[Congressional Record Volume 143, Number 69 (Thursday, May 22, 1997)]
[Senate]
[Pages S5002-S5013]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. REID (for himself, Mr. Grassley, and Mr. Glenn):
  S. 779. A bill to amend title XVIII of the Social Security Act to 
increase the number of physicians that complete a fellowship in 
geriatric medicine and geriatric psychiatry, and for other purposes; to 
the Committee on Finance.


              THE MEDICARE PHYSICIAN WORKFORCE ACT OF 1997

  S. 780. A bill to amend title III of the Public Health Service Act to 
include each year of fellowship training in geriatric medicine or 
geriatric psychiatry as a year of obligated service under the National 
Health Corps Loan Repayment Program; to the Committee on Labor and 
Human Resources.


             THE GERIATRICIANS LOAN FORGIVENESS ACT OF 1997

  Mr. REID. Good morning Mr. President. I come to the floor today to 
offer two bills which are written to address the national shortage of 
geriatricians we are experiencing in this country. A problem I am sorry 
to say that is getting worse, not better. I am pleased to have as 
original cosponsors of my bills Senator Grassley, the distinguished 
Chairman of the Senate Special Committee on Aging and Senator Glenn, 
also a member of the Aging Committee, one for whom I have tremendous 
respect and regard.
  Our Nation is growing older. Today, life expectancy for women is 79, 
for men it is 73. While the population of the United States has tripled 
since 1900, the number of people age 65 or older has increased 11 
times, to more than 33 million Americans. By 2030, this group is 
projected to double in size to nearly 70 million.
  Mr. President, I first became concerned about this problem when a 
read a report issued by the Alliance for Aging Research in May of 1996 
entitled, ``Will you Still Treat Me When I'm 65?'' The report concluded 
that there are only 6,784 primary-care physicians certified in 
geriatrics. This number represents less than one percent of the total 
of 684,414 doctors in the United States. The report goes on to state 
that the United States should have at least 20,000 physicians with 
geriatric training to provide appropriate care for the current 
population, and as many as 36,000 geriatricians by the year 2030 when 
there will be close to 70 million older Americans.
  The bills I am introducing today, the Medicare Physician Worforce 
Improvement Act of 1997 and the Geriatricians Loan Forgiveness Act of 
1997, aim--in modest ways and at very modest cost--to encourage an 
increase in the number of trained doctors seniors of today and tomorrow 
will need, those with certified training in geriatrics.
  One provision of the Medicare Physician Workforce Improvement Act of 
1997 will allow the Secretary of Health and Human Services to double 
the payment made to teaching hospitals for geriatric fellows capping 
the double payment to be provided to a maximum of 400 fellows per year. 
This is intended to serve as an incentive to teaching hospitals to 
promote and recruit for geriatric fellows.
  Another provision directs the Secretary of Health and Human Services 
to increase the number of certified geriatricians appropriately trained 
to provide the highest quality care to Medicare beneficiaries in the 
best and most sensible settings by establishing up to five geriatric 
medicine training consortia demonstration projects nationwide. In 
short, allow Medicare to pay for the training of doctors who serve 
geriatric patients in the settings where this care is so often 
delivered. Not only in hospitals, but also ambulatory care facilities, 
skilled nursing facilities, clinics, and day treatment centers.

  The second bill I am offering today, The Geriatricians Loan 
Forgiveness Act of 1997 has but one simple provision. That is to 
forgive $20,000 of education debt incurred by medical students for each 
year of advanced training required to obtain a certificate of added 
qualifications in geriatric medicine or psychiatry. My bill would count 
their fellowship time as obligated service under the National Health 
Corps Loan Repayment Program.
  Mr. President, the graduating medical school class of physicians in 
1996 reported they had incurred debts of $75,000 on average. My bill 
will offer an incentive to physicians to pursue advanced training in 
geriatrics by forgiving a small portion of their debt.
  Last year Medicare paid out more than $6.5 billion to teaching 
hospitals and academic medical centers toward the costs of clinical 
training and experience needed by physicians after they graduate from 
medical school. It is ironic, only a tiny fraction of those Medicare 
dollars are directed to the training of physicians who focus mainly on 
the needs of the elderly. Of over 100,000 residency and fellowship 
positions that Medicare supports nationwide, only about 250 are in 
geriatric medicine and psychiatry programs. Existing slots in geriatric 
training programs oftentimes go unfilled. With 518 slots available in 
geriatric medicine and psychiatry in 1996, only 261, barely one-half of 
them were filled.
  By allowing doctors who pursue certification in geriatric medicine to 
become eligible for loan forgiveness, and by offering an incentive to 
teaching institutions to promote the availability of fellowships, and 
recruit geriatric fellows, my bills will provide a measure of incentive 
for top-notch physicians to pursue fellowship training in this vital 
area.
  We must do more to ensure quality medicine today for our seniors and 
it is certainly in our best interest to prepare for the future when the 
number of seniors will double. Geriatric medicine requires special and 
focused training. Too often, problems in older persons are 
misdiagnosed, overlooked, or dismissed as the normal result of aging 
because doctors are not trained to recognize how diseases and 
impairments might appear differently in the elderly than in younger 
patients. One need only look at undiagnosed clinical depression in 
seniors or the consequences of adverse reaction to medicines to see how 
vital this specialized training really is. This lack of knowledge comes 
with a cost, in lives lost, and in unnecessary hospitalizations and 
treatments.
  We need trained geriatricians to train new medical students. Of the 
108 medical schools reporting for the 1994 to 1995 academic year, only 
11 had a separate required course in geriatrics, 53 offered geriatrics 
as an elective, 96 included geriatrics as part of another required 
course and one reported not offering geriatrics coursework at all. Mr. 
President, this is simply not good enough.

  In a country where by 2030, 1 in 5 citizens will be over the age of 
65, there are only two departments of geriatrics at academic medical 
centers across the entire country. Yet, every academic medical center 
has a Department of Pediatrics. This just does not seem to make sense 
to me. While certainly no

[[Page S5003]]

one would argue the need for emphasis on pediatrics, there is no less 
of a need for emphasis on geriatrics as well. In England, it is my 
understanding that every academic medical center has a department of 
geriatrics. Do our friends in England know something we do not?
  Mr. President, we have here a perfect case where an ounce of 
prevention will be worth a pound of cure. While not every patient over 
65 will need a geriatrician, in fact most will not, we need 
academicians and researchers to train the medical community about the 
field of geriatrics and we need primary care physicians to have access 
to trained geriatricians when a patient's case warrants it. As our 
oldest old population increases, the population growing the fastest and 
most appropriate for geriatric intervention, we must ensure that access 
to geriatricians becomes a reality.
  I believe the Medicare Physician Workforce Act of 1997 and the 
Geriatricians Loan Forgiveness Act of 1997 are steps in the right 
direction. While they will not solve the total problem, they do make a 
critical first step.
  Mr. President, I am grateful to the American Geriatrics Society for 
their assistance in working with my staff on this bill and I especially 
want to thank my cosponsors, Senators Grassley and Glenn, for their 
support and leadership on this issue.
  Mr. President, I ask unanimous consent that additional material be 
printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:


                              The American Geriatrics Society,

                                       New York, NY, May 20, 1997.
     Hon. Harry Reid,
     U.S. Senate,
     Washington, DC.
       Dear Senator Reid: On behalf of the American Geriatrics 
     Society (AGS), I am writing to offer our strongest support to 
     the ``Medicare Physician Workforce Improvement Act of 1997'' 
     and the ``Geriatricians Loan Forgiveness Act of 1997.''
       With more than 6500 physician and other health care 
     professional members, the AGS is dedicated to improving the 
     health and well being of all older adults. While we provide 
     primary care and supportive services to all patients, the 
     focus of geriatric practice is on the frailest and most 
     vulnerable elderly. The average age of a geriatrician's 
     caseload exceeds 80, and our patients often have multiple 
     chronic illnesses. Given the complexity of medical and social 
     needs among our country's oldest citizens, we are strongly 
     committed to a multi-disciplinary approach to providing 
     compassionate and effective care to our patients.
       As you know, America faces a critical shortage of 
     physicians with special training in geriatrics. Even as the 
     76 million persons of the baby boom generation reach 
     retirement age over the next 15 to 20 years, the number of 
     certified geriatricians is declining. By providing modest 
     incentives--which will encourage teaching hospitals to 
     increase the number of training fellowships in geriatric 
     medicine and psychiatry, provide loan assistance to 
     physicians who pursue such training, and support development 
     of innovative and flexible models for training in 
     geriatrics--your bills represent very positive steps toward 
     reversing that trend.
       The American Geriatrics Society has been pleased to work 
     closely with your office to develop initiatives to preserve 
     and improve the availability of highest quality medical care 
     for our oldest and most vulnerable citizens. We believe that 
     the ``Medicare Physician Workforce Improvement Act'' and the 
     ``Geriatricians Loan Forgiveness Act'' represent a cost-
     effective approach to training the physicians our nation 
     increasingly will need. We commend you for your leadership on 
     an issue of such vital importance to the Medicare program and 
     our elderly citizens.
           Sincerely,
                                              Dennis Jahnigen, MD,
     President.
                                                                    ____



                                  Alliance for Aging Research,

                                     Washington, DC, May 16, 1997.
     Hon. Harry Reid,
     Hart Senate Office Building,
     Washington, DC.
       Dear Senator Reid: As the Executive Director for the 
     Alliance for Aging Research, an independent, not-for-profit 
     organization working to improve the health and independence 
     of older Americans, I am writing in support of the ``Medicare 
     Physician Workforce Improvement Act'' and the ``Geriatricians 
     Loan Forgiveness Act.''
       As you know, on May 14, 1996 the Alliance released a 
     report, ``Will You Still Treat Me When I'm 65?'', addressing 
     the national shortage of geriatricians. Currently, there are 
     only 6,784 primary-care physicians certified in geriatrics, 
     the area of medicine that addresses the complex needs of 
     older patients. That is less than one percent of the total of 
     684,414 doctors in the U.S. We currently need 20,000 
     geriatricians and a total of 36,858 by the year 2030 to care 
     for the graying baby boomers. These two pieces of legislation 
     take the important first steps in solving this problem.
       In addition to increasing the number of physicians trained 
     in geriatrics, we need to develop a strong cadre of academics 
     and researchers within our medical schools to help mainstream 
     geriatrics into both general practice and specialties. 
     Increasing the number of fellowship positions in geriatric 
     medicine will improve the situation.
       We must have this kind of support and commitment from the 
     federal government, along with private philanthropy and 
     business if we are to sufficiently care for our aging 
     population. The Alliance for Aging Research is encouraged by 
     your leadership and support in this area and we look forward 
     to working with you to bring these issues before Congress.
           Best regards,
                                                     Daniel Perry,
                                               Executive Director.

