[Congressional Record Volume 146, Number 41 (Wednesday, April 5, 2000)]
[Senate]
[Pages S2234-S2249]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
[[Page S2234]]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. REID (for himself and Mr. Inouye):
S. 2357. A bill to amend title 38, United States Code, to permit
retired members of the Armed Forces who have a service-connected
disability to receive military retired pay concurrently with veterans'
disability compensation; to the Committee on Veterans' Affairs.
armed forces concurrent retirement and disability payment act of 2000
Mr. REID. Mr. President, I am pleased today to introduce legislation
along with my esteemed colleague Senator Inouye that will correct an
inequity for veterans who have retired from our Armed Forces with a
service-connected disability.
Our legislation will permit retired members of the Armed Forces who
have a service connected disability to receive military retired pay
concurrently with veterans' disability compensation.
Mr. President, disabled military retirees are only entitled to
receive disability compensation if they agree to wave a portion of
their retired pay equal to the amount of compensation. This requirement
discriminates unfairly against disabled career soldiers by requiring
them to essentially pay their own disability compensation.
Military retirement pay and disability compensation were earned and
awarded for entirely different purposes. Current law ignores the
distinction between these two entitlements. Members of our Armed Forces
have dedicated 20 or more years to our country's defense earning their
retirement for service. Whereas disability compensation is awarded to a
veteran for injury incurred in the line of duty.
It is inequitable and unfair for our veterans not to receive both of
these payments concurrently. We have an opportunity to show our
gratitude to these remarkable men and women who have sacrificed so much
for this great country of ours. I hope the Senate will seriously
consider passing this legislation, to end at last, this disservice to
our retired military men and women.
Mr. President, this legislation represents an honest attempt to
correct an injustice that has existed for far too long. Allowing
disabled veterans to receive military retired pay and veterans
disability compensation concurrently will restore fairness to Federal
retirement policy.
This legislation is supported by veterans service organizations,
including the Disabled American Veterans, the American Legion, and
Paralyzed Veterans of America. This is simply the right thing to do.
Our veterans have earned this and now it is our chance to honor their
service to our nation.
I ask unanimous consent that the text of the Armed Forces Concurrent
Retirement Disability Payment Act of 2000 and attached documents be
printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
S. 2357
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 ``Armed Forces Concurrent
Retirement and Disability Payment Act of 2000''.
SEC. 2. CONCURRENT PAYMENT OF RETIRED PAY AND COMPENSATION
FOR RETIRED MEMBERS WITH SERVICE-CONNECTED
DISABILITIES.
(a) Concurrent Payment.--Section 5304(a) of title 38,
United States Code, is amended by adding at the end the
following new paragraph:
``(3) Notwithstanding the provisions of paragraph (1) and
section 5305 of this title, compensation under chapter 11 of
this title may be paid to a person entitled to receive
retired or retirement pay described in such section 5305
concurrently with such person's receipt of such retired or
retirement pay.''.
(b) Effective Date.--The amendment made by subsection (a)
shall take effect on the date of the enactment of this Act,
and apply with respect to payments of compensation for months
beginning on or after that date.
(c) Prohibition on Retroactive Benefits.--No benefits shall
be paid to any person by virtue of the amendment made by
subsection (a) for any period before the effective date of
this Act as specified in subsection (b).
____
Nevada Paralyzed
Veterans of America,
Las Vegas, NV, April 4, 2000.
Senator Harry Reid,
Hart Senate Office Building,
Washington, DC.
Dear Senator Reid: Nevada Paralyzed Veterans of America is
dedicated to all efforts that will support and enhance the
quality of life of our members. We consider ourselves an
important voice of reason and logic when issues of substance
arise regarding legislation and health care. In the tradition
of excellence that we acquired during our active military
training we continue to strive to maintain the same in
promoting quality of life post disability.
As President of Nevada Paralyzed Veterans of America
(Nevada PVA), I would like to offer my support of your
legislation to permit the concurrent receipt of service-
connected disability compensation and retirement pay, without
deductions. Nevada PVA has consistently supported legislation
that would attempt to remedy the unjust disparity in benefits
for the men and women who have served in our Armed Services.
While Nevada PVA supports these measures, as we have in the
past, we must be assured that the other benefits currently
being received by veterans are in no way compromised or
reduced. VA has just recently begun getting the funding it
needs to avoid the devastating effects of past flat-lined
budgets. We hope that Congress will see the wisdom of
providing concurrent receipts.
Thank you again for your continued support of our veterans
and for your legislation. We look forward to the passage of
your bill and the benefits it will bring to our deserving
service-connected disabled veterans.
Sincerely,
Lupo A. Quitoriano, Ph.D.,
President.
____
Disabled American Veterans,
Department of Nevada,
Las Vegas, NV, April 4, 2000.
Senator Harry Reid.
Dear Sir: It is our understanding that you are about to
introduce legislation that would establish ``Concurrent
Payments of Department of Veterans Affairs Disability
Compensation and Military Retirement''.
The Department of Nevada DAV goes on record, with the
National DAV, in supporting such legislation.
I submit, for your perusal, Resolution #30 from the DAV
Legislative Program, approved at convention in 1999.
``Whereas, ex-service members who are retired from the
military on length of service must waive a portion of their
retired pay in order to receive disability compensation from
the Department of Veterans Affairs (VA) and
``Whereas, it would be more equitable if the laws and
regulations were changed to provide that in such cases the
veteran would be entitled to receive both benefits
concurrently since eligibility was established and earned
under two entirely different sets of enabling laws and
regulations: NOW
``Therefore be it resolved that the Disabled American
Veterans in National Convention assembled in Orlando,
Florida, August 21-25, 1999, supports legislation and changes
in applicable regulations which would provide that a veteran
who is retired for length of service and is later adjudicated
as having service-connected disabilities, may receive
concurrent benefits from the military department and from VA
without deduction from either.''
Senator Reid, we thank you for introducing such
legislation. As usual, where Veterans are concerned, you are
right out front.
Sincerely yours,
William D. Brzezinski,
Adjutant.
____
American Legion,
Department of Nevada,
Carson City, NV, April 4, 2000.
Hon. Harry Reid,
Washington, DC.
Dear Senator Reid: It has come to my attention that you are
in the process of drafting a bill (Armed Forces Concurrent
Retirement and Disability Payment Act of 2000) that will
eliminate the present practice of deducting disability
compensation from the retired pay of military retired
veterans. I have always felt this practice was not fair to
our retired veterans. They are in fact funding their own
disability compensation.
Commander Joe McDonnell and I, First Vice Commander of the
American Legion Department of Nevada, support this bill. If I
can be of assistance to you to get this bill passed feel free
to call on me.
Sincerely,
Ron Gutzman,
First Vice Commander.
______
By Mr. INHOFE (for himself and Ms. Landrieu):
S. 2358. A bill to amend the Public Health Service Act with respect
to the operation by the National Institutes of Health of an
experimental program to stimulate competitive research; to the
Committee on Health, Education, Labor, and Pensions.
