[Congressional Record Volume 146, Number 19 (Monday, February 28, 2000)]
[Senate]
[Pages S867-S870]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. KYL:
  S. 2110. A bill to amend title XVIII of the Social Security Act to 
provide for payment of claims by health care providers against 
insolvent Medicare+Choice Organizations, and for other purposes; to the 
Committee on Finance.


                       bankruptcy of premier HMO

  Mr. KYL. Mr. President, I rise to bring to the attention of the 
Senate a serious problem facing many thousands of Medicare 
beneficiaries in Arizona. On November 16, 1999, Premier Health Care of 
Arizona went into receivership. The health care of more than 20,000 
Medicare beneficiaries who were enrolled in Premier has been affected 
by this solvency.
  Since Premier Medicare HMO was placed in receivership, I have been 
advised that some non-contract providers--providers outside of the HMO 
network--have asserted that Medicare beneficiaries are personally 
liable for unpaid claims and have referred the outstanding claims to 
collection agencies.
  These unpaid claims--some of which may date back more than six months 
and amount to significant sums of money--have made it difficult for 
many contract and non-contract providers to continue to provide care to 
Medicare beneficiaries. Because Premier operated in a largely rural 
area where few alternative providers were accessible, this has created 
a dire health-care delivery situation for Medicare beneficiaries.
  Mr. President, today I introduce legislation that addresses the 
Arizona situation, as well as future

[[Page S868]]

Medicare+Choice insolvencies, wherever they may occur. This legislation 
mandates that, after a Medicare+Choice goes into receivership, the 
receiver--in this case, the state insurance commissioner--may apply to 
the Secretary of HHS for payment of all valid, unpaid provider claims 
for items or services furnished to Medicare enrollees before the date 
the receiver was appointed.
  Contract providers will be paid at their contract rate, while non-
contract providers will be paid for the ``reasonable cost'' of the 
covered item or service. Amounts needed to make these payments will be 
paid out of the Part A or Part B trust fund, as is appropriate based on 
which fund would have paid the claim on a fee-for-services basis.
  To recover these amounts paid to providers, the bill establishes that 
HCFA will become a creditor of the receivership estate and assumes the 
priority position of the respective providers it has paid.
  The bill also mandates that Medicare+Choice enrollees may not be held 
liable to contract or non-contract providers for any claims that are 
unpaid by the Medicare+Choice organization.
  While the regulation of state-licensed Medicare+Choice organizations 
is primarily a state responsibility, the Medicare law makes clear that 
the Secretary of Health and Human Services and the administrator of 
HCFA have an ongoing ``responsibility to ensure that it (HCFA) 
contracts only with fiscally-sound Medicare+Choice organizations.''
  To this end, Section 1857(d) gives the Secretary the right to audit 
and inspect any books and records that pertain either to the ability of 
the Medicare HMO to bear the risk of potential financial loss, or to 
the quality and timeliness of services provided for Medicare 
beneficiaries. See 42 CFR 422.502, 516 and 552.
  My bill strengthens current law and regulation by requiring that, 
once HCFA determines that a Medicare+Choice organization may not be 
able to bear the risk of financial losses, the Secretary must promptly 
notify the appropriate state officials and provide those officials with 
the information on which that determination is based.
  The bill also strengthens current law by requiring that, when 
Medicare+Choice organizations fail to provide prompt payments to 
providers, the Secretary must pay providers directly. Under my bill, if 
the Medicare+Choice plan fails to provide prompt payment of 10 percent 
of claims submitted for services and supplies furnished to enrollees 
within 60 days of the date on which the claim was submitted, the 
Secretary must pay contract and non-contract providers directly--there 
is no discretion as there is in current law.
  To avoid a repeat of this problem with other carriers in the future, 
the bill requires that Medicare+Choice organizations post a surety bond 
of no less than $500,000, as well as meet any additional requirements 
related to bonding or escrow accounts that the Secretary deems 
necessary. The bond requirement may be waived if a comparable surety 
bond is required under state law.
  Mr. President, this legislation will enable the government to fulfill 
its promise to those seniors who have chosen to receive their Medicare 
coverage through a Medicare+Choice organization. It will prevent 
seniors from being billed for covered services and providers from 
losing large sums in unpaid bills.
  If providers aren't paid, many may be unwilling--or unable--to 
continue providing care. If quality care is not available through 
experienced providers, or if seniors are the subject of legal action 
for the bills of insolvent Medicare+Choice organizations, beneficiaries 
will lose confidence in the Medicare+Choice programs, and ultimately, 
in Medicare fee-for-service as well. We simply can't let that happen.
  The Congress must ensure that providers are paid and Medicare 
beneficiaries are protected. This is a commitment we have made to 
seniors--it is a commitment we must fulfill.
                                 ______
                                 
