Floor Statements

Mr. President, today I would like to recognize Mr. William Greenblatt, a man whose accomplishments are a true testament to what a business and community leader should be, as he celebrates his fiftieth birthday on June 9, 2004.

Mr. Greenblatt began his career providing photography services for commercial, industrial, public relations and non-profit organizations including the City of St. Louis, Make-A-Wish Foundation, United Way, and American Heart Association. He also serves as the St. Louis Fire Department's photographer recreating fire scene construction and investigations as well as documenting training and incidents.

During Mr. Greenblatt's career, he has had the honor of being the official photographer for many of Missouri's most prominent Federal, State, and local politicians, as well as St. Louis artists Nelly and Toya. In addition to his services at United Press International, he has contributed to numerous publications such as the Chicago Tribune, Los Angeles Times, Newsweek Magazine, New York Times, and the Washington Post.

Mr. Greenblatt has dedicated both his professional and personal life to the betterment of his community. He has served on several non-profit boards as well as being a member of several professional organizations including the St. Louis Regional Chamber and Growth Association, St. Louis Journalism Review Board of Editorial Advisors, Urban League of Metropolitan St. Louis, and the James S. McDonnell Board of Directors.

Throughout his service, Mr. Greenblatt has been honored with several achievements including placing in the Baseball Hall of Fame Photo Contest, Certificate of Appreciation from the City of St. Louis Emergency Management Agency, Outstanding Citizen Award.

Mr. Greenblatt has a distinguished record of service in his public and private life. I would like to thank him for his dedication to his profession as well as his contributions to the St. Louis Community. On behalf of Missouri, I wish him a happy 50th birthday.

Mr. President, I call up amendment No. 3384 and ask unanimous consent to incorporate the modifications that are at the desk.

Mr. President, we are not going to take much time, although I see my colleague from Iowa is here. This is a measure designed to compensate the former energy workers at the Mallinkrodt site in the St. Louis, MO, area and the Iowa atomic energy workers at what was known as the Burlington Atomic Energy Commission plant and the Iowa ordinance plant.

We have gone through many iterations trying to work it out to make sure that all sides are comfortable. I appreciate the courtesies of the New York Senators who have issues. We look forward to working with them on solving their issues. There has been a great deal of work put into this. Some people may think it is small, when it is less than a couple hundred million dollars, but let me tell you, this is huge to the former workers and their families who are directly affected.

I went back to Missouri last Friday, after we had talked about this on the Senate floor. I met with some of the workers and some of their families. The young woman who has been the leader in this effort, Denise Brock, was there. She told me how much this meant to her mother, who lost her husband several years ago as a result of the cancers brought on by excessive radiation. She also told me that when I spoke last Thursday about Jim Mitalski, a former Mallinkrodt worker who had gone into the hospital and slipped into a coma--he lost a foot, had multiple cancers--she said she made a recording of the floor remarks I made, took it down and played it next to Mitalski's bedside where he seemed to be in a deep sleep. She said as she played it and we mentioned his name, she saw a smile come over his face, and she believed that he did know that we were going to do something. Unfortunately, Mr. Mitalksi has since died.

That is happening to workers in Iowa, in Missouri, and all across the country. Yes, they were on the forefront. They were the atomic warriors, and they made what nobody knew at that time were great sacrifices of their health so we could win World War II.

Mr. President, I thank the Chair and I thank all of the people who worked on this issue.

I thank all parties for their assistance. I urge adoption of this after the appropriate comments are made.

I rise in strong opposition to the Daschle amendment. I strongly share the Senator's goal of improving health care and benefits for our Nation's veterans. I think for a number of reasons this is a misguided approach and will not achieve the desired goal of assuring access for all veterans.

I speak to this with a good deal of experience. Currently, I am chairman of the Appropriations VA-HUD Subcommittee. This is the committee that funds the VA. Since 1995, I have been in the leadership as either the chairman or the ranking member, and I can assure my colleagues that throughout that timeframe VA medical care has been a top priority on a bipartisan basis for that committee. The VA has received from that committee very strong support for medical care.

Since 1998, VA medical care has increased by $11 billion, and since 2001 it has increased by $7.3 billion, or 34.7 percent. That is a huge increase, and we made those increases because there were needs. Under the appropriations process, we can respond to those needs. That is why I think the Daschle amendment may have some questionable long-term implications.

Under the current system of discretionary appropriations, the Congress has the flexibility to make the necessary funding adjustments on an annual basis to respond to the challenging health care needs of veterans and to ensure proper accountability with the system so that veterans' needs are being adequately addressed.

Under the mandatory system proposed by the Senator from South Dakota, there would be a fixed funding system based solely on enrollment levels and a contrived inflationary index. Further, discretionary appropriations would be capped at the 2004 appropriations level for VA medical care. Let me go back and take a look. Here is something. I am reading from a chart that has been prepared by the Budget Committee. It shows, going back to 1993, that in that year, for example, the Consumer Price Index, CPIU, hospital and related services, was up 8.37 percent. The CPIU medical care was up 5.97 percent. But VA medical care was up 9.1 percent in the appropriated accounts. In other words, if we had been using either of those formulas, we would have gotten less under the formula than we actually got appropriated.

Of the last 10 years, there were 4 years--1996, 1997, 1998, and 1999--when the index would have provided more. But overall, as I said, let's go back to 2002. Then the highest index on medical care was 4.72 percent. The budget was increased 7.6 percent. In 2003, the hospital and related services index went up 7.36 percent, but the VA medical care budget increases in the appropriations bill went up 12.3 percent. That is almost a 5-percent higher rate of increase under the appropriations formula.

