Congressional Record, Volume 141 Issue 47 (Tuesday, March 14, 1995)

[Congressional Record Volume 141, Number 47 (Tuesday, March 14, 1995)]
[Senate]
[Pages S3891-S3903]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

By Mr. ROCKEFELLER:
S. 548. A bill to provide quality standards for mammograms performed
by the Department of Veterans Affairs; to the Committee on Veterans'
Affairs.

the women veterans' mammography quality standards act

Mr. ROCKEFELLER. Mr. President, for a number of years, I have
been active--both through legislation and oversight activity--in
seeking to improve VA's response to women veterans. While there has
been some progress, much remains to be done. During the last Congress,
we were poised to make some significant improvements, particularly in
defining which services VA must furnish to women veterans.
Unfortunately, that legislation, along with other vital measures, died
in the closing hours of the Congress. While those issues may still be
brought into play on legislation later on this year, one element of our
prior effort can clearly be separated out at this time and dealt with
on its own merits--and that's what the bill I am introducing today will
do.

background

Mr. President, the bill I am introducing, which is cosponsored by
Senators Akaka, Jeffords, Mikulski, Moseley-Braun, and Murkowski, would
ensure that women veterans will receive safe and accurate mammograms.
Under this measure, VA facilities that furnish mammography would be
required to meet quality assurance and quality control standards that
are no less stringent than those to which other mammography providers
are subject under the Mammography Quality Standards Act. VA facilities
that contract with non-VA facilities would be required to contract only
with facilities that comply with that act. I will now highlight briefly
the provisions contained in this legislation.

summary of provisions

Mr. President, this legislation would establish quality standards for
mammography services furnished by VA which would:
First, require that all VA facilities that furnish mammography be
accredited by a private nonprofit organization designated by the
Secretary of Veterans Affairs.
Second, require the Secretary to designate only an accrediting body
that meets the standards for accrediting bodies issued by the Secretary
of Health and Human Services for purposes of accrediting mammography
facilities subject to the Mammography Quality Standards Act of 1992--
Public Law 102-539.
Third, require the Secretary, in consultation with the Secretary of
Health and Human Services, to issue quality assurance and quality
control standards for mammography services furnished in VA facilities
that would be no less stringent than the Department
[[Page S3892]] of Health and Human Services regulations to which other
mammography providers are subject under the Mammography Quality
Standards Act of 1992.
Fourth, require the Secretary to issue such regulations not later
than 120 days after enactment of this legislation.
Fifth, require the Secretary to inspect mammography equipment
operated by VA facilities on an annual basis in a manner consistent
with requirements contained in the Mammography Quality Standards Act
concerning annual inspections of mammography equipment by the Secretary
of Health and Human Services, except that the Secretary of Veterans'
Affairs would not have the authority to delegate inspection
responsibilities to a State agency.
Sixth, require VA health care facilities that provide mammography
through contracts with non-VA providers to contract only with
mammography providers that comply with the Department of Health and
Human Services' quality assurance and quality control regulations.
Seventh, require the Secretary, not later than 180 days after the
Secretary prescribes the mammography quality assurance and quality
control regulations, to submit a report to the House and Senate
Committees on Veterans' Affairs on the implementation of those
regulations.

conclusion

Mr. President, in closing, I emphasize just how vital improving VA
health services for women veterans is to VA's future. Regardless of the
outcome of national health care reform efforts, progress on health care
reform at the State level dictates that VA must compete directly with
non-VA providers. In addition, the State plans probably will provide
veterans entitled to VA care, many of whom are presently uninsured, a
wider range of health care choices. Under this scenario, VA would have
to furnish a full continuum of health services, including quality
mammography, in order to compete successfully for women veteran
patients.
This bill would hold VA to the mammography standards required of
other providers. Anything less would deny the great debt we owe to the
courageous women who have sacrificed themselves in service to our
Nation.
Mr. President, I look forward to working with the chairman of the
Committee on Veterans' Affairs, Senator Simpson, the cosponsors of this
bill, and the other members of the committee to gain prompt action on
it in our committee and the Senate. 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. 548

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 ``Women Veterans' Mammography
Quality Standards Act''.

SEC. 2. MAMMOGRAPHY QUALITY STANDARDS.

(a) Performance of Mammograms.--Mammograms may not be
performed at a Department of Veterans Affairs facility unless
that facility is accredited for that purpose by a private
nonprofit organization designated by the Secretary of
Veterans Affairs. The organization designated by the
Secretary under this subsection shall meet the standards for
accrediting bodies establishing by the Secretary of Health
and Human Services under section 354(e) of the Public Health
Service Act (42 U.S.C. 263b(e)).
(b) Quality Standards.--(1) Not later than 120 days after
the date of the enactment of this Act, the Secretary of
Veterans Affairs shall prescribe quality assurance and
quality control standards relating to the performance and
interpretation of mammograms and use of mammogram equipment
and facilities by personnel of the Department of Veterans
Affairs. Such standards shall be no less stringent than the
standards prescribed by the Secretary of Health and Human
Services under section 354(f) of the Public Health Service
Act.
(2) The Secretary of Veterans Affairs shall prescribe
standards under this subsection in consultation with the
Secretary of Health and Human Services.
(c) Inspection of Department Equipment.--(1) The Secretary
of Veterans Affairs shall, on an annual basis, inspect the
equipment and facilities utilized by and in Department of
Veterans Affairs health-care facilities for the performance
of mammograms in order to ensure the compliance of such
equipment and facilities with the standards prescribed under
subsection (b). Such inspection shall be carried out in a
manner consistent with the inspection of certified facilities
by the Secretary of Health and Human Services under section
354(g) of the Public Health Services Act.
(2) The Secretary of Veterans Affairs may not delegate the
responsibility of such secretary under paragraph (1) to a
State agency.
(d) Application of Standards to Contract Providers.--The
Secretary of Veterans Affairs shall ensure that mammograms
performed for the Department of Veterans Affairs under
contract with any non-Department facility or provider conform
to the quality standards prescribed by the Secretary of
Health and Human Services under section 354 of the Public
Health Service Act.
(e) Report.--(1) The Secretary of Veterans Affairs shall
submit to the Committees on Veterans' Affairs of the Senate
and House of Representatives a report on the quality
standards prescribed by the Secretary under subsection
(b)(1).
(2) The Secretary shall submit the report not later than
180 days after the date on which the Secretary prescribes
such regulations.
(f) Definition.--In this section, the term ``mammogram''
shall have the meaning given such term in section 354(a)(5)
of the Public Health Service Act (42 U.S.C. 263b(a)).

______

By Mr. EXON:
S. 550. A bill to amend the National Labor Relations Act and the
Railway Labor Act to prevent discrimination based on participation in
labor disputes; to the Committee on Labor and Human Resources.

Labor dispute legislation

Mr. EXON.
Mr. President, I rise today to introduce a bill which I hope--and I
emphasize ``I hope''--will serve as a common ground for the two warring
factions very prominent in our society today.

My bill amends the Federal labor law by providing a short-term ban on
permanent replacement workers for the first 60 days of a strike. Then
permanent replacements could be gradually phased in over a 12-month
period so that an employer could hire 100 percent of their work force
as permanent replacements by the end of a year.
I believe that those two warring factions--management and labor--need
to focus more on what is in our Nation's long-term best interests and
less on getting and keeping an upper hand. I caution either side from
thinking that crushing blows or complete victories are within reach.
They are not. I have proposed my idea before but neither side wanted to
take the first step.
To management I say you have leveraged a rarely used practice into
what is now the sledgehammer of negotiations. The right to strike hangs
by the thread that separates the difference between being fired and
being permanently replaced. To labor I say the global economy has
remade the rules. International competitiveness may mean that labor
will have to settle for less than the whole loaf sometimes.
I voted against NAFTA and against GATT for various reasons, but some
of the most important involved my concern that our chase for cheap
labor would erode the ground under our workers and the standard of
living in America. But that is over and done with. We can shore up as
best we can, but I fear the erosion may continue, not subside.
The two old bulls, labor and management, are still at it, with their
horns locked, straining. The harmful effects of that intransigence can
be seen in the festering sore of professional baseball. They often
threaten to pull the Senate into the trenches and seem to have done so
once again.
Mr. President, I make this appeal: Congress has the power to step in
and set some ground rules instead of being pushed this way and pushed
that. Let us take this opportunity to impose some order, set some
rules, then hopefully set this issue aside and see if such a resolution
works.
Under my bill, management is barred from simply replacing workers
permanently the day after the strike. Certainly management can keep the
plant open, if they choose, with temporary workers. Labor knows,
however, that the meter is running under my bill and that the effect of
the strike is diminished with time.
For example, after 60 days, the employer can hire 10 percent of the
work force as replacements, permanent replacements; after 90 days, 20
percent;
[[Page S3893]] after 4 months, 30 percent; after 5 months, 40 percent;
after 6 months, 50 percent; after 9 months, 75 percent; and after 1
year, 100 percent, if that is the desire of management.
Management will say that the 60-day ban is too long, while labor will
say that a year before being completely replaced is too short. I say
that sounds like the start of a good compromise.
Congress can break this logjam, and I think it should. I do not
believe this is a matter to be resolved by Executive order but, rather,
by law. I think this proposal can satisfy well-meaning and well-
intentioned people on both sides of the issue and may help us to look
forward in both the Senate and this country to something better.
Mr. President, I suggest that we look ahead to the 21st century. Let
us quit sticking our heads in the sand with meaningless gestures.
Anyone who is looking beyond next year or the next election, who truly
believes in collective bargaining, should recognize that international
competition in the 21st century demands labor/management cooperation
and not war.
I submit it is not fair or reasonable to expect a union worker to
strike for economic grievances when he or she could lose their job the
very first day that they dare walk the picket line. Some collective
bargaining. With just a little bit of backbone and a little bit of
reason and a little bit of understanding, we could properly correct
this situation that continues to tear American labor and management
apart.
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. 550

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

SEC. 1. PREVENTION OF DISCRIMINATION DURING AND AT THE
CONCLUSION OF LABOR DISPUTES.

