Pandemic Flu Preparedness
In April of 2009, an outbreak of a new strain of influenza known as the “H1N1 flu” was identified.    Since then, a number of outbreaks of illness have been reported in the United States, including in Nevada, and around the world.  In July, the World Health Organization (WHO) raised its influenza pandemic alert level to Phase 6, an influenza pandemic.  The WHO’s pandemic declaration is based on the geographic spread of the virus, and not the severity of the illnesses it causes.

While it remains uncertain how severe the H1N1 virus outbreak will be, I have worked to ensure that we have the funding and planning necessary to ensure that we are prepared to minimize the impact the H1N1 flu or of any potential flu pandemic.  The Senate recently approved legislation (P.L. 111-32) that was enacted in June that will provide $7.7 billion for preparation for and response to a global disease pandemic, including for the H1N1 flu.  These funds will support activities such as supplementing antiviral stockpiles, vaccine development, purchase and administration as well as international efforts to stem the outbreak.  These funds are in addition to the over $6 billion for pandemic planning I have fought to secure since 2005 when the avian flu was spreading in several countries.  These funds have supported key pandemic planning activities including: global and domestic flu surveillance, the purchase of antivirals, investments in our domestic vaccine manufacturing capacity, and funding for state and local health departments.   In addition, I encouraged then President Bush to release a pandemic plan and introduced comprehensive legislation, the Pandemic Preparedness and Response Act (S. 3312), to help America prepare for and protect against the threat of a flu pandemic.

For more detailed information or for the most current developments related to the H1NI Flu, I would encourage you to visit the Centers for Disease Control and Prevention (CDC) website at http://flu.gov.  For Nevada specific information, please visit the Nevada State Health Division at http://health.nv.gov/.

Health Care Workforce
As Nevada continues to grow, so do our health care needs.  On February 14, 2007, I introduced legislation with Senator Bill Nelson (D-FL) to help ensure that communities across our state have the doctors they need and the quality care they deserve. Our bill, the Resident Physician Shortage Reduction Act (S. 588), would expand the number of Medicare-supported physician residency training positions in states like Nevada that are facing significant shortages of resident physicians. Under current law, there are caps on the number of those positions. There are no exceptions to the permanent caps, and most importantly for Nevada, no adjustments are made for population growth. Our bill will allow these caps to be raised and thus allow more physicians to train in Nevada, thereby ensuring that more will stay in the state to practice.

Because Nevada is facing a nursing shortage, I will also continue to support the comprehensive Title VIII nursing education and workforce programs. These Title VIII programs merit funding because they help to encourage bright students to join the nursing profession, keep the current workforce strong, and open doors to advanced education. We also need to ensure that working conditions -- such as needlestick laws, staffing ratios, and mandatory overtime rules -- support our nurses' desire to provide the highest quality care possible.

Rural Health
The federal government's rural health programs play a critical role in sustaining and improving the fragile health care infrastructure common in Nevada's rural communities. For this reason, I have consistently worked to ensure funding for programs like the rural outreach grants and the State Offices of Rural Health. Title VII Health Professions programs have been especially important to Nevada, improving access to primary care for medically underserved populations and supporting the health care workforce. Nevadans directly benefit from Title VII programs that work to alleviate the shortages of primary care doctors, dentists, nurses, and other allied health professionals.

Health Care Infrastructure
Nevadans should not have to travel far away to receive the high quality health care they deserve and need. Not only have I been working to improve rural Nevadans' access to health care, I worked to secure millions of dollars of federal support to improve the health care infrastructure in our state so we may meet the increasing needs of our growing population.

The Family Smoking Prevention and Tobacco Control Act
According to the Centers for Disease Control and Prevention, nearly one out of every five deaths in the United States each year are caused by tobacco use, more than the annual deaths resulting from HIV, illegal drugs and alcohol, car accident fatalities, suicide, and homicide combined.  More than 1,000 kids become new regular smokers every day and tobacco use costs the nation a staggering $96 billion in health care costs each year.  In Nevada, 3,300 adults die each year as a result of their own smoking and 440 adult nonsmokers die each year from exposure to secondhand smoke.  Despite the enormous public health and financial burdens of smoking, tobacco products are unregulated.

The Senate recently passed legislation, The Family Smoking Prevention and Tobacco Control Act of 2009, that was signed into law on June 22, 2009.   This new law, which I cosponsored, will give the Food and Drug Administration (FDA) the authority and resources to regulate the manufacturing, marketing, and sale of tobacco products.  FDA regulation of tobacco will prohibit tobacco companies from: marketing their products to children, using deceptive marketing and labeling about the harm caused by tobacco or secretly changing their products.  This new law will go a long way towards reducing the high rate of death and disease caused by tobacco.

The Family Smoking Prevention and Tobacco Control Act of 2009 was passed with broad bipartisan support.  This new law is supported by over one thousand public health, faith, medical and scientific organizations, including the American Public Health Association, American Cancer Society, American Academy of Pediatrics, Nevada Clergy Association, the Children’s Defense Fund and the AARP.