NATIONAL INSTITUTES OF HEALTH EPSCoR PROGRAM ACT OF 2000
Mr. INHOFE. Mr. President, I am pleased to introduce the National
Institutes of Health EPSCoR Program Act of 2000 with my colleague,
Senator Landrieu of Louisiana. This legislation we are introducing
today, when passed, stands to make a major impact on the scope of
biomedical research done in America today.
Small and medium sized states, like ours, have been unfairly
discriminated
[[Page S2235]]
against in their competition for federal research dollars. In 1978,
Congress created the EPSCoR program (Experimental Program to Stimulate
Competitive Research), to make sure that all states would have the
opportunity to compete for scientific research funds. Despite this
intention, the EPSCoR program only served to exacerbate the exiting
funding disparity. You may ask, how can this be so? The answer is
really quite simple.
The EPSCoR program does not extend to one of the biggest sources of
scientific research--the National Institutes of Health (NIH). We are
all aware, the NIH budget is growing rapidly; NIH's FY 2000 budget is
$17.9 billion--up 8.43 percent in the past 5 years. Yet, despite this
tremendous boom, 24 states receive 93 percent of NIH research grants,
while the other 26 states split the remaining 7 percent.
Although the NIH budget has resulted in great scientific gains, the
research divide continues. One-half of the states have seen little
benefit in the recent NIH increase. The time has come to correct this
allocation program, but in a way that insures we have the best
biomedical research in the world, and that those benefits are extended
to the entire country. Research institutes provide a great opportunity
to improve the health care delivery and quality in their home state,
but only limited opportunity exists in half the states, because of the
existing funding divide.
The legislation we are introducing will provide $200 million to NIH-
EPSCoR states will enable states that currently receive historically
low amounts of NIH grants to participate in two special funds.
The first fund is to finance new infrastructure needs in these
states. Because of their continued lack of equitable funding, many
EPSCoR states have fallen behind in their infrastructure needs and are
unable to compete against non-EPSCoR states. Our legislation will
allocate $3.5 million each year to every NIH-EPSCoR state, to be used
for projects the state EPSCoR committee targets as meeting the state
biomedical research committees' goals. Because the state is responsible
for choosing its infrastructure needs, we may finally be able to get
away from the yearly requests for special projects in our states and
allow federal funds to be spent in the most efficient manner possible.
The second fund is dedicated toward research in the new NIH-EPSCoR.
This research is for meritorious projects, co-funded by the NIH-EPSCoR
fund and the NIH Institute or Center. These projects must meet existing
NIH standards or merit and quality, but will not have to compete
against proposals from the non-EPSCoR states, which already dominate
the grant process.
Finally, this process will be self sustaining. Because research is
typically less expensive to perform in NIH-EPSCoR states, the savings
in administrative costs are recaptured to fund additional research. In
FY 1999 we estimate these savings would have added up to $49 million,
which would have flowed back to NIH-EPSCoR states for additional
research projects.
In recent years, we have made great strides in biomedical research,
however, that research has been limited to only a select few. I ask you
to join us in resolving this discrepancy and restore equity to the NIH
process and would invite my colleagues to join us in this effort.
______
By Mr. SHELBY:
S. 2360. A bill to amend the Gramm-Leach-Bliley Act to provide for a
limitation on sharing of behavioral profiling information, and for
other purposes; to the Committee on Banking, Housing and Urban Affairs.
freedom from behavioral profiling act of 2000
Mr. SHELBY. Mr. President, I rise today to introduce the ``Freedom
from Behavioral Profiling Act of 2000.'' This legislation would
disallow financial institutions from buying and selling an individual's
most personal and detailed buying habits without proper notification
and without his or her permission. Put another way, financial
institutions would only be allowed to buy, sell or otherwise share an
individual's behavioral profile if the institution has disclosed to the
consumer that such information may be shared and the institution has
received the consumer's affirmative consent to do so.
Technology exists today that allows financial institutions to monitor
and collect your personal buying and spending habits. According to the
April 3 issue of Business Week magazine, Visa International is ``using
neural networks to build up elaborate behavioral profiles. Over months,
these systems . . . track a person's behavior online and off, then
match it against models of similar personality and behavior types . .
.''
What this means is that financial institutions have the ability to
follow you to the grocery store to track your purchases--whether you
are abiding by your doctors recommended diet--and then to the drug
store to see what kind of drugs you are purchasing. The institution can
also track where you go throughout the day and into the evening, and
exactly what time you were there.
Business Week also reported that such ``far-flung threads'' as your
``taste in paperbacks, political discussion groups'' and clothing are
being ``sewn into online profiles where they are increasingly
intertwined with your data on health, your education loans and your
credit history.'' What does this information have to do with getting a
mortgage? More importantly, are these institutions sharing these
behavioral profiles? Given the track record of some of the blue chip
firms like Chase Manhattan Bank and U.S. Bancorp, I believe the risk is
too great to assume otherwise.
Even more important, what happens when these behavioral profiles get
into the wrong hands? That rarely happens you say. Guess again. A
Russian teenager using the name ``Maxus'' stole 350,000 credit card
numbers from CD Universe's Web site last December. He then told CD
Universe that he would post the numbers on the Internet unless they
paid him $100,000. When they refused to pay him he posted the credit
cards numbers and thousands of visitors downloaded more than 25,000
account numbers between December 25 and January 7.
A similar case happened on March 24 of this year when two teens in a
small Welsh village hacked into computers of several online merchants
making off with more than 26,000 credit card numbers. The FBI says
losses connected to the thefts could exceed $3 million.
Mr. President, if teenagers from around the world are gaining access
to account numbers, there is no question they can steal data banks of
behavioral profiles. In fact, they are. A front page article in the New
York Times dated April 3, 2000, reports that ``Law enforcement
authorities are becoming increasingly worried about a sudden, sharp
rise in the incidence of identity theft, the outright pilfering of
people's personal information and, with that information in hand,
thieves can acquire credit, make purchases and even secure residences
in someone else's name.''
Mr. President, an important point here is that potential criminals do
not even have to steal the information. Due to the significant
loopholes in the Gramm-Leach-Bliley Act passed last year, an
individual's behavioral profile could legally be passed along without
the affirmative consent of that individual. The unchecked growth of
data banks and the business of profiling unquestionably facilitates
identity theft.
Some may suggest that there is no harm in behavioral profiling. I
disagree. Despite the fact that consumers are ``shielded'' in
fraudulent cases, subject to only $50 maximum liability, the burden is
on credit card owners to prove the fraudulent charges are not their
own. If the fraudulent charge is not found immediately, continued
purchases or applications for more cards by the criminal can wreak
havoc on an individual's credit rating. In fact, one witness recently
testified before the Senate Subcommittee on Terrorism, Technology and
Government Information that she spent over 400 hours trying to clear
her name and restore her good credit.
