Floor Statements

Mr. President, I rise to laud the life and work of the Honorable Ted Stevens, Senator from Alaska. Ted was a fellow World War II veteran and my partner in the Senate who fought hard on behalf of Alaska and this great Nation.

When it came to policy, we disagreed more often than we agreed, but we were never disagreeable with one another. We were always positive and forthright.

We shared a bond in that we believed it was our mission to ensure that Hawaii and Alaska were not forgotten by the lower 48 and our efforts were constant reminders of the economic and international importance of the Pacific.

Our beloved Ted was much more than the Senator of Alaska, much more than a fighter and an advocate and an example of what bipartisan effort can accomplish. Ted was a father, grandfather, and loving husband who put his family before everything else. We have lost a great man, and I join my colleagues in mourning his passing.

Mr. President, recently in meeting with the Librarian of Congress, Dr. James H. Billington, our chat focused upon Senator Ted Stevens. I learned that on August 14, 2010, Dr. Billington had written a special tribute to Senator Ted Stevens. Yesterday, I received a copy of this tribute and I wish to share it with my colleagues.

Our beloved Ted was much more than the Senator of Alaska, much more than a fighter and a brilliant parliamentarian. This tribute says something about him and his impact on Alaska and the world. I thank Dr. Billington for his heartfelt tribute to our great friend and colleague.

Mr. President, I ask unanimous consent to have Dr. Billington's tribute printed in the Record.

Mr. President, today I rise to recognize the need for a health care professional skilled in caring for the specific needs of a growing elderly population. In the next 30 years we will see a unique change in population demographics in this country. The geriatric population is increasing and by the year 2030, the over 65 age group will make up 20 percent of the population. More people will reach the 100-year mark. My home State of Hawai`i is home to more 100-year olds per capita than any other State. The risk for developing disease and illness becomes greater as one ages. As we see an increase in the age of our population, those living with chronic illnesses such as cardiovascular disease, respiratory diseases, diabetes and cancer, will continue to rise in numbers as well. These are patient's who require care in the ambulatory, hospital, and home care settings. The chronically ill geriatric patients usually are living with multiple co- morbidities and possess poly pharmacy challenges. We are living in a time when it is crucial to develop the skills and expertise to care for these patients and provide them with the quality health care they deserve in a cost effective manner.

While the terms dual, joint, double or combined degrees are used interchangeably, the overall definition is students working for two different and distinct degrees in parallel, completing two degrees in less time than it would take to complete each separately. Under the leadership of Katharyn F. Daub, EdD, CTN, CNE, Director School of Nursing, John M. Pezzuto, Ph.D., Dean, College of Pharmacy, and Donald O. Straney, Ph.D., Chancellor, University of Hawai`i at Hilo, the University of Hawai`i at Hilo has created a model that would partner both their school of nursing and pharmacy to meet the needs of the changing health care field through the implementation of a dual-degree program that would combine a Doctor of Nursing Practice, DNP, with a Doctor of Pharmacy, PharmD.

The overall purpose of this innovative cross cutting dual or joint degree nursing program is to prepare nurses to expand the traditional scope of nursing practice, with the goal of strengthening health care teams. The American Association of Colleges of Nursing, AACN, 2009 survey of schools of nursing documents that there are over 100 nursing schools that offer dual degree programs: 74 MSN/MBA programs; 34 MSN/ MPH programs; 10 MSN/MHA programs; 5 MSN/MPA programs; 4 MSN/MDIV programs; and 3 MSN/JD programs. Currently there is no dual degree program that combines nursing and pharmacology.

Through this dual collaborative role we would be able to meet the unique needs of rural communities across age continuums and in diverse settings. The nurse/pharmacist would enhance collaboration between DNPs and physicians regarding drug therapy. The program also would provide for the implementation of safer medication administration. It would broaden the scope of practice for pharmacists through education and training in diagnosis and management of common acute and chronic diseases, and create new employment opportunities for private physician or nurse managed clinics, walk-in clinics, school/college clinics, long-term facilities, veteran administration facilities, hospitals and hospital clinics, hospice centers, home health care agencies, pharmaceutical companies, emergency departments, urgent care sites, physician group practices, extended care facilities, and research centers.