      By Mrs. FEINSTEIN:
  S. 2111. A bill to direct the Secretary of Agriculture to convey for 
fair market value 1.06 acres of land in the San Bernardino National 
Forest, California to KATY 101.3 FM, a California corporation; to the 
Committee on Energy and Natural Resources.


                        LAND CONVEYANCE TO KATY

  Mrs. FEINSTEIN. Mr. President. I am pleased to introduce this bill 
today to assist Katy Gill, the owner of KATY radio, a station 
broadcasting out of a one acre parcel of the San Bernardino Forest and 
acting as an important public service announcement source for the 
residents of Idylwood, California.
  KATY radio has been caught up in some unfortunate circumstances 
involving an antennae site that the station had at one time, been 
leasing from GTE. When GTE decided to move out of the area, KATY was no 
longer able to legally operate. This bill will allow KATY to purchase 
at fair market value the title to 1.06 acres of land in San Bernardino 
National Forest so that the station could continue broadcasting.
  This legislation is supported by the Forest Service and KATY radio 
station listeners throughout Idylwood, California. I know of no 
opposition to such legislation. Representatives Mary Bono, Jerry Lewis 
and Don Young have introduced similar legislation in the House. I look 
forward to working with my colleagues in the House and the relevant 
Senate committee members to ensure that we address this issue before 
the end of the 106th Congress.
                                 ______
                                 
      By Mr. TORRICELLI (for himself, Mr. Jeffords, Mrs. Murray, Mr. 
        Kerry, and Ms. Landrieu):
  S. 2112. A bill to provide housing assistance to domestic violence 
victims; to the Committee on Banking, Housing, and Urban Affairs.


     The Domestic Violence and Sexual Assault Victim's Housing Act

 Mr. TORRICELLI. Mr. President, I rise with my colleagues 
Senator Jeffords, Senator Landrieu, Senator Murray, and Senator Kerry 
to introduce ``The Domestic Violence and Sexual Assault Victim's 
Housing Act of 2000.'' This legislation provides funding for shelter 
assistance to women and children fleeing domestic violence, stalking, 
and sexual assault. Due to the fact that domestic violence victims 
often have no safe place to go and financial obstacles make it 
difficult to rebuild lives, this funding is needed to help support a 
continuum between emergency shelter and independent living.
  In my home state of New Jersey, one act of domestic violence occurs 
approximately every six minutes and thirty-seven seconds. Nationally, 
it is estimated that a woman is beaten every fifteen seconds. Yet, many 
individuals and families fleeing domestic violence are forced to return 
to their abusers because of inadequate shelter or lack of money. Half 
of all homeless women and children are fleeing domestic violence. Even 
if they leave their abusers to go to a shelter, they often return home 
because the isolation from familiar surroundings, friends, and 
neighborhood resources makes them feel even more vulnerable. Shelters 
and transitional facilities are often located far from a victim's 
neighborhood. And, if emergency shelter is available, a supply of 
affordable housing and services are needed to keep women from having to 
return to a violent home.
  The issue of homelessness for battered women goes beyond the ability 
to find a space in a domestic violence shelter. Because women escaping 
abusers often leave suddenly, they often have no money saved for a 
security deposit and first month's rent. This is especially problematic 
in New Jersey as rents are so expensive. New Jersey is the second most 
expensive state in the nation to rent a two-bedroom apartment and 45 
percent of all New Jersey renters cannot afford the State's average 
rent for a two-bedroom apartment. And, many battered women may have to 
leave their jobs because of workplace stalking by their abusers. Women 
who leave violent situations often incur additional expenses as they 
must purchase clothing, cookware, and furniture. The lack of financial 
security hinders their ability to secure safe, decent, and affordable 
housing for themselves and their families.
  This is why Senator's Jeffords, Landrieu, Murray, Kerry and I are 
introducing ``The Domestic Violence and Sexual Assault Victim's Housing 
Act of 2000.'' Under current law, domestic violence shelters must apply 
for federal homeless assistance along with

