Floor Statements

Madam President, 12 years ago Al Qaeda terrorists attacked our homeland, killing nearly 3,000 people. I will never forget the heroes of that day, many of whom laid down their lives for others.

Their courage is epitomized by the words spoken by a fire department captain at the World Trade Center. He radioed in to say, ``We're still heading up.'' Indeed, these firefighters were still heading up while others were fleeing the flames and the acrid smoke. Where that kind of courage and determination comes from is hard to contemplate, but we are so grateful our first responders have that kind of dedication and courage.

Nor will I ever forget the many people who continue to live with the scars, whether they are civilians who lost a loved one that day, firefighters, police officers, or other first responders who rushed to the scene, or our brave military servicemembers who answered the call to defend our country in the years that followed. We must never lose sight of their sacrifice.

This week we have been considering the weighty issue of whether to grant the administration the authority to use military force against Syria. This day, the anniversary of those horrific attacks on our country 12 years ago, should not pass without our calling attention to another important matter of unfinished business critical to our national security and to our Nation's conscience.

A year ago today terrorists with links to Al Qaeda attacked our diplomatic facility in Benghazi, Libya. Despite a steadily escalating stream of threat reporting, and an obvious inability of Libyan security forces to protect

our diplomatic personnel and our facilities, the State Department had denied urgent requests for increased security measures. Officials kept the woefully vulnerable Benghazi compound open, setting the stage for attackers to essentially walk right into the compound and set it ablaze.

Tragically we lost four brave, dedicated diplomats and security personnel that terrible day and night: Glen Doherty, Tyrone Woods, Sean Smith, and Ambassador Chris Stevens. We laud their courage and we honor their memory, but we must also remedy the security failures and punish those responsible for their deaths.

Today I draw attention to the lessons that must be learned from the attacks in Benghazi and to the work that still must be done to bring the attackers to justice. First we must ensure that such wholesale failure to read the signs of escalating danger and to respond to urgent security needs never happens again.

Last year, as chairman and ranking member of the Senate Homeland Security Committee, former Senator Joe Lieberman and I conducted an investigation into the terrorist attacks at Benghazi. In our bipartisan report entitled ``Flashing Red,'' we found the State Department downplayed the terrorist threat in Benghazi despite numerous previous attacks on western targets, that they ignored repeated requests for additional security, and that they insufficiently fortified a shamefully ill-protected American compound. The Benghazi facility should either have been closed until security was strengthened or the threat abated.

We identified changes that must be made, including greater attention to security at high-risk posts around the world and better management to ensure that the recommendations of previous security reviews are fully implemented. It was discouraging to read previous accountability review board reports after the attacks in Africa, for example, back in the late 1990s and see similar patterns of requests for security being denied in Washington.

Second, Secretary of State John Kerry should hold personnel accountable for the problems identified in our committee report and by the Accountability Review Board. After our committee and the ARB identified systemic failures and leadership deficiencies that contributed to the grossly inadequate security in Benghazi, it is totally unacceptable for the State Department to hold no one responsible for the broader mismanagement that occurred prior to the attack.

Finally, a year after the attack, the terrorists who invaded the Benghazi compound still have not been brought to justice despite repeated promises and pledges by President Obama to do so.

After a long-delayed investigation, including a period of weeks when the FBI agents were not allowed to even access the Benghazi facility, Federal authorities have recently filed criminal charges against several suspects. But serious questions remain about the pace, the extent, and the effectiveness of these investigations and charges.

A major problem is the willingness--or lack thereof--of the Libyan Government to fully cooperate. I am told that the whereabouts of one of the prime suspects is known and that he is walking about fully, openly, and freely. Yet he has not been picked up. He has not been arrested. He has not been taken into captivity. Why not?

The administration must follow through on its commitment by taking the steps necessary to bring the attackers to justice, as the President promised. And the State Department, in the meantime, must implement all of the actions needed to prevent a Benghazi-like attack from taking place again. Surely, on the anniversary of the attacks on our Nation 12 years ago and the attacks 1 year ago in Benghazi, we owe it to Chris Stevens and his colleagues and to the American people.

Madam President, seeing no one seeking recognition, I suggest the absence of a quorum.

Mr. President, first, I wish to congratulate the bill's sponsors, Senators Shaheen and Portman, for crafting the underlying bipartisan, commonsense energy efficiency bill.

I am proud to be a cosponsor of their legislation, and I am pleased to see that the bill is being considered and look forward to the debate on energy efficiency.

I would hope that as we consider amendments to this bill, we could consider amendments that relate to the issue of energy so we can make real progress and that we don't end up--as happened before the recess when I was managing a bill on the transportation and housing appropriations for the minority side--distracted on two issues that had nothing to do with the underlying bill, important though it was.

I am very pleased to join my colleague, the distinguished Senator from Colorado Mr. Udall in sponsoring an amendment to help streamline the available Federal Energy Efficiency Financing Program to help improve the health and lower energy costs of our Nation's schools.

There are a number of Federal initiatives already available to schools to help them become more efficient. However, in many cases schools are not taking full advantage of these programs. I think this is particularly a problem in rural States such as Alaska or Maine, where the schools don't have the luxury of having grant writers who can spend all day searching for Federal funding that might allow them to upgrade their energy efficiency or reduce emissions from their energy systems.

Large urban schools may have the ability to hire those full-time grant writers, but I know in my State of Maine it is very difficult for schools to even become aware of these programs. One of the purposes of the amendment that Senator Udall and I are offering is to help schools, regardless of their size, take advantage of existing programs.

I wish to stress that we are not creating a whole lot of new programs. All we are doing is providing a streamlined coordinating structure for schools to help them better navigate available Federal programs and financing options. I also wish to emphasize--particularly to my Republican colleagues--that our amendment still leaves all the decisions to the States, local school boards, and local officials about how best to meet the energy needs of their schools.

So what does our amendment do? Specifically, the amendment would establish the Department of Energy as the lead agency in coordinating a cross-developmental effort to help initiate, develop, and finance energy efficiency, renewable energy, and retrofitting projects for our schools. It would also require a review of existing Federal programs and financing mechanisms, the formation of a streamlined process of communication and outreach to the States, local education agencies, and schools of these existing programs to make them more aware of their existence, and the development of a mechanism for Governors, State energy programs, and local educational and energy officials to form a peer-to-peer network to support the initiation of these projects.

Finally, the amendment would require the Department of Energy to provide technical assistance to help schools navigate the financing and development of these projects. Assisting our Nation's schools in navigating and tapping into existing Federal programs that will help them lower their energy usage and save the taxpayers' money at a time of very tight and constrained educational budgets simply makes good common sense.