Additional research and evaluation would determine the extent of which graduates of this program improve primary health care, address disparities, diversify the workforce, and increase quality of service for underserved populations.

I urge you to consider the benefits of the development of a joint degree in nursing and pharmacology.

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

Mr. President, today I rise to recognize the need for a health care professional skilled in caring for the specific needs of a growing elderly population. In the next 30 years we will see a unique change in population demographics in this country. The geriatric population is increasing and by the year 2030, the over 65 age group will make up 20 percent of the population. More people will reach the 100-year mark. My home State of Hawai`i is home to more 100-year olds per capita than any other State. The risk for developing disease and illness becomes greater as one ages. As we see an increase in the age of our population, those living with chronic illnesses such as cardiovascular disease, respiratory diseases, diabetes and cancer, will continue to rise in numbers as well. These are patient's who require care in the ambulatory, hospital, and home care settings. The chronically ill geriatric patients usually are living with multiple co- morbidities and possess poly pharmacy challenges. We are living in a time when it is crucial to develop the skills and expertise to care for these patients and provide them with the quality health care they deserve in a cost effective manner.

While the terms dual, joint, double or combined degrees are used interchangeably, the overall definition is students working for two different and distinct degrees in parallel, completing two degrees in less time than it would take to complete each separately. Under the leadership of Katharyn F. Daub, EdD, CTN, CNE, Director School of Nursing, John M. Pezzuto, Ph.D., Dean, College of Pharmacy, and Donald O. Straney, Ph.D., Chancellor, University of Hawai`i at Hilo, the University of Hawai`i at Hilo has created a model that would partner both their school of nursing and pharmacy to meet the needs of the changing health care field through the implementation of a dual-degree program that would combine a Doctor of Nursing Practice, DNP, with a Doctor of Pharmacy, PharmD.

The overall purpose of this innovative cross cutting dual or joint degree nursing program is to prepare nurses to expand the traditional scope of nursing practice, with the goal of strengthening health care teams. The American Association of Colleges of Nursing, AACN, 2009 survey of schools of nursing documents that there are over 100 nursing schools that offer dual degree programs: 74 MSN/MBA programs; 34 MSN/ MPH programs; 10 MSN/MHA programs; 5 MSN/MPA programs; 4 MSN/MDIV programs; and 3 MSN/JD programs. Currently there is no dual degree program that combines nursing and pharmacology.

Through this dual collaborative role we would be able to meet the unique needs of rural communities across age continuums and in diverse settings. The nurse/pharmacist would enhance collaboration between DNPs and physicians regarding drug therapy. The program also would provide for the implementation of safer medication administration. It would broaden the scope of practice for pharmacists through education and training in diagnosis and management of common acute and chronic diseases, and create new employment opportunities for private physician or nurse managed clinics, walk-in clinics, school/college clinics, long-term facilities, veteran administration facilities, hospitals and hospital clinics, hospice centers, home health care agencies, pharmaceutical companies, emergency departments, urgent care sites, physician group practices, extended care facilities, and research centers.

Additional research and evaluation would determine the extent of which graduates of this program improve primary health care, address disparities, diversify the workforce, and increase quality of service for underserved populations.

I urge you to consider the benefits of the development of a joint degree in nursing and pharmacology.

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

Madam President, I wish to step back in history, if I may.

On December 7, 1941, something terrible happened in Hawaii--Pearl Harbor was bombed by the Japanese. Three weeks later, the Government of the United States declared that all Japanese Americans, citizens born in the United States or of Japanese ancestry, were to be considered enemy aliens. As a result, like these undocumented people, they could not put on the uniform of this land.

Well, I was 17 at that time, and naturally I resented this because I loved my country and I wanted to put on a uniform to show where my heart stood.

But we were denied. So we petitioned the government, and a year later they said: OK, if you wish to volunteer, go ahead.