 Mr. GRASSLEY. Mr. President, I am pleased to be an original 
cosponsor of two very important bills being offered by my colleague on 
the Senate Special Committee on Aging, Senator Harry Reid. The 
legislation we are introducing today will encourage more of our 
nation's physicians to specialize in geriatric medicine. As our 
population continues to age and with the impending retirement of the 
baby boomers, the need for trained geriatricians will be great. In my 
home State of Iowa, 15 percent of the population is over 65 with the 
third largest percentage of elderly in the Nation.
  The incentives for residents to choose geriatrics as a specialty are 
limited. The financial rewards are fewer than most other specialties. 
In addition, patients require more time and attention because they 
typically have a multitude of health problems. With the cost of 
education so high, many residents face enormous debt when they complete 
medical school. Institutions have trouble attracting students to 
specialize in geriatric medicine due to the lack of financial 
incentives.
  The Geriatricians Loan Forgiveness Act of 1997 will provide help to 
residents. This bill gives the Secretary of the Department of Health 
and Human Services [DHHS] the authority to forgive up to $20,000 of 
loans under the National Health Service Corps Loan Repayment Program on 
behalf of a resident who completes the required 1 year fellowship to 
become a geriatrician. The maximum amount of residents eligible is 400.
  The other bill I am cosponsoring today is the Medicare Physician 
Workforce Improvement Act of 1997. We spent nearly $7 billion last year 
on graduate medical education under the Medicare Program. Yet, only 200 
of the over 100,000 residency and fellowship positions funded by 
Medicare are in geriatric medicine. This does not make sense. Medicare 
is a program for seniors. Therefore, we should be supporting physicians 
who specialize in geriatrics.
  The Medicare Physician Workforce Improvement Act has two provisions 
to encourage academic medical centers to train physicians in geriatrics 
under the Medicare graduate medical education [GME] program. The first 
provision provides for an adjustment in a hospital's count of primary 
care residents to allow each resident enrolled in an approved medical 
residency or fellowship program in geriatric medicine to be counted as 
two full-time equivalent primary care residents for the 1-year period 
necessary to be certified in geriatric medicine. A limit is placed on 
the number of residents enrolled each year to control the cost. No more 
than 400 fellows nationwide can be eligible in any given year. This 
provision will encourage institutions to train more geriatricians using 
Medicare funds.
  The second provision is budget neutral. It directs the Secretary of 
DHHS to establish five geriatric medicine training consortium 
demonstration projects nationwide. The demonstration will allow current 
Medicare GME funds to be distributed to a consortium consisting of a 
teaching hospital, one or more skilled nursing facilities, and one or 
more ambulatory care or community-based facilities to train residents 
in geriatrics. This provision could be beneficial to rural areas and 
other areas not served by an academic medical center.
  I applaud Senator Reid for his efforts to provide our Nation's 
elderly with qualified trained geriatricians. I ask my colleagues on 
both sides of the aisle to join Senator Reid and me in support of these 
legislative initiatives.

[[Page S5004]]

                                 ______
                                 
      By Mr. HATCH (for himself, Mr. Craig, Mr. Gramm, Mr. Enzi, Mr. 
        Cochran, Mr. Helms and Mr. Kempthorne):
  S. 781. A bill to establish a uniform and more efficient Federal 
process for protecting property owners' rights guaranteed by the fifth 
amendment; to the Committee on the Judiciary.


                    THE OMNIBUS PROPERTY RIGHTS ACT

  Mr. HATCH. Mr. President, I am pleased today to once again introduce 
the Omnibus Property Rights Act. Many Members of the Senate have as a 
paramount concern the protection of individual rights protected by our 
Constitution.
  One particular right--the right to own and use private property free 
from arbitrary governmental action--is increasingly under attack from 
the regulatory state. Indeed, despite the constitutional requirement 
for the protection of property rights, the America of the late 20th 
century has witnessed an explosion of Federal regulation that has 
jeopardized the private ownership of property with the consequent loss 
of individual liberty.
  Under current Federal regulations, thousands of Americans have been 
denied the right to the quiet use and enjoyment of their private 
property. Arbitrary bureaucratic enforcement of Federal and State 
regulatory programs has prevented Americans from building homes and 
commercial buildings, plowing fields, repairing barns and fences, 
clearing brush and fire hazards, felling trees, and even removing 
refuse and pollutants, all on private property.
  Fairness and simple justice demand that Americans owning property be 
entitled to the full use of their property. Ensuring compensation for 
regulatory takings is the first step toward restoring the fundamental 
right to own and use private property guaranteed by the takings clause 
of the fifth amendment to our Constitution. That is why I am once again 
introducing legislation--the Omnibus Property Rights Act--to protect 
private property owners from overzealous regulators. This bill, similar 
in substance and procedure to the bills I introduced last Congress, 
represents the most comprehensive legislative mechanism to date to 
foster and protect the private ownership of property.
  The omnibus bill contains three different approaches contained in 
different titles.
  The first substantive title of the bill encompasses property rights 
litigation reform. This title establishes a distinct Federal fifth 
amendment ``takings'' claim against Federal agencies by aggrieved 
property owners, thus clarifying the sometimes incoherent and 
contradictory constitutional property rights case law. Property 
protected under this section includes real property, including fixtures 
on land, such as crops and timber, mining interests, and water rights. 
This title is triggered when a taking, as defined by the Supreme Court, 
occurs. Moreover, it allows for compensation when the property, or 
``affected portion'' of property, is reduced in value by 33 percent or 
more.
  It has been alleged that this bill would impede government's ability 
to protect public health, safety, and the environment. This is not 
true. This first title contains a ``nuisance exception'' to 
compensation. It codifies that part of the 1992 Supreme Court decision 
in Lucas versus South Carolina Coastal Council, which held that 
restrictions on property use based on ``background principles of the 
state's law of property and nuisance'' need not be compensated. Thus, 
by adopting the Supreme Court's recent Lucas holding, the Omnibus 
Property Rights Act provides that only innocent property holders are to 
be compensated for government takings. Those that demonstrably misuse 
their property to pollute or to harm public health and safety are not 
entitled to compensation under the bill's nuisance provision.

  Finally, this title also resolves the jurisdictional dispute between 
the Federal district courts and the Court of Federal Claims over fifth 
amendment ``takings'' cases--sometimes called the Tucker Act shuffle--
by granting each court concurrent jurisdiction.
  A second title in essence codifies President Reagan's Executive Order 
12630. Under this title, a Federal agency must conduct a private 
property taking impact analysis before issuing or promulgating any 
policy, regulation, or related agency action which is likely to result 
in a taking of private property.
  A third title provides for alternative dispute resolution in 
arbitration proceedings.
  The three titles of the Omnibus Property Rights Act together function 
to provide the property owner with mechanisms to vindicate the 
fundamental constitutional right of private ownership of property, 
while instituting powerful internal incentives for Federal agencies 
both to protect private property and include such protection in agency 
planning and regulating.
  It is very significant that the nonpartisan Congressional Budget 
Office, after a year of research, concluded in a study dated March 8, 
1996, that the incentives built into the very similar bills I 
introduced last Congress would have encouraged agencies to act more 
responsibly, that the administrative cost of the bill would be quite 
small, and that compensation costs would be even smaller.
  Despite some critics' charges that these very similar bills would be 
too costly, CBO found that the costs of both the omnibus bills will 
diminish to an insignificant level over time. This is predicated on the 
CBO finding that each of the omnibus bills contain powerful incentives, 
which over time will reduce costs. These include: First, the bills' 
bright line legal standards, which better enable agencies to avoid 
takings disputes; second, the takings impact assessment requirement, 
which requires agencies to analyze the affect of proposed regulations 
on property rights; and third, the requirement that compensation be 
paid from the agency's budget, which inevitably will act as a deterrent 
to unconstitutional and unlawful takings. Based on extensive research, 
CBO estimated that each omnibus bill should cost no more than $30 or 
$40 million a year for the first 5 years of implementation, thereafter 
diminishing to insignificant amounts. The new bill will cost even less.


                     Importance of Private Property

  The private ownership of property is essential to a free society and 
is an integral part of our Judeo-Christian culture and the Western 
tradition of liberty and limited government. Private ownership of 
property and the sanctity of property rights reflects the distinction 
in our culture between a preexisting civil society and the state that 
is consequently established to promote order. Private property creates 
the social and economic organizations that counterbalance the power of 
the state by providing an alternative source of power and prestige to 
the state itself. It is therefore a necessary condition of liberty and 
prosperity.
  While government is properly understood to be instituted to protect 
liberty within an orderly society and such liberty is commonly 
understood to include the right of free speech, assembly, religious 
exercise and other rights such as those enumerated in the Bill of 
Rights, it is all too often forgotten that the right of private 
ownership of property is also a critical component of liberty. To the 
17th century English political philosopher, John Locke, who greatly 
influenced the Founders of our Republic, the very role of government is 
to protect property: ``The great and chief end therefore, on Men 
uniting into Commonwealths, and putting themselves under Government, is 
the preservation of their property.''
  The Framers of our Constitution likewise viewed the function of 
government as one of fostering individual liberties through the 
protection of property interests. James Madison, termed the ``Father of 
the Constitution,'' unhesitantly endorsed this Lockean viewpoint when 
he wrote in The Federalist No. 54 that ``[government] is instituted no 
less for the protection of property, than of the persons of 
individuals.'' Indeed, to Madison, the private possession of property 
was viewed as a natural and individual right both to be protected 
against government encroachment and to be protected by government 
against others.
  To be sure, the private ownership of property was not considered 
absolute. Property owners could not exercise their rights as a nuisance 
that harmed their neighbors, and government could use, what was termed 
in the 18th century, its despotic power of eminent domain to seize 
property for public use. Justice, it became to be believed, required 
compensation for the property taken by government.

[[Page S5005]]

  The earliest example of a compensation requirement is found in 
chapter 28 of the Magna Carta of 1215, which reads, ``No constable or 
other bailiff of ours shall take corn or other provisions from anyone 
without immediately tendering money therefor, unless he can have 
postponement thereof by permission of the seller.'' But the record of 
English and colonial compensation for taken property was spotty at 
best. It has been argued by some historians and legal scholars that 
compensation for takings of property became recognized as customary 
practice during the American colonial period.
  Nevertheless, by the time of American independence, the compensation 
requirement was considered a necessary restraint on arbitrary 
governmental seizures of property. The Vermont Constitution of 1777, 
the Massachusetts Constitution of 1780, and the Northwest Ordinance of 
1787, recognized that compensation must be paid whenever property was 
taken for general public use or for public exigencies. And although 
accounts of the 1791 congressional debate over the Bill of Rights 
provide no evidence over why a public use and just compensation 
requirement for takings of private property was eventually included in 
the fifth amendment, James Madison, the author of the fifth amendment, 
reflected the views of other supporters of the new Constitution who 
feared the example to the new Congress of uncompensated seizures of 
property for building of roads and forgiveness of debts by radical 
state legislatures. Consequently, the phrase ``[n]or shall private 
property be taken for public use, without just compensation'' was 
included within the fifth amendment to the Constitution.