I urge my colleagues on both sides of the aisle to support the Udall- Collins amendment numbered 1845. I thank not only the sponsors of the bill but the leaders of the energy committee, Senator Wyden and Senator Murkowski, for their help and assistance to us.

I hope we can start the debate on this bill on a positive note by adopting a bipartisan amendment that is going to help our schools save money, reduce energy costs, and also lower emissions. That is the way to start the debate on this bill.

I thank the Presiding Officer and yield the floor.

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

I ask unanimous consent that I be permitted to proceed as in morning business for up to 25 minutes.

Mr. President, the decision on whether to authorize the President of the United States to use the military might of our great Nation against another country is the most significant vote a Senator can cast. The Constitution vests this responsibility in Congress--a duty that rests heavily on the shoulders of each and every Member.

We are now engaged in a serious debate about what the appropriate response should be to the horrific use of

chemical weapons by the regime of Syrian President Asad who killed his own people using chemical weapons on August 21. This was not the first use of chemical weapons by President Asad. He launched several smaller scale attacks, murdering his citizens, and, notably, many, if not all, of those attacks occurred after the President drew his redline a year ago. But it was not until the large-scale August 21 attack of this year, which resulted in the deaths of approximately 1,400 people, that President Obama decided a military strike against Syria was warranted. The fact is Asad violated the international convention prohibiting the use of chemical weapons and crossed President Obama's redline many times during the past year.

Deciding whether to grant the President this authority is a very difficult decision. I have participated in numerous discussions with the President, the Vice President, and experts in and out of government. I have attended many classified briefings as a member of the Senate Select Committee on Intelligence, and I have carefully weighed the assessments of the intelligence community and military and State Department officials. My constituents have also provided me with valuable insights that have helped to guide my decision. After much deliberation and thought, I have decided I cannot support the resolution that was approved by the Senate Foreign Relations Committee last week.

One of the criteria for the use of military force is surely whether the adversary poses an imminent threat to the American people. More than once President Obama has stated Syria's chemical weapons and delivery systems do not pose a direct imminent threat to the United States. Neither the United States nor any of our allies have been attacked with chemical weapons. Instead, President Obama justifies the attack he is proposing as a response to the violation of international norms, despite the fact that we currently lack international partners to enforce the Convention on Chemical Weapons through military means.

Although the term ``limited air strikes'' sounds less threatening, the fact is even limited air strikes constitute an act of war. If bombs were dropped from the air or cruise missiles were launched into an American city, we would certainly consider that to be an act of war, and that is why this decision is fraught with consequences.

American military strikes against the Asad regime, in my judgment, risk entangling the United States in the middle of a protracted, dangerous, and ugly civil war. GEN Martin Dempsey, the Chairman of the Joint Chiefs of Staff, has warned us that the use of U.S. military force ``cannot resolve the underlying and historic ethnic, religious, and tribal issues that are fueling this conflict.''

The introduction of American Armed Forces into this violent conflict could escalate to the point where we are perceived to be, or actually are, involved in a Syrian civil war or a proxy war with Hezbollah or Iran.

In this complex conflict, it is also becoming increasingly difficult to sort out the good guys from the bad. There is no doubt that Asad is a brutal, ruthless dictator who murders his own citizens and who is supported by thousands of Hezbollah terrorist fighters. The opposition, however, is not pure. It has now been infiltrated by not one but two affiliates of Al Qaeda as well as by criminal gangs. Caught in the middle are millions of Syrians who simply want to lead peaceful lives. The tragic result has been more than 100,000 people killed, 4 million displaced internally, and 2 million refugees.

We do not know how Asad or his allies would respond to a U.S. military attack, but an asymmetric attack by Hezbollah aimed at one of our bases or at other American interests abroad certainly is one potential response. My concern is that reprisals, followed by subsequent retaliations, followed by still more reprisals could lead to an escalation of violence which never was intended by the President but which may well be the result of the first strike.

I have raised this issue directly with administration officials since the ``one and done'' strike, as retired GEN Michael Hayden puts it, may well not work. I have asked the administration what they would do if Asad waits until the 91st day, when the authorization for the use of military force expires, and then conducts an attack using chemical weapons that kills a much smaller number of people. What will we do then? In each case where I have raised this question, I have been told that we would likely launch another military strike.

In addition to my concern about being dragged into the Syrian civil war, I question whether the proposed military response would be more effective in achieving the goal of eliminating Asad's stockpile of chemical weapons than a diplomatic approach would be.

Let's be clear. The strikes proposed by the President would not eliminate Asad's chemical weapons, nor his means of delivering them. In the President's own words, the purpose of these strikes is ``to degrade Asad's capabilities to deliver chemical weapons.'' Indeed, you will not find any military or intelligence official who believes that the strike contemplated by the administration would eliminate Syria's chemical weapons stockpile or all of the delivery systems. General Dempsey wrote to Armed Services Committee Chairman Carl Levin that even if an explicit military mission to secure Syria's chemical weapons were undertaken, it would result in the control of ``some, but not all'' chemical weapons in Syria, and that is not what is being discussed because that would undoubtedly involve boots on the ground.

According to the President, the purpose of his more narrow objective is to deliver a calculated message to convince Asad not to use his remaining chemical weapons and delivery systems ever again. But would such a strike be effective in preventing Asad from using these weapons again on a small scale after he has absorbed the strike just to deliver his own message that he retains the capability to do so? Asad would retain a sufficient quantity of chemical weapons, and he knows that we did not respond to smaller chemical weapons attacks that he undertook before the August 21, 2013, event.

So on the one hand, the President is seeking to conduct a precision military strike that is sufficient to deter Asad from using any chemical weapons again. On the other hand, he wants to narrow the scope of a military strike so that Asad does not perceive this act of war as a threat to his regime. Yet the President has previously stated that U.S. policy is the removal of Asad.

While administration officials have gone out of their way to state that the military strikes are only to deter and degrade Asad's chemical weapons use and are not intended to pick sides in the civil war, the text of the resolution before us is at odds with the administration's representations. The text states that it is the policy of the United States to ``change the momentum on the battlefield in Syria so as to create favorable conditions for a negotiated settlement that ends the conflict and leads to a democratic government in Syria.'' Well, no one could ever consider the Asad dictatorship to be a democratic government in Syria.