Well, to make a long story short, the regiment I served in, made up of Japanese Americans, had the highest casualties in Europe but the most decorated in the history of the United States. I think the beneficiaries of the Senator from Illinois will do the same.

Mr. President, on August 5, 2010, I was presented with the flag of the United States Public Health Service by the Commissioned Officers Association, COA, of the U.S. Public Health Service, PHS, and its affiliated PHS Commissioned Officers Foundation. The Public Health Service Commissioned Corps is one of our Nation's seven uniformed services. When the COA was kind enough to present me with their Health Leader of the Year Award several weeks ago, it was noted that, while I had the flags of the five armed services displayed in my office on Capitol Hill, there was no PHS flag to complete the display.

The first thing I noticed when presented with the PHS flag was its color--a bright yellow field with dark blue crest and inscription. The PHS flag reveals the history of our Nation's Public Health Service. The Public Health Service traces its origins to 1798 with the passage of an ``Act for the Relief of Sick and Disabled Seamen.'' The economic survival of our young country was almost totally dependent on maritime commerce and this law was aimed at protecting the health of merchant seaman, without whose labors the young nation would not long survive, much less prosper.

Medical quarantine of ships found to be carriers of disease was an essential tool in protecting the commercial interests of the United States. The PHS flag is the same yellow color as the maritime ``quebec'' signal flag which is the international signal for a ship under quarantine.

Emblazoned on the yellow field of the PHS flag is a crossed ``fouled'' anchor and caduceus. The fouled anchor--an anchor wrapped by its chain and thus unusable--is the symbol of a ship or sailor in distress. Interestingly, the caduceus in the PHS crest is the mark of Hermes, the Greek god of commerce--later the Roman god Mercury--and consists of a staff with two entwined serpents. The caduceus, emblem of commerce, is often confused with the ancient Greek Rod of Asclepius--a staff entwined by a single serpent--which represents the healing arts.

So the crest of the Public Health Service signifies the importance of protecting the Nation's commercial interests by ensuring we have a healthy workforce. This is as critical to the United States today as it was in 1798--and we are faced in the 21st century with perhaps more threats to the health of our workforce than ever before.

Leadership in the protection of our Nation's public health originates within the Public Health Service whose origins can be traced to that 1798 law passed by Congress. And leadership within the Public Health Service is embodied by the Office of the Surgeon General and the officers of the PHS Commissioned Corps. These uniformed health professionals are essential defenders of our national security which is dependent on a healthy population--the bedrock upon which is built our commerce and our national defense.

We all owe these PHS Commissioned Corps officers our support for their often unheralded efforts in protecting and promoting the Nation's security. I am proud to honor their service by displaying the PHS flag in my personal office on Capitol Hill.

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

Madam President, I rise to speak in support of Solicitor General Elena Kagan.

Solicitor General Elena Kagan is widely regarded as one of the Nation's leading legal scholars. Her public service and legal experience, work as a teacher, service as a White House and Senate aide, and representing the government as the Nation's Solicitor General, have contributed to Ms. Kagan's intellect, judgment, and independence.

As the first woman to serve as dean at Harvard Law School, Ms. Kagan was highly respected for her ability to build consensus among diverse groups. She diversified the political discourse on campus by hiring professors from a wide political spectrum. While working as a White House aide, Ms. Kagan was known to reach across the aisle to work with both Democrats and Republicans on issues like restricting tobacco companies from targeting ads at children. As the daughter of a public school teacher and a housing lawyer, Ms. Kagan understands that decisions made by the Supreme Court have an impact on the lives of Americans. As Solicitor General, she has argued cases to protect consumers, prevent elections from being taken over by special interests, and protect our national security. Ms. Kagan recognizes the extraordinary role of the Supreme Court to

uphold the law and enable all Americans to receive a fair hearing and an equal chance at justice.

Solicitor General Kagan has my full support in her nomination to the U.S. Supreme Court.

