[Pages S3792-S3796]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

By Mr. NELSON of Nebraska (for himself and Mr. Brownback):
S. 2284. A bill to expand the medicare rural community hospital
demonstration program to include outpatient services; to the Committee
on Finance.
Mr. NELSON of Nebraska. Mr. President, today I introduce legislation
to continue the relief to six hospitals in Nebraska that have been
struggling financially under the current Medicare payment structure.
Local hospitals can best meet the unique needs of rural communities
which is why I am committed to ensuring that these hospitals have the
resources they need. Vital services like hospitals are increasingly
important for the survival of our rural communities. Towns can't
adequately serve residents--or attract new residents--without access to
basic services. We need to focus on ensuring that hospitals and other
vital services have the resources they need, so that communities will
have the essential services they require.
Last year, Senator Brownback and I proposed legislation to provide
cost-based reimbursement for rural community hospitals. Rural Community
Hospitals (RCH) are hospitals with between 25-50 beds. Those hospitals
had been adversely affected by Medicare formulas that set rates for
reimbursement nationwide. These rates did not take into account the
higher costs of practicing medicine in rural areas as these areas do
not have the benefits of volume that larger hospitals enjoy. RCHs are
also too large to qualify for critical access designation given to
hospitals with fewer than 25 beds.

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I am pleased that provisions from this legislation were included in
the Medicare Prescription Drug, Improvement, and Modernization Act of
2003 as a pilot program. The program provided cost-based reimbursements
for inpatient services.
The legislation Senator Brownback and I are introducing today will
expand the pilot program to cover outpatient services as well. This
legislation will again address a critical shortcoming in current
reimbursement practices and help Rural Community Hospitals serve their
communities and invest in the future of rural health care.
Six Nebraska hospitals would be affected by expanding the scope of
the pilot program. Those hospitals are: Beatrice Community Hospital,
Columbus Community Hospital, McCook Community Hospital, Jennie Melham
Memorial Medical Center in Broken Bow, Phelps Memorial Health Center in
Holdrege, and Tri County Hospital in Lexington.
We made some progress for our rural hospitals by creating the RCH
pilot program last year. This legislation would expand on that victory
by ensuring that all Medicare treatments, whether inpatient or
outpatient, would receive cost-based reimbursement. Expanding this
program will make a big difference to these hospitals and more
importantly, the patients they serve.
______

By Mr. HATCH (for himself and Mr. Bennett):
S. 2285. A bill to direct the Secretary of the Interior to convey a
parcel of real property to Beaver County, Utah; to the Committee on
Energy and Natural Resources.
Mr. HATCH. Mr. President, I rise today to introduce a bill that would
direct the Secretary of the Interior to convey a parcel of property to
Beaver County, UT. This bill would allow Beaver County in Southwestern
Utah to obtain and maintain, without restrictions, the former
Minersville State Park. In sum, this bill is necessary to allow County
officials to sell a small portion of this land--which has essentially
been under their control for over 40 years--in order to offset funding
needed to maintain the remainder of the park.
Some history might be beneficial at this point. In 1961, Beaver
County obtained a lease for 207 acres of land from the Bureau of Land
Management (BLM) to develop a recreational locale under the Recreation
and Public Purposes Act. In 1963, Beaver County turned over the acreage
to the State for the development of a park. Over the course of nearly
40 years, the State of Utah spent about one million dollars to develop
campsites, a boat ramp, a dock, and other camping amenities to turn
this area into the Minersville Reservoir State Park. In 2002, in an
endeavor to reduce operating costs, Utah State Parks transferred
control of the area back over to Beaver County. As County officials
stated during negotiations, in order for Beaver County to afford
management of the day to day operations of the would-be county park,
they would need to sell some of the property to private investors.
However, it was not until after park management responsibility was
transferred to the county that the BLM pointed out that the state had
not yet acquired the property through the Recreation and Public
Purposes Act process. The plan for Beaver County to sell some of the
land to pay for park operation, however, is not allowed under the
Recreation and Public Purposes Act lease, which only allows the
property to be developed for recreation or other purposes. The only way
for Beaver County to undertake responsibility for park is to remove the
current Federal restrictions on the property.
Today, Beaver County faces financial constraints in operating this
park that threaten its continued use. Due to the prevailing
restrictions in the Recreation and Public Purposes Act lease, initiated
more than 40 years ago, the good people of southern Utah and visitors
to the area will not be able to access and enjoy this county park. The
campsites would be littered and unkept. The boat ramp and the boat
docks would have to be closed. The park would become a destitute
recreation area, because there would be no one to administer park
maintenance and upkeep. The only public access to Minersville
Reservoir, which features a converted blue ribbon trout fishery, would
go to waste because of the Federal government's current Recreation and
Public Purposes Act lease restriction.
I don't believe that letting management of the park revert to the BLM
is a viable option either. The intensive, day to day management this
small park requires can be best accomplished to local officials. If
Beaver County acquires the property, it will continue to make this park
an excellent recreational refuge, a superb fishery, and a great place
to visit. Beaver County will be able to provide a clean and safe park
enjoyed by all who visit. That is why I am introducing this legislation
this legislation that would convey the Minersville Park land to Beaver
County.
I thank the Senate for the opportunity to address this issue today,
and I urge my colleagues to support this legislation.
______

