[Congressional Record Volume 141, Number 55 (Friday, March 24, 1995)]
[Senate]
[Pages S4574-S4585]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. BRADLEY (for himself and Mr. Lautenberg):
  S. 611. A bill to authorize extension of time limitation for a FERC-
issued hydroelectric license; to the Committee on Energy and Natural 
Resources.


            ferc-issued license authorization extension act

 Mr. BRADLEY. Mr. President, I introduce legislation which 
would allow the Federal Energy Regulatory Commission to extend a 
license already granted to the Mount Hope pumped storage project. It is 
my understanding that the FERC has no objection to this extension and 
that the agency itself would grant the extension, if it were not 
statutorily prohibited from doing so.
  I am very pleased to have Senator Lautenberg as a cosponsor on this 
legislation.
  The Mt. Hope project is an advanced pumped-storage hydroelectric 
plant. It will be constructed on an existing industrial site that has 
been active for almost 300 years. It will be largely underground, once 
it is established, and should have a very limited environmental impact.
  This project will cost $1.8 billion to construct and will be financed 
entirely by the private sector. It is estimated that this single 
project will create up to 1,300 jobs during construction and provide 
about $20 million annually in property taxes.
  Mr. President, the project's existing license will expire in August, 
1996. When the license was originally requested and granted in the 
early 1990's, the sponsors presumed that the financing would be 
complete and construction underway by 1996, as required. Unfortunately, 
the extended economic recession intervened. Because of the general 
economic climate and the difficulty of financing any project of this 
magnitude, the start-up date has slipped.
  Normally, I am very hesitant to intervene in any way in a regulatory 
process. However, since I understand that the FERC has no objections 
and will support this extension, I am willing to move ahead. I also 
understand that the Congressman representing this district, Rodney 
Frelinghuysen, is preparing companion legislation.
  When the FERC granted the original license, they required public 
hearings and an extensive environmental analysis. While I understand 
that there is substantial local support for this project, this 
legislation will now be the subject of additional hearings. Before 
agreeing to move the legislation in the Senate, I will weigh carefully 
any new comments or concerns about the project and I will be contacting 
local community members to gauge the level of their enthusiasm and 
support.
  Mr. President, I ask unanimous consent to have the text of the bill 
printed following these remarks.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:
                                 S. 611

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled, That 
     notwithstanding the time limitation of section 13 of the 
     Federal Power Act, the Federal Energy Regulatory Commission, 
     upon the request of the licensee for FERC Project No. 9401 is 
     authorized, in accordance with the good faith, due diligence, 
     and public interest requirements of section 13 and the 
     Commission's procedures under such section, to extend until 
     August 3, 1999, the time required for the licensee to 
     commence the construction of such project. This section shall 
     take effect for the project upon the expiration of the 
     extension (issued by the Commission under section 13) of the 
     period required for commencement of construction of such 
     project.
                                 ______

      By Mr. ROCKEFELLER (for himself, Mr. Daschle, Mr. Graham, and Mr. 
        Murkowski):
  S. 612. A bill to amend title 38, United States Code, to provide for 
a hospice care pilot program for the Department of Veterans Affairs; to 
the Committee on Veterans' Affairs.


                  veterans' hospice care services act

 Mr. ROCKEFELLER. Mr. President, in the spirit of strengthening 
our commitment to provide a comprehensive package of health care 
benefits to veterans eligible for care in the VA health care system, I 
am today introducing a bill that would require VA to conduct a hospice 
care pilot program to determine how best to provide hospice care 
services to terminally ill veterans. I am proud that Senators Daschle, 
Graham, and Murkowski have joined with me as original cosponsors. As 
the number of veterans who are elderly or have terminal illnesses 
continues to grow, the need and demand for VA hospice care is likely to 
increase. We must stay ahead of the surge and explore the various ways 
to provide such care, so our veterans and their families will have the 
best choices available to them.
  Our legislation is derived from S. 1141, which I sponsored and which 
was incorporated into the committee bill, S. 1030, of the 103d 
Congress. Though S. 1030 passed the Senate, it did not pass the House. 
The bill also builds upon S. 1358 of the 102d Congress which Senator 
Graham introduced on June 24, 1991, and the Senate passed on October 
16, 1991.
  Although VA has expanded and improved hospice care services over the 
past 4 years, it continues to fall short of the goals we envisioned. 
Thus we feel compelled to introduce the Veterans' Hospice Care Services 
Act of 1995.


                         summary of provisions

  Mr. President, this legislation would expand comprehensive VA hospice 
care programs and promote VA research on hospice care. The bill would 
amend chapter 17 of title 38 to establish a new subchapter VII, the 
provisions of which would:
  First, require VA, during the period beginning on October 1, 1995, 
and ending on December 31, 2000, to conduct a pilot program in order to 
assess the desirability of furnishing hospice care services to 
terminally ill veterans, and determine the most effective and efficient 
means of furnishing such services.
  Second, require VA to furnish hospice care services under the pilot 
program to any veteran who has a life expectancy of 1 year or less, as 
certified by a VA physician and who is entitled to VA hospital care, 
eligible for and receiving VA hospital or nursing home care, eligible 
for and receiving care in a community nursing home under a VA contract, 
or eligible for and receiving care in a State veterans home for which 
VA is making per diem payments to offset the costs of that care.
  Third, specify that the hospice care services that VA must provide to 
veterans under the pilot program are: The services to which Medicare 
beneficiaries are entitled under the Medicare's hospice care benefit, 
and personal care services, including care or services relating to 
activities of daily living, such as dressing, personal hygiene, 
feeding, and housekeeping.
  [[Page S4575]] Fourth, require the Secretary to establish hospice 
care demonstration projects that would provide these services at not 
fewer than 15 but mote than 30 VA medical centers [VAMC's] by one of 
these means: A hospice operated by a VAMC, a non VA hospice under 
contract with a VAMC and pursuant to which the VA facility furnishes 
any necessary inpatient services, or a non-VA facility furnishes any 
necessary inpatient services.
  Fifth, require that each of the three means for furnishing hospice 
care services be used at not fewer than five VAMC's.
  Sixth, require the Secretary to ensure, to the maximum extent 
feasible, that VAMC's selected to conduct demonstration projects under 
the pilot program include facilities that: Are located in urban areas 
and rural areas, encompass the full range of affiliations between 
VAMC's and medical schools, operate and maintain various numbers of 
beds, and meet any additional criteria or standards that the Secretary 
may deem relevant or necessary.
  Seventh, provide that the amount paid by VA or a non-VA hospice under 
a hospice care services contract generally may not exceed the amount 
that would be paid to that hospice under the Medicare hospice benefit, 
and authorize the Secretary to pay an amount in excess of the Medicare 
reimbursement rate, if the Secretary determines, on a case-by-case 
basis, that the Medicare rate would not adequate compensate the hospice 
for the costs associated with furnishing necessary care to a terminally 
ill veteran.
  Eighth, require the Secretary to designate not fewer than 10 VAMC's 
that would function as a control group and furnish a less comprehensive 
range of hospice care services to terminally ill veterans that the 
range that VAMC's participating in the pilot program must provide, by 
VA personal providing one or more hospice care services to veterans at 
a VAMC, or VA personal monitoring the furnishing by non-VA provider of 
one or more hospice care services to veterans.
  Ninth, require the Secretary to ensure, to the maximum extent 
practicable, that terminally ill veterans receive information regarding 
their eligibility, if any, for Medicare's hospice care benefit.
  Tenth, require the Secretary, not later than September 30, 1996, and 
on an annual basis thereafter, until October 1, 2001, to submit 
periodic written reports to the House and Senate Committee on Veterans' 
Affairs about the pilot program.
  Eleventh, require the Under Secretary for Health, not later than 
August 1, 1999, to submit to the House and Senate Committees on 
Veterans' Affairs a detailed final report on the pilot program, 
including an assessment of the desirability of furnishing hospice care 
services to terminally ill veterans, an assessment of the optimal means 
of furnishing hospice care services to terminally ill veterans, and his 
recommendations, if any, for additional legislation regarding such 
care.
  Twelth, clarify that the pilot program would not preclude VA from 
furnishing hospice care services at VAMC's not participating in the 
pilot program or the control group.


                               background

  Clearly, terminally ill veterans need an alternative to customary, 
curative care, and the Department of Veterans Affairs has made steady 
progress in meeting the demand.
  However, VA headquarters officials have given only general guidance 
to VAMC's regarding the types of hospice care services they must 
provide and the manner in which they must provide them. Not 
surprisingly, significant variations exist in the manner in which 
VAMC's provide these services. Only 39 of 171 VAMC's operate their own 
hospice units. These units are freestanding buildings or separate units 
where a homelike atmosphere is created. Other VAMC's provide hospice in 
units that are converted patient rooms where cure-oriented care is 
administered adjacent to the hospice rooms. Still other VAMC's only 
provide some hospice services such as caregiver counseling and pain 
management. Many offer only an assessment of a terminally ill veterans' 
needs and referral to a non-VA hospice.
  Neither uniformity nor marked variation in the provision of VA 
hospice care may be the answer. Each local area may need to tailor its 
programs and services to the unique needs of the veterans they serve, 
as well as the delivery modalities in their areas.
  Yet I continue to believe that there are important questions that 
need to be asked and answered about the ways to provide such care. For 
example, some claim that we can best meet terminally ill veterans' 
needs by integrating hospice concepts into mainstream care for 
terminally ill persons. Others believe that because most VAMC's are 
affiliated with medical schools that emphasize technology-intensive, 
curative interventions, veterans would be better served if VA 
contracted with community hospice providers. There may not be only one 
correct approach, and that is fine. But I do know that we must address 
these difficult questions if we truly care about meeting terminally ill 
veterans' needs.
  The pilot program this legislation envisions could be of great help 
in assessing these concerns. The bill calls for VA to establish hospice 
demonstration projects at 15 to 30 VAMC's that will provide a 
comprehensive range of hospice care services. Ten other VAMC's will 
constitute a control group and offer a less comprehensive range of 
hospice services. In essence, an experiment will be set up, whereby 
consistent data can be generated and valuable information extrapolated. 
This study will help health care providers identify veterans most 
likely to benefit from that program and tailor the program's services 
to meet their needs.
  This year's bill, like S. 1030 of the 103d Congress, contains a 
provision that explicitly states that VA can continue to provide 
hospice care services at any VAMC, which would guarantee that no 
veteran will lose access to hospice care as a result of the pilot 
program. We certainly do not want VA to eliminate its existing hospice 
programs. Rather, we seek to ensure that VA studies and learns from 
them.
                               conclusion
  Mr. President, many terminally ill veterans do not want to spend 
their last days in a hospital environment receiving high technology, 
curative care. These veterans, who have served our country with honor 
and dignity, choose a different type of environment, one where pain 
management and emotional support are the focus. They are veterans like 
Tom, a West Virginian whose plight the committee learned of in 1991. 
The executive director of the Hospice of Huntington, WV, Charlene 
Farrell, told the committee that while Tom was in the hospital, 
suffering from cancer, this depressed veteran asked that the drapes be 
closed so he could sit in darkness. Eventually, his daughters decided 
to use their modest resources to purchase hospice care from a non-VA 
provider, because their father longed for the type of care and support 
that a hospital simply cannot offer. We owe veterans like Tom nothing 
less than the best hospice care our Nation can provide. The Veterans 
Hospice Care Services Act of 1995 will help us meet our obligation to 
these brave men and women.
  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. 612
       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 ``Veterans' Hospice Care 
     Services Act of 1995''.

