[Congressional Record Volume 143, Number 149 (Thursday, October 30, 1997)]
[Senate]
[Pages S11449-S11464]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. BROWNBACK (for himself, Mr. Smith of Oregon, Mr. Lugar, 
        Mr. Hagel, Mr. McCain, Mr. Helms, and Mr. Byrd):
  S. 1344. A bill to amend the Foreign Assistance Act of 1961 to target 
assistance to support the economic and political independence of the 
countries of South Caucasus and Central Asia; to the Committee on 
Foreign Relations.


                   The Silk Road Strategy Act of 1997

  Mr. BROWNBACK. Mr. President, I am introducing the Silk Road Strategy 
Act of 1977. This is an overarching policy between the countries of the 
South Caucasus and Central Asia, which includes the countries of 
Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, 
Turkmenistan, and Uzbekistan. Those are not common names to most 
Americans, but the area of the world that they are around, the Caspian 
Sea, I think, is going to become far more common knowledge to many 
Americans, as there is 4 trillion dollars worth of known oil and gas in 
the region.
  The region is reaching out to us. They are seeking to put off the 
Russian imperialism that has been in the region for years and seeking 
to get away from Iranian influence in the area.
  Thus, we are putting forward this Silk Road strategy as an active and 
positive role in reviving the economies of this region of the world and 
to building them as major forces.
  I think the United States has a vital political, social and economic 
interest in the region, and we need to act now rather than later. I 
don't think our window of opportunity in working with these countries 
as they seek freedom and yearn to be free and build opportunity for 
their people is long. Probably within the next 3 years, they are going 
to be making courses and decisions that will decide the long-term fate 
of the people of this region.
  They seek to be united with the United States. I ask, overall, that 
my colleagues look at this potential opportunity, at this bill and 
support the Silk Road Strategy Act of 1997. It is a key interest area 
for us and our future.
  This bill is aimed at focusing the attention of U.S. policy on the 
need to play an active and positive role in reviving the economies of 
these parts of the ancient Silk Road which was once the economic 
lifeline of Central Asia and the South Caucasus and the main 
transportation corridor to Europe and the West.
  The United States has vital political, social, and economic interests 
there and they need to be acted on now, before it is too late. These 
countries are at an historic crossroad: They are independent for the 
first time in almost a century, located at the juncture of many of 
today's major world forces and they are all rich in natural resources. 
They are emerging from almost a century of plunder by a Communist 
regime which, while it actively drained their resources, put little 
back. They now find themselves free to govern themselves, and they are 
looking west.
  The very fact that they have little experience of independence and 
that their economies are essentially starting from scratch, leaves them 
in a precarious situation, which is all the more precarious because of 
their geographic location: consider this: They are placed between the 
Empire from which they recently declared independence and an extremist 
Islamic regime to the south--both of which have a strong interest in 
exerting economic and political pressure upon them.
  These countries are very important to us:
  They are a major force in containing the spread northward of anti-
western Iranian extremism. Though Iranian activity in the region has 
been less blatant than elsewhere in the world, they are working very 
hard to bring the region into their sphere of influence and economic 
control.
  The Caspian Sea basin contains proven oil and gas reserves which, 
potentially, could rank third in the world after the Middle East and 
Russia and exceed $4 trillion in value. Investment in this region could 
ultimately reduce United States dependence on oil imports from the 
volatile Persian Gulf and could provide regional supplies as an 
alternative to Iranian sources.
  Strong market economies near Russia and China can only help to 
positively influence these two countries on their rocky path toward 
freedom.
  Finally, this region offers us a historic opportunity to spread 
freedom and democratic ideals. After years of fighting communism in 
this region, the doors are open to promote institutions of democratic 
government and to create the conditions for the growth of pluralistic 
societies, including religious tolerance.
  The single best way to consolidate our goals in the region is to 
promote regional cooperation and policies which will strengthen the 
sovereignty of each nation. Each of these countries has its own 
individual needs; however, many of the problems in the region overlap 
and are shared, and a number of common solutions and approaches can 
apply. This bill encourages this goal.
  All of the Silk Road countries are currently seeking U.S. investment 
and encouragement, and they are looking to us to assist them in working 
out regional political, economic and strategic cooperation. This bill 
authorizes assistance in all these areas.
  Given the correct infrastructure development, this region is and will 
continue to become, a key transit point that will ultimately link 
Central Asia with the West--as it did in the time when caravans 
traveled along these same routes in the Middle Ages.

  Opportunities to assist this infrastructure development abound--
taking advantage of these opportunities could not only cement political 
ties, but commercial and economic ones as well.
  The United States should do everything possible to promote this 
sovereignty and independence, as well as encourage solid diplomatic and 
economic cooperation between these nations.
  In order to do this we need to take a number of positive steps: We 
should be strong and active in helping to resolve local conflicts; we 
should be providing economic assistance to provide positive incentives 
for international private investments and increased trade; we should be 
assisting in the development of infrastructure necessary for 
communities, transportation, and energy and trade on an East-West axis; 
we should be providing security assistance to help fight the scourge of 
narcotics trafficking, the spread of weapons of mass destruction and 
the spread or organized crime; and--perhaps the most important of all--
we should be supplying all the assistance possible to strengthen 
democracy, tolerance and the development of civil society. These are 
the best ways to insure these countries remain independent and strong 
and that they move toward open and free government.
  Mr. President, the time to focus and act in this region is now. We 
have the opportunity to help these countries rebuild from the ground up 
and to encourage them to continue their strong independent stances, 
especially in relation to Iran and the spread of extremist, anti-
Western fundamentalism, which is one of the most clear and present 
dangers facing the United States today. I hope my colleagues will join 
me and support his 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. 1344

       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 ``Silk Road Strategy Act of 
     1997''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:

[[Page S11450]]

       (1) The ancient Silk Road, once the economic lifeline of 
     Central Asia and the South Caucasus, traversed much of the 
     territory now within the countries of Armenia, Azerbaijan, 
     Georgia, Kazakstan, Kyrgyzstan, Tajikistan, Turkmenistan, and 
     Uzbekistan.
       (2) Economic interdependence spurred mutual cooperation 
     among the peoples along the Silk Road and restoration of the 
     historic relationships and economic ties between those 
     peoples is an important element of ensuring their sovereignty 
     as well as the success of democratic and market reforms.
       (3) The development of strong political and economic ties 
     between countries of the South Caucasus and Central Asia and 
     the West will foster stability in the region.
       (4) The development of open market economies and open 
     democratic systems in the countries of the South Caucasus and 
     Central Asia will provide positive incentives for 
     international private investment, increased trade, and other 
     forms of commercial interactions with the rest of the world.
       (5) The Caspian Sea Basin, overlapping the territory of the 
     countries of the South Caucasus and Central Asia, contains 
     proven oil and gas reserves that may exceed 
     $4,000,000,000,000 in value.
       (6) The region of the South Caucasus and Central Asia will 
     produce oil and gas in sufficient quantities to reduce the 
     dependence of the United States on energy from the volatile 
     Persian Gulf region.
       (7) United States foreign policy and international 
     assistance should be narrowly targeted to support the 
     economic and political independence of the countries of the 
     South Caucasus and Central Asia.

     SEC. 3. POLICY OF THE UNITED STATES.

       It shall be the policy of the United States in the 
     countries of the South Caucasus and Central Asia--
       (1) to promote and strengthen independence, sovereignty, 
     and democratic government;
       (2) to assist actively in the resolution of regional 
     conflicts;
       (3) to promote friendly relations and economic cooperation;
       (4) to help promote market-oriented principles and 
     practices;
       (5) to assist in the development of the infrastructure 
     necessary for communications, transportation, and energy and 
     trade on an East-West axis in order to build strong 
     international relations and commerce between those countries 
     and the stable, democratic, and market-oriented countries of 
     the Euro-Atlantic Community; and
       (6) to support United States business interests and 
     investments in the region.

     SEC. 4. UNITED STATES EFFORTS TO RESOLVE CONFLICTS IN 
                   GEORGIA, AZERBAIJAN, AND TAJIKISTAN.

       It is the sense of Congress that the President should use 
     all diplomatic means practicable, including the engagement of 
     senior United States Government officials, to press for an 
     equitable, fair, and permanent resolution to the conflicts in 
     Georgia and Azerbaijan and the civil war in Tajikistan.

     SEC. 5. AMENDMENT OF THE FOREIGN ASSISTANCE ACT OF 1961.

       Part I of the Foreign Assistance Act of 1961 (22 U.S.C. 
     2151 et seq.) is amended by adding at the end the following 
     new chapter:

 ``Chapter 12--Support for the Economic and Political Independence of 
          the Countries of the South Caucasus and Central Asia

     ``SEC. 499. UNITED STATES ASSISTANCE TO PROMOTE 
                   RECONCILIATION AND RECOVERY FROM REGIONAL 
                   CONFLICTS.

       ``(a) Purpose of Assistance.--The purposes of assistance 
     under this section are--
       ``(1) to create the basis for reconciliation between 
     belligerents;
       ``(2) to promote economic development in areas of the 
     countries of the South Caucasus and Central Asia impacted by 
     civil conflict and war; and
       ``(3) to encourage broad regional cooperation among 
     countries of the South Caucasus and Central Asia that have 
     been destabilized by internal conflicts.
       ``(b) Authorization for Assistance.--
       ``(1) In general.--To carry out the purposes of subsection 
     (a), the President is authorized to provide humanitarian 
     assistance and economic reconstruction assistance under this 
     Act, and assistance under the Migration and Refugee 
     Assistance Act of 1962 (22 U.S.C. 2601 et seq.), to the 
     countries of the South Caucasus and Central Asia to support 
     the activities described in subsection (c).
       ``(2) Definition of humanitarian assistance.--In this 
     subsection, the term `humanitarian assistance' means 
     assistance to meet urgent humanitarian needs, in particular 
     meeting needs for food, medicine, medical supplies and 
     equipment, and clothing.
       ``(c) Activities Supported.--Activities that may be 
     supported by assistance under subsection (b) are limited to--
       ``(1) providing for the essential needs of victims of the 
     conflicts;
       ``(2) facilitating the return of refugees and internally 
     displaced persons to their homes; and
       ``(3) assisting in the reconstruction of residential and 
     economic infrastructure destroyed by war.
       ``(d) Policy.--It is the sense of Congress that the United 
     States should, where appropriate, support the establishment 
     of neutral, multinational peacekeeping forces to implement 
     peace agreements reached between belligerents in the 
     countries of the South Caucasus and Central Asia.

     ``SEC. 499A. ECONOMIC ASSISTANCE.

       ``(a) Purpose of Assistance.--The purpose of assistance 
     under this section is to foster the conditions necessary for 
     regional economic cooperation in the South Caucasus and 
     Central Asia.
       ``(b) Authorization for Assistance.--To carry out the 
     purpose of subsection (a), the President is authorized to 
     provide technical assistance to the countries of the South 
     Caucasus and Central Asia to support the activities described 
     in subsection (c).
       ``(c) Activities Supported.--Activities that may be 
     supported by assistance under subsection (b) are limited to 
     the development of the structures and means necessary for the 
     growth of private sector economies based upon market 
     principles.
       ``(d) Policy.--It is the sense of Congress that the United 
     States should--
       ``(1) assist the countries of the South Caucasus and 
     Central Asia to develop laws and regulations that would 
     facilitate the ability of those countries to join the World 
     Trade Organization;
       ``(2) provide permanent nondiscriminatory trade treatment 
     (MFN status) to the countries of the South Caucasus and 
     Central Asia; and
       ``(3) consider the establishment of zero-to-zero tariffs 
     between the United States and the countries of the South 
     Caucasus and Central Asia.

     ``SEC. 499B. DEVELOPMENT OF INFRASTRUCTURE.

       ``(a) Purpose of Assistance.--The purposes of assistance 
     under this section are--
       ``(1) to develop the physical infrastructure necessary for 
     regional cooperation among the countries of the South 
     Caucasus and Central Asia; and
       ``(2) to encourage closer economic relations between those 
     countries and the United States and other developed nations.
       ``(b) Authorization for Assistance.--To carry out the 
     purposes of subsection (a), the following types of assistance 
     to the countries of the South Caucasus and Central Asia are 
     authorized to support the activities described in subsection 
     (c):
       ``(1) Activities by the Export-Import Bank to complete the 
     review process for eligibility for financing under the 
     Export-Import Bank Act of 1945.
       ``(2) The provision of insurance, reinsurance, financing, 
     or other assistance by the Overseas Private Investment 
     Corporation.
       ``(3) Assistance under section 661 of this Act (relating to 
     the Trade and Development Agency).
       ``(c) Activities Supported.--Activities that may be 
     supported by assistance under subsection (b) are limited to 
     promoting actively the participation of United States 
     companies and investors in the planning, financing, and 
     construction of infrastructure for communications, 
     transportation, and energy and trade including highways, 
     railroads, port facilities, shipping, banking, insurance, 
     telecommunications networks, and gas and oil pipelines.
       ``(d) Policy.--It is the sense of Congress that the United 
     States representatives at the International Bank for 
     Reconstruction and Development, the International Finance 
     Corporation, and the European Bank for Reconstruction and 
     Development should encourage lending to the countries of the 
     South Caucasus and Central Asia to assist the development of 
     the physical infrastructure necessary for regional economic 
     cooperation.

     ``SEC. 499C. SECURITY ASSISTANCE.

       ``(a) Purpose of Assistance.--The purpose of assistance 
     under this section is to assist countries of the South 
     Caucasus and Central Asia to secure their borders and 
     implement effective controls necessary to prevent the 
     trafficking of illegal narcotics and the proliferation of 
     technology and materials related to weapons of mass 
     destruction (as defined in section 2332a(c)(2) of title 18, 
     United States Code), and to contain and inhibit transnational 
     organized criminal activities.
       ``(b) Authorization for Assistance.--To carry out the 
     purpose of subsection (a), the President is authorized to 
     provide the following types of assistance to the countries of 
     the South Caucasus and Central Asia to support the activities 
     described in subsection (c):
       ``(1) Assistance under chapter 5 of part II of this Act 
     (relating to international military education and training).
       ``(2) Assistance under chapter 8 of this part of this Act 
     (relating to international narcotics control assistance).
       ``(3) The transfer of excess defense articles under section 
     516 of this Act (22 U.S.C. 2321j).
       ``(c) Activities Supported.--Activities that may be 
     supported by assistance under subsection (b) are limited to 
     assisting those countries of the South Caucasus and Central 
     Asia in developing capabilities to maintain national border 
     guards, coast guard, and customs controls.
       ``(d) Policy.--It is the sense of Congress that the United 
     States should encourage and assist the development of 
     regional military cooperation among the countries of the 
     South Caucasus and Central Asia through programs such as the 
     Central Asian Battalion and the Partnership for Peace of the 
     North Atlantic Treaty Organization.

     ``SEC. 499D. STRENGTHENING DEMOCRACY, TOLERANCE, AND THE 
                   DEVELOPMENT OF CIVIL SOCIETY.