By Ms. COLLINS:
S. 2288. A bill to amend the Public Health Service Act to assist
States in establishing, maintaining, and improving systems to reduce
the diversion and abuse of prescription drugs; to the Committee on
Health, Education, Labor, and Pensions.
Ms. COLLINS. Mr. President, the abuse of prescription drugs has
reached epidemic proportions in this country. In many States, including
my home State of Maine, deaths from prescription drug overdoses now
exceed deaths from illicit drugs. Nationwide, emergency room visits for
prescription drug problems more than doubled in the last decade.
The number of Americans who divert prescription drugs from their
intended purposes and abuse them was estimated at 4 million in 1998.
Today, the estimate is 11 million Americans. At a time when, according
to the National Institute on Drug Abuse, our young people are turning
away from marijuana, cocaine, ecstasy, and even alcohol, they
unfortunately are turning to the medicine cabinet.
Nearly one in five of our Nation's high school juniors and seniors
say they abuse prescription drugs.
The cost of drug abuse to our society in treatment, health care,
lost productivity, crime, and incarceration exceeds $150 billion a
year. The cost to its victims is incalculable. That is why today I am
introducing the Prescription Drug Stewardship Act. I use the word
``stewardship'' to emphasize our responsibility as individuals and as a
society to see that these beneficial medications are used for their
intended purposes, not to cause addiction, disability, and even death.
This legislation attacks the spiraling cycle of diversion and abuse
with three key stewardship activities:
First, computerized prescription drug systems to better track the
flow of medications.
Second, ongoing practitioner training to help our busy medical
professionals keep current with the trends in diversion treatment and
abuse.
Third, and perhaps most important, public education to help our
citizens better understand the dangers posed by the misuse of these
drugs.
I have found in talking with experts in this field that many
individuals who would never think of trying heroin, for example, will
take leftover prescription drugs that may, in the long run, be equally
addictive and just as harmful.
Combined with improved and more accessible substance abuse treatment
programs, the legislation I am introducing would help to stem the
rising tide of abuse and addiction that has swamped families and
weakened communities in my State and across the country.
My bill would authorize per year for each of the next 3 years to fund
prescription drug monitoring and education programs at the State level.
It would create competitive grant programs which would be administered
by the Substance Abuse and Mental Health Services Administration. They
would require States to demonstrate their commitment to stewardship
with matching funds and also to meet the privacy requirements under
current law as they carry out these important activities.
What we have found is that the most abused medications are those that
relieve pain and anxiety. For millions of legitimate patients suffering
from illness or injury, these medicines are