     SEC. 2. PROGRAMS FOR FURNISHING HOSPICE CARE TO VETERANS.

       (a) Establishment of Programs.--Chapter 17 of title 38, 
     United States Code, is amended by adding at the end the 
     following:


  ``subchapter vii--hospice care pilot program; hospice care services

     ``Sec. 1761. Definitions

       ``For the purposes of this subchapter--
       ``(1) The term `terminally ill veteran' means any veteran--
       ``(A) who is (i) entitled to receive hospital care in a 
     medical facility of the Department under section 1710(a)(1) 
     of this title, (ii) eligible for hospital or nursing home 
     care in such a facility and receiving such care, (iii) 
     receiving care in a State home facility for which care the 
     Secretary is paying per diem under section 1741 of this 
     title, or (iv) transferred to a non-Department nursing home 
     for nursing home care under section 1720 of this title and 
     receiving such care; and
     [[Page S4576]]   ``(B) who has a medical prognosis (as 
     certified by a Department physician) of a life expectancy of 
     six months or less.
       ``(2) The term `hospice care services' means--
       ``(A) the care, items, and services referred to in 
     subparagraphs (A) through (H) of section 1861(dd)(1) of the 
     Social Security Act (42 U.S.C. 1395x(dd)(1)); and
       ``(B) personal care services.
       ``(3) The term `hospice program' means any program that 
     satisfies the requirements of section 1861(dd)(2) of the 
     Social Security Act (42 U.S.C. 1395x(dd)(2)).
       ``(4) The term `medical facility of the Department' means a 
     facility referred to in section 1701(4)(A) of this title.
       ``(5) The term `non-Department facility' means a facility 
     (other than a medical facility of the Department) at which 
     care to terminally ill veterans is furnished, regardless of 
     whether such care is furnished pursuant to a contract, 
     agreement, or other arrangement referred to in section 
     1762(b)(1)(D) of this title.
       ``(6) The term `personal care services' means any care or 
     service furnished to a person that is necessary to maintain a 
     person's health and safety within the home or nursing home of 
     the person, including care or services related to dressing 
     and personal hygiene, feeding and nutrition, and 
     environmental support.
     ``Sec. 1762. Hospice care: pilot program requirements

       ``(a)(1) During the period beginning on October 1, 1995, 
     and ending on December 31, 2000, the Secretary shall conduct 
     a pilot program in order--
       ``(A) to assess the desirability of furnishing hospice care 
     services to terminally ill veterans; and
       ``(B) to determine the most effective and efficient means 
     of furnishing such services to such veterans.
       ``(2) The Secretary shall conduct the pilot program in 
     accordance with this section.
       ``(b)(1) Under the pilot program, the Secretary shall--
       ``(A) designate not less than 15 nor more than 30 medical 
     facilities of the Department at or through which to conduct 
     hospice care services demonstration projects;
       ``(B) designate the means by which hospice care services 
     shall be provided to terminally ill veterans under each 
     demonstration project pursuant to subsection (c);
       ``(C) allocate such personnel and other resources of the 
     Department as the Secretary considers necessary to ensure 
     that services are provided to terminally ill veterans by the 
     designated means under each demonstration project; and
       ``(D) enter into any contract, agreement, or other 
     arrangement that the Secretary considers necessary to ensure 
     the provision of such services by the designated means under 
     each such project.
       ``(2) In carrying out the responsibilities referred to in 
     paragraph (1) the Secretary shall take into account the need 
     to provide for and conduct the demonstration projects so as 
     to provide the Secretary with such information as is 
     necessary for the Secretary to evaluate and assess the 
     furnishing of hospice care services to terminally ill 
     veterans by a variety of means and in a variety of 
     circumstances.
       ``(3) In carrying out the requirement described in 
     paragraph (2), the Secretary shall, to the maximum extent 
     feasible, ensure that--
       ``(A) the medical facilities of the Department selected to 
     conduct demonstration projects under the pilot program 
     include facilities located in urban areas of the United 
     States and rural areas of the United States;
       ``(B) the full range of affiliations between medical 
     facilities of the Department and medical schools is 
     represented by the facilities selected to conduct 
     demonstration projects under the pilot program, including no 
     affiliation, minimal affiliation, and extensive affiliation;
       ``(C) such facilities vary in the number of beds that they 
     operate and maintain; and
       ``(D) the demonstration projects are located or conducted 
     in accordance with any other criteria or standards that the 
     Secretary considers relevant or necessary to furnish and to 
     evaluate and assess fully the furnishing of hospice care 
     services to terminally ill veterans.
       ``(c)(1) Subject to paragraph (2), hospice care to 
     terminally ill veterans shall be furnished under a 
     demonstration project by one or more of the following means 
     designated by the Secretary:
       ``(A) By the personnel of a medical facility of the 
     Department providing hospice care services pursuant to a 
     hospice program established by the Secretary at that 
     facility.
       ``(B) By a hospice program providing hospice care services 
     under a contract with that program and pursuant to which 
     contract any necessary inpatient services are provided at a 
     medical facility of the Department.
       ``(C) By a hospice program providing hospice care services 
     under a contract with that program and pursuant to which 
     contract any necessary inpatient services are provided at a 
     non-Department medical facility.
       ``(2)(A) The Secretary shall provide that--
       ``(i) care is furnished by the means described in paragraph 
     (1)(A) at not less than five medical facilities of the 
     Department; and
       ``(ii) care is furnished by the means described in 
     subparagraphs (B) and (C) of paragraph (1) in connection with 
     not less than five such facilities for each such means.
       ``(B) The Secretary shall provide in any contract under 
     subparagraph (B) or (C) of paragraph (1) that inpatient care 
     may be provided to terminally ill veterans at a medical 
     facility other than that designated in the contract if the 
     provision of such care at such other facility is necessary 
     under the circumstances.
       ``(d)(1) Except as provided in paragraph (2), the amount 
     paid to a hospice program for care furnished pursuant to 
     subparagraph (B) or (C) of subsection (c)(1) may not exceed 
     the amount that would be paid to that program for such care 
     under section 1814(i) of the Social Security Act (42 U.S.C. 
     1395f(i)) if such care were hospice care for which payment 
     would be made under part A of title XVIII of such Act.
       ``(2) The Secretary may pay an amount in excess of the 
     amount referred to in paragraph (1) (or furnish services 
     whose value, together with any payment by the Secretary, 
     exceeds such amount) to a hospice program for furnishing care 
     to a terminally ill veteran pursuant to subparagraph (B) or 
     (C) of subsection (c)(1) if the Secretary determines, on a 
     case-by-case basis, that--
       ``(A) the furnishing of such care to the veteran is 
     necessary and appropriate; and
       ``(B) the amount that would be paid to that program under 
     section 1814(i) of the Social Security Act would not 
     compensate the program for the cost of furnishing such care.
     ``Sec. 1763. Care for terminally ill veterans

       ``(a) During the period referred to in section 1762(a)(1) 
     of this title, the Secretary shall designate not less than 10 
     medical facilities of the Department at which hospital care 
     is being furnished to terminally ill veterans in order to 
     furnish the care referred to in subsection (b)(1).
       ``(b)(1) Palliative care to terminally ill veterans shall 
     be furnished at the facilities referred to in subsection (a) 
     by one of the following means designated by the Secretary:
       ``(A) By personnel of the Department providing one or more 
     hospice care services to such veterans at or through medical 
     facilities of the Department.
       ``(B) By personnel of the Department monitoring the 
     furnishing of one or more of such services to such veterans 
     at or through non-Department facilities.
       ``(2) The Secretary shall furnish care by the means 
     referred to in each of subparagraphs (A) and (B) of paragraph 
     (1) at not less than five medical facilities designated under 
     subsection (a).

     ``Sec. 1764. Information relating to hospice care services

       ``The Secretary shall ensure to the extent practicable that 
     terminally ill veterans who have been informed of their 
     medical prognosis receive information relating to the 
     eligibility, if any, of such veterans for hospice care and 
     services under title XVIII of the Social Security Act (42 
     U.S.C. 1395 et seq.).

     ``Sec. 1765. Evaluation and reports

       ``(a) Not later than September 30, 1996, and on an annual 
     basis thereafter until October 1, 2001, the Secretary shall 
     submit a written report to the Committees on Veterans' 
     Affairs of the Senate and House of Representatives relating 
     to the conduct of the pilot program under section 1762 of 
     this title and the furnishing of hospice care services under 
     section 1763 of this title. Each report shall include the 
     following information:
       ``(1) The location of the sites of the demonstration 
     projects provided for under the pilot program.
       ``(2) The location of the medical facilities of the 
     Department at or through which hospice care services are 
     being furnished under section 1763 of this title.
       ``(3) The means by which care to terminally ill veterans is 
     being furnished under each such project and at or through 
     each such facility.
       ``(4) The number of veterans being furnished such care 
     under each such project and at or through each such facility.
       ``(5) An assessment by the Secretary of any difficulties in 
     furnishing such care and the actions taken to resolve such 
     difficulties.
       ``(b) Not later than August 1, 1999, the Secretary shall 
     submit to the committees referred to in subsection (a) a 
     report containing an evaluation and assessment by the Under 
     Secretary for Health of the hospice care pilot program under 
     section 1762 of this title and the furnishing of hospice care 
     services under section 1763 of this title. The report shall 
     contain such information (and shall be presented in such 
     form) as will enable the committees to evaluate fully the 
     desirability of furnishing hospice care services to 
     terminally ill veterans.
       ``(c) The report under subsection (b) shall include the 
     following:
       ``(1) A description and summary of the pilot program.
       ``(2) With respect to each demonstration project conducted 
     under the pilot program--
       ``(A) a description and summary of the project;
       ``(B) a description of the facility conducting the 
     demonstration project and a discussion of how such facility 
     was selected in accordance with the criteria set out in, or 
     prescribed by the Secretary pursuant to, subparagraphs (A) 
     through (D) of section 1762(b)(3) of this title;
       ``(C) the means by which hospice care services care are 
     being furnished to terminally ill veterans under the 
     demonstration project;
       ``(D) the personnel used to furnish such services under the 
     demonstration project;
     [[Page S4577]]   ``(E) a detailed factual analysis with 
     respect to the furnishing of such services, including (i) the 
     number of veterans being furnished such services, (ii) the 
     number, if any, of inpatient admissions for each veteran 
     being furnished such services and the length of stay for each 
     such admission, (iii) the number, if any, of outpatient 
     visits for each such veteran, and (iv) the number, if any, of 
     home-care visits provided to each such veteran;
       ``(F) the direct costs, if any, incurred by terminally ill 
     veterans, the members of the families of such veterans, and 
     other individuals in close relationships with such veterans 
     in connection with the participation of veterans in the 
     demonstration project;
       ``(G) the costs incurred by the Department in conducting 
     the demonstration project, including an analysis of the 
     costs, if any, of the demonstration project that are 
     attributable to (i) furnishing such services in facilities of 
     the Department, (ii) furnishing such services in non-
     Department facilities, and (iii) administering the furnishing 
     of such services; and
       ``(H) the unreimbursed costs, if any, incurred by any other 
     entity in furnishing services to terminally ill veterans 
     under the project pursuant to section 1762(c)(1)(C) of this 
     title.
       ``(3) An analysis of the level of the following persons' 
     satisfaction with the services furnished to terminally ill 
     veterans under each demonstration project:
       ``(A) Terminally ill veterans who receive such services, 
     members of the families of such veterans, and other 
     individuals in close relationships with such veterans.
       ``(B) Personnel of the Department responsible for 
     furnishing such services under the project.
       ``(C) Personnel of non-Department facilities responsible 
     for furnishing such services under the project.
       ``(4) A description and summary of the means of furnishing 
     hospice care services at or through each medical facility of 
     the Department designated under section 1763(a)(1) of this 
     title.
       ``(5) With respect to each such means, the information 
     referred to in paragraphs (2) and (3).
       ``(6) A comparative analysis by the Under Secretary for 
     Health of the services furnished to terminally ill veterans 
     under the various demonstration projects referred to in 
     section 1762 of this title and at or through the designated 
     facilities referred to in section 1763 of this title, with an 
     emphasis in such analysis on a comparison relating to--
       ``(A) the management of pain and health symptoms of 
     terminally ill veterans by such projects and facilities;
       ``(B) the number of inpatient admissions of such veterans 
     and the length of inpatient stays for such admissions under 
     such projects and facilities;
       ``(C) the number and type of medical procedures employed 
     with respect to such veterans by such projects and 
     facilities; and
       ``(D) the effectiveness of such projects and facilities in 
     providing care to such veterans at the homes of such veterans 
     or in nursing homes.
       ``(7) An assessment by the Under Secretary for Health of 
     the desirability of furnishing hospice care services by 
     various means to terminally ill veterans, including an 
     assessment by the Director of the optimal means of furnishing 
     such services to such veterans.
       ``(8) Any recommendations for additional legislation 
     regarding the furnishing of care to terminally ill veterans 
     that the Secretary considers appropriate.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by adding at the end the 
     following:

  ``subchapter vii--hospice care pilot program; hospice care services

``1761. Definitions.
``1762. Hospice care: pilot program requirements.
``1763. Care for terminally ill veterans.
``1764. Information relating to hospice care services.
``1765. Evaluation and reports.''.
       (c) Authority To Carry Out Other Hospice Care Programs.--
     The amendments made by subsection (a) may not be construed as 
     terminating the authority of the Secretary of Veterans 
     Affairs to provide hospice care services to terminally ill 
     veterans under any program in addition to the programs 
     required under the provisions added by such amendments.
       (d) Authorization of Appropriations.--Funds are authorized 
     to be appropriated for the Department of Veterans Affairs for 
     the purposes of carrying out the evaluation of the hospice 
     care pilot programs under section 1765 of title 38, United 
     States Code (as added by subsection (a)), as follows:
       (1) For fiscal year 1996, $1,200,000.
       (2) For fiscal year 1997, $2,500,000.
       (3) For fiscal year 1998, $2,200,000.
       (4) For fiscal year 1999, $100,000.
                                 ______

      By Mr. ROCKEFELLER (for himself, Mr. Graham, Mr. Akaka, Mr. 
        Dorgan, Mr. Murkowski, Mr. Jeffords, Mr. Daschle, Mr. Leahy, 
        Mrs. Murray, and Mr. Wellstone):
  S. 613. A bill to authorize the Secretary of Veterans Affairs to 
conduct pilot programs in order to evaluate the feasibility of 
participation of the Department of Veterans Affairs health care system 
in the health care systems of States that have enacted health care 
reform; to the Committee on Veterans' Affairs.


             va state health care reform pilot program act

 Mr. ROCKEFELLER. Mr. President, although the efforts of the 
last Congress to provide national health care reform failed, many 
States have already enacted reform legislation. These States have taken 
the first, important steps on the road to universal coverage. I applaud 
the efforts of these courageous legislators. They are giving their 
citizens health care security. These State plans provide Congress with 
the perfect opportunity to learn from their successes and to study the 
effects of reform on existing Federal medical programs, including the 
VA medical system.
  The VA medical system--the Nation's largest health care system--
cannot participate fully in health care reform efforts in specific 
States because current Federal law makes it impossible for VA 
facilities to do so. This deprives VA of the kinds of experiences and 
information it needs to thrive under national health care reform. If 
this situation continues, we will miss a valuable opportunity to study 
the effects of reform.
  At a February 9, 1994, Senate Committee on Veterans' Affairs' hearing 
on VA participation in State health care reform, then-Acting Deputy 
Under Secretary of Health, Elwood Headley, M.D., stated that as a 
public health care system, VA lacks experience in participating in a 
competitive environment.
  Mr. President, I believe VA will do well in a national plan under 
which costs are controlled and coverage is expanded for all Americans, 
because VA already operates within a fixed budget. VA must, however, 
have the opportunity to learn what kinds of changes are needed in the 
VA medical system as a whole.
  It is in the spirit of improving VA medical services for veterans 
that I am today introducing a bill that would require VA to conduct a 
pilot health care reform program. This VA State Health Care Reform 
Pilot Program would enable VA to participate in the health care reform 
programs of several States. I am delighted to be joined in sponsoring 
this bill by Committee members Bob Graham, Dan Akaka, Byron Dorgan, 
Frank Murkowski, and Jim Jeffords, and by Senators Tom Daschle, Patrick 
Leahy, Patty Murray, and Paul Wellstone.
  At the committee's February 9, 1994, hearing, John Bollinger, deputy 
executive director of the Paralyzed Veterans of America, testified that 
``the pilot programs will give VA in those states the opportunity to 
become a full participant in the health care system. It will also 
provide valuable experience to draw upon when the full VA system faces 
the same challenges in the context of national health care reform.'' I 
agree wholeheartedly.


                         summary of provisions

  Mr. President, this legislation would enable VA to evaluate the most 
appropriate means of participating in reformed State health care 
systems, providing invaluable information to help them prepare for 
national health care reform.
  This bill would give VA the authority to select up to five States 
with comprehensive health benefit plans in place, or where such plans 
are imminent, to participate in the pilot program for a period of 2 
years. The bill would authorize VA facilities in the selected States to 
offer free comprehensive care to all compensable service-connected 
veterans and to all veterans with incomes below the current levels that 
apply to inpatient care.
  The legislation would grant the Secretary authority to waive certain 
laws and regulations that could interfere with the ability of VA 
facilities to participate in State health care reform activities.
  This legislation would give VA medical center directors flexibility 
in allocating their resources, except with respect to regional 
programs, such as spinal cord injury services, post-traumatic stress 
disorder, blind rehabilitation, and substance abuse programs, which are 
funded from central office.
  The bill would give the head of the VA in selected States--the VA 
health system director--the authority to contract out for medical 
services without prior review from VA central office. 
[[Page S4578]] For other services, VA facilities within the State would 
have the authority to enter into contracts below $250,000 without prior 
review by central office. Contracts above $250,000 would be reviewed by 
central office, but would automatically be approved if central office 
did not make a decision within 30 days. This would give local VA 
facilities the autonomy they need to increase their number of providers 
in a timely manner.
  This bill would also give local VA facilities more flexibility in the 
hiring process, by extending authority that is currently available for 
hiring certain title 38 personnel to the hiring of all staff. This is 
intended to help VA facilities hire the best possible employees in a 
timely manner.
  The bill would exempt VA facilities in the pilot program from FTE 
cuts. Arbitrary FTE cuts could make it impossible for VA facilities to 
compete under health care reform.
  The legislation would give the participating VA facilities the 
authority to carry over leftover funding from one year to the next. 
Again, this would help VA facilities make better use of limited funds.
  Finally, this legislation would give VA the authority to collect 
employer contributions and other third-party payments for noncore 
veterans who choose VA health care. These payments would enable VA 
facilities to provide care for all veterans who choose VA health care, 
not just core veterans.


                               conclusion

  Mr. President, VA needs legislative relief from restrictions in 
current law which, although enacted for good and appropriate reasons, 
could prevent VA facilities from competing as providers in certain 
States. The major obstacle which must be overcome is that VA facilities 
cannot qualify as providers under some state plans because of current 
eligibility requirements. Under various State proposals, all citizens 
would be eligible to choose a provider, and all providers must offer 
the same basic package of services. In most States, VA could not be 
considered a provider for several reasons, including the restrictions 
which limit preventive and primary care.
  Mr. President, the ``VA State Health Care Reform Pilot Program'' 
would provide VA with invaluable experience regarding how it needs to 
change in order to survive and thrive under health care reform. the 
``VA State Health Care Reform Pilot Program'' will help us meet our 
obligation to the brave men and women who served in every branch of the 
Armed Forces, by improving the VA medical system that serves them.
  Mr. President, one final note before closing. On Friday, March 17, 
1995, Secretary of Veterans Affairs Jesse Brown submitted to our 
committee notice of a plan to realign the field management of the 
Veterans Health Administration. Pursuant to section 510(b) of title 38, 
United States Code, this realignment cannot go into effect for 90 days 
of continuous session of Congress.
  Should there be no action of the Congress to modify the Secretary's 
proposed plan--and I know of no such proposed action at this point--VA 
will undertake a very significant realignment of the field management 
structure of VHA. I mention this possibility in the context of my 
introduction of this measure today, because it is likely that the 
proposed pilot authority would have to be modified in light of the 
realignment. Such changes in the legislation can be discussed later in 
the committee's consideration of the issue, at which time we will have 
a better sense of the outcome of the Secretary's proposed field 
realignment.
  Mr. President, I am looking forward to working with Senator Simpson 
and all the members of the Senate Committee on Veterans' Affairs, as 
well as with the chairman of the House Committee on Veterans' Affairs, 
Bob Stump, and chairman of the House Subcommittee on Hospitals and 
Health Care, Tim Hutchinson. This legislation was passed by the Senate 
in the last Congress, and I hope that we can move forward with it in 
this Congress.
  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. 613
       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 ``VA State Health Care Reform 
     Pilot Program Act''.

     SEC. 2. PURPOSE OF PILOT PROGRAMS.

       The purpose of this Act is to authorize the participation 
     of the Department of Veterans Affairs health care system in 
     the health care systems of States that have enacted health 
     care reform in order to evaluate the most appropriate means 
     of enabling the Department health care system to participate 
     in such systems and in the National health care system 
     contemplated under any plans for National health care reform.

     SEC. 3. HEALTH CARE PILOT PROGRAMS.