Section 8 of the National Labor Relations Act (29 U.S.C.
158) is amended--
(1) in subsection (a)--
(A) by striking the period at the end of paragraph (5) and
inserting ``: or''; and
(B) by adding at the end thereof the following new
paragraph:
``(6) subject to subsection (h), to promise, threaten, or
take other action--
``(A) to hire a permanent replacement for an employee who--
``(i) at the commencement of a labor dispute was an
employee of the employer in a bargaining unit in which a
labor organization was the certified or recognized exclusive
representative. or, on the basis of written authorizations by
a majority of the employees, was seeking to be so certified
or recognized; and
``(ii) in connection with the dispute has engaged in
converted activities for the purpose of collective bargaining
or other mutual aid or protection through that labor
organization; or
``(B) to withhold or deny any other employment right or
privilege to an employee, who meets the criteria of clauses
(i) and (ii) of subparagraph (A) and who is working for or
has unconditionally offered to return to work for the
employer, out of a preference for any other individual that
is based on the fact that the individual is performing, has
performed, or has indicated a willingness to perform
bargaining unit work for the employer during the labor
dispute.''; and
(2) by adding at the end thereof the following new
subsection:
``(h)(1) An employer may not hire a permanent replacement
for an employee described in subsection (a)(6) unless the
employer compiles with the requirements under paragraph (2).
``(2)(A) An employer may hire a permanent replacement for
an employee described in subsection (a)(6)(A) during the
period beginning 61 days after the date of the commencement
of a dispute described in subsection (a)(6) and ending 90
days after the date of such commencement. The total number of
replacements made under this subsection during such period
shall not exceed 10 percent of the total number of employees
who were in the bargaining unit described in subsection
(a)(6)(A)(i) on the date of the commencement of the dispute.
``(B) An employer may hire a permanent replacement for an
employee described in subsection (a)(6)(A) during the period
beginning 91 days after the date of the commencement of a
dispute described in subsection (a)(6) and ending 120 days
after the date of such commencement. The total number of
replacements made under this subsection during such period
shall not exceed 20 percent of the total number of employees
who were in the bargaining unit described in subsection
(a)(6)(A)(i) on the date of the commencement of the dispute.
``(C) An employer may hire a permanent replacement for an
employee described in subsection (a)(6)(A) during the period
beginning 121 days after the date of the commencement of a
dispute described in subsection (a)(6) and ending 150 days
after the date of such commencement. The total number of
replacements made under this subsection during such period
shall not exceed 30 percent of the total number of employees
who were in the bargaining unit described in subsection
(a)(6)(A)(i) on the date of the commencement of the dispute.
``(D) An employer may hire a permanent replacement for an
employee described in subsection (a)(6)(A) during the period
beginning 151 days after the date of the commencement of a
dispute described in subsection (a)(6) and ending 180 days
after the date of such commencement. The total number of
replacements made under this subsection during such period
shall not exceed 40 percent of the total number of employees
who were in the bargaining unit described in subsection
(a)(6)(A)(i) on the date of the commencement of the dispute.
``(E) An employer may hire a permanent replacement for an
employee described in subsection (a)(6)(A) during the period
beginning 181 days after the date of the commencement of a
dispute described in subsection (a)(6) and ending 270 days
after the date of such commencement. The total number of
replacements made under this subsection during such period
shall not exceed 50 percent of the total number of employees
who were in the bargaining unit described in subsection
(a)(6)(A)(i) on the date of the commencement of the dispute.
``(F) An employer may hire a permanent replacement for an
employee described in subsection (a)(6)(A) during the period
beginning 271 days after the date of the commencement of a
dispute described in subsection (a)(6) and ending 360 days
after the date of such commencement. The total number of
replacements made under this subsection during such period
shall not exceed 75 percent of the total number of employees
who were in the bargaining unit described in subsection
(a)(6)(A)(i) on the date of the commencement of the dispute.
``(G) An employer may hire a permanent replacement for an
employee described in subsection (a)(6)(A) effective 361 days
after the date of the commencement of a dispute described in
subsection (a)(6).''.

SEC. . PREVENTION OF DISCRIMINATION DURING AND AT THE
CONCLUSION OF RAILWAY LABOR DISPUTES.

Paragraph Fourth of section 2 of the Railway Labor Act (45
U.S.C. 152) is amended--
(1) by inserting ``(a)'' after ``Fourth.'';
(2) by adding at the end thereof the following new
subsections:
``(b) Subject to subsection (c), no carrier, or officer or
agent of the carrier, shall promise, threaten or take other
action--
``(1) to hire a permanent replacement for an employee who--
``(A) at the commencement of a dispute was an employee of
the carrier in a craft or class in which a labor organization
was the designated or authorized representative or, on the
basis of written authorizations by a majority of the craft or
class, was seeking to be so designated or authorized; and
``(B) in connection with that dispute has exercised the
right to join, to organize, to assist in organizing, or to
bargain collectively through that labor organization; or
``(2) to withhold or deny any other employment right or
privilege to an employee, who meets the criteria of
subparagraphs (A) and (B) of paragraph (1) and who is working
for or has unconditionally offered to return to work for the
carrier, out of a preference for any other individual that is
based on the fact that the individual is employed, was
employed, or indicated a willingness to be employed during
the dispute.
``(c)(1) A carrier, or an officer or agent of the carrier,
may not hire a permanent replacement for an employee under
subsection (b) unless the carrier or officer or agent
complies with the requirements under paragraph (2).
``(2)(A) A carrier, or an officer or agent of the carrier,
may hire a permanent replacement for an employee described in
subsection (b) during the period beginning 61 days after the
date of commencement of a dispute described in subsection (b)
and ending 90 days after the date of such commencement. The
total number of replacements made under this subsection
during such period shall not exceed 10 percent of the total
number of employees who were in the craft or class described
in subsection (b).
``(B) A carrier, or an officer or agent of the carrier, may
hire a permanent replacement for an employee described in
subsection (b) during the period beginning 91 days after the
date of commencement of a dispute described in subsection (b)
and ending 120 days after the date of such commencement. The
total number of replacements made under this subsection
during such period shall not exceed 20 percent of the total
number of employees who were in the craft or class described
in subsection (b).
``(C) A carrier, or an officer or agent of the carrier, may
hire a permanent replacement for an employee described in
subsection (b) during the period beginning 121 days after the
date of commencement of a dispute described in subsection (b)
and ending 150 days after the date of such commencement. The
total number of replacements made under this subsection
during such period shall not exceed 30 percent of the total
number of employees who were in the craft or class described
in subsection (b).
``(D) A carrier, or an officer or agent of the carrier, may
hire a permanent replacement for an employee described in
subsection (b)
[[Page S3894]] during the period beginning 151 days after the
date of commencement of a dispute described in subsection (b)
and ending 180 days after the date of such commencement. The
total number of replacements made under this subsection
during such period shall not exceed 40 percent of the total
number of employees who were in the craft or class described
in subsection (b).
``(E) A carrier, or an officer or agent of the carrier, may
hire a permanent replacement for an employee described in
subsection (b) during the period beginning 181 days after the
date of commencement of a dispute described in subsection (b)
and ending 270 days after the date of such commencement. The
total number of replacements made under this subsection
during such period shall not exceed 50 percent of the total
number of employees who were in the craft or class described
in subsection (b).
``(F) A carrier, or an officer or agent of the carrier, may
hire a permanent replacement for an employee described in
subsection (b) during the period beginning 271 days after the
date of commencement of a dispute described in subsection (b)
and ending 360 days after the date of such commencement. The
total number of replacements made under this subsection
during such period shall not exceed 75 percent of the total
number of employees who were in the craft or class described
in subsection (b).
``(G) A carrier, or an officer or agent of the carrier, may
hire a permanent replacement for an employee described in
subsection (b) effective 361 days after the date of
commencement of a dispute described in subsection (b).''.
______

By Mr. BURNS (for himself and Mr. Baucus):
S. 552. A bill to allow the refurbishment and continued operation of
a small hydroelectric facility in central Montana by adjusting the
amount of charges to be paid to the United States under the Federal
Power Act, and for other purposes; to the Committee on Energy and
Natural Resources.

flint creek hydroelectric facility legislation

Mr. BURNS. Mr. President, I rise today to introduce legislation to
allow for the orderly transfer of a license for the operation of a
small hydroelectric facility in my State of Montana. This operation is
no longer generating electricity. The utility that owns it, Montana
Power, no longer finds it economical to continue to do so. Montana
Power would like to turn the operation and ownership of the dam over to
someone else. And there is a potential buyer, the county of Granite.
The county would like to buy the facility, refurbish it, and continue
to generate low-cost electricity for itself and its neighbors.
However, FERC, the agency that must approve the license request is
demanding that the buyer pay for the rent of Forest Service land that
lies under the lake that was created by the dam. The Forest Service
gets no benefit from the land. It's under several feet of water. And
the Federal Government already owns one-third of my State of Montana.
I believe that this bill, which will defer the rental costs for 5
years which will allow the county to get its repair work done and get
the generation on-line, is an equitable solution to the problem posed
by FERC. I hope that they will support the bill.
______

By Ms. MOSELEY-BRAUN:
S. 553. A bill to amend the Age Discrimination in Employment Act of
1967 to reinstate an exemption for certain bona fide hiring and
retirement plans applicable to State and local firefighters and law
enforcement officers, and for other purposes; to the Committee on Labor
and Human Resources.