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vital and their availability is proper and humane. They can make the
difference between suffering and the ability to carry on with a normal
life for people who are in serious pain or suffering from serious
disease or injury. It is tragically clear, however, that these
medications, many of them as powerful or as addictive as illegal drugs,
increasingly are being diverted from their legitimate use to
trafficking and abuse.
I want to emphasize that the problems is not with these medications
when they are prescribed, dispensed, and consumed responsibly. In fact,
we know that pain is still undertreated in this country, and that most
physicians are extremely responsible in trying to relieve pain felt by
their patients. The problem is what happens when the chain of
responsibility breaks.
Oversight of the licensing and practices for prescribing and
dispensing of these medications has long been a matter of State
jurisdiction. As a former State regulator who was in charge of
licensing boards for physicians and pharmacists, for example, I
certainly have no desire to change that system. The States have not
shirked their stewardship responsibility. They simply have been
overwhelmed by this epidemic of diversion and abuse, and they need some
Federal assistance, not to take over their programs, but to help them
in a partnership to make them more effective.
This national calamity has hit rural States particularly hard. The
Presiding Officer's home State of North Carolina is one of those States
that has felt the devastating impact of this epidemic. Kentucky,
Virginia, West Virginia all report prescription drug abuse at epidemic
levels. But no State, unfortunately, has been hit harder than my State
of Maine.
From 1997 to 2002, the number of accidental deaths in Maine from all
drugs soared from 19 to 126, an increase of more than 500 percent, and
prescription drugs were present in 60 percent of these deaths.
The 2002 Main Youth Drug and Alcohol Survey found that a disturbing
25 percent of my State's high school juniors and seniors abuse
prescription drugs. That is an astonishing number and a very disturbing
statistic. In the last 5 years, enrollment in Main clinics that treat
opiate addiction has increased tenfold.
These shocking numbers from Main demonstrate that drug abuse and
addiction is not longer a big-city problem. It is a problem that
afflicts our citizens no matter where they live, whether it is Los
Angeles, CA, or Calais, ME. In fact, a hearing I helped put together
last year demonstrated that there is a terrible problem in Washington
County in Downeast, ME. Some estimates are that as many as 1,000 of the
citizens of this county of only 35,000 citizens are struggling with
drug addiction and abuse. This was a hearing before the HELP Committee.
It actually was 2 years ago. But last August, I chaired a committee
meeting of the Governmental Affairs Committee in Bangor, ME, where we
heard from law enforcement officers, from drug treatment counselors,
and from many others who are expert in drug addiction and abuse. The
picture they painted was a startling one. It showed that drug abuse,
and abuse of prescription drugs in particular, is a problem throughout
the entire State of Maine.