[[Page S869]]

other organizations assisting the general homeless population. This 
legislation creates a specific grant targeted towards shelters 
providing assistance to individuals and families fleeing domestic 
violence, stalking, and sexual assault only. Funding is authorized 
through the Stewart B. McKinney Homeless Assistance Act for five years 
beginning at $50 million for fiscal year 2001. Non-profit, community-
based housing organizations receive the funds through a competitive 
grant process administered by the Department of Housing and Urban 
Development. Groups would use the grant to provide emergency and 
transitional housing or direct financial assistance for rent, security 
deposit, and first month's rent. In addition, the legislation also 
requires organizations to provide a 25% match in funds for services 
such as child care, employment assistance, and healthcare. This 
assistance helps provide a stable home base so that those fleeing 
domestic violence learn new job skills, work full-time jobs, or search 
for adequate child care.

  The Domestic Violence and Sexual Assault Victim's Housing Act of 2000 
is supported by the National Coalition Against Domestic Violence and 
the NOW Legal Defense and Education Fund. Senators Jeffords, Landrieu, 
Murray, Kerry and I look forward to working with them and all others 
interested in helping us address the continuing national epidemic of 
domestic violence. I urge my colleagues to join us in our efforts to 
prevent victims of domestic violence from having to choose between 
violence and homelessness.
  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. 2112

       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 ``Domestic Violence and Sexual 
     Assault Victims' Housing Act''.

     SEC. 2. FINDINGS.

       Congress finds as follows:
       (1) Housing can prevent domestic violence and mitigate its 
     effects. The connection between domestic violence and housing 
     is overwhelming. Of all homeless women and children, 50 
     percent are fleeing domestic violence.
       (2) Among cities surveyed, 44 percent identified domestic 
     violence as a primary cause of homelessness.
       (3) Women's poverty levels aggravate the problems of 
     homelessness and domestic violence. Two out of three poor 
     adults are women. Female-headed households are six times 
     poorer than male-headed households. In 1996, of the 7,700,000 
     poor families in the country, 4,100,000 of them were single 
     female-headed households. In addition, 5,100,000 poor women 
     who are not in families are poor.
       (4) Almost 50 percent of the women who receive Temporary 
     Assistance to Needy Families funds cite domestic violence as 
     a factor in the need for assistance.
       (5) Many women who flee violence are forced to return to 
     their abusers because of inadequate shelter or lack of money. 
     Even if they leave their abusers to go to a shelter, they 
     often return home because the isolation from familiar 
     surroundings, friends, and neighborhood resources makes them 
     feel even more vulnerable. Shelters and transitional housing 
     facilities are often located far from a domestic violence 
     victim's neighborhood. While this placement may be deliberate 
     to protect domestic violence victims from their abusers, it 
     can also be intimidating and alienating for a woman to leave 
     her home, community, cultural support system, and all that 
     she knows for shelter way across town. Thus, women of color 
     and immigrant women are less likely to become shelter 
     residents.
       (6) Women who do leave their abusers lack adequate 
     emergency shelter options. The overall number of emergency 
     shelter beds for homeless people is estimated to have 
     decreased by an average of 3 percent in 1997 while requests 
     for shelter increased on the average by 3 percent. Emergency 
     shelters struggle to meet the increased need for services 
     with about 32 percent of the requests for shelter by homeless 
     families going unmet. In fact 88 percent of cities reported 
     having to turn away homeless families from emergency shelters 
     due to inadequate resources for services.
       (7) Battered women and their children comprise an 
     increasing proportion of the emergency shelter population. 
     Many emergency shelters have strict time limits that require 
     women to find alternative housing immediately forcing them to 
     separate from their children.
       (8) A stable, sustainable home base is crucial for women 
     who have left situations of domestic violence and are 
     learning new job skills, participating in educational 
     programs, working full-time jobs, or searching for adequate 
     child care in order to gain self-sufficiency. Transitional 
     housing resources and services provide a continuum between 
     emergency shelter provision and independent living.