       ``(a) Purpose of Assistance.--The purpose of assistance 
     under this section is to promote institutions of democratic 
     government and to create the conditions for the growth of 
     pluralistic societies, including religious tolerance.
       ``(b) Authorization for Assistance.--To carry out the 
     purpose of subsection (a), the

[[Page S11451]]

     President is authorized to provide the following types of 
     assistance to the countries of the South Caucasus and Central 
     Asia.
       ``(1) Technical assistance for democracy building.
       ``(2) Technical assistance for the development of 
     nongovernmental organizations.
       ``(3) Technical assistance for development of independent 
     media.
       ``(4) Technical assistance for the development of the rule 
     of law.
       ``(5) International exchanges and advanced professional 
     training programs in skill areas central to the development 
     of civil society.
       ``(c) Activities Supported.--Activities that may be 
     supported by assistance under subsection (b) are limited to 
     activities that directly and specifically are designed to 
     advance progress toward the development of democracy.
       ``(d) Policy.--It is the sense of Congress that the Voice 
     of America and RFE/RL, Incorporated, should maintain high 
     quality broadcasting for the maximum duration possible in the 
     native languages of the countries of the South Caucasus and 
     Central Asia.

     ``SEC. 499E. INELIGIBILITY FOR ASSISTANCE.

       ``(a) In General.--Except as provided in subsection (b), 
     assistance may not be provided under this chapter for a 
     country of the South Caucasus or Central Asia if the 
     President determines and certifies to the appropriate 
     congressional committees that the country--
       ``(1) is engaged in a consistent pattern of gross 
     violations of internationally recognized human rights;
       ``(2) has, on or after the date of enactment of this 
     chapter, knowingly transferred to another country--
       ``(A) missiles or missile technology inconsistent with the 
     guidelines and parameters of the Missile Technology Control 
     Regime (as defined in section 11B(c) of the Export 
     Administration Act of 1979 950 U.S.C. App. 2410b(c); or
       ``(B) any material, equipment, or technology that would 
     contribute significantly to the ability of such country to 
     manufacture any weapon of mass destruction (including 
     nuclear, chemical, and biological weapons) if the President 
     determines that the material, equipment, or technology was to 
     be used by such country in the manufacture of such weapons;
       ``(3) has supported acts of international terrorism;
       ``(4) is prohibited from receiving such assistance by 
     chapter 10 of the Arms Export Control Act or section 
     306(a)(1) and 307 of the Chemical and Biological Weapons 
     Control and Warfare Elimination Act of 1991 (22 U.S.C. 
     5604(a)(1), 5605); or
       ``(5) has initiated an act of aggression against another 
     state in the region after the date of enactment of the Silk 
     Road Strategy Act of 1997.
       ``(b) Exception to Ineligibility.--Notwithstanding 
     subsection (a), assistance may be provided under this chapter 
     if the President determines and certifies in advance to the 
     appropriate congressional committees that the provision of 
     such assistance is important to the national interest of the 
     United States.

     ``SEC. 499F. ADMINISTRATIVE AUTHORITIES.

       ``(a) Assistance Through Governments and Nongovernmental 
     Organizations.--Assistance under this chapter may be provided 
     to governments or through nongovernmental organizations.
       ``(b) Use of Economic Support Funds.--Except as otherwise 
     provided, any funds that have been allocated under chapter 4 
     of part II for assistance for the independent states of the 
     former Soviet Union may be used in accordance with the 
     provisions of this chapter.
       ``(c) Terms and Conditions.--Assistance under this chapter 
     shall be provided on such terms and conditions as the 
     President may determine.
       ``(d) Superseding Existing Law.--The authority to provide 
     assistance under this chapter supersedes any other provision 
     of law, except for--
       ``(1) this chapter;
       ``(2) section 634A of this Act and comparable notification 
     requirements contained in sections of the annual foreign 
     operations, export financing, and related programs Act; and
       ``(3) section 1341 of title 31, United States Code 
     (commonly referred to as the ``Anti-Deficiency Act''), the 
     Congressional Budget and Impoundment Control Act of 1974, the 
     Balanced Budget and Emergency Deficit Control Act of 1985, 
     and the Budget Enforcement Act of 1990.

     ``SEC. 499G. DEFINITIONS.

       ``In this chapter:
       ``(1) Appropriate congressional committees.--The term 
     `appropriate congressional committees' means the Committee on 
     Foreign Relations of the Senate and the Committee on 
     International Relations of the House of Representatives.
       ``(2) Countries of the south caucasus and central asia.--
     The term `countries of the South Caucasus and Central Asia' 
     means Armenia, Azerbaijan, Georgia, Kazakstan, Kyrgystan, 
     Tajikistan, Turkmenistan, and Uzbekistan.''.

     SEC. 6. ANNUAL REPORT.

       Beginning one year after the date of enactment of this Act, 
     and annually thereafter, the President shall submit a report 
     to the appropriate congressional committees--
       (1) identifying the progress of United States foreign 
     policy to accomplish the policy identified in section 3;
       (2) evaluating the degree to which the assistance 
     authorized by chapter 12 of part I of the Foreign Assistance 
     Act of 1961, as added by section 5 of this Act, was able to 
     accomplish the purposes identified in those sections; and
       (3) recommending any additional initiatives that should be 
     undertaken by the United States to implement the policy and 
     purposes contained in this Act.

     SEC. 7. DEFINITIONS.

       In this Act:
       (1) Appropriate congressional committees.--The term 
     ``appropriate congressional committees'' means the Committee 
     on Foreign Relations of the Senate and the Committee on 
     International Relations of the House of Representatives.
       (2) Countries of the south caucasus and central asia.--The 
     term ``countries of the South Caucasus and Central Asia'' 
     means Armenia, Azerbaijan, Georgia, Kazakstan, Kyrgystan, 
     Tajikistan, Turkmenistan, and Uzbekistan.
                                 ______
                                 
      By Mr. ROCKEFELLER (for himself and Ms. Collins):
  S. 1345. A bill to amend titles XVIII and XIX of the Social Security 
Act to expand and clarify the requirements regarding advance directives 
in order to ensure that an individual's health care decisions are 
complied with, and for other purposes; to the Committee on Finance.


        the advance planning and compassionate care act of 1997

  Mr. ROCKEFELLER. Mr. President, I am extremely pleased to be 
introducing the Advance Planning and Compassionate Care Act of 1997 
with my colleague from Maine, Senator Collins. I have already had the 
great pleasure of working with Senator Collins on legislation earlier 
this year to improve the portability of Medigap insurance policies. We 
were successful in getting a good portion of that legislation enacted 
this year, so I am very pleased to have another opportunity to work 
with Senator Collins on another set of issues that are so important to 
millions of Medicare beneficiaries and the rest of America.

  We introduce this legislation to ask Congress to take action that 
responds directly and humanely to the needs of elderly and others 
during some of their most difficult and often traumatic time of their 
lives. The United States deserves to be extremely proud of the medical 
advances and efforts that have extended our people's life expectancy 
and our ability to overcome disease and medical setbacks. But we need 
to take some additional, tangible steps to also make progress in the 
practices and care that affect our citizens when they ultimately face 
death or the real possibility of death. Our bill provides some of those 
steps.
  While this is a difficult area to discuss, it is a very real area for 
Americans year in and year out. This is legislation designed to respond 
to pressing needs of patients, their family members, and their health 
care providers, and I hope that Congress will adopt these steps in the 
next year.
  In view of the debate this year on physician assisted suicide and 
from my own personal experiences, I have spent considerable time 
delving into the concerns and dilemmas that face patients, their family 
members, and their physicians when confronted with death or the 
possibility of dying. In almost all such difficult situations, people 
are not thinking about physician-assisted suicide. The needs and 
dilemmas that confront them have much more to do with the kind of care 
and information that they need, often desperately.
  The legislation we are introducing today builds on bipartisan 
legislation enacted in 1990, called the Patient Self-Determination Act. 
That legislation was championed by my former colleague from Missouri, 
Senator Danforth. I held a subcommittee hearing on Senator Danforth's 
legislation and it became very clear that the lack of a national policy 
on advance directives was not acceptable. As a result of that bill, 
hospitals, skilled nursing facilities, home health agencies, hospice 
programs, and HMO's participating in the Medicaid and Medicare programs 
must provide every adult receiving medical care with written 
information concerning patient involvement in their own treatment 
decisions. The health care institutions must also document in the 
medical record whether the patient has an advance directive. In 
addition, States were required to write description of their State laws 
concerning advance directives.
  Mr. President, at the time of that bill's enactment, we realized that 
it was only the first step toward increasing public awareness and 
addressing

[[Page S11452]]

some very difficult issues related to end-of-life care. As a result of 
that legislation, a growing number of Americans do have advance 
directives. But recent studies have found that the majority of 
Americans have not discussed end-of-life issues with their families or 
their physicians and have not relayed their treatment preferences 
either verbally or in writing.
  There is also an increasing awareness that physicians and many other 
health care providers are uncomfortable addressing end-of-life issues 
and are even apparently unwilling to respect their patient's 
preferences in some cases. Another complicating factor is the great 
variation that exists among State laws, and the lack of a legal 
requirement that an advance directive written in one State be respected 
in another State.
  Mr. President, the legislation we are introducing today focuses on 
the need to improve end-of-life care for Medicare beneficiaries. It 
addresses the need to develop models of compassionate care and quality 
measures for end-of-life care in the Medicare Program, and it will 
encourage individuals to have more open communication with family 
members and health care providers concerning their preferences for end-
of-life care.
  The first section of the Advance Planning and Compassionate Care Act 
strengthens the previously enacted Patient Self Determination Act in 
the following ways.
  First, it requires that every Medicare beneficiary have the 
opportunity to discuss health care decisionmaking issues with an 
appropriately trained professional, when he or she makes a request. 
This measure would help make sure that patients and their families have 
the ability to discuss and address concerns and issues relating to 
their care, including end-of-life care, with a trained professional. 
Many health care institutions already have teams of providers to 
address difficult health care decisions and some even mediate among 
patients, families, and providers. In smaller institutions, social 
workers, chaplains, nurses, or other trained professional could be made 
available for consultation.
  Second, our bill requires that a person's advance directive be placed 
in a prominent part of the medical record. Often advance directives can 
not even be found in the medical record, making it more difficult for 
providers to respect patients' wishes. It is essential that an 
individual's advance directive be readily available and visible to 
anyone involved in their health care.
  Third, it will assure that an advance directive valid in one State 
will be valid in another State. At present, portability of advance 
directives from State to State is not assured. Such portability can 
only be guaranteed through Federal legislation.

  The second part of our bill directs the Secretary of Health and Human 
Services to advise Congress on an approach to adopting the provisions 
of the Uniform Health Care Decisions Act for Medicare beneficiaries. 
The Uniform Health Care Decisions Act was developed by the Uniform Law 
Commissioners, a group with representation from all States that has 
been in existence for over 100 years. The Uniform Health Care Decisions 
Act includes all the important components of model advance directive 
legislation. A great deal of legal effort went into its development, 
with input by all the States and approval by the American Bar 
Association. Medicare beneficiaries deserve a uniform approach to 
advance directives, especially since many move from one State to 
another while in the Medicare Program. The tremendous variation in 
State laws that currently exists only adds to the confusion of health 
care professionals and their patients.
  Just this month, a study done by Dr. Jack Wennberg at Dartmouth 
University documented the tremendous variation that exists in the 
medical care that Medicare beneficiaries receive in the last few months 
of their lives. This sort of analysis highlights that patient 
preferences have little to do with the sort of care patients receive in 
their final months of life. Where you live determines the sort of 
medical care you will receive more so than what you might prefer.
  The third part of this legislation would encourage the development of 
models for end-of-life care for Medicare beneficiaries who do not 
qualify for the Medicare hospice benefit but still have chronic, 
debilitating and ultimately fatal illnesses. The tremendous advances in 
medicine and medical technology over the past 30 to 50 years have 
resulted in a greatly lengthened life expectancy for Americans, as well 
as vastly improved functioning and quality of life for the elderly and 
those with chronic disease. Many of these advances have been made 
possible by federally financed health care programs, such as the 
Medicare Program that assures access to high quality health care for 
all elderly Americans. Medicare has also funded much of the development 
of technology and a highly skilled physician workforce through support 
of medical education and academic medical centers. These advances have 
also created major dilemmas in addressing terminal or potentially 
terminal disease, as well as a sense of loss of control by many with 
terminal illness.
  I believe it is time for Medicare to help seniors have access to 
compassionate, supportive, and pain free care during prolonged 
illnesses and at the end of life. As we begin to discuss restructuring 
the Medicare Program for the long term, this will be one of my primary 
goals. Our legislation instructs the Department of Health and Human 
Services to develop appropriate quality measures and models of care for 
persons with chronic, debilitating disease, including the very frail 
elderly who will comprise an increasing number of Medicare 
beneficiaries. Our bill also sets up a consumer hotline that can 
provide the American public with information on the legal, medical, and 
ethical issues related to advance directives and medical 
decisionmaking.
  Mr. President, I am learning more and more about the importance of 
educating health care providers and the public that chronic, 
debilitating, terminal disease need not be associated with pain, major 
discomfort, and loss of control. We can control pain and treat 
depression, as well as the other causes of suffering during the dying 
process. We must now apply this knowledge to assure all Americans 
appropriate end-of-life care. And to make sure that Medicare 
beneficiaries are able to receive the most effective medicine to 
control their pain, Medicare's coverage rules would be expanded under 
our bill to include coverage for self-administered pain medications.
  Under current law, Medicare generally does not pay for any outpatient 
prescription drugs. The only pain medication paid for by the Medicare 
Program are those drugs that are administered by a portable pump. The 
pump is covered by Medicare as durable medical equipment and the drugs 
used with that pump are also covered. Our bill would expand coverage to 
include self-administered pain medications, for example oral drugs or 
transdermal patches. These alternatives are as effective in pain relief 
and, most obviously, a much more comfortable way for patients to 
receive their pain medication.
  Mr. President, much also needs to be done to assure that all health 
care providers have the appropriate training to use what is already 
known about supportive care. The public must be educated and empowered 
to discuss these issues with family members as well as their own 
physicians so that each individual's wishes can be respected. More 
research is needed to develop appropriate measures of quality end-of-
life care and incorporate these measures into medical practice in all 
health care settings. And finally, appropriate financial incentives 
must be present within Medicare, especially, to allow the elderly and 
disabled their choice of appropriate care at the end of life. 
Medicare's coverage policy should not be the sole determinate of the 
route that pain medication is administered.
  To conclude, I am proud to offer this legislation with Senator 
Collins. We hope consideration of this bill will be an opportunity to 
take notice of the many constructive steps that can be taken to address 
the needs of patients and family members grappling with great pain and 
medical difficulties. During this time when physician assisted suicide 
obtains so many headlines, we are eager to call on Congress to turn to 
the alternative ways of providing help and relief to seniors and other 
Americans who only are interested in such alternatives.

[[Page S11453]]

  I ask unanimous consent that a summary and a copy of the bill be 
printed in its entirety in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1345

       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 ``Advance Planning and 
     Compassionate Care Act of 1997''.

     SEC. 2. EXPANSION OF ADVANCE DIRECTIVES.