            Current Protection of Property Rights Fall Short

  Judicial protection of property rights against the regulatory state 
has been both inconsistent and ineffective. Physical invasions and 
government seizures of property have been fairly easy for courts to 
analyze as a species of eminent domain, but not so for the effect of 
regulations which either diminish the value of the property or 
appropriate a property interest.
  This key problem to the regulatory takings dilemma was recognized by 
Justice Oliver Wendell Holmes in Pennsylvania Coal Co. v. Mahon, 260 
U.S. 393 (1922). How do courts determine when regulation amounts to a 
taking? Holmes' answer, ``if regulation goes too far it will be 
recognized as a taking,'' 260 U.S. at 415, is nothing more than an ipse 
dixit. In the 73 years since Mahon, the Court has eschewed any set 
formula for determining how far is too far, preferring to engage in ad 
hoc factual inquiries, such as the three-part test made famous by Penn 
Central Transportation Co. v. City of New York, 438 U.S. 104 (1978), 
which balances the economic impact of the regulation on property and 
the character of the regulation against specific restrictions on 
investment-backed expectations of the property owner.
  Despite the valiant attempt by the Rehnquist Court to clarify 
regulatory takings analysis in Nollan v. California Coastal Comm'n, 483 
U.S. 825 (1987), Lucas v. South Carolina Coastal Council, 112 S.Ct. 
2886 (1992), and in its recent decision of Dolan v. City of Tigard, No. 
93-518 (June 24, 1994), takings analysis is basically incoherent and 
confusing and applied by lower courts haphazardly. The incremental, 
fact-specific approach that courts now must employ in the absence of 
adequate statutory language to vindicate property rights under the 
fifth amendment thus has been ineffective and costly.
  There is, accordingly, a need for Congress to clarify the law by 
providing bright line standards and an effective remedy. As Chief Judge 
Loren A. Smith of the Court of Federal Claims, the court responsible 
for administering takings claims against the United States, opined in 
Bowles v. United States, 31 Fed. Cl. 37 (1994), ``[j]udicial decisions 
are far less sensitive to societal problems than the law and policy 
made by the political branches of our great constitutional system. At 
best courts sketch the outlines of individual rights, they cannot hope 
to fill in the portrait of wise and just social and economic policy.''
  This incoherence and confusion over the substance of takings claims 
is matched by the muddle over jurisdiction of property rights claims. 
The Tucker Act, which waives the sovereign immunity of the United 
States by granting the Court of Federal Claims jurisdiction to 
entertain monetary claims against the United States, actually 
complicates the ability of a property owner to vindicate the right to 
just compensation for a Government action that has caused a taking. The 
law currently forces a property owner to elect between equitable relief 
in the Federal district court and monetary relief in the Court of 
Federal Claims. Further difficulty arises when the law is used by the 
Government to urge dismissal in the district court on the ground that 
the plaintiff should seek just compensation in the Court of Federal 
Claims, and is used to urge dismissal in the Court of Federal Claims on 
the ground that plaintiff should first seek equitable relief in the 
district court.
  This Tucker Act shuffle is aggravated by section 1500 of the Tucker 
Act, which denies the Court of Federal Claims jurisdiction to entertain 
a suit which is pending in another court and brought by the same 
plaintiff. Section 1500 is so poorly drafted and has brought so many 
hardships, that Justice Stevens, in Keene Corporation v. United States, 
113 S.Ct. 2035, 2048 (1993), has called for its repeal or amendment.
  Title II of the Omnibus Property Rights Act addresses these problems. 
In terms of clarifying the substance of takings claims, it first 
clearly defines property interests that are subject to the act's 
takings analysis. In this way a floor definition of property is 
established by which the Federal Government may not eviscerate. This 
title also establishes the elements of a takings claim by codifying and 
clarifying the holdings of the Nollan, Lucas, and Dolan cases.
  For instance, Dolan's rough proportionality test is interpreted to 
apply to all exaction situations whereby an owner's otherwise lawful 
right to use property is exacted as a condition for granting a Federal 
permit. And a distinction is drawn between a noncompensable mere 
diminution of value of property as a result of Federal regulation and a 
compensable partial taking, which is defined as any agency action that 
diminishes the fair market value of the affected property by 33 percent 
or more. The result of drawing these bright lines will not be the end 
fact-specific litigation, which is endemic to all law suits, but it 
will ameliorate the ever increasing ad hoc and arbitrary nature of 
takings claims.
  Finally, I once again want to respond to any suggestion that may 
arise that this act will impede Government's ability to protect the 
environment or promote health and safety through regulation. This 
legislation does not, contrary to the assertions of some, emasculate 
the Government's ability to prevent individuals or businesses from 
polluting. It is well established that the Constitution only protects a 
right to reasonable use of property. All property owners are subject to 
prior restraints on the use of their property, such as nuisance laws 
which prevents owners from using their property in a manner that 
interferes with others.
  The Government has always been able to prevent harmful or noxious 
uses of property without being obligated to compensate the property 
owner, as long as the limitations on the use of property inhere in the 
title itself. In other words, the restrictions must be based on 
background principles of State property and nuisance law already 
extant. The Omnibus Property Rights Act codifies this principle in a 
nuisance exception to the requirement of the Government to pay 
compensation.
  Nor does the Omnibus Property Rights Act hinder the Government's 
ability to protect public health and safety. The act simply does not 
obstruct the Government from acting to prevent imminent harm to the 
public safety or health or diminish what would be considered a public 
nuisance. Again, this is made clear in the provision of the act that 
exempts nuisance from compensation. What the act does is force the 
Federal Government to pay compensation to those who are singled out to 
pay for regulation that benefits the entire public.
  In other words, it does not prevent regulation, but fulfills the 
promise of the fifth amendment, which the Supreme Court in Armstrong v. 
United States, 364 U.S. 40, 49 (1960), opined is

[[Page S5006]]

``to bar Government from forcing some people alone to bear public 
burdens, which in all fairness and justice, should be borne by the 
public as a whole.''
  I hope that all Senators will join me in supporting this long overdue 
legislation.
                                 ______
                                 
      By Mr. LUGAR:
  S. 782. A bill to amend the Department of Agriculture Reorganization 
Act of 1994 to remove the provision that prevents the recovery of an 
amount disbursed as a result of an erroneous decision made by a State, 
county, or area committee; to the Committee on Agriculture, Nutrition, 
and Forestry.


              THE USDA'S FINALITY RULE REPEAL ACT OF 1997

 Mr. LUGAR. Mr. President, I introduce legislation to repeal an 
outdated agricultural law that has cost taxpayers millions of dollars 
over the last several years.
  Historically, as part of its statutory mandate to support farmers' 
income, the Department of Agriculture made payments to farmers for the 
planting of certain crops and in cases of natural disaster. In the 
process of carrying out this mission, USDA sometimes mistakenly 
overpaid farmers.
  A provision of the 1990 farm bill, known as the finality rule or the 
90-day rule, allowed farmers to keep these overpayments if they were 
not discovered within 90 days of the payment or application for farm 
program benefits. Repayment is required in cases of fraud or 
misrepresentation involving the farmer.
  Whatever its merits in 1990, changes in farm policy and new evidence 
indicate that the finality rule should be repealed. At the time of the 
1990 farm bill, to be eligible for farm program payments, it was 
necessary for the county or State USDA office to determine that farmers 
were actively engaged in farming and that their operations were 
structured properly. Farmers often relied on these determinations 
before deciding which crops to plant, the size of the plantings, and 
how to structure their farming operation for the crop year.
  However, the landmark reforms in the 1996 farm bill eliminated these 
justifications for the finality rule. Under the 1996 farm bill, farm 
payments are no longer linked to the planting decisions of farmers and 
the structure of the farming operation is unlikely to change. Today, 
payments are made based on a formula which does not vary from one year 
to the next.
  The finality rule does not only apply to farm program payments. It 
applies to most types of payments received by farmers including 
disaster relief assistance. But these disaster payments have been 
dramatically scaled back in recent years. In 1994, Congress passed the 
Federal Crop Insurance Reform and Department of Agriculture 
Reorganization Act which largely eliminated disaster assistance 
payments for most major crops. Instead of disaster aid, farmers were 
encouraged to buy crop insurance.
  A recent report from the General Accounting Office provides further 
evidence that the finality rule should be repealed. According to GAO, 
from November 1990 through September 1996, USDA applied the finality 
rule to 10,694 cases in which the overpayments were not discovered 
within the 90-day time-frame. The rule allowed farmers to keep $4.2 
million in overpayments. Nearly 90 percent of the overpayments involved 
crop disaster initiatives or old-style farm programs which no longer 
exist.
  GAO also looked closely at finality rule payments in fiscal years 
1995 and 1996. Even though the justification for the finality rule was 
to prevent farmers from having to repay large amounts of money years 
after the money was paid, GAO found that most of the overpayments 
involved small sums and were discovered within 9 months or less. 
According to GAO, in the years studied, 86 percent of the finality rule 
cases involved $500 or less. In addition, 59 percent had overpayments 
amounting to 10 percent or less of the correct payment amounts, and 
two-thirds were discovered within 9 months of the date of payment or 
the filing of a program application. It should be noted that while most 
of the overpayments were small, a few large overpayments accounted for 
the bulk of the dollar value of the overpayments. An examination of the 
GAO data indicate that the finality rule, in its application, has not 
served its original stated purpose.
  Mr. President, the U.S. Department of Agriculture agrees that the 
finality rule should be repealed. In those limited number of cases in 
which repayment would work a hardship on the farmer, the very cases 
that finality rule was supposed to assist, USDA has indicated that it 
would use existing procedures already in place for debt collection in 
hardship cases.
  In summary, Mr. President, the finality rule was largely designed for 
programs which have been dramatically altered, it generally does not 
serve the hardship cases for which it was designed, and it can be 
replaced by other existing procedures designed for hardship cases. The 
Department of Agriculture and the General Accounting Office support its 
repeal. It is time to remove this outdated law from the books. I urge 
my colleagues to support this bill.
  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. 782

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

     SECTION 1. RECOVERY OF AMOUNTS BASED ON ERRONEOUS DECISIONS 
                   OF STATE, COUNTY, AND AREA COMMITTEES.

