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Welcome to “Kansas Common Sense.” Thanks for your continued interest in receiving my weekly newsletter. Please feel free to forward it on to your family and friends if it would interest them.

Tragedy at Fort Hood
On Wednesday, our nation suffered a tragic shooting incident at Ft. Hood in Killeen, Texas. I ask all Kansans to join Robba and me in keeping the four victims, their families and the sixteen people injured in our thoughts and prayers. I commend those who stepped-in to stop the violence and saved lives in doing so. Reports regarding the mental health of the shooter are troubling and deeply saddening. It is disheartening that so many return home and suffer from invisible wounds that can take a painful amount of time to diagnose and treat. I will continue to look for ways to support those who struggle with mental health and who have honorably served this nation, both past and present. To learn more about invisible wounds and how you can help our heroes, visit Intrepid Fallen Heroes Fund.

Discussing Medical Research with NIH Directors
On Wednesday, I participated in a Senate Appropriations Health Subcommittee hearing on the Administration’s Fiscal Year 2015 budget request for the National Institutes of Health (NIH). I serve as the lead Republican on this subcommittee, which has jurisdiction over funding for NIH, the focal point of our nation’s health research infrastructure. NIH Director Francis Collins and several of NIH’s directors were the witnesses at this hearing, so it presented a good opportunity to visit with them about the medical research advances that are enabling Americans to live longer, healthier lives. We also discussed the challenges currently facing our nation’s scientists and researchers.

NIH represents hope for millions of patients suffering from conditions ranging from Alzheimer’s disease to cancer. NIH-supported research has raised life expectancy, improved quality of life, and is an economic engine helping to sustain American competitiveness. Just in the past year, cutting-edge NIH research discovered a blood test to help predict if a healthy person will develop dementia or Alzheimer’s disease, uncovered a set of rare mutations to a gene that provides protection against Type 2 diabetes, and used targeted immunotherapy to induce remission in leukemia. A continued commitment to NIH is essential to address our nation’s growing health concerns, spur medical innovation, reduce health care costs, and strengthen our country’s global leadership in biomedical research.

NIH is now at a critical juncture. Without a consistent commitment to funding our premier medical research agency, the future of biomedical research in the United States is in jeopardy. Young scientists are discouraged by the shortage of grant opportunities. Many could flee the research field or pursue research opportunities in other countries, putting our nation at serious risk of losing our global competitiveness in the biomedical research field. As Congress faces unprecedented challenges to control government spending, now is the time to reevaluate our federal funding priorities and invest in biomedical research. Click here to see video clips of my discussions with the NIH chiefs during this hearing.

 

Demanding Answers from Administration on Internet Governance Transition
This week, I joined Senator John Thune of South Dakota and Senator Marco Rubio of Florida in seeking clarification from Assistant Secretary of Commerce Larry Strickling — head of the National Telecommunications and Information Administration (NTIA) — regarding the recent announcement that NTIA intends to relinquish responsibility of the Internet Assigned Numbers Authority (IANA) functions to the global multi-stakeholder community. The IANA is responsible for the global coordination of the domain name system, assigning IP addresses and other internet protocol resources. The current internet governance model has worked incredibly well and has led to immense freedom and prosperity for individuals around the world. We must not allow the IANA functions to fall under the control of repressive governments, America’s enemies or unaccountable bureaucrats. I will continue to pressure the Administration to explain the need for this transition, and will work to make certain to protect our free and open internet from new threats should the Administration move forward with the planned transition. To learn more, click here.

Questioning Under Secretary for Terrorism and Financial Intelligence
Last Wednesday, the Treasury Under Secretary for Terrorism and Financial Intelligence (TFI) David Cohen, the government’s top sanctions official, testified before the Appropriations Subcommittee on Financial Services and General Government. The Treasury Department’s sanction efforts have proved to be useful tools in recent years.