I think that shows the flexibility with which the appropriations process works. But there are other things we have to do in the appropriations bill. First, the funding formula creates an artificially fixed level. It doesn't reflect the unique medical care needs of veterans. The VA system was specifically created to respond to the unique needs of veterans who suffered health problems born on the battlefield. VA provides special services for veterans who have been exposed to environmental hazards or toxic substances or suffered spinal cord injuries or loss of limbs. This is especially evident in our veterans returning from Iraq and Afghanistan, many of whom we have met in Walter Reed Hospital to see the care they are getting in the regular military hospitals.

But our veteran population is aging. They are going to need special long-term care services not accounted for under the Daschle funding formula. Veterans in need of nursing home care are expected to increase from some 640,000 to over 1 million by 2012 and remain at that level until 2023.

More importantly, I think the mandatory funding option eliminates the strongest tool of the Congress, the purse strings, to ensure accountability within the VA health care system. We are fortunate that the VA now has a very strong leader who is a great administrator and who is thoroughly committed to the needs of veterans, Secretary Tony Principi. He has made tremendous strides in improving the VA health care system because he demands the VA be accountable and responsive to the needs of veterans. Nevertheless, I have seen years where the VA has not had the same kind of leadership that it has under Secretary Principi. I believe it is necessary and was necessary at previous times that Congress have the ability to ensure the VA system is held accountable and makes the necessary reforms so they can provide timely, quality health care services to our Nation's veterans.

Even the President's task force acknowledges that providing sufficient funding to the VA will not by itself guarantee timely access. Let me give an example. Over 10 years ago, we were able to push successfully for improvements to health care access by forcing the VA to open more community-based outpatient facilities so veterans would not be forced to drive hours to receive medical care. I know how important that is. In my home State of Missouri some veterans would spend a whole day driving to the veterans hospital in Colombia, MO, or St. Louis or Kansas City. We found by adopting a system of community- based health care clinics we could provide the services, the primary care services, the pre-op services, in a setting that was less expensive. We could take them in a hospital that is more accessible and save much time and energy for the veterans, while ensuring they get the health care they need. We have been able to successfully push the VA to develop a comprehensive capital needs assessment, known as CARES, to realign the VA care and medical infrastructure so the system is modernized and located closer to where veterans live.

Many people have fulminated against the CARES process because its purpose is to look at unneeded veterans facilities. I have heard some statements that are totally unwarranted, saying that the CARES project is going to take away needed facilities, needed care for veterans.

To the contrary, the whole concept of CARES was one that we pushed in our

Appropriations Committee and that the previous administration, the Clinton administration, adopted. The General Accounting Office had found that the VA is currently wasting $1 million per day on unneeded and empty buildings. That comes right out of the medical care budget. When you have a huge hospital that is 10-percent full, the costs are astronomical for serving that small population.

Under the CARES process, those services will be moved to a more appropriate structure, and the funds will then be used to provide services, whether it is community outpatient services or some other specific kind of service or just putting more money into the medical professionals to make sure the veterans get the health care they deserve.

The GAO had found that more than 25 percent of veterans enrolled in VA health care, over 1.7 million veterans, live over 60 minutes driving time from a VA hospital. Under the Daschle system, Congress would no longer have the ability to force the VA to make the reforms necessary, as outlined under its CARES program, to improve care and access for our veterans. Instead, the system could build in waste and failure to be responsive to the needs of those who are supposed to benefit from the system.

The third problem with the amendment is that the VA cannot spend all of the additional funds contemplated in the Daschle amendment due to infrastructure and hiring concerns. The VA has an outdated and aging infrastructure. That is why we are pushing the CARES program. In many cases, VA does not have the space to accommodate the needs of patients and health care workers. We need to make sure that money is funneled into providing those facilities to meet the current and future needs of veterans rather than the facilities designed to meet the needs of veterans 40 years ago when their needs were very different and their locations were very different.

In some hospitals, patients are forced to wait in hallways because of the lack of waiting area space. As mentioned earlier, CARES will address these infrastructure needs, but it is going to take years to implement fully the CARES restructuring process. Further, many of my colleagues know that there is a severe nursing shortage in this country. In some facilities, the VA is having a difficult time retaining and recruiting qualified nurses. The VA is also seeking physician pay reform legislation because it is currently restricted in what it can pay for doctors, which hurts the VA's ability to recruit and pay doctors. Those are aspects on which we have to continue to work.

Last, the Daschle amendment imposes a set ceiling on VA health funding as opposed to the current system which has no ceiling and allows Congress to provide more funding as necessary.

As I said at the outset, we provided a 34.7-percent increase in VA health care funding since 2001. If the Daschle amendment had been in place using the available indexes, the likelihood would be that there would be at least 10-percent less funding that would be going to the VA as a result of the fixed mandatory funding system.

In closing, I urge my colleagues to oppose the Daschle amendment. Members can oppose the Daschle amendment and be concerned about the needs of veterans and help us work to make sure veterans get the health care they need, continuing to support our efforts in the Senate, in the Appropriations Committee, to get the kind of funding we need. We have done so on a bipartisan basis. I intend to continue to work to do so.

However, we are going to have to have the flexibility to make sure we hold the VA accountable, to make sure they provide the services, and that they make the changes necessary.

Funding is critical. I certainly agree with that. I am proud to say we have succeeded in providing that funding over the past several years. Funding, however, is not the sole antidote for the problems addressing the VA health care needs. We must ensure that the VA system remains responsive and accountable to our veterans.

I fear adoption of an amendment such as this would be an empty promise to our Nation's veterans who have special needs and demand a health care system that is accountable and responsive to their needs. Our system of checks and balances has played a critical role in transforming the VA health care system which is now underway to ensuring that we will be able to meet the health care needs of veterans well into the 21st century.

The Daschle amendment significantly reduces the role of Congress in ensuring improvements in reforms to the VA health care system so it is more accountable to the needs of the veterans. By capping the discretionary amount of appropriations at the 2004 level, our hands would be tied in making adjustments to the funding needs of our veterans. This is especially dangerous considering the hundreds of thousands of troops currently deployed across the globe fighting the war on terror and in Iraq. I strongly believe in putting the needs of veterans first.