In ``card-not-present'' transactions, that is orders by mail,
telephone or Internet where no signature is required, merchants are
forced to cover the loss. Thus, identity theft and fraudulent purchases
also take a toll on the small business man. Reports suggest that one
out of every ten online purchases is fraudulent. My colleagues know
that small businesses do not have the margins to eat the charge on one
out of every 10 purchases.
[[Page S2236]]
Mr. President, the American people are only now becoming aware of the
behavioral profiling practices of the industry. The more they find out,
the more they do not like it. That is why I am offering this
legislation . . . to give the consumer the ability to control his or
her most personal behavioral profile. Where they go, who they see, what
they buy and when they do it--all of these are personal decisions that
the majority of Americans do not want monitored and recorded under the
watchful eye of corporate America.
Mr. President, colleagues in the Senate, I hope you will join me in
an effort to give the people what they want--the ability to control the
indiscriminate sharing of their own personal, and private, consumption
habits.
______
By Mr. VOINOVICH (for himself, Mr. Breaux, Mr. Inhofe, and Ms.
Landrieu):
S. 2362. A bill to amend the Clean Air Act to direct the
Administrator of the Environmental Protection Agency to consider risk
assessments and cost-benefit analyses as part of the process of
establishing a new or revised air quality standard; to the Committee on
Environment and Public Works.
AIR QUALITY STANDARD IMPROVEMENT ACT OF 2000
Mr. VOINOVICH. Mr. President, I rise today with my
distinguished colleague from Louisiana, Senator Breaux, to introduce a
bill that will provide a commonsense approach to promulgating
regulations under the Clean Air Act. We are pleased that Senators
Inhofe and Landrieu have joined us as original cosponsors. We introduce
this bill today in a bipartisan manner to increase public health,
safety and environmental protection.
As a father and grandfather, I understand the importance of ensuring
a clean environment for our future generations. Throughout my 33 years
of public service, I have demonstrated a commitment to preserving our
environment and the health and well-being of all Ohioans. I sponsored
legislation to create the Ohio Environmental Protection Agency when I
served in the state legislature, and I fought to end oil and gas
drilling in the Lake Erie bed. As Governor, I increased funding for
environmental protection by over 60 percent. While in the Ohio House of
Representatives, I was responsible for creating the Environment and
Natural Resources Committee and was honored to serve as the first vice
chairman of that committee.
In addition, the state of Ohio has made significant improvements in
air quality in recent years. When I first entered office as Governor in
1991, most of Ohio's urban areas were not attaining the 1-hour ozone
standard. By the time I left, all but one city was in attainment.
However, the Cincinnati community has worked together, through a
variety of programs, to attain the 1-hour standard and is now awaiting
final action by the EPA to redesignate it as in attainment.
Overall, the ozone pollution level in Ohio has gone down by 25%, and
in many urban areas, it has gone down by more than 50% in the past 20
years. Ohio is doing its part to provide cleaner air. Nevertheless,
over the years, I have become more and more concerned that just in
order to comply with federal laws and regulations, our citizens,
businesses and state and local governments must pay costs that can be
inordinately burdensome or totally unnecessary.
In the 104th Congress, I worked closely with a coalition of state and
local government officials and members of the House and Senate to pass
effective safe drinking water reforms. The results of our efforts
culminated in the Safe Drinking Water Act Amendments, legislation which
was enacted with broad bipartisan support in 1996. In addition, the
bill had the support of environmental organizations, and I was pleased
to attend the President's bill-signing ceremony when these reforms were
signed into law. In fact, at that time the President praised the
bipartisan work and said, ``Today we helped ensure that every family in
America will have safe, clean drinking water to drink every time they
turn on a faucet or stop at a public water fountain. From now on our
water will be safer and our country will be healthier for it.''
This cooperative effort is notable because it showed that a law could
include commonsense reforms that make the government more accountable
based on public awareness of risks, costs and benefits. I believe it
set a key precedent for reform of other environmental regulations.
I specifically mention the drinking water program because it is the
model for the bill we are introducing today. This bill includes the
very same risk assessment and cost-benefit analysis provisions that
govern our drinking water. This bill clarifies EPA's obligation to
identify risks, consider costs and benefits of a proposed rule and
consider incremental costs and benefits of alternative air quality
standards. However, EPA would retain flexibility in making final
regulatory decisions.
If we can agree these tools improve rulemakings for something as
important as the water we drink, where a regulatory mistake could
endanger millions of lives, they certainly must be good enough to
protect the air that we breathe.
When I was Governor of Ohio, I became more and more concerned that
the EPA was not taking into consideration sound science, costs and
benefits during the rulemaking process. I was particularly concerned
about the standards for ozone and particulate matter. In fact, I was
very concerned that the costs to this country to implement the new
National Ambient Air Quality Standards (NAAQS) for ozone and
particulate matter far outweighed the benefits to public health and the
environment.
In fact, according to EPA's own estimates, the costs for implementing
the NAAQS standard for ozone exceeded the benefits. The President's own
Council of Economic Advisors predicted that the benefits would be
small, while the costs of reaching full attainment could total $60
billion.
Just last spring, a U.S. appeals court remanded EPA's ozone and
PM2.5 standards, ruling that EPA did not justify its
decision with sound scientific evidence. Ohio was a party to this
lawsuit, which began when I was Governor. The court didn't say that EPA
couldn't regulate at these levels, but that EPA didn't give sufficient
justification for doing so.
That has been my point all along. I have argued that the NAAQS
standards were going to be costly and that we didn't even know if
making those investments was going to make a difference. I believe this
bill would help us avoid some of the legal and legislative wrangling
that has occurred in the past few years with respect to how we achieve
clean air.
Federal agencies should not force businesses and consumers to throw
billions of dollars at a problem without knowing if they're hitting the
right target. Yet, the EPA is asking all of America to pay for these
new regulations simply because the EPA said it is the right thing to do
and that it has the authority to do so. However, they have failed to
adequately determine the effects of changing the ozone and particulate
matter standards.
The challenge facing public officials today is determining how best
to protect the health of our citizens and our environment with limited
resources. We need to do a much better job of ensuring that
regulations' costs bear a reasonable relationship with their benefits,
and we need to do a better job of setting priorities and spending our
resources wisely.
I believe the bill we introduce today will help achieve these goals
in air regulations. First, I believe this bill will increase the
public's knowledge of how and why the EPA makes air regulations. In
essence, this bill asks EPA to answer several simple, but vital
questions:
What science is needed to help us make good decisions?
What is the nature of the risk being considered?
What are the benefits of the proposed regulation?
How much will it cost?
And, are there better, less burdensome ways to achieve the same
goals?
It will also improve the quality of government decision-making by
allowing the EPA to set priorities and focus on the worst risks first.
Careful thought, reasonable assumptions, peer review and sound science
will help target problems and find better solutions.
Mr. President, Executive Order 12866 already requires agencies to
conduct risk assessment and cost benefit analysis. What this bill will
do is clarify
[[Page S2237]]
that EPA must conduct risk assessment and cost benefit analysis. This
bill does not mandate outcomes. In fact, it does nothing to
circumscribe the EPA Administrator's ability to propose and implement
regulations to protect public health. Quite simply, it imposes
commonsense discipline and accountability in the rulemaking process by
confirming that EPA has the flexibility to take risks and costs into
consideration when setting standards that are going to affect public
health or the environment.
