[Congressional Record Volume 146, Number 35 (Monday, March 27, 2000)]
[Senate]
[Pages S1747-S1749]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mrs. FEINSTEIN (for herself and Mrs. Boxer):
S. 2294. A bill to establish the Rosie the Riveter-World War II Home
Front National Historical Park in the State of California, and for
other purposes; to the Committee on Energy and Natural Resources.
rosie the riveter-world war ii home front national historical park act
Mrs. FEINSTEIN. Mr. President, I am proud to introduce this bill
today to establish the Rosie the Riveter/World War II Home Front
National Historic Park. This park will be constructed on the former
site of Richmond Kaiser Shipyard #2 which produced WWII ships at the
site of the present-day Marina Park in Richmond California.
The Home Front industrial buildup in Richmond, California and across
America to strengthen U.S. military capability and eventually win World
War II started in early 1941 with the Lend Lease Program. Employment at
the Richmond Shipyards peaked at 90,000 and forced an unprecedented
integration of workers into the nation's work force.
``Rosie the Riveter'' was a term coined to help recruit female
civilian workers and came to symbolize a workforce mobilized to fill
the gap created by working men who left their jobs for active military
duty. Nationwide, six million women entered the WWII Home Front
workforce, which also provided unprecedented opportunities for
minorities.
I am proud to offer this legislation to commemorate these invaluable
contributions to the U.S. victory in World War II, and I urge my
colleagues to support this bill.
______
By Mr. CRAPO:
S. 2296. A bill to provide grants for special environmental
assistance for the regulation of communities and habitat (SEARCH) to
small communities; to the Committee on Environment and Public Works.
PROJECT SEARCH
Mr. CRAPO. Mr. President, I rise today to introduce legislation to
authorize a national environmental grants program for small communities
called Project SEARCH.
The national Project SEARCH (Special Environmental Assistance for the
Regulation of Communities and Habitat) concept is based on a
demonstration program that has been operating with great success in
Idaho in 1999 and 2000. In short, the bill establishes a simplified
application process for communities of under 2,500 individuals to
receive assistance in meeting a broad array of federal, state, or local
environmental regulations. Grants would be available for initial
feasibility studies, to address unanticipated costs arising during the
course of a project, or when a community has been turned down or
underfunded by traditional sources. The grant program would require no
match from the recipients.
Some of the major highlights of the program are:
A simplified application process--no special grants coordinators
required;
No unsolicited bureaucratic intrusions into the decision-making
process;
Communities must first have attempted to receive funds from
traditional sources;
It is open to studies or projects involving any environmental
regulation;
Applications are reviewed and approved by citizens panel of
volunteers;
The panel chooses number of recipients and size of grants;
The panel consists of volunteers representing all regions of the
state; and
No local match is required to receive the SEARCH funds.
Over the past several years, it has become increasing apparent that
small communities are having problems complying with environmental
rules and regulations due primarily to lack of funding, not a
willingness to do so. They, like all of us, want clean water and air
and a healthy natural environment. Sometimes, they simply cannot
shoulder the financial burden with their limited resources.
In addition, small communities wishing to pursue unique collaborative
efforts might be discouraged by grant administrators who prefer
conformity. Some run into unexpected costs during a project and have
borrowed and bonded to the maximum. Others are in critical habitat
locations and any project may have additional costs, which may not be
recognized by traditional financial sources. Still others just need
help
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for the initial environmental feasibility study so they can identify
the most effective path forward.
With these needs in mind, in 1998, I was able to secure $1.3 million
through the Environmental Protection Agency (EPA) for a demonstration
grant program for Idaho's small communities. Idaho's program does not
replace other funding sources, but serves as a final resort when all
other means have been exhausted.
The application process was simplified so that any small town mayor,
county commissioner, sewer district chairman, or community leader could
manage it without hiring a professional grant writer. An independent
citizens committee with statewide representation was established to
make the selections and get the funds on the ground as quickly as
possible. No bureaucratic or political intrusions were permitted.
Although the EPA subsequently insisted that grants be limited to
water and wastewater projects, forty-four communities in Idaho
ultimately applied, not including two that failed to meet the
eligibility requirements. Ultimately, twenty-one communities were
awarded grants in several categories, and ranged in size from $9,000 to
$319,000. A Native American community, a migrant community, and several
innovative collaborative efforts were included in the successful
applicants. The communities that were not selected are being given
assistance in exploring other funding sources and other advice.