Those needs are not best served by these amendments which would, in my opinion, based on my experience working with the system, hurt our ability to meet that goal. That is why I close by urging my colleagues not to support the amendment by the Senator from South Dakota.

Mr. President, I would advise the distinguished chairman of the committee that we have made a modification on this to change the offset to an across-the-board reduction in the DOE appropriations. Discussions are continuing with you. We would like to have the same treatment for these workers as the other workers who were described in the Bunning amendment.

This is a work in progress. We do have an across-the-board offset in authorization for all DOE programs in this bill, but, obviously, we are going to have to continue to work with you and work in conference to make sure this is an effective, agreeable offset.

Mr. President, I yield to the distinguished Senator from Iowa.

I am happy to yield to the distinguished minority whip.

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

Mr. President, I believe we can have the discussions on the substance of amendment No. 3384 as we work with the managers on both sides and perhaps the Finance Committee to make sure we have the appropriate offset.

The amendment I wish to address, and I know Senator Harkin and Senator Talent will address it, is the Energy Workers Special Exposure Cohort Designation Act of 2004, which I will be offering on behalf of myself, Senator Harkin, and Senator Talent.

It will designate former nuclear production facilities in Missouri and Iowa as special exposure cohorts under the Energy Employees Occupational Illness Compensation Program Act of 2000. This was a very compassionate act designed to provide lump sum payments of $150,000 to people who had worked in the nuclear weapons production program from 1942 to 1967--way before we understood the dangers of radiation--and who suffered very high levels of radiation and have now been diagnosed, suffered, and many have died from multiple cases of cancer.

This problem was brought to my attention by Denise Brock, whose father had died while waiting for the bureaucracy to work through the steps set up under the program to qualify for that particular $150,000 compensation.

There are a very convoluted set of steps that have to be followed unless you are in a special cohort. There were four States that were designated as having needs that automatically qualified these workers.

We have found upon research that the exposure to the workers in Missouri was in many instances the highest exposure in any place. My colleague and I have met with those workers. Eight workers came into my office with Ms. Brock last spring, in May. Since then, three of them have died. They had multiple cancers. A brave fellow that I met when I met with the group in St. Charles County several months ago, Jim Mitalski, wheelchair-bound because cancer was in his right foot, had at least three other cancers. I am sad to say he slipped into a coma yesterday. His doctors suggest this may be his final coma. He has not been compensated.

The Mallinkrodt workers, who worked at the St. Louis downtown site from 1942 to 1958 and moved out to the Weldon Springs facility in St. Charles County, which operated until 1967, were exposed to levels of radionuclides and radioactive materials that were much greater than the current maximum allowable Federal standards. Many workers were exposed to 200 times the recommended levels of maximum exposure.

The chief safety officer for the Atomic Energy Commission during the Mallinkrodt St. Louis operations described that as one of the two worst plants with respect to worker exposures. Workers were excreting in excess of a milligram of uranium per day, which caused kidney damage.

A recent epidemiological survey found excess levels of nephritis kidney cancer from inhalation of uranium dust.

The Department of Energy has admitted that those Mallinkrodt workers were subjected to risks and had their health endangered as a result of working with these highly radioactive materials.

The Department of Energy reported that workers at the Weldon Springs feed materials plant handled plutonium and recycled uranium which were highly radioactive. NIOSH admits that the operation at the St. Louis downtown site consisted of intense periods of processing extremely high levels of radionuclides. The institute has virtually no personnel monitoring data for Mallinkrodt workers which would be necessary for them to reconstruct the dosages to make them qualify under the act. Under these circumstances, I believe simple justice and equity demands that we provide assistance for these severely ill workers and for their surviving families.

This amendment would add the Mallinkrodt facilities, along with the Iowa Army Ammunition Plant, to the four existing special exposure cohort sites. These are sites where a group of employees with specific cancers who worked at specific nuclear facilities or participated under certain nuclear weapons tests and met other requirements are eligible for expedited compensation. This special exposure cohort designation would make the workers at these Missouri and Iowa sites eligible for the expedited compensation as opposed to requiring them to participate in the long, complex, and cumbersome bureaucratic process known as ``dose reconstruction.'' They are faced with a situation where the bureaucrats are asking them to go back and help them reconstruct the dosages over 50 years ago--or more. They have no records. They are very sick people. They are dying of multiple cancers, the kinds of cancers and other problems caused by exposure to radioactivity. It is not feasible for them to go back and reconstruct. Without the records, we know that these people are seriously ill and are afflicted with all kinds of cancers. We, therefore, ask our colleagues if they will accept the amendment as we work to modify the offset.

The total cost over 10 years for the people who worked in the Missouri and Iowa sites is expected to be $180 million. That is over 10 years. Given the fact that these people are suffering from very serious cancers, I hope my colleagues will join Senator Harkin, Senator Talent, and me in saying these people badly need the assistance this designation will provide them.

I will withhold submitting the amendment until we have further discussions with the managers to ascertain their desires and the appropriate offset. But offset or no, let me reemphasize to my colleagues that $180 million for people who are suffering mightily from multiple cancers is the least we can do to take care of the brave atomic workers who helped us develop the weapons that ended World War II and who are now paying every day with the suffering from the exposure to that radioactivity.

I yield the floor.

Mr. President, I ask unanimous consent to set this amendment aside temporarily. I further ask unanimous consent that the time not be charged against either side on this amendment for the purpose of resolving an amendment discussed earlier today.

Mr. President, I guess that is objection to the unanimous consent request.

Mr. President, I thank my good friend, the chairman, and certainly I thank the ranking member, for their accommodation. I call up amendment No. 3384 which is at the desk.

I ask unanimous consent the reading of the amendment be dispensed with.

I send to the desk a modification on behalf of myself, Senator Harkin, Senator Talent, and Senator Grassley, and ask it be immediately considered as a modification.