       (a) In General.--The Secretary may carry out pilot programs 
     on the participation of the Department of Veterans Affairs 
     health care system in the health care systems of States that 
     have adopted comprehensive health benefit plans. The 
     Secretary shall carry out any pilot program under this Act in 
     accordance with the provisions of this Act.
       (b) States Eligible for Designation.--(1) The Secretary 
     shall designate each of not more than five States as a 
     location for a pilot program under this Act. The Secretary 
     shall complete the designation of States as locations for 
     pilot programs not later than 30 days after the date of the 
     enactment of this Act.
       (2) The Secretary may designate a State as a location for a 
     pilot program under this Act if the Secretary determines 
     that--
       (A) the State has enacted, or will soon enact, a statute 
     establishing or providing for a comprehensive health benefit 
     plan; and
       (B) the participation of the health care system of the 
     Department under the plan is feasible and appropriate in 
     light of the purpose of this Act.
       (c) Department Participation in State Health Benefit 
     Plans--(1) To the maximum extent practicable, the Secretary 
     shall provide eligible persons under each pilot program under 
     this Act with the comprehensive package of basic health care 
     benefits that would otherwise be available to such persons 
     under the comprehensive health benefit plan of the State in 
     which the pilot program is carried out. The Secretary shall 
     provide such benefits through the health care system of the 
     Department in such State as if such system were a provider of 
     such benefits under such plan.
       (2) Notwithstanding any other provision of law, a State may 
     not prohibit the participation of the Department under the 
     comprehensive health benefit plan of the State under a pilot 
     program unless the chief executive officer of the State 
     certifies to the Secretary that--
       (A) the benefits to be provided by the Department under the 
     pilot program do not meet requirements for quality of 
     benefits established by or provided under the plan; or
       (B) the location of Department facilities (including 
     facilities providing services by contract or agreement with 
     the Secretary) in the State is such that the proximity of 
     eligible persons to such facilities does not meet 
     requirements so established for such proximity.
       (3) Not later than 30 days after the designation of a State 
     as a location for a pilot program under this Act, and at such 
     other times as the Secretary may determine, the Secretary and 
     the health system director for that State shall jointly 
     determine the regulations under the authority of the 
     Secretary the waiver or modification of which is necessary in 
     order to facilitate the carrying out of the pilot program. 
     Upon such determination, the Secretary shall waive or modify 
     the application of such regulations to the pilot program.
       (4) The Secretary shall furnish any eligible person living 
     in a State in which a pilot program is carried out (including 
     any eligible person electing to receive benefits under the 
     pilot program and any eligible person not electing to receive 
     benefits under the pilot program) with the health care 
     benefits for which such person is eligible under chapter 17 
     of title 38, United States Code, notwithstanding that the 
     comprehensive package of basic health care benefits provided 
     under the comprehensive health benefit plan of the State does 
     not otherwise include such health care benefits. The 
     Secretary shall furnish any health care benefits under this 
     paragraph in accordance with the provisions of that chapter.
       (5) The Secretary may not provide any health care benefit 
     under a pilot program under this Act that the Secretary is 
     not otherwise authorized to provide under the laws 
     administered by the Secretary.
       (d) Health System Director.--(1) The Secretary shall 
     designate a health system director for each State in which a 
     pilot program is carried out under this Act. To the maximum 
     extent feasible, the Secretary shall delegate to the health 
     system directors the responsibilities of the Secretary under 
     this Act.
       (2)(A) Subject to subparagraph (B), the Secretary shall 
     designate an individual as health system director for a State 
     from among nominees for that position selected by a panel 
     composed of individuals who are senior management personnel 
     of the Department medical centers located in that State.
       (B) An individual selected for nomination to be a health 
     system director of a State under subparagraph (A) shall be--
     [[Page S4579]]   (i) the director or chief of staff of a 
     Department medical center located in the State in which the 
     pilot program is carried out; or
       (ii) any other individual having experience with the 
     Department medical system that is equivalent to the 
     experience with that system of an individual in a position 
     referred to in clause (i).
       (e) Administrative Reorganization.--The Secretary may carry 
     out any administrative reorganization of an office, facility, 
     activity, or function of the health care system of the 
     Department in a State in which a pilot program is carried out 
     that the Secretary and the health system director jointly 
     determine to be necessary in order to facilitate the carrying 
     out of the pilot program. Section 510(b) of title 38, United 
     States Code, shall not apply to any such administrative 
     reorganization.
       (f) Provision of Benefits.--(1)(A) Except as provided in 
     subparagraph (B), the Secretary shall provide health care 
     benefits under a pilot program--
       (i) through the direct provision of such services by the 
     health care system of the Department in the State in which 
     the pilot program is carried out; or
       (ii) by contract or other agreement in accordance with 
     paragraph (2).
       (B) The Secretary may exclude facilities of the Department 
     from participation in a pilot program. Any facilities so 
     excluded shall continue to provide health care benefits to 
     veterans and other persons eligible for such benefits in 
     accordance with the provisions of laws administered by the 
     Secretary.
       (2) The health system director of a pilot program may enter 
     into contracts and agreements for the provision of health 
     care services and contracts and agreements for other services 
     with respect to the pilot program under paragraph (1)(A)(ii). 
     Any such contract or agreement (including any lease) shall 
     not be subject to the following provisions of law:
       (A) Section 8110(c) of title 38, United States Code, 
     relating to contracting of services at Department health-care 
     facilities.
       (B) Section 8122(a)(1) of such title, relating to the lease 
     of Department property.
       (C) Section 8125 of such title, relating to local contracts 
     for the procurement of health-care items.
       (D) Section 702 of title 5, United States Code, relating to 
     the right of review of agency wrongs by courts of the United 
     States.
       (E) Sections 1346(a)(2) and 1491 of title 28, United States 
     Code, relating to the jurisdiction of the district courts of 
     the United States and the United States Court of Federal 
     Claims, respectively, for the actions enumerated in such 
     sections.
       (F) Subchapter V of chapter 35 of title 31, United States 
     Code, relating to adjudication of protests of violations of 
     procurement statutes and regulations.
       (G) Sections 3526 and 3702 of such title, relating to the 
     settlement of accounts and claims, respectively, of the 
     United States.
       (H) Subsections (b)(7), (e), (f), (g), and (h) of section 8 
     of the Small Business Act (15 U.S.C. 637(b)(7), (e), (f), 
     (g), and (h)), relating to requirements with respect to small 
     businesses for contracts for property and services.
       (I) The provisions of law assembled for purposes of 
     codification of the United States Code as section 471 through 
     544 of title 40 that relate to the authority of the 
     Administrator of General Services over the lease and disposal 
     of Federal Government property.
       (J) The Office of Federal Procurement Policy Act (41 U.S.C. 
     401 et seq.), relating to the procurement of property and 
     services by the Federal Government.
       (K) Chapter 3 of the Federal Property and Administrative 
     Services Act of 1949 (41 U.S.C. 251 et seq.), relating to the 
     procurement of property and services by the Federal 
     Government.
       (L) Office of Management and Budget Circular A-76.
       (3)(A) Notwithstanding any other provision of law, 
     contracts and agreements for the provision of health care 
     services under this subsection may include contracts and 
     other agreements with insurers, health care providers, or 
     other individuals or entities that provide health care 
     services.
       (B) Contracts and agreements under this paragraph may be 
     entered into without prior review by the Central Office of 
     the Department.
       (4)(A) Contracts and agreements under this subsection for 
     services other than the services referred to in paragraph (3) 
     (including contracts and agreements for procurement of 
     equipment, maintenance and repair services, and other 
     services related to the provision of health care services) 
     shall not be subject to prior review by the Central Office if 
     the amount of such contracts or agreements is less than 
     $250,000.
       (B) Contracts and agreements for services under this 
     paragraph shall be subject to prior review by the Central 
     Office if the amount of such contracts or agreements is 
     $250,000 or greater. If the Central Office fails to approve 
     or reject a contract or agreement under this clause within 30 
     days of its submittal to the Central Office, such contract or 
     agreement shall be deemed approved by the Central Office.
       (g) Department Personnel.--(1) Notwithstanding any other 
     provision of law and to the extent necessary to carry out the 
     purpose of a pilot program, the Secretary may--
       (A) appoint personnel to positions in the health care 
     system of the Department in the State in which the pilot 
     program is carried out in accordance with such standards for 
     such positions as the Secretary may establish; and
       (B) promote and advance personnel serving in such positions 
     in accordance with such standards as the Secretary may 
     establish.
       (2) Not later than 60 days after the designation of a State 
     as a location for a pilot program under this Act, or at such 
     other time as the Secretary may determine, the Secretary 
     shall request authority from the Director of the Office of 
     Management and Budget to permit the Secretary to employ a 
     number of full time equivalent employees in the health care 
     system of the Department in that State which exceeds the 
     number of such employees that would otherwise be authorized 
     for such employment by the Director.
       (3) Notwithstanding any other provision of law, employees 
     of the Department at facilities of the Department under a 
     pilot program shall not, during the carrying out of the pilot 
     program, be subject to any reduction in the number of full 
     time employees of the Department or as a result of a 
     reduction in the number of full time employees of the Federal 
     Government.
       (h) Eligible Persons.--(1) A person eligible for health 
     care benefits under a pilot program is any person residing in 
     a State in which a pilot program is carried out as follows:
       (A) Any veteran.
       (B) Any spouse or child of a veteran.
       (C) Any individual eligible for care under paragraph (2) or 
     (3) of section 1713(a) of title 38, United States Code.
       (2) Notwithstanding any other provision of law, a State may 
     not require that any person other than a person referred to 
     in paragraph (1) be eligible for health care benefits through 
     the Department under a pilot program.
       (i) Copayments and Other Charges.--(1) Except as provided 
     in paragraph (2), the Secretary may collect from or on behalf 
     of any individual receiving health care benefits from the 
     Secretary under a pilot program under this Act a premium, 
     deductible, copayment, or other charge with respect to the 
     provision of a benefit under the pilot program. The amount of 
     the premium, deductible, copayment, or other charge collected 
     with respect to a benefit provided under a pilot program may 
     not exceed the maximum amount otherwise permitted for a 
     premium, deductible, copayment, or other charge with respect 
     to that benefit under the comprehensive health benefits plan 
     of the State in which the pilot program is carried out.
       (2)(A) Except as provided in subparagraph (B), the 
     Secretary shall not collect under the pilot programs 
     premiums, deductibles, copayments, and other charges with 
     respect to the benefits provided by the Department to the 
     following:
       (i) Veterans with compensable service-connected 
     disabilities.
       (ii) Veterans whose discharge or release from active 
     military, naval, or air service was for a compensable 
     disability that was incurred or aggravated in the line of 
     duty.
       (iii) Veterans who are in receipt of, or who, but for a 
     suspension pursuant to section 1151 of title 38, United 
     States Code (or both a suspension and the receipt of retired 
     pay), would be entitled to disability compensation, but only 
     to the extent that such veterans' continuing eligibility for 
     such care is provided for in the judgment or settlement 
     provided for in such section.
       (iv) Veterans who are former prisoners of war.
       (v) Veterans of the Mexican border period or of World War 
     I.
       (vi) Veterans who are unable to defray the expenses of 
     necessary care, as determined in accordance with section 
     1722(a) of such title.
       (B) The Secretary may collect premiums, deductibles, 
     copayments, and other charges with respect to benefits 
     provided under a pilot program to veterans referred to in 
     subparagraph (A) from any third party obligated to provide, 
     or to pay the expenses of, such benefits to or for such 
     veterans under the comprehensive health benefits plan of the 
     State in which the pilot program is carried out.
       (j) Funding.--(1) There is established in the Treasury a 
     fund to be known as the Department of Veterans Affairs Health 
     Care Reform Fund (hereafter referred to in this subsection as 
     the ``Fund'').
       (2)(A) Notwithstanding any other provision of law, amounts 
     shall be deposited in the Fund as follows:
       (i) Amounts collected under a pilot program in accordance 
     with subsection (i).
       (ii) Amounts made available to a pilot program based upon a 
     determination under paragraph (3).
       (iii) Amounts transferred to the Fund with respect to a 
     pilot program under paragraph (4).
       (iv) Such other amounts as the Secretary and the health 
     system directors of the pilot programs jointly determine to 
     be necessary in order to carry out the pilot programs.
       (v) Such other amounts as may be appropriated to the pilot 
     programs.
       (B) The Secretary shall make available amounts under 
     clauses (ii) and (iv) of subparagraph (A) from amounts 
     appropriated to the Department of Veterans Affairs for the 
     provision of health care services.
       (C) The Secretary shall establish and maintain a separate 
     account under the Fund for each pilot program carried out 
     under this Act. Any deposits and expenditures with respect to 
     a pilot program shall be made to or from the account 
     established and maintained with respect to that pilot 
     program.
       (3)(A) For each year of the operation of a pilot program 
     under this Act, the Secretary 
     [[Page S4580]] shall deposit in account of the Fund for the 
     pilot program an amount (as determined by the Secretary) 
     equal to the amount that would otherwise be made available to 
     the health care system of the Department in the State in 
     which the pilot program is carried out for the payment of the 
     cost of health care services by such system in that State in 
     that year. The Secretary shall deposit such amount at the 
     beginning of such year.
       (B) The costs referred to in subparagraph (A) shall not 
     include costs relating to the provision by the Secretary of 
     the following services:
       (i) Services relating to post-traumatic stress disorder.
       (ii) Services relating to spinal-cord dysfunction.
       (iii) Services relating to substance abuse.
       (iv) Services relating to the rehabilitation of blind 
     veterans.
       (v) Services relating to prosthetics.
       (4) Funds deposited in the Medical-Care Cost Recovery Fund 
     established under section 1729(g) of title 38, United States 
     Code, during any fiscal year in an amount in excess of the 
     Congressional Budget Office baseline (as of the date of the 
     enactment of this Act) for deposits in that fund for that 
     fiscal year shall not be subject to paragraph (4) of section 
     1710(f), 1712(f), or 1729(g) (as the case may be) of that 
     title, but shall be transferred to the fund established under 
     this subsection. Such transfer for any fiscal year shall be 
     made at any time that the total of amounts so received less 
     amounts estimated to cover the expenses, payments, and costs 
     described in paragraph (3) of section 1729(g) of that title 
     is in excess of the applicable Congressional Budget Office 
     baseline.
       (5)(A) Notwithstanding any other provision of law, the 
     health system director for a State in which a pilot program 
     is carried out shall determine the costs for which amounts in 
     the Fund may be expended in carrying out the pilot program.
       (B)(i) Except as provided in clause (ii), the costs of 
     carrying out a pilot program under this paragraph shall 
     include any costs of marketing and advertising under the 
     program, costs of legal services provided to such pilot 
     program by the General Counsel of the Department of Veterans 
     Affairs, and costs relating to acquisition (including 
     acquisition of land), construction, repair, or renovation of 
     facilities.
       (ii) Costs under this subparagraph shall not include any 
     costs relating to a major medical facility project or a major 
     medical facility lease as such terms are defined in 
     subparagraphs (A) and (B) of section 8104(a)(3) of title 38, 
     United States Code, respectively.
       (C) Amounts in the Fund for the payment of costs of a pilot 
     program under this subsection shall be available for such 
     purpose without fiscal year limitation.
       (k) Termination.--A pilot program carried out under this 
     Act shall terminate not later than 2 years after the date of 
     the commencement of provision of benefits under the pilot 
     program.