Furthermore, on September 3 Secretary of State John Kerry testified that ``it is not insignificant that to deprive [Asad] of the capacity to use chemical weapons or to degrade the capacity to use those chemical weapons actually deprives him of a lethal weapon in this ongoing civil war, and that has an impact.''

That is a very mixed message from this administration about the purpose of these strikes.

All of us want to see a peaceful Syria, no longer led by Asad, nor controlled by the radical Islamic extremists who are part of his opposition. But is military action that could well get us involved in Syria's civil war the right answer?

When I think about the proper response to Asad's abhorrent use of chemical weapons, I am mindful of the suffering and death that has occurred as well as the international conventions banning chemical weapons. Since this is an international norm, however, where are our international partners--the United Nations, NATO, the Arab League?

I have grave reservations about undertaking an act of war to enforce an international convention without the international support we have previously had when undertaking similar action in the past, such as in Kosovo,

Afghanistan, and even Iraq. While NATO's Secretary General has expressed support for consequences, NATO's North Atlantic Council, which is the body that approves military action for NATO, has not approved this military action. The Arab League has condemned with words the use of chemical weapons, but there is yet to be any Arab League statement that explicitly endorses military action or promises to be engaged in that action. Even our ally who has been most supportive, France, has asked for a delay to allow the U.N. inspectors to deliver their report next week.

Let me add that I believe that report early next week will verify that it was the Asad regime that used sarin gas. That is my expectation.

A military strike may well enforce the international norm with respect to chemical weapons, but at the same time it would weaken the international norm of limiting military action to instances of self- defense or those cases where we have the support of the international community or at least our allies in NATO or the Arab League.

In addressing this difficult and tragic crisis in Syria, the administration initially presented us with only two choices: Take military action or make no response at all. I reject and have rejected from the start the notion that the United States has only two choices-- undertaking an act of war or doing nothing in response to President Asad's attack on his citizens. There are a variety of nonmilitary responses to consider that may well be more effective. The most promising of these options, proposed by the Russians--one of Asad's strongest allies--would place Syria's chemical weapons stockpile in the custody of the international community before they would ultimately be destroyed.

I am not naive about ``trusting'' the Russians. My point is that this option may well be in Russia's own interests, would be more effective in securing the stockpile of chemical weapons in Syria, and would involve the international community. This diplomatic alternative would put Syria's chemical weapons under verified international control and would once and for all prevent Asad or anyone else in Syria from using those weapons. A risk of attacking Asad's facilities is that the chemical weapons could fall into the hands of terrorist elements in the country. That risk would be eliminated if the weapons were removed completely from Syria.

One of the arguments advanced by proponents of the authorization for the use of military force resolution is that America's credibility is on the line. This is a legitimate concern. To be sure, it was unfortunate that the President drew a line in the sand without first having a well-vetted plan, consulting with Congress, and obtaining the necessary support for doing so. I would maintain, however, that the credibility of our great Nation is beyond that of just one statement by the President, even in his important capacity as Commander in Chief. The credibility of the United States is backed by a military that is the most advanced and capable in the world. The strength of our military sends the clear, unmistakable message that the United States is capable of exerting overwhelming force whenever we decide it is the right thing to do and it is necessary to do so. It would be a mistake for our adversaries to interpret a single vote regarding a military response to Syria's chemical weapons program as having ramifications for our willingness to use force when our country or our allies face direct imminent threats, especially with regard to the proliferation of nuclear weapons and intercontinental ballistic missile capabilities.

At the very least we have an obligation to pursue all nonmilitary options that may well be more effective in preventing the future use of Asad's chemical weapons than the military option the President has proposed to undertake.

For these reasons, should the authorization for the use of military force approved by the Senate Foreign Relations Committee come to the Senate floor, I shall cast my vote in opposition.

My hope, however, is that the negotiations underway with the Russians will pave the way for the removal of chemical stockpiles from Syria and for their verified ultimate destruction. That is the best outcome for this crisis. That would lead to a safer world.

Thank you, Madam President.

Madam President, the Senate will shortly decide whether to invoke cloture on the fiscal year 2014 Transportation, Housing and Urban Development appropriations bill. We have spent nearly 2 weeks debating this bill and working through approximately 85 amendments.

We were making progress. We even had a vote on a nongermane amendment, which clearly would have fallen to a point of order had one been raised. So no one has been shut out of this process.

Chairman Murray and I have repeatedly encouraged Senators to come to the floor, file, and debate their amendments to improve the bill we reported.

It has been an open and transparent debate thus far, a return to regular order--something I have heard virtually everyone here urge us to do.

Nevertheless, some Senators are intent on preventing this legislation from moving forward, despite the fact that this bill is not the final version of the transportation and housing appropriations bill. It is only one step in the process but an essential step--one that will allow the Senate to move forward and eventually negotiate with the House of Representatives to decide on a top line and to further improve the bill.

A considerable number of my colleagues have advocated for the House funding level of $44 billion and have opposed the Senate bill. But I would like to point out that not one of my colleagues has offered a specific amendment, account by account, to reduce the funding levels, program by program, in this bill to meet the $44 billion level in the House bill.

I personally offered an amendment that said that in October, if we find we have breached the top line of the Budget Control Act, we would go back to the appropriations process and redo the bill to meet that top line.

I would also point out that yesterday the House leadership was forced to pull its THUD bill from the floor due to lack of support. Some Republican Members thought the spending levels were too high. But it is surely significant that a substantial number of Republicans felt the bill, as written, was far too low and would hurt our homeless veterans, would delay repair of our crumbling infrastructure, and would slash the Community Development Block Grant Program to the lowest level in history, to below the 1975 level when it was first created by President Ford.

Let me point out that the numbers in the House bill were not realistic. That is one of the reasons it failed. The numbers in our bill are not unrealistic. They are too high. They would come down in conference. The President's request was artificially low due to several budget gimmicks and scoring differences. We took care of those gimmicks. We have an honest bill that is before our Members. Let me give you just one example of a gimmick that was in the President's budget. His request for the section 8 project-based rental assistance is insufficient to fully fund the 12-month renewal contracts with private owners.

We are not going to be throwing people out of those subsidized apartments after 10 months in the year. So Senator Murray and I added funding to more accurately reflect what was needed. That was over $1 billion of the difference. There was the difference in the scoring by CBO and OMB. We have to go by CBO. That accounted for $1.8 billion.

It is disappointing to me that we have not gone to conference on the budget because we would not be in this dilemma. We would have agreed- upon allocations that would guide the appropriations process. But in the absence of that, what is wrong with proceeding with this bill with cutting spending in it? If Members have amendments they wish to offer to cut spending--and there are a few that have been offered, but as I said, none that bring it down to the House's level in an account-by- account manner.