I promise I will speak very briefly. We discussed this amendment at great length today. This is an amendment designed to take care of and put in a special employee cohort, workers in some very dirty nuclear bomb plants in Iowa and Missouri, back in the 1940s and 1950s. At the request of the managers, we added a number of conditions to it. We worked through the authorizations, and the funding of it is by authorization. I believe we have worked that out.

I think the amendment will be set aside. If anybody is really interested in it we will be happy to refer them to the Congressional Record, and at the appropriate time we will come back and restate why this is so important. It is relatively inexpensive--$180 million over 10 years. I hope my colleagues will be willing to accept it.

With that, I thank the managers and my cosponsors and I yield the floor.

I thank my colleague.

Mr. President, I ask the distinguished manager, I understand that the measure that Senators Harkin, Talent, Grassley, and I have proposed is in order for 9:30 tomorrow morning.

We hope it will be brief. We will talk with you. We hope that perhaps it may be accepted.

I would like to spare the body a rollcall vote.

Mr. President, I rise today to speak of the life, leadership and the truly remarkable legacy of the 40th President of the United States, Ronald Reagan.

President Reagan was a great communicator with a powerful message. He preached the gospel of hope, freedom and opportunity not just for America but for the world. Reagan was a genuinely optimistic person who brought that spirit of optimism and hope to the American people and to enslaved peoples around the world. He was a man who took disappointment and moved on. He was a man of unfailing good humor, care and thoughtfulness. Even people who disagreed with his policies across the board could not help but like him.

In the U.S., his policies encouraged the return of more tax dollars to average Americans and unfettered entrepreneurship to create jobs and build the economy. Reagan's strong military opposition to the Soviet Union helped bring down the walls that harbored communism and tyranny throughout Eastern Europe and much of the world.

In a letter to the American people in 1994 Ronald Reagan announced he was one of the millions of Americans with Alzheimer's disease. One of the most courageous things Ronald and Nancy Reagan did was to announce publicly that he had Alzheimer's disease. Through their courage and commitment, the former President and his wife, Nancy, changed the face of Alzheimer's disease by increasing public awareness of the disease and of the need for research into its causes and prevention.

In honor of Ronald Reagan, today my colleague Senator Mikulski and I are introducing the Ronald Reagan Alzheimer's Breakthrough Act of 2004. This bill will increase research for Alzheimer's and increase assistance to Alzheimer, patients and their families. This bill will serve as a living tribute to President Reagan and will: 1. double funding for Alzheimer's Research at the National Institute of Health; 2. increase funding for the National Family

Caregiver Support Program from $153 million to $250 million; 3. reauthorize the Alzheimer's Demonstration Grant Program that provides grants to states to fill in gaps in Alzheimer's services such as respite care, home health care, and day care; 4. authorize $1 million for the Safe Return Program to assist in the identification and safe, timely return of individuals with Alzheimer's disease and related dementias who wander off from their caregivers; 5. Establish a public education campaign to educate members of the public about prevention techniques that can maintain their brain'' as they age, based on the current research being undertaken by NIH; 6. establish a $3,000 tax credit for caregivers to help with the high health costs of caring for a loved one at home; and 7. encourage families to prepare for their long term needs by providing an above-the-line tax deduction for the purchase of long term care insurance.

Ironically it was President Reagan who drew national attention to Alzheimer's for the very first time when he launched a national campaign against Alzheimer's disease some 22 years ago.

In 1983 President Reagan proclaimed November as National Alzheimer's Disease Month. In his proclamation President Reagan said ``the emotional, financial and social consequences of Alzheimer's disease are so devastating that it deserves special attention. Science and clinical medicine are striving to improve our understanding of what causes Alzheimer's disease and how to treat is successfully. Right now, research is the only hope for victims and families.''

Today, approximately 4.5 million Americans have Alzheimer's, with annual costs for this disease estimated to exceed $100 billion. Today there are more than 4.5 million people in the United States with Alzheimer's, and that number is expected to grow by 70 percent by 2030 as baby boomers age.

In my home State of Missouri, alone, there are over 110,000 people with Alzheimer's disease. Based on population growth, unless science finds a way to prevent or delay the onset of this disease, that number will increase to over 130,000 by 2025--that is an 18 percent increase.

In large part due to President Reagan, there has been enormous progress in Alzheimer research--95 percent of what we know we discovered during the past 15 years. There is real potential for major breakthroughs in the next 10 years. Baby boomers could be the first generation to face a future without Alzheimer's disease if we act now to achieve breakthroughs in science.

President and Mrs. Reagan have been leading advocates in the fight against Alzheimer's for more than 20 years, and million of American have been helped by their dedication, compassion and effort to support caregivers, raise public awareness about Alzheimer's disease and increase of nation's commitment to Alzheimer's research.

This bill will serve as a living tribute to President Reagan and will offer hope to all those suffering from the disease today. As we celebrate the life and legacy of Ronald Reagan, we are inspired by his legendary optimism and hope, and today we move forward to confront this expanding public health crisis with renewed vigor, passion, and compassion.

Mr. President, I rise today to speak of the life, leadership and the truly remarkable legacy of the 40th President of the United States, Ronald Reagan.

President Reagan was a great communicator with a powerful message. He preached the gospel of hope, freedom and opportunity not just for America but for the world. Reagan was a genuinely optimistic person who brought that spirit of optimism and hope to the American people and to enslaved peoples around the world. He was a man who took disappointment and moved on. He was a man of unfailing good humor, care and thoughtfulness. Even people who disagreed with his policies across the board could not help but like him.

In the U.S., his policies encouraged the return of more tax dollars to average Americans and unfettered entrepreneurship to create jobs and build the economy. Reagan's strong military opposition to the Soviet Union helped bring down the walls that harbored communism and tyranny throughout Eastern Europe and much of the world.