The response and feedback from all participants has been overwhelming
positive. Environmental officials from the state and EPA who witnessed
the process have stated that the process worked well and was able to
accomplish much on a volunteer basis. There was even extraordinary
appreciation from other funding agencies because some communities they
were not able to reach were provided funds for feasibility studies. The
only negative comments were from those who wished that the EPA had not
limited the program to water and wastewater projects.
The conclusion of all participants was that Project SEARCH is a
program worthy of being expanded nationally. So many small communities
in so many states can benefit from a program that assists underserved
and often overlooked communities. This legislation provides us the
opportunity to help small communities throughout the United States.
______
By Mr. JEFFORDS (for himself, Mr. Reed, and Mr. Leahy):
S. 2298. A bill to amend title XVIII of the Social Security Act to
clarify the definition of homebound with respect to home health
services under the Medicare Program; to the Committee on Finance.
THE HOMEBOUND CLARIFICATION ACT
Mr. JEFFORDS. Mr. President, I am here today to introduce the
Homebound Clarification Act of 2000. This important bill has been
crafted to protect Medicare beneficiaries from a growing problem that
is impeding access to vital home care services. I want to recognize my
cosponsors, Senator Reed of Rhode Island and Senator Leahy, for their
continued effort and dedication to protecting access to home health
care.
Federally funded home health care is an often quiet but invaluable
part of life for America's seniors. Medical treatment can often mean
being subjected to a strange and unfamiliar environment. For our
nation's elderly, who may have special needs, this inconvenience can be
more severe and detrimental to successful recovery. Home health care
means that people recovering from surgery can go home sooner--it means
that someone recovering from an accident can get physical therapy in
their home, it means our seniors can stay at home, and out of nursing
homes.
The sooner you can return patients to their homes, the sooner they
can recover. The familiar environment of the home, family, and friends
is more nurturing to recovering patients than the often stressful and
unfamiliar surroundings of a hospital. Home health is also a great
avenue for education. It empowers families to assist in the care of
their loved ones. It is smart policy from human and financial
standpoints.
But there are some seniors who are being denied access to this smart
policy. An individual must be considered ``homebound'' to qualify for
Medicare reimbursement for home health. Though an individual is not
required to be bed-ridden, the condition of the individual should
include ``a normal inability to leave the home.'' Under the current
definition, an individual is ``homebound'' if ``leaving the home
requires a considerable and taxing effort by the individual, and that
absences of the individual from home are infrequent and of short
duration, or are attributable to the need to receive medical
treatment.'' The definition allows for ``infrequent'' or ``short
duration,'' recognizing that short excursions may be a part of a
successful recovery process, but leaves it up to fiscal intermediaries
to interpret exactly what number is frequent and how short an absence
must be. Interpretation of this definition has varied widely.
Sadly, there is a ready supply of disturbing examples of the
overzealous and arbitrary interpretation of the definition. Many
seniors have found themselves virtual prisoners in their homes,
threatened with loss of coverage if they attend adult day care, weekly
religious services, or even visit family members in the hospital. This
makes no sense because all of these activities are steps on the road to
successful and healthy recovery. Often, health professionals want
patients to get outside for fresh air or exercise, as part of their
care plan. This helps fight off depression.
Seniors deserve a more consistent standard to depend upon, rather
than a completely arbitrary number of absences from the home. In April
1999, Secretary of Health and Human Services Donna Shalala sent a
report to Congress on the homebound definition. The report identifies
the wide variety in interpretation of the definition and the absurdity
of some coverage determinations that follow. While the Administration
unfortunately stopped short of taking action themselves, Shalala did
propose that a clarification of the definition is needed to improve
uniformity of determination.
The Homebound Clarification Act states that eligibility of an
individual depends on the condition of the patient, how ``taxing'' it
is for the patient to leave home. It strikes the clause that states:
``that absences of the individual from home are infrequent or of
relatively short duration, or are attributable to the need to receive
medical treatment.'' This is consistent with the intent of Congress and
the Administration. This will not open the door to wider coverage of
home health, but rather protect coverage for those who need it.