the age discrimination in employment amendments of 1995

Ms. MOSELEY-BRAUN. Mr. President, I introduce the Age
Discrimination in Employment Amendments of 1995, legislation designed
to give State and local governments the same right to set mandatory
retirement ages and maximum hiring ages for their police and
firefighters that the Federal Government currently enjoys.
Throughout the 104th Congress, there has been a great deal of
discussion about the need for those of us in this body to hold
ourselves accountable to the same standards other Americans have to
meet.
We have debated and passed congressional coverage legislation, which
will apply to Congress a number of laws that have already been applied
to the private sector. We have also debated and passed unfunded
mandates legislation in order to ensure that the Federal Government
does not impose mandates on State and local governments without the
funding necessary to cover the cost of those mandates.
The legislation I am introducing today is based on this same basic
theme. Currently, the Federal Government enjoys a permanent exemption
from the Age Discrimination in Employment Act that allows it to set
mandatory retirement ages and maximum hiring ages for its public safety
officers. In effect, this exemption authorizes Federal public safety
agencies to use mandatory retirement ages and maximum hiring ages for
their police officers and firefighters including:
The U.S. Park Police; the Federal Bureau of Investigation; Department
of Justice Law Enforcement personnel; District of Columbia
firefighters; U.S. Forest Service firefighters; the Central
Intelligence Agency; the Capitol Police; and Federal firefighters.
However, this same exemption from the Age Discrimination in
Employment Act is not available to State and local governments.
My legislation corrects this disparity by allowing State and local
governments the right to set mandatory retirement and maximum hiring
ages if they so choose.
Mr. President, I want to emphasize that last point. This legislation
merely allows State and local governments to set mandatory retirement
and maximum hiring ages if they so choose.
The bill does not set national, mandatory retirement and maximum
hiring ages for police and firefighters. It does not require State
local governments to create their own mandatory retirement and maximum
hiring ages. It does not even encourage them to do so. It merely grants
State and local governments the same rights in this area which are
currently being enjoyed by the Federal Government.
As a general rule, the Age Discrimination in Employment Act prohibits
employers from discriminating against workers solely on the basis of
age, and generally prohibits the use of mandatory retirement and
maximum hiring ages.
Prior to Congress enacting an exemption in 1986, the Age
Discrimination in Employment Act allowed State and local governments to
use mandatory retirement and maximum hiring ages for their public
safety officers only if they could prove in court that these rules were
bona fide occupational qualifications [BFOQ's] reasonably necessary for
the normal operation of the business.
Although this approach sounds reasonable, courts in some
jurisdictions ruled limits permissible while identical limits were held
impermissible in other jurisdictions. For example, the Missouri
Highway Patrol's maximum hiring age of 32 was upheld while Los Angeles
County Sheriff's maximum hiring age of 35 was not. East Providence's
mandatory retirement age of 60 for police officers was upheld while
Pennsylvania's mandatory retirement age of 60 was struck down.

As a result, no State or local government could be sure of the
legality of its hiring or retirement policies. They could, however, be
sure of having to spend scarce financial resources to defend their
policies in court.
The 1986 amendment to the Age Discrimination in Employment Act
authorized State and local governments to set maximum hiring ages and
mandatory retirement ages until January 1, 1994. It also ordered the
EEOC and the Department of Labor to conduct a study to determine:
Whether physical and mental fitness tests can accurately assess the
ability of police and firefighters to perform the requirements of their
jobs; which particular types of tests are most effective; and what
specific standards such tests should satisfy.
Finally, the 1986 amendment directed the EEOC to promulgate
guidelines on the administration and use of physical and mental fitness
tests for police and firefighters.
Despite the very clear mandate in the 1986 amendment, neither the
EEOC nor its researchers complied with that mandate.
While the Penn State researchers who conducted the study concluded
that age was a poor predictor of job performance, they failed to
evaluate which particular physical and mental fitness tests are most
effective to evaluate public safety officers and
[[Page S3895]] which specific standards such tests should satisfy.
Nor did the EEOC promulgate guidelines to assist State and local
governments in the administration and use of such tests, as Congress
directed. As a result, State and local governments find themselves
without a public safety exemption from the Age Discrimination in
Employment Act, and also without any guidance as how to test their
employees.
I firmly believe that, as a rule, Congress should avoid exempting
whole classes of employees from the protection of civil rights laws. We
should not carve out exemptions merely because an employer finds civil
rights compliance to be too costly or inconvenient. Exemptions must be
made only when there is a strong compelling need to do so and there is
no other reasonable alternative.
That is the situation here. State and local fire and police agencies
must be exempt from ADEA in order to protect and promote the safety of
the public. This is literally a life or death matter; if police
officers and firefighters cannot adequately perform their duties,
people die and people get hurt.
Numerous medical studies have found that age directly affects an
individual's ability to perform the duties of a public safety officer.
This is not a stereotype. This is not ageism. This is a medical fact.
Consider the facts the American Heart Association found that clearly
demonstrate the increased risk of heart attack and death in older
individuals. One in six men and one in seven women between the ages of
45-64 has some form of heart disease. The ratio soars to one in three
at age 65 and beyond. For people over age 55, incident of stroke more
than doubles in each successive decade.
The diminishing of physical capabilities can also be seen in
statistics in the field of public safety. For example, although
firefighters over 50 comprise only one-seventh of the total number of
firefighters, they account for one-third of all firefighter deaths
Now, you may ask why State and local governments cannot just develop
tests to screen out those individuals who may still retain their
strength at the age of 60 or 70. However, there is no adequate test
that can simulate the conditions that firefighters and police officers
face in the line of duty.
The fact that an individual passes a fitness test one day does not,
in and of itself, mean that the individual is capable of performing the
sustained, strenuous, constant, physical activity required of a public
safety officer. If a 75-year-old walks in and takes a test, and happens
to be healthy on that particular day, a State or local government would
have to hire that individual, even though that individual may not, day
in and day out, be capable of physically performing his or her job.
Mr. President, as many of you in this body know, I come from a law
enforcement background. My father was a police officer. My uncle was a
police officer. My brother still is a police officer. I feel very
strongly that we in Congress need to do everything we can to ensure
that our rank and file officers have everything they need to do their
jobs.
The legislation I offer here today is widely supported by rank and
file public safety officers. In fact, my office has been besieged by
calls and letters and visits from police officers and firefighters who
want to see a permanent exemption enacted into law. I would like to
read a list of organizations that support this legislation:
The Fire Department Safety Officers Association; the Fraternal Order
of Police; the International Association of Firefighters; the
International Association of Chiefs of Police; the International
Brotherhood of Police Officers; the International Society of Fire
Service Instructors; the International Union of Police Associations,
AFL-CIO; the National Association of Police Organizations; The National
Sheriffs Association; the National Troopers Coalition; the American
Federation of State, County and Municipal Employees; the National
Public Employer Labor Relations Association; the New York State
Association of Chiefs of Police; and the City of Chicago Department of
Police.
This legislation is also supported by the following State and local
governmental organizations:
The National League of Cities; the National Association of Counties;
the National Conference of State Legislatures; and the U.S. Conference
of Mayors.
Mr. President, I strongly urge my colleagues to support and quickly
enact this carefully drawn, greatly needed legislation.
Mr. President, I ask unanimous consent that the full text of this
bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 553
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 ``Age Discrimination in
Employment Amendments of 1995''.

SEC. 2. AGE DISCRIMINATION AMENDMENT.

(a) Repeal of Repealer.--Section 3(b) of the Age
Discrimination in Employment Amendments of 1986 (29 U.S.C.
623 note) is repealed.
(b) Exemption.--Section 4(j) of the Age Discrimination in
Employment Act of 1967 (29 U.S.C. 623(j)), as in effect
immediately before December 31, 1993--
(1) is reenacted as such section; and
(2) as so reenacted, is amended in paragraph (1) by
striking ``attained the age'' and all that follows through
``1983, and'' and inserting the following: ``attained--
``(A) the age of hiring or retirement, respectively, in
effect under applicable State or local law on March 3, 1983;
or
``(B) if an age of retirement was not in effect under
applicable State or local law on March 3, 1983, 55 years of
age; and''.
SEC. 3. STUDY AND GUIDELINES FOR PERFORMANCE TESTS.

(a) Study.--Not later than 3 years after the date of
enactment of this Act, the Chairman of the Equal Employment
Opportunity Commission (referred to in this section as ``the
Chairman'') shall conduct, directly or by contract, a study,
and shall submit to the appropriate committees of Congress a
report based on the results of the study that shall include--
(1) a list and description of all tests available for the
assessment of abilities important for the completion of
public safety tasks performed by law enforcement officers and
firefighters;
(2) a list of the public safety tasks for which adequate
tests described in paragraph (1) do not exist;
(3) a description of the technical characteristics that the
tests shall meet to be in compliance with applicable Federal
civil rights law and policies;
(4) a description of the alternative methods that are
available for determining minimally acceptable performance
standards on the tests;
(5) a description of the administrative standards that
should be met in the administration, scoring, and score
interpretation of the tests; and
(6) an examination of the extent to which the tests are
cost effective, safe, and comply with the Federal civil
rights law and regulations.
(b) Advisory Guidelines.--Not later than 4 years after the
date of enactment of this Act, the Chairman shall develop and
issue, based on the results of the study required by
subsection (a), advisory guidelines for the administration
and use of physical and mental fitness tests to measure the
ability and competency of law enforcement officers and
firefighters to perform the requirements of the jobs of the
officers and firefighters.
(c) Consultation Requirement; Opportunity for Public
Comment.--
(1) Consultation.--The Chairman shall, during the conduct
of the study required by subsection (a), consult with--
(A) the Deputy Administrator of the United States Fire
Administration;
(B) the Director of the Federal Emergency Management
Agency;
(C) organizations that represent law enforcement officers,
firefighters, and employers of the officers and firefighters;
and
(D) organizations that represent older individuals.
(2) Public comment.--Prior to issuing the advisory
guidelines required in subsection (b), the Chairman shall
provide an opportunity for public comment on the proposed
advisory guidelines.
(d) Development of Standards for Wellness Programs.--Not
later than 2 years after the date of enactment of this Act,
the Chairman shall propose advisory standards for wellness
programs for law enforcement officers and firefighters.
(e) Authorization of Appropriations.--There is authorized
to be appropriated $5,000,000 to carry out this section.

SEC. 4. EFFECTIVE DATES.