I am still hopeful we will be able to pass this bill and start bringing other appropriations bills to the floor before the end of the fiscal year because forcing the government to operate under continuing resolutions is irresponsible. It ends up costing more money in the long run. It is wasteful because we continue to fund programs that are no longer needed because we are just continuing current law.

So I urge my colleagues to think very carefully about this vote. It would be so unfortunate if we go home to our constituents in August and are forced to tell them we are unable to do our job. We should continue working on this bill. We should invoke cloture. This bill undoubtedly would have been reduced in conference had we been allowed to go forward.

I do wish to thank many of my colleagues for working with us as we tried so hard to advance this important legislation. I am particularly grateful to Chairman Murray for her bipartisan approach and collaboration and for working so closely with me throughout the process.

Finally, I would be remiss if I did not thank our staffs on both sides of the aisle for their hard work. They have worked night and day on this bill. I will put all of their names in the Record. I know my time is expiring.

Let's do the right thing. Let's proceed to end the debate on this bill, take

care of the rest of the germane amendments and proceed to final passage and ultimately to conference with the House. Let's show that we mean it when we say we are committed to full and open debate and returning to the process that used to serve us well.

Madam President, it is with great regret that on behalf of Senator Coburn, I am objecting.

I wish to point out that we have worked very hard to clear this list of amendments, and they include amendments from Members on both sides of the aisle. It is a fair list, and I had hoped we would be able to proceed tonight.

Regrettably, there is an objection on our side from Senator Coburn.

I am, however, optimistic that with further work we will be able to deal with that objection. My hope is that in the morning we will have an agreement that will allow me to agree, as the manager on our side, to this list. Unfortunately, at this time, I do need to object.

Mr. President. I rise today to commemorate the 250th anniversary of the Town of Fryeburg, ME, the first town established in the beautiful White Mountains of Maine and New Hampshire. The same spirit of determination and resiliency that carved a community out of the wilderness two and a half centuries ago still guides Fryeburg today.

In 1763, the Seven Years' War between France and Great Britain for control of North America ended with a resounding British victory. In recognition of his courageous service, GEN Joseph Frye, an American- born militia commander, was rewarded with a homestead grant in the White Mountains region. He chose the place where the great Saco River tumbles from the mountains on its journey to the sea, a place of vast forests and fertile farmland. That first settlement of seven lots soon grew into a thriving town, incorporated in 1777 and named in General Frye's honor.

That first settlement was built on the foundation laid a half century before by another early American hero, CPT John Lovewell. His valiant deeds to secure the colonies' northern frontier--including the legendary Battle of the Pond in 1725--were celebrated by such authors as Longfellow, Hawthorne, and Thoreau. From those long ago days to the present, the Veterans Honor Roll in Bradley Park memorializes the more than 1,200 patriots from Fryeburg who have served our Nation in times of peril.

As the town of Fryeburg became a bustling center of industry with lumber and grain mills, the townspeople invested their prosperity in education and in 1792 established Fryeburg Academy, one of America's oldest preparatory schools. Among the academy's first teachers was Daniel Webster, before he began his remarkable career as a statesman in the U.S. Senate and as America's Secretary of State. Fryeburg's connection to the world of ideas was strengthened in 1997 when the International Musical Arts Institute was established, bringing world- class musicians and conservatory students together every summer for concerts that enrich the community.

The coming of the railroads in the mid-19th century made Fryeburg, with its spectacular scenery, mountain breezes, and pristine waters, a favorite destination for city dwellers escaping the summer heat. Among those who found their way to Fryeburg during that era was the legendary Arctic explorer Robert Peary, who sharpened his navigation skills while surveying the town as a young civil engineer. Today, visitors and residents alike enjoy Fryeburg's many quiet parks, beautifully maintained historic buildings, and exciting outdoor recreation opportunities. The annual Fryeburg Fair, Maine's largest agricultural exhibition, keeps the town's origins and traditions alive.

The celebration of Fryeburg's 250th anniversary is not merely about the passing of time. It is about human accomplishment. We celebrate the people who, for longer than America has been a nation, have pulled together, cared for one another, and built a great community. Thanks to those who came before, Fryeburg, ME, has a wonderful history. Thanks to those there today, it has a bright future.

Thank you, Madam President.

Colleagues, as the chairman of our subcommittee, Senator Murray, has pointed out, we are continuing to work through the amendments that have been filed on this bill.

I do not think I need to remind any of our colleagues on either side of the aisle that the August recess is fast approaching and the Senate will have to wrap up its work on this bill before we adjourn.

So I would say to my colleagues, if you have good ideas or even not so good ideas about this bill, we urge you to come to the floor and file your amendment and do so as soon as possible.

As Chairman Murray has pointed out, there has been an open amendment process. We have disposed of some amendments; a couple through rollcall votes, a few others through unanimous consent. But we could have done a lot more last week had people been willing to come to the floor and allow us to proceed to amendments that were filed.

I also want to highlight a letter the Appropriations Committee has received from more than 2,420 national, State, and local organizations, and State and local government officials in support of the funding that is in the programs that are included in this important bill. This is an important bill. It is a bill that will help us rebuild our crumbling infrastructure. It is a bill that helps us meet the housing needs of homeless veterans, of disabled senior citizens, of very low-income families. It is a bill that will help the private sector create thousands of new jobs at a time when our economy needs them--in fact, hundreds of thousands of new jobs.

It is not surprising to me that so many organizations are lending their voices in support of this bill. I want to read one quote from the letter from these organizations. The letter notes that:

Through these investments, Congress supports small business

job creation, expands our nation's infrastructure capacity,

supports economic recovery and growth, reduces homelessness

and housing hardships, and promotes lasting community and

family economic success.

I think that is a very good description of the purpose and the programs in this bill.

One of the programs in this bill that is extremely popular and has been used very well to promote economic development and community reinvestment in my State is the funding for the Community Development Block Grant Program. That is an area where our bill differs greatly from the House bill.

I want to point out that tomorrow the House of Representatives is expected to consider its version of the fiscal year 2014 Transportation and Housing and Urban Development appropriations bill. Think about this. If we pass our bill, they pass their bill, we could actually proceed to a conference committee and work out the differences between our respective bills. The differences are marked. I do not minimize the differences in terms of priorities and funding, but that is what Congress is all about.

If we do pass our bill and the House proceeds to pass its version of the T-HUD appropriations bill, we will be the first but I hope not the only fiscal year 2014 spending bill that is ready for conference, goes to conference, and I hope becomes law.