     SEC. 3. AUTHORIZATION OF APPROPRIATIONS.

       For purposes of section 4, the authorization of 
     appropriations under section 429(a) of the Stewart B. 
     McKinney Homeless Assistance Act (42 U.S.C. 11389(a)) shall 
     be increased by $50,000,000 for fiscal year 2001 and by such 
     sums as may be necessary for fiscal years 2002 through 2005.

     SEC. 4. USE OF AMOUNTS FOR HOUSING ASSISTANCE FOR VICTIMS OF 
                   DOMESTIC VIOLENCE, STALKING, OR ADULT OR CHILD 
                   SEXUAL ASSAULT.

       (a) In General.--The additional amounts to be made 
     available by section 3 under section 429 of the Stewart B. 
     McKinney Homeless Assistance Act (42 U.S.C. 11389) shall be 
     made available by the Secretary only to qualified, nonprofit, 
     nongovernmental organizations (as such term is defined in 
     section 5) only for the purpose of providing supportive 
     housing (as such term is referred to in subchapter IV of part 
     C of the Stewart B. McKinney Homeless Assistance Act (42 
     U.S.C. 11384)) and tenant-based rental assistance, financial 
     assistance for security deposit, first month's rent, or 
     ongoing rental assistance on behalf of individuals or 
     families victimized by domestic violence, stalking, or adult 
     or child sexual assault (as such terms are defined in section 
     5) who have left or are leaving a residence as a result of 
     the domestic violence, stalking, or adult or child sexual 
     assault. Each organization shall be required to supplement 
     the assistance provided under this subsection with a 25 
     percent match of funds for supportive services (as such term 
     is referred to in subchapter IV of part C of the Stewart B. 
     McKinney Homeless Assistance Act (42 U.S.C. 11385)) from 
     sources other than this subsection. Each organization shall 
     certify to the Secretary its compliance with this subsection 
     and shall include with the certification a description of the 
     sources and amounts of such supplemental funds.
       (b) Determination.--For purposes of subsection (a), an 
     individual or a family victimized by domestic violence, 
     stalking, or adult or child sexual assault shall be 
     considered to have left or to be leaving a residence as a 
     result of domestic violence, stalking, or adult or child 
     sexual assault if the qualified, nonprofit, nongovernmental 
     organization providing support, including tenant-based rental 
     assistance, financial assistance for security deposit, first 
     month's rent, or ongoing rental assistance under subsection 
     (a) determines that the individual or member of the family 
     who was a victim of the domestic violence, stalking, or adult 
     or child sexual assault reasonably believes that relocation 
     from such residence will assist in avoiding future domestic 
     violence, stalking, or adult or child sexual assault against 
     such individual or another member of the family.
       (c) Allocation.--Amounts made available pursuant to 
     subsection (a) shall be allocated by the Secretary on the 
     basis of a national competition among the qualified, 
     nonprofit, nongovernmental organizations that submit 
     applications to the Secretary that best demonstrate a need 
     for such assistance, including the extent of service provided 
     to underserved populations as defined in section 2003(7) of 
     the Omnibus Crime Control and Safe Streets Act of 1968 (42 
     U.S.C. 3796gg-2(7)) and the ability to undertake and carry 
     out a program under subsection (a), as the Secretary shall 
     determine. Of the total funds appropriated under section 3 in 
     any of the enumerated fiscal years, at least 5 percent shall 
     be used for grants to Indian tribes or Indian tribal 
     organizations that provide emergency shelter, transitional 
     housing, or permanent housing or supportive services to 
     individuals or families victimized by domestic violence, 
     stalking, or adult or child sexual assault and Indian tribes 
     or Indian tribal organizations which receive such grants may 
     apply for and receive other grants from the total funds 
     appropriated under this Act. All other grants awarded shall 
     go to qualified, nonprofit, nongovernmental organizations. 
     If, at the end of the 6th month of any fiscal year for which 
     sums are appropriated under section 3, the amount 
     appropriated has not been made available to a qualified, 
     nonprofit, nongovernmental organization under subsection (a) 
     for purposes outlined therein, the Secretary shall reallot 
     such amount to qualified, nonprofit, nongovernmental 
     organizations that are eligible for funding under subchapter 
     IV of part C of the Stewart B. McKinney Homeless Assistance 
     Act (42 U.S.C. 11381-11389). Funds made available by the 
     Secretary through reallotment under the preceding sentence 
     shall remain available for expenditure until the end of the 
     fiscal year following the fiscal year in which such funds 
     become available for reallotment.