       (a) Medicare.--Section 1866(f) of the Social Security Act 
     (42 U.S.C. 1395cc(f)) (as amended by section 4641 of the 
     Balanced Budget Act of 1997 (Public Law 105-33; 111 Stat. 
     487)) is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (B), by inserting ``and if presented by 
     the individual, to include the content of such advance 
     directive in a prominent part of such record'' before the 
     semicolon;
       (B) in subparagraph (D), by striking ``and'' at the end;
       (C) in subparagraph (E), by striking the period and 
     inserting ``; and''; and
       (D) by inserting after subparagraph (E) the following:
       ``(F) to provide each individual with the opportunity to 
     discuss issues relating to the information provided to that 
     individual pursuant to subparagraph (A) with an appropriately 
     trained professional.''; and
       (2) by adding at the end the following:
       ``(4)(A) An advance directive validly executed outside of 
     the State in which such advance directive is presented by an 
     adult individual to a provider of services or a prepaid or 
     eligible organization shall be given the same effect by that 
     provider or organization as an advance directive validly 
     executed under the law of the State in which it is presented 
     would be given effect.
       ``(B) Nothing in this paragraph shall be construed to 
     authorize the administration, withholding, or withdrawal of 
     health care unless it is consistent with the laws of the 
     State in which an advance directive is presented.
       ``(C) The provisions of this paragraph shall preempt any 
     State law to the extent such law is inconsistent with such 
     provisions. The provisions of this paragraph shall not 
     preempt any State law that provides for greater portability, 
     more deference to a patient's wishes, or more latitude in 
     determining a patient's wishes.''.
       (b) Medicaid.--Section 1902(w) of the Social Security Act 
     (42 U.S.C. 1396a(w)) is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (B)--
       (i) by striking ``in the individual's medical record'' and 
     inserting ``in a prominent part of the individual's current 
     medical record''; and
       (ii) by inserting ``and if presented by the individual, to 
     include the content of such advance directive in a prominent 
     part of such record'' before the semicolon;
       (B) in subparagraph (D), by striking ``and'' at the end;
       (C) in subparagraph (E), by striking the period and 
     inserting ``; and''; and
       (D) by inserting after subparagraph (E) the following:
       ``(F) to provide each individual with the opportunity to 
     discuss issues relating to the information provided to that 
     individual pursuant to subparagraph (A) with an appropriately 
     trained professional.''; and
       (2) by adding at the end the following:
       ``(5)(A) An advance directive validly executed outside of 
     the State in which such advance directive is presented by an 
     adult individual to a provider or organization shall be given 
     the same effect by that provider or organization as an 
     advance directive validly executed under the law of the State 
     in which it is presented would be given effect.
       ``(B) Nothing in this paragraph shall be construed to 
     authorize the administration, withholding, or withdrawal of 
     health care otherwise prohibited by the laws of the State in 
     which an advance directive is presented.
       ``(C) The provisions of this paragraph shall preempt any 
     State law to the extent such law is inconsistent with such 
     provisions. The provisions of this paragraph shall not 
     preempt any State law that provides for greater portability, 
     more deference to a patient's wishes, or more latitude in 
     determining a patient's wishes.''.
       (c) Effective Dates.--
       (1) In general.--Subject to paragraph (2), the amendments 
     made by subsections (a) and (b) shall apply to provider 
     agreements entered into, renewed, or extended under title 
     XVIII of the Social Security Act, and to State plans under 
     title XIX of such Act, on or after such date (not later than 
     1 year after the date of the enactment of this Act) as the 
     Secretary of Health and Human Services specifies.
       (2) Extension of effective date for state law amendment.--
     In the case of a State plan under title XIX of the Social 
     Security Act which the Secretary of Health and Human Services 
     determines requires State legislation in order for the plan 
     to meet the additional requirements imposed by the amendments 
     made by subsection (b), the State plan shall not be regarded 
     as failing to comply with the requirements of such title 
     solely on the basis of its failure to meet these additional 
     requirements before the first day of the first calendar 
     quarter beginning after the close of the first regular 
     session of the State legislature that begins after the date 
     of the enactment of this Act. For purposes of the previous 
     sentence, in the case of a State that has a 2-year 
     legislative session, each year of the session is considered 
     to be a separate regular session of the State legislature.

     SEC. 3. STUDY AND RECOMMENDATIONS TO CONGRESS ON ISSUES 
                   RELATING TO ADVANCE DIRECTIVE EXPANSION.

       (a) Study.--The Secretary of Health and Human Services 
     shall conduct a thorough study regarding the implementation 
     of the amendments made by section 2 of this Act.
       (b) Report.--Not later than 18 months after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall submit a report to Congress that contains a 
     detailed statement of the findings and conclusions of the 
     Secretary regarding the study conducted pursuant to 
     subsection (a), together with the Secretary's recommendations 
     for such legislation and administrative actions as the 
     Secretary considers appropriate.

     SEC. 4. STUDY AND LEGISLATIVE PROPOSAL TO CONGRESS.

       (a) Study.--
       (1) In general.--The Secretary of Health and Human Services 
     shall conduct a thorough study of all matters relating to the 
     creation of a national, uniform policy on advance directives 
     for individuals receiving items and services under titles 
     XVIII and XIX of the Social Security Act (42 U.S.C. 1395 et 
     seq., 1396 et seq.).
       (2) Matters studied.--The matters studied by the Secretary 
     of Health and Human Services shall include issues 
     concerning--
       (A) the election or refusal of life-sustaining treatment;
       (B) the provision of adequate palliative care including 
     pain management;
       (C) the portability of advance directives, including the 
     cases involving the transfer of an individual from one health 
     care setting to another;
       (D) immunity for health care providers that follow the 
     instructions in an individual's advance directive;
       (E) exemptions for health care providers from following the 
     instructions in an individual's advance directive;
       (F) conditions under which an advance directive is 
     operative;
       (G) revocation of an advance directive by an individual;
       (H) the criteria for determining that an individual is in 
     terminal status; and
       (I) surrogate decision making regarding end of life care.
       (b) Report to Congress.--Not later than 1 year after the 
     date of enactment of this Act, the Secretary of Health and 
     Human Services shall submit a report to Congress that 
     contains a detailed description of the results of the study 
     conducted pursuant to subsection (a).
       (c) Consultation.--In conducting the study and developing 
     the report under this section, the Secretary of Health and 
     Human Services shall consult with physicians and other health 
     care provider groups, consumer groups, the Uniform Law 
     Commissioners, and other interested parties.

     SEC. 5. DEVELOPMENT OF STANDARDS TO ASSESS END-OF-LIFE CARE.

       The Secretary of Health and Human Services, through the 
     Administrator of the Health Care Financing Administration, 
     the Director of the National Institutes of Health, and the 
     Administrator of the Agency for Health Care Policy and 
     Research, shall develop outcome standards and measures to 
     evaluate the performance of health care programs and projects 
     that provide end-of-life care to individuals and the quality 
     of such care.

     SEC. 6. NATIONAL INFORMATION HOTLINE FOR END-OF-LIFE 
                   DECISIONMAKING.

       The Secretary of Health and Human Services, through the 
     Administrator of the Health Care Financing Administration, 
     shall establish and operate directly, or by grant, contract, 
     or interagency agreement, out of funds otherwise appropriated 
     to the Secretary, a clearinghouse and 24-hour toll-free 
     telephone hotline, to provide consumer information about 
     advance directives, as defined in section 1866(f)(3) of the 
     Social Security Act (42 U.S.C. 1395cc(f)(3)), and end-of-life 
     decisionmaking.

     SEC. 7. EVALUATION OF AND DEMONSTRATION PROJECTS FOR 
                   INNOVATIVE AND NEW APPROACHES TO END-OF-LIFE 
                   CARE FOR MEDICARE BENEFICIARIES.

       (a) Definitions.--In this section:
       (1) Medicare beneficiaries.--The term ``medicare 
     beneficiaries'' means individuals who are entitled to 
     benefits under part A or eligible for benefits under part B 
     of the medicare program.
       (2) Medicare program.--The term ``medicare program'' means 
     the health care program under title XVIII of the Social 
     Security Act (42 U.S.C. 1395 et seq.).
       (3) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (b) Evaluation of Existing Programs.--
       (1) In general.--The Secretary, through the Administrator 
     of the Health Care Financing Administration, shall conduct 
     ongoing evaluations of innovative health care programs that 
     provide end-of-life care to medicare beneficiaries who are 
     seriously ill or who suffer from a medical condition that is 
     likely to be fatal.
       (2) Requirements.--Evaluations conducted under this 
     subsection shall include the following:

[[Page S11454]]

       (A) Evidence that the evaluated program implements 
     practices or procedures that result in improved patient 
     outcomes, resource utilization, or both.
       (B) A definition of the population served by the program 
     and a determination as to how accurately that population 
     reflects the total medicare beneficiaries in the area who are 
     in need of services offered by the program.
       (C) A description of the eligibility requirements and 
     enrollment procedures for the program.
       (D) A detailed description of the services provided to 
     medicare beneficiaries served by the program and the 
     utilization rates for such services.
       (E) A description of the structure for the provision of 
     specific services.
       (F) A detailed accounting of the costs of providing 
     specific services under the program.
       (G) A description of any procedures for offering medicare 
     beneficiaries a choice of services and how the program 
     responds to the preferences of the medicare beneficiaries 
     served by the program.
       (H) An assessment of the quality of care and of the 
     outcomes for medicare beneficiaries and the families of such 
     beneficiaries served by the program.
       (I) An assessment of any ethical, cultural, or legal 
     concerns regarding the evaluated program and with the 
     replication of such program in other settings.
       (J) Identification of any changes to regulations, or of any 
     additional funding, that would result in more efficient 
     procedures or improved outcomes, for the program.
       (3) External evaluators.--The Secretary shall contract with 
     1 or more external evaluators to coordinate and conduct the 
     evaluations required under this subsection and under 
     subsection (c)(4).
       (4) Use of outcome measures and standards.--An evaluation 
     conducted under this subsection and subsection (c)(4) shall 
     use the outcome standards and measures required to be 
     developed under section 5 as soon as those standards and 
     measures are available.
       (c) Demonstration Projects.--
       (1) Authority.--The Secretary, through the Administrator of 
     the Health Care Financing Administration, shall conduct 
     demonstration projects to develop new and innovative 
     approaches to providing end-of-life care to medicare 
     beneficiaries who are seriously ill or who suffer from a 
     medical condition that is likely to be fatal.
       (2) Application.--Any entity seeking to conduct a 
     demonstration project under this subsection shall submit to 
     the Secretary an application in such form and manner as the 
     Secretary may require.
       (3) Selection criteria.--
       (A) In general.--In selecting entities to conduct 
     demonstration projects under this subsection, the Secretary 
     shall select entities that will allow for demonstration 
     projects to be conducted in a variety of States, in an array 
     of care settings, and that reflect--
       (i) a balance between urban and rural settings;
       (ii) cultural diversity; and
       (iii) various modes of medical care and insurance, such as 
     fee-for-service, preferred provider organizations, health 
     maintenance organizations, hospice care, home care services, 
     long-term care, and integrated delivery systems.
       (B) Preferences.--The Secretary shall give preference to 
     applications for demonstration projects that--
       (i) will serve medicare beneficiaries who are dying of 
     illnesses that are most prevalent under the medicare program, 
     including cancer, heart failure, chronic obstructive 
     respiratory disease, dementia, stroke, and progressive 
     multifactorial frailty associated with advanced age; and
       (ii) appear capable of sustained service and broad 
     replication at a reasonable cost within commonly available 
     organizational structures.
       (4) Evaluations.--Each demonstration project conducted 
     under this subsection shall be evaluated at such regular 
     intervals as the Secretary determines are appropriate. An 
     evaluation of a project conducted under this subsection shall 
     include the items described in subsection (b)(2) and the 
     following:
       (A) A comparison of the quality of care and of the outcomes 
     for medicare beneficiaries and the families of such 
     beneficiaries served by the demonstration project to the 
     quality of care and outcomes for such individuals that would 
     have resulted if care had been provided under existing 
     delivery systems.
       (B) An analysis of how ongoing measures of quality and 
     accountability for improvement and excellence could be 
     incorporated into the demonstration project.
       (C) A comparison of the costs of the care provided to 
     medicare beneficiaries under the demonstration project to the 
     costs of that care if it had been provided under the medicare 
     program.
       (5) Waiver authority.--The Secretary may waive compliance 
     with any requirement of titles XI, XVIII, and XIX of the 
     Social Security Act (42 U.S.C. 1301 et seq., 1395 et seq., 
     1396 et seq.) which, if applied, would prevent a 
     demonstration project carried out under this subsection from 
     effectively achieving the purpose of such a project.
       (d) Annual Reports to Congress.--
       (1) In general.--Beginning 1 year after the date of 
     enactment of this Act, and annually thereafter, the Secretary 
     shall submit to Congress a report on the quality of end-of-
     life care under the medicare program, together with any 
     suggestions for legislation to improve the quality of such 
     care under that program.
       (2) Summary of recent studies.--A report submitted under 
     this subsection shall include a summary of any recent studies 
     and advice from experts in the health care field regarding 
     the ethical, cultural, and legal issues that may arise when 
     attempting to improve the health care system to meet the 
     needs of individuals with serious and eventually fatal 
     illnesses.
       (3) Continuation or replication of demonstration 
     projects.--Beginning 3 years after the date of enactment of 
     this Act, the report required under this subsection shall 
     include recommendations regarding whether the demonstration 
     projects conducted under subsection (c) should be continued 
     and whether broad replication of any of those projects should 
     be initiated.
       (e) Funding.--The Secretary shall provide for the transfer 
     from the Federal Hospital Insurance Trust Fund established 
     under section 1817 of the Social Security Act (42 U.S.C. 
     1395i) of such sums as are necessary for the costs of 
     conducting evaluations under subsection (b), conducting 
     demonstration projects under subsection (c), and preparing 
     and submitting the annual reports required under subsection 
     (d). Amounts may be transferred under the preceding sentence 
     without regard to amounts appropriated in advance in 
     appropriations Acts.

     SEC. 8. MEDICARE COVERAGE OF SELF-ADMINISTERED MEDICATION FOR 
                   CERTAIN PATIENTS WITH CHRONIC PAIN.

       (a) In General.--Section 1861(s)(2) of the Social Security 
     Act (42 U.S.C. 1395x(s)(2)) (as amended by section 4557 of 
     the Balanced Budget Act (Public Law 105-33; 111 Stat. 463)) 
     is amended--
       (1) by striking ``and'' at the end of subparagraph (S);
       (2) in subparagraph (T), by striking the period at the end 
     and inserting ``; and''; and
       (3) by inserting after subparagraph (T) the following:
       ``(U) self-administered drugs which may be dispensed only 
     upon prescription and which are prescribed for the relief of 
     chronic pain in patients with a life-threatening disease or 
     condition;''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply to items and services furnished on or after June 
     1, 1998.
                                  ____


      Advance Planning and Compassionate Care Act of 1997--Summary

       More than 70 percent of the 2 million Americans expected to 
     die this year will be over the age of 65. The Medicare and 
     Medicaid programs pay for the majority of care at the end of 
     life. Dr. Jack Wennberg, health researcher at Dartmouth 
     University, recently documented the tremendous geographic 
     variation that exists in end of life care provided to 
     Medicare beneficiaries. The type of medical care a patient 
     received in their last month of life was driven more by where 
     a person lived than by personal preferences.