       Section 281 of the Department of Agriculture Reorganization 
     Act of 1994 (7 U.S.C. 7001) is amended--
       (1) by striking subsection (a); and
       (2) by redesignating subsections (b) and (c) as subsections 
     (a) and (b), respectively.
                                 ______
                                 
      By Mr. D'AMATO (by request):
  S. 784. A bill to reform the United States Housing Act of 1937, 
deregulate the public housing program and the program for rental 
housing assistance for low-income families, and increase community 
control over such programs, and for other purposes.


            THE PUBLIC HOUSING MANAGEMENT REFORM ACT OF 1997

 Mr. D'AMATO. Mr. President, as chairman of the Committee on 
Banking, Housing and Urban Affairs, I introduce the Public Housing 
Management Reform Act of 1997 at the request of the Secretary of the 
Department of Housing and Urban Development, the Honorable Andrew M. 
Cuomo.
                                 ______
                                 
      By Mr. SMITH of Oregon:
  S. 785. A bill to convey certain land to the city of Grants Pass, OR; 
to the Committee on Energy and Natural Resources.


               THE GRANTS PASS LAND TRANSFER ACT OF 1997

 Mr. SMITH of Oregon. Mr. President, I am today introducing 
legislation to transfer 320 acres of Oregon and California grant lands 
currently under the jurisdiction of the Bureau of Land Management [BLM] 
to the city of Grants Pass, OR. I am pleased to introduce this 
legislation because it exemplifies how I believe our government should 
work. I believe government works best when the local community has an 
opportunity to participate in making decisions important to them.
  Since 1968, the city of Grants Pass has leased 200 acres of BLM land 
to operate the Merlin Municipal Solid Waste Facility under permit by 
the Oregon Department of Environmental Quality [DEQ]. The current lease 
ends April 14 in the year 2000 and, pursuant to BLM's national policy, 
the lease will not be renewed. The city of Grants Pass has made an 
incredible commitment of time, manpower, and financial resources over 
several years to address and minimize the environmental concerns of the 
Merlin landfill. The long-term management and resolution of these 
environmental issues can best be handled by the city of Grants Pass 
through ownership of the property.
  The 120 acres not part of the Merlin landfill are described by BLM as 
``scab lands'' and are not subject to timber harvest. In addition, if 
the additional 120 acres are retained they would be landlocked or 
without access. For these reasons, the BLM recommends that these 120 
acres be included in the land transfer. The 120 acres and any of the 
200 acres not used for solid waste management will be retained 
exclusively for public use.
  The reason for this legislation is simple: Existing Federal law 
providing for the transfer of Federal land either does not cover Oregon 
and California grant lands, presents administrative procedural 
requirements, or does not provide

[[Page S5007]]

the United States with the necessary environmental liability 
safeguards.
  The Grants Pass land transfer legislation is supported at all levels 
of government--local, State, and Federal. This legislation is a 
companion bill to that of my good friend and colleague from the House, 
Congressman Bob Smith, and is being heard today before the House 
Subcommittee on National Parks and Public Lands. I encourage my 
colleagues to join me in support of this legislation.
  Mr. President, I ask unanimous consent that the provisions of the 
bill be inserted in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 785

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

     SECTION 1. CONVEYANCE OF BLM LAND TO GRANTS PASS, OREGON.

       (A) Conveyance Required.--Effective on the date the City of 
     Grants Pass, Oregon tenders to the Secretary of the Interior 
     an indemnification agreement and without monetary 
     compensation, all right, title, and interest of the United 
     States in and to the real property described in subsection 
     (b) is conveyed, by operation of law, to the City of Grants 
     Pass, Oregon (in this section referred to as the ``City'').
       (b) Property Described.--
       The real property referred to in subsection (a) is that 
     parcel of land depicted on the map entitled ``      '' and 
     dated       , 1997, consisting of--
       (1) approximately 200 acres of Bureau of Land Management 
     land on which the City has operated a landfill under lease; 
     and
       (1) approximately 200 acres of Bureau of Land Management 
     land that area adjacent to the land described in subparagraph 
     (1).
       (c) Consideration.--As consideration for the conveyance 
     under subsection (a), the Secretary shall require the City to 
     agree to indemnify the Government of the United States for 
     all liability of the Government that arises from the 
     property.
                                 ______
                                 
      By Mrs. MURRAY:
  S. 788. A bill to suspend temporarily the duty on certain materials 
used in the manufacture of skis and snowboards; to the Committee on 
Finance.


                      duty suspension legislation

 Mrs. MURRAY. Mr. President, I introduce legislation of 
importance to the economy and quality of life in my home State of 
Washington. The measure I am introducing will help maintain the 
competitiveness of an industry that makes vital contributions to our 
State and this Nation.
  One of my top priorities here in the U.S. Senate is to support 
policies that promote economic growth for people in Washington State 
and across the country. To me, this means preserving current jobs and 
creating new jobs in all sectors of our economy.
  The K2 Corp., located on Vashon Island in Washington State, makes an 
important contribution toward achieving this goal. As the last 
remaining major U.S. manufacturer of skis and just one of three major 
snowboard makers in this country, K2 employs more than 700 people at 
its Vashon Island facility. The products made by K2 represent a 
substantial percentage of the American skis and snowboards sold around 
the world. Maintaining the competitiveness of K2 helps ensure the 
United States remains a player in the global ski market.
  To the extent possible, K2 purchases materials used in the 
manufacture of skis and snowboards from companies based in Washington 
State and other regions of our country. However, K2 is unable to find a 
domestic source that meets its requirements for two key raw materials--
steel edges and polyethylene base material. As a result, K2 must 
purchase these two commodities abroad and pay customs duties on the 
imported products. This forces K2 to spend more for these materials, 
thus diverting resources that could be used to expand business and 
develop new technologies.
  My legislation seeks to make these resources available to K2 
suspending U.S. customs duty on imports of these two raw materials--
steel edges and polyethylene base material. It helps ensure K2 and 
America continue to have a role in the international ski industry. 
Together, these materials comprise a very small portion of all the 
materials used to produce skis. However, without the ability to acquire 
them at a reasonable cost, K2's ability to compete on an international 
scale would be adversely affected.
  K2 strives to continue as a key player in the increasingly 
competitive international ski and snowboard market. This duty 
suspension legislation will help enable K2 to compete and to continue 
supporting our Nation's economy. I urge my colleagues to support this 
legislation, which strengthens the U.S. ski and snowboard industry and 
supports American jobs.
                                 ______
                                 
      By Mr. GRASSLEY (for himself, Mr. Breaux, Mr. D'Amato, Mr. Wyden, 
        Mr. Jeffords, Mr. Kohl and Mr. Chafee):
  S. 789. A bill to amend title XVIII of the Social Security Act to 
provide Medicare beneficiaries with additional information regarding 
Medicare managed care plans and Medicare select policies; to the 
Committee on Finance.


              MEDICARE BENEFICIARY INFORMATION ACT OF 1997

  Mr. GRASSLEY. Mr. President, I rise today with my colleague, Senator 
Breaux, to introduce the Medicare Beneficiary Information Act of 1997. 
Medicare is a Federal program paid for with taxpayer dollars. 
Therefore, Congress has the duty and obligation to ensure beneficiaries 
have access to necessary information to select an appropriate health 
plan for their individual health care needs.
  This legislation is based upon many of the recommendations made to 
members of the Senate Special Committee on Aging at a hearing we held 
on April 10, 1997. This bill will improve competition among Medicare 
health plans and provide Medicare beneficiaries with the useful 
information they need to make an informed choice when selecting a 
health plan. Good, reliable information that allows consumers to select 
among competing options is essential for any market to work. The health 
care market is no exception. Under Medicare, accurate, widely-available 
comparative information does not exist. The Medicare Beneficiary 
Information Act of 1997 addresses this problem by including the 
following provisions:
  While beneficiaries now have to call all the health plans in their 
area, wait for the marketing materials to come, and then try and 
compare all the different brochures with no standard terminology 
required, this bill instructs the Secretary to develop comparison 
charts for each Medicare HMO market and for Medicare Select plans. The 
Secretary has discretion to utilize existing mechanisms in place, such 
as regional Health Care Financing Administration [HCFA] offices and 
Insurance Counseling Assistance [ICA's] programs, to develop and 
distribute these charts.
  Comparison charts would be distributed by Medicare health plans in 
their marketing materials and at the time of enrollment and annually 
thereafter. In addition, the charts would be available upon request 
through HCFA. The charts would help beneficiaries understand the 
difference between the HMO's in their market. The charts would also 
contain a description of standard fee-for-service Medicare, so 
beneficiaries have a reference point.
  The charts will tell beneficiaries about, for example, the health 
plans' additional benefits; additional premiums; out-of-pocket 
expenses; disenrollment rates, as recommended by the General Accounting 
Office at the Aging Committee hearing; appeal rates, reversed and 
denied; coverage for out-of-area services.
  The bill also requires plans to inform beneficiaries about their 
rights and responsibilities using understandable, standard terminology 
regarding benefits; appeals and grievance procedures; restrictions on 
payments for services not provided by the plan; out-of-area coverage; 
coverage of emergency services and urgently needed care; coverage of 
out-of-network services; and any other rights the Secretary determines 
to be helpful to beneficiaries.
  These provisions are also included in the bill I introduced on May 6, 
entitled the ``Medicare Patient Choice and Access Act of 1997,'' or S. 
701. Senator Breaux and I believe that providing Medicare beneficiaries 
with proper information to select the health plan that best meets their 
individual health care needs is so important, we decided to introduce 
this free-standing bill. Increasing choices within the Medicare program 
has strong bipartisan support, but this approach is meaningless if 
beneficiaries cannot make an informed choice. Our bill can be enacted 
and implemented quickly. HCFA is already collecting this data and plans 
to start

[[Page S5008]]

distributing comparative information this summer through the Internet. 
However, Internet access is not enough. We need to provide this 
information in written form and through Medicare counseling programs as 
well. Medicare beneficiaries, as research has shown, prefer reviewing 
written materials and having someone with which to talk. Our bill would 
enable beneficiaries to obtain a user-friendly chart utilizing existing 
Medicare counseling programs, local Medicare offices and through health 
plans participating in the Medicare program.

  We ask our colleagues on both side of the aisle to join us in 
cosponsoring this important legislation. I ask unanimous consent that a 
copy of the bill be submitted for the Record. I also ask unanimous 
consent that a news column by Senator Breaux be included in the Record.
  There being no objection, the material was ordered to be printed in 
the the Record, as follows:

                                 S. 789

       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 ``Medicare Beneficiary 
     Information Act of 1997''.