     SEC. 4. REPORTS ON PILOT PROGRAMS.

       (a) Collection of Information.--(1) The Secretary shall 
     collect such information with respect to the provision of 
     health care benefits under each pilot program as is necessary 
     to permit the Secretary to evaluate the pilot program in 
     light of the purpose of the pilot program under this Act.
       (2) The information collected by the Secretary under 
     paragraph (1) shall include aggregated data on the following:
       (A) The number of persons participating in each pilot 
     program, including the age, sex, health status, disability 
     ratings (if any), employment status, and incomes of such 
     persons.
       (B) The nature of benefits sought by such persons under 
     each pilot program.
       (C) The nature and quantity of benefits provided to such 
     persons under each pilot program.
       (D) The cost to the Department of providing such benefits 
     under each pilot program.
       (b) Reports.--(1) Not later than 14 months after the date 
     of the completion of the designation of States as locations 
     for pilot programs under this Act, the Secretary shall submit 
     to the Committees on Veterans' Affairs of the Senate and 
     House of Representatives a report on the progress of the 
     Secretary in carrying out the pilot programs. Such report 
     shall include the information referred to in subsection 
     (a)(2) on the date of the report.
       (2) Not later than November 30 of the year of the 
     termination of the final pilot program under this Act, the 
     Secretary shall submit to the committees referred to in 
     paragraph (1) a report on the pilot programs carried out 
     under this Act. The report shall include the following:
       (A) The information referred to in subsection (a)(2), 
     together with the comments and conclusions of the Secretary 
     with respect to such information.
       (B) An assessment by the Secretary of the utility of each 
     pilot program for carrying out the purpose of this Act.
       (C) An assessment by the Secretary of appropriate means of 
     integrating the health care system of the Department into the 
     health care systems of States that have enacted health care 
     reform and into the National health care system contemplated 
     under any plans for National health care reform.
       (D) Such other information, assessments, and conclusions as 
     the Secretary considers appropriate.

     SEC. 5. DEFINITIONS.

       For the purposes of this Act--
       (1) The terms ``Secretary'', ``Department'', ``veteran'', 
     ``child'' and ``spouse'' have the meanings given such terms 
     in paragraphs (1), (2), (4), and (31) of section 101 of title 
     38, United States Code, respectively.
       (2) The term ``comprehensive health benefit plan'', in the 
     case of a State, means a plan or system established under the 
     law of the State that--
       (A) attempts to ensure the access of residents of the State 
     to a comprehensive package of basic health care benefits; and
       (B) ensures such access by providing that such benefits 
     shall be provided directly or by contract by public and 
     private entities.
       (3) The term ``comprehensive package of basic health care 
     benefits'' means the health care benefits provided for by a 
     State under the comprehensive health benefit plan of the 
     State.
       (4) The term ``health care system of the Department'', in 
     the case of a State designated as a location for a pilot 
     program, means the facilities and personnel of the Department 
     located in that State that provide health care services under 
     chapter 17 of title 38, United States Code.
                                 ______

      By Mr. BINGAMAN (for himself and Mr. Domenici):
  S. 614. A bill to confer jurisdiction of the U.S. Court of Federal 
Claims with respect to land claims of Pueblo of Isleta Indian Tribe, 
and for other purposes; to the Committee on the Judiciary.


                    pueblo of isleta land claims act

  Mr. BINGAMAN. Mr. President, I rise today with my good friend and 
distinguished colleague, Senator Domenici, to reintroduce a bill on 
behalf of our constituents, the people of the Pueblo of Isleta in New 
Mexico. The Senate approved and passed an identical version of this 
measure in the previous Congress. Unfortunately, the House adjourned 
before its Members were able to take action on our bill, but a similar 
measure was approved by the House in the 102d Congress.
  The legislation we are introducing today will provide authority for 
New Mexico's Pueblo of Isleta to file an aboriginal land claim in the 
United States Court of Federal Claims under the Indian Claims Act. The 
bill does not pass judgment on the claim or give the Pueblo priority on 
the court's docket. If, however, the Pueblo of Isleta proves to the 
court that it does indeed have a valid claim of aboriginal land use and 
occupancy, then appropriate monetary compensation would be determined 
by the court.
  In April 1992, the House Judiciary Subcommittee on Administrative Law 
and Governmental Relations held a hearing on an early version of our 
bill. During that hearing, testimony made clear that the Pueblo of 
Isleta--like all the Pueblo Tribes in New Mexico--had standing to 
pursue land claims under the Indian Claims Act of 1946. Under the act, 
claims could be based either on title to the land or aboriginal use, 
but all claims must have been filed by 1951.
  Unfortunately, due to incomplete or improper advice from counsel, the 
Pueblo of Isleta filed only a limited claim based on a Spanish land 
grant, to which there was a written record, before the 1951 deadline. 
According to tribal leaders, their fore-fathers were not informed by 
counsel that they could file a claim based on aboriginal land use. 
Significantly, the Pueblo's counsel was a Bureau of Indian Affairs 
official who was later found by the court to have given erroneous 
advice on a similar matter to the Pueblo of Zuni. Like many other 
tribes, the Pueblos of Zuni and Isleta were completely dependent on the 
Bureau of Indian Affairs for advice and assistance regarding land 
claims during the 1940's and 1950's.
  Mr. President, this legislation would simply allow the Pueblo of 
Isleta to pursue a claim today, much like legislation Congress approved 
some years ago for the Pueblo of Zuni. Again, the bill does not give 
the Pueblo priority on the court's docket, and it does not pass 
judgement on the claim itself.
  The people of the Pueblo of Isleta are entitled to their day in 
court. This bill assures them of that right. I urge my colleagues to 
support its swift passage.
  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. 614

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,
     [[Page S4581]] SECTION 1. JURISDICTION.

       (a) In General.--Notwithstanding sections 2401 and 2501 of 
     title 28, United States Code, and section 12 of the Act of 
     August 13, 1946 (60 Stat. 1052, chapter 959), or any other 
     law that would interpose or support a defense of 
     untimeliness, jurisdiction is hereby conferred upon the 
     United States Court of Federal Claims to hear, determine, and 
     render judgment on any claim by the Pueblo of Isleta Indian 
     Tribe of New Mexico against the United States with respect to 
     any lands or interests therein in the State of New Mexico or 
     any adjoining State that were held by aboriginal title or 
     otherwise and that were acquired from the tribe without 
     payment of adequate compensation by the United States.
       (b) Interest.--As a matter of adequate compensation, the 
     United States Court of Federal Claims may award interest at a 
     rate of 5 percent per year to accrue from the date on which 
     such lands or interests therein were acquired from the tribe 
     by the United States.
       (c) Limitations.--Such jurisdiction is conferred only with 
     respect to claims accruing on or before August 13, 1946. All 
     such claims must be filed not later than 3 years after the 
     date of enactment of this Act.
       (d) Jurisdiction Is Not Dependent on Exhaustion.--Such 
     jurisdiction is conferred notwithstanding any failure of the 
     tribe to exhaust any available administrative remedy.

     SEC. 2. CERTAIN DEFENSES NOT APPLICABLE.