In a letter to the American people in 1994 Ronald Reagan announced he was one of the millions of Americans with Alzheimer's disease. One of the most courageous things Ronald and Nancy Reagan did was to announce publicly that he had Alzheimer's disease. Through their courage and commitment, the former President and his wife, Nancy, changed the face of Alzheimer's disease by increasing public awareness of the disease and of the need for research into its causes and prevention.

In honor of Ronald Reagan, today my colleague Senator Mikulski and I are introducing the Ronald Reagan Alzheimer's Breakthrough Act of 2004. This bill will increase research for Alzheimer's and increase assistance to Alzheimer, patients and their families. This bill will serve as a living tribute to President Reagan and will: 1. double funding for Alzheimer's Research at the National Institute of Health; 2. increase funding for the National Family

Caregiver Support Program from $153 million to $250 million; 3. reauthorize the Alzheimer's Demonstration Grant Program that provides grants to states to fill in gaps in Alzheimer's services such as respite care, home health care, and day care; 4. authorize $1 million for the Safe Return Program to assist in the identification and safe, timely return of individuals with Alzheimer's disease and related dementias who wander off from their caregivers; 5. Establish a public education campaign to educate members of the public about prevention techniques that can maintain their brain'' as they age, based on the current research being undertaken by NIH; 6. establish a $3,000 tax credit for caregivers to help with the high health costs of caring for a loved one at home; and 7. encourage families to prepare for their long term needs by providing an above-the-line tax deduction for the purchase of long term care insurance.

Ironically it was President Reagan who drew national attention to Alzheimer's for the very first time when he launched a national campaign against Alzheimer's disease some 22 years ago.

In 1983 President Reagan proclaimed November as National Alzheimer's Disease Month. In his proclamation President Reagan said ``the emotional, financial and social consequences of Alzheimer's disease are so devastating that it deserves special attention. Science and clinical medicine are striving to improve our understanding of what causes Alzheimer's disease and how to treat is successfully. Right now, research is the only hope for victims and families.''

Today, approximately 4.5 million Americans have Alzheimer's, with annual costs for this disease estimated to exceed $100 billion. Today there are more than 4.5 million people in the United States with Alzheimer's, and that number is expected to grow by 70 percent by 2030 as baby boomers age.

In my home State of Missouri, alone, there are over 110,000 people with Alzheimer's disease. Based on population growth, unless science finds a way to prevent or delay the onset of this disease, that number will increase to over 130,000 by 2025--that is an 18 percent increase.

In large part due to President Reagan, there has been enormous progress in Alzheimer research--95 percent of what we know we discovered during the past 15 years. There is real potential for major breakthroughs in the next 10 years. Baby boomers could be the first generation to face a future without Alzheimer's disease if we act now to achieve breakthroughs in science.

President and Mrs. Reagan have been leading advocates in the fight against Alzheimer's for more than 20 years, and million of American have been helped by their dedication, compassion and effort to support caregivers, raise public awareness about Alzheimer's disease and increase of nation's commitment to Alzheimer's research.

This bill will serve as a living tribute to President Reagan and will offer hope to all those suffering from the disease today. As we celebrate the life and legacy of Ronald Reagan, we are inspired by his legendary optimism and hope, and today we move forward to confront this expanding public health crisis with renewed vigor, passion, and compassion.

Mr. President, today I congratulate Mr. William Greenblatt, a man whose accomplishments are a true testament to what a business and community leader should be, as he celebrated his 50th birthday on June 9, 2004.

Mr. Greenblatt began his career providing photography services for commercial, industrial, public relations

and nonprofit organizations including the City of St. Louis, Make-A- Wish Foundation, United Way, and American Heart Association. He also serves as the St. Louis Fire Department's photographer recreating fire scene construction and investigations as well as documenting training and incidents.

During Mr. Greenblatt's career, he has had the honor of being the official photographer for many of the most prominent Missouri Federal, State, and local politicians, as well as St. Louis artists Nelly and Toya. In addition to his services at United Press International, he has contributed to numerous publications such as the Chicago Tribune, Los Angeles Times, Newsweek Magazine, New York Times, and the Washington Post.

Mr. Greenblatt has dedicated both his professional and personal life to the betterment of his community. He has served on several nonprofit boards as well as being a member of several professional organizations including the St. Louis Regional Chamber and Growth Association, St. Louis Journalism Review Board of Editorial Advisors, Urban League of Metropolitan St. Louis, and the James S. McDonnell Board of Directors.

Throughout his service, Mr. Greenblatt has been honored with several achievements including placing in the Baseball Hall of Fame Photo Contest, Certificate of Appreciation from the City of St. Louis Emergency Management Agency, Outstanding Citizen Award.

Mr. Greenblatt has a distinguished record of service in his public and private life. I thank him for his dedication to his profession as well as his contributions to the St. Louis Community. On behalf of Missouri, I wish him a happy 50th birthday.

Mr. President, I thank and commend my colleague from Maryland who has been a great champion of the effort to deal with the terribly distressing and fatal disease of Alzheimer's in proposing--and I am happy to join her--a measure to honor Ronald Reagan, his memory, his life, his work, and his family with a living tribute, a redoubled effort on behalf of this Nation to deal with Alzheimer's.

Senator Mikulski and others who have lived with and lost a loved one from Alzheimer's can say very clearly how difficult it must have been for Mrs. Reagan and the Reagan family as this true leader went through the final stages of his life, crippled and debilitated by Alzheimer's, to see this man who was so vigorous, who had contributed so much be reduced to the indignities of Alzheimer's.

His life and legacy can be honored in many ways. People will remember him for many reasons. I will speak of those in a moment. But by increasing research for Alzheimer's disease, helping to limit the number and maybe even eliminate Alzheimer's, providing assistance to families who must deal with patients with Alzheimer's, and providing assistance in identifying and preventing Alzheimer's is vitally important.