I want to make very clear that this bill does not mandate how EPA
sets standards. The Administrator will have discretion to set
appropriate standards to protect human health. EPA would be required to
conduct an analysis of incremental costs and benefits of alternative
standards, but would have the flexibility to choose between a standard
where the benefits justify its cost or, when health considerations
dictate, the maximum feasible standard.
In addition, this bill does not keep information about air quality
from the public. To the contrary, this bill is a public right-to-know
bill that requires EPA to tell the public what information it
considered before making a final decision.
Nor does the bill ``gut'' the Clean Air Act, as some contend. In
fact, it strengthens it by asking EPA to tell the public what the risks
are that warrant regulation and what options are available to most
efficiently and effectively reduce those risks. This bill will ensure
that the Agency sets priorities and it makes sure that our limited
resources are being spent to address the real risks to public health
and the environment. While many air regulations set by EPA are well
intended, we want to ensure that these regulations are going to achieve
their purpose and not unnecessarily pass significant burdens onto our
citizens and state and local governments.
I strongly believe our challenge is to determine how best to meet our
obligation of protecting the environment and health of our citizens
with the limited financial resources we have available and with the
scientific evidence to back up our actions. It should not be the
government's policy to initiate or enact regulations simply because it
sounds like a good idea. It should be because the evidence shows that
it is the right thing to do.
I have spoken to my colleague and chairman of the Environment and
Public Works Committee's Clean Air Subcommittee, Senator Inhofe, and he
has agreed to include this bill in a package of bills that will be
introduced in the near future to advance discussions on Clean Air Act
reauthorization.
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. 2362
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 ``Air Quality Standard
Improvement Act of 2000''.
SEC. 2. PURPOSES.
The purposes of this Act are--
(1) to establish more effective environmental standards to
continue to safeguard public health and the environment;
(2) to promote better resource allocation to ensure that
serious risks to air quality are addressed first;
(3) to improve the ability of the Administrator of the
Environmental Protection Agency to use scientific and
economic analysis in developing air quality standards;
(4) to yield increased public health and environmental
benefits and more effective protections while minimizing
costs;
(5) to require that relevant qualitative and quantitative
information be considered in the process of evaluating the
costs and benefits of air quality standards;
(6) to promote the right of the public to know about the
costs and benefits of air standards, the risks addressed, the
risks reduced, and the quality of scientific and economic
analysis used to support decisions; and
(7) to require the Administrator of the Environmental
Protection Agency to conduct risk assessments and cost-
benefit analyses as part of the process of establishing a new
or revised air quality standard.
SEC. 3. RISK ASSESSMENT AND COST-BENEFIT ANALYSIS.
The Clean Air Act (42 U.S.C. 7401 et seq.) is amended by
adding at the end the following:
``TITLE VII--RISK ASSESSMENT AND COST-BENEFIT ANALYSIS
``SEC. 701. DEFINITION OF AIR QUALITY STANDARD.
``In this title, the term `air quality standard' means--
``(1) a national ambient air quality standard established
under section 109 (including the setting of any emissions
budget for purposes of attaining or maintaining any national
ambient air quality standard);
``(2) an increment or ceiling for the prevention of
significant deterioration established under section 163;
``(3) regulations established under section 169A to address
the regional haze or other impairment of visibility by
manmade air pollution in a mandatory class I Federal area;
``(4) any finding or emission limitation determined under
section 126;
``(5) any emission standard or requirement that applies to
on-road and nonroad mobile sources (including aircraft engine
standards) established under title II;
``(6) any requirement that imposes a limitation on the
quality of fuel used in mobile sources;
``(7) any emission limitation or emission budget for sulfur
dioxide or nitrogen oxides established under title IV;
``(8) any preconstruction review requirement that regulates
new sources or major modifications of existing sources in
attainment or nonattainment areas;
``(9) the setting of any emissions budget or other
requirement for purposes of attaining or maintaining any
national ambient air quality standard under section 110;
``(10) any new source performance standard, existing source
performance standard, or design, equipment, work practice, or
operational standard established or revised under section
111;
``(11) any standard to protect public health and the
environment described in section 112(f);
``(12) any new regulation applicable to an electric utility
steam generating unit under section 112(n);
``(13) the designation of a pollutant under section 115 as
causing or contributing to air pollution that may reasonably
be anticipated to endanger public health or welfare in a
foreign country;
``(14) any air pollution control technique information,
transportation planning guidelines, information on procedures
and methods to reduce mobile source air pollution, or control
technique guidelines issued under sections 108 and 183;
``(15) any identification of attainment dates for national
ambient air quality standards under part D;
``(16) any identification of control measures for the
reduction of interstate ozone air pollution under section
184; and
``(17) any identification of reasonably available control
measures and best available control measures for particulate
matter under section 190.
``SEC. 702. RISK ASSESSMENT, MANAGEMENT, AND COMMUNICATION.
``(a) Use of Science in Decisionmaking.--In carrying out
this Act, (including establishing a new or revised air
quality standard under this Act), the Administrator shall
base any scientific or technical conclusions on--
``(1) the best available, peer-reviewed science and
supporting studies conducted in accordance with sound and
objective scientific practices;
``(2) data collected by accepted methods or the best
available methods (if the reliability of the method and the
nature of the decision justifies use of the data);
``(3) data (including the underlying research data) that
have been made available to the public, subject to the
exemptions under section 552 of title 5, United States Code.
``(b) Public Information.--
``(1) In general.--In carrying out this section, the
Administrator shall ensure, to the maximum extent
practicable, that the presentation of information on public
health effects concerning any new or revised air quality
standard is comprehensive, informative, understandable, and
conveniently available for public comment prior to the
promulgation of any regulation under this Act.
``(2) Specifications.--The Administrator shall, in a
document made available to the public in support of a
regulation proposed or promulgated under this Act concerning
an air quality standard, specify, to the maximum extent
practicable--
``(A) each population addressed by any estimate of public
health effects;
``(B) the expected risk or central estimate of risk for the
specific populations or resources, where applicable, and each
appropriate upper-bound or lower-bound estimate of risk;
``(C) each significant uncertainty identified in the
process of the assessment of public health effects, and
studies that would assist in resolving the uncertainty; and
``(D) peer-reviewed studies known to the Administrator that
support, are directly relevant to, or fail to support any
estimate of public health effects, and the methodologies used
to reconcile inconsistencies in the scientific data.
``(3) Health risk reduction and cost analysis.--
``(A) In general.--As part of the process of proposing a
new or revised air quality standard, the Administrator shall
publish in the Federal Register and seek public comment on an
analysis of each of the following:
[[Page S2238]]
``(i) Quantifiable and nonquantifiable benefits for which
there are factual bases in the rulemaking record to conclude
that the benefits are likely to occur as the result of
actions taken to comply with the new or revised air quality
standard.