       Any award made to any Indian tribe other than the Pueblo of 
     Isleta Indian Tribe of New Mexico before, on, or after the 
     date of the enactment of this Act, under any judgment of the 
     Indian Claims Commission or any other authority, with respect 
     to any lands that are the subject of a claim submitted by the 
     tribe under section 1 shall not be considered a defense, 
     estoppel, or set-off to such claim, and shall not otherwise 
     affect the entitlement to, or amount of, any relief with 
     respect to such claim.
                                 ______

      By Mr. AKAKA (for himself and Mr. Craig):
  S. 615. A bill to amend title 38, United States Code, to require the 
Secretary of Veterans Affairs to furnish outpatient medical services 
for any disability of a former prisoner of war; to the Committee on 
Veterans' Affairs.


                  veterans outpatient health care act

  Mr. AKAKA. Mr. President, today I am introducing legislation that 
would ensure that all former prisoners of war [POW's] receive 
outpatient care provided by the Department of Veterans Affairs [VA]. 
Under current law, POW's with service-connected disabilities are 
entitled to outpatient medical services. However, POW's with less than 
30 percent disability may be provided outpatient services at the 
discretion of VA. This distinction is unfair to many POW's and fails to 
recognize the trauma and brutality of imprisonment endured by all 
former POW's. I am pleased to have Senators Craig, Rockefeller, and 
Campbell join me as original cosponsors of this measure.
  Mr. President, the need for this legislation is clear. All of 
America's POW's deserve to be treated equally. Americans would agree 
that those who served in defense of our Nation and were imprisoned by 
the enemy deserve special consideration.
  Some may feel this legislation is unnecessary because VA has been 
providing outpatient services to POW's. But, when times get tough and 
funding becomes tight, POW's without service-connected disabilities, or 
with a lower disability rating, may be denied outpatient care. This is 
exactly what happened in 1990. Due to budgetary reasons, two midwestern 
VA medical centers began denying outpatient services to former POW's. 
Fortunately, through congressional intervention, this policy was 
reversed and POW's continued to receive ambulatory care. Although we 
are facing a lean fiscal climate, accountants should not determine 
whether our POW's receive outpatient care.
  This bill only seeks to ensure that VA will continue to provide 
outpatient services at all times to POW's. As of January 1, 1995, there 
were only 62,676 former U.S. POW's, 94 percent of whom served in World 
War II. As we observe the 50th anniversary of the conclusion of World 
War II, this bill provides a fitting tribute to the sacrifices made by 
POW's on behalf of our country.
  Mr. President, I ask unanimous consent that the text of the bill and 
additional material be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                 S. 615

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

     SECTION 1. ELIGIBILITY OF FORMER PRISONERS OF WAR TO RECEIVE 
                   OUTPATIENT MEDICAL SERVICES FROM THE DEPARTMENT 
                   OF VETERANS AFFAIRS.

       Section 1712(a)(1) of title 38, United States Code, is 
     amended--
       (1) by striking out ``and'' at the end of subparagraph (C);
       (2) by striking out the period at the end of subparagraph 
     (D) and inserting in lieu thereof ``; and''; and
       (3) by adding at the end the following new subparagraph:
       ``(E) to any former prisoner of war for any disability.''.
                                                                    ____

                                     American Ex-Prisoners of War,


                                      National Capital Office,

                                   Washington, DC, March 22, 1995.
     Hon. Daniel K. Akaka,
     U.S. Senate,
     Washington, DC.
       Dear Senator Akaka: On behalf of our 33,000 members, I want 
     to thank you very warmly for introducing the bill to 
     guarantee outpatient care for ex-POWs.
       This bill, which was passed in 1992 by the Senate, means a 
     great deal to our members. Several years ago two VA Medical 
     Centers discontinued outpatient care to ex-POWs to save 
     money. Although outpatient care was restored to those 
     Centers, we never know when this may occur again.
       Senator Akaka, we consider you a good friend of the former 
     prisoners of war, and we are looking forward to working with 
     your colleagues to assure enactment by Congress.
       Again our sincere gratitude to you for introducing this 
     bill for us.
           Sincerely,
                                              Charles S. Prigmore,
                                               National Commander.

 Mr. CRAIG. Mr. President, I am pleased to be joining my 
colleague from Hawaii, Senator Akaka, in introducing legislation that 
will clarify veterans health services for ex-prisoners of war [ex-POW].
  This bill will amend title 38 of the United States Code, ensuring 
access to outpatient medical services for any disability of a former 
prisoner of war. Mr. President, these services are currently being 
provided in accordance with a directive from the Secretary of the 
Veterans Administration. This bill is necessary in order to secure, by 
law, access to these services by our veterans who have suffered as 
prisoners of war.
  The law currently covers inpatient medical services for ex-POWs. 
However, as medical care continues to convert into more outpatient 
care, we need to ensure that those who are in need of care can obtain 
it in the most cost-effective manner. In the long-term this should 
ensure that we continue to provide care in the most cost effective 
manner as more ailments are treated on an outpatient basis. In short, 
we will be better able to control costs and provide better delivery of 
care to those veterans who suffered at the hands of our enemies as 
prisoners of war.
  Mr. President, I would like to point out that bills similar to this 
one have previously passed the Senate. However, they have never 
completed the process leading to enactment. I hope that my colleagues 
will see the merit in this legislation and support it so that we can 
see it signed into law during this Congress.
                                 ______

      By Mr. BINGAMAN:
  S. 616. A bill to amend the Tariff Act of 1930 to provide parity 
between the United States and certain free-trade agreement countries 
with respect to the exemption for personal and household effects 
purchased abroad by returning residents, and for other purposes; to the 
Committee on Finance.


                           border tariffs act

  Mr. BINGAMAN. Mr. President, I rise today to offer a bill to correct 
an inequity that has developed along our border with Mexico with 
respect to tariffs on goods crossing the border.
  The United States currently permits duty-free entry of $400 of retail 
goods for personal consumption each month. There is a 10-percent duty 
on the next 1,000 dollars' worth of purchases brought into the United 
States. Mexico, by contrast, limits the amount of goods that can be 
imported for personal consumption to $50 per day. Goods above that 
amount have a duty of approximately 33 percent.
  Mr. President, this difference in policy obviously hampers trade 
along our borders. It is yet another burden on our border businesses, 
which are also currently struggling with the adverse effects of the 
peso crisis on the ability of Mexican citizens to purchase goods in the 
United States.
  Before introducing this legislation in the 103d Congress, I had hoped 
that this problem could be corrected administratively. I wrote to the 
Secretary of 
[[Page S4582]] State about this issue. With my fellow border Senators, 
I also contacted the Commissioner of Customs in our country and 
President Salinas in Mexico. All, ultimately, to no avail.
  I still believe that there are two tracks we can take to persuade the 
Government of Mexico to increase its duty-free limit, and I believe 
that we should pursue both of them. The first is to get our Government 
to negotiate with the Government of Mexico to equalize the duties. My 
good friend and colleague from Arizona, Senator DeConcini, who retired 
at the end of the 103d Congress, inserted language in the fiscal year 
1995 Commerce, State, Justice appropriations report that would direct 
the U.S. Trade Representative to make doing so a priority. It is my 
understanding that USTR officials have raised the issue in trade talks, 
but that the issue has yet to be resolved. Until it is resolved, I 
believe that we should pursue a second track, that of changing the 
exemption provided for in our tariff laws to match that of Mexico's. 
Together, these two actions can help ensure that retail businesses on 
both sides of the border are on the same footing.
  So, today, I rise to again offer legislation that would equalize the 
amount of personal retail goods that can cross the border duty-free in 
either direction. This legislation simply says that our duty will not 
be lower than Mexico's.
                                 ______

      By Mr. COATS (for himself and Mr. Lieberman):
  S. 618. A bill to provide a low-income school choice demonstration 
program; to the Committee on Labor and Human Resources.


                    school choice demonstration act

  Mr. COATS. Mr. President, I rise today, with my colleague from 
Connecticut, to introduce the School Choice Demonstration Act. This 
bill will establish 10 to 20 demonstration projects to study the 
effects of providing low-income parents and their children with 
financial assistance to enable them to select the public or private 
school of their choice.
  This is a very simple and straightforward bill--we want to enable 
low-income parents to choose the school their children attend. They can 
select a public or a private school, but the point is that they will be 
able to make a choice. Up until now, only those families who can afford 
to send their children to private schools have had that option. Senator 
Lieberman and I believe that all families should have the opportunity 
to choose where their children will be educated. For too long, we have 
asked everyone to pay for a particular type of education without 
ensuring that people have a say in what they receive for their money.
  American education has reached a critical point. Time has taught us 
that we cannot simply throw more and more money at the public schools, 
and rely on that to improve education. As many of you know, annual per 
pupil spending has tripled in the last 30 years, while student 
achievement has dropped dramatically, evidenced by a decrease in 
average SAT scores of almost 90 points. Clearly, more money is not the 
solution.
  We have to do something soon. In inner cities across America, almost 
half of all high school students fail to graduate. This is a chilling 
statistic. We should take it as a wake up call. Obviously, something is 
seriously wrong with our educational system. This bill proposes an 
option for some students who are not succeeding in the public education 
system.
  Our bill is simple. It says, let us allot a small amount of funds, so 
that 10 to 20 demonstration grants can be awarded to local districts 
around the country who are interested in offering increased educational 
opportunities to their students. The funds granted by this bill will 
provide assistance to children from the lowest-income homes. The 
children eligible under this program are those children who qualify for 
reduced or free school lunches. These funds will only go to low-income 
families. And they are to be used to pay for education costs at public 
or private schools. The parents choose which school their child will 
attend.
  We have incorporated a very strict civil rights and desegregation 
protection clause to make sure that participating schools can in no way 
discriminate on the basis of race. We also stipulate that demonstration 
projects cannot continue if they interfere with these desegregation 
plans.
  The cost of this program will be $30 million and there will be no 
more than 20 projects. School districts would voluntarily apply for the 
grants through the secretary of education, and we have established some 
criteria for the secretary to make the determination as to which 
districts would be included.
  This bill also requires that a nationwide evaluation of the 
demonstration program be conducted. Up until now, discussion concerning 
the actual effects of school choice policies has been limited by a lack 
of conclusive data. This bill addresses that need for objective data. 
An evaluation will give us a baseline
 from which to conduct our discussion at the Federal level.

  Many localities are already experimenting with some type of school 
choice. My home State of Indiana, for example, has several existing 
choice initiatives under way. One program, originated by Golden Rule 
Insurance, helps low-income children in Indianapolis attend the private 
school of their choice by awarding them scholarships to cover up to 
half of the tuition costs. There are currently 1,100 students being 
sponsored, and 650 kids are on the waiting list. Our public schools are 
also experimenting with choice. Indianapolis public schools, for 
example, has initiated the select schools program, by which parents can 
choose which IPS school their child will attend. Eighty-six percent of 
IPS parents participated in this program this year.
  I have spoken with educators in a district in Indiana who have 
already expressed an interest in the program. Some public school 
educators have met with private and parochial school educators and 
there is a real interest in testing the concept to see how it works, to 
work out the bugs, and to see if it would actually make a difference.
  None of you should have any reason to oppose this bill. It is not a 
mandate. It is a purely voluntary program for those local education 
associations who are interested in broadening the educational 
opportunities offered in their community. This bill provides a basis by 
which we in Congress can evaluate the validity of this particular 
concept. If it results in substantially new opportunities for low-
income children, then shouldn't such data be offered to school 
districts and education agencies across this country? Why would we not 
want to have this information available so we can make intelligent 
choices? After all, we are not here to protect a particular system. Our 
bottom line is to provide the best education opportunities to American 
children. For far too long, we have denied low-income families the 
educational choice that many others have.
  It is important to understand what this bill does not do. It does not 
force choice on anyone. This bill presents a purely voluntary program. 
It will not upset the American public education system. Ten to twenty 
voluntary choice programs throughout the country will not upset public 
education.
  Furthermore, Federal resources will not be drained from any public 
school or education system. The Secretary cannot reduce or deny funds 
that a public school would otherwise be eligible for, even though 
students in that school or school system opted out or numbers 
decreased. This bill does not violate civil rights protections. It does 
not destroy public education. In fact, I think it enhances public 
education.
  My home is Fort Wayne, IN. For decades our education system has 
thrived on competition. We have a vigorous Catholic school education 
system in Fort Wayne, IN. We have a Lutheran school system because of 
our heavy concentration of people of Lutheran belief. They have 
established their own system.
  These two systems exist, along with other private education 
opportunities, side by side with the public education system in Fort 
Wayne and they are all thriving. They are thriving because the parents 
and students of Fort Wayne have a choice. The competition between those 
three systems has caused each system to better their education program 
to compete with each other for the students, and they work hand in 
hand. Parents in Fort Wayne have opportunities which parents in many 
States and areas do not have.
  This bill says that it is time for low-income families to have the 
same 
[[Page S4583]] choice concerning their child's school that those who 
can afford to send their kids to private schools already have. Let's 
try this limited demonstration project and see if it improves the 
education of some of America's neediest children.
  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. 618
       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 ``Low-Income School Choice 
     Demonstration Act of 1995''.