One of the facts that struck me as we listened to the experts was that as we get older more and more of us are going to suffer from Alzheimer's disease. We were told in our hearing about a month ago that if you reach 85, you have a 50-percent chance of getting Alzheimer's disease. What a tragic figure. There is something we must do, and we believe this legislation is one way of making a major effort, showing a commitment, reaching out a hand of hope to the families of those who have Alzheimer's, providing information to all of us on what we might be able to do to lessen the likelihood we will be struck with Alzheimer's.

As Senator Mikulski said, this bill will serve as a tribute to President Reagan by doubling the funding for Alzheimer's research at the National Institutes of Health. It would increase funding for the National Family Caregiver Support Program to $250 million. It would reauthorize the Alzheimer's demonstration grant program that provides grants to States to fill in gaps in Alzheimer's services, such as respite care, home health care, and daycare.

I have done a fair amount of work in home care and daycare. I can tell you that a family living with a patient with Alzheimer's needs a break. They need someone to care for that loved one so they can get out and renew their batteries, refresh their view on life. This can help.

We would authorize $1 million for a safe return program to assist in the identification and safe, timely return of individuals with Alzheimer's disease and related dementias who too frequently wander off from their caregivers. We hear the tragedies where they can't find their way home and fall victim to natural or even automobile accidents while they are gone. We would establish a public education program to educate members of the public about prevention techniques, how you can maintain your brain, as you age, based on the current research being undertaken by NIH.

We would establish a $5,000 tax credit to help with the high health costs of caring for a loved one at home.

Today, as Senator Mikulski said, about 4.5 million Americans have Alzheimer's, costing about $100 billion a year. But if current trends continue, and as more of us age, by 2050, 11 to 16 million individuals could have this disease.

Over the past 20 years tremendous progress has been made in the prevention, diagnosis, and treatment of Alzheimer's. It is now possible to diagnose Alzheimer's with more than 90-percent accuracy. There are new drugs, new treatments introduced each year, and investments in research have set the stage for scientific and medical advances to prevent or slow down the progression of Alzheimer's. Quite frankly, most of the successful research to date has been in slowing the impact, not preventing it. But this research offers hope for the 4.5 million people and their families who suffer from the disease today.

These are some of what we can do as an honor to the President. It is my great pleasure to speak in this Chamber about the life and leadership and the truly remarkable legacy of the 40th President of the United States, Ronald Reagan.

We mourn his loss. We pray for comfort for his family. But most of all, we give thanks for his life, his leadership, and his contributions. Truly, he is a man who changed the mood of the country. He changed the economy of the country. And in many ways, he changed the mood and the attitude of the world.

People talk about President Reagan as the Great Communicator. Nobody could deliver a line better than he could. But do you know something about communication? Communication is only as good as the message you have to communicate. The power of Ronald Reagan was that he delivered with enthusiasm, with optimism, with cheer, with love, a message of hope, freedom, and opportunity, not just for Americans but for the world.

I had the pleasure of getting to know Ronald Reagan. He was a genuinely optimistic person who brought the spirit of optimism and hope to us as Americans and to enslaved peoples around the world. Ronald Reagan was a man who took disappointment and moved on. He was a man of unfailing good humor, care, and thoughtfulness. Even people who disagreed with his policies across the board could not help but like him.

And those of us who may have disappointed him found it did not interfere with his friendship. He campaigned for me in 1972 when I was a 33-year-old kid running for Governor of the State of Missouri. I had never seen anything like it. When he came into town, we had all of the security and escorts. But it wasn't until he went up on stage and started making his presentation that I saw what it was that had brought so many people from southwest Missouri in to hear this leader. He had a message then--the same message--of optimism, growth, and hope for the future.

I was fortunate enough to be elected and to serve with him for 2 years. Two years after that, I hosted the Republican National Convention, and I had made a commitment to our President at the time, who selected our State for the national convention. So I supported him and not President Reagan. But about 10 years later, when I was running for the Senate, he came to Missouri three times and he put on the most amazing campaign rallies I ever had. We still talk about it, because people came to hear his message. I stood there, side by side with Jack Danforth, and we smiled and glowed in the wonderful feeling he generated. He helped me a great deal.

President Reagan helped the United States. He came to the Presidency at a time when a lot of people were saying maybe the Presidency cannot work, maybe nobody can govern this country, maybe it is too much to expect somebody to lead. Well, he led very boldly. Quite simply, he thought that if you returned tax dollars to the average American and took off the fetters on

small business, you would create jobs and build the economy. By the significant lowering of the tax rates, as my friend from Oklahoma, Senator Nickles, said, he put money back into the pockets of small businesses, and small business became the engine of economic growth, creating three-quarters of the new jobs. He built an economy, and that economy allowed us to put money into defense.

He tried to negotiate with the Soviets. He asked Mr. Gorbachev if he would sit down and talk with him about how we could end the competition between Soviet communism and the United States. Mr. Gorbachev didn't respond. So he built up our defenses and showed the Russians, the Soviets, that they could not defeat us. He went boldly to Berlin and called on Mr. Gorbachev--much to the distress of the State Department, I might add, and some of his own team--``Mr. Gorbachev, tear down this wall.''

Well, that wall came down literally and figuratively. He had a message that went far beyond Mr. Gorbachev. That message went to the enslaved peoples behind the Iron Curtain. I had the pleasure of visiting some of those countries right before and right after they fell, a few years after President Reagan had set in motion the inexorable machine of freedom. His message of hope, freedom, and opportunity continues to reverberate around the world. I have had the pleasure of meeting with people and traveling to other countries and seeing how this message--the American dream--he championed is taking hold. He wasn't the only one responsible for it, but we never had a better proponent of it. I believe this message of the American hopes and the American ideals, for which Ronald Reagan spoke so eloquently, is winning the battle.