(a) General Effective Date.--Except as provided in
subsection (b), this Act and the amendments made by this Act
shall take effect on the date of enactment of this Act.
(b) Special Effective Date.--The repeal made by section
2(a) and the reenactment made by section 2(b)(1) shall take
effect on December 31, 1993.
______

By Mr. FEINGOLD:
[[Page S3896]] S. 554. A bill to amend the provisions of titles 5
and 28, United States Code, relating to equal access to justice, award
of reasonable costs and fees, hourly rates for attorney fees,
administrative settlement offers, and for other purposes, to the
Committee on the Judiciary.

the equal access to justice reform amendments on 1995
Mr. FEINGOLD. Mr. President, I introduce a bill to amend the
Equal Access to Justice Act.
This legislation makes some needed improvements to the act to speed
up the process of awarding attorney's fees to private parties who
prevail in certain suits against the United States.
Mr. President, there has been considerable attention paid in the past
few weeks to legislation such as regulatory reform, tort reform, and
various pieces of the Republican contract which claim to address the
concerns of many Americans that substantial change needs to take place
in many areas.
My bill deals with some aspects of these concerns by assisting
ordinary citizens who face legal conflicts with their Federal
Government and prevail. The basic premise of EAJA is about giving
individuals and small businesses the ability to confront the Government
on a more equal footing. It is another step toward getting Government
off the backs of the average citizen and small business owner.
I am convinced the improvements I have proposed will make the Equal
Access to Justice Act work better and reduce the overall costs to
taxpayers.
Mr. President, this is an area in which I have worked for several
years before coming to this body.
My interest in this issue arises from my experience both as a private
attorney and a member of the Wisconsin Senate.
When I was in private practice, I was aware of how attorneys' fees
and the other costs associated with litigation could be a burden to a
plaintiff with limited resources, even if the claim was just.
Once I entered the State senate, I authored legislation modeled on
the Federal law. The State law, found in section 814.246 of the
Wisconsin statutes, was enacted in 1985.
It seemed to me then, and does now, that we should do what we can to
remove this burden to plaintiffs who need their claims reviewed and
decided by an impartial decisionmaker.
When I joined the U.S. Senate, I began looking at how these two
Federal statutes operate and whether change was needed. I was
particularly interested in how we could make the system work better.
I am convinced change is necessary and that we can bring the system
up to date to reflect 14 years worth of experience.
Mr. President, the Equal Access to Justice Act was enacted in 1980
and made permanent in 1985. The original intent of the act was to make
the task of suing the Federal Government less daunting for small
business owners. It was perceived that these owners suffered onerous
Government regulation and other indignities rather than sue for relief
because of the prohibitive costs of litigation.
Much of the work of this original Federal legislation was done by
then-Representative Robert Kastenmeier of Wisconsin, who represented my
home town of Middleton with distinction and served on the House
Judiciary Committee for many years.
By giving prevailing parties in certain kinds of cases the right to
seek attorney's fees and other costs from the United States, the act
sought to prevent business owners from having to risk their companies
in order to seek justice. It was, in effect, a way to give David
another rock for his sling.
And it is the Davids, not the Goliaths, who benefit from this act.
Although I have reservations about the general concept of loser-pays
rules, when a citizen faces the overpowering resources of the Federal
Government, it is only fair that, when that citizen wins in court, the
Government ought to reimburse the costs.
An individual with a net worth greater than $2 million may not
request fees under EAJA, nor may a business or other organization with
a net worth greater than $7 million and which employs more than 500
people, unless it qualifies either as a nonprofit under certain Federal
tax laws or as an agricultural cooperative.
Collaterally, the act sought to provide a deterrence to excessive
Government regulation, a subject in which we all share an interest.
Some would certainly argue that latter goal has not been achieved.
But the Equal Access to Justice Act has been successful in other areas,
although perhaps not quite as planned, Mr. President.
For one thing, the cost has been much smaller than originally
anticipated. The Equal Access to Justice Act was originally estimated
to cost at least $68 million per year, but according to the
Administrative Office of the U.S. Courts, annual EAJA awards from 1988
to 1992 generally hovered around $5 to $7 million.
This is despite the fact that litigants are winning more cases than
anticipated.
A study conducted by Prof. Susan Gluck Mezey of Loyola University at
Chicago and Prof. Susan M. Olson of the University of Utah found that
plaintiffs have been more successful than original estimates believed.
Professors Mezey and Olson examined 629 Federal district and
appellate court decisions involving EAJA claims during the 1980's.
The Mezey-Olson study, published in the July-August 1993 edition of
Judicature magazine, pointed out that the Congressional Budget Office
originally assumed plaintiffs would receive fees under the act in about
25 percent of the claims filed against the Government.
However, the professors found in their sample that about 36 percent
of litigants other than those suing the Department of Health and Human
Services have won fees. Plaintiffs suing HHS, many of them seeking
Social Security disability benefits, have a success rate most lawyers
would envy, about 69 percent.
The Mezey-Olson study shows that most successful plaintiffs who seek
fees have been these Social Security disability benefits applicants.
Another study, prepared in 1993 by Prof. Harold Krent of the
University of Chicago law school for the Administrative Conference of
the United States, found that, while the original intent of the Equal
Access to Justice Act was supposed to make things a little easier on
the applicants for fees, as currently written, it ``probably creates a
perverse incentive to litigate'' on the part of Government attorneys.
This is because the act gives the government a chance to avoid paying
fees, even when it loses its case, to the small business owner or
individual who would otherwise see their costs paid. The Government can
do this by showing it had substantial justification for its actions,
despite the fact that those actions proved onerous to that small
business owner or individual.
Professor Krent argues that the issues of whether fees should be
awarded or whether the Government had substantial justification to act
as it did can be nearly as exhaustive to litigate as the original
complaint. This despite the fact that the substantial justification
argument is successful in a relatively small number of cases.
We can fix that. We can bring the administrative costs of the Equal
Access to Justice Act down.
My bill amends the act in several ways, and it is intended to make
use of the act's provisions more acceptable to its original
beneficiaries, the small business owners.
First, my bill raises the current $75-per-hour fee award cap to $125
per hour. It keeps the cost-of-living increase as a possible factor in
setting the award, but it eliminates language which permits further
increasing the award due to some special factor, defined by example in
the existing statute as ``the limited availability of qualified
attorneys or agents for the proceedings involved.''
This brings the fee cap more closely into line with current hourly
rates charged by attorneys. It also makes these suits more attractive
to attorneys, which in turn means prospective plaintiffs will have a
larger pool of attorneys from which to choose. This, I think, obviates
the need for the special factor language. I also believe eliminating
that provision simplifies the process.
Second, my bill makes more specific the method of computing cost-of-
living increases to fee awards. Under existing
[[Page S3897]] law, courts have been forced to make these
determinations without adequate statutory guidance. Professor Krent
notes in his study that ``courts have split as to when the cost-of-
living increase is applicable--for instance, whether it should be
calculated as of the date of the work performed, or as of some later
date.''
My bill states that a cost-of-living adjustment should be calculated
from the date of final disposition. In other words, if the work was
performed in 1988 but the final disposition occurred in 1994, we should
base the fee calculation on 1994.
Third, my bill eliminates language in the act that allows the
Government to escape paying attorney's fees even if it loses a suit if
it can show substantial justification for its actions.
I believe that if an individual or small business owner go up against
the Federal Government and win, they win. If you are successful in your
suit against the Government or in your defense against Government
enforcement, and the law provides for Government payment of your fees,
the government should pay the fees.
Further, Professor Krent's study indicates that fee awards were
denied in only a small percentage of EAJA cases because of the
substantial justification defense.
It may sound as though we're actually increasing the cost of this
act, but these steps may well have the opposite effect. Even though fee
awards may go up somewhat, the time and cost of litigation to the
government will be reduced, and we should have a more cost-effective
system.
Let me refer again to Professor Krent's study for guidance as to
possible increased efficiency and cost-effectiveness.
Professor Krent noted that it is probably impossible to make an exact
determination of the expense of litigating the substantial
justification issue.
It is his opinion, based on a study of cases between June 1989 and
June 1990, that the substantial justification defense may save some
money in awards, but not enough to justify the cost of litigating the
issue.
In short, this has not proven cost effective, except in a few Social
Security cases involving large awards, unless you count some deterrent
effect, which Professor Krent believes is impossible to quantify.
Fourth, the bill would set up a process to encourage settlement of
the fee issue without litigation.
The legislation will provide the government the opportunity, similar
to the process described in rule 68 of the Federal Rules of Civil
Procedure, to make an offer of settlement up to 10 days prior to a
hearing on the fee claim. If that offer is rejected and the party
applying for reimbursement later wins a smaller award, that party shall
not be entitled to receive attorney's fees or other expenses incurred
after the date of the offer.
This, I think, will speed up the process, thereby reducing the time
and expense of litigation.
Finally, Mr. President, my bill also requires review of the act and
looks ahead to possible future expansion.
Expanding the coverage of the Equal Access to Justice Act to
additional areas of litigation is not directly addressed, but it is an
issue on which I hope there can be future discussion.
My bill requires the Justice Department to submit a report to
Congress within 180 days that provides an analysis of the variations in
the frequency of fee awards paid by specific Federal districts under
EAJA and include recommendations for extending the application of the
act to other Federal judicial proceedings.
According to the Administrative Conference of the United States, it
remains unclear ``whether EAJA covers all litigation against the United
States in article I courts, even though such proceedings are often
directly analogous to those covered by the act in article III courts.''
Congress has taken some steps. In 1985, for example, EAJA was amended
to cover the U.S. Claims Court. The Court of Veterans Appeals, which
had decided in 1992 it was not covered by EAJA, is now covered by
legislation.
Likewise, my bill requires the Administrative Office of the U.S.
Courts to submit a report to Congress within 180 days that provides an
analysis of the variations in the frequency of fee awards paid by
applicable Federal agencies under EAJA and include recommendations for
extending the application of the act to other Federal agencies and
administrative proceedings.
The United States Supreme Court, in a 1991 decision, Ardestani versus
INS, held that EAJA fees are available only in cases where hearings are
required by law to conform to the procedural provisions of section 554
of the Administrative Procedure Act.
However, Congress had already created a statutory exception. In 1986,
Congress extended EAJA's coverage to include the Program Fraud Civil
Remedies Act.
It is reasonable, I believe, to investigate whether certain agency
proceedings, such as deportation cases, that are nearly identical to
proceedings covered by section 554 should be likewise covered by EAJA.
It may be appropriate to expand EAJA to cover certain cases subject
to proceedings which are substantially the same as, but not
specifically covered by, the Administrative Procedure Act.
The study provision is also meant to be responsive to recommendations
made by members of a business advisory group with whom I meet on a
regular basis. It was suggested that there was a need to examine why
some agencies have had fee judgments awarded against them at a higher
rate than others.
Let me here acknowledge the work of the Administrative Conference of
the United States, which has been very helpful by conducting research
into this issue, making recommendations that helped form the basis of
this bill and providing valuable assistance to me in preparing this
legislation.
We all know the small business owner has a rough row to hoe and that
unnecessary or overburdening Government regulation is sometimes an
obstacle to doing business. The Equal Access to Justice Act was
conceived to help overcome that obstacle, and my amending bill is
submitted to make the act work better.
Mr. President, I ask unanimous consent that the text of this
legislation be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 554
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. EQUAL ACCESS TO JUSTICE REFORM.