     SEC. 5. DEFINITIONS.

       For purposes of this Act:
       (1) Domestic violence.--The term ``domestic violence'' 
     includes acts or threats of violence or extreme cruelty (as 
     such term is referred to in section 216 of the Immigration 
     and Nationality Act (8 U.S.C. 1186a)), not including acts of 
     self-defense, committed by a current or former spouse of the 
     victim, by a person with whom the victim has a child in 
     common, by a person who is cohabiting with or has cohabited 
     with the victim, by a person who is or has been in a 
     continuing social relationship of a romantic or intimate 
     nature

[[Page S870]]

     with the victim, by a person similarly situated to a spouse 
     of the victim under the domestic or family violence laws of 
     the jurisdiction, or by any other person against a victim who 
     is protected from that person's acts under the domestic or 
     family violence laws of the jurisdiction.
       (2) Family victimized by domestic violence, stalking, or 
     adult or child sexual assault.--
       (A) In general.--The term ``family victimized by domestic 
     violence, stalking, or adult or child sexual assault'' means 
     a family or household that includes an individual who has 
     been determined under subparagraph (B) to have been a victim 
     of domestic violence, stalking, or adult or child sexual 
     assault, but does not include any individual described in 
     paragraph (1), (2), or (3) who committed the domestic 
     violence, sexual assault, or adult or child sexual assault. 
     The term includes any such family or household in which only 
     a minor or minors are the individual or individuals who was 
     or were a victim of domestic violence, stalking, or sexual 
     assault only if such family or household also includes a 
     parent, stepparent, legal guardian, or other responsible 
     caretaker for the child.
       (B) Determination that family or individual was a victim of 
     domestic violence, stalking, or adult or child sexual 
     assault.--For purposes of subparagraph (A), a determination 
     under this subparagraph is a determination that domestic 
     violence, stalking, or adult or child sexual assault has been 
     committed, which is made by any agency or official of a 
     State, Indian tribe, tribal organization, or unit of general 
     local government based upon--
       (i) information provided by any medical, legal, counseling, 
     or other clinic, shelter, sexual assault program or other 
     program or entity licensed, recognized, or authorized by the 
     State, Indian tribe, tribal organization, or unit of general 
     local government to provide services to victims of domestic 
     violence, stalking, or adult or child sexual assault;
       (ii) information provided by any agency of the State, 
     Indian tribe, tribal organization, unit of general local 
     government, or qualified, nonprofit, nongovernmental 
     organization that provides or administers the provision of 
     social, medical, legal, or health services;
       (iii) information provided by any clergy;
       (iv) information provided by any hospital, clinic, medical 
     facility, or doctor licensed or authorized by the State, 
     Indian tribe, tribal organization, or unit of general local 
     government to provide medical services;
       (v) a petition, application, or complaint filed in any 
     State, Federal, or tribal court or administrative agency, 
     documents or records of action or decision of any court, law 
     enforcement agency, or administrative agency, including any 
     record of any protective order, injunction, or temporary or 
     final order issued by civil or criminal courts, any self-
     petition or any police report; or
       (vi) any other reliable evidence that domestic violence, 
     stalking, or adult or child sexual assault has occurred.