Finally, in his last and boldest move, when Ronald Reagan learned he had Alzheimer's--a disease which was not spoken about often because people hated to think of what would happen to their loved ones, so they didn't talk about it--he said, ``I have Alzheimer's disease,'' and Americans woke up and they thought, this is a world leader who is suffering from this disease; let's do something about it. Let's get serious about Alzheimer's disease. That public announcement gave us a push that I believe we can continue by carrying on with his work with a living memorial.

So as we say goodbye to this remarkable American, we join in our prayers and thoughts with Mrs. Nancy Reagan and her family, and we celebrate the life of a great American who made a real difference for people throughout the world. Let us honor his memory by helping millions more whom we might be able to save from the scourge of Alzheimer's disease and the burdens and the sorrow that imposes on their families.

I thank the Chair.

Mr. President, Sieglinde Kurz received her Bachelor of Arts degree from Fontbonne College, St. Louis, Missouri in 1961 and her Masters Degree in Health Care Management from Northwestern University, Evanston, Illinois in 1976.

Linda Kurz started her career with Department of Veterans Affairs in November 1965 as a Research Chemist in Renal Hypertension Research at the St. Louis VA Medical Center.

Linda Kurz, during her government career was the Administrative Assistant to the Associate Director, Hines, Illinois; Associate Director, VA Medical Center, Tomah, Wisconsin; Associate Deputy Regional Director, Northeastern Region, Albany, NY; Associate Director, VA Medical Center, Marion, Illinois; Director, Construction Project Coordination and Budget, VA Headquarters, Washington, DC; Director, VA Medical Center, Marion, Illinois. She left the Marion VAMC to accept the position of Director at the St. Louis VAMC.

Linda Kurz served as Director of the St. Louis VA for 5 years and 8 months from May 1998 through January 2004, one of the largest and most complex VA facilities in the Nation.

Linda Kurz provided leadership for this dual division hospital, providing care for in excess of 36,000 veterans annually, within a primary service area of metropolitan St. Louis, including 9 counties in Missouri and 14 counties in West Central Illinois and lead a care team of 1900 full time employee equivalents.

Linda's lifetime achievements include: A leader in the health care management field, mentor for VHA Health Care Management Trainees, Executive Career Field Director Trainees and achieved the status of Diplomat in the American College of Healthcare Executives.

Linda Kurz, was listed as one of the top female directors in Missouri Hospital Association Newsletter, Summer 2003 Edition and in Who's Who Among Top Executives in 1998-1999 and during her tenure as Director St. Louis VA Medical Center was recognized in 1999, with the Vice- Presidential ``Hammer and Scissors'' award for her efforts in piloting the first Department of Veterans Affairs Canteen Integration.

During her tenure at the St. Louis VA, Linda has worked tirelessly to improve access to care for veterans and opened three health clinics; she supported her employees by providing educational opportunities for mid-level managers through programs such as mini-MBA and she promoted an open policy, communicating with staff at all levels by establishing employee and supervisory forums.

Linda Kurz will retire after 37 years of government service, having devoted countless hours and years to the welfare of the American Veterans.

Madam President, I feel truly honored to be able to join with my colleagues in recognizing today six of our own who are part of the ``greatest generation'' and who made a tremendous contribution to the freedom--

not just of our country but to the world.

A lot has been said about Senators Inouye, Akaka, Hollings, Lautenberg, Stevens, and Warner. I endorse almost everything said about all of them. I consider all of them good friends. I have stories on a few of them, but I will not tell the stories if they will not reciprocate and tell stories on me.

But these are, as has just been said, very humble men who did absolutely amazing things, who made tremendous contributions, and yet they walk among us today with one foot in front of the other. You don't know it when you deal with them.

I have had the privilege in recent times visiting some of the battlefields in Europe--the battlefield of Bastogne with Senator Hollings. My wife and I have been to Normandy beaches--Utah Beach, Omaha Beach, Sainte Mere Eglise--places where absolutely remarkable things were done.

These are tremendous monuments. Unfortunately, I am not going to be able to go to D-Day. But I urge my colleagues to visit these locations when you have an opportunity and see the living memorials which are set up there and the movies that were taken of the events. When you see the conflicts they faced and the bravery, you think: Why on Earth would somebody ever try to do that? There were literally hundreds--and probably thousands--of undertakings that were seemingly impossible which the brave soldiers of the U.S. forces undertook on D-Day.

I join with my colleague from Connecticut, who mentioned two other great heroes, the former leader of this body, Bob Dole, and former President George Bush, who made tremendous contributions. These people deserve our greatest admiration and our thanks, along with all of the other veterans, and the families of all of these men deserve special thanks.

I note that I think one Beth Stevens is watching close by, daughter of this good Senator from Alaska. I know how proud these young people are of their parents.

I do not know how many of you saw the movie, ``Ike: Countdown to D- Day.'' It was a fabulous movie, telling about all of the problems and the hassles that went into the planning of D-Day. Getting ready to lead an invasion of 130,000 troops, 5,000 ships, 11,000 aircraft, you see how many things could go wrong, not the least of which was when Eisenhower told his Chief of Staff, General Beetle Smith, We are surrounded by some of the biggest swelled heads in history, and my job is to keep them pulling together.

We had uncommon leadership from people who were ordinary human beings, but we had uncommon valor from so many of the 16 million people who served there. We say to all, Our sincerest thanks, our deepest respect. We congratulate and thank them. Having watched that D-Day movie, I can only say how lucky General Eisenhower was when there was not 24-hour television coverage. If you were watching every day the kinds of problems and the hassles that General Eisenhower had to endure, with the media we now have they would probably call for the firing of General Eisenhower and the impeachment of the President because lots of things went wrong. But these brave people, these brave men persevered, and we owe them our heartfelt thanks.

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

Mr. President, shortly we are going to be voting on the nomination of Raymond Gruender to be United States Circuit Judge for the Eighth Circuit Court of Appeals.