During the hearing, Under Secretary Cohen confirmed reports that Russia and Iran are working together on an oil-for-goods deal. Such a transaction would violate sanctions on Iran and potentially trigger the United States to apply further sanctions on Russia. I asked about the timing of this Russia-Iran cooperation — the Under Secretary said he was unable to comment publicly on this. If this oil-for-good deal is a recent development, this would be quite troubling. The White House has said such a deal would raise “serious concerns” and would be inconsistent with the nuclear talks between world powers and Iran. I will investigate this matter further and will continue to evaluate our sanction’s effects on the Iranian’s ability to produce a nuclear weapon. You can watch my Q&A with Under Secretary Cohen by clicking here.

 
Hire More Heroes Act
As a member of the U.S. Senate Veterans’ Affairs Committee, I introduced the Hire More Heroes Act — legislation that encourages companies to hire more American veterans while providing relief from the burdensome ACA employer mandate. Veterans who have served our nation with duty and honor deserve job opportunities when they return to civilian life. Unfortunately, the Affordable Care Act’s onerous employer mandate is keeping our heroes from finding good-paying jobs. The Hire Our Heroes Act would allow employers to exempt veterans or reservists who have health care coverage through TRICARE or the U.S. Department of Veterans Affairs from the employer mandate requirements. This measure would then make it easier for businesses to consider hiring veterans amidst the continued delays and confusion of Obamacare, while also helping to make certain veterans can support their families. To learn more about the Hire More Heroes Act, click here.

FDA Spent Grains
A proposed rule change by the U.S. Food and Drug Administration (FDA) could significantly alter the relationship between America’s farmers and small brewers, in a manner detrimental to both industries. The process of brewing beer inevitably produces barrels full of heavy, wet spent grains. Through this process, known as mashing, these grains have been heated to extract sugars and other nutrients that go into beer, but the remaining byproduct left over has no remaining usefulness to the brewer. To farmers, however, these spent grains are a valuable dietary supplement for livestock. In fact, these grains are a better feed source after brewers are finished with them than they would have been before. Farmers and brewers have long had a handshake agreement in the exchange of these spent grains, which have proven through the years to be a reliable, safe and high quality feed. A recent study indicates that nearly 90 percent of spent grains produced by craft brewers are used for animal feed.

Last Monday, I joined Senator Susan Collins of Maine and a bipartisan group of 13 Senators in delivering a letter to the FDA expressing our concerns with the proposed rule changes. The cost of compliance with the rule would effectively prohibit brewers from providing spent grains to farmers for animal feed, to the detriment of farmers, who rely on such beneficial relationships to keep their operations profitable. Furthermore, small brewers would face the wasteful and costly burden of having to landfill their spent grains. I am hopeful the letter we sent to FDA Commissioner Margaret Hamburg will put a stop to the overreach of these proposed rules. To view a copy of the letter, please click here.

In Kansas, the business of craft brewing has escalated in recent years, led by such companies as Free State Brewing in Lawrence, Tallgrass Brewing in Manhattan, among many others, not to mention nationally-known Boulevard Brewing just across the state line in Kansas City. I am a member of the Senate Small Brewers Caucus, and also a cosponsor of Senate legislation (S. 917) that, if enacted, would create more than 5,000 jobs in small breweries across the country. I will be sure to continue my efforts in Congress to help support this budding, job-creating industry.

U.N. Arms Trade Treaty
Last Wednesday, April 2, marked the first anniversary of the adoption of the United Nations’ Arms Trade Treaty (ATT). In October, I led 50 bipartisan U.S. Senators – half of the Senate – in writing to President Obama regarding our substantive concerns with the ATT, in particular its inherent threat to the Second Amendment rights of Americans. Unfortunately, we never received even the courtesy of an acknowledgement, let alone a formal written response. Even worse, the Administration has begun new efforts to implement the ATT without having first obtained the advice and consent of the Senate.