     SEC. 2. MEDICARE BENEFICIARY INFORMATION.

       (a) In General.--Section 1876(c)(3)(E) of the Social 
     Security Act (42 U.S.C. 1395mm(c)(3)(E)) is amended to read 
     as follows:
       ``(E)(i) Each eligible organization shall provide in any 
     marketing materials distributed to individuals eligible to 
     enroll under this section and to each enrollee at the time of 
     enrollment and not less frequently than annually thereafter, 
     an explanation of the individual's rights and 
     responsibilities under this section and a copy of the most 
     recent comparative report (as established by the Secretary 
     under clause (ii)) for that organization.
       ``(ii)(I) The Secretary shall develop an understandable 
     standardized comparative report on the plans offered by 
     eligible organizations, that will assist beneficiaries under 
     this title in their decisionmaking regarding medical care and 
     treatment by allowing the beneficiaries to compare the 
     organizations that the beneficiaries are eligible to enroll 
     with. In developing such report the Secretary shall consult 
     with outside organizations, including groups representing the 
     elderly, eligible organizations under this section, providers 
     of services, and physicians and other health care 
     professionals, in order to assist the Secretary in developing 
     the report.
       ``(II) The report described in subclause (I) shall include 
     a comparison for each plan of--
       ``(aa) the premium for the plan;
       ``(bb) the benefits offered by the plan, including any 
     benefits that are additional to the benefits offered under 
     parts A and B;
       ``(cc) the amount of any deductibles, coinsurance, or any 
     monetary limits on benefits;
       ``(dd) the number of individuals who disenrolled from the 
     plan within 3 months of enrollment and during the previous 
     fiscal year, stated as percentages of the total number of 
     individuals in the plan;
       ``(ee) the procedures used by the plan to control 
     utilization of services and expenditures, including any 
     financial incentives;
       ``(ff) the number of applications during the previous 
     fiscal year requesting that the plan cover certain medical 
     services that were denied by the plan (and the number of such 
     denials that were subsequently reversed by the plan), stated 
     as a percentage of the total number of applications during 
     such period requesting that the plan cover such services;
       ``(gg) the number of times during the previous fiscal year 
     (after an appeal was filed with the Secretary) that the 
     Secretary upheld or reversed a denial of a request that the 
     plan cover certain medical services;
       ``(hh) the restrictions (if any) on payment for services 
     provided outside the plan's health care provider network;
       ``(ii) the process by which services may be obtained 
     through the plan's health care provider network;
       ``(jj) coverage for out-of-area services;
       ``(kk) any exclusions in the types of health care providers 
     participating in the plan's health care provider network; and
       ``(ll) any additional information that the Secretary 
     determines would be helpful for beneficiaries to compare the 
     organizations that the beneficiaries are eligible to enroll 
     with.
       ``(III) The comparative report shall also include--
       ``(aa) a comparison of each plan to the fee-for-service 
     program under parts A and B; and
       ``(bb) an explanation of medicare supplemental policies 
     under section 1882 and how to obtain specific information 
     regarding such policies.
       ``(IV) The Secretary shall, not less than annually, update 
     each comparative report.
       ``(iii) Each eligible organization shall disclose to the 
     Secretary, as requested by the Secretary, the information 
     necessary to complete the comparative report.
       ``(iv) In this subparagraph--
       ``(I) the term `health care provider' means anyone licensed 
     under State law to provide health care services under part A 
     or B;
       ``(II) the term `network' means, with respect to an 
     eligible organization, the health care providers who have 
     entered into a contract or agreement with the organization 
     under which such providers are obligated to provide items, 
     treatment, and services under this section to individuals 
     enrolled with the organization under this section; and
       ``(III) the term `out-of-network' means services provided 
     by health care providers who have not entered into a contract 
     agreement with the organization under which such providers 
     are obligated to provide items, treatment, and services under 
     this section to individuals enrolled with the organization 
     under this section.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to contracts entered into or renewed under 
     section 1876 of the Social Security Act (42 U.S.C. 1395mm) 
     after the expiration of the 1-year period that begins on the 
     date of enactment of this Act.

     SEC. 3. APPLICATION OF ADDITIONAL INFORMATION TO MEDICARE 
                   SELECT POLICIES.

       (a) In General.--Section 1882(t) of the Social Security Act 
     (42 U.S.C. 1395ss(t)) is amended--
       (1) in paragraph (1)--
       (A) by striking ``and'' at the end of subparagraph (E);
       (B) by striking the period at the end of subparagraph (F) 
     and inserting a semicolon; and
       (C) by adding at the end the following:
       ``(G) notwithstanding any other provision of this section 
     to the contrary, the issuer of the policy meets the 
     requirements of section 1876(c)(3)(E)(i) with respect to 
     individuals enrolled under the policy, in the same manner 
     such requirements apply with respect to an eligible 
     organization under such section with respect to individuals 
     enrolled with the organization under such section; and
       ``(H) the issuer of the policy discloses to the Secretary, 
     as requested by the Secretary, the information necessary to 
     complete the report described in paragraph (4).''; and
       (2) by adding at the end the following:
       ``(4) The Secretary shall develop an understandable 
     standardized comparative report on the policies offered by 
     entities pursuant to this subsection. Such report shall 
     contain information similar to the information contained in 
     the report developed by the Secretary pursuant to section 
     1876(a)(3)(E)(ii).''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply to policies issued or renewed on or after the 
     expiration of the 1-year period that begins on the date of 
     enactment of this Act.

     SEC. 4. NATIONAL INFORMATION CLEARINGHOUSE.

       (a) In General.--Not later than 18 months after the date of 
     enactment of this Act, the Secretary shall establish and 
     operate, out of funds otherwise appropriated to the 
     Secretary, a clearinghouse and (if the Secretary determines 
     it to be appropriate) a 24-hour toll-free telephone hotline, 
     to provide for the dissemination of the comparative reports 
     created pursuant to section 1876(c)(3)(E)(ii) of the Social 
     Security Act (42 U.S.C. 1395mm(c)(3)(E)(ii)) (as amended by 
     section 2 of this Act) and section 1882(t)(4) of the Social 
     Security Act (42 U.S.C. 1395ss(t)(4)) (as added by section 3 
     of this Act). In order to assist in the dissemination of the 
     comparative reports, the Secretary may also utilize medicare 
     offices open to the general public, the beneficiary 
     assistance program established under section 4359 of the 
     Omnibus Budget Reconciliation Act of 1990 (42 U.S.C. 1395b-
     3), and the health insurance information counseling and 
     assistance grants under section 4359 of that Act (42 U.S.C. 
     1395b-4).
                                                                    ____


       Giving Older Consumers Better Info on Health Care Benefits

               (John Breaux, U.S. Senator for Louisiana)

       The federal government needs to provide older Americans 
     with better information about all their health care options. 
     That was the conclusion of a senate hearing I recently 
     cochaired as the new ranking Democrat on the Senate Special 
     Aging Committee. We called in a number of health care experts 
     to talk about the quality of information provided to millions 
     of Medicare beneficiaries, including nearly 600,000 in 
     Louisiana.
       Many who testified said that right now Medicare 
     beneficiaries are not being given all the information they 
     need to adequately compare the costs and benefits of their 
     health care coverage.
       We learned that many beneficiaries simply do not know how 
     managed care is different from standard fee-for-service 
     Medicare. And they are not getting simple explanations of the 
     differences among the Medicare Health Maintenance 
     Organizations (HMO's) in their local areas. Because it is 
     generally agreed that HMO's best serve their enrollees when 
     they compete on factors other than just price, providing 
     Medicare beneficiaries with more and better information is 
     essential.
       Consumers ideally need simple, readable comparison charts 
     so they are able to readily understand the differences 
     between plans. Currently, the Health Care Financing 
     Administration (HCFA), which administers Medicare, does not 
     provide beneficiaries with any comparative data. This means 
     older people who want to learn about managed care options 
     must call a toll-free number to see what HMO's are in their 
     area and then call each company one-by-one and request their 
     health care information. The problem is that each local plan 
     with a Medicare contract presents information using different 
     formats and language, so it's difficult or even impossible to 
     make cost and benefit comparisons.

[[Page S5009]]

       And while the vast majority of Medicare beneficiaries--87 
     percent nationally--remain enrolled in traditional fee-for-
     service Medicare, this is changing rapidly. The number of 
     beneficiaries nationwide who enroll in HMO's is growing by 
     about 30 percent a year. In Louisiana, the growth rate is 
     more than 50 percent. The number of health plans with 
     Medicare contracts is also increasing rapidly. In 1993, there 
     were 110 such plans. Last year, the number more than doubled 
     to 241.
       In a recent report to the Congress, the General Accounting 
     Office (GAO) was critical of the type of information older 
     Americans get on their health care options. The Prospective 
     Payment Assessment Commission also said in a recent report 
     that ``cost and benefit definitions should be standardized so 
     that beneficiaries can better compare plans.''
       And the Institute of Medicine last year reported that 
     ``current information available to Medicare beneficiaries 
     lags far behind the kinds of assistance provided by 
     progressive private employers to their employees.''
       One way to begin addressing these disturbing structural 
     problems is to provide more and better information so that 
     beneficiaries can make informed choices. It is really a 
     fairly simple concept, but one that government often loses 
     sight of--people make wiser and less costly decisions for 
     themselves and their families if they have the right kind of 
     information.
       In fact, in its October 1996 report, GAO recommended that 
     the federal government require plans to use standard formats 
     and terminology; produce benefit and cost comparison charts 
     with all Medicare options available for all areas; and 
     analyze, compare and widely distribute certain statistics 
     about HMO's, including their disenrollment rates and rate of 
     complaints.
       Clearly, we must find a better way to inform Medicare 
     consumers about their choices because good information is the 
     key to making the right health care choices for ourselves and 
     our loved ones.
                                 ______
                                 
      By Mr. DASCHLE:
  S. 790. A bill to amend the Internal Revenue Code of 1986 to allow 
Indian tribes to receive charitable contributions of inventory; to the 
Committee on Finance.