We ask that seniors put their trust in the Medicare program. We are
responsible for making sure that the Medicare program lives up to its
promise and that home health will be available to those who need it.
Once again, I would like to thank my cosponsors, Senators Reed and
Leahy for their work. We look forward to working with the rest of
Congress to turn this legislation into law.
______
By Mr. L. CHAFEE (for himself and Ms. Snowe):
S. 2299. A bill to amend title XIX of the Social Security Act to
continue State Medicaid disproportionate share hospital (DSH)
allotments for fiscal year 2001 at the levels for fiscal year 2000; to
the Committee on Finance.
The Medicaid DSH Preservation Act of 2000
Mr. L. CHAFEE. Mr. President, I am pleased to be joined today by
Senator Snowe in introducing the Medicaid DSH Preservation Act of 2000.
This legislation will freeze Medicaid disproportionate share hospital
(DSH) reductions at Fiscal Year 2000 levels, thereby mitigating the
forthcoming reductions in Fiscal Years 2001 and 2002. This bill will
also provide a growth rate adjustment to help compensate for the
increases in the cost of providing care to the most needy and indigent
patients.
In addition to the Medicare payment reductions in the Balanced Budget
Act of 1997 (BBA), federal payments to the Medicaid DSH program were
also reduced by $10.4 billion over 5 years, with these reductions being
absorbed by States and our Nation's vulnerable safety net hospitals.
Medicaid DSH payments help reimburse hospitals' costs of treating
Medicaid patients, particularly those with complex medical needs. These
payments also make it possible for communities to care for the
uninsured--a population that is projected to increase considerably
during the next few years.
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The impact of these financial pressures was not fully anticipated at
the time the BBA was enacted. Other Financial pressures such as
declining Medicaid enrollment have had a significant impact on these
safety net hospitals, thereby adding to the rapidly rising number of
Americans without health insurance. At a time when our Nation's
uninsured rate continues to climb above 44 million, it makes little
sense to be reducing much-needed Medicaid DSH payments to our nation's
safety net hospitals.
Hospitals in Rhode Island will absorb $400 million in reductions as a
result of changes made to the Medicare and Medicaid programs in the
BBA. Ten out of fourteen hospitals in my State had operating losses in
1999. After the BBA was enacted, it was predicted that cuts in federal
Medicare and Medicaid payments would cost hospitals in Rhode Island
$220 million over 5 years; however, this estimate has proven to be
about $180 million off the mark. Every other State is experiencing
similar problems. Since the BBA was signed into law, the American
Hospital Association commissioned a study by the Lewin Group, which
estimated that there would be $71 billion less paid to hospitals
nationwide over 5 years. The original estimate of the impact of the BBA
was $18 billion. While the Balanced Budget Refinement Act of 1999
provided some relief to our Nation's financially strapped hospitals,
that relief was targeted to the Medicare program. Clearly, more needs
to be done to keep our vulnerable safety net hospitals from continuing
on this downward spiral.
This legislation we are introducing today represents a commonsense
compromise that will help prevent the further erosion of our Nation's
safety net hospitals and the long-term viability of our country's
health care system.
I urge my colleagues to join me in supporting this important
legislation and I ask unanimous consent that the legislation be printed
in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 2299
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 ``Medicaid DSH Preservation
Act of 2000''.
SEC. 2. CONTINUATION OF MEDICAID DSH ALLOTMENTS AT FISCAL
YEAR 2000 LEVELS FOR FISCAL YEAR 2001.
Section 1923(f) of the Social Security Act (42 U.S.C.
1396r-4(f)), as amended by section 601 of the Medicare,
Medicaid, and SCHIP Balanced Budget Refinement Act of 1999,
as enacted into law by section 1000(a)(6) of Public Law 106-
113 (113 Stat. 1501A-394), is amended--
(1) in paragraph (2)--
(A) in the heading, by striking ``2002'' and inserting
``2001'';
(B) in the matter preceding the table, by striking ``2002''
and inserting ``2001''; and
(C) in the table in such paragraph, by striking the column
labeled ``FY 02'' relating to fiscal year 2002; and
(2) in paragraph (3)--
(A) in the heading, by striking ``2003'' and inserting
``2002''; and
(B) in subparagraph (A), by striking ``2003'' and inserting
``2002''.
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