     SEC. 2. PURPOSE.

       The purpose of this Act is to determine the effects on 
     students and schools of providing financial assistance to 
     low-income parents to enable such parents to select the 
     public or private schools their children will attend.

     SEC. 3. DEFINITIONS.

       As used in this Act--
       (1) the term ``choice school'' means any public or private 
     school, including a private sectarian school or a public 
     charter school, that is involved in a demonstration project 
     assisted under this Act;
       (2) the term ``eligible child'' means a child in grades 1 
     through 12 who is eligible for free or reduced price lunches 
     under the National School Lunch Act;
       (3) the term ``eligible entity'' means a public agency, 
     institution, or organization, such as a State, a State or 
     local educational agency, a consortium of public agencies, or 
     a consortium of public and private nonprofit organizations, 
     that can demonstrate, to the satisfaction of the Secretary, 
     its ability to--
       (A) receive, disburse, and account for Federal funds; and
       (B) carry out the activities described in its application 
     under this Act;
       (4) the term ``evaluating agency'' means any academic 
     institution, consortium of professionals, or private or 
     nonprofit organization, with demonstrated experience in 
     conducting evaluations, that is not an agency or 
     instrumentality of the Federal Government;
       (5) the term ``local educational agency'' has the same 
     meaning given such term in section 14101 of the Elementary 
     and Secondary Education Act of 1965;
       (6) the term ``parent'' includes a legal guardian or other 
     individual acting in loco parentis;
       (7) the term ``school'' means a school that provides 
     elementary education or secondary education (through grade 
     12), as determined under State law; and
       (8) the term ``Secretary'' means the Secretary of 
     Education.

     SEC. 4. AUTHORIZATION OF APPROPRIATIONS.

       There are authorized to be appropriated $30,000,000 for 
     fiscal year 1996, and such sums as may be necessary for each 
     of the fiscal years 1997 and 1998, to carry out this Act.

     SEC. 5. PROGRAM AUTHORIZED.

       (a) Reservation.--From the amount appropriated pursuant to 
     the authority of section 4 in any fiscal year, the Secretary 
     shall reserve and make available to the Comptroller General 
     of the United States 5 percent for evaluation of programs 
     assisted under this Act in accordance with section 11.
       (b) Grants.--
       (1) In general.--From the amount appropriated pursuant to 
     the authority of section 4 and not reserved under subsection 
     (a) for any fiscal year, the Secretary shall award grants to 
     eligible entities to enable such entities to carry out at 
     least 10, but not more than 20, demonstration projects under 
     which low-income parents receive education certificates for 
     the costs of enrolling their eligible children in a choice 
     school.
       (2) Amount.--The Secretary shall award grants under 
     paragraph (1) for fiscal year 1996 so that--
       (A) not more than 2 grants are awarded in amounts of 
     $5,000,000 or less; and
       (B) grants not described in subparagraph (A) are awarded in 
     amounts of $3,000,000 or less.
       (3) Continuing eligibility.--The Secretary shall continue a 
     demonstration project under this Act by awarding a grant 
     under paragraph (1) to an eligible entity that received such 
     a grant for a fiscal year preceding the fiscal year for which 
     the determination is made, if the Secretary determines that 
     such eligible entity was in compliance with this Act for such 
     preceding fiscal year.
       (c) Use of Grants.--Grants awarded under subsection (b) 
     shall be used to pay the costs of--
       (1) providing education certificates to low-income parents 
     to enable such parents to pay the tuition, the fees, the 
     allowable costs of transportation, if any, and the costs of 
     complying with section 9(a)(1), if any, for their eligible 
     children to attend a choice school; and
       (2) administration of the demonstration project, which 
     shall not exceed 15 percent of the amount received in the 
     first fiscal year for which the eligible entity provides 
     education certificates under this Act or 10 percent in any 
     subsequent year, including--
       (A) seeking the involvement of choice schools in the 
     demonstration project;
       (B) providing information about the demonstration project, 
     and the schools involved in the demonstration project, to 
     parents of eligible children;
       (C) making determinations of eligibility for participation 
     in the demonstration project for eligible children;
       (D) selecting students to participate in the demonstration 
     project;
       (E) determining the amount of, and issuing, education 
     certificates;
       (F) compiling and maintaining such financial and 
     programmatic records as the Secretary may prescribe; and
       (G) collecting such information about the effects of the 
     demonstration project as the evaluating agency may need to 
     conduct the evaluation described in section 11.
       (d) Special Rule.--Any school participating in the 
     demonstration program under this Act shall comply with title 
     VI of the Civil Rights Act of 1964 and not discriminate on 
     the basis of race, color, or national origin.

     SEC. 6. AUTHORIZED PROJECTS; PRIORITY.

       (a) Authorized Projects.--The Secretary may award a grant 
     under this Act only for a demonstration project that--
       (1) involves at least one local educational agency that--
       (A) receives funds under section 1124A of the Elementary 
     and Secondary Education Act of 1965; and
       (B) is among the 20 percent of local educational agencies 
     receiving funds under section 1124A of such Act in the State 
     and having the highest number of children described in 
     section 1124(c) of such Act; and
       (2) includes the involvement of a sufficient number of 
     public and private choice schools, in the judgment of the 
     Secretary, to allow for a valid demonstration project.
       (b) Priority.--In awarding grants under this Act, the 
     Secretary shall give priority to demonstration projects--
       (1) in which choice schools offer an enrollment opportunity 
     to the broadest range of eligible children;
       (2) that involve diverse types of choice schools; and
       (3) that will contribute to the geographic diversity of 
     demonstration projects assisted under this Act, including 
     awarding grants for demonstration projects in States that are 
     primarily rural and awarding grants for demonstration 
     projects in States that are primarily urban.

     SEC. 7. APPLICATIONS.

       (a) In General.--Any eligible entity that wishes to receive 
     a grant under this Act shall submit an application to the 
     Secretary at such time and in such manner as the Secretary 
     may prescribe.
       (b) Contents.--Each application described in subsection (a) 
     shall contain--
       (1) information demonstrating the eligibility for 
     participation in the demonstration program of the eligible 
     entity;
       (2) with respect to choice schools--
       (A) a description of the standards used by the eligible 
     entity to determine which public and private schools are 
     within a reasonable commuting distance of eligible children 
     and present a reasonable commuting cost for such eligible 
     children;
       (B) a description of the types of potential choice schools 
     that will be involved in the demonstration project;
       (C)(i) a description of the procedures used to encourage 
     public and private schools to be involved in the 
     demonstration project; and
       (ii) a description of how the eligible entity will annually 
     determine the number of spaces available for eligible 
     children in each choice school;
       (D) an assurance that each choice school will not impose 
     higher standards for admission or participation in its 
     programs and activities for eligible children provided 
     education certificates under this Act than the choice school 
     does for other children;
       (E) an assurance that each choice school operated, for at 
     least 1 year prior to accepting education certificates under 
     this Act, an educational program similar to the educational 
     program for which such choice school will accept such 
     education certificates;
       (F) an assurance that the eligible entity will terminate 
     the involvement of any choice school that fails to comply 
     with the conditions of its involvement in the demonstration 
     project; and
       (G) a description of the extent to which choice schools 
     will accept education certificates under this Act as full or 
     partial payment for tuition and fees;
       (3) with respect to the participation in the demonstration 
     project of eligible children--
       (A) a description of the procedures to be used to make a 
     determination of eligibility for participation in the 
     demonstration project for an eligible child, which shall 
     include--
       (i) the procedures used to determine eligibility for free 
     or reduced price lunches under the National School Lunch Act; 
     or
       (ii) any other procedure, subject to the Secretary's 
     approval, that accurately establishes the eligibility for 
     such participation for an eligible child;
       (B) a description of the procedures to be used to ensure 
     that, in selecting eligible children to participate in the 
     demonstration project, the eligible entity will--
       (i) apply the same criteria to both public and private 
     school eligible children; and
       (ii) give priority to eligible children from the lowest 
     income families;
       (C) a description of the procedures to be used to ensure 
     maximum choice of schools for participating eligible 
     children, including procedures to be used when--
     [[Page S4584]]   (i) the number of parents provided education 
     certificates under this Act who desire to enroll their 
     eligible children in a particular choice school exceeds the 
     number of eligible children that the choice school will 
     accept; and
       (ii) grant funds and funds from local sources are 
     insufficient to support the total cost of choices made by 
     parents with education certificates under this Act; and
       (D) a description of the procedures to be used to ensure 
     compliance with section 9(a)(1), which may include--
       (i) the direct provision of services by a local educational 
     agency; and
       (ii) arrangements made by a local educational agency with 
     other service providers;
       (4) with respect to the operation of the demonstration 
     project--
       (A) a description of the geographic area to be served;
       (B) a timetable for carrying out the demonstration project;
       (C) a description of the procedures to be used for the 
     issuance and redemption of education certificates under this 
     Act;
       (D) a description of the procedures by which a choice 
     school will make a pro rata refund of the education 
     certificate under this Act for any participating eligible 
     child who withdraws from the school for any reason, before 
     completing 75 percent of the school attendance period for 
     which the education certificate was issued;
       (E) a description of the procedures to be used to provide 
     the parental notification described in section 10;
       (F) an assurance that the eligible entity will place all 
     funds received under this Act into a separate account, and 
     that no other funds will be placed in such account;
       (G) an assurance that the eligible entity will provide the 
     Secretary periodic reports on the status of such funds;
       (H) an assurance that the eligible entity will cooperate 
     with the Comptroller General of the United States and the 
     evaluating agency in carrying out the evaluations described 
     in section 11; and
       (I) an assurance that the eligible entity will--
       (i) maintain such records as the Secretary may require; and
       (ii) comply with reasonable requests from the Secretary for 
     information; and
       (5) such other assurances and information as the Secretary 
     may require.

     SEC. 8. EDUCATION CERTIFICATES.