My legislation would provide States, such as Maine, with the
resources to carry out three critical stewardship activities. The first
would help States to monitor the flow of prescription drugs from
practitioner to pharmacy to patient. We know that prescription drugs
often find their way to the street when unscrupulous individuals obtain
multiple prescriptions from multiple doctors. These so-called doctor
shoppers operate in every State. Sometimes they act alone and sometimes
they act in concert with organized gangs of criminals. Each can divert
hundreds, even thousands, of pills per day. Many of these drugs have a
street value 10 times the cost at the pharmacy.
Twenty States now have prescription tracking systems. Maine began
operating such a system or putting it together just this summer. About
half of these systems use the latest computer technology and have
proven that illegal diversion can be curtailed without reducing access
to these medications by legitimate patients and without breaching that
essential doctor-patient confidentiality.
We want to make sure any system we put in place does not chill a
doctor's ability to prescribe legitimate medication for patients who
are suffering and need help with their pain.
These systems have also demonstrated an effective prescription drug
system more than pays for itself by reducing the tremendous costs
associated with drug abuse and addiction. Thirty States, however, have
no system whatsoever for monitoring or tracking prescription drugs in a
way that would help us identify and put a stop to doctor shopping. My
legislation would provide the States with the resources to start up
such a system to help improve its quality or to maintain it.
The testimony I heard last August in Bangor, ME, before the
Governmental Affairs Committee, along with my colleague Senator Sununu,
provided the basis not only for that provision of our bill but also for
two others. The testimony we heard that day from those who are on the
front lines, law enforcement, hospital emergency room physicians, and
treatment clinic personnel, was alarming. They told us medical
practitioners need our help. Our doctors, our physician assistants, our
nurses are busy professionals, often far too busy. Many simply do not
have the time to travel to seminars where they would receive
information about the latest trends in drug abuse, learn how to
recognize drug-seeking behavior, dependence, or addiction among their
patients. The most effective and efficient way to provide that kind of
training to medical personnel is to take the education to them through
one-on-one small group mentoring in their offices or in their
hospitals.
The second part of my legislation would provide grants for such
mentoring projects so practitioners with special training in drug abuse
issues can pass along this vital knowledge to their colleagues who are
practicing in communities all over America. Experts also tell us a
major reason so many Americans with no history of abusing illegal drugs
now are abusing prescriptions drugs is many people have a terrible
misconception that these prescription drugs are somehow safe to abuse,
that it is safe to take someone else's prescription. After all, they
think they are researched in high-tech laboratories, manufactured in
modern factories, prescribed and dispensed by highly trained medical
experts; therefore, they must be safe. When they are used properly,
they are, but as the overdose and addiction statistics prove, when used
improperly they can be fatal.
We need an aggressive public education campaign to warn our citizens
about the dangers of abusing prescription drugs. The reduction in
smoking rates, in illicit drug use, even in drunk-driving deaths is
testament to the progress we can make with seemingly intractable
problems when we commit the resources for public education campaigns in
partnership with the States. I believe the same approach can help our
citizens become better stewards of prescription medications.
I urge my colleagues to join me in support of the legislation I am
introducing today to address the increasingly devastating problem of
prescription drug abuse.
______

By Mr. SESSIONS:
S. 2289. A bill to amend title 18, United States Code, to combat
terrorism against railroad carriers and mass transportation systems on
land, on water, or through the air, and for other purposes; to the
Committee on the Judiciary.
Mr. SESSIONS. Mr. President, I ask unanimous consent that the text of
the bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:

S. 2289

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Railroad Carriers and Mass
Transportation Protection Act of 2004''.

SEC. 2. ATTACKS AGAINST RAILROAD CARRIERS AND MASS
TRANSPORTATION SYSTEMS.

(a) In General.--Chapter 97 of title 18, United States
Code, is amended by striking sections 1992 through 1993 and
inserting the following:

[[Page S3795]]

``Sec. 1992. Terrorist attacks and other violence against
railroad carriers and against mass transportation systems
on land, on water, or through the air