(a) Short Title.--This Act may be cited as the ``Equal
Access to Justice Reform Amendments of 1995''.
(b) Award of Costs and Fees.--
(1) Administrative proceedings.--Section 504(a)(2) of title
5, United States Code, is amended by inserting after ``(2)''
the following: ``At any time after the commencement of an
adversary adjudication covered by this section, the
adjudicative officer may ask a party to declare whether such
party intends to seek an award of fees and expenses against
the agency should it prevail.''.
(2) Judicial proceedings.--Section 2412(d)(1)(B) of title
28, United States Code, is amended by inserting after ``(B)''
the following: ``At any time after the commencement of an
adversary adjudication covered by this section, the court may
ask a party to declare whether such party intends to seek an
award of fees and expenses against the agency should it
prevail.''.
(c) Hourly Rate for Attorney Fees.--
(1) Administrative proceedings.--Section 504(b)(1)(A)(ii)
of title 5, United States Code, is amended by striking out
all beginning with ``$75 per hour'' and inserting in lieu
thereof ``$125 per hour unless the agency determines by
regulation that an increase in the cost-of-living based on
the date of final disposition justifies a higher fee.);''.
(2) Judicial proceedings.--Section 2412(d)(2)(A)(ii) of
title 28, United States Code, is amended by striking out all
beginning with ``$75 per hour'' and inserting in lieu thereof
``$125 per hour unless the court determines that an increase
in the cost-of-living based on the date of final disposition
justifies a higher fee.);''.
(d) Offers of Settlement.--
(1) Administrative proceedings.--Section 504 of title 5,
United States Code, is amended--
(A) by redesignating subsections (e) and (f) as subsections
(f) and (g), respectively; and
(B) by inserting after subsection (d) the following new
subsection:
``(e)(1) At any time after the filing of an application for
fees and other expenses under this section, an agency from
which a fee award is sought may serve upon the applicant an
offer of settlement of the claims made in the application. If
within 10 days after service of the offer the applicant
serves written notice that the offer is accepted, either
party may then file the offer and notice
[[Page S3898]] of acceptance together with proof of service
thereof.
``(2) An offer not accepted shall be deemed withdrawn. The
fact that an offer is made but not accepted shall not
preclude a subsequent offer. If any award of fees and
expenses for the merits of the proceeding finally obtained by
the applicant is not more favorable than the offer, the
applicant shall not be entitled to receive an award for
attorneys' fees or other expenses incurred in relation to the
application for fees and expenses after the date of the
offer.''.
(2) Judicial proceedings.--Section 2412 of title 28, United
States Code, is amended--
(A) by redesignating subsections (e) and (f) as subsections
(f) and (g), respectively; and
(B) by inserting after subsection (d) the following new
subsection:
``(e)(1) At any time after the filing of an application for
fees and other expenses under this section, an agency of the
United States from which a fee award is sought may serve upon
the applicant an offer of settlement of the claims made in
the application. If within 10 days after service of the offer
the applicant serves written notice that the offer is
accepted, either party may then file the offer and notice of
acceptance together with proof of service thereof.
``(2) An offer not accepted shall be deemed withdrawn. The
fact that an offer is made but not accepted shall not
preclude a subsequent offer. If any award of fees and
expenses for the merits of the proceeding finally obtained by
the applicant is not more favorable than the offer, the
applicant shall not be entitled to receive an award for
attorneys' fees or other expenses incurred in relation to the
application for fees and expenses after the date of the
offer.''.
(e) Elimination of Substantial Justification Standard.--
(1) Administrative Proceedings.--Section 504 of title 5,
United States Code, is amended--
(A) in subsection (a)(1) by striking out all beginning with
``, unless the adjudicative officer'' through ``expenses are
sought''; and
(B) in subsection (a)(2) by striking out ``The party shall
also allege that the position of the agency was not
substantially justified.''.
(2) Judicial proceedings.--Section 2412(d) of title 28,
United States Code, is amended--
(A) in paragraph (1)(A) by striking out ``, unless the
court finds that the position of the United States was
substantially justified or that special circumstances make an
award unjust'';
(B) in paragraph (1)(B) by striking out ``The party shall
also allege that the position of the United States was not
substantially justified. Whether or not the position of the
United States was substantially justified shall be determined
on the basis of the record (including the record with respect
to the action or failure to act by the agency upon which the
civil action is based) which is made in the civil action for
which fees and other expenses are sought.''; and
(C) in paragraph (3) by striking out ``, unless the court
finds that during such adversary adjudication the position of
the United States was substantially justified, or that
special circumstances make an award unjust''.
(f) Reports to Congress.--
(1) Administrative proceedings.--No later than 180 days
after the date of the enactment of this Act, the
Administrative Conference of the United States shall submit a
report to the Congress--
(A) providing an analysis of the variations in the
frequency of fee awards paid by specific Federal agencies
under the provisions of section 504 of title 5, United States
Code; and
(B) including recommendations for extending the application
of such sections to other Federal agencies and administrative
proceedings.
(2) Judicial proceedings.--No later than 180 days after the
date of the enactment of this Act, the Department of Justice
shall submit a report to the Congress--
(A) providing an analysis of the variations in the
frequency of fee awards paid by specific Federal districts
under the provisions of section 2412 of title 28, United
States Code; and
(B) including recommendations for extending the application
of such sections to other Federal judicial proceedings.
(g) Effective Date.--The provisions of this Act and the
amendments made by this Act shall take effect 30 days after
the date of the enactment of this Act and shall apply only to
an administrative complaint filed with a Federal agency or a
civil action filed in a United States court on or after such
date.
______

By Mrs. KASSEBAUM (for herself, Mr. Kennedy, and Mr. Frist):
S. 555. A bill to amend the Public Health Service Act to consolidate
and reauthorize health professions and minority and disadvantaged
health education programs, and for other purposes; to the Committee on
Labor and Human Resources.

Health Professionals Consolidation and Reauthorization Act

Mrs. KASSEBAUM. Mr. President, on behalf of Senator Kennedy, Senator
Frist, and myself, I rise today to introduce legislation aimed at
improving the supply and distribution of health professionals for our
Nation's underserved communities.
The Health Professions Consolidation and Reauthorization Act of 1995
would consolidate over 44 different health professions programs
administered by the U.S. Public Health Service. Furthermore, this
legislation would target Federal health professions funding to support
training initiatives designed to improve the health of citizens in our
Nation's underserved areas.
For three decades, through the Public Health Service and Medicare,
the Federal Government has funded the training of health professionals.
Once perceived to be in undersupply, physicians are now in oversupply
as a result of this Federal intervention. However, the uneven
distribution of physicians still leaves many areas underserved.
Furthermore, many believe the Nation now has too many subspecialist
physicians and too few primary care providers. To correct these
problems, a better targeted Federal health professions strategy is
needed.
Currently, through titles III, VII, and VIII of the Public Health
Service Act, the Federal Government provides over $400 million for 44
separate initiatives. When the title VII and VIII programs were last
reauthorized in 1992, the General Accounting Office [GAO] was requested
to review their effectiveness in: First, increasing the supply of
primary care providers and other health professionals; second,
improving their representation in rural and medically underserved
areas; and third, improving minority representation in the health
professions.
GAO recommended that Congress or the Secretary of Health and Human
Services should establish:
First, national goals for the title VII and VIII programs.
Second, common outcome measures and reporting requirements for each
goal;
Third, restrictions limiting the use of funds to activities whose
results can be measured and reported against these goals; and
Fourth, criteria for allocating funding among professions based on
relative need in meeting national goals.
The Health Professions Consolidation and Reauthorization Act of 1995
builds on GAO's recommendations and is based on defined goals for these
programs. In addition, all programs would include a strong evaluation
component to ensure that they are really improving national, regional,
and State work force goals.
The act targets Federal funding based on the following goals:
First, Federal health professions education programs and distribution
programs should assure health through: improvements in the distribution
of and quality of health professionals needed to provide health
services in underserved areas; and enhancement of the production and
distribution of public health personnel to improve the State and local
public health infrastructure.
Second, the bureaucracy required to administer the current 44
independent programs should be simplified and reduced.
Under this proposal, future Federal support for health professionals
programs would be targeted to: primary and preventive care; minorities
and the disadvantaged; community-based training in underserved areas;
advanced degree nursing; and the National Health Service Corps. In
recognition of the need for fiscal restraint, funding for these
programs would be decreased by 10 percent at the end of 4 years.
Mr. President, the Health Professions Consolidation and
Reauthorization Act of 1995 maintains the traditional goal of Federal
health professions programs, which is to improve the supply and
distribution of health professionals in underserved areas. I believe,
however, that it offers a more effective and targeted approach by
moving away from small, narrowly defined categorical programs toward
broad areas of focus. In addition, my proposal places an emphasis on
outcomes measurement--a feature sadly lacking in our current efforts.
As discussion of these issues develops, I would welcome any
suggestions my colleagues or others may have for improving this
legislation.
Mr. President, I ask unanimous consent that a summary of the bill be
printed in the Record.
[[Page S3899]] There being no objection, the summary was ordered to
be printed in the Record, as follows:
Summary of the Health Professions Education Consolidation and
Reauthorization Act of 1995

background

Titles III, VII, and VIII of the Public Health Service Act
authorize 45 different programs. The goal of these programs
is to improve the supply and distribution of a variety of
types of health professionals and to improve the
representation of minorities and disadvantaged individuals in
the health professions.
The focus of Title VII programs is on the training of
physicians, general dentists, physician assistants, allied
health personnel, public health professionals, and
veterinarians. Title VIII provides for nurse training. Title
III deals with the National Health Service Corps, which helps
to place providers in underserved areas. These Titles include
programs for direct student assistance, such as loans and
scholarships, loan repayments programs, and expansion and
maintenance of training programs.

summary

I. Primary care and preventive medicine training

Under this provision, funds for family physician, general
pediatrician, general internists, preventive medicine
physician, and physician assistant training would be
authorized. These providers are generally needed to fill both
rural and underserved health professional shortage areas and
to help improve staffing in public health departments.
Generally, priority would be given to programs which have a
history of training health professionals who eventually enter
practice in rural and urban underserved areas.

II. Minority and disadvantaged training

Under this provision, the Secretary would have broad
discretion to fund projects which improve the number and
quality of minority and disadvantaged health professionals.
Many believe that an increased number of minority and
disadvantaged providers would result in improvements of
services in underserved areas, because such individuals are
more likely to practice in those areas than are others.
Generally, most minorities are currently under-represented in
the health professions relative to their representation
within the entire U.S. population.