I want to tell my colleagues this is one of the finest young men I know. He worked his way through Washington University, getting an MBA and a law degree in 6 years while working full time to support himself. His personal story is a very touching one, with very significant difficulties which he overcame.

He served as an assistant U.S. Attorney under Republican and Democratic administrations.

He has been in private practice of law and has tried cases in district courts--criminal and a wide range of civil cases.

He served as an appellate lawyer.

Most recently, he has been U.S. Attorney for the Eastern District of Missouri.

I can assure you this is a man who will bring not only integrity, legal skills, and judicial knowledge to the Eighth Circuit, but he is a person of great human understanding and intellect. He will be a pleasure to appear before.

We can be proud the President has nominated a man who has such great respect among the bar in the Eastern District of Missouri and law enforcement personnel, as well as plaintiffs' and defendants' attorneys.

I urge my colleagues to vote for Raymond Gruender.

Mr. President, I suggest the absence of a quorum.

Mr. President, today, I join my colleagues, Senators Harkin, Durbin, Talent, Grassley, Coleman, Fitzgerald and Pryor to introduce bipartisan legislation to provide transportation efficiency and environmental sustainability on the Mississippi and Illinois Rivers.

As the world becomes more competitive, we must also. In the heartland, the efficiency, reliability, capacity, and safety of our transportation options are critical--often make-or-break. As we look 50 years into the future, and as we anticipate and try to promote commercial and economic growth, we have to ask ourselves a fundamental question: should we have a system that permits and promotes growth, or should we be satisfied to restrict our growth to the confines of a transportation straight jacket designed not for 2050, but for 1980?

Further, we must ask ourselves if dramatic investments should be made to address environmental problems and opportunities that exist on these great waterways.

In both cases, the answer is, ``Of course we should modernize and improve.''

We have a system which is in environmental and economic decline. Jobs and markets and the availability of habitat for fish and wildlife are at stake.

We cannot be for increased trade, commercial growth, and job creation without supporting the basic transportation infrastructure necessary to move goods from buyers to sellers. New efficiency helps give our producers an edge that can make or break opportunities in the international marketplace.

Seventy years ago, some argued that a transportation system on the Mississippi River was not justified. Congress decided that its role was not to try to predict the future but to shape the future and decided to invest in a system despite the naysayers. Over 80 million tons per year later, it is clear that the decision was wise.

Now, that system that was designed for paddlewheel boats and to last 50 years is nearly 70 years old and we must make decisions that will shape the next 50-70 years. As we look ahead, we must promote growth policies that help Americans who produce and employ.

We must work for policies that promote economic growth, job creation, and environmental sustainability. We know that trade and economic growth can be fostered or it can be discouraged by policies and other realities which include the quality of our transportation infrastructure.

So in 20 and 30 and 40 and 50 years, where will the growth in transportation occur to accommodate the growth in demand for commercial shipping? The Department of Transportation suggests that congestion on our roads and rails will double in the next quarter century. The fact of the matter is that the great untapped capacity is on our water.

This is good news because water transportation is efficient, it is safe, it conserves fuel, and it protects the air and the environment. One medium-sized barge tow can carry the freight of 870 trucks. That fact alone speaks volumes to the benefits of water. If we can, would we rather have 870 diesel engines on the roads of downtown St. Louis, or two diesel engines on the water watching the traffic buildup and smog glide by?

The veteran Chief Economist at USDA testified that transportation efficiency and the ability of farmers to win markets at higher prices are ``fundamentally related.'' He predicts that corn exports over the next 10 years will rise 45 percent, 70 percent of which will travel down the Mississippi.

Over the past 35 years, waterborne commerce on the Upper Mississippi River has more than tripled. The system currently carries 60 percent of our Nation's corn exports and 45 percent of our Nation's soybean exports and it does so at two-thirds the cost of rail--when rail is available.

Over the previous 11 years, the U.S. Army Corps of Engineers have spent $70 million doing a six year study. During that period, there have been 35 meetings of the Governors Liaison Committee, 28 meetings on the Economic Coordinating Committee, among the States along the Upper Mississippi and Illinois waterways, and there have been 44 meetings of the Navigation and Environmental Coordination Committee. Additionally, there have been 130 briefings for special interest groups, 24 newsletters. There have been six sets of public meetings in 46 locations with over 4,000 people in attendance. To say the least, this has been a very long, very transparent, and very representative process.

However, while we have been studying, our competitors have been building. Given the extraordinary delay so far, and given the reality that large scale construction takes not weeks or months, but decades, further delay is no longer an option.

This is why I am leased to be joined by a bipartisan group of Senators who agree that we must improve the efficiency and the environmental sustainability of our great resources. Today, we introduce legislation to adopt the initial recommendations of the Corps of Engineers and their public and private partners to increase the lock capacity on the Upper Mississippi and Illinois Rivers and the begin an ambitious program of ecosystem restoration.

This plan gets the Corps back in the business of building the future, rather than just haggling about predicting the future. More will need to be done later on ecosystem and lock expansions further upstream, but this begins the improvement schedule underway.

In this legislation, we authorize $1.46 billion for ecosystem restoration--two times the federal share of lock capacity expansion which we authorize on locks 20-25 on the Mississippi River and Peoria and LaGrange on the Illinois. The new 1,200 foot locks on the Mississippi River will provide equal capacity in the bottleneck region below the 1,200 foot lock 19 at Keokuk above locks 26 and 27 near St. Louis. Half the cost of the new locks will be paid for by private users who pay into the Inland Waterways Trust fund. Additional funds will be provided for mitigation and small scale and nonstructural measures to improve efficiency.

As we look ahead, the locks at 14-18 will have to be addressed as will further investments to ecosystem restoration efforts.

This effort is supported by a broad-based group of the States, farm groups, shippers, labor, and those who pay taxes into the Trust Fund for improvements.

I thank my colleagues for their work together on this bipartisan effort.

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