Madam President, I rise to speak on a matter of great importance to me. Recently, I met with Gil Kerlikowske, Director of National Drug Control Policy and his Deputy Director for Demand Reduction, David Mineta. In that meeting, they shared alarming information with me about the rates of prescription drug abuse among veterans and active duty military personnel. The Office of National Drug Control Policy, ONDCP, and the Centers for Disease Control have characterized the rate of prescription drug abuse in our country as an epidemic, with rates of unintentional drug overdose deaths having increased fivefold since 1990.

Our active duty military forces and veterans are not immune from this disturbing trend. In the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel, prescription drug misuse was reported by one in nine personnel in the past month and nearly one in five in the past year. Further, the percentage of men and women reporting prescription drug misuse in all military services combined--11.5 percent--was more than twice that of the civilian population in the age group 18-64--4.4 percent.

Unfortunately, substance abuse remains a problem for newly returning veterans as well.

Data collected between 2002 and 2008 indicate that across

all medical conditions of returning veterans, mental health

disorders are the second most common--40 percent--with both

post traumatic stress and substance use disorders among the

highest within this category.

Aggregated data from the Substance Abuse and Mental Health

Services Administration's annual household survey reveals

that from 2004 to 2006, 7.1 percent of veterans--an estimated

1.8 million persons 18 or older--met criteria for a past-year

substance use disorder.

The Army recently released a study highlighting the importance of suicide prevention. The Army experienced 239 suicide deaths across the total Army, including the active reserve members, in fiscal year 2009. This number does not include 74 drug overdoses in the same year. As the Army stated in its recently released report, ``Health Promotion, Risk Reduction, Suicide Prevention,'' this is an issue that cannot be ignored. I urge ONDCP to pursue solutions, along with the Veterans Affairs and Department of Defense, to address the serious issue of prescription drug abuse in both the active duty military and among veterans of all service, including the Reserve Component.

Mr. President, I rise today to honor the life of my friend, a consummate civil servant and respected legal mind, ``CJ'' William S. Richardson.

Bill Richardson was born into a working class family of mixed ethnic heritage representative of Hawaii's community. He was part Native Hawaiian, part Chinese, and part Caucasian. From these humble beginnings, one of Hawaii's greatest figures emerged. Like many men in my generation, Bill fought in World War II, serving as a platoon leader for the U.S. Army; he would later be inducted into the Infantry Officer Candidate School Hall of Fame. This was just one of many achievements in a life filled with distinction: Bill served as chairman of Hawaii's Democratic Party from 1956 to 1962, providing strong advocacy for statehood, which Hawaii achieved in 1959. From 1962 to 1966, he served as the State's Lieutenant Governor. In 1966, Bill became the first Native Hawaiian to serve as Chief Justice of the Hawaii State Supreme Court. As ``CJ,'' he deftly blended Hawaii's history and cultural practices with modern law, establishing a traditional Hawaiian understanding of water rights as the law of the land, and demanding public access to Hawaii's shoreline.

Yet his dedication to Hawaii did not stop at writing landmark legal opinions that redefined the State. It was Bill Richardson who recognized the need to build a law school in Hawaii. He was dedicated to creating more, and better, educational and professional opportunities for Hawaii. In keeping with his personal and legal opinions, he remained focused on the need for such opportunities within Hawaii's most disadvantaged communities. With this vision, and by his perseverance, Bill worked with Hawaii's legislature to open Hawaii's first, and only, law school in 1973. The school, appropriately named the William S. Richardson School of Law after its greatest champion, has committed itself to educating attorneys from places as close as Honolulu and as far away as Thailand, with a clear focus on educating the Pacific's traditionally disadvantaged groups. The school continues to follow Bill's vision: to promote justice, ethical responsibility and public service. The law school was, perhaps, Bill's best and most profound achievement.

Bill passed away on June 21, 2010, at the age of 90. Although I am saddened by my friend's passing, I am comforted by knowing that his legacy will live on through his family, his work, and the thousands of attorneys educated by the school bearing his name.

Mr. President, today I rise to recognize all of the providers who work in retail-based convenient care clinics in a resolution to designate August 2 through August 8, 2010, as National Convenient Care Clinic Week. National Convenient Care Clinic Week will provide a national platform from which to promote the pivotal services offered by the more than 1,100 retail-based convenient care clinics in the United States.