III. Community-based training in underserved areas

This authority would be similar to the current Area Health
Education Center program. These centers are located in
underserved areas. They train medical students and other
health professionals to provide services in rural and
underserved areas. Exposure to these settings is generally
recognized as a determinant in whether a health professional
would return to practice in such settings. In addition, these
centers help support practicing providers in such areas
through continuing medical education support.

IV. Consolidated student assistance

This section would have a few authorities, but only one
appropriation. This proposal would combine most of the
current scholarship and loan programs into the current
National Health Service Corps Scholarship and Loan Repayment
program. As such, individuals would receive financial support
only in return for service provided in primary care
underserved areas. This would help to eliminate the 4,000
positions currently available in underserved areas. In
addition, transfer of the current funding for scholarship
programs to the Corps would help it fund more applications.
Currently the National Health Service Corps is only able to
provide scholarships in return for service to one out of
every 10 applicants.
In addition, the current scholarship programs for minority
and disadvantaged individuals would be consolidated into a
single scholarship program for disadvantaged students.
The authorities which would be left in place from current
law are those which do not require appropriations, but rather
are revolving loan funds which currently exist at schools.

V. Nursing

The provisions of this proposal would be similar to those
included in the Nursing Education Act reauthorization which
was approved by the Senate last year. Under it, six current
nursing programs would be consolidated into three to
emphasize primary care nursing and the production of minority
and disadvantaged nurses.

VI. Other priority areas

The Secretary could fund any number of other projects for
health professionals training which meet national workforce
needs to improve health services in underserved areas. For
instance, under this provision, the Secretary could fund
projects to train allied health professionals.
VII. Other provisions from last year's Minority Health Improvement Act
Conference Report

Office of Minority Health

The authority for the office would be extended through FY
1999. Furthermore, the provision assures that the office is
only coordinating services--not conducting its own services
and research program. The authorization would be $19 million
for each fiscal year through FY 1999. This would be a 10%
reduction from the current appropriation of $20.668 million.
(This is consistent with the general reductions in
authorizations throughout the health professions bill).

State Offices of Rural Health

There would be ``such sums as necessary'' authorized
through FY 1997. The cumulative appropriations would be
capped at $20 million. In FY 1998, after these offices have
been established in every state, the program would be
repealed. The current appropriation for this program is
$3.875 million.

Birth Defects

An enhanced program for an intramural program on birth
defects at the Centers for Disease Control and Prevention
(CDC) would be authorized. Through this program, research
centers would be established, epidemiologic review of data
would occur, and a national information clearing house would
be established. This program is consistent with current CDC
plans in this area. No funds would be authorized specifically
for this program, but funding would occur under the general
CDC program authority.

Traumatic Brain Injury

This provision is identical to that in the conference
report. It would provide for the National Institutes of
Health (NIH) to conduct research on traumatic brain injury
without an authorization for a separate appropriation. It
would also authorize $5 million a year for a demonstration
program to be administered through the Health Resources and
Services Administration, subject to the availability of
funding, for the development of state systems of care for
persons with traumatic brain injury. Finally, the provision
would authorize a consensus conference at NIH regarding the
treatment of individuals with this illness.

Health Services for Pacific Islanders

This would extend the Pacific Islanders initiative, with
technical changes only. The program would be authorized at $3
million in FY 1996 and in each year through FY 1999. Finally,
a study would be authorized to determine the usefulness of
this initiative.

Demonstration Projects Regarding Alzheimer's Disease

There would be $5 million authorized in each of the fiscal
years from FY 1996 through FY 1999. There are many technical
revisions.

Miscellaneous Centers for Disease Control and Prevention Provisions

Epidemiologic Intelligence Service officers, funded through
state and local governments, would not count in FTE
determinations of CDC. Current fellowship programs at CDC
would be authorized.
minority and disadvantaged training

Purposes: (1) Provide for the training of minority and
disadvantaged health professionals to improve health care
access in underserved areas and to improve representation in
the health professions; and (2) Provide administrative
flexibility and simplification.
General Description: Under this provision, the Secretary
would have broad discretion to fund projects which improve
the number and quality of minority and disadvantaged health
professionals. Many believe that an increased number of
minority and disadvantaged providers would result in
improvements of services in underserved areas because such
individuals tend to practice in those areas more than others.
Generally, most minority groups are currently under-
represented in the health professions relative to their
representation within the entire U.S. population.
Current Law Authorities Consolidated: (The numbers before
each program are keyed to the Labor Committee document:
``Health Professions Education: Summary of Federal Training
Programs.''
9. Centers of Excellence in Minority Health
10. Health Careers Opportunity Program
11. Minority Faculty Fellowships
12. Faculty Loan Repayment
Summary of Provisions:

Eligible entities

Schools of medicine, osteopathic medicine, dentistry,
pharmacy, podiatric medicine, optometry, veterinary medicine,
public health, allied health professions schools; schools
offering graduate programs in clinical psychology; state or
local governments; a consortia of health professions schools;
or other public or private nonprofit entities could apply.

Activities

Grants and contracts would be made, as appropriate, to
plan, develop, or operate:
1. Demonstrative programs.
2. Minority faculty development and loan repayment
programs.
3. Programs to develop the pipeline for individuals from
disadvantaged backgrounds to enter and remain in health
professions schools.
4. Programs of excellence in the health professions
education for minority individuals, including centers of
excellence at certain historically black colleges and
universities.
5. For the provision of technical assistance, work force
analysis, and information dissemination.
Any grant which is funded could incorporate one or all of
these activities. In addition, a preference would be given to
projects which involve more than one health profession
discipline or training institution and, beginning in fiscal
year 1999, for centers of excellence at certain historically
black colleges and universities.
[[Page S3900]] The Secretary would fund grant applications
which have the greatest chance of improving minority
representation in the health professions and which have an
above average record of retention and graduation of
individuals from disadvantaged backgrounds.

Outcomes evaluation

Each program would be required to set performance outcomes
and would be held accountable for meeting such outcomes. The
performance outcome standards would be consistent with state,
local, and national work force development priorities.

Non-Federal matching

The Secretary would have discretion to require
institutional or state and local government matching grants
to ensure the continuation of the project once federal aid
ends.

Transition

Current grantees would continue to operate under existing
authorities through the remainder of their funding cycles.
The new provisions would apply only to new grants.

Authorization

There would be $51 million authorized for fiscal year 1996
and such sums as necessary through fiscal year 1999. Combined
funding for these authorities in fiscal year 1995 is $50.806
million. For fiscal years 1996 through 1998, there would be a
4.25% setaside for the centers of excellence at certain
historically black colleges and universities.
primary care and preventive medicine training

Purposes: (1) Provide for the training of primary care
providers and preventive medicine public health personnel to
improve access to and quality of health care in underserved
areas and to enhance state and local public health
infrastructure; (2) Provide administrative flexibility and
simplification.
General Description: Under this provision, funding for
family physician, general pediatrician, general internist,
preventive medicine physician, and physician assistant
training would be authorized. These providers are generally
needed to fill both rural and underserved health professional
shortage areas and to help improve staffing in public health
departments. Generally, priority would be given to programs
which have a history of training health professionals who
eventually enter practice in rural and urban underserved
areas.
Current Law Authorities Consolidated: (The numbers before
each program are keyed to the Labor Committee document:
``Health Professions Education: Summary of Federal Training
Programs.'')
1. Family Medicine Training
2. General Internal Medicine and General Pediatrics
Training
3. Physician Assistant Training
5. Preventive Medicine and Dental Public Health
12. Geriatric Medicine and Dentistry Faculty Development
Summary of Provisions:

Eligible entities

Health professions schools, academic health centers, or
other public or private nonprofit entities could apply.

Activities

Grants and contracts would be made as appropriate to
develop, operate, expand, or improve:
1. Departments (or academic administrative units) of family
medicine.
2. Residency training programs in family medicine, general
internal medicine, general pediatrics, or preventive
medicine.
3. Physician assistant training programs.
4. Faculty development initiatives in primary care,
including geriatrics.
5. Medical school primary care training initiatives.

Departments of Family Medicine

Departments of family medicine would be funded. Such units
lead to a greater number of medical students choosing careers
in primary care.

Residency Training Programs

Family medicine, general internal medicine, and general
pediatrics residency programs would compete with one another
for funding. Two outcome standards would be established to
determine a funding preference. First, those programs with
the highest percentage of providers who enter primary care
practice upon the completion of training would receive a
priority. In addition, programs which successfully produce
professionals who go on to provide service in underserved
areas would receive a preference.
Preventive medicine residencies would not compete for
funding with family medicine, general internal medicine, or
general pediatrics. Rather, they would receive an appropriate
amount of funding, as determined by the Secretary. A
preference would be given to those programs which train a
high percentage of individuals who enter practice in state
and local public health departments.

Physician Assistant Training Programs

Physician assistant training programs would receive an
appropriate amount of funding, as determined by the
Secretary, from the appropriation for this section. Those
programs which have a higher output of providers who
eventually enter practice in underserved areas would receive
a preference for funding.

Faculty Development

The Secretary would determine which type of faculty
development projects to fund based on national and state work
force goals. Geriatric fellowships and faculty development
could be funded.

Medical School Primary Care Training

Primary care training activities at medical schools would
be funded through departments (or administrative units) of
family medicine, general internal medicine, or general
pediatrics. Applications from general internal medicine and
general pediatrics administrative units would be required to
demonstrate their institution's commitment to primary care
education by: (1) A mission statement which has a primary
care medical education objective; (2) faculty role models and
administrative units in primary care, and general pediatrics;
and (3) required undergraduate community-based medical
student clerkships in family medicine, internal medicine, and
pediatrics.

Outcomes evaluation

Each program would be required to set performance outcomes
and would be held
accountable for meeting such outcomes. The performance
outcome standards would be consistent with state, local,
and national work force development priorities.

Non-Federal matching

The Secretary would have discretion to require
institutional or state and local government matching grants
to ensure the continuation of the project once federal aid
ends.

Transition

Current grantees would continue to operate under existing
authorities through the remainder of their funding cycles.
The new provisions would apply only to new grants.