     A victim's statement that domestic violence, stalking, or 
     adult or child sexual assault has occurred shall be 
     sufficient unless the agency has an independent, reasonable 
     basis to find the individual not credible.
       (3) Indian tribe.--The term ``Indian tribe'' shall have the 
     same meaning given the term in section 2002(3) of the Omnibus 
     Crime Control and Safe Streets Act of 1968 (42 U.S.C. 3796gg-
     2(3)).
       (4) Qualified, nonprofit, nongovernmental organization.--
     The term ``qualified, nonprofit, nongovernmental 
     organization'' means a private organization that--
       (A) is organized, or has as one of its primary purposes, to 
     provide emergency shelter, transitional housing, or permanent 
     housing for victims of domestic violence, stalking, or adult 
     or child sexual assault or is a medical, legal, counseling, 
     social, psychological, health, job training, educational, 
     life skills development, or other clinical services program 
     for victims of domestic violence, stalking, or adult or child 
     sexual assault that undertakes a collaborative project with a 
     qualified, nonprofit, nongovernmental organization that 
     primarily provides emergency shelter, transitional housing, 
     or permanent housing for low-income people;
       (B) is organized under State, tribal, or local laws;
       (C) has no part of its net earnings inuring to the benefit 
     of any member, shareholder, founder, contributor, or 
     individual;
       (D) is approved by the Secretary as to financial 
     responsibility; and
       (E) demonstrates experience in providing services to 
     victims of domestic violence, stalking, or adult or child 
     sexual assault.
       (5) Secretary.--The term ``Secretary'' means the Secretary 
     of Housing and Urban Development.
       (6) Sexual assault.--The term ``sexual assault'' means any 
     conduct proscribed by chapter 109A of title 18, United States 
     Code, whether or not the conduct occurs in the special 
     maritime and territorial jurisdiction of the United States, 
     on an Indian reservation, or in a Federal prison and includes 
     both assaults committed by offenders who are strangers to the 
     victims and assaults committed by offenders who are known to 
     the victims or related by blood or marriage to the victim.
       (7) Stalking.--The term ``stalking'' means engaging in a 
     course of conduct directed at a specific person that would 
     cause a reasonable person to fear death, sexual assault, or 
     bodily injury to himself or herself or a member of his or her 
     immediate family, when the person engaging in such conduct 
     has knowledge or should have knowledge that the specific 
     person will be placed in reasonable fear of death, sexual 
     assault, or bodily injury to himself or herself or a member 
     of his or her immediate family and when the conduct induces 
     fear in the specific person of death, sexual assault, or 
     bodily injury to himself or herself or a member of his or her 
     immediate family.
       (8) State.--The term ``State'' means the States of the 
     United States, the District of Columbia, the Commonwealth of 
     Puerto Rico, the Commonwealth of the Northern Mariana 
     Islands, Guam, the Virgin Islands, American Samoa, and any 
     other territory or possession of the United States.
       (9) Transitional housing.--The term ``transitional 
     housing'' includes short-term housing and is given the 
     meaning of subchapter IV, part C of the Stewart B. McKinney 
     Homeless Assistance Act (42 U.S.C. 11384(b)).
       (10) Tribal organization.--The term ``tribal organization'' 
     means a private, nonprofit, nongovernmental, or tribally 
     chartered organization--
       (A) whose primary purpose is to provide emergency shelter, 
     transitional housing, or permanent housing or supportive 
     services to individuals or families victimized by domestic 
     violence, stalking, or adult or child sexual assault;
       (B) that operates within the exterior boundaries of an 
     Indian reservation; and
       (C) whose board of directors reflects the population 
     served.
       (11) Unit of general local government.--The term ``unit of 
     general local government'' has the meaning given the term in 
     section 102(a) of the Housing and Community Development Act 
     of 1974 (42 U.S.C. 5302(a)).

                          ____________________