``(a) General Prohibitions.--Whoever, in a circumstance
described in subsection (c), knowingly--
``(1) wrecks, derails, sets fire to, or disables railroad
on-track equipment or a mass transportation vehicle;
``(2) with intent to endanger the safety of any passenger
or employee of a railroad carrier or mass transportation
provider, or with a reckless disregard for the safety of
human life, and without previously obtaining the permission
of the railroad carrier--
``(A) places any biological agent or toxin, destructive
substance, or destructive device in, upon, or near railroad
on-track equipment or a mass transportation vehicle; or
``(B) releases a hazardous material or a biological agent
or toxin on or near the property of a railroad carrier or
mass transportation provider;
``(3) sets fire to, undermines, makes unworkable, unusable,
or hazardous to work on or use, or places any biological
agent or toxin, destructive substance, or destructive device
in, upon, or near any--
``(A) tunnel, bridge, viaduct, trestle, track,
electromagnetic guideway, signal, station, depot, warehouse,
terminal, or any other way, structure, property, or
appurtenance used in the operation of, or in support of the
operation of, a railroad carrier, without previously
obtaining the permission of the railroad carrier, and with
intent to, or knowing or having reason to know such activity
would likely, derail, disable, or wreck railroad on-track
equipment; or
``(B) garage, terminal, structure, track, electromagnetic
guideway, supply, or facility used in the operation of, or in
support of the operation of, a mass transportation vehicle,
without previously obtaining the permission of the mass
transportation provider, and with intent to, or knowing or
having reason to know such activity would likely, derail,
disable, or wreck a mass transportation vehicle used,
operated, or employed by a mass transportation provider;
``(4) removes an appurtenance from, damages, or otherwise
impairs the operation of a railroad signal system or mass
transportation signal or dispatching system, including a
train control system, centralized dispatching system, or
highway-railroad grade crossing warning signal, without
authorization from the rail carrier or mass transportation
provider;
``(5) with intent to endanger the safety of any passenger
or employee of a railroad carrier or mass transportation
provider or with a reckless disregard for the safety of human
life, interferes with, disables, or incapacitates any
dispatcher, driver, captain, locomotive engineer, railroad
conductor, or other person while the person is employed in
dispatching, operating, or maintaining railroad on-track
equipment or a mass transportation vehicle;
``(6) engages in conduct, including the use of a dangerous
weapon, with the intent to cause death or serious bodily
injury to any person who is on the property of a railroad
carrier or mass transportation provider that is used for
railroad or mass transportation purposes;
``(7) conveys false information, knowing the information to
be false, concerning an attempt or alleged attempt that was
made, is being made, or is to be made, to engage in a
violation of this subsection; or
``(8) attempts, threatens, or conspires to engage in any
violation of any of paragraphs (1) through (8);

shall be fined under this title or imprisoned not more than
20 years, or both.
``(b) Aggravated Offense.--Whoever commits an offense under
subsection (a) of this section in a circumstance in which--
``(1) the railroad on-track equipment or mass
transportation vehicle was carrying a passenger or employee
at the time of the offense;
``(2) the railroad on-track equipment or mass
transportation vehicle was carrying high-level radioactive
waste or spent nuclear fuel at the time of the offense;
``(3) the railroad on-track equipment or mass
transportation vehicle was carrying a hazardous material at
the time of the offense that--
``(A) was required to be placarded under subpart F of part
172 of title 49, Code of Federal Regulations; and
``(B) is identified as class number 3, 4, 5, 6.1, or 8 and
packing group I or packing group II, or class number 1, 2, or
7 under the hazardous materials table of section 172.101 of
title 49, Code of Federal Regulations; or
``(4) the offense results in the death of any person;