Finally, let me say, I recognize the Senate bill is not perfect, despite the heroic efforts Senator Murray and I made in committee and the input and insight from our colleagues that are incorporated into this bill. But it is a good-faith bipartisan effort that attempts to strike the right balance between fiscal responsibility and our Nation's infrastructure and housing needs.

I am confident the bill that would come back from conference would be, frankly, at a lower spending level, which I and many on my side of the aisle want to see. But I was encouraged by the Senate's vote last week of 73 to 26 to allow the Senate to proceed to this bill. I know we can make improvements. That is what the amendment process is all about.

Again, I want to second what our chairman has said and encourage our colleagues to get their amendments filed and to work with both of us so we can proceed to wrap up this work session on a high note of passing, on time, an individual appropriations bill. I am willing to work hard over the recess to conference the two bills, to get going on that. I know the chairman is as well.

I want to thank the chairman and my staff and her staff also for working so hard.

Mr. President, in one terrifying week this spring, Lewiston, ME, my State's second largest city, was attacked by arsonists who destroyed nine buildings and left hundreds of people homeless. I rise today in tribute to the firefighters of Lewiston who answered those cruel attacks with skill and courage and who saved their city with no loss of life or serious injury.

We have always had a deep respect and admiration for our firefighters and

first responders. In recent years, however, the American people have been reminded of the vital protections they provide to our communities. From the Twin Towers in 2001 to the Boston Marathon in 2013, we have seen these heroes rush into danger that others flee. We have seen them risk their lives to save the lives of others.

That is precisely what the people of Lewiston have seen since their first fire company was established in 1849. Through the years, fire has claimed textile and lumber mills, stores and schools, homes and even city hall. Yet never has a fire, no matter how fierce, been allowed to spiral out of control into a conflagration. The willingness of the people of Lewiston to always rebuild is testament to the confidence they have that their valiant firefighters will protect their property and their lives.

That protection comes at a high price. The Lewiston Firefighters Memorial bears the names of nine men who made the ultimate sacrifice in the line of duty.

Today, under the leadership of Fire Chief Paul LeClair and International Association of Firefighters Local 785 president Rick Cailler, the Lewiston Fire Department is recognized as one of the best in Maine, known for its professionalism, efficiency, and dedication. In the special language of the firefighter community, the Lewiston firefighters are considered ``the toughest Jakes on the job.''

They are tough yet filled with community spirit and compassion. Through the generosity of its members, the Local 785 Community Fund sponsors youth sports teams, charities, and the arts, and provides children in need with Christmas toys. Their annual ``Fill the Boot'' campaign raises many thousands of dollars for the fight against Muscular Dystrophy.

America's firefighters play a vital role in the security of our Nation and the safety of our people. Whether it is in response to a terrorist attack, a natural disaster, or a fire, Americans rely on our firefighters, and our firefighters always answer the call. The firefighters of Lewiston, ME, are a shining example of that commitment, and I join the people of their city in saluting them.

Madam President, it is my understanding that the Senator from Arizona wishes to address the Chamber about an upcoming motion to recommit the bill.

I yield time to the Senator from Arizona.

I yield 5 minutes to Senator Hoeven.

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

Madam President, later this afternoon, Senator Toomey will be offering a motion to recommit the Transportation-HUD appropriations bill back to the Appropriations Committee. While I commend Senator Toomey's goal of ensuring that the fiscal year 2014 spending levels comply with the Budget Control Act spending caps, I do not believe this is the right approach.

Let me be clear. I voted in the Appropriations Committee, as did every Republican member of that committee, for a top-line level of $967 billion. That is the amount that is in the Budget Control Act. That is law. But this is the very first appropriations bill that has been brought to the Senate floor. We have no idea where we are going to be at the end of the process.

The two leaders of the Appropriations Committee have called for regular order, and I commend them for bringing appropriations bills to the floor starting with this one, one at a time, for debate, amendment, and full consideration. We have had many amendments filed to this bill. Several of them would reduce spending that is in this bill. One reduces spending by $50 million for the HOME program that is being offered by the Senator from Arizona. There is another that reduces spending by over $1 billion for the Community Development Block Grant Program. That is not a cut I happen to believe should be made, but that is a legitimate amendment that, if it passes, would reduce spending in this bill by $1 billion. There are other amendments that have been proposed to reduce spending in this bill.

So this is turning the process upside down. It is recommitting to committee a bill before we have had the opportunity to determine what the final spending level in the bill is even going to be as a result of the many amendments that have been filed. Furthermore, we are not going to know if we have reached the cap until we finish all of the appropriations bills.

I realize my Democratic colleagues want a far higher spending cap than I do and that the Budget Control Act provides, but I don't think we should short-circuit the process when there has been a good-faith effort to bring appropriations bills to the floor.

What I would propose in lieu of the approach offered by my friend and colleague Senator Toomey is an amendment which I am going to file this afternoon that says not later than October 1, the Committee on Appropriations shall revise the suballocations to the subcommittees for fiscal year 2014 such that the suballocations comply with the discretionary spending limits that are in the Balanced Budget and Emergency Deficit Control Act--what we refer to as the Budget Control Act, the BCA.

To me, this is the proper way to do it. If, at the end of the fiscal year, we find that the appropriations bills that have been passed exceed the statutory cap in the BCA, then we should reopen the process and reallocate the funds--the ceilings, the caps--across each of the subcommittees and produce bills that comply with the law.

Frankly, since current law applies this cap anyway, if we don't do that, sequestration will take effect on January 1 of next year. I do not think that is a good approach because it treats all programs as if they are the same and does not allow us to set priorities.

So I think the approach of the Senator from Pennsylvania is premature, a blunt instrument, and there is a reasonable alternative. I think it discourages a return to regular order where we bring the appropriations bills to the floor and where Members are free to eliminate whole programs, to cut billions if they wish to do so. Indeed, Members have worthwhile amendments that would reduce spending, but to send the bill back to committee before we have even had a chance to consider those amendments and before we have allowed the Senate to work its will is, to me, completely upside down of the way the process should work.

Furthermore, I will make the point once again that this is the first appropriations bill. How can we say the cap is breached when it is the very first bill to be brought before the Senate? Frankly, having gone through this process where we did have a freestanding Transportation- HUD bill and Senator Murray and I went to conference with our House counterparts, we came back with a consensus bill that became law that was in between the amounts in the Senate bill and the House bill. So we ended up at a lower level, which we knew we would, and which I will not feel I am going out on a limb in predicting we would in this case as well, since the Senate bill is higher than the House bill.