On January 15, 2014, the Obama Administration issued a new conventional arms export control policy, effectively reversing the policy which had been in place since the Clinton presidency. The new policy language, while never specifically referencing the ATT, mirrors the treaty nearly word for word in criteria and standards. I am disturbed by both the secrecy behind producing the new policy and the disregard it shows for the role of the Senate in this process.

As such, on Wednesday I delivered another letter to the White House expressing my regret at these actions and at the President’s failure to respond to our letter from the fall. I have called upon President Obama to withdraw the new arms control policy and to consult fully with relevant Congressional committees and concerned offices and he works to revise the policy. I was also compelled to, once again, reiterate the wide bipartisan, bicameral opposition to the ATT in Congress, and restate our previous notice that we do not regard the U.S., as bound to uphold the treaty’s object and purpose.

The U.N. Arms Trade Treaty is an issue I have been following and opposing for years. [Include links] In May 2012, I spoke on the Senate floor about S. 2205, the Second Amendment Sovereignty Act, which I introduced to prohibit funding to negotiate the U.N. ATT. Last spring, I introduced S. Con. Res. 7, a concurrent resolution sponsored by 35 Senators, outlining specific criteria that must be met for the U.N. ATT to be ratified by the U.S. Senate. Click here to view my recent letter to the president.

Congress Punts Again on Medicare Payment Formula
Medicare reimbursement to physicians is calculated through a payment formula called the Sustainable Growth Rate (SGR). The SGR was originally introduced as a way to contain the growth in health spending, but a decade of short-term “SGR patches” have frustrated health care providers, threatened access for Medicare beneficiaries, and created budgetary dilemmas for Congress. On Monday, the Senate passed a one-year SGR patch to temporarily stave off physician Medicare payments being cut by almost 25 percent. The House passed this bill the previous week, and President Obama signed the measure into law. I voted against this temporary patch (the 17th temporary patch since 2002) and am disappointed Congress did not permanently replace the flawed SGR formula. Click here to view my remarks on this issue. The SGR, which I did not support when it was created, has caused a volatile and unsustainable system for patients and health care providers alike. The reality is patient care suffers when providers are forced to endure an exasperating wait-and-see game every few months to find out what amount they will be reimbursed for the care they provide. Rather than continually punting responsibility for this issue to a later date, Congress can—and must—do better to end this piecemeal approach to legislating and work together to permanently repeal the SGR in a fiscally responsible manner.

 
FAA Proposal to Support Small Aircraft Pilots
On Wednesday, the Federal Aviation Administration (FAA) announced that they will commence a rulemaking process that could expand the number of pilots allowed to fly without obtaining a third-class medical certificate. Instead, private pilots could fly by using other criteria to demonstrate their fitness to fly.

Last month, I joined Senator Pat Roberts and Senator John Boozman (R-AR) in introducing the General Aviation Pilot Protection Act. This legislation, S. 2103, expands on the success of FAA’s 2004 Sport Pilot rule, which allows pilots to fly many types of small, light aircraft without a third-class medical certificate, while requiring them to undergo biennial flight reviews by a certified flight instructor. During these reviews, instructors continue to evaluate each pilot’s physical and cognitive condition, as well as his or her ability to safely operate an aircraft.

While every pilot should have a strong commitment to safety, I am pleased the FAA is considering this commonsense rule change, and am hopeful an improved FAA rule will remove an unnecessary hurdle for many pilots trying to get off the ground. I will be monitoring FAA’s actions and look forward to receiving feedback from pilots in Kansas as they review this proposal. Click here to learn more.

Discussing RAC Audit Concerns with CMS Administrator
On Tuesday, I met with Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner to discuss my ongoing concerns with the Medicare Recovery Audit Contractor (RAC) program. CMS is the division of the U.S. Department of Health and Human Services (HHS) responsible for administering Medicare and Medicaid. This agency is under the jurisdiction of the Senate Appropriations Health Subcommittee of which I am Ranking Member.