   Charitable Contributions of Inventory to Indian Tribes legislation

  Mr. DASCHLE. Mr. President, I am pleased to introduce legislation to 
expand the current inventory charitable donation rule to include Indian 
tribes. This proposal is short and simple.
  Under current law, companies may obtain a special charitable donation 
tax deduction under Internal Revenue Code section 170(e)(3) for 
contributing their excess inventory to the ill, the needy, or infants. 
While not limited to any particular type of company or inventory, this 
deduction commonly is used by food processing companies whose excess 
food inventories otherwise would spoil. Indian tribes have had 
difficulty obtaining these donations, however, because of an ambiguity 
in the law as to whether or not donating companies may deduct donations 
to organizations on Indian reservations.
  The current language in section 170(e)(3) requires charitable 
donations of excess inventory to be made to organizations that are 
described in section 501(c)(3) of the Code and exempt from taxation 
under section 501(a). While Indian tribes are exempt from taxation, 
they are not among the organizations described in section 501(c)(3). 
Accordingly, it is not clear that a direct donation of excess inventory 
to an Indian tribe would qualify for the charitable donation deduction 
under section 170(e)(3).
  Ironically, the Indian Tribal Government Tax Status Act found in 
section 7871 provides that an Indian tribal government shall be treated 
as a State for purposes of determining tax deductibility of charitable 
contributions made pursuant to section 170. Unfortunately, the act does 
not expressly extend to donations made under section 170(e)(3) because 
that provision technically does not include States as eligible donees.
  Mr. President, it is well documented that Native Americans, like 
other citizens, may meet the qualifications for this special charitable 
donation. No one would argue that it is not within the intent of 
section 170(e)(3) to allow contributions to Native American 
organizations to qualify for the special charitable donation deduction 
in that section of the code. The bill I am introducing today simply 
would allow those contributions to qualify for the deduction. By 
allowing companies to make qualified contributions to Indian tribes 
under section 170(e)(3), the bill would clearly further the intended 
purpose of both Internal Revenue Code section 170(e)(3) and the Indian 
Tribal Government Tax Status Act.
  The appropriateness of the measure is exhibited by the fact that it 
was included in the Revenue Act of 1992 (H.R. 11), which was vetoed for 
unrelated reasons. At that time, the measure was supported on policy 
grounds by the staffs of the joint committee on Taxation and Finance 
Committee. In 1995, the joint committee estimated that the proposal 
would have a negligible effect on Federal receipts over the 6-year 
period it estimated.
  I strongly encourage my colleagues to support this bill and ask 
unanimous consent that its text be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 790

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

     SECTION 1. CHARITABLE CONTRIBUTIONS OF INVENTORY TO INDIAN 
                   TRIBES.

       (a) In General.--Section 170(e)(3) of the Internal Revenue 
     Code of 1986 (relating to a special rule for certain 
     contributions of inventory or other property) is amended by 
     adding at the end the following new subparagraph:
       ``(D) Special rule for Indian tribes.--
       ``(i) In general.--An Indian tribe (as defined in section 
     7871(c)(3)(E)(ii)) shall be treated as an organization 
     eligible to be a donee under subparagraph (A).
       ``(ii) Use of property.--For purposes of subparagraph 
     (A)(i), if the use of the property donated is related to the 
     exercise of an essential governmental function of the Indian 
     tribal government, such use shall be treated as related to 
     the purpose or function constituting the basis for the 
     organization's exemption.''
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to taxable years beginning after December 31, 
     1996.
                                 ______
                                 
      By Mr. DASCHLE (for himself, Mr. Dorgan, Mr. Grassley, Mr. 
        Johnson and Mr. Conrad):
  S. 791. A bill to amend the Internal Revenue Code of 1986 with 
respect to the treatment of certain amounts received by a cooperative 
telephone company; to the Committee on Finance.


          Tax Treatment of Telephone Cooperatives Act of 1997

  Mr. DASCHLE. Mr. President, today I am introducing legislation that 
reaffirms the intent of the U.S. Congress, originally expressed in 
1916, to grant tax exempt status to telephone cooperatives. This 
exemption is now set forth in section 501(c)(12) of the Internal 
Revenue Code.
  I am joined by my distinguished colleagues, Senators Dorgan, 
Grassley, Johnson, and Conrad.
  This legislation is identical to a bill I introduced in the 103d and 
104th Congresses and to a measure that was included in the Revenue Act 
of 1992, which ultimately was vetoed.
  Congress has always understood that a tax exemption is necessary to 
ensure that reliable, universal telephone service is available in rural 
America at a cost that is affordable to the rural consumer. Telephone 
cooperatives are nonprofit entities that provide this service where it 
might otherwise not exist due to the high cost of reaching remote, 
sparsely populated areas.
  The facilities of a telephone cooperative are used to provide both 
local and long distance communications services. Perhaps the most 
important of these for rural users is long distance. Without these 
services, both local and long distance, people in rural areas could not 
communicate with their own neighbors, much less with the world. While 
telephone cooperatives comprise only a small fraction of the U.S. 
telephone industry--about 1 percent--their services are vitally 
important to those who must rely upon them.
  Under Internal Revenue Code section 501(c)(12), a telephone 
cooperative qualifies for tax exemption only if at least 85 percent of 
its gross income consists of amounts collected from members for the 
sole purpose of meeting losses and expenses. Thus, the bulk of the 
revenues must be related to providing services needed by members of the 
cooperative, that is, rural consumers. No more than 15 percent of the 
cooperative's gross income may come from nonmember sources, such as 
property rentals or interest earned on funds on deposit in a bank. For 
purposes of the 85 percent test, certain categories of income are 
deemed neither member nor nonmember income and are excluded from the 
calculation. The reason for the 85 percent test is to ensure that 
cooperatives do not abuse their tax exempt status.

[[Page S5010]]

  A technical advice memorandum [TAM] released by the Internal Revenue 
Service a few years ago threatens to change the way telephone 
cooperatives characterize certain expenses for purposes of the 85 
percent test. If the rationale set forth in the TAM is applied to all 
telephone cooperatives, the majority could lose their tax exempt 
status.
  Specifically, the IRS now appears to take the position that all fees 
received by telephone cooperatives from long distance companies for use 
of the local lines must be excluded from the 85 percent test and that 
fees received for billing and collection services performed by 
cooperatives on behalf of long distance companies constitute nonmember 
income to the cooperative.
  The legislation I am introducing today would clarify that access 
revenues paid by long distance companies to telephone cooperatives are 
to be counted as member revenues, so long as they are related to long 
distance calls paid for by members of the cooperative. In addition, the 
legislation would indicate that billing and collection fees are to be 
excluded entirely from the 85 percent test calculation.
  Mr. President, it is no secret that mere distance is the single most 
important obstacle to rural development. In the telecommunications 
industry today, we have the ability to bridge distances more 
effectively than ever before. Technology in this area has advanced at 
an incredible pace; however, maintaining and upgrading the rural 
telecommunications infrastructure is an exceedingly expensive 
proposition. We must do all we can to encourage this development, and 
ensuring that telephone cooperatives retain their legitimate tax exempt 
status is a vital step toward this goal. I believe that providing 
access to customers for long distance calls as well as billing and 
collecting for those calls on behalf of the cooperative's members and 
long distance companies are indisputably part of the exempt function of 
providing telephone service, especially to rural communities. The 
nature and function of telephone cooperatives have not materially 
changed since 1916, and neither should the formula upon which they rely 
to obtain tax exempt status.

  In the 104th Congress, the Joint Committee on Taxation estimated the 
cost of this legislation to be $61 million over a 6-year period. At the 
appropriate time, I will recommend appropriate offsets to cover the 
cost of this measure over the 10-year period required under the Budget 
Act.
  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. 791

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

     SECTION 1. TREATMENT OF CERTAIN AMOUNTS RECEIVED BY A 
                   COOPERATIVE TELEPHONE COMPANY.

       (a) Nonmember Income.--
       (1) In general.--Paragraph (12) of section 501(c) of the 
     Internal Revenue Code of 1986 (relating to list of exempt 
     organizations) is amended by adding at the end the following 
     new subparagraph:
       ``(E) In the case of a mutual or cooperative telephone 
     company (hereafter in this subparagraph referred to as the 
     `cooperative'), 50 percent of the income received or accrued 
     directly or indirectly from a nonmember telephone company for 
     the performance of communication services by the cooperative 
     shall be treated for purposes of subparagraph (A) as 
     collected from members of the cooperative for the sole 
     purpose of meeting the losses and expenses of the 
     cooperative.''
       (2) Certain billing and collection service fees not taken 
     into account.--Subparagraph (B) of section 501(c)(12) of such 
     Code is amended by striking ``or'' at the end of clause 
     (iii), by striking the period at the end of clause (iv) and 
     inserting ``, or'', and by adding at the end the following 
     new clause:
       ``(v) from billing and collection services performed for a 
     nonmember telephone company.''
       (3) Conforming amendment.--Clause (i) of section 
     501(c)(12)(B) of such Code is amended by inserting before the 
     comma at the end thereof ``, other than income described in 
     subparagraph (E)''.
       (4) Effective date.--The amendments made by this subsection 
     shall apply to amounts received or accrued after December 31, 
     1996.
       (5) No inference as to unrelated business income treatment 
     of billing and collection service fees.--Nothing in the 
     amendments made by this subsection shall be construed to 
     indicate the proper treatment of billing and collection 
     service fees under part III of subchapter F of chapter 1 of 
     the Internal Revenue Code of 1986 (relating to taxation of 
     business income of certain exempt organizations).
       (b) Treatment of Certain Investment Income of Mutual or 
     Cooperative Telephone Companies.--
       (1) In general.--Paragraph (12) of section 501(c) of such 
     Code (relating to list of exempt organizations) is amended by 
     adding at the end the following new subparagraph:
       ``(F) In the case of a mutual or cooperative telephone 
     company, subparagraph (A) shall be applied without taking 
     into account reserve income (as defined in section 512(d)(2)) 
     if such income, when added to other income not collected from 
     members for the sole purpose of meeting losses and expenses, 
     does not exceed 35 percent of the company's total income. For 
     the purposes of the preceding sentence, income referred to in 
     subparagraph (B) shall not be taken into account.''
       (2) Portion of investment income subject to unrelated 
     business income tax.--Section 512 of such Code is amended by 
     adding at the end the following new subsection:
       ``(d) Investment Income of Certain Mutual or Cooperative 
     Telephone Companies.--
       ``(1) In general.--In determining the unrelated business 
     taxable income of a mutual or cooperative telephone company 
     described in section 501(c)(12)--
       ``(A) there shall be included, as an item of gross income 
     derived from an unrelated trade or business, reserve income 
     to the extent such reserve income, when added to other income 
     not collected from members for the sole purpose of meeting 
     losses and expenses, exceeds 15 percent of the company's 
     total income, and
       ``(B) there shall be allowed all deductions directly 
     connected with the portion of the reserve income which is so 
     included.
       For purposes of the preceding sentence, income referred to 
     in section 501(c)(12)(B) shall not be taken into account.
       ``(2) Reserve income.--For purposes of paragraph (1), the 
     term `reserve income' means income--
       ``(A) which would (but for this subsection) be excluded 
     under subsection (b), and
       ``(B) which is derived from assets set aside for the repair 
     or replacement of telephone system facilities of such 
     company.''
       (3) Effective date.--The amendments made by this subsection 
     shall apply to amounts received or accrued after December 31, 
     1996.
                                 ______
                                 