                 (1) Better Information and Counseling

       Current law: This bill builds on federal legislation 
     (Patient Self-Determination Act) enacted in 1990 that 
     requires health care facilities to distribute information on 
     advance directives to their patients. Since passage of that 
     legislation, there has been an increase in the number of 
     individuals who have an advance directive but a recent Robert 
     Wood Johnson study found that while 20 percent of 
     hospitalized patients had an advance directive less than half 
     had ever talked with any of their doctors about having a 
     directive and only about one-third had their wishes 
     documented in their medical record. Many people do not 
     understand the importance of discussing their advance 
     directives with family members and their health care 
     provider. In addition, a 1994 survey found that only 5 out of 
     126 medical schools offered a separate, required course in 
     end of life care. Other surveys of doctors and medical 
     residents found little or no experience in discussing care 
     for dying patients.
       Proposal: Improves the type and amount of information 
     available to consumers by making sure that when a person 
     enters a hospital, nursing home, or other health care 
     facility, there is a knowledgeable person available to 
     discuss end of life care planning if requested, so that good 
     decisions--decisions based on the patient's own needs and 
     values--can be made. Requires that if a person has an advance 
     directive it must be placed in a prominent part of the 
     medical record where all the doctors and nurses can clearly 
     see it. Establishes a 24-hour hotline and information 
     clearinghouse to provide consumers with information on end of 
     life decision making.


                 (2) Portability of Advance Directives

       Current law: The specifics of advance directive legislation 
     vary greatly from state to state. Portability from state to 
     state can only be assured through federal legislation.
       Proposal: Ensures that an advance directive valid in one 
     state will be honored in another state, as long as the 
     contents of the advance directive do not conflict with the 
     laws of the state. In addition, requires the Secretary of 
     Health and Human Services to gather information and consult 
     with experts on the possibility of an uniform advance 
     directive for all Medicare beneficiaries, regardless of where 
     they live. An uniform advance directive would enable people 
     to document the kind of care they wish to get at the end of 
     their lives in a way that is easily recognizable and 
     understood by everyone.

[[Page S11455]]

        (3) Measures to Improve the Quality of End of Life Care

       Current Law: There are few quality measures or standards 
     available to assess the quality of care provided to Medicare 
     beneficiaries at the end of their life. The tremendous 
     geographic variation in medical care that currently exists on 
     end of life care reinforces the notion that most people do 
     not receive care driven by quality concerns but rather by the 
     availability of medical resources in the community and other 
     factors not related to quality care.
       Proposal: Requires the Secretary of Health and Human 
     Services, in conjunction with the Health Care Financing 
     Administration, National Institutes of Health, and the Agency 
     for Health Care Policy and Research, to develop outcome 
     standards and other measures to evaluate the quality care 
     provided to dying patients.


     (4) Pilot Project Funding to Improve End of Life Care Services

       Current Law: The only Medicare benefit aimed at improving 
     end of life care for Medicare beneficiaries is hospice care 
     which only serves a small minority of beneficiaries. In 1994, 
     the Medicare hospice benefit was provided to 340,000 dying 
     patients for the last few weeks of their lives. The hospice 
     benefit is limited to beneficiaries who have a terminal 
     illness with a life expectancy of 6 months or less. Cancer 
     and AIDS are virtually the only diseases that follow a 
     predictable course of decline near death. Cancer patients are 
     usually referred to hospice care when the individual's 
     functioning declines, usually 3-6 weeks before death. 
     Medicare beneficiaries with other diseases generally do not 
     have access to hospice care because the 6 month life 
     expectancy requirement is often difficult to determine.
       A review of studies done by an Institute of Medicine study 
     panel found that 40 to 80 percent of patients with a terminal 
     illness were inadequately treated for pain ``despite the 
     availability of effective pharmacological and other options 
     for relieving pain.''
       Proposal: Provides funding for demonstration projects to 
     develop new and innovative approaches to improving end of 
     life care provided to Medicare beneficiaries, in particular 
     those individuals who do not qualify for, or select, hospice 
     care. Also, includes funding to evaluate existing pilot 
     programs that are providing innovative approaches to end of 
     life care.


               (5) Improved Coverage of Pain Medications

       Current Law: With a few exceptions, Medicare does not 
     generally pay the cost of self-administered drugs prescribed 
     for outpatient use. The only outpatient pain medications 
     currently covered by Medicare are those that are administered 
     by a portable pump. The pump is covered by Medicare as 
     durable medical equipment, and the drugs associated with that 
     pump are also covered. It is widely recognized among 
     physicians treating patients with cancer and other life-
     threatening diseases that self-administered pain medications, 
     including oral drug and transdermal patches, offer 
     alternatives that are equally effective at controlling pain, 
     more comfortable for the patient, and much less costly than 
     the pump.
       Proposal: Requires Medicare coverage for self-administered 
     pain medications prescribed for outpatient use for patients 
     with life-threatening disease and chronic pain.

  Ms. COLLINS. Mr. President, I am pleased to be joining my colleague 
from West Virginia, Senator Rockefeller, in introducing the Advance 
Planning and Compassionate Care Act which is intended to improve the 
way we care for people at the end of their lives.
  Noted health economist Uwe Reinhardt once observed that ``Americans 
are the only people on earth who believe that death is negotiable.'' 
Advancements in medicine, public health, and technology have enabled 
more and more of us to live longer and healthier lives. However, when 
medical treatment can no longer promise a continuation of life, 
patients and their families should not have to fear that the process of 
dying will be marked by preventable pain, avoidable distress, or care 
that is inconsistent with their values or wishes.
  The fact is, dying is a universal experience, and it is time to 
reexamine how we approach death and dying and how we care for people at 
the end of their lives. Clearly there is more that we can do to relieve 
suffering, respect personal choice and dignity, and provide 
opportunities for people to find meaning and comfort at life's 
conclusion.
  Unfortunately, most Medicare patients and their physicians do not 
currently discuss death or routinely make advance plans for end-of-life 
care. As a result, about one-fourth of Medicare funds are now spent on 
care at the end of life that is geared toward expensive, high-
technology interventions and rescue care. While four out of five 
Americans say they would prefer to die at home, studies show that 
almost 80 percent die in institutions where they may be in pain, and 
where they are subjected to high-technology treatments that merely 
prolong suffering.
  Moreover, according to a Dartmouth study released earlier this month, 
where a patient lives has a direct impact on how that patient dies. The 
study found that the amount of medical treatment Americans receive in 
their final months varies tremendously in the different parts of the 
country, and it concluded that the determination of whether or not an 
older patient dies in the hospital probably has more to do with the 
supply of hospital beds than the patient's needs or preference.
  The Advance Planning and Compassionate Care Act is intended to help 
us improve the way our health care system serves patients at the end of 
their lives. Among other provisions, the bill makes a number of changes 
to the Patient Self-Determination Act of 1990 to facilitate appropriate 
discussions and individual autonomy in making difficult discussions 
about end-of-life care. For instance, the legislation requires that 
every Medicare beneficiary receiving care in a hospital or nursing 
facility be given the opportunity to discuss end-of-life care and the 
preparation of an advanced directive with an appropriately trained 
professional within the institution. The legislation also requires that 
if a patient has an advanced directive, it must be displayed in a 
prominent place in the medical record so that all the doctors and 
nurses can clearly see it.
  The legislation will expand access to effective and appropriate pain 
medications for Medicare beneficiaries at the end of their lives. 
Severe pain, including breakthrough pain that defies usual methods of 
pain control, is one of the most debilitating aspects of terminal 
illness. However, the only pain medication currently covered by 
Medicare in an outpatient setting is that which is administered by a 
portable pump.
  It is widely recognized among physicians treating patients with 
cancer and other life-threatening diseases that self-administered pain 
medications, including oral drugs and transdermal patches, offer 
alternatives that are equally effective in controlling pain, more 
comfortable for the patient, and much less costly than the pump. 
Therefore, the Advance Planning and Compassionate Care Act would expand 
Medicare to cover self-administered pain medications prescribed for the 
relief of chronic pain in life-threatening diseases or conditions.
  In addition, the legislation authorizes the Department of Health and 
Human Services to study end-of-life issues for Medicare and Medicaid 
patients and also to develop demonstration projects to develop models 
for end-of-life care for Medicare beneficiaries who do not qualify for 
the hospice benefit, but who still have chronic debilitating and 
ultimately fatal illnesses. Currently, in order for a Medicare 
beneficiary to qualify for the hospice benefit, a physician must 
document that the person has a life expectancy of 6 months or less. 
With some conditions--like congestive heart failure--it is difficult to 
project life expectancy with any certainty. However, these patients 
still need hospice-like services, including advance planning, support 
services, symptom management, and other services that are not currently 
available.
  Finally, the legislation establishes a telephone hotline to provide 
consumer information and advice concerning advance directives, end-of-
life issues and medical decisionmaking and directs the Agency for 
Health Care Policy and Research to develop a research agenda for the 
development of quality measures for end-of-life care.
  The legislation we are introducing today is particularly important in 
light of the current debate on physician-assisted suicide. As the 
Bangor Daily News pointed out in an editorial published earlier this 
year, the desire for assisted suicide is generally driven by concerns 
about the quality of care for the terminally ill; by the fear of 
prolonged pain, loss of dignity, and emotional strain on family 
members. Such worries would recede and support for assisted suicide 
would evaporate if better palliative care and more effective pain 
management were widely available, and I ask unanimous consent that this 
editorial be included in the Record.
  Mr. President, patients and their families should be able to trust 
that the care they receive at the end of their lives is not only of 
high quality,

[[Page S11456]]

but also that it respects their desires for peace, autonomy, and 
dignity. The Advanced Planning and Compassionate Care Act that Senator 
Rockefeller and I are introducing today will give us some of the tools 
that we need to improve care of the dying in this country, and I urge 
all of my colleagues to join us as cosponsors.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                      Life and Death With Dignity

       When Maine legislators consider a bill this session on 
     physician-assisted suicide, they will face a question that 
     the nation's medical community has been unable to settle 
     after long debate. Legislators should respect the enormity of 
     what they are being asked to consider, recognizing that there 
     are many steps between the current state of caring for the 
     terminally ill and hastening their deaths.
       Even as the Supreme Court last week was considering 
     constitutional questions surrounding doctor-assisted suicide, 
     a coalition of 40 health care, religious and retiree groups 
     gathered in Washington to find a middle ground to this 
     debate. The coalition--including the American Medical 
     Association, the American Association of Retired Persons, 
     B'nai B'rith and the American Cancer Society--argues that the 
     desire for assisted suicide often is driven by concerns about 
     the quality of care for the terminally ill. Thoughts of 
     doctor-assisted suicide, these groups maintain, are brought 
     about by the fear of prolonged pain, loss of dignity and the 
     emotional strain on family members, among other reasons.
       The coalition suggests that the nation's medical system has 
     failed to meet the physical and emotional needs of dying 
     patients. One study from Memorial Sloan-Kettering in New York 
     estimated that 1.6 million terminally ill people a year would 
     be good candidates for hospice care but only about 350,000 
     receive it. Why not try to solve these problems before 
     codifying doctor-assisted suicide?
       The Maine legislation, called the Death With Dignity Act, 
     is narrowly drawn, based on legislative work on a similar 
     bill from last session. It would allow physicians to assist 
     in the suicide of a terminally ill person who makes three 
     oral and one written request to die and has satisfied a 
     counselor that he or she is capable of making the decision. 
     The act goes to some lengths to prevent coercion and to allow 
     the person to back out of the suicide. It is well-crafted and 
     sensitive legislation. But absent advances in the quality of 
     care for the terminally ill, it also may be premature.
       And despite the safeguards, doubts about who will be 
     allowed to pursue this process remain. In a friend-of-the-
     court brief addressed to the cases being considered by the 
     Supreme Court, the America Geriatric Society explains the 
     source of some of these doubts: ``The image of an 
     independent, capable person thoughtfully evaluating his or 
     her options, unaffected by biased third parties or other 
     circumstances . . . is so far from the experience of dying as 
     to be fanciful. Dying persons are often very weak, prone to 
     strong emotions and vulnerable to the suggestions, 
     expectations and guidance of others.''
       The medical community has developed wondrous means for 
     keeping bodies functioning long beyond what could have been 
     expected even a few years ago, perhaps even longer than is 
     desirable. The debate over assisted suicide in state after 
     state demands that physicians go beyond that now in 
     respecting the humanity and mortality that resides within 
     those bodies by providing the terminally ill with the 
     opportunity for less painful, more dignified deaths.
                                 ______
                                 
      By Mr. TORRICELLI (for himself and Mr. Lautenberg):
  S. 1346. A bill to amend title 18, United States Code, to increase 
the penalties for certain offenses in which the victim is a child; to 
the Committee on the Judiciary.


                         JOAN'S LAW ACT OF 1997

  Mr. TORRICELLI. Mr. President, I am introducing this bill today, 
along with my colleague from New Jersey Senator Lautenberg, on behalf 
of Rosemarie D'Alessandro, the mother of a young girl murdered some 24 
years ago in New Jersey.
  Mrs. D'Alessandro's 7-year-old daughter Joan was delivering Girl 
Scout cookies down the street from her Hillsdale home one day when 
Joseph McGowan, a high school chemistry teacher, destroyed her life and 
changed the lives of her family members forever. McGowan raped Joan, 
killed her, and dumped her broken, battered body in a ravine some 15 
miles away--she was not found for 3 full days.
  For Joan's mom, Rosemarie, that shattering event was only the 
beginning of what would become a literal lifetime of trauma, pain and 
distress. Although the man who murdered Joan was put away for life, he 
has already had two parole hearings and is scheduled for another in 
2003.
  And Rosemarie D'Alessandro cannot rest while these hearings go on. To 
make sure this murderer remains behind bars, Rosemarie must fight each 
and every day against the system that might free him, and must sit 
through appeal after appeal when he is denied release.
  But rather than becoming consumed with the tragedy that stole her 
daughter from her, Rosemarie D'Alessandro has used her grief and her 
anger to accomplish an astonishing goal--Joan's Law is now in the books 
in New Jersey, and now any child molester who murders a child under 14 
in my State must receive life in prison without the possibility of 
parole. Rosemarie D'Alessandro stood up and told the world ``enough is 
enough.'' No other family should have to bear the double tragedy of 
suffering the loss of a child and then being forced to relive it over 
and over again through parole hearings and appeals. And no other family 
in New Jersey will ever have to again.
  Well, we do not have parole in the Federal system, but we can make 
sure that anyone who molests or commits a serious, violent crime 
against a child 14 or under will serve the rest of his life behind bars 
if that child dies. My bill states that any person who is convicted of 
a Federal offense defined as a serious violent felony should be 
sentenced either to death or imprisonment for life when the victim of 
the crime is under 14 years of age and dies as a result of the offense.
  Mr. President, with this bill, we intend to send the strongest 
possible message to anyone who would dare molest or attack a vulnerable 
child--do so at your own risk, because we will find you and we will put 
you behind bars for the rest of your life if that child dies. I hope my 
colleagues will quickly join me and Senator Lautenberg in passing this 
legislation, so that the inevitable tragedies that happen to children 
throughout America every day will no longer be compounded upon the 
families of those victims.
  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. 1346

       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 ``Joan's Law Act of 1997''.