``(ii) Quantifiable and nonquantifiable health benefits for
which there are factual bases in the rulemaking record to
conclude that the benefits are likely to occur from
reductions in other related pollutants that may be attributed
to compliance with the new or revised air quality standard,
excluding benefits resulting from compliance with other
proposed or promulgated regulations.
``(iii) Quantifiable and nonquantifiable costs for which
there is a factual basis in the rulemaking record to conclude
that the costs are likely to occur as the result of actions
taken to comply with or attain the new or revised air quality
standard, which costs shall include monitoring, actions taken
to comply with or attain the new or revised air quality
standard, and other costs, and excluding costs resulting from
compliance with other proposed or promulgated regulations.
``(iv) The incremental costs and benefits associated with
each alternative new or revised air quality standard
considered.
``(v) The effects of the air pollutant or pollutants for
which a new or revised air quality standard is being
considered on the general population, including, to the
extent relevant and appropriate and where data are reasonably
available, the effects on groups within the general
population such as infants, children, pregnant women, the
elderly, individuals with a history of serious illness, or
other subpopulations that are identified as likely to be at
greater risk of adverse health effects due to exposure to an
air pollutant than the general population.
``(vi) Any risk that may occur as the result of compliance
with or attainment of the new or revised air quality
standard, including risks associated with other related
pollutants.
``(vii) Other relevant factors, including the quality and
extent of the information available concerning the new or
revised air quality standard, the uncertainties in the
analysis supporting clauses (i) through (vi), and factors
with respect to the degree, and quantitative and qualitative
descriptions of the nature, of any risk.
``(B) Approaches to measure and value benefits.--The
Administrator may identify valid approaches for the
measurement and valuation of benefits under this paragraph,
including approaches to identify consumer willingness to pay
for reductions in health risks from air pollutants.
``(C) Authorization of appropriations.--There is authorized
to be appropriated to the Administrator to conduct studies,
assessments, and analyses described in this section
$35,000,000 for each of fiscal years 2000 through 2003.
``SEC. 703. COST-BENEFIT ANALYSIS.
``(a) Definitions.--In this section:
``(1) Benefit.--The term `benefit' means the reasonably
identifiable significant favorable effects, quantifiable and
nonquantifiable, including social, health, safety,
environmental, and economic effects, that are expected to
result from implementation of, or compliance with, a new or
revised air quality standard.
``(2) Cost.--The term `cost' means the reasonably
identifiable significant adverse effects, quantifiable and
nonquantifiable, including social, health, safety,
environmental, and economic effects, that are expected to
result from implementation of, or compliance with, a new or
revised air quality standard.
``(3) Cost-benefit analysis.--The term `cost-benefit
analysis' means an evaluation of the costs and benefits of a
new or revised air quality standard, quantified to the extent
feasible and appropriate and otherwise qualitatively
described, that is prepared in accordance with the
requirements of this section at the level of detail
appropriate and practicable for reasoned decisionmaking on
the matter involved, taking into consideration uncertainties,
the significance and complexity of the decision, and the need
to adequately inform the public.
``(b) Analysis.--For each new or revised air quality
standard proposed, the Administrator--
``(1) shall conduct and publish, for public comment, a
cost-benefit analysis to determine whether the benefits of
the new or revised air quality standard justify, or do not
justify, the costs; and
``(2) may analyze the potential distributional effects of
the new or revised air quality standard.
``(c) Determination of Health Risk Reduction and Cost
Considerations.--
``(1) Determination of no justification for cost.--
``(A) In general.--Notwithstanding any other provision of
this Act, if the Administrator determines, based on an
analysis conducted under subsection (b), that the benefits of
a new or revised air quality standard proposed or promulgated
in accordance with this Act do not justify the costs, the
Administrator may, after notice and opportunity for public
comment, promulgate an alternative new or revised air quality
standard at a cost that is justified by the benefits.
``(B) Scope of consideration.--In making a determination
under subparagraph (A), the Administrator shall consider--
``(i) only public health benefits, with respect to a
determination concerning a primary national ambient air
quality standard; and
``(ii) public health and environmental benefits, with
respect to a determination concerning any air quality
standard other than a national ambient air quality standard.
``(2) Judicial review.--A determination by the
Administrator under paragraph (1)--
``(A) shall be reviewed by a court only as part of a review
of a final regulation that has been promulgated based on the
determination; and
``(B) shall be set aside by a court if the court finds that
the determination is arbitrary and capricious.
``(d) Authorization of Appropriations.--There are
authorized to be appropriated such sums as are necessary to
carry out this section.''.
______
By Mr. CRAPO:
S. 2363. A bill to subject the United States to imposition of fees
and costs in proceedings relating to State water rights adjudications;
to the Committee on Energy and Natural Resources.
water adjudication fee fairness act of 2000
Mr. CRAPO. Mr. President, I rise to introduce the Water
Adjudication Fee Fairness Act of 2000. This bill would require the
federal government to pay the same filing fees and costs associated
with state water rights' adjudications as is currently required of
states and private parties.
To establish relative rights to water--water that is the lifeblood of
many states, particularly in the west--states must conduct lengthy,
complicated, and expensive proceedings in water rights' adjudications.
In 1952, Congress recognized the necessity and benefit of requiring
federal claims to be adjudicated in these state proceedings by adopting
the McCarran Amendment. The McCarran Amendment waives the sovereign
immunity of the United States and requires the federal government to
submit to state court jurisdiction and to file water rights' claims in
state general adjudication proceedings.
These federal claims are typically among the most complicated and
largest of claims in state adjudications, and federal agencies are
often the primary beneficiary of adjudication proceedings where states
officially quantify and record their water rights. However, in 1992,
the United States' Supreme Court held that, under existing law, the
U.S. need not pay fees for processing federal claims.
When the United States does not pay a proportionate share of the
costs associated with adjudications, the burden of funding the
proceedings unfairly shifts to other water users and often delays
completion of the adjudications by diminishing the resources necessary
to complete them. Delays in completing adjudications result in the
inability to protect private and public property interests or determine
how much unappropriated water may remain to satisfy important
environmental and economic development priorities.
Additionally, because they are not subject to fees and costs like
other water users in the adjudication, federal agencies can file
questionable claims without facing court costs, inflating the number of
their claims for future negotiation purposes. This creates an unlevel
playing field favoring the federal agencies and places a further
financial and resources burden on the system.
For example, in the Snake River Basin Adjudication, which is in Idaho
and is probably the largest water adjudication proceeding in the
country, the United States Forest Service filed more than 3,700 federal
claims. The Idaho Department of Water Resources expended thousands of
dollars giving notice to all other claimants. Additionally the State of
Idaho and private claimants spent over $800,000 preparing objections to
the Forest Service's claims. On the eve of the objective deadline, the
U.S. withdrew all but 71 of the claims--the Department of Justices'
explanation: litigation strategy.
This example is not an isolated incident. At best, the taxpayers and
states should not be forced to incur these costs simply because the
agency does not take the time to seriously evaluate its claims. At
worst, the taxpayers should not bear the brunt of the federal
government's Machiavellian tactics.