Why can't we let the process work? Why can't we consider the amendments that have been offered, some of which may well pass and reduce spending? Why can't we go to conference with the House where I believe additional cuts are probably likely? And why can't we let the appropriations process unfold the way it should? Why should we short- circuit it now by saying, that is enough, let's return the bill to committee, we don't trust what is going to happen, when there are safeguards we can put in to ensure that at the end of the day we will be at the cap of $967 billion?

As I said, I will file my amendment this afternoon to give us an actual mechanism to ensure that at the beginning of the fiscal year we are at those levels. That is one approach, and I think it is a far better approach.

Thank you, Madam President.

Mr. President, I too wish to comment on the progress we have made this week. We have been considering this appropriations bill under regular order. We have actually cleared several amendments today. We have had some votes. We have defeated a motion to recommit the bill to committee so that we can proceed to go forward.

Senator Murray and I will be here on Monday, ready and open for business. We will start sequencing amendments.

I hope Members on both sides of the aisle will approach this bill in a cooperative spirit with respect to further rights of Senators to offer their amendments and get votes, and that we will not see Members drawing lines in the sand or deciding that they are going to block action going forward because I think this bill could be a model of how we should operate.

Thank you, Mr. President.

Amendment No. 1744

Madam President, I just want to commend the Senator for his amendment. The fact is that 25 percent of our Nation's bridges are either structurally deficient or functionally obsolete, as described by the Senator from Ohio.

In my home State of Maine, nearly a third of our 2,408 bridges are deficient. Senator Portman's amendment targets these funds to ensure that they are awarded to structurally deficient or functionally obsolete projects in an effort to respond to our Nation's crumbling infrastructure.

Like Senator Murray, I support this amendment, and I too am prepared to accept it on a voice vote.

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Madam President, we have had a good discussion about how to proceed with this bill. The chairman of the full committee has been extremely constructive in exercising her leadership. She very much wants a new approach, and I commend her for bringing bills individually to the Senate floor.

What we are going to propose--and through the Chair I would like to engage in a colloquy with the chairman of the full committee--is that, as usual, we would go back and forth, one side then the other, in considering amendments but that we would allow Senator Coburn to file a series of amendments at this point. They are already filed, but he will call them up and make them pending, with the understanding that we would set aside individual amendments so we could keep going back and forth and so that other colleagues on the Republican side who have amendments would not be shut out but, rather, would be accommodated as well.

Is that the understanding of the chairman of the Appropriations Committee?

I would say through the Presiding Officer that is my understanding as well. And I think this was a very good example of everyone operating in good faith.

I, for one, am prepared for the Senator from Oklahoma to proceed, but I would note that the Cardin amendment is the pending amendment.

Madam President, I am pleased to join Chairman Murray as we begin floor consideration of the fiscal year 2014 appropriations bill for the Department of Transportation, Housing and Urban Development, and related agencies. This return to regular order in which appropriations bills are considered individually, with the opportunity for full debate and for Members to come to the floor and offer their amendments, is welcome indeed.

Like Senator Murray, I wish to commend the two leaders of our Appropriations Committee--Senator Mikulski, the chair, and Senator Shelby, the ranking member--for their commitment to returning to regular order. We simply must stop the irresponsible practice of waiting until the eleventh hour and then producing a bundled bill totaling thousands of pages with little or no opportunity for truly careful deliberation and debate.

I wish to thank our subcommittee chairman for working very closely with me to craft this bipartisan bill. She has been a tremendous leader of our subcommittee and has operated in a way that has been completely bipartisan.

This bill makes responsible investments in transportation and economic development and includes input and priorities from Members from both sides of the aisle. We listened to the concerns of our Members, and the bill was approved by a bipartisan vote of 22 to 8 in committee.

The fact is that the transportation and housing appropriations bill has a long tradition of bipartisan support. Every Senator has unmet transportation and housing needs in his or her home State, from crumbling roads and bridges, to economic development needs, to a growing population of low-income families, elderly, and disabled individuals who need our help.

According to the American Society of Civil Engineers, the condition of our Nation's infrastructure remains poor. Our roads, airports, and transit systems received a grade of D, while our bridges, ports, and rail systems received only a C. In fact, in my State of Maine the roads and bridges are among the worst in the Nation's rural transportation network. This matters because we need efficient and safe transportation networks to move our people around the country and to move our products to market.

The bill before us does not begin to solve all of our Nation's transportation and housing woes. We simply do not have the money to do that. After all, we cannot ignore the size of our unsustainable $17 trillion national debt. We also cannot ignore the need for investments that will help the private sector create jobs and allow our people and products to travel safely and efficiently and our most vulnerable citizens to receive decent housing.

I understand that some Members are very concerned about supporting any

funding bill that has an allocation that is higher than the House counterpart. I certainly agree it is important that we adhere to current law, which limits spending to $967 billion. But it is our responsibility to consider the merits of each of the Senate funding bills and produce bills based on our best judgments. Then we negotiate with our House counterparts in conference. That is the way the process is supposed to work. That is how we produce compromises. That is how we produce appropriations bills. The Senate should not be a rubberstamp for the House, nor should the House be a rubberstamp for the Senate. Each body should come forth with its individual appropriations bills, and then we should meet in conference, negotiate, and produce bills that can have the support of both bodies.

The fact is that the fiscal year 2014 House transportation and HUD allocation of $44.1 billion is, in my judgment, insufficient to meet the true needs of both transportation and housing. In fact, the House allocation was $51.6 billion just last fiscal year, so this year's House allocation reflects a dramatic cut. Could there be further cuts in our bill? Absolutely. I am sure there will be some worthwhile amendments offered on the Senate floor, and, more importantly, I believe that when we negotiate with our House counterparts we will produce a bill that is most likely somewhere in between the two allocations.

Our bill is by no means a perfect bill, but the House bill includes policy choices I believe most Senators will find problematic if they take a close look at the House provisions. Let me cite one example.

Our bill provides nearly $3.2 billion for the Community Development Block Grant Program. The CDBG Program supports economic development leading to job creation across the country. I want to point out that the President's budget cut that program. It proposed $2.8 billion, which is the lowest funding level since 1976, when President Gerald Ford was in office. The CDBG Program is one of the most popular Federal programs because of the flexibility it gives communities and States to tailor their economic development projects. Yet the House bill would cut the program even beyond the President's budget by reducing this important program by more than $1.1 billion below the 1976 levels. That is when the program was first created in a Republican administration that recognized that States and communities are best able to use the flexibility of the Community Development Block Grant Program to meet the needs of their citizens, to spur downtown development, to create incentives for businesses to locate, and to produce good jobs.