     SEC. 2. DEATH OR LIFE IN PRISON FOR CERTAIN OFFENSES WHOSE 
                   VICTIMS ARE CHILDREN.

       Section 3559 of title 18, United States Code, is amended by 
     adding at the end the following:
       ``(d) Death or Life Imprisonment for Crimes Against 
     Children.--Notwithstanding any other provision of law, a 
     person who is convicted of a Federal offense that is a 
     serious violent felony (as defined in subsection (c)) or a 
     violation of section 2251 shall, unless a sentence of death 
     is imposed, be sentenced to imprisonment for life, if the 
     victim of the offense--
       ``(1) is less than 14 years of age at the time of the 
     offense; and
       ``(2) dies as a result of the offense.''.

  Mr. LAUTENBERG. Mr. President, when a child is murdered, families are 
devastated and communities are rocked to their very core. When a 
murderer is prosecuted, grieving parents and siblings are forced to 
relive the often brutal details of the most profound tragedy 
imaginable. And, if a conviction is obtained, in too many instances, 
the families of a young victim must repeatedly relieve the crime every 
time the murderer goes before a parole board.
  The families of murder victims, especially murdered children, need 
closure. They need to know that they can put the horror and a tragedy 
behind them. They need to know that they can begin rebuilding their 
lives. But most importantly, they need to know that the person 
responsible for the crime will never bring harm and grief to another 
family.
  This is why, Mr. President, I am today joining my colleague from New 
Jersey, Senator Torricelli, in introducing legislation that will 
significantly increase the penalties on criminals convicted of a 
Federal crime where a child under the age of 14 is killed during the 
commission of that crime. I also want to commend and acknowledge 
Congressman Bob Franks, also from New Jersey, who introduced similar 
legislation in the House.
  Mr. President, this legislation is a Federal companion for an 
important New Jersey law called Joan's Law.

[[Page S11457]]

Joan's Law was named after a 7-year-old New Jersey girl, Joan 
D'Alessandro, who was raped and murdered in 1973. Joan's murderer, a 
man who lived across State lines and actually had the gall to 
participate in the family's desperate search for their missing 
daughter, was located, convicted of the crime, and sentenced to 20 
years in State prison. He is now eligible for parole, and has twice 
sought release since his incarceration.
  To their horror, frustration, and understandable anger, Joan's family 
has repeatedly had to fight parole for this cruel killer. They have 
been forced to relive this tragedy again and again and to beg that 
others be protected from the brutal individual who ripped apart their 
family.
  The bill we are introducing today will impose a similar, equally 
severe and necessary penalty--life imprisonment--on anyone convicted of 
committing a Federal crime where a child, 14 years of age or younger, 
dies as a result of that crime.
  The bill sends a strong message that our society will not tolerate 
nor forgive the brutal acts of a criminal who takes a young life. This 
bill sends the message in no uncertain terms that society will take the 
steps necessary to protect itself from cold-blooded killers who 
victimize children. This bill will help to protect all of our families 
and children from the repeat offenders who, all too often, insinuate 
themselves into our communities and prey on defenseless children.
  Mr. President, I urge all of my colleagues to join with Senator 
Torricelli and I in support of this bill and to work for its fast 
enactment.
                                 ______
                                 

                             By Mr. GLENN:

  S. 1347. A bill to permit the city of Cleveland, OH, to convey 
certain lands that the United States conveyed to the city; to the 
Committee on Commerce, Science, and Transportation.


              the cleveland airport expansion act of 1997

  Mr. GLENN. Mr. President, I am pleased to introduce legislation to 
assist in improving air transportation for the people and businesses of 
northeast Ohio and the Nation.
  The city of Cleveland has a major capacity improvement program 
underway at Cleveland Hopkins International Airport. For some time, 
Cleveland and the city of Brook Park had been involved in a dispute 
regarding property crucial to the development project. To their credit, 
both communities were able to resolve their differences through a 
comprehensive settlement agreement that will allow the airport's 
improvement program to move forward. This important settlement 
agreement includes changing municipal boundaries and the 
noncontroversial, jurisdictional transfer of property.
  Mr. President, Congress has addressed similar restrictions many times 
by enacting specific provisions allowing the Secretary of 
Transportation to act in similar cases. As part of the comprehensive 
settlement agreement this is clearly in the public interest and will 
allow Cleveland to meet northeast Ohio's increasing requirements for 
better air transportation.
  Mr. President, since the closing of the settlement agreement is to 
occur before December 31, 1997, this legislation is needed prior to 
adjournment. I appreciate the support of the leadership of the 
Committee on Commerce, Science, and Transportation, and I urge my 
colleagues to support this legislation.
                                 ______
                                 

   By Mr. LIEBERMAN (for himself, Mr. Daschle, Mr. Moynihan, and Mr. 
                                Kerrey):

  S. 1348. A bill to provide for innovative strategies for achieving 
superior environmental performance, and for other purposes; to the 
Committee on Environment and Public Works.


          the innovative environmental strategies act of 1997

  Mr. LIEBERMAN. Mr. President, I am pleased to introduce today The 
Innovative Environmental Strategies Act of l997. I'm honored that 
Senators Daschle, Moynihan, and Kerrey have joined me as cosponsors, 
and that the legislation is being introduced in the House by 
Congressman Dooley and Congresswoman Tauscher. I'm also very pleased 
that the legislation has been endorsed by the Clinton administration 
and has received positive responses from representatives of industry 
and environmental groups. I look forward to a process of building 
further consensus on this bill from all affected interests.
  The legislation allows companies to propose alternatives to 
environmental requirements if those alternative proposals will achieve 
better environmental performance. The legislation provides EPA with the 
authority to waive or modify regulatory requirements for this purpose. 
It is designed to encourage more pollution prevention and to promote 
better, more cost-effective solutions for environmental protection.
  This legislation seeks to build on both the work of President 
Clinton's Project XL--standing for excellence and leadership--and the 
Aspen Institute which undertook a 3-year effort to reach consensus 
among a wide group of divergent interests on an alternative path to 
achieving a cleaner, cheaper way to protect and enhance the 
environment. The Aspen Institute's work resulted in an excellent 
report, ``The Alternative Path, A Cleaner, Cheaper Way to Protect and 
Enhance the Environment.''
  This bill modifies legislation introduced at the end of last 
Congress. At that time, I indicated that I welcomed all proposals and 
suggestions on how to alter and improve the bill. I have received a 
significant number of comments from industry, governmental and 
environmental group representatives. The new bill attempts to reflect 
many of those comments, in addition to a new GAO report examining EPA's 
reinvention efforts, ``Challenges Facing EPA's Efforts to Reinvent 
Environmental Regulation,'' and a recently released report by the 
National Academy of Public Administration, ``Resolving the Paradox of 
Environmental Protection.'' The National Academy report recommends 
statutory authorization for EPA's XL program.
  There is clearly a wide consensus in this country that our 
environmental laws have performed remarkably well. As the writer Gregg 
Easterbrook has pointed out, environmental protection is probably the 
single greatest success story of American government in the period 
since World War II.
  In many cases, however, we need to do more to provide the level of 
protection most Americans expect from government. For example, over one 
third of our rivers and lakes still do not fully meet water quality 
standards. Health advisories for eating fish have increased. The number 
of people suffering from asthma has reached epidemic proportions in 
some communities, particularly among children.
  Pollution prevention--preventing pollution before it occurs--is one 
approach that can help us do both better both in terms of protecting 
the environment and actually saving companies money. The greater 
efficiency resulting from less waste disposal and reduced use of toxic 
chemicals can significantly bolster the competitiveness of companies.
  Recently, I listened to a presentation indicating that perhaps the 
Nation is not doing as well in pollution prevention as we should be. A 
l995 report by the research group INFORM, ``Toxics Watch l995,'' 
reviewed thousands of documents submitted by industry to EPA to show 
whether progress was made to further pollution prevention. While 25 
percent of the forms indicated some effort in pollution prevention had 
been made, the remaining 75 percent gave no such indication. And, 
according to INFORM, while some leading companies have taken major 
pollution prevention steps, the broader picture is troublesome: total 
waste generation is increasing.
  While these facts show there is clearly a need to improve protection 
of our environment and pollution prevention, there is just as clearly a 
need to review our methods of environmental protection in order to find 
better, more efficient, more innovative ways to achieve greater 
progress toward meeting our environmental goals. In some cases, the 
traditional approaches to regulation have hindered companies from doing 
a better job at pollution prevention.
  There is a growing consensus that innovative environmental strategies 
can form the basis for a new approach to environmental protection that 
will

[[Page S11458]]

achieve superior environmental results, including greater pollution 
prevention, at less cost for regulated industry. This consensus can be 
seen, for example, in the work of the President's Council on 
Sustainable Development which brought together leaders from government, 
environmental, civil rights, labor and native American organizations in 
an effort to achieve consensus on national environmental, economic and 
social goals, as well as in the work of the Aspen Institute.
  This bill establishes an innovative environmental strategies program 
at EPA. The Administrator of EPA is authorized to enter into 
approximately 50 agreements with regulated entities seeking 
modifications or waivers from environmental requirements if certain 
criteria are met. The basic premise of the bill is that better 
environmental performance can be achieved by allowing environmental 
managers at companies, in partnership with an active group of community 
stakeholders, to develop their own means of reaching environmental 
goals. This approach recognizes that the regulated industry is now in 
an excellent position to experiment and decide what approaches will 
yield better environmental results than the company is achieving under 
existing regulations. Allowing flexibility can substantially reduce 
compliance costs and make industries more competitive, provide for much 
greater community involvement in the decisions of their neighboring 
industrial plants, foster more cooperative partnerships, and encourage 
greater innovation and pollution prevention.
  Another key element of this program is incorporating the lessons 
learned from the innovative environmental strategies into the overall 
regulatory structure of the Agency, where appropriate.
  While the bill authorizes approximately 50 innovative strategy 
agreements, these individual strategies should have widespread benefits 
for other companies as the Agency incorporates the lessons learned into 
its overall approach to environmental protection.
  Let me discuss a few specific provisions of the bill.
  First, the bill establishes benchmarks from which to determine 
whether better environmental results will be achieved under the 
innovative environmental strategy. For existing facilities, the 
benchmark generally will be either the level of releases of a pollutant 
into the air, land or water actually being achieved by the facility or 
the level of releases allowed under the applicable regulatory 
requirements and reasonably foreseeable future requirements, whichever 
is lower. The Administrator is given some flexibility in determining 
the appropriate measurement for the benchmark. For example, measuring 
releases per unit of production encourages pollution prevention but may 
result in releases of concern to the community; the Administrator 
should take both these factors into account in determining whether a 
per unit measurement is appropriate. The Administrator shall determine 
whether an innovative environmental strategy achieves better 
environmental results based on the magnitude of reduction in the level 
of releases or improvement in pollution prevention relative to each 
benchmark. In addition, the Administrator shall evaluate other benefits 
that would result from the strategy. These include whether the strategy 
results in environmental performance more protective than the best 
performance practice of comparable facilities or improvement in 
environmental conditions that are priorities to stakeholders, even if 
those conditions are not regulated under EPA statutes.
  Different types of innovative environmental strategies are possible 
under this legislation. For example, in some cases, a facility may 
demonstrate better environmental results by showing a reduction in 
releases of pollutants and, in exchange, seek a modification of 
reporting or other paperwork requirements. In other cases, a facility 
may demonstrate better environmental results by showing a reduction in 
releases of pollutants, but seek modification of a rule to allow for 
flexibility with respect to emission levels at different sources within 
the facility. There may be some cases where the innovative 
environmental strategy would result in large decreases in some 
pollutants while resulting in a small increase in another pollutant. 
But there are a number of specific requirements that must be met under 
those circumstances. Among other requirements, the Administrator must 
determine, based on a well-established analytic methodology acceptable 
both to the Administrator and the stakeholders, that the strategy will 
achieve better overall environmental results with an adequate margin of 
safety and will not result in an increase in the risk of adverse 
effects or shift the risk of adverse effects to the health of an 
individual, population, or natural resource affected by the strategy. I 
recognize that it is difficult to make such determinations because we 
have inadequate information about many chemicals and we often do not 
know how properly to evaluate cumulative or synergistic effects. The 
Administrator should pay close attention to these factors in evaluating 
projects. These examples are only illustrative of a range of potential 
projects.

  The bill also provides that in appropriate cases, the Administrator 
may establish a benchmark for measuring better environmental 
performance based on pollution prevention.
  The bill requires that the innovative environmental strategy provide 
a means and level of accountability, monitoring, enforceability and 
public access to information for all enforceable provisions at least 
equivalent to that provided by the rule that is being modified or 
waived. A related requirement is that adequate information must be made 
accessible so that any member of the public can verify environmental 
performance. Other requirements that must be met by the petitioner are 
set forth in section 7.
  Effective stakeholder participation is the second key element of the 
legislation. Any company submitting a proposal must undertake a 
stakeholder participation process. One of the criteria for approval of 
a project by EPA is that the stakeholders have obtained adequate 
independent technical support for an effective stakeholder process. 
Under the bill, the stakeholder process is open to anyone, except a 
business competitor, subject to manageability factors. The stakeholder 
group should genuinely represent the full range of interests affected 
by projects and the policies to be shaped by projects. Involving 
citizens, including workers and members of the local community, in the 
development of an innovative environmental strategy is absolutely 
critical. Companies that have formulated successful innovative 
environmental strategies have told me that without the support of the 
local community these strategies simply will not work. Empowerment of 
the local community through stakeholder processes will help build trust 
and make implementation of the agreement easier. In other words, the 
innovative environmental strategy should be a partnership between the 
proponent and the stakeholders.
  The bill requires the Administrator to give great weight to the views 
of the stakeholders. Obtaining broad community support for the 
strategy, as shown through stakeholder support, is very important. 
Additionally, the stakeholders and the proponent of the strategy may 
decide as part of the guidelines setting up the stakeholder process, 
that the stakeholders as a group or individual stakeholder participants 
should have a veto right with respect to whether the strategy goes 
forward. If the proponent still presents a proposal for the strategy 
even with such objections, the Administrator is required to reject the 
strategy if the objection has a clear and reasonable foundation and 
relates to the criteria for approval. The principle here is simple: 
stakeholders and the facility owner need to come to agreement on the 
guidelines that will govern the project. This agreement on the 
guidelines should be reached at the start of the process. It must be 
followed; if not, the Administrator will not be able to make the 
finding that the requirements of section 6 of the statute have been 
met.
  The bill also attempts to address the recommendations made in the GAO 
report of July 1997, ``Challenges Facing EPA's Efforts to Reinvent 
Environmental Regulation'', which examined EPA's XL program. First, the 
GAO concludes that EPA will be limited in its ability to truly reinvent 
environmental regulation without legislative changes. Second, the GAO 
recommends