I recognize that the federal government has a legitimate right to
some reserved water rights; however, the federal government should play
by the same rules as the states and other private users. The Water
Adjudication Fee Fairness Act is legislation that remedies this
situation by subjecting the
[[Page S2239]]
United States, when party to a general adjudication, to the same fees
and costs as state and private users in water rights adjudications.
This measure has the full support of the Western States Water Council
and the Western Governor's Association. I ask my colleagues to join me
in supporting water users, taxpayers, the states, and welcome their co-
sponsorship.
I ask unanimous consent that a copy 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. 2363
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 ``Water Adjudication Fee
Fairness Act of 2000''.
SEC. 2. FINDINGS.
The Congress finds the following:
(1) Generally, water allocation in the western United
States is based upon the doctrine of prior appropriation,
under which water users' rights are quantified under State
law. Appropriative rights carry designated priority dates
that establish the relative right of priority to use water
from a source. Most States in the West have developed
judicial and administrative proceedings, often called general
adjudications, to quantify and document these relative
rights, including the rights to water claimed by the United
States Government under either State or Federal law.
(2) State general adjudications are typically complicated,
expensive civil court and administrative actions that can
involve hundreds or even thousands of claimants. Such
adjudications give certainty to water rights, provide
direction for water administration, and reduce conflict over
water allocation and water usage. Those claiming and
establishing rights to water are the primary beneficiaries of
State general adjudication proceedings.
(3) The Congress has recognized the benefits of the State
general adjudication system, and by enactment of section 208
of the Department of Justice Appropriation Act, 1953 (43
U.S.C. 666; popularly known as the ``McCarran Amendment''),
required the United States to submit to State court
jurisdiction and to file claims in State general adjudication
proceedings.
(4) Water rights claims by Federal agencies under either
State or Federal law are often the largest or most complex
claims in State general adjudications. However, the United
States Supreme Court, in the case United States v. Idaho, 508
U.S. 1 (1992), determined that the McCarran Amendment does
not require the United States to pay some filing fees simply
because they were misconstrued or perceived to be the same as
costs taxed against all parties.
(5) Since Federal agency water rights claims are among the
most difficult to adjudicate, and since the United States is
not required to pay some fees and costs paid by non-Federal
claimants, the burden of funding adjudication proceedings
unfairly shifts to private water users and State taxpayers.
(6) The lack of Federal Government funding to support State
water rights adjudications in relation to the complexity of
the claims involved has produced significant delays in
completion of many State general adjudications. These delays
inhibit the ability of both the States and Federal agencies
to protect private and public property interests. Also,
failure to complete the final adjudication of claims to water
restricts the ability of resource managers to determine how
much unappropriated water is available to satisfy
environmental and economic development demands.
SEC. 3. LIABILITY OF UNITED STATES FOR FEES AND COSTS IN
WATER USE RIGHTS PROCEEDINGS.
(a) In General.--In any State administrative or judicial
proceeding for the adjudication or administration of rights
to the use of water in which the United States is a party,
the United States shall be subject to the imposition of fees
and costs on its claims to water rights under either State or
Federal law to the same extent as a private party to the
proceeding.
(b) Application.--Subsection (a) shall apply to proceedings
pending on or initiated after the date of enactment of this
Act, including with respect to fees and costs imposed in such
a proceeding before the date of the enactment of this Act.
(c) Report to Congress.--The head of any Federal agency
that files or has pending any water rights claim shall
prepare and submit to the Congress, within 90 days after the
end of each fiscal year, a report that identifies--
(1) each such claim filed by the agency that has not yet
been decreed;
(2) all fees and costs imposed on the United States for
each claim identified under paragraph (1);
(3) any portion of such fees and costs that has not been
paid; and
(4) the source of funds used to pay such fees and costs.
(d) Fees and Costs Defined.--In this section, the term
``fees and costs'' means any administrative fee,
administrative cost, claim fee, judicial fee, or judicial
cost imposed by a State on a party claiming a right to the
use of water under either State or Federal law in a State
proceeding referred to in subsection (a).
______
By Mr. SANTORUM (for himself and Mr. Gregg):
S. 2364. A bill to amend the Social Security Act to require Social
Security Administration publications to highlight critical information
relating to the future financing shortfalls of the social security
program; to the Committee on Finance.
SOCIAL SECURITY RIGHT TO KNOW ACT
Mr. SANTORUM. Mr. President, today, I am pleased to join with my
colleague, Senator Judd Gregg of New Hampshire, in introducing the
Social Security Right to Know Act of 2000.
This legislation is aimed at providing the American people with
accurate and up-to-date information about the current and future
financial operations of the Social Security program, so that they may
be in a better position to understand the choices involved in putting
our most vital social program on sound financial footing for the long
term.
I would like to commend the Senator from New Hampshire for his
instrumental role in promoting a similar proposal in the form of an
amendment to the Social Security earnings test repeal legislation that
this body recently considered and passed. Unfortunately, we did not
take advantage of Senator Gregg's tireless efforts to reach across
party lines to incorporate improved reporting to the public about the
Social Security program as part of the earnings test repeal. This
legislation is a complement to Senator Gregg's prior efforts, and I am
pleased to be offering this legislation here today with his support.
As Congress continues to consider options to preserve and strengthen
our Social Security system, it is increasingly important that Americans
have access to certain salient information with respect to Social
Security's current and future financial picture.
Why is this so important? As all of my colleagues will recall, in his
State of the Union Address to Congress on January 27, 1998, President
Clinton declared that it was time for the nation to begin a dialogue on
the ``necessary measures to strengthen the Social Security system for
the twenty-first century.'' He went on to say that the American people
should be invited to join in this discussion, facing these issues
squarely, and forming a true consensus on how we should proceed. In his
address, the president announced a series of public policy forums to be
held around the country, and also called for a White House Conference
on Social Security to be held in December, 1998. The president
indicated that early in 1999 he would convene the leaders of Congress
to craft historic legislation that would re-create ``a Social Security
system that is strong in the twenty-first century.''
I know that there was bipartisan support here in the Senate and in
the House of Representatives for President Clinton's calling to make
long-term Social Security reform our most important domestic policy
priority. And two years ago I was optimistic about the prospects for
enacting such historical legislation, particularly about the
opportunity to engage the nation in an honest national discussion about
the need to reform Social Security, and exchange ideas as to how we
might best achieve this. But, as we all know, we held a national
dialogue on Social Security, and the American people did participate in
the policy forums which came to pass, and yet here we are today with
little progress toward a bipartisan consensus on sustainable Social
Security reform.
I believe that this is so partly because of the fact that there is a
tremendous amount of misinformation and lack of understanding among the
American public about Social Security's financing challenges, and this
lack of understanding continues to harden popular resistance to long-
term Social Security solutions.