The RAC program began in 2010 with the objective of verifying accurate Medicare payments to health care providers. However, the program is seriously flawed and causing major problems for many Kansas hospitals and providers in our state. They have been forced to divert significant resources away from caring for patients to appeal incorrect audit decisions that are ultimately overturned through appeal. I have raised concerns about this program in letters to HHS, at Appropriations Committee hearings and through language I worked to include in the 2014 Omnibus Appropriations bill, so I was pleased to visit with Administrator Tavenner about these issues. CMS needs to achieve a balance of safeguarding Medicare finances while avoiding costly burdens on hospitals and health care providers that are affecting their ability to care for patients. The broken RAC program is unreasonably burdening providers, and has created a two-year appeals backlog within HHS. According to the HHS Inspector General, more than half of RAC appeals are reversed, while several Kansas hospitals have appeal-win rates around 95 percent. During our meeting, Administrator Tavenner and I discussed actions CMS is taking to improve the RAC program. Click here to read more these actions.

During this meeting, we also discussed my opposition to Obama Administration proposals that would cut reimbursements to Critical Access Hospitals (CAHs) and eliminate hospitals from the CAH program. Additionally, we visited about CMS’ cuts to Medicare reimbursement for home health care services, which are threatening many Kansas seniors’ access home health care. Home health care is a cost-effective alternative to other forms of care – especially in rural areas where patients tend to be more geographically dispersed. I also expressed my objection to CMS’ unreasonable and inflexible physician supervision rules relating to the provision of outpatient therapeutic services. These regulations are making it difficult for many hospitals in Kansas and other rural states to provide these services to patients. In February, the Senate passed S. 1954, legislation I introduced to prevent the federal government from enforcing these burdensome supervision regulations for CAHs and other small, rural hospitals in 2014.

Kansas Listening Tour Stop in Lincoln
On Saturday, I continued my statewide listening tour in Lincoln at the Sunrise Café.I enjoyed the opportunity to visit with nearly 40 area residents about the economy, health care and internet governance. Thanks to Trooper Brent Van Buren and Lincoln Co. Sheriff Mike Weigel for attending. Thanks also to Jo Buttenhoff for allowing me to hold the meeting at the Café. The work I do in Washington and the issues I focus on are largely based on the conversations I have with Kansans. Check my website for upcoming Kansas Listening Tour stops.

Kansas City Community Leaders Update
During my weekend back in Kansas, I received an update from Kansas City community leaders. The meeting included Olathe Mayor Copeland, Prairie Village Mayor Shaffer, Leawood Mayor Peggy Dunn and KCMO Mayor James, and they shared area efforts to attract the 2016 Republican National Convention to Kansas City. According to Kansas City Convention & Visitors Association’s Jon Stephens, hosting the convention in Kansas City could bring $200 million in economic activity, along with millions of media mentions. Five other cities remain in the running to host this event, and the full decision is expected this fall.

Leadership of Franklin County Meet
It was good to visit with community leaders from Franklin County during my time in Kansas over the weekend. The county, city of Ottawa, school board, main street, chamber and development council had a joint meeting to discuss ways to improve economic development. I commend these Kansans for working together to improve the communities they call home, as well as make certain their children may return to raise families of their own. It was great to meet these community leaders and offer any help I may provide. Thanks to Ottawa Chamber of Commerce CEO John Coen for the invitation.