Today, thousands of nurse practitioners, physician assistants, and physicians provide care in convenient care clinics. At a time when Americans are more and more challenged by the inaccessibility and high costs of health care, convenient care offers a vital, high-quality primary care alternative.

A resolution will help pave the way for this effort. I ask my colleagues to join me in supporting this tribute to convenient care clinics.

Mr. President, today I rise to recognize all of the providers who work in retail-based Convenient Care Clinics in a Resolution to designate August 2 through August 8, 2010, as National Convenient Care Clinic Week. National Convenient Care Clinic Week will provide a national platform from which to promote the pivotal services offered by the more than 1,100 retail-based convenient care clinics in the United States.

Today, thousands of nurse practitioners, physician assistants, and physicians provide care in convenient care clinics. At a time when Americans are more and more challenged by the inaccessibility and high costs of health care, convenient care offers a vital high-quality primary care alternative.

This resolution will help pave the way for this effort. I ask my colleagues to join me in supporting this tribute to Convenient Care Clinics.

Mr. President, my heart is heavy with sadness following the passing of a dear friend, Robert C. Byrd, Senator from West Virginia.

We have been friends for nearly 50 years and I am overcome with memories. Nearly 48 years ago Senator Byrd was one of the first to greet me in the Chamber of the U.S. Senate.

Since that first moment of friendship we have worked together on many projects. And since those early days, I have called him, ``my leader.''

He was my mentor. Over the years he provided me countless opportunities and tasked me with positions of critical national oversight while guiding my actions with the temperance he learned as the longest serving Senator in history.

He was a Senator's Senator. His many accomplishments were historic and he fought tirelessly to improve the lives of working families in West Virginia. We shared the belief that we must provide for the people who trust us to represent their communities in Washington.

I owe much to my leader, Senator Byrd. He will forever have my gratitude and respect and I will miss him dearly. My thoughts and prayers are with the Byrd family during this difficult time.

Mr. President, as America mourns, I ask my colleagues to join me in paying tribute to Senator Byrd.

Mr. President, I wish to recognize the 110th anniversary of the Kuakini Health System. This great institution of Hawaii was born from necessity and boundless compassion for others. From the humble beginnings of 38 beds, the Kuakini Health System's hospital has grown to serve a 250-bed occupancy. This impressive establishment has marked the lives of countless people and has indeed laid the foundation for a legacy that will endure for years to come.

I am proud to honor the Kuakini Health System. Through the unwavering dedication to serve those in need, its staff has played a pivotal role in the health care of Hawaii's residents. Since its inception, the standards of high quality care were set as the basis for this medical center and though it has been many years, these core values were never lost and the aspiration for excellence has only amplified. Such attributes can be exemplified through the many accomplishments that have set this center apart from all others in Hawaii. It leads in the fields of oncology, geriatric and cardiac care, gastroenterology services, orthopedic surgery, pulmonary disease treatment, and telemedicine and cyberhealth. The commitment demonstrated by all its members is commendable and a model of distinction. The Kuakini Health System is and will always remain an integral part of Hawaii's community. They have my respect and profound appreciation for their steadfast ambition and the necessary work they do.

Mr. President, I ask my colleagues to join me in acknowledging this truly remarkable occasion for the Kuakini Health System.

Mr. President, this will be the fourth time this year the Senate will be voting on an amendment offered by the Senator from Alabama which seeks to constrain discretionary spending. Each one of the amendments has been similar.

This is the fifth time I have risen to speak in opposition to this amendment, and I must admit I find myself somewhat at a loss for words. There are only so many ways to highlight the negative impact of this amendment on current services and the President's initiatives, while explaining how it does not address real deficit reduction.

Fortunately, the Senate has voted this amendment down three times already. I thank my colleagues for rejecting this amendment in the past, and I certainly hope we will do so again.