[[Page S11459]]

that the Agency's reinvention initiatives include an evaluation 
component measuring the extent to which the initiative has achieved its 
intended effect. Therefore, the bill requires that, within 18 months 
after entering into an agreement, the Administrator provide a report 
evaluating whether the lessons learned from a particular strategy can 
be incorporated into the overall regulatory or statutory structure of 
the Agency. The legislation also requires a broader report to Congress 
within 3 years.
  Finally, the GAO proposes that EPA develop a systematic process that 
would help address problems that come up during reinvention projects in 
a timely fashion. This process should be set up to identify the kinds 
of problems that can be resolved at lower levels within the Agency and 
which should be elevated for management's attention. While the bill 
does not specifically address this recommendation, I hope that EPA will 
seriously examine how it can implement this constructive 
recommendation.
  As the GAO report notes, the EPA has undertaken a broad range of 
reinvention efforts. This legislation in no way affects the ability of 
EPA to proceed under its appropriate authorities with those efforts, 
including agreements under XL.
  I ask unanimous consent that the full text of the legislation be 
included in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1348

       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 ``Innovative Environmental 
     Strategies Act of 1997''.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) superior environmental performance can be achieved in 
     some cases by granting regulated entities the flexibility to 
     develop innovative environmental strategies for achieving 
     environmental results in partnership with affected 
     stakeholders;
       (2) innovative environmental strategies also have the 
     potential to--
       (A) substantially reduce compliance costs;
       (B) foster cooperative partnerships among industry, 
     government, public interest groups, and local communities;
       (C) encourage regulated entities to meet and exceed 
     environmental obligations through greater innovation and 
     greater pollution prevention; and
       (D) increase the involvement of members of the local 
     community and other citizens in decisions relating to the 
     environmental performance goals and priorities of a facility; 
     and
       (3) the lessons learned from successful innovative 
     environmental strategies should be incorporated into the 
     broader system of environmental regulation.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Administrator.--The term ``Administrator'' means the 
     Administrator of the Environmental Protection Agency.
       (2) Agency.--The term ``agency'' means the Environmental 
     Protection Agency.
       (3) Agency rule.--
       (A) In general.--The term ``agency rule'' means a rule (as 
     defined in section 551 of title 5, United States Code) 
     promulgated by the agency.
       (B) Exclusions.--The term ``agency rule'' does not 
     include--
       (i) an emissions reduction requirement under title IV of 
     the Clean Air Act (42 U.S.C. 7651 et seq.); or
       (ii) a requirement under subtitle B of the Emergency 
     Planning and Community Right to Know Act of 1986 (42 U.S.C. 
     11021 et seq.).
       (4) Person.--The term ``person'' means an individual, 
     trust, firm, joint stock company, corporation (including a 
     government corporation), partnership, association, State, 
     Indian tribe, municipality, commission, political subdivision 
     of a State, interstate body, or department, agency, or 
     instrumentality of the United States.

     SEC. 4. INNOVATIVE ENVIRONMENTAL STRATEGY AGREEMENTS.

       (a) In General.--
       (1) Proposal.--A person that owns or operates a facility 
     that is subject to an agency rule, requirement, policy, or 
     practice may submit to the Administrator a proposal for an 
     innovative environmental strategy for achieving better 
     environmental results.
       (2) Agreement.--If the Administrator finds that the 
     requirements of section 7 are met and approves the proposed 
     strategy, the Administrator may enter into an innovative 
     environmental strategy agreement with respect to the 
     facility.
       (3) Contents.--An agreement under paragraph (1)--
       (A) may--
       (i) modify or waive otherwise applicable agency rules, 
     requirements, policies, or practices;
       (ii) establish new environmental standards for a facility; 
     or
       (iii) establish new requirements not contained in existing 
     agency rules or existing environmental statutes;
       (B) may not contravene the specific terms of a statute; and
       (C) should further the purposes of applicable environmental 
     statutes.
       (b) Cosponsor.--
       (1) In general.--The Administrator shall establish 
     procedures under which a person other than the owner or 
     operator of a facility may cosponsor a proposal.
       (2) Priority.--The Administrator shall give priority to 
     proposals co-sponsored by a stakeholder group.

     SEC. 5. SUBMISSION OF PROPOSAL.

       (a) Contents of Proposal.--A proposal for an innovative 
     environmental strategy shall be clearly and concisely written 
     and shall--
       (1) identify any agency rule, requirement, policy, or 
     practice for which a modification or waiver is sought and any 
     alternative requirement that is proposed;
       (2) describe the proposed innovative environmental strategy 
     and the facility to which the strategy would pertain; and
       (3) demonstrate the manner in which the innovative 
     environmental strategy is expected to meet the requirements 
     of section 7.
       (b) Preliminary Review.--The Administrator shall review the 
     proposal and determine whether, in the Administrator's sole 
     discretion, the proposed strategy is sufficiently promising 
     that the Administrator is prepared to enter into negotiations 
     toward execution of an innovative environmental strategy 
     agreement.
       (c) Notification.--The Administrator shall notify the 
     proponent of a determination under subsection (b) not later 
     than 90 days after submission, unless the proponent agrees to 
     a longer review.

     SEC. 6. STAKEHOLDER PARTICIPATION PROCESS.

       (a) In General.--The proponent of a proposal under section 
     5 shall--
       (1) upon approval of the proposal for negotiation toward an 
     agreement, undertake a stakeholder participation process in 
     accordance with this section; and
       (2) work to ensure that there is adequate independent 
     technical support for an effective stakeholder process.
       (b) Development of Process.--
       (1) In general.--The stakeholder participation process 
     shall be developed by the stakeholders and the proponent, in 
     consultation with the Administrator.
       (2) Requirements.--The stakeholder participation process 
     shall--
       (A) be balanced and representative of interests that may be 
     affected by the proposed strategy;
       (B) ensure opportunities for public access to the process 
     and make publicly available in a timely manner the 
     proceedings of the stakeholder participation process, except 
     with respect to confidential business information;
       (C) establish procedures for conducting the stakeholder 
     participation process, including open meetings as 
     appropriate;
       (D) if necessary, provide for appropriate agreements to 
     protect confidential business information; and
       (E) establish guidelines for the role of stakeholders, 
     individually and as a group or subgroup, in the development 
     of the strategy, including whether the stakeholders have an 
     advisory, consultative, decisionmaking or veto role with 
     respect to the strategy.
       (c) FACA.--A stakeholder process satisfying the 
     requirements of this section shall not be subject to the 
     requirements of the Federal Advisory Committee Act (5 U.S.C. 
     App.).
       (d) Public Notice of Application.--After a proposal is 
     approved for negotiation toward an agreement, the proponent 
     shall provide public notice of the proposal in a manner, 
     approved by the Administrator, that is reasonably calculated 
     to reach potentially interested parties including--
       (1) community groups;
       (2) environmental groups;
       (3) potentially affected employees;
       (4) persons living near or working in or near the affected 
     facility; and
       (5) relevant Federal, State, tribal, and local agencies.
       (e) Participation.--
       (1) In general.--A person that, not later than 60 days 
     after the date on which public notice is first given under 
     subsection (c), notifies the proponent of the person's 
     intention to participate in the stakeholder participation 
     process may participate in the process, except that a person 
     that has a business interest in competition with that of the 
     proponent may be excluded.
       (2) Additional stakeholders.--Additional stakeholders may 
     be added by the proponent, the Administrator or the 
     stakeholder group after the stakeholder group is initially 
     constituted in order to ensure full representation of all 
     potentially affected interests throughout the process, 
     including representation with respect to any new issues that 
     may be raised during the process, and to ensure that 
     appropriate expert assistance is available for the 
     stakeholders.
       (f) Limitation on Number of Participants.--
       (1) In general.--In order to provide for a manageable 
     stakeholder process, the Administrator may limit the number 
     of stakeholder participants if the Administrator determines 
     that the stakeholder participants adequately represent, in a 
     balanced manner, the full range of interests (excluding 
     competitive business interests) that may be affected by the 
     innovative environmental strategy.

[[Page S11460]]

       (2) Notice.--Before approving a limit on the number of 
     stakeholder participants, the Administrator shall ensure that 
     appropriate notice was provided to each of the groups 
     identified in subsection (d).
       (3) Additional stakeholders.--Notwithstanding any limit on 
     the number of stakeholders that may be approved, additional 
     stakeholders may be added to meet the requirements of 
     subsection (e).
       (g) Negotiation.--After the stakeholder group has been 
     identified, and procedures for the stakeholder process have 
     been agreed on under subsection (b)(2)(E), the proponent, the 
     stakeholders, and the Administrator shall initiate the 
     process of negotiating toward an innovative environmental 
     strategy agreement.

     SEC. 7. REQUIREMENTS FOR APPROVAL.

       (a) In General.--The Administrator may enter into an 
     innovative environmental strategy agreement if the 
     Administrator determines that--
       (1) the strategy is expected to achieve better 
     environmental results (as determined under subsection (c));
       (2) the strategy has potential value as a model for future 
     changes in the broader regulatory structure or as a 
     demonstration of new technologies or measures with potential 
     for reducing pollution on a broader scale;
       (3) the strategy provides for access to information 
     adequate to enable verification of environmental performance 
     by any interested person;
       (4) the strategy provides a means and level of 
     accountability, transparency, monitoring, reporting, and 
     public and agency access to information relating to 
     activities being carried out under an innovative 
     environmental strategy that is at least equivalent to that 
     provided under the agency rule, requirement, policy, or 
     practice that the agreement seeks to modify or waive, 
     including reporting of the benchmarks in the agreement;
       (5) no person or populations would be subjected to unjust 
     or disproportionate adverse environmental impacts as a result 
     of implementation of the strategy;
       (6) the strategy will ensure worker health and safety 
     protections that are the same or superior to those provided 
     under existing law;
       (7) the strategy is not expected to result in adverse 
     transport of a pollutant;
       (8) any Federal, State, tribal, or local environmental 
     agencies required to be signatories under section 8(c) are 
     prepared to sign the agreement and the consultation required 
     under section 8(c)(3) has occurred;
       (9) the stakeholder participation process met the 
     requirements of section 6, and the stakeholders have obtained 
     adequate independent technical support for an effective 
     process;
       (10) there is broad community support for the strategy, as 
     shown by stakeholder support and other relevant factors; and
       (11) the strategy is expected to reduce regulatory burdens 
     or provide other social or economic benefits.
       (b) Other Considerations.--In determining whether to enter 
     into an agreement, or to negotiate toward an agreement, the 
     Administrator shall consider--
       (1) whether the facility has a strong record of compliance 
     with environmental and public health regulations and whether 
     the proponent has demonstrated a strong commitment to achieve 
     pollution prevention with respect to the facility;
       (2) the extent to which the strategy involves new 
     approaches to environmental protection and multimedia 
     pollution prevention;
       (3) the extent to which there is a link between the 
     modification or waiver sought, the better environmental 
     results expected, and other benefits; and
       (4) the feasibility of the strategy and the ability of the 
     proponent to carry out the strategy.
       (c) Better Environmental Results.--
       (1) Evaluation.--The Administrator shall determine whether 
     a strategy is expected to achieve better environmental 
     results based on the magnitude of reduction in the level of 
     releases or improvement in pollution prevention relative to 
     each benchmark established under paragraphs (4) through (7);
       (2) Other considerations.--In addition to making the 
     determination under paragraph (1), the Administrator shall 
     evaluate the extent to which the strategy--
       (A) results in environmental performance more protective 
     than the best performance practice of comparable facilities;
       (B) relies on pollution prevention;
       (C) incorporates continuous improvement toward ambitious 
     quantitative environmental goals;
       (D) produces clear reduction of risk, based on a well-
     accepted analytical method acceptable to the Administrator 
     and the stakeholders;
       (E) improves environmental conditions that are priorities 
     to stakeholders, including conditions not regulated under 
     statutes administered by the agency;
       (F) reflects historic demonstration of leadership in 
     environmental performance of the facility;
       (G) substantially addresses community and public health 
     priorities of concern to stakeholders, including concerns not 
     addressed under statutes administered by the agency;
       (H) addresses other factors that the Administrator 
     determines clearly improve environmental performance in the 
     context of a specific strategy; and
       (I) includes reductions in releases or improvement in 
     pollution prevention in addition to those considered by the 
     Administrator for purposes of paragraph (1).
       (3) Findings.--The Administrator shall provide findings 
     setting forth the basis for the determination that the 
     innovative environmental strategy is expected to achieve 
     better environmental results. If the Administrator determines 
     that the magnitude of reduction in the level of releases or 
     improvement in pollution prevention would be a reduction or 
     improvement, but not a significant reduction or improvement, 
     the Administrator may approve a proposal only if the 
     Administrator determines that the strategy is expected to 
     result in a clear and substantial improvement in 
     environmental protection, considering the other factors in 
     this subsection.
       (4) Benchmark.--The benchmark for releases of each 
     pollutant into the air, water, or land shall be as follows:
       (A) Existing facilities.--For existing facilities, the 
     benchmark shall be the lesser of--
       (i) the level of releases of each pollutant into the air, 
     water, or and being achieved before the date of submission of 
     the proposal; or
       (ii) the level of releases of each pollutant into the air, 
     water, or land allowed under applicable regulatory 
     requirements and any reasonably anticipated future regulatory 
     requirements;

     except that the Administrator may, based on extraordinary 
     site-specific circumstances, modify the level under 
     subparagraph (A)(i) on a case by case basis for a facility 
     that has reduced releases significantly below applicable 
     regulatory requirements before the date of submission of the 
     proposal.
       (B) New or modified facilities.--For new or significantly 
     expanded facilities, the benchmark shall be based on the 
     lesser of--
       (i) the level of releases of each pollutant into the air, 
     water, or land allowed under applicable regulatory 
     requirements and any reasonably anticipated future regulatory 
     requirements; or
       (ii) the level of releases of each pollutant into the air, 
     water, or land based on best industry practices.
       (5) Pollution prevention.--
       (A) No release of a pollutant.--In appropriate 
     circumstances not involving release of a pollutant, the 
     Administrator may establish a pollution prevention benchmark 
     to evaluate changes in inputs to production of materials or 
     substances of potential environmental or public health 
     concern.
       (B) Release of a pollutant.--In circumstances involving a 
     release of a pollutant, the Administrator may establish a 
     pollution prevention benchmark in addition to the benchmark 
     under paragraph (4).
       (6) Basis of measurement.--A benchmark may be established 
     on the basis of total emissions, on a per-unit of production 
     basis, or on a comparable basis of measurement, as determined 
     by the Administrator.
       (7) Other considerations.--The Administrator may determine 
     that the requirements of this section are met if a benchmark 
     is not met, if--
       (A) with respect to other benchmarks, the strategy achieves 
     a significant increment of reduced level of releases below 
     that permitted by the benchmark;
       (B) the strategy, based on a well-established analytic 
     methodology acceptable to the Administrator and the 
     stakeholders--
       (i) is expected to achieve overall better environmental 
     results with an adequate margin of safety;
       (ii) is not expected to result in an increase in the risk 
     of adverse effects, or shift the risk of adverse effects, to 
     the health of an individual, population, or natural resource 
     affected by the strategy; and
       (iii) is expected to achieve clear risk reduction; and
       (C) the strategy is not expected to result in an exceedance 
     of an ecological, health, or risk-based environmental 
     standard.
       (d) Views of Stakeholders.--
       (1) In general.--The Administrator shall give great weight 
     to the views of individual stakeholders and to the 
     stakeholders as a group in determining whether to approve or 
     disapprove a strategy.
       (2) Stakeholders with decisionmaking role.--The 
     Administrator shall deny a proposal if--
       (A) the stakeholder group and the proponent have determined 
     under section 6 that the group, any subgroup, or 1 or more 
     individual stakeholders in the group will have the ability to 
     veto a decision by the proponent to go forward with the 
     strategy;
       (B) the group or 1 or more stakeholders objects to the 
     strategy; and
       (C) the Administrator determines that the objection relates 
     to the criteria stated in section 7 and that the objection 
     has a clear and reasonable foundation.