Our bill also continues funding for the TIGER grant program, which supports transportation infrastructure projects that have a significant impact on the Nation, a region or metropolitan area. The House bill not only eliminates this program but also rescinds funding for the current fiscal year by 50 percent. That means a round of grants that are just about to be funded could not go through.

For aviation programs our bill provides sufficient funding to ensure that the NextGen modernization efforts will continue to improve the efficiency, safety, and capacity of our aviation system.

With the lower funding levels as proposed by the House, here is the irony: We would simply end up paying more in the long term than we would now by providing the funding when it is needed.

So this program isn't a matter of whether we need it; it is when are we going to fund it. Funding it now, as we have been doing year after year in an incremental way, allows the NextGen Program for aviation to stay on track, and it will end up costing less than if we cut the funding and stretch it out over many more years.

Our bill also includes $1.4 billion for Amtrak while the House bill provides only $950 million. But in no way is the Senate funding extravagant. In fact, it is nearly $1.2 billion less than the administration's request for Amtrak, and it avoids gimmicks that the Obama administration used in this account.

While the needs for Amtrak infrastructure far exceed what we were able to provide, our bill is a step in the right direction. Under the House proposal, Amtrak would be forced to consider cutting service, which could affect millions of passengers, diverting them to our already congested highways and busy airports.

In reality, the overall resources provided in this bill are well below the level of investment that our Nation's infrastructure requires, as the subcommittee chairman so correctly pointed out. Nevertheless, it would spur creation by the private sector of good jobs now, when they are needed most, and it would establish the foundations for future economic growth.

Just as important to our economic future, however, is reining in Federal spending. Getting our national debt under control must be a priority governmentwide. In setting priorities for the coming year, this bill strikes the right balance between thoughtful investment and fiscal restraint.

I appreciate the opportunity to present this important bill to our Chamber, to our colleagues. As we debate this bill, I urge our colleagues to support the motion to proceed to the compromises our committee worked so hard to achieve and, most of all, to come forward with suggestions for improvements through amendments.

Let me end by emphasizing that point. I have the assurance of the subcommittee chairman that Republicans will be allowed to offer amendments. So I would say to my colleagues: Even if you don't like this bill, there is no reason to oppose the motion to proceed on the bill. You will be given an opportunity to offer amendments, to change the numbers in this bill, to cut programs if you wish. But let's get on this bill so we can return to the normal process of full and fair debate on individual appropriations bills, rather than waiting to the eleventh hour, bundling them together with little review, with insufficient care, deliberation, and debate or relying on continuing resolutions, stop-gap measures, which wreak havoc on the ability of programs to be carried out in a cost-effective manner.

I see our ranking member of the full committee is on the floor and I yield to him.

Mr. President, first, let me commend the Senator from Louisiana for his amendment. It would restrict criminals who have been convicted of certain violent or sex crimes from receiving housing assistance through HUD's public housing choice neighborhood and tenant- and project-based section 8 programs.

Public housing authorities and private property owners who provide assistance under these programs are already required under Federal law to deny admission or assistance to individuals who are subject to lifetime registration on a sex offender registry under a State program. However, when you move to the next stage, strangely enough, it is discretionary.

Under current law, prior violent criminal activity may be grounds for the denial of assistance for public housing and the section 8 programs, but it is not required to be grounds to deny that kind of assistance. That is exactly the point that Senator Vitter is trying to make. So his amendment would tighten the current law to make it very clear that under certain categories--aggravated sexual abuse, murder, and murder in the second degree, sexual exploitation, and other abuse of children and violence against women--individuals convicted of those crimes would not qualify for public housing assistance under the programs that I have mentioned.

As Senator Vitter said, this is a commonsense amendment. It will help to make housing safer for the law-abiding citizens residing there. He has targeted serious crimes, and I think his amendment should be adopted. I am going to support the amendment, and I will be urging its adoption.

Mr. President, I yield the floor, and I suggest the absence of a quorum.

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

Mr. President, one of the issues and questions that have been raised by many of my colleagues about this bill is that at first glance it appears to be higher than the President's budget request for these two departments--Transportation and HUD and the related agencies--and I want to explain why that is. It is a very legitimate question, but it has a very good answer.

The answer is the President's budget for the agencies and departments under our jurisdiction is artificially low because it relies on gimmicks, and it relies on scoring differences between CBO and OMB. Let me explain just a couple of areas where it will become evident to my colleagues why the difference exists and why the President's budget submission actually is not less than the bill that is on the floor now, if true budgeting principles and accounting were used.

First of all, the President's budget proposes to shift $2 billion in existing discretionary programs to mandatory in order to appear to achieve savings, including $1.5 billion from Amtrak's operating capital and debt service grants and $450 million by removing large hub airports from the Airport Improvements Program.

In addition, the President's budget request assumes an increase in the passenger facility charge at airports from $4.50 to $8.00. Well, we have seen this movie before. When the FAA authorization was being considered just last year, Congress rejected this fee increase. There is no reason to believe it is going to be accepted now. Yet that is built into the President's budget assumptions. We have seen him do this on a host of tax issues too, so this is not unknown for this administration.

There is another area I think is highly significant. The President's request for section 8 project-based rental assistance is insufficient to fully fund existing 12-month renewal contracts with the private property owners who participate in this program. In fact, it is about 10 percent short of the amount the administration knows is going to be needed to renew these contracts for the full 12 months of the fiscal year. That is about $1.2 billion short. That is about half of the difference we are talking about between the President's budget request and our bill.

Surely, it is not responsible to assume that somehow we are not going to pay these private property owners who are participating in the project-based section 8 program for the full year of rental assistance. It is not going to stop after 10 months. They are not going to be evicting their tenants who are receiving the subsidy.

So true and accurate budgeting would have required the President to put $1.2 billion into his budget request for this program.

Finally, CBO scored FHA receipts--the fees, the mortgage insurance premiums--at $1.8 billion below OMB's score, which increased the cost of maintaining the existing level of services in our bill.

We know there are disputes between CBO and OMB all the time. In this case, I am not suggesting that it is a gimmick, as in the other two examples I have given. I am suggesting there is an honest difference of opinion. But the fact is, whether we like it or not at times, we are bound by CBO's score, and CBO's estimate of those FHA receipts--those fees, those mortgage insurance premiums--is $1.8 billion below OMB's score. That is quite a difference.