shall be fined under this title or imprisoned for any term of
years or life, or both. In the case of a violation described
in paragraph (2), the term of imprisonment shall be not less
than 30 years; and, in the case of a violation described in
paragraph (4), the offender shall be fined under this title
and imprisoned for life and be subject to the death penalty.
``(c) Circumstances Required for Offense.--A circumstance
referred to in subsection (a) is any of the following:
``(1) Any of the conduct required for the offense is, or,
in the case of an attempt, threat, or conspiracy to engage in
conduct, the conduct required for the completed offense would
be, engaged in, on, against, or affecting a mass
transportation provider or railroad carrier engaged in or
affecting interstate or foreign commerce.
``(2) Any person travels or communicates across a State
line in order to commit the offense, or transports materials
across a State line in aid of the commission of the offense.
``(d) Nonapplicability.--Subsection (a) does not apply to
the conduct with respect to a destructive substance or
destructive device that is also classified under chapter 51
of title 49 as a hazardous material in commerce if the
conduct--
``(1) complies with chapter 51 of title 49 and regulations,
exemptions, approvals, and orders issued under that chapter,
or
``(2) constitutes a violation, other than a criminal
violation, of chapter 51 of title 49 or a regulation or order
issued under that chapter.
``(e) Definitions.--In this section--
``(1) the term `biological agent' has the meaning given to
that term in section 178(1);
``(2) the term `dangerous weapon' means a weapon, device,
instrument, material, or substance, animate or inanimate,
that is used for, or is readily capable of, causing death or
serious bodily injury, including a pocket knife with a blade
of less than 2\1/2\ inches in length and a box cutter;
``(3) the term `destructive device' has the meaning given
to that term in section 921(a)(4);
``(4) the term `destructive substance' means an explosive
substance, flammable material, infernal machine, or other
chemical, mechanical, or radioactive device or material, or
matter of a combustible, contaminative, corrosive, or
explosive nature, except that the term `radioactive device'
does not include any radioactive device or material used
solely for medical, industrial, research, or other peaceful
purposes;
``(5) the term `hazardous material' has the meaning given
to that term in chapter 51 of title 49;
``(6) the term `high-level radioactive waste' has the
meaning given to that term in section 2(12) of the Nuclear
Waste Policy Act of 1982 (42 U.S.C. 10101(12));
``(7) the term `mass transportation' has the meaning given
to that term in section 5302(a)(7) of title 49, except that
the term includes school bus, charter, and sightseeing
transportation;
``(8) the term `on-track equipment' means a carriage or
other contrivance that runs on rails or electromagnetic
guideways;
``(9) the term `railroad on-track equipment' means a train,
locomotive, tender, motor unit, freight or passenger car, or
other on-track equipment used, operated, or employed by a
railroad carrier;
``(10) the term `railroad' has the meaning given to that
term in chapter 201 of title 49;
``(11) the term `railroad carrier' has the meaning given to
that term in chapter 201 of title 49;
``(12) the term `serious bodily injury' has the meaning
given to that term in section 1365;
``(13) the term `spent nuclear fuel' has the meaning given
to that term in section 2(23) of the Nuclear Waste Policy Act
of 1982 (42 U.S.C. 10101(23));
``(14) the term `State' has the meaning given to that term
in section 2266 ;
``(15) the term `toxin' has the meaning given to that term
in section 178(2); and
``(16) the term `vehicle' means any carriage or other
contrivance used, or capable of being used, as a means of
transportation on land, on water, or through the air.''.
(b) Conforming Amendments.--
(1) The table of sections at the beginning of chapter 97 of
title 18, United States Code, is amended--
(A) by striking ``RAILROADS'' in the chapter heading and
inserting ``RAILROAD CARRIERS AND MASS TRANSPORTATION SYSTEMS
ON LAND, ON WATER, OR THROUGH THE AIR'';
(B) by striking the items relating to sections 1992 and
1993; and
(C) by inserting after the item relating to section 1991
the following:

``1992. Terrorist attacks and other violence against railroad carriers
and against mass transportation systems on land, on
water, or through the air.''.

(2) The table of chapters at the beginning of part I of
title 18, United States Code, is amended by striking the item
relating to chapter 97 and inserting the following:

``97. Railroad carriers and mass transportation systems on land, on
water, or through the air...................................1991''.

(3) Title 18, United States Code, is amended--
(A) in section 2332b(g)(5)(B)(i), by striking ``1992
(relating to wrecking trains), 1993 (relating to terrorist
attacks and other acts of violence against mass
transportation systems),'' and inserting ``1992 (relating to
terrorist attacks and other acts of violence against railroad
carriers and against mass transportation systems on land, on
water, or through the air),'';
(B) in section 2339A, by striking ``1993,''; and
(C) in section 2516(1)(c) by striking ``1992 (relating to
wrecking trains),'' and inserting ``1992 (relating to
terrorist attacks and other acts of violence against railroad
carriers and against mass transportation systems on land, on
water, or through the air),''.

[[Page S3796]]

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