Kansans in the Office
Association of Community Cancer Centers
Brenda Bernard of Salina
Ryan Bernard of Newton 

Workforce Alliance of South Central Kansas
Kelly Bergeron of Wichita
Kathy Jewett of Wichita
Rod Blackburn of Wichita
Keith Lawing of Wichita
Tom Weigard of Junction City
John Coen of Ottawa 

Workforce Partnership
Scott Anglemyer of Shawnee
Trent Howerton of Olathe
Marvin Hunt of Lawrence 

Pittsburg State University
President Steve Scott of Pittsburg
Shawn Naccarato of Pittsburg 

American College of Surgeons
Tyler Hughes of McPherson
James Hamilton of Topeka
Josh Broghammer of Fairway
Joshua Mammen of Overland Park 

Women Construction Owners and Executives
Sheila Ohrenberg of Overland Park 

Advocates for Youth
Chelsey Weatherford of Leawood 

National Water Resources Association
David Brenn of Lawrence
Mark Rude of Garden City 

Kansas Respiratory Care Society
Karen Schell of Emporia
Cheryl Skinner of Marysville 

National Association of Pediatric Nurse Practitioners
Jill Ariagno of Leawood 

Goodyear
Brian Riley of Topeka 

Salina Regional Health Center
Mike Terry of Salina
Joel Phelps of Salina
Tom Bell of Salina
Bennie Salkil of Salina 

WaterOne
Michael Armstrong of Lenexa
Darci Meese of Lenexa
Terryl Pajor of Wichita 

American Public Works Association
Carla Anderson of Lecompton 

American Society for Biochemistry and Molecular Biology
Gerry Carlson of Kansas City 

Kansas City Startup Village
Adam Amedondo of Kansas City
Tyler VonWinkle of Kansas City 

F-18 Supplier Conference
Harry Thurmond of Wichita
Stephen Gollatz of Wichita
Stephanie Nichols of Wichita
Anthony Amabile of Wichita
Steve Collatz of Wichita 

American Association of Oral and Maxillofacial Surgeons
Brett Ferguson of Truman
Douglas Fain of Stilwell
Bill Whitlow of Hutchinson
Matthew Lowe of Pittsburg 

Flint Hills Job Corp
Mario Morales of Manhattan
Gary Vesta of Manhattan
Kendal Moere of Manhattan 

Novo Nordisk
Dave Bradley of Overland Park
Kelly Stonestreet of Overland Park 

Kansas Occupational Therapy Association
LaDessa Forrest of Wichita 

Kansas Center for Childhood Safety
Phyllis Larimore of Olathe 

American Rental Association
Phillip Kelling of Overland Park
Lynne Kelling of Overland Park 

Laborers' International Union of North America
Carol Hodges of Shawnee 

Local Initiatives Support Corporation
Stephen Samuels of Kansas City
Allison Bregman of Kansas City 

Charles Engineering
David Hutchinson of Clearwater
Jim Charles of Clearwater 

American Cable Association
Kelvin Fee of Lawrence 

Child Care Aware of Kansas
Cheryl Dunn of Wichita
Michelle Gilbert of Topeka
Angie Saenger of Salina
Leadell Ediger of Salina 

Kansas Dietetics Association
Kyleen Harris of Wichita
Courtney Schnefke of Lenexa 

Capitol Tour
Tom Perrier of Eureka
Carolyn Perrier of Eureka
Steve Sales of Overland Park
Diane Sales of Overland Park
Patrick White of Overland Park
Kayla White of Overland Park
Todd Detwiler of Emporia
Meg Detwiler of Emporia
Larry Everhart of Paola
Nancy Everhart of Paola
Jack Herbert of Abilene
Jessie Prickett of Solomon
Aleta Hokanson of Abilene
Andrew Zastrow of Manhattan
Jeff Kelly of Abilene
Harley Calvin of Ness City
Diane Calvin of Ness City
Chelsey Calvin of Ness City

Honored to Serve You in Washington
It is an honor to serve you in Washington, D.C. Thank you to the many Kansans who have been calling and writing in to share their thoughts and opinions on the issues our state and country face. I appreciate the words of Kansans, whether in the form of a form of letter, a Facebook comment or a phone call, who wish to make their voice heard.

Please let me know how I can be of assistance. You can contact me by email by clicking here. You can also click here to contact me through one of my Kansas offices or my Washington, D.C., office.

Very truly yours,

Jerry