     SEC. 8. FINAL DETERMINATION ON AGREEMENT.

       (a) Proposal.--
       (1) In general.--Not later than 180 days after the date on 
     which negotiations are initiated under section 6(g) or such 
     later date as may be agreed to by the proponent and the 
     stakeholders, the Administrator shall--
       (A) provide public notice and opportunity to comment on a 
     proposed innovative environmental strategy agreement; or
       (B) notify the proponent and the stakeholder group that the 
     Administrator does not intend to enter into an agreement.
       (2) Form of notice.--Public notice under paragraph (1) 
     shall be provided by--
       (A) publishing a notice in the Federal Register; and

[[Page S11461]]

       (B) providing public notice to persons potentially 
     interested in the strategy in the manner described in section 
     6(d).
       (3) Comment period.--The public comment period shall be not 
     less than 30 days, and shall be extended by an additional 30 
     days if an extension is requested by any person not later 
     than 15 days after the beginning of the public comment 
     period.
       (b) Final Decision.--
       (1) In general.--Not later than 60 days after the end of 
     the public comment period, the Administrator shall determine 
     whether to enter into an agreement, and shall give notice of 
     the determination in the same manner as notice was given of 
     the proposed agreement.
       (2) Response.--The Administrator--
       (A) shall respond to comments received; and
       (B) may modify the agreement in response to the comments.
       (c) Signatories.--
       (1) In general.--The parties to an innovative environmental 
     strategy agreement--
       (A) shall include the Administrator, the proponent, and any 
     Federal, State, or local agency or Indian tribe with 
     jurisdiction over the subject matter of the agreement under 
     this Act; and
       (B) may include a stakeholder.
       (2) Joint rules requirements and policies.--If an agreement 
     waives or modifies a rule, requirement, or policy issued by 
     the agency jointly with another Federal agency, the other 
     Federal agency shall be a signatory to the agreement.
       (3) Consultation.--The Administrator shall consult with and 
     consider the views of any Federal agency with management 
     responsibility or regulatory or enforcement authority over 
     land or natural resources that may be affected by the 
     strategy.

     SEC. 9. STATE ROLE.

       (a) In General.--If a proposed strategy involves waiving or 
     modifying requirements imposed under State, tribal, or local 
     law, the Administrator shall not approve an agreement unless 
     procedures required under those laws for such waiver or 
     modification are followed in addition to the execution of the 
     innovative environmental strategy agreement.
       (b) Part of Federal Program.--If a proposed strategy 
     involves waiving or modifying requirements of State, tribal, 
     or local law that are part of an authorized or delegated 
     Federal program, execution of an innovative environmental 
     strategy agreement by the Administrator and by the State, 
     Indian tribe, or local government shall be deemed to provide 
     authorization or approval of the program as modified by the 
     agreement.

     SEC. 10. ENFORCEABILITY.

       (a) Specification of Enforceable Provisions.--
       (1) Definition of voluntary commitment.--In this section, 
     the term ``voluntary commitment'' means a commitment that the 
     parties to the agreement consider to be a necessary part of 
     the strategy but is not enforceable under this section.
       (2) Inclusion in agreement.--An innovative environmental 
     strategy agreement shall include enforceable requirements and 
     may include voluntary commitments.
       (3) Enforceable requirements.--
       (A) Identification.--Enforceable requirements shall be 
     clearly identified and distinguished in the agreement from 
     voluntary commitments.
       (B) Inclusion of all necessary actions.--In all cases, 
     enforceable requirements shall include, at a minimum, all 
     actions necessary to achieve better environmental results 
     relied upon by the Administrator for purposes of section 
     7(c)(1), and all accountability, monitoring, reporting, and 
     public and agency access requirements mandated by paragraphs 
     (3) and (4) of section 7(a).
       (4) Voluntary commitments.--Failure to implement a 
     voluntary commitment may constitute a ground for termination 
     of the agreement.
       (b) Treatment of Agreement as Permit, Condition, or 
     Requirement.--
       (1) Definition of otherwise applicable requirement.--In 
     this subsection, the term ``otherwise-applicable 
     requirement'' means a rule, permit, condition, policy, 
     practice, or other requirement that an innovative 
     environmental strategy agreement modifies, waives, or 
     replaces.
       (2) Identification of enforceable requirements.--An 
     innovative environmental strategy agreement shall state in a 
     separate section designated ``Enforceable Requirements'' all 
     of the enforceable requirements of the agreement.
       (3) Identification of modified, otherwise waived or 
     relocated requirements.--An innovative environmental strategy 
     agreement shall identify (including citation to the specific 
     provision of a statute or rule), with respect to each 
     enforceable requirement, each otherwise-applicable 
     requirement that the agreement waives, modifies, or replaces.
       (4) Treatment.--Each enforceable requirement shall be 
     deemed, for purposes of enforcement, to be a permit issued 
     under, a condition imposed by, or a requirement of the 
     statute or rule under which the otherwise-applicable 
     requirement that the agreement modifies, waives, or replaces 
     was imposed.
       (5) Enforceability.--Each enforceable requirement shall be 
     enforceable in the same manner and to the same extent (by the 
     United States, by a State or Indian tribe, or by any other 
     person) as the otherwise-applicable requirement would have 
     been enforceable but for the agreement.
       (6) New enforceable requirement derived from or imposed 
     under current law.--An enforceable requirement that does not 
     modify, waive, or replace a requirement shall be enforceable 
     in the same manner and to the same extent as a permit, 
     condition, or requirement under the statute or rule from or 
     under which the enforceable requirement derives or is 
     imposed.
       (7) Enforceable requirement that does not modify, waive, or 
     replace another requirement.--If an enforceable requirement 
     does not derive from or is not imposed under any statutory or 
     regulatory provision, the agreement shall specify the statute 
     under which the enforceable requirement shall be deemed to be 
     imposed for purposes of enforcement and shall be enforceable 
     (by the United States, a State, Indian tribe, and by other 
     persons) in the same manner and to the same extent as a 
     permit, condition, or requirement under that statute or 
     regulation.
       (8) Emergency or imminent hazard authority.--Nothing in 
     this Act limits or affects the Administrator's emergency or 
     imminent hazard authorities.
       (c) Specification of Affected Requirements.--
       (1) In general.--When the Administrator approves an 
     innovative environmental strategy agreement under subsection 
     (a), the Administrator shall specify in the agreement each 
     rule, requirement, policy, or practice that is modified or 
     waived by the innovative agreement.
       (2) No modification or waiver.--Each rule, requirement, 
     policy, or practice not specified pursuant to the preceding 
     sentence is not modified and waived.
       (d) Termination or Modification of Agreement.--
       (1) In general.--The Administrator may terminate or modify 
     an innovative environmental strategy agreement if the 
     Administrator determines that--
       (A) the strategy fails or will fail to achieve the better 
     environmental results identified pursuant to section 7;
       (B) better environmental results are no longer being 
     achieved by the strategy by reason of the enactment of a new 
     provision of law or promulgation of a new regulation;
       (C) there has been noncompliance with the terms of the 
     agreement (including a voluntary commitment);
       (D) there has been a change or transfer in ownership or 
     operational control of the facility to which the agreement 
     relates, or a material change, alteration, or addition to the 
     facility; or
       (E) any other event specified in the agreement as a ground 
     for termination or modification has occurred.
       (2) Effect.--On termination of an innovative environmental 
     strategy agreement, the owner or operator of the facility to 
     which the agreement related shall immediately become subject 
     to each otherwise-applicable requirement (as defined in 
     subsection (b)).
       (e) Term of Agreement.--
       (1) In general.--The term of an innovative environmental 
     strategy agreement shall not exceed 5 years, unless the 
     Administrator determines, after considering the views of the 
     stakeholders, that--
       (A) a longer period of time is required--
       (i) to achieve the better environmental results identified 
     under section 7; or
       (ii) in a case in which a proponent is making a substantial 
     investment in reliance on the agreement, to ensure a 
     reasonable degree of confidence that the investment will be 
     recovered; and
       (B) the requirements of section 7 continue to be met.
       (2) Extension or renewal.--In consultation with the 
     stakeholders and with the concurrence of the signatories to 
     the agreement and after public notice and opportunity for 
     comment consistent with section 8, the Administrator may 
     extend or renew an agreement for an additional term or terms, 
     but the Administrator may not extend or renew an agreement if 
     the extension or renewal would not further the purposes of 
     this Act or the strategy would no longer meet the 
     requirements of section 7.

     SEC. 11. JUDICIAL REVIEW.

       (a) Failure To Perform Nondiscretionary Act or Duty.--
       (1) In general.--Any person may commence a civil action in 
     the United States District Court for the District of Columbia 
     against the Administrator for failure to perform an act or 
     duty under this Act that is not discretionary with the 
     Administrator.
       (2) Timing.--No action may be commenced under subsection 
     (a) before the date that is 60 days after the date on which 
     the plaintiff gives notice to the Administrator of the act or 
     duty that the Administrator has failed to perform and of the 
     intent of the plaintiff to commence the action.
       (b) Decision To Enter Into Agreement.--
       (1) In general.--A person other than a signatory to an 
     innovative environmental strategy agreement may seek judicial 
     review of a decision by the Administrator to enter into such 
     an agreement in accordance with chapter 7 of title 5, United 
     States Code.
       (2) Appeal.--A petition on appeal of a judgment in a civil 
     action under this subsection shall be filed in the United 
     States Court of Appeals for the District of Columbia Circuit 
     not later than 90 days after the date on which public notice 
     of the decision to enter into the agreement is published 
     under section 8(b).
       (c) No Judicial Review of or Record Justification for 
     Decision Not To Enter Into

[[Page S11462]]

     Agreement.--A decision not to enter into, modify, renew, or 
     enter into negotiations toward an innovative environmental 
     strategy agreement and decisions under section 6 regarding 
     the stakeholder process shall not be subject to judicial 
     review and shall not require record justification by the 
     Administrator.

     SEC. 12. LIMITATION ON NUMBER OF AGREEMENTS.

       (a) In General.--The Administrator shall not enter into 
     more than 50 innovative environmental strategy agreements 
     unless, in the Administrator's sole discretion, and taking 
     into account the full range of the agency's obligations, the 
     Administrator determines that adequate resources exist to 
     enter into a greater number of agreements.
       (b) Limit.--The Administrator, in the Administrator's sole 
     discretion, may limit the number of agreements to less than 
     50.
       (c) Priority Consideration Diversity.--The Administrator 
     shall--
       (1) give priority consideration to proposals from small 
     businesses; and
       (2) seek to ensure that the agreements entered into reflect 
     proposals from a diversity of industrial sectors, 
     particularly from sectors where there is significant 
     potential for environmental improvement.

     SEC. 13. SMALL BUSINESS PROPOSALS.

       The Administrator shall establish a program to facilitate 
     development of proposals for innovative environmental 
     strategies from small businesses and groups of small 
     businesses and to provide for expedited and tailored review 
     of such proposals.

     SEC. 14. SAVINGS CLAUSE.

       (a) Effect of Decisions by the Administrator.--A decision 
     by the Administrator to enter into an agreement under this 
     Act shall not affect the validity or applicability of any 
     rule, requirement, policy, or practice, that is modified or 
     waived in the agreement with respect to any facility other 
     than the facility that is subject to the agreement.
       (b) Other Agreements.--Nothing in this Act affects the 
     authority of the Administrator in existence on the date of 
     enactment of this Act to enter into or carry out agreements 
     providing for innovative environmental strategies or affects 
     any other existing authority under which the Administrator 
     may undertake innovative initiatives.
       (c) Other Federal Agencies.--Nothing in this Act affects 
     the regulatory or enforcement authority of any other Federal 
     agency under the laws implemented by the Federal agency 
     except to the extent provided in an agreement to which the 
     other Federal agency is a party.
       (d) Limits on Purposes and Uses of Agreements.--An 
     agreement under this Act--
       (1) may not be adopted for the purpose of curing or 
     addressing past or ongoing violations or noncompliance at a 
     participating facility;
       (2) may not be used as a legal or equitable defense by any 
     party or facility not party to the agreement, or by a party 
     to the agreement as a defense in an action unrelated to any 
     requirement imposed under the agreement;
       (3) shall not limit or affect the Administrator's authority 
     to issue new generally applicable regulations or to apply 
     regulations to the facility that is the subject of the 
     agreement;
       (4) shall not give rise to any claim for damages or 
     compensation in the event of a change in statutes or 
     regulations applicable to such facility; and
       (5) shall not be admissible for any purpose in any judicial 
     proceeding other than a proceeding to challenge, defend, or 
     enforce the agreement.
       (e) Applicable Law.--
       (1) Contract law.--An innovative environmental strategy 
     agreement--
       (A) shall not be interpreted or applied according to 
     contract law principles; and
       (B) shall not be subject to contract or other common law 
     defenses.
       (2) OSHA.--For purposes of section 4(b)(1) of the 
     Occupational Safety and Health Act of 1970 (29 U.S.C. 
     653(b)(1)), the exercise by the Administrator of any 
     authority under this Act shall not be deemed to constitute or 
     exercise of authority to prescribe or enforce a standard or 
     regulation affecting occupational safety or health.

     SEC. 15. EVALUATION AND REPORT.

       (a) Evaluation.--The Administrator shall establish an 
     ongoing process with public participation to--
       (1) evaluate lessons learned from innovative environmental 
     strategies; and
       (2) determine whether the approaches embodied in an 
     innovative environmental strategy should be proposed for 
     incorporation in an agency rule.
       (b) Reports.--
       (1) Individual strategies.--Not later than 18 months after 
     entering into an innovative environmental strategy agreement, 
     the Administrator shall submit to Congress a report 
     evaluating whether the approaches embodied in an innovative 
     environmental strategy should be proposed for incorporation 
     in a statute or a regulation.
       (2) Aggregate effect.--Not later than 3 years after the 
     date of enactment of this Act, the Administrator shall submit 
     to Congress a report on the aggregate effect of the 
     innovative environmental strategy agreements entered into 
     under this Act, including--
       (A) the number and characteristics of the agreements;
       (B) estimates of the environmental and public health 
     benefits, including any reductions in quantities or types of 
     emissions and wastes generated;
       (C) estimates of the effect on compliance costs;
       (D) the degree and nature of public participation and 
     accountability;
       (E) estimates of nonenvironmental benefits obtained;
       (F) conclusions on the functioning of the stakeholder 
     participation process; and
       (G) a comparison of effectiveness of the program relative 
     to comparable State programs, using comparable performance 
     measures.

     SEC. 16. IMPLEMENTATION AUTHORITY.

       The Administrator may issue such regulations as are 
     necessary to carry out the agency's functions under this Act.

     SEC. 17. TECHNICAL ASSISTANCE GRANTS.

       The Administrator may establish a program to provide grants 
     for technical assistance to stakeholder groups.

     SEC. 18. AUTHORIZATION OF APPROPRIATIONS.