      By Mr. DASCHLE (for himself, Mr. Dorgan, Mr. Conrad and Mr. 
        Johnson):

  S. 792. A bill to amend the Internal Revenue Code of 1986 to provide 
that certain cash rentals of farmland will not cause recapture of 
special estate tax valuation; to the Committee on Finance.


         the Special Use Valuation for Family Farms Act of 1997

  Mr. DASCHLE. Mr. President, since 1988, I have studied the effects on 
family farmers of a provision in estate tax law known as section 2032A. 
While section 2032A may seem a minor provision to some, it is 
critically important to family run farms. A problem with respect to the 
Internal Revenue Service's interpretation of this provision has been 
festering for a number of years and threatens to force the sale of many 
family farms.
  Section 2032A, which bases the estate tax applicable to a family farm 
on its use as a farm, rather than on its market value, reflects the 
intent of Congress to help families keep their farms. A family that has 
worked hard to maintain a farm should not have to sell it to a third 
party solely to pay stiff estate taxes resulting from increases in the 
value of the land. Under section 2032A, inheriting family members are 
required to continue farming the property for at least 15 years in 
order to avoid having the IRS recapture the tax savings.
  At the time section 2032A was enacted, it was common practice for one 
or more family members to cash lease the farm from the other members of 
the family. This practice made sense in a situation in which some 
family members were more involved than others in the day-to-day farming 
of the land. Typically, the other family members would continue to be 
at risk with respect to the value of the farm and participate in 
decisions affecting the farm's operation. Cash leasing among family 
members remained a common practice after the enactment of section 
2032A. An inheriting child would continue to cash lease from his or her 
siblings, with no reason to suspect from the statute or otherwise that 
the cash leasing arrangement might jeopardize the farm's qualification 
for special use valuation.
  Based at least in part on some language that I am told was included 
in a Joint Committee on Taxation publication in early 1982, the 
Internal Revenue

[[Page S5011]]

Service has taken the position that cash leasing among family members 
will disqualify the farm for special use valuation. The matter has 
since been the subject of numerous audits and some litigation, though 
potentially hundreds of family farmers may yet be unaware of the change 
of events. Cases continue to arise under this provision.
  In 1988, Congress provided partial clarification of this issue for 
surviving spouses who cash lease to their children. Due to revenue 
concerns, however, no clarification was made of the situation where 
surviving children cash lease among themselves.
  My concern is that many families in which inheriting children or 
other family members have cash leased to each other may not even be 
aware of the IRS's position on this issue. At some time in the future, 
they are going to be audited and find themselves liable for enormous 
amounts in taxes, interest and penalties. For those who cash leased in 
the late 1970's, this could be devastating because the taxes they owe 
are based on the inflated land values that existed at that time.
  A case that arose in my State of South Dakota illustrates the 
unfairness and devastating impact of the IRS interpretation of section 
2032A. Janet Kretschmar, who lives with her husband, Craig, in 
Cresbard, SD, inherited her mother's farm along with her two sisters in 
1980. Because the property would continue to be farmed by the family 
members, estate taxes were paid on it pursuant to section 2032A, saving 
over $50,000 in estate tax.
  Janet and Craig continued to farm the land and have primary 
responsibility for its day-to-day operation. They set up a simple and 
straightforward arrangement with the other two sisters whereby Janet 
and Craig would lease the sisters' interests from them.
  Seven years later, the IRS told the Kretschmars that the cash lease 
arrangement had disqualified the property for special use valuation and 
that they owed $54,000 to the IRS. According to the IRS, this amount 
represented estate tax that was being recaptured as a result of the 
disqualification. This came as an enormous surprise to the Kretschmars, 
as they had never been notified of the change in interpretation of the 
law and had no reason to believe that their arrangement would no longer 
be held valid by the IRS for purposes of qualifying for special use 
valuation. The fact is that, if they had known this, they would have 
organized their affairs in one of several other acceptable, though more 
complicated, ways.
  For many years, I have sought inclusion in tax legislation of a 
provision that would clarify that cash leasing among family members 
will not disqualify the property for special use valuation. In 1992, 
such a provision was successfully included in H.R. 11, the Revenue Act 
of 1992 and passed by Congress. Unfortunately, H.R. 11 was subsequently 
vetoed. In 1995, I introduced this provision as freestanding 
legislation; however, it did not reach the full Senate for a vote.
  Today, I am reintroducing a bill that is identical to the section 
2032A measure which was passed in the Revenue Act of 1992. I am joined 
in this effort by Senators Dorgan, Conrad and Mr. Johnson whose 
expertise on tax and rural issues are well known.
  I must emphasize that there may be many other cases in other 
agricultural States where families are cash leasing the family farm 
among each other, unaware that the IRS could come knocking at their 
door at any minute. I urge my colleagues in the Senate who may have 
such cases in their State to work with us and support this important 
clarification of the law.
  I intend to request that the Joint Committee on Taxation estimate the 
revenue impact of this proposal. At an appropriate time thereafter, I 
will recommend any necessary offsets over a 10-year period as required 
by the Budget Act.
  Mr. President, I ask unanimous consent that the full 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. 792

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

     SECTION 1. CERTAIN CASH RENTALS OF FARMLAND NOT TO CAUSE 
                   RECAPTURE OF SPECIAL ESTATE TAX VALUATION.

       (a) In General.--Subsection (c) of section 2032A of the 
     Internal Revenue Code of 1986 (relating to tax treatment of 
     dispositions and failures to use for qualified use) is 
     amended by adding at the end the following new paragraph:
       ``(8) Certain cash rental not to cause recapture.--For 
     purposes of this subsection, a qualified heir shall not be 
     treated as failing to use property in a qualified use solely 
     because such heir rents such property on a net cash basis to 
     a member of the decedent's family, but only if, during the 
     period of the lease, such member of the decedent's family 
     uses such property in a qualified use.''
       (b) Conforming Amendment.--Section 2032A (b)(5)(A) is 
     amended by striking the last sentence.
       (c) Effective Date.--The amendment made by subsection (a) 
     shall apply with respect to rentals occurring after December 
     31, 1976.
                                 ______
                                 
      By Mr. DODD:
  S. 793. A bill to amend the Public Health Service Act to require that 
the Center for Substance Abuse Treatment carry out treatment programs 
for adolescents; to the Committee on Labor and Human Resources.


           THE SERVICES FOR CHILDREN OF SUBSTANCE ABUSERS ACT

  S. 794. A bill to amend the Public Health Service Act to revise and 
extend the grant program for services for children of substance 
abusers; to the Committee on Labor and Human Resources.


           THE SUBSTANCE ABUSE TREATMENT FOR ADOLESCENTS ACT

  Mr. DODD. Mr. President, I rise today to introduce two bills which 
seek to address one of the most critical problems tearing at the fabric 
of American society: substance abuse. When we consider health care 
costs, lost time on the job, increased crime, and other related 
factors, it is estimated that drug and alcohol abuse cost this Nation 
more than $300 billion in 1993. While some efforts to address this 
problem have been successful, there is still a great deal of work to be 
done. The two bills that I am introducing, the Services for Children of 
Substance Abusers Act and the Substance Abuse Treatment for Adolescents 
Act, seek to provide additional tools for families to fight the battle 
of addiction and its debilitating social consequences.
  Addiction threatens the American family in several ways. The long 
term emotional health of an individual is shaped during childhood, and 
the children of substance abusers face numerous obstacles during their 
development. The children of substance abusers are typically deprived 
of the parent's attention and concern, and often the financial support 
to provide food, clothing, and shelter. In the most dramatic cases, 
children are exposed to substances prenatally and are deprived of a 
healthy future before they are even born.
  An estimated 7 million children are growing up with at least one 
substance abusing parent, and more than 200,000 women who gave birth in 
the United States in 1992 used illegal drugs at some time during their 
pregnancy. In addition, alcohol consumption by pregnant women has 
recently surged, despite public campaigns about the effects of alcohol 
on the developing fetus. Clearly these parents will need help if they 
hope to overcome their addictions and raise healthy children. 
Unfortunately, these parents often face several obstacles on the road 
to recovery.
  The basic problem with our current drug and alcohol treatment 
programs is that they fail to address the wide range of problems that 
addicted parents face. Many were physically or sexually abused as 
children. Many are victims of domestic violence. Many lack any formal 
job skills. Many will need child care assistance if they hope to enroll 
in a treatment program. Many fear that they will lose their children if 
they come forward for treatment. In short, these parents face several 
problems which extend far beyond their addictions.
  The Children of Substance Abusers Act is currently authorized in the 
Public Health Services Act, but it has never been funded. Today, I 
introduce a revised version of this legislation that seeks to give 
families affected by substance abuse somewhere to turn. The heart of 
the bill is the grant program which will provide $50 million for a 
comprehensive range of health, developmental, and social services to 
children, parents, and other family members. These services will 
enhance the

[[Page S5012]]

ability of parents to access drug and alcohol treatment and promote 
family preservation, where appropriate.
  The bill ensures that all children whose parents are substance 
abusers can enter the program and receive a range of services. The 
legislation addresses another critical need by providing grants to 
train professionals, child welfare workers, and other providers serving 
children to identify and address the effects of familial substance 
abuse.
  For years we have talked about the impact of substance abuse on 
families. We have all visited the neonatal intensive care units, and we 
have all seen reports on children who were abused and neglected because 
their parents were on drugs. The time has come for Congress to respond 
to what is going on in this country and take an aggressive step toward 
alleviating these problems.
  The Children of Substance Abusers Act is critical to our efforts to 
reach out to those families that are struggling with substance abuse, 
and I urge my colleagues to support the legislation I introduce today 
and fund this critical program.
  On another front, the increased prevalence of substance abuse among 
young Americans poses an additional public health crisis. Last year, 
the percentage of teens using drugs within the past month rose from 8.2 
to 10.9 percent, and the rate of drug use among 12 to 17 year-olds has 
doubled since 1992. I am particularly disappointed to learn that 
Connecticut's students report higher rates of drug use than their peers 
nationwide.
  Annually, more than 400,000 Americans under the age of 18 are in need 
of treatment, and in Connecticut approximately 6,700 students need 
substance abuse treatment. However, young people have few places to 
turn. Most treatment programs are designed for adults, and there are 
limited resources available for the treatment of adolescents with drug 
and alcohol problems.
  Federal and state initiatives have focused on preventing children 
from becoming substance abusers. While prevention efforts are effective 
and necessary, they do not provide for those adolescents with substance 
abuse problems. In addition, most substance abusing adolescents have 
co-occurring disorders, such as depression, learning disabilities, 
post-traumatic stress disorders, and other health problems which make 
treatment even more challenging.
  The Substance Abuse Treatment for Adolescents Act seeks to create a 
funding stream for adolescent treatment. This would be the first time 
that any money has ever been earmarked specifically for adolescent 
treatment, setting aside an estimated $70 million annually to address 
this problem. This bill would also eliminate the need within the public 
system for adolescent providers to compete with other groups for scarce 
treatment dollars, thereby allowing them to focus upon the real 
problem: successfully treating adolescent substance abusers.
  Mr. President, this legislation marks a significant step on the road 
toward improved treatment for adolescent substance abuse. It tells 
families that we care about their children's health and well-being, and 
it sends a signal to those individuals who struggle to help our kids 
overcome addiction that their hard work is not for naught, but will 
soon be rewarded.
  Mr. President, I ask unanimous consent that the text of the bills be 
printed in the Record.
  There being no objection, the bills were ordered to be printed in the 
Record, as follows:

                                 S. 793

       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 ``Substance Abuse Treatment 
     for Adolescents Act''.