There are a number of reasons why this amendment is a bad idea. Let me remind my colleagues, again, of several of those reasons:

The Senator from Alabama uses last year's budget resolution as his starting point. He believes that since Congress passed a budget resolution last year with a nonbinding target for this year, that we should now make that target binding.

But, since this amendment was originally proposed, the Budget Committee has reviewed the President's budget request for fiscal year 2011 and has marked up a new budget resolution. In doing so, the committee has changed their recommendation.

Since the committee with jurisdiction has determined the levels that it believes the Congress should keep to, I am not sure what advantage the Senate would have in agreeing to the notional targets in last year's resolution.

I have stated this before, but it is important to note again for my colleagues. The President's budget proposal for fiscal year 2011 allows growth in Homeland Security; this amendment does not assume growth. This could result in fewer border patrol agents and firefighting grants and would weaken TSA's ability to respond to threats to aviation security.

The President has requested more than $732 billion in his budget for national defense for fiscal year 2011, including the cost of war. This amendment only allocates $614 billion.

As I stated several weeks ago, over the 3 years covered in this amendment, the caps that would be put into place are $141 billion below President Obama's 3-year plan, including $50 billion below defense and $91 billion below nondefense spending.

The Sessions amendment is $82 billion below the budget resolution which the committee adopted, and includes a cut of $50 billion from Defense, over 3 years. In the near term, for fiscal year 2011, the Sessions amendment will require the Appropriations Committee to cut defense spending by $9.5 billion and nondefense spending by about $11 billion.

Such across-the-board cuts make for a great photo opportunity for appearing to reduce the deficit, but the consequences could be severe. The lack of direction is reckless. Important needs would go unmet. This amendment could result in cutting research funds for traumatic brain injury, worsening the shortage of air traffic controllers, cutting afterschool centers and veterans employment programs, to name just a few.

This week, the President has asked Federal agencies to identify 5 percent in spending cuts for fiscal year 2012 to areas that are not critical to their overall mission. A more thorough, deliberative approach such as this is clearly more sensible than slashing budgets across-the-board with little or no consideration of the consequences.

As I have said now several times before, a critical flaw in this amendment is it does nothing to seriously reduce the deficit. It fails to address the two principal reasons for the government's current financial distress.

The two drivers behind the growth in the debt are unchecked mandatory spending and the huge tax cuts for the wealthy passed, with no offsets, by the previous administration. This amendment fails to address either of those two problems. It simply does not get the job done. Further, it hinders the efforts of those who do seek to address the deficit in a comprehensive manner.

The fact of the matter is that many of our Republican colleagues are more than willing to put a cap on discretionary spending. At the same time, they refuse to support policies that would ensure the Nation has sufficient incoming revenue to make a real impact on the deficit, even though mandatory spending has increased significantly for the last few years.

We all know that it is impossible to achieve a balanced budget simply by freezing discretionary spending. In fact, we could eliminate all discretionary spending increases for defense and nondefense spending and still not even come close to balancing the budget.

And again, I remind my Democratic colleagues that if we cut discretionary spending without also reaching an agreement on mandatory spending and taxes, we will find it impossible to get those who do not want to address revenues to come to a meaningful compromise.

I would also remind my colleagues that the deficit reduction commission is working, as we speak, to come up with a comprehensive solution to the current systemic imbalances we face.

And in the fall, they will make their recommendations to the Congress, and we have a firm commitment to bring those recommendations up for a vote.

The Senate has already rejected this flawed plan three times this year. The flaws remain, and the Senate should reject it a fourth time.

This amendment fails to address the real causes of our deficits and the national debt in a fair and comprehensive manner. It would provide far less funding than either the President or the Senate Budget Committee recommend.

For all of these reasons, I urge my colleagues once again to vote no.

Madam President, I move to reconsider the vote.

Madam President, the Senator from Oklahoma feels we have had enough debate, so we will not debate this further.

I move to table amendment No. 4231, as modified.

I ask for the yeas and nays.

Madam President, I have been advised by the Senator from Oklahoma that we have had enough debate. Therefore, I move to table amendment No. 4232 and ask for the yeas and nays.