Authorization

There would be $76 million authorized for fiscal year 1996
and such sums as necessary through fiscal year 1999. Combined
funding for these authorities in fiscal year 1995 is $75.285
million. Family medicine departments would receive no less
than 12 percent of the overall funding. This is consistent
with the current set-aside that such departments receive.

community-based training in underserved areas

Purposes: (1) Provide support for training centers remote
from health professions schools to improve and maintain the
distribution of health providers in rural and urban
underserved areas; (2) Provide the Secretary the option of
funding geriatric training centers; (3) Provide
administrative flexibility and simplification.
General Description: This authority, most similar to the
current Area Health Education Center (AHEC) program, would
enhance the community-based training in underserved areas of
various health professionals. This goal would be achieved
through greater flexibility in the design of such programs
and through the leveraging of state and local resources.
AHECs are generally located in underserved areas remote from
academic health centers. They train health professionals to
provide services in rural and underserved areas. Exposure to
these settings is generally recognized as a determinant in
whether a health professional returns to practice in such
settings. In addition, these centers help support practicing
providers in such areas through continuing medical education
programs. Finally, the current program for funding geriatric
training centers could continue at the discretion of the
Secretary.
Current Law Authorities Consolidated: (The numbers before
each program are keyed to the Senate Labor Committee
document: ``Health Professions Education: Summary of Federal
Training Programs.'')
40. Area Health Education Centers
41. Health Education and Training Centers
42. Geriatric Education Centers
43. Rural Health Interdisciplinary Training
Summary of Provision:

Eligible entities

Health professions schools, academic health centers, state
or local governments, or other appropriate public or private
nonprofit entities.
Activities

Grants and contracts would be made as appropriate to plan,
develop, operate, expand, conduct demonstration projects, and
to provide trainee support, for projects which:
1. Improve the distribution, supply, quality, utilization,
and efficiency of personnel providing health services in
urban and rural underserved populations.
2. Encourage the regionalization of educational
responsibilities of the health professions schools into urban
and rural underserved areas.
3. Are designed to prepare individuals effectively to
provide health services in underserved areas through:
preceptorships, the conduct or affiliation with community-
based primary care residency programs, agreements with
community-based organizations for the delivery of education
and training in the health professions, and other programs.
4. Conduct interdisciplinary training of the various health
professions.
5. Provide continuing medical and health professional
education to professionals practicing in the underserved
areas served by the grantee.
A preference would be given to projects which involve one
or more health professions discipline or training
institution, train individuals who actually enter practice in
underserved areas, and have a high output of graduates who
enter primary care practice.
[[Page S3901]] In addition, the Secretary may fund
geriatric training centers if the Secretary determines such
entities are needed to improve the geriatric skills of health
providers.

Outcomes evaluation

Non-Federal matching

The Secretary would have discretion to require
institutional or state and local government matching grants
to ensure the continuation of the project once federal aid
ends.

Transition

Current grantees would continue to operate under existing
authorities through the remainder of their funding cycles.
The new provisions would apply only to new grants.

Authorization

There would be $39 million authorized for fiscal year 1996
which would be reduced to $25 million by fiscal year 1999.
Combined funding for these authorities in fiscal year 1995 is
$39.159 million. The $14 billion in funding reductions over
the three-year period is equivalent to the current combined
appropriations for the Health Education and Training Centers,
Rural Health Interdisciplinary Training Programs, and the
geriatric training centers. Funding will be phased down to
allow for the completion of current project funding periods.
health professions work force development

Purpose: Provide support to strengthen capacity for the
education of individuals in certain health professions which
the Secretary determines to have a severe shortage of
personnel and for improving the care of underserved
populations and other high-risk groups.
Current Law Authorities Consolidated: (The numbers before
each program are keyed to the Labor Committee document:
``Health Professions Education: Summary of Federal Training
Programs.'')
4. Public Health Special Projects
6. Health Administration Traineeships and Special Projects
13. Geriatric Optometry Training
14. General Dentistry Training
15. Allied Health Advanced Training and Special Projects
16. Podiatric Primary Care Residency Training
17. Chiropractic Demonstration Projects
45. AIDS Dental Services
Summary of Provisions:

Eligible Entities

Schools of medicine, osteopathic medicine, public health,
dentistry, allied health, optometry, podiatric medicine,
chiropractic medicine, veterinary medicine, pharmacy, or
graduate programs in mental health practice.

Activities

Grants and contracts would be made as appropriate to plan,
develop, or operate programs to strengthen the capacity for
health professions education and practice. The Secretary
shall have broad discretion to fund projects, but shall give
priority to projects which would improve care for underserved
populations and other high-risk groups and which would
increase the number of practitioners in any health
professions field for which the Secretary determines there is
a severe shortage of professionals.
In general, funds under this section could be used to
provide for faculty development, model demonstrations,
trainee support, technical assistance, or work force
analysis.

Outcomes evaluation

Non-Federal matching

The Secretary would have discretion to require
institutional or state and local government matching grants
to ensure the continuation of the project once federal aid
ends.

Transition

Current grantees would continue to operate under existing
authorities through the remainder of their funding cycles.
The new provisions would apply only to new grants.

Authorization

There would be $20 million authorized for fiscal year 1996
which would be reduced to $5 million by fiscal year 1999.
Combined funding for these authorities in fiscal year 1995 is
$20.264 million. The three-year period to phase down this
funding would allow for the completion of current project
award periods.
NURSING WORK FORCE DEVELOPMENT

Purposes: (1) Provide for the training of advanced degree
nurses and other nurses to improve access to and quality of
health care in underserved medical and public health areas;
and (2) Provide administrative flexibility and
simplification.
General Description: This proposal would provide for the
training of advanced degree nurses, including nurse
practitioners, nurse midwives, nurse anesthetists, and public
health nurses. In addition, projects to improve nursing work
force personnel diversity and to expand the training of
nurses in certain priority settings would occur. The
Secretary would have broad discretion to determine which
projects to fund. Generally, projects which would ultimately
lead to a greater number of nursing providers for rural and
underserved areas, including local and state public health
departments, would receive a funding preference.
Current Law Authorities Consolidated: (The numbers before
each program are keyed to the Labor Committee document:
``Health Professions Education: Summary of Federal Training
Programs.'')
18. Nursing Special Projects
19. Advanced Nurse Education
20. Nurse Practitioner/Nurse Midwife Education
21. Nurse Anesthetist Training
22. Nursing Education Opportunities for Individuals from
Disadvantaged Backgrounds
32. Professional Nurse Traineeships
Summary of Provisions:

Eligible entities

Schools of nursing (collegiate, associate degree, diploma),
nursing centers, state or local governments, and other public
or nonprofit private entities.

Activities

Grants and contracts would be made, as appropriate, to
plan, develop, or operate:
1. Advanced practice nurses training programs including
programs for nurse practitioners, nurse midwives, nurse
anesthetists, and public health nurses.
2. Programs to increase nursing work force diversity.
3. Projects to strengthen the capacity for basis nurse
education in certain priority areas.
Amounts provided under any one of these areas could be used
for faculty development, demonstrations, trainee support,
work force analysis, technical assistance, and dissemination
of information.
In determining which projects to fund under each of these
areas, the Secretary would give priority to those projects
which would substantially benefit rural or underserved
populations, including public health departments. Generally,
those programs which tend to produce nurses for these areas,
including primary care nurses, would receive funding
priority. In addition, the Secretary would have broad
discretion to distribute the appropriation among these
different activity areas. Funds would be allocated among
these activities to meet the priority for underserved areas
and to meet relevant national and state nursing work force
goals.
The National Advisory Council on Nurse Education and
Practice would continue to advise the Secretary regarding
nursing issues. Funding for this council would be provided
through the appropriations under this section.

Advance Practice Nurses Training

Projects that support the enhancement of advanced practice
nursing education and practice would be funded. In addition,
a grantee could use a portion of the funds to provide for
traineeships. Such traineeships would provide stipends to
students to help cover the costs of tuition, books, fees, and
reasonable living expenses. Programs which could receive
support under this authority are those which train nurse
practitioners, nurse midwives, nurse anesthetists, public
health nurses, and other advanced degree nurses.

Programs To Increase Nursing Work Force Diversity

Projects to increase nursing education opportunities for
individuals who are from disadvantaged racial and ethnic
backgrounds under-represented among registered nurses would
be funded. Such projects could provide student stipends or
scholarships, pre-entry preparation, or retention activities.

Projects To Strengthen Basic Nurse Education

Funding priority would be given to basic nurse education
programs designed to: (1) improve nursing services in schools
and other community settings; (2) provide care for
underserved populations and other high-risk groups such as
elderly, individuals with HIV-AIDS, substance abusers,
homeless, and battered women; (3) provide skills needed under
new health care systems; (4) develop cultural competencies
among nurses; (5) and serve other priority areas.

Outcomes evaluation

The Secretary would have discretion to require
institutional or state and local government matching grants
to ensure the continuation of the project once federal aid
ends.

Transition

Current grantees would continue to operate under existing
authorities through the remainder of their funding cycles.
The new provisions would apply only to new grants.