Case in point: last week, we saw the release of the 2000 Annual
Report of the Board of Trustees of the Federal Old-Age and Survivors
Insurance and Disability Insurance Trust Funds, popularly referred to
as the Social Security Trustees' Report. The Social Security
Administration relayed that this Report revealed that the Social
Security program's long-range financial picture has improved since last
year. Specifically, the Board of Trustees announced
[[Page S2240]]
that the Social Security Trust Fund assets will not be depleted until
2037--three years later than reported in last year's report.
At first glance, this statistic might convey an air of reassurance to
the public, such to the point in some minds that if we can just
continue to grow our economy at its current rate, we will obviate the
need for enacting fundamental reforms to Social Security. Or at least,
such reporting of Social Security's finances might lead to the common
conclusion that the program is perfectly fine for nearly 40 years.
This reliance on the paradigm of trust fund accounting is one of the
main reasons that we have not been able to achieve bipartisan consensus
on long-term Social Security reform. There is scarce mention in the
Trustees' Report that the Social Security Trust Fund balances ``are
available to finance future benefit payments . . . only in a
bookkeeping sense. They do not consist of real economic assets that can
be drawn down in the future to fund benefits. Instead, they are claims
on the Treasury that, when redeemed, will have to be financed by
raising taxes, borrowing from the public, or reducing benefits, or
other expenditures. The existence of a large trust fund balance,
therefore, does not have any impact on the Government's ability to pay
benefits.''
Mr. President, if this description of the Trust Funds sounds
familiar, it is because this is the exact wording contained in the
Administration's budget up until its most recent submission for Fiscal
Year 2001. What this means, in other words, is that the trust funds are
merely claims on future government revenues, IOUs to be redeemed
through higher taxation, lower spending on Social Security or other
government obligations, or a return to deficit financing.
I think that this is a rather important piece of information for the
American people to understand in assessing Social Security's future.
But it should not be buried in some multi-hundred page budget document
or 223-page Social Security Trustees' Report. Maybe if we made this
information more accessible and apparent, then we would have more
concern for the fact that Social Security's financing problems begin as
soon as 2015--when Social Security dedicated payroll tax receipts are
no longer sufficient to pay benefits--and not in 2037. The Social
Security Trustees last week revealed it will cost $11.3 trillion in new
money between 2015 and 2037 to convert into cash benefits the IOUs held
by the Social Security Trust Fund. But we have no actual resources
necessary to meet these benefit promises between 2015 to 2037.
Also not mentioned in the most recent Trustees' Report, Mr.
President, is the fact that the system's unfunded obligations actually
grew from the 1999 Report's release by about $1 trillion in constant
2000 dollars, according to analysis by the House Budget Committee. This
is because the change in valuation period adds a new, expensive,
underfunded 75th year and drops a year when benefit costs are
relatively cheaper. This is a paradox of pay-as-you-go financing that
is not known or understood by most of the public, and is rarely if ever
referenced in the media. To be sure, the unfunded obligations of the
United States government are measured and accounted for in some obscure
Department of Treasury publications, but this data should be at the
front and center of the Social Security reform discussion, in plain
view for every American to access.
Another information gap which the Social Security Right to Know Act
seeks to close relates to individual Social Security statements,
formerly known as Personal and Earnings and Benefits Statements
(PEBES). This document was conceived by our friend and
venerable colleague, Senator Daniel Patrick Moynihan of New York. In
1989, Senator Moynihan persuaded Congress to adopt the requirement for
the Social Security Administration to provide this document as a way
``to reassure Americans that Social Security will be there for them,''
and to help them adequately plan for retirement by indicating that
Social Security doesn't fully replace wages or salaries.
Though well intentioned, the current Social Security statement falls
short of its desired goal by glaringly omitting certain information
critical to understanding the system's serious future funding problems,
and the related implications for individual and family retirement
planning. To be fair, the statements do make reference to such bland
phrases as ``changed in the past,'' ``must do so again'' and ``we are
working to resolve.'' But the truth is that by 2037, the program will
collect sufficient revenues to pay only $0.72 for every dollar of
promised benefits. Overall, Social Security's deficit that year will
come to more than $1 trillion in today's dollars. Again, this is
important information that should be made abundantly clear in order for
the American public to assess Social Security's and their own financial
futures.
This is why this legislation is so important. For too long, the
nature and scope of Social Security's financing problems have been
shrouded by inconsistent and incomplete information, which has yielded
public confusion and has polarized the Social Security reform debate.
The Social Security Right to Know Act would improve the information
contained in current Social Security Administration publications, and
thereby enable Americans to better plan for their own retirement and to
understand the benefits and costs that the current Social Security
system will produce.
This legislation will do several things to shed more light on what
lies ahead for Social Security. First, it will expand the Personal and
Earnings and Benefits Statements (PEBES), now called ``Social Security
Statements,'' to include information about the projected date of the
program's first financing deficits as estimated by the Social Security
Trustees, and also the percentage of promised benefits that can be
funded under current law.
Second, it will require the Trustees' Report to include an estimate
of Social Security's aggregate unfunded obligations--i.e., the
difference between the program's promised benefit outlays and its cash
income over the long-range 75-year evaluation period--and the change in
such amount from the previous year's estimates.
Third, it calls on the Trustees to submit to Congress a separate
summary publication that highlights salient data pertaining to Social
Security's financing, identifying the first year that Social Security
is projected to run a cash deficit, as well as the size of projected
deficits.
Fourth, it will expand the PEBES or Social Security Statements and
the annual Social Security Trustees' Report to include an explanation
of the role of the Social Security Trust Funds as debt owed by the
federal government, as opposed to an asset of the federal government.
Fifth, it will broaden the public accessibility of the economic
modeling employed by the Office of the Chief Actuary.
Our bill would introduce no new information that is not already
acknowledged somewhere in past publications of the Social Security
Trustees or in previous Presidential budget submissions. However, it is
our view that the importance of this information is so great that it
should be displayed before every wage-earner and beneficiary of the
Social Security system, and not buried in documentation that is now
available only to policymakers.
Americans deserve ``straight talk''--clear and accessible
information--about Social Security's long-term financing challenges in
order that they might better understand the consequences of a rapidly
growing aging population, and the reality of the choices before us.
This is just what the Social Security Right to Know Act is designed to
provide. And with these objectives in mind, this legislation is long
overdue.
I presume that we are all in agreement that the federal government
should be telling Americans the full truth about Social Security. It is
my sincere hope that our colleagues will look at this legislation and
join us in building on Senator Gregg's prior efforts and other
bipartisan ideas to make sure that Americans have as much information
as possible in our national discussion on how best to save and
strengthen Social Security. The Social Security Right to Know Act is an
effort to continue a process, based on the principle that ``knowledge
is power,'' and I truly believe that the information that this
legislation is seeking to provide Americans in a clear and
[[Page S2241]]
concise manner is essential for our moving forward toward sustainable
solutions to Social Security's funding problems. Though some of our
colleagues may have ideas and input as to how best to provide the
American public with a better understanding of Social Security's
future--and I am open to working with my colleagues to improve this
bill's specific provisions as we continue this process toward Social
Security reform--it is my firm belief that with the intent and
principles contained in this legislation, we as a nation will be in a
better position to cease assessing Social Security's future in terms of
preconceived, fixed notions, and take heed of the demographic and
economic realities which lie ahead.