       (a) Education Certificates.--
       (1) Amount.--The amount of an eligible child's education 
     certificate under this Act shall be determined by the 
     eligible entity, but shall be an amount that provides to the 
     recipient of the education certificate the maximum degree of 
     choice in selecting the choice school the eligible child will 
     attend.
       (2) Considerations.--
       (A) In general.--Subject to such regulations as the 
     Secretary shall prescribe, in determining the amount of an 
     education certificate under this Act an eligible entity shall 
     consider--
       (i) the additional reasonable costs of transportation 
     directly attributable to the eligible child's participation 
     in the demonstration project; and
       (ii) the cost of complying with section 9(a)(1).
       (B) Schools charging tuition.--If an eligible child 
     participating in a demonstration project under this Act was 
     attending a public or private school that charged tuition for 
     the year preceding the first year of such participation, then 
     in determining the amount of an education certificate for 
     such eligible child under this Act the eligible entity shall 
     consider--
       (i) the tuition charged by such school for such eligible 
     child in such preceding year; and
       (ii) the amount of the education certificates under this 
     Act that are provided to other eligible children.
       (3) Special rule.--An eligible entity may provide an 
     education certificate under this Act to the parent of an 
     eligible child who chooses to attend a school that does not 
     charge tuition or fees, to pay the additional reasonable 
     costs of transportation directly attributable to the eligible 
     child's participation in the demonstration project or the 
     cost of complying with section 9(a)(1).
       (b) Adjustment.--The amount of the education certificate 
     for a fiscal year may be adjusted in the second and third 
     years of an eligible child's participation in a demonstration 
     project under this Act to reflect any increase or decrease in 
     the tuition, fees, or transportation costs directly 
     attributable to that eligible child's continued attendance at 
     a choice school, but shall not be increased for this purpose 
     by more than 10 percent of the amount of the education 
     certificate for the fiscal year preceding the fiscal year for 
     which the determination is made. The amount of the education 
     certificate may also be adjusted in any fiscal year to comply 
     with section 9(a)(1).
       (c) Maximum Amount.--Notwithstanding any other provision of 
     this section, the amount of an eligible child's education 
     certificate shall not exceed the per pupil expenditure for 
     elementary or secondary education, as appropriate, by the 
     local educational agency in which the public school to which 
     the eligible child would normally be assigned is located for 
     the fiscal year preceding the fiscal year for which the 
     determination is made.
       (d) Income.--An education certificate under this Act, and 
     funds provided under the education certificate, shall not be 
     treated as income of the parents for purposes of Federal tax 
     laws or for determining eligibility for any other Federal 
     program.

     SEC. 9. EFFECT ON OTHER PROGRAMS; USE OF SCHOOL LUNCH DATA.

       (a) Effect on Other Programs.--
       (1) In general.--An eligible child participating in a 
     demonstration project under this Act, who, in the absence of 
     such a demonstration project, would have received services 
     under part A of title I of the Elementary and Secondary 
     Education Act of 1965 shall be provided such services.
       (2) Part b of the individuals with disabilities education 
     act.--Nothing in this Act shall be construed to affect the 
     requirements of part B of the Individuals with Disabilities 
     Education Act.
       (b) Counting of Eligible Children.--Notwithstanding any 
     other provision of law, any local educational agency 
     participating in a demonstration project under this Act may 
     count eligible children who, in the absence of such a 
     demonstration project, would attend the schools of such 
     agency, for purposes of receiving funds under any program 
     administered by the Secretary.
       (c) Special Rule.--Notwithstanding section 9 of the 
     National School Lunch Act, an eligible entity receiving a 
     grant under this Act may use information collected for the 
     purpose of determining eligibility for free or reduced price 
     lunches to determine an eligible child's eligibility to 
     participate in a demonstration project under this Act and, if 
     needed, to rank families by income, in accordance with 
     section 7(b)(3)(B)(ii). All such information shall otherwise 
     remain confidential, and information pertaining to income may 
     be disclosed only to persons who need that information for 
     the purposes of a demonstration project under this Act.
       (d) Construction.--
       (1) Sectarian institutions.--Nothing in this Act shall be 
     construed to supersede or modify any provision of a State 
     constitution or State law that prohibits the expenditure of 
     public funds in or by sectarian institutions, except that no 
     provision of a State constitution or State law shall be 
     construed to prohibit the expenditure in or by sectarian 
     institutions of any Federal funds provided under this Act.
       (2) Desegregation plans.--Nothing in this Act shall be 
     construed to interfere with any desegregation plans that 
     involve school attendance areas affected by this Act.

     SEC. 10. PARENTAL NOTIFICATION.

       Each eligible entity receiving a grant under this Act shall 
     provide timely notice of the demonstration project to parents 
     of eligible children residing in the area to be served by the 
     demonstration project. At a minimum, such notice shall--
       (1) describe the demonstration project;
       (2) describe the eligibility requirements for participation 
     in the demonstration project;
       (3) describe the information needed to make a determination 
     of eligibility for participation in the demonstration project 
     for an eligible child;
       (4) describe the selection procedures to be used if the 
     number of eligible children seeking to participate in the 
     demonstration project exceeds the number that can be 
     accommodated in the demonstration project;
       (5) provide information about each choice school, including 
     information about any admission requirements or criteria for 
     each choice school participating in the demonstration 
     project; and
       (6) include the schedule for parents to apply for their 
     eligible children to participate in the demonstration 
     project.

     SEC. 11. EVALUATION.

       (a) Annual Evaluation.--
       (1) Contract.--The Comptroller General of the United States 
     shall enter into a contract, with an evaluating agency that 
     has demonstrated experience in conducting evaluations, for 
     the conduct of an ongoing rigorous evaluation of the 
     demonstration program under this Act.
       (2) Annual evaluation requirement.--The contract described 
     in paragraph (1) shall require the evaluating agency entering 
     into such contract to annually evaluate each demonstration 
     project under this Act in accordance with the evaluation 
     criteria described in subsection (b).
       (3) Transmission.--The contract described in paragraph (1) 
     shall require the evaluating agency entering into such 
     contract to transmit to the Comptroller General of the United 
     States--
       (A) the findings of each annual evaluation under paragraph 
     (1); and
       (B) a copy of each report received pursuant to section 
     12(a) for the applicable year.
       (b) Evaluation Criteria.--The Comptroller General of the 
     United States, in consultation with the Secretary, shall 
     establish minimum criteria for evaluating the demonstration 
     program under this Act. Such criteria shall provide for--
       (A) a description of the implementation of each 
     demonstration project under this Act and the demonstration 
     project's effects on all participants, schools, and 
     communities in the demonstration project area, with 
     particular attention given to the effect of parent 
     participation in the life of the school and the level of 
     parental satisfaction with the demonstration program; and
       (B) a comparison of the educational achievement of all 
     students in the demonstration project area, including a 
     comparison of--
       (i) students receiving education certificates under this 
     Act; and
     [[Page S4585]]   (ii) students not receiving education 
     certificates under this Act.

     SEC. 12. REPORTS.

       (a) Report by Grant Recipient.--Each eligible entity 
     receiving a grant under this Act shall submit to the 
     evaluating agency entering into the contract under section 
     11(a)(1) an annual report regarding the demonstration project 
     under this Act. Each such report shall be submitted at such 
     time, in such manner, and accompanied by such information, as 
     such evaluating agency may require.
       (b) Reports by Comptroller General.--
       (1) Annual reports.--The Comptroller General of the United 
     States shall report annually to the Congress on the findings 
     of the annual evaluation under section 11(a)(2) of each 
     demonstration project under this Act. Each such report shall 
     contain a copy of--
       (A) the annual evaluation under section 11(a)(2) of each 
     demonstration project under this Act; and
       (B) each report received under subsection (a) for the 
     applicable year.
       (2) Final report.--The Comptroller General shall submit a 
     final report to the Congress within 9 months after the 
     conclusion of the demonstration program under this Act that 
     summarizes the findings of the annual evaluations conducted 
     pursuant to section 11(a)(2).

  Mr. LIEBERMAN. Mr. President, I am very pleased to join Senator Coats 
today to introduce the Low-Income School Choice Demonstration Act. I 
know Senator Coats shares my deep commitment to improving education. 
All of our children deserve and need the best possible academic 
instruction. Increasing school choice will help give more children the 
opportunity they deserve.
  Our bill authorizes up to 20 demonstration projects to determine the 
effects on students and schools of providing education vouchers to low-
income parents for their children. Parents would use the vouchers to 
choose the public or private school their child would attend. The 
demonstration programs will give participating children new 
opportunities, and will provide those participating children new 
opportunities, and will provide those of us seeking to strengthen 
education with a fair evaluation of private school choice programs.
  Education in America is in need of change. We are failing too many of 
our children. The performance of our kids lags behind that of children 
living in those countries we compete with in the global marketplace. 
While we have many fine schools, we have too many that do not give our 
children what they need to succeed.
  I have visited many excellent public schools in Connecticut, and have 
met countless dedicated and effective teachers and administrators. I 
command them for their work and am committed to supporting their 
efforts. At the same time, it is clear that the public schools are not 
working for all students, particularly in our poorest communities. We 
have a responsibility to seek more effective ways to address the needs 
of these children.
  School choice programs expand opportunity for low-income children. 
They provide low-income children with the same options other kids have. 
For some that may mean another public school, for others a private or 
parochial school.
  Private school choice opens doors for children in our poorest 
neighborhoods, where religious schools--particularly Catholic schools--
often have had better results than public schools. I have long believed 
what some research has shown--that the success of parochial schools is 
in part due to their students' and teachers' shared beliefs and strong 
moral values. Lower-income parents who want their kids to learn in a 
religious environment should have that chance, just as wealthier 
parents do.
  Some fear that school choice programs will hurt our public schools, 
but I think choice will help revitalize public education. A national 
panel of experts, the Panel on the Economics of Educational Reform, 
recently concluded that public schools have few incentives for 
innovation. Good, effective teachers are often not
 rewarded by greater pay. Programs are rarely evaluated systematically 
to see if they are working.

  Choice programs and charter school programs hold schools accountable 
for results. Voucher programs let parents and students reward good 
schools--public or private schools--with their business. That increased 
competition may help those students who stay put as well as those who 
choose to attend a new school.
  As a U.S. Senator I have worked to promote public and private school 
choice. Last year Congress passed legislation, which I had co-authored, 
to promote the establishment of charter schools--public schools that 
are freed from burdensome regulatory requirements and are instead held 
accountable for improving the performance of their students. I am 
pleased that Congress made a commitment to public school choice, and 
will work to ensure the new program the rapidly growing interest in 
charter schools.
  This year Senator Coats and I are introducing legislation that 
establishes demonstration programs that provide parents with the 
ability to choose private or public schools, including public charter 
schools and private parochial schools. The demonstrations will allow 
low-income children to attend the public or private school of their 
choice. The bill will also fund evaluations so that we can learn more 
about how voucher programs affect public and private schools, and how 
they affect our children's ability to learn.
  Improving public education is and must be our country's top priority. 
What we are trying to do is find new ways to accomplish that goal. 
School choice programs should be tested. They create competition for 
failing bureaucracies and failing schools. They reward public and 
private schools that work. And, most important, they give our poorest 
students the chance for a better education and a better life.
  Mr. President, I thank Senator Coats for his leadership on this bill, 
and I look forward to continuing to work with him to ensure our 
children have the education and opportunity they deserve.
                                 ______

      By Mr. SMITH (for himself, Mr. Lautenberg, Mr. Faircloth, Mr. 
        McConnell, Mr. Simon, Mr. Mack, Mr. Bond, Mr. Graham, Mr. 
        Lieberman, Mr. Warner and Mr. Reid):
  S. 619. A bill to phase out the use of mercury in batteries and 
provide for the efficient and cost-effective collection and recycling 
or proper disposal of used nickel cadmium batteries, small sealed lead-
acid batteries, and certain other batteries, and for other purposes; to 
the Committee on Environment and Public Works.

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