Authorization

There would be $62 million authorized for fiscal year 1996,
which would be reduced to $59 million for fiscal year 1999.

consolidated financial assistance and other loan programs

Purposes: (1) Provide consolidation of current loan
repayment, scholarship, and scholarship payback programs into
a flexible National Health Service Corps program requiring
service payback in underserved areas in return for federal
financial assistance; (2)
[[Page S3902]] Continue certain loan programs which do not
require federal appropriations or that guarantee the
availability of loan sources in the market for health
professions students; (3) Consolidate scholarship programs
for the disadvantaged; and (4) Provide administrative
flexibility and simplification.
General Description: This proposal would combine most of
the current targeted scholarship and loan repayment programs
into the existing National Health Service Corps Scholarship
and Loan Repayment program. As such, individuals would only
receive ``free'' financial support in return for service
provided in underserved areas. This would help to eliminate
the shortage of over 4,000 positions in primary care
underserved areas and in underserved public health positions
in state and local health departments.
The three scholarship programs for minorities and
disadvantaged students would also be consolidated into a
single scholarship program for disadvantaged students.
The authorities which would not be consolidated are those
which do not require appropriations but, rather, are
revolving loan funds which currently exist at schools. In
addition, the current Health Education Assistance Loan
Guarantee program would also be left in place.
(This consolidated program is meant to complement and other
federal financial assistance programs for which health
professional and public health professional students qualify.
Generally, the funds provided under the Perkins and Stafford
Loan programs, administered through the Department of
Education, provide sufficient resources to allow anyone the
opportunity to pursue a career in any health professions
training program. For instance, medical students may qualify
for $23,500 annually in loans under these two programs--more
than enough to finance the average medical school education.)
Current Law Authorities Consolidated: (The numbers before
each program are keyed to the Labor Committee document:
``Health Professions Education: Summary of Federal Training
Programs.''
23. Scholarships for Disadvantaged Students
25. Exceptional Financial Need Scholarships
26. Financial Assistance to Disadvantaged Health
Professions Students
28. State Loan Repayment Program
29. Community Based Scholarship Program
30. Nursing Loan Repayment Program
36. National Health Service Corps Scholarship Program
37. National Health Service Corps Loan Repayment Program
39. Public Health Traineeships
Current Law Authorities Continued Without Consolidation:
(These are revolving loan funds administered by schools which
do not require appropriations.)
33. Nursing Student Loan
34. Primary Care Loan Program
35. Health Professional Student Loans
36. Loans for Disadvantaged Students
Current Law Authority Requiring a Separate Appropriation:
38. Health Education Assistance Loans
Summary of Provisions:

Part I. Consolidated Scholarships and Loans

A. National Health Service Corps Scholarship and Loan Payback

Eligible entities

Health professionals and public health professionals (for
loan payback only).

Activities

The Secretary would have broad authority to offer the
following scholarship or loan repayment options to persons
who agree to provide services through the National Health
Service Corps in underserved areas. This consolidated
authority would be patterned after the existing National
Health Service Corps Scholarship and Loan Repayment programs.
1. Provide scholarships to health professional students in
return for a commitment for such students to practice in the
National Health Service Corps in underserved areas once their
education is completed.
2. Provide loan repayment to:
a. Health professionals and public health personnel in
return for a commitment from such persons to practice in the
National Health Service Corps designated underserved sites
or, in the case of public health personnel, state and local
health departments with public health professional shortages.
b. Nurses for an amount no greater than 85 percent of their
debt for persons who agree to practice in National Health
Service Corps designated underserved areas.
3. Provide funding to states to operate their own loan
repayment or scholarship programs. States could designate
their own underserved areas utilizing their own criteria if
such criteria are approved by the Secretary.
The Secretary would determine how much to provide for each
activity to meet the goals of providing service to
underserved areas and retaining providers in underserved
areas. States applying for grant funding to run their own
programs would receive priority.

Authorization

There would be $90 million authorized for fiscal year 1996
and such sums as necessary through fiscal year 1999. This
amount of funding is consistent with the combined current
appropriations for these programs.

B. Scholarships for Disadvantaged Students

Eligible entities

Health professions schools.

Activities

The Secretary would award grants to health professions
schools for the awarding of scholarships to disadvantaged
students. Eligible entities would receive a preference based
on the proportion of graduating students going into primary
care, the proportion of minority students, and the proportion
of graduates working in medically underserved areas.

Authorization

There would be $32 million authorized for fiscal year 1996
through 1999. This amount of funding is consistent with the
combined current appropriation for these programs.

Part II. Current Loan Authorities Continued Without Appropriations

Activities

The current Nursing Student Loan (NSL) program, Primary
Care Loan (PCL) program, Health Professions Student Loan
(HPSL) program, and the Loans for Disadvantaged Students
(LDS) programs would continue. These programs would continue
using the revolving funds which remain at health professions
schools.

Authorization

There would be $8 million authorized in each of fiscal
years 1996 through 1998 for the LDS program. For fiscal year
1999, the authority for appropriations would be repealed
after the revolving funds begin to be paid back by current
loan recipients.
The NSL, PCL, and HPSL programs, which do not currently
receive appropriations, would not be authorized to receive
appropriations.

Part III. HEAL Loans

Activities

The HEAL loan program would continue in its current form.

Authorization

This program would continue to be authorized at such sums
as necessary to guarantee sufficient funds for the insurance
pool for loan defaulters. The current premiums provided by
borrowers are insufficient to meet the needs of this fund. As
a result of reforms made in this program in fiscal year 1992,
HHS is improving its loan collection and the insurance fund
is growing. Over time, this program may not require
appropriations. The current appropriation is $24.972 million.
______

By Mr. KERRY (for himself and Mr. Kennedy):
S. 556. A bill to amend the Trade Act of 1974 to improve the
provisions of trade readjustment allowances during breaks in training,
and for other purposes; to the Committee on Finance.

trade adjustment assistance improvement act

Mr. KERRY. Mr. President, last October I received a letter from a
Mrs. Myra Hoey of Blandford, MA. Mrs. Hoey detailed a problem that her
husband, David, was having with the Trade Adjustment Assistance program
which oversees the benefits provided to workers displaced by the North
American Free-Trade Agreement. David Hoey was an employee at the
Westfield River Paper Co. in Massachusetts. Along with over 100 other
employees, David lost his job when the paper company moved to Canada
after Congress approved NAFTA.
When we passed NAFTA in 1993, we recognized the importance of
assisting those working families, like the Hoeys, who might be
displaced by this agreement in obtaining gainful employment in another
field through the Trade Adjustment Assistance Program. For many years
the Trade Adjustment Assistance Program has been very helpful to the
citizens of this Nation by helping them to seize an opportunity for a
second chance--for another career or further education. However, Mr.
President, occasionally some Federal guidelines fall behind the times
and need to be adjusted in order to continue to be effective. Mrs. Hoey
and the other workers in Westfield, MA, discovered--the hard way--that
the Trade Adjustment Assistance Program has problems that need to be
fixed.
Workers displaced because of import-related movement of companies are
eligible for trade adjustment assistance [TAA]. Workers displaced
specifically because of NAFTA related movement are eligible for trade
readjustment allowances [TRA]. TAA and TRA provide 52 weeks of
unemployment insurance-like payments to these workers and pay for
approved training programs to train these workers.
Because their employer moved to Canada, the Westfield River Paper Co.
employees were eligible for TRA, and a number of them began a
retraining program at Springfield Technical Community College during
the fall of last year. These workers dedicated themselves to the task
of learning new skills so that they could support their families.
However, during Christmas
[[Page S3903]] break from their training, these hard-working former
employees found out that their benefits were cut off for a full month.
This is because the law that created TAA includes a provision that
limits TAA and TRA payments during scheduled breaks in training to the
first 14 days of these breaks.
Consequently, those workers who are out of work and are training for
new jobs and who are enrolled in programs with 6-week winter breaks
lose a month of benefits, even though they are willingly participating
in good faith in a training program and have no other source of income.
The missed weeks of benefits are tacked on to the end of the displaced
workers' benefit year so that a total of 52 weeks of TRA is still
provided.
The motivation behind this provision is to encourage workers to chose
training
programs with shorter breaks so that the workers will be moved into
the workforce with greater speed. In addition, workers are implicitly
encouraged to select programs that train them quickly because benefits
only last 1 year.

However, not all workers have a plethora of programs from which to
choose. Some are limited to only those programs offered by their local
community college. Most colleges and universities have winter breaks
longer than what is allowed by TRA, and as a result, benefits are
temporarily suspended to those people enrolled in this program at those
colleges.
Extending to 45 calendar days the period of a break in training
through which TAA and TRA benefits can be paid would be helpful to
displaced workers. It would be very nearly cost-neutral, because no
additional weeks of benefits would be provided, and it would eliminate
inequities in the existing system. And at the risk of redundancy,
workers would still be encouraged to choose programs with smaller
breaks, because the total amount of time that they will receive
benefits will still be only a year. Finally, a 45 calendar day training
break limitation would encourage workers to engage in summer programs
if their period of retraining overlaps summer recess.
The bill I am introducing today, the Trade Adjustment Assistance
Program Improvement Act, provides this increase in the training break
during which benefits may continue to be paid. It also would clear up
another problem as well, one that touches only on TRA's. I welcome my
distinguished senior colleague from Massachusetts, Senator Kennedy, as
an original cosponsor.
In order to qualify for a TRA, the law currently requires a displaced
worker to enroll in training by the end of the 16th week after his or
her initial unemployment compensation benefit period. the rationale for
the time limit is that adjustment assistance is generally more
effective if adjustment decisions are made relatively early in the
unemployment period. However, the current language creates some
inequities because the initial benefit period is triggered by initial
lay offs and continues to run even if a worker is recalled.
For example, if a worker is recalled 4 weeks after an initial layoff,
then is laid off a second time after 12 weeks of employment, that
worker would not qualify for TRA even if the worker immediately
enrolled in training because the 16 weeks of his initial benefit period
would have expired.
It makes a lot more sense to allow the worker 16 weeks from his or
her most recent separation in order to determine whether retraining is
needed. This would provide the worker an opportunity to conduct a job
search and to explore other options before making an enrollment
decision, while at the same time encouraging the person to make a
decision at a point early enough to promote effective adjustment.
Therefore, this bill takes into account situations involving recalls
and would require that in order to qualify for TRA, a worker must
enroll in training by the end of the 16th week after his or her most
recent separation from the impacted firm.
These two changes, one to both TAA and TRA, and one only to TRA,
would improve the entire TAA system in small but tangible ways, and at
slight additional cost enable these programs more effectively to help
the people they were designed to aid. People like David and Myra Hoey,
and other workers in Michigan, Tennessee, Washington, Pennsylvania, and
around the Nation will get the assistance they need to get back on
their feet and into the work force.
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. 556

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 ``Trade Adjustment Assistance
program Improvement act of 1995''.

SEC. 2. PROVISION OF TRADE READJUSTMENT ALLOWANCES DURING
BREAKS IN TRAINING.

Section 233(f) of the Trade Act of 1974 (19 U.S.C. 2293(f))
is amended by striking ``14 days'' and inserting ``45 days''.

SEC. 3. TRANSITIONAL ADJUSTMENT ASSISTANCE PROGRAM.

(a) In General.--Section 250(d)(3)(B)(i) of the Trade Act
of 1974 (19 U.S.C. 2331(d)(3)(B)(i)) is amended by striking
``of such worker's initial unemployment compensation benefit
period'' and inserting ``after such worker's most recent
qualifying separation''.
(b) Effective Date.--The amendment made by subsection (a)
shall apply with respect to workers covered under a
certification issued on or after the date of enactment of
this Act.

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