So if you add up those gimmicks, with the Amtrak program moving from discretionary to mandatory, the assumption that Congress is all of a sudden just months later going to change its mind on the passenger facility charges and nearly double them after rejecting that idea just months ago, the failure to fully fund the project-based section 8 rental assistance, and the difference between CBO and OMB--the genuine dispute on FHA receipts--if you add all that up, it is not accurate to say our bill is $2.4 billion above the President's request. What we employed was CBO's estimate. We got rid of the gimmicks, and we used honest

budgeting, and that accounts for the difference.

I hope my colleagues will not be misled into thinking that somehow this bill is above the President's budget request. When you apply honest accounting principles and take into account the $1.8 billion difference between the scoring of CBO and OMB, it is obviously not different. In fact, I would argue that we are under the President's budget request.

I move to lay that motion on the table.

The motion to lay on the table was agreed to.

Madam President, I want to second what the chair of our subcommittee, the Senator from Washington, said. Frankly, we could have done 10 amendments today in the time that we were on the floor, ready to work through amendments. I know there are many amendments out there. I encourage our colleagues on both sides of the aisle not to wait until the eleventh hour. It is going to be much harder for us to work to accommodate amendments at that point.

Tomorrow is the opportunity for people to come to the floor early. We will be here ready to work.

Mr. President, I rise today on behalf of myself and Senator Schumer to introduce legislation to ensure that our seniors and disabled citizens have timely access to home health services under the Medicare program.

Nurse practitioners, physician assistants, certified nurse midwives and clinical nurse specialists are all playing increasingly important roles in the delivery of health care services, particularly in rural and medically underserved areas of our country where physicians may be in scarce supply. In recognition of their growing role, Congress, in 1997, authorized Medicare to begin paying for physician services provided by these health professionals as long as those services are within their scope of practice under state law.

Despite their expanded role, these advanced practice registered nurses and physician assistants are currently unable to order home health services for their Medicare patients. Under current law, only physicians are allowed to certify or initiate home health care for Medicare patients, even though they may not be as familiar with the patient's case as the non-physician provider. In fact, in many cases, the certifying physician may not even have a relationship with the patient and must rely upon the input of the nurse practitioner, physician assistant, clinical nurse specialist or certified nurse midwife to order the medically necessary home health care. At best, this requirement adds more paperwork and a number of unnecessary steps to the process before home health care can be provided. At worst, it can lead to needless delays in getting Medicare patients the home health care they need simply because a physician is not readily available to sign the form.

The inability of advanced practice registered nurses and physician assistants to order home health care is particularly burdensome for Medicare beneficiaries in medically underserved areas, where these providers may be the only health care professionals available. For example, needed home health care was delayed by more than a week for a Medicare patient in Nevada because the physician assistant was the only health care professional serving the patient's small town, and the supervising physician was located 60 miles away.

A nurse practitioner told me about another case in which her collaborating physician had just lost her father and was not available. As a consequence, the patient experienced a two-day delay in getting needed care while they waited to get the paperwork signed by another physician. Another nurse practitioner pointed out that it is ridiculous that she can order physical and occupational therapy in a subacute facility but cannot order home health care. One of her patients had to wait eleven days after being discharged before his physical and occupational therapy could continue simply because the home health agency had difficulty finding a physician to certify the continuation of the same therapy that the nurse practitioner had been able to authorize when the patient was in the facility.

The Home Health Care planning Improvement Act will help to ensure that our Medicare beneficiaries get the home health care that they need when they need it by allowing physician assistants, nurse practitioners, clinical nurse specialists and certified nurse midwives to order home health services. Our legislation is supported by the National Association for Home Care and Hospice, the American Nurses Association, the American Academy of Physician Assistants, the American College of Nurse Practitioners, the American College of Nurse Midwives, the American Academy of Nurse Practitioners and the Visiting Nurse Associations of America. I urge all of my colleagues to join us as cosponsors of this important legislation.

Mr. President, I rise today on behalf of myself and Senator Schumer to introduce legislation to ensure that our seniors and disabled citizens have timely access to home health services under the Medicare program.

Nurse practitioners, physician assistants, certified nurse midwives and clinical nurse specialists are all playing increasingly important roles in the delivery of health care services, particularly in rural and medically underserved areas of our country where physicians may be in scarce supply. In recognition of their growing role, Congress, in 1997, authorized Medicare to begin paying for physician services provided by these health professionals as long as those services are within their scope of practice under state law.

Despite their expanded role, these advanced practice registered nurses and physician assistants are currently unable to order home health services for their Medicare patients. Under current law, only physicians are allowed to certify or initiate home health care for Medicare patients, even though they may not be as familiar with the patient's case as the non-physician provider. In fact, in many cases, the certifying physician may not even have a relationship with the patient and must rely upon the input of the nurse practitioner, physician assistant, clinical nurse specialist or certified nurse midwife to order the medically necessary home health care. At best, this requirement adds more paperwork and a number of unnecessary steps to the process before home health care can be provided. At worst, it can lead to needless delays in getting Medicare patients the home health care they need simply because a physician is not readily available to sign the form.

The inability of advanced practice registered nurses and physician assistants to order home health care is particularly burdensome for Medicare beneficiaries in medically underserved areas, where these providers may be the only health care professionals available. For example, needed home health care was delayed by more than a week for a Medicare patient in Nevada because the physician assistant was the only health care professional serving the patient's small town, and the supervising physician was located 60 miles away.

A nurse practitioner told me about another case in which her collaborating physician had just lost her father and was not available. As a consequence, the patient experienced a two-day delay in getting needed care while they waited to get the paperwork signed by another physician. Another nurse practitioner pointed out that it is ridiculous that she can order physical and occupational therapy in a subacute facility but cannot order home health care. One of her patients had to wait eleven days after being discharged before his physical and occupational therapy could continue simply because the home health agency had difficulty finding a physician to certify the continuation of the same therapy that the nurse practitioner had been able to authorize when the patient was in the facility.

The Home Health Care planning Improvement Act will help to ensure that our Medicare beneficiaries get the home health care that they need when they need it by allowing physician assistants, nurse practitioners, clinical nurse specialists and certified nurse midwives to order home health services. Our legislation is supported by the National Association for Home Care and Hospice, the American Nurses Association, the American Academy of Physician Assistants, the American College of Nurse Practitioners, the American College of Nurse Midwives, the American Academy of Nurse Practitioners and the Visiting Nurse Associations of America. I urge all of my colleagues to join us as cosponsors of this important legislation.