       There are authorized to be appropriated to the agency to 
     carry out this Act $4,000,000 for each of fiscal years 1999 
     through 2003 (including such sums as are necessary to provide 
     technical assistance to stakeholder groups).
                                 ______
                                 
      By Mr. DODD (for himself and Mr. Lieberman):
  S. 1349. A bill to authorize the Secretary of Transportation to issue 
a certificate of documentation with appropriate endorsement for 
employment in the coastwise trade for the vessel Prince Nova, and for 
other purposes; to the Committee on Commerce, Science, and 
Transportation.


               THE CROSS SOUND FERRY SERVICE ACT OF 1997

  Mr. DODD. Mr. President, I rise today to introduce with Senator 
Lieberman legislation to waive the 1920 Merchant Marine Act, commonly 
known as the Jones Act, to allow Cross Sound Ferry Services, Inc., to 
purchase, rebuild, and operate the 1964 Canadian-built vessel Prince 
Nova. Faced with an increased demand for its services and a shortage of 
suitable U.S.-built ferries, Cross Sound cannot purchase a domestically 
built vessel.
  Cross Sound Ferry Services, a family owned, nonsubsidized operation, 
provides auto, truck, and high speed passenger service between Orient 
Point, NY, and New London, CT. According to the proposed waiver, Cross 
Sound will purchase the Prince Nova, and spend more than three times 
the purchase price, no less than $4.2 million, on the conversion, 
restoration, repair, rebuilding, or retrofitting of the ferry in a 
shipyard located in New London.
  Cross Sound Ferry Service, a vital link between New England and 
eastern Long Island, provides an alternative mode of transportation 
that saves trucks and autos up to 200 miles in each direction, and 
reduces traffic, congestion, and wear on major roadways. From an 
environmental standpoint, ferry service reduces fuel consumption and 
pollution. Currently, the I-95 corridor throughout the Northeast is 
under a tremendous traffic burden. If the waiver is granted, it is 
expected that the new and expanded service the Prince Nova will provide 
will save 6 million miles and 360,000 travel hours.
  Cross Sound's commitment to service the Prince Nova in a United 
States shipyard will create high-skilled, high-wage jobs. Additionally, 
this waiver will undoubtably better facilitate commerce and encourage 
economic development in the region by allowing consumers easier access 
to goods and services. Furthermore, it will provide businesses with an 
additional mode to transport their products.
  An identical waiver was passed last week in the House of 
Representatives as part of the Coast Guard Authorization Act of 1997. 
It is our hope that it will receive the same favorable consideration in 
the Senate.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1349

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

     SECTION 1. DOCUMENTATION OF THE VESSEL PRINCE NOVA.

       (a) Documentation Authorized.--Notwithstanding section 27 
     of the Merchant Marine Act, 1920 (46 U.S.C. App. 883), 
     section 8 of the Act of June 19, 1886 (24 Stat. 81, chapter 
     421; 46 U.S.C. App. 289), and section 12106 of title 46, 
     United States Code, the Secretary of Transportation may issue 
     a certificate of documentation with appropriate endorsement 
     for employment in the coastwise trade

[[Page S11463]]

     for the vessel PRINCE NOVA (Canadian registration number 
     320804).
       (b) Expiration of Certificate.--A certificate of 
     documentation issued for the vessel under subsection (a) 
     shall expire unless--
       (1) the vessel undergoes conversion, reconstruction, 
     repair, rebuilding, or retrofitting in a shipyard located in 
     the United States;
       (2) the cost of that conversion, reconstruction, repair, 
     rebuilding, or retrofitting is not less than the greater of--
       (A) 3 times the purchase value of the vessel before the 
     conversion, reconstruction, repair, rebuilding, or 
     retrofitting; or
       (B) $4,200,000; and
       (3) not less than an average of $1,000,000 is spent 
     annually in a shipyard located in the United States for 
     conversion, reconstruction, repair, rebuilding, or 
     retrofitting of the vessel until the total amount of the cost 
     required under paragraph (2) is spent.
                                 ______
                                 
      By Mr. LEAHY (for himself and Mr. Jeffords):
  S. 1350. A bill to amend section 332 of the Communications Act of 
1934 to preserve State and local authority to regulate the placement, 
construction, and modification of certain telecommunications 
facilities, and for other purposes; to the Committee on Commerce, 
Science, and Transportation.


             THE TELECOMMUNICATIONS FACILITIES ACT OF 1997

  Mr. LEAHY. Mr. President, I ask unanimous consent that a copy of my 
bill to preserve State and local authority to regulate the placement, 
construction, and modification of telecommunication facilities be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1350

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

     SECTION 1. FINDINGS AND PURPOSES.

       (a) Findings.--Congress make the following findings:
       (1) The placement of commercial telecommunications, radio, 
     or television towers near homes can greatly reduce the value 
     of such homes, destroy the views from such homes, and reduce 
     substantially the desire to live in such homes.
       (2) States and localities should be able to exercise 
     control over the construction and location of such towers 
     through the use of zoning, planned growth, and other controls 
     relating to the protection of the environment and public 
     safety.
       (3) There are alternatives to the construction of 
     additional telecommunications towers to meet 
     telecommunications needs, including the co-location of 
     antennae on existing towers and the use of alternative 
     technologies.
       (4) On August 19, 1997, the Federal Communications 
     Commission issued a proposed rule, MM Docket No. 97-182, 
     which would preempt the application of State and local zoning 
     and land use ordinances regarding the placement of 
     telecommunications towers. It is in the interest of the 
     Nation that the Commission not adopt this rule.
       (5) It is in the interest of the Nation that the second 
     memorandum opinion and order and notice of proposed rule 
     making of the Commission with respect to application of such 
     ordinances to the placement of such towers, WT Docket No. 97-
     192, ET Docket No. 93-62, and RM-8577, be modified in order 
     to permit State and local governments to exercise their 
     zoning and land use authorities, and their power to protect 
     public health and safety, to regulate the placement of 
     telecommunications towers and to place the burden of proof in 
     civil actions relating to the placement of such towers on the 
     person or entity that seeks to place, construct, or modify 
     such towers.
       (b) Purposes.--The purposes of this Act are as follows:
       (1) To repeal the limitations on the exercise of State and 
     local authorities regarding the placement, construction, and 
     modification of personal wireless service facilities that 
     arise under section 332(c)(7) of the Communications Act of 
     1934 (47 U.S.C. 332(c)(7)).
       (2) To permit State and local governments to regulate the 
     placement, construction, and modification of such facilities 
     on the basis of the environmental effects of the operation of 
     such facilities.
       (3) To prohibit the Federal Communications Commission from 
     adopting rules which would preempt State and local regulation 
     of the placement of such facilities.

     SEC. 2. STATE AND LOCAL AUTHORITY OVER PLACEMENT, 
                   CONSTRUCTION, AND MODIFICATION OF CERTAIN 
                   TELECOMMUNICATIONS FACILITIES.

       (a) Repeal of Limitations.--Section 332(c)(7)(B) of the 
     Communications Act of 1934 (47 U.S.C. 332(c)(7)(B)) is 
     amended--
       (1) in clause (i), by striking ``thereof--'' and all that 
     follows through the end and inserting ``thereof shall not 
     unreasonably discriminate among providers of functionally 
     equivalent services.'';
       (2) by striking clause (iv);
       (3) by redesignating clause (v) as clause (iv); and
       (4) in clause (iv), as so redesignated, by striking the 
     third sentence and inserting the following: ``In any such 
     action in which a person seeking to place, construct, or 
     modify a tower facility is a party, such person shall bear 
     the burden of proof.''.
       (b) Prohibition on Adoption of Rule.--Notwithstanding any 
     other provision of law, the Federal Communications Commission 
     may not adopt as a final rule the proposed rule set forth in 
     ``Preemption of State and Local Zoning and Land Use 
     Restrictions on Siting, Placement and Construction of 
     Broadcast Station Transmission Facilities'', MM Docket No. 
     97-182, released August 19, 1997.

  Mr. JEFFORDS. Mr. President, I rise today to continue a discussion 
that my colleague, Senator Leahy, began earlier, with regard to the 
Federal Communications Commission proposed rulemaking on regulations 
for wireless and digital broadcast facilities.
  University of Vermont instructor and landscape designer Jean 
Veissering recently stated ``We have a real spiritual connection with 
hilltops. They tend to be almost sacred ground. Building something 
jarringly out of character upon them seems almost like a sacrilege.'' 
Mr. President, I share Jean's sentiments completely. In addition, it is 
the beautiful views of the majestic mountain ranges that in many ways 
defines what Vermont is all about.
  Vermonters take great pride in their heritage as a State committed to 
the ideals of freedom and unity. That heritage goes hand and hand with 
a unique quality of life and the desire to grow and develop while 
maintaining Vermont's beauty and character. Ethan Allan and his Green 
Mountain Boys and countless other independent minded Vermonters helped 
shape the Nation's 14th State while making outstanding contributions to 
the independence of this country. Today, that independence still 
persists in the hills and valleys of Vermont. Vermonters have worked 
hard over the years to maintain local control over issues that impact 
them directly.
  Throughout my years in Congress, I fought hard to protect the ability 
of Vermonters to step out of their kitchen doors and see an 
unobstructed view. Thousands of Americans travel to Vermont each year 
to take in the splendid nature of the State.
  However, Vermont could have looked quite different if it were not for 
some foresight on behalf of several Vermonters. In the 1960's, the 
State of Vermont was entering into a period of unchecked development. 
In response, Governor Dean C. Davis created the Commission on 
Environmental Control in May of 1969. The commission drafted a set of 
recommendations to help manage the precious resources of the State.
  As the attorney general for the State at that time, I was one of the 
primary drafters of an environmental land use law which would later 
become known as Act 250. Act 250 was specifically written to control 
development, not to stop development, and in turn, this act has led 
Vermont to economic prosperity through balanced environmental 
protection.
  After reviewing the Commission on Environmental Control's 
recommendation and the proposed legislation, Governor Davis made one 
very basic, but important change in the legislation. The proposed 
legislation had called for a State agency to administer the act. The 
Governor was adamant in his belief that the control should be as close 
to the people as possible. It is that control which the FCC's proposed 
rulemaking is looking to preempt.
  Governor Davis' recommendation led to placing the permitting process 
in the hands of local environmental review boards with appeal rights to 
the Vermont Environmental Board. Thus, the act is administered by men 
and women who are directly involved in their communities and thoroughly 
familiar with local concerns.
  When reviewing an application for new development, the local 
environmental review boards take into account the economic needs of the 
State along with regional concerns. The review board's underlying goal 
is to direct the impact of development toward the positive. The 
positive approach has led to a high priority on preserving the 
environment, protecting the natural resources, and maintaining the 
quality of life of all Vermonters.
  On October 9, 1997, the State of Vermont Environmental Board filed 
comments with the Federal Communications Commission that stated: ``Far 
from being an impediment to personal wireless service deployment, 
Vermont's Act 250 demonstrates that the

[[Page S11464]]

path to economic prosperity is through balanced environmental 
protection, not preemption of such protection.'' I share the board's 
sentiments and feel that the FCC should take no further steps to 
preempt Vermont's Act 250 with respect to personal wireless service 
facilities.
  Mr. President, the Green Mountain State has unique topography, 
dominated by rolling valleys and tall mountains. In turn, the citizens 
of the State have taken many steps to help preserve the beautiful views 
and pristine environment. The determination of the location of visible 
transmission towers should remain within the jurisdiction of local 
control. I feel that the Telecommunication Act of 1996 recognizes and 
protects the interest of local and State government in the area of land 
use regulation.
  As the attorney general of the State of Vermont at the time of the 
enactment of Act 250, I am proud of the role I and many other 
Vermonters played in the subsequent management of the precious natural 
resources of the State. I support Act 250 and feel that the placement 
of communications towers should be left in the hands of the residents 
of Vermont not by a Federal agency.
  I have written to the Chairman of the FCC with regard to my concerns 
about this proposed rulemaking. In addition, yesterday the Senate 
confirmed William Kennard to be the next Chairman of the FCC. Upon his 
confirmation, I wrote a letter to Chairman Kennard personally inviting 
him to the State of Vermont to see first hand how this proposed 
rulemaking would impact the State. I hope that he will join me on a 
tour of the State which will demonstrate to him the importance of local 
control with respect to the placement of broadcast facilities. Further, 
I look forward to explaining how Act 250 has allowed for the 
development of wireless communication in the State while protecting the 
environment.
  Mr. President, in conclusion, I want to commend Mr. Leahy for 
introducing this very important legislation for the State of Vermont. I 
am pleased to be a cosponsor and I look forward to working with him to 
protect Vermont's interests unique landscape.
                                 ______
                                 
      By Mr. BURNS:
  S. 1351. A bill to amend the Sikes Act to establish a mechanism by 
which outdoor recreation programs on military installations will be 
accessible to disabled veterans, military dependents with disabilities, 
and other persons with disabilities; to the Committee on Armed 
Services.


                  the disabled sportsmen's access act

  Mr. BURNS. Madam President, I rise today to introduce the Disabled 
Sportsmen's Access Act. This legislation will provide new opportunities 
for sportsmen with disabilities to hunt and fish on the numerous 
Department of Defense facilities across this Nation. This legislation 
will also allow the Department of Defense to work with private sector 
groups to build facilities and operate programs for the benefit of 
sportsmen with disabilities.
  The beginnings of this legislation originate from a program developed 
at the Marine Corps Base at Quantico, VA. The program, run by Lt. Col. 
Lewis Deal, is a prime example of the work that can be done to provide 
new opportunities for people with disabilities. Lieutenant Colonel Deal 
has combined private sector volunteers work with donations from other 
people to build permanent disabled accessible blinds for deer hunting, 
which are used during both gun and bow seasons. These blinds provide 
people living with disabilities many of the same opportunities for 
outdoor recreation that we all enjoy.
  There are plans underway at this time to construct a fishing pier on 
the Potomac River for access by people with disabilities. This pier is 
to be built with lower railings, and stops to provide access and 
security for disabled persons.
  This legislation, uses the current program at Quantico, to allow the 
Department of the Defense to provide access to it's 30 million acres of 
wildlands by disabled individuals, as long as it does not interfere 
with the primary mission of the military, that of our Nation's defense. 
The military installations around the Nation offer a number of 
recreational and outdoor activities for both military and civilian 
personnel.
  This legislation, will encourage the Department of Defense to give 
access to individuals with disabilities and allow the Department to 
accept donations or money and materials as well as use volunteers for 
the construction of facilities accessible to sportsmen with 
disabilities. The bill would allow this voluntary work to be done 
without cost to the Federal Government or the taxpayer.
  Madam President, this legislation has the support of numerous 
organizations, including the bipartisan Congressional Sportsmen's 
Caucus, the Paralyzed Veterans of America, Disabled American Veterans. 
Among sportsmen's groups the bill has the endorsement of the Wheeling 
Sportsmen of America, Safari Club International, Wildlife Management 
Institute, the International Association of Fish and Wildlife Agencies 
and the Congressional Sportsmen's Foundation. I join today with my 
friend Congressman Duke Cunningham to bring this important legislation 
to the attention of my colleagues.
  I hope that all my colleagues in Congress would join Congressman 
Cunningham and myself in supporting this legislation for disabled 
sportsmen in our country.

                          ____________________