, today I am introducing the American Green Building Act.

Our Federal Government is the largest single energy consumer in the world.

Buildings account for over a third of America's energy consumption. Buildings also account for 49 percent of sulfur dioxide emissions, 25 percent of nitrous oxide emissions, and 10 percent of particulate emissions, all of which damage our air quality. Buildings produce 38 percent of the country's carbon dioxide emissions--the chief pollutant blamed for global warming.

Federal buildings are a large part of this problem.

Energy used in Federal buildings in fiscal year 2002 accounted for 38 percent of the total Federal energy bill. Total Federal buildings and facilities energy expenditures in fiscal year 2002 were $3.73 billion.

The American Green Building Act would require all new Federal buildings to live up to green building LEED, Leadership and Energy in Environmental Design, Silver standards, set by the United States Green Building Council. These standards were created to promote sustainable site development, water savings, energy efficiency, materials selection, and indoor environmental quality. The average LEED-certified building uses 32 percent less electricity, 26 percent less natural gas and 36 percent less total energy. LEED-certified buildings in the U.S. are in aggregate saving 150,000 metric tons of carbon dioxide reduction, equivalent to 30,000 passenger cars not driven for one year. A single LEED-certified building is designed to save an average of 352 metric tons of carbon dioxide emissions annually, which is equivalent to 70 passenger cars not driven for one year. This standard would only apply to Federal buildings for which the design phase for construction or major renovation is begun after the date of enactment of the provision. The General Services Administration or relevant agency may waive this requirement for a building if it finds that the requirement cannot be met because of the quantity of energy required to carry out the building's purpose or because the building is used to carry out an activity relating to national security.

My bill will also require that significant new development or redevelopment projects undertaken by the Federal Government plan for storm water runoff. The hardened surfaces of modern life, such as roofs, parking lots, and paved streets, prevent rainfall from infiltrating the soil. Over 100 million acres of land have been developed in the United States. Development is increasing faster than population: Population growth in the Chesapeake Watershed, for example, increased by 8 percent during the 1990s, but the rate of impervious surface increased by 42 percent. Development not only leads to landscape changes but also to contamination of storm water runoff by pollutants throughout the watershed. Storm water runoff can carry pollutants to our streams, rivers, and oceans, and poses a significant problem for the Chesapeake Bay. Every other pollution source in the Chesapeake is decreasing, but pollution from storm water runoff is increasing. In urbanized areas, increased storm water runoff can cause increased flooding, stream bank erosion, degradation of in-stream habitat and a reduction in groundwater quality. For these reasons, as the Federal Government moves forward with development, we need to plan for how to manage storm water runoff. The storm water provisions in the American Green Building Act will be used to intercept precipitation and allow it to infiltrate rather than being collected on and conveyed from impervious surfaces.

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

Mr. President, today I am introducing legislation to restore the authority of State and local governments to protect the environment and ensure public safety with respect to the siting of Liquefied Natural Gas (LNG) terminals within their States. This measure would strike a provision in the Energy Policy Act of 2005 which gave the Federal Regulatory Energy Commission (FERC) power to preempt State and local concerns in the siting, construction and operation of LNG facilities.

In recent years, the LNG industry has proposed building dozens of new LNG terminals throughout the United States, as LNG's share of the natural gas market continues to grow rapidly. Many of these terminals are being planned near populated areas or in environmentally sensitive coastal areas. As a highly hazardous and combustible fuel source, LNG poses serious safety concerns to local communities from potential accidents, as well as terrorism risks. Richard Clarke, a former Bush Administration Counter Terrorism official, noted that LNG terminals and tankers present ``especially attractive targets'' to terrorists. Experts have identified anumber of potentially catastrophic events that could arise from an LNG release, including pool fires--an extremely intense fire that cannot be extinguished and can spread over considerable distance, flammable vapor clouds that may drift some distance from the spill site, and flameless explosions. According to the Congressional Research Service, there have been approximately 13 serious accidents at LNG plants around the world over the past six decades, including three accidents which caused fatalities--two in Algeria in 1977 and 2004 respectively, and another at Cove Point, MD; in 1979, which killed one worker and caused some $3 million in damages.

In the State of Maryland, which is already home to one of six operating LNG terminals in the United States, AES Sparrows Point LNG, LLC and Mid-Atlantic Express, LLC has proposed building a new terminal near a densely-populated area of Baltimore. Our area Congressional Delegation, Governor O'Malley, Baltimore County Executive Jim Smith and other local officials and community leaders believe this project poses unacceptable public safety, economic and environmental risks and does not serve the public interest. Yet, under current law, the Federal Energy Regulatory Commission now has exclusive authority to approve onshore LNG terminal siting applications. While the law requires FERC to consult with State and local governments regarding safety concerns, they have no role in the final decision. Moreover, while the law permits states to conduct safety inspections of LNG terminals, they do not have the authority to require any safety precautions or to take enforcement actions if they discover problems at a facility during a safety inspection.

It is vital, in my opinion, that State and local authorities and the public have a meaningful opportunity to participate in the decision- making process about the siting of these plants. These terminals have the potential for tremendous impacts on the communities in which they would be constructed and would operate. The measure I am introducing today seeks to restore that authority and give Governors the same veto powers for onshore LNG terminal proposals as they currently exercise for offshore terminal proposals under the Deepwater Port Act. I urge my colleagues to join me in supporting this measure.