     SEC. 2. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.

       Section 507 of the Public Health Service Act (42 U.S.C. 
     290bb) is amended by adding at the end the following:
       ``(d) Provision of Services.--Notwithstanding any other 
     provision of law, the Secretary, acting through the Center 
     for Substance Abuse Treatment, shall ensure that not less 
     than 20 percent of the amounts appropriated under this 
     subpart for the programs and activities of the Center for 
     Substance Abuse Treatment for each fiscal year, but in no 
     case less than $20,000,000, is used to carry out adolescent 
     specific substance abuse treatment programs. Such programs 
     shall include the provision of services to such adolescents 
     as well as the conduct of evaluations and research concerning 
     the effects of such services.''.
                                                                    ____


                                 S. 794

       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 ``Services for Children of 
     Substance Abusers Reauthorization Act''.

     SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

       (a) Administration and Activities.--
       (1) Administration.--Section 399D(a) of the Public Health 
     Service Act (42 U.S.C. 280d(a)(1)) is amended--
       (A) in paragraph (1), by striking ``Administrator'' and all 
     that follows through ``Administration'' and insert ``Director 
     of the Substance Abuse and Mental Health Services 
     Administration''; and
       (B) in paragraph (2), by striking ``Administrator of the 
     Substance Abuse and Mental Health Services Administration'' 
     and inserting ``Administrator of the Health Resources and 
     Services Administration''.
       (2) Activities.--Section 399D(a)(1) of the Public Health 
     Service Act (42 U.S.C. 280d(a)(1)) is amended--
       (A) in subparagraph (B), by striking ``and'' at the end;
       (B) in subparagraph (C), by striking the period and 
     inserting the following: ``through family social services; 
     child protective services; child care providers (including 
     Head Start, schools, and early childhood development 
     programs); community-based family resource and support 
     centers; the criminal justice system; health and mental 
     health providers through screenings conducted during regular 
     childhood examinations and other examinations; self and 
     family member referrals; treatment services; and other 
     service providers and agencies serving children and families; 
     and''; and
       (C) by adding at the end the following:
       ``(D) to provide education and training to health care 
     professionals, child welfare providers, and the personnel or 
     such providers who provide services to children and 
     families.''.
       (3) Identification of certain children.--Section 
     399D(a)(3)(A) of the Public Health Service Act (42 U.S.C. 
     280d(a)(3)(A)) is amended--
       (A) in clause (i), by striking ``(i) the entity'' and 
     inserting ``(i)(I) the entity'';
       (B) in clause (ii)--
       (i) by striking ``(ii) the entity'' and inserting ``(II) 
     the entity''; and
       (ii) by striking the period and inserting ``; and''; and
       (C) by adding at the end the following:
       ``(iii) the entity will identify children who may be 
     eligible for medical assistance under a State program under 
     title XIX of the Social Security Act.''.
       (b) Services for Children.--Section 399D(b) of the Public 
     Health Service Act (42 U.S.C. 280d(b)) is amended--
       (1) in paragraph (1), by inserting ``alcohol and drug,'' 
     after ``psychological,''; and
       (2) by striking paragraph (5) and inserting the following:
       ``(5) Drug and alcohol treatment and prevention 
     services.''.
       (c) Services for Affected Families.--Section 399D(c) of the 
     Public Health Service Act (42 U.S.C. 280d(c)) is amended--
       (1) in paragraph (1)--
       (A) in the matter preceding subparagraph (A), by inserting 
     before the semicolon the following: ``, or through an entity 
     the meets applicable State licensure or certification 
     requirements regarding the services involved''; and
       (B) by adding at the end the following:
       ``(D) Aggressive outreach to family members with substance 
     abuse problems.
       ``(E) Inclusion of consumer in the development, 
     implementation, and monitoring of Family Services Plan.''; 
     and
       (2) in paragraph (2)--
       (A) by striking subparagraph (A) and inserting the 
     following:
       ``(A) Alcohol and drug treatment services, including 
     screening and assessment, diagnosis, detoxification, 
     individual, group and family counseling, relapse prevention, 
     and case management.'';
       (B) by striking subparagraph (C) and inserting the 
     following:
       ``(C) Pre- and post-pregnancy family planning services and 
     counseling on the human immunodeficiency virus and acquired 
     immune deficiency syndrome.'';
       (C) in subparagraph (D), by striking ``conflict and''; and
       (D) in subparagraph (E), by striking ``Remedial'' and 
     inserting ``Career planning and''.
       (d) Eligible Entities.--Section 399D(d) of the Public 
     Health Service Act (42 U.S.C. 280d(d)) is amended--
       (1) by striking the matter preceding paragraph (1) and 
     inserting:
       ``(d) Eligible entities.--The Secretary shall distribute 
     the grants through the following types of entities:'';
       (2) in paragraph (1), by inserting ``or prevention'' after 
     ``drug treatment''; and
       (3) in paragraph (2)--
       (A) in subparagraph (A), by striking ``; and'' and 
     inserting ``; or''; and
       (B) in subparagraph (B), by inserting ``or pediatric health 
     or mental health providers and family mental health 
     providers'' before the period.

[[Page S5013]]

       (e) Submission of Information.--Section 399D(h) of the 
     Public Health Service Act (42 U.S.C. 280d(h)) is amended--
       (1) in paragraph (2)--
       (A) by inserting ``including maternal and child health'' 
     before ``mental'';
       (B) by striking ``treatment programs''; and
       (C) by striking ``and the State agency responsible for 
     administering public maternal and child health services'' and 
     inserting ``, the State agency responsible for administering 
     alcohol and drug programs, the State lead agency, and the 
     State Interagency Coordinating Council under part H of the 
     Individuals with Disabilities Education Act''; and
       (2) in paragraph (3)(B), by inserting before the semicolon 
     the following: ``when the child can be cared for at home 
     without endangering the child's safety''.
       (f) Reports.--Section 399D(i)(6) of the Public Health 
     Service Act (42 U.S.C. 280d(k)(6)) is amended--
       (1) in subparagraph (D), by striking ``and'' at the end;
       (2) in subparagraph (E), by adding ``and'' after the 
     semicolon; and
       (3) by adding at the end the following:
       ``(F) the number of children described in subparagraph (C) 
     for whom the permanent plan is other than family 
     reunification;''.
       (g) Evaluations.--Section 399D(l) of the Public Health 
     Service Act (42 U.S.C. 280d(l)) is amended--
       (1) in paragraph (4), by inserting before the semicolon the 
     following: ``, including increased participation in work or 
     employment-related activities and decreased participation in 
     welfare programs'';
       (2) in paragraph (5), by striking ``children whose'' and 
     inserting ``children who can be cared for at home without 
     endangering their safety and whose''; and
       (3) in paragraph (6), by inserting before the semicolon the 
     following: ``if the reunification would not endanger the 
     child''.
       (h) Report to Congress.--Section 399D(m) of the Public 
     Health Service Act (42 U.S.C. 280d(m)) is amended--
       (1) in paragraph (2), by adding ``and'' at the end;
       (2) in paragraph (3), by striking the semicolon at the end 
     and inserting a period; and
       (3) by striking paragraphs (4) and (5).
       (i) Data Collection.--Section 399D(n) of the Public Health 
     Service Act (42 U.S.C. 280d(n)) is amended by adding at the 
     end the following: ``The periodic report shall include a 
     quantitative estimate of the prevalence of alcohol and drug 
     problems in families involved in the child welfare system, 
     the barriers to treatment and prevention services facing 
     these families, and policy recommendations for removing the 
     identified barriers, including training for child welfare 
     workers.''.
       (j) Definition.--Section 399D(o)(2)(B) of the Public Health 
     Service Act (42 U.S.C. 280d(o)(2)(B)) is amended by striking 
     ``dangerous''.
       (k) Authorization of Appropriations.--Section 399D(p) of 
     the Public Health Service Act (42 U.S.C. 280d(p)) is amended 
     to read as follows:
       ``(p) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $50,000,000 for fiscal year 1998, and such sums 
     as may be necessary for fiscal year 1999.''.
       (l) Grants for Training and Conforming Amendments.--Section 
     399D of the Public Health Service Act (42 U.S.C. 280d) is 
     amended--
       (1) by striking subsection (f);
       (2) by striking subsection (k);
       (3) by redesignating subsections (d), (e), (g), (h), (i), 
     (j), (l), (m), (n), (o), and (p) as subsections (e) through 
     (o), respectively;
       (4) by inserting after subsection (c), the following:
       ``(d) Training for Health Care Professionals, Child Welfare 
     Providers, and Other Personnel.--The Secretary may make a 
     grant under subsection (a) for the training of health care 
     professionals, child welfare providers, and other personnel 
     who provide services to vulnerable children and families. 
     Such training shall be to assist professionals in recognizing 
     the drug and alcohol problems of their clients and to enhance 
     their skills in identifying and obtaining substance abuse 
     prevention and treatment resources.'';
       (5) in subsection (k)(2) (as so redesignated), by striking 
     ``(h)'' and inserting ``(i)''; and
       (6) in paragraphs (3)(E) and (5) of subsection (m) (as so 
     redesignated), by striking ``(d)'' and inserting ``(e)''.
                                 ______
                                 
      By Mr. TORRICELLI (for himself and Mrs. Feinstein):
  S. 796. A bill to reduce gun trafficking, and for other purposes; to 
the Committee on the Judiciary.

                          ____________________