Mr. President, I again thank Senator Gregg for working with me in
this effort, and ask unanimous consent that the text of the bill be
printed in the Record.
Mr. President, in closing, I would like to pay tribute to two of this
Chamber's leaders on this issue: The Honorable Daniel Patrick Moynihan
of New York and The Honorable Bob Kerrey of Nebraska. Both Senators
Moynihan and Kerrey have been truly instrumental in advancing the cause
of sustainable Social Security reform, and their presence and valued
input on this issue will be sorely missed in the next session of
Congress. I applaud both of them for their leadership in seeking to
balance the interests and needs of younger and older Americans, and for
their courage in working toward saving and strengthening Social
Security in a manner that is fiscally responsible, actuarially sound
and fair to all generations.
Mr. GREGG. Mr. President, I am pleased to be an original cosponsor of
this legislation, and I thank Senator Santorum for his leadership in
drafting it.
My colleagues in the Senate may recall that last week, I prepared an
amendment to the earnings limit legislation that would have achieved
many of the same objectives that are outlined by the Senator from
Pennsylvania with respect to this bill. I believe that we have begun a
process, an important dialogue involving many interested parties in
both the executive and legislative branches, and that the result of
this process will ultimately be improved information for the public and
for Congress regarding the state of the Social Security program, and
the benefits that it can finance.
I am pleased by the number of important individuals who have
expressed interest in this effort. I am especially gratified by the
interest of Senator Roth and of Congressman Archer, the two members of
Congress with principal jurisdiction over the Social Security program.
They have each indicated that they are willing to explore these
informational issues via various means, and to lend their considerable
influence to the effort.
I am further pleased that various individuals within the
administration have sought to work with us on our concerns, and to lay
a groundwork for improved reporting to the public regarding the Social
Security program.
In that context, I would stress that we are not at the end of this
process, and that we do not have universal agreement on the best way to
proceed. I do not believe that either Senator Santorum or I would say
that the language in either this bill, or the one that I offered last
week, is perfect, and cannot be improved upon. Senator Santorum's
draft, like my original draft, would seek to include additional
information in the annual Trustees' Reports. I do not know whether the
Trustees' reports are necessarily the optimal place to report such
information, and to the extent that individuals within the
administration may have views as to how and where this information is
best presented, I know that Senator Santorum and I would both be
flexible as to how this is done. The important thing is that this
information is routinely presented to Congress and to the public in a
clear, understandable, helpful way, and the best time and format for
this is certainly a matter where reasonable people can disagree.
I do, however, want to review the elements of Senator Santorum's
legislation, and to express why I believe that they are so important.
First, it would add important new information to the Personal
Earnings and Benefit Statements that individuals are now receiving from
the Social Security Administration. Those statements currently tell
individuals how much they are promised in terms of benefits, and about
their earnings history. Taken literally, however, they could provide a
misleading picture as to what current law can actually finance. It is a
misnomer to say that ``current law'' would provide a certain amount of
benefits, when legally, the Social Security Administration does not
have the authority to send out checks without financing. What ``current
law'' would literally mandate, according to GAO, according to CRS, and
according to everyone else who has studied this closely, is that
benefits would be effectively cut sharply beginning in 2037 because
benefit checks would have to wait until the available funds came in to
finance them.
Mr. President, it is unlikely that Congress would permit such a sharp
and sudden set of benefit cuts to occur. Of course, neither we nor a
future Congress would permit that. But it is also untrue to tell
Americans that ``current law'' would provide them with all promised
benefits. That is manifestly untrue by any definition. It is neither a
true statement of current law, nor it is a true statement of how tax
levels and benefit levels would look after necessary adjustments are
made to the program to bring it into balance. Social Security
beneficiaries certainly have a right to be told the truth about their
benefits--the date through which they can currently be funded, the
extent to which benefits could be provided under current estimates, as
well as the additional revenues that must be collected through tax
dollars, when the program first begins to experience cash flow
deficits.
Currently, there is a great misperception regarding Social Security
financing that too many individuals are willing to tacitly encourage--
the idea that the existence of a positive Social Security Trust Fund
balance enhances the ability of the federal government to pay Social
Security benefits. It does not. The Social Security Trust Fund balance
is actually a debt owed by the federal government, and it does not in
any way finance benefits without requiring that the federal government
turn to taxpayers to pay off that debt. Americans deserve to be told
the truth about that, and Senator Santorum's language includes a
statement that would explain the meaning of the Trust Fund, and the
options before Congress when the program enters a phase of cash-flow
deficits.
Many of the paragraphs in the Santorum language, regarding increased
clarity in the annual Trustees' report, are somewhat similar to
language that I sought to pursue last week. Again, I would simply
reiterate that reasonable people can disagree as to the proper venue
for the reporting of this information. I personally am of the view that
the annual Trustees' Reports should provide to Congress the relevant
information that Congress, as the body that must budget for the Social
Security program, needs to budget for it in the appropriate way.
Congress has a right to insist, in my view, not on how these
evaluations should be made, but that all relevant information be
presented clearly to the Congress when they are made. However, the most
important thing is that we reach an agreement among interested parties
with common goals as to how best to do this.
Currently, we receive 75-year actuarial estimates from the Trustees
regarding the health of the Social Security Trust Fund. We only look at
its impact on the overall federal budget over 10 years, through
measurements by CBO and other bodies. We don't look out over the long
term to judge the larger fiscal problems facing this long-term program
and the unified federal budget. That is a problem. It tempts Congress
and the Executive Branch to pursue ``solutions'' to Social Security's
insolvency that improve the part of the picture that we see--the Trust
Fund balance--heedless of the consequences for the part of the picture
that we do not see--the impact on the unified federal budget. This is
not an adequate method of approaching the problem of financing benefits
over the long term. I believe that Congress should insist that
portraits of the program's finances evaluate all scenarios on an
absolutely level playing field, one that shows all costs borne by the
system,
[[Page S2242]]
and one that judges all possible solutions in terms of what they would
actually cost and what they could actually pay. I commend Senator
Santorum for his effort here, even as my mind is open on the best way
to achieve this objective.
Mr. President, I would simply close by saying that the Social
Security program is too important to allow to operate in a fog of
incomprehension and misunderstanding. There ought not to be resistance
to efforts to bring additional ``sunshine'' upon the operations of the
Social Security system as a whole. We currently operate, too often, in
an atmosphere of selective information--one that measures only benefit
promises, and current tax levels, without acknowledging the mismatch
between the two, and what they mean for one another. A view that looks
only at the Trust Fund balance, and not at the realities of the
system's cost to future payers of both income and payroll taxes. This
selective presentation of information encourages Congress to remain
inactive, because it allows us to pretend that the consequences of
current law are not actually worse than the choices that would be made
in the course of reforming the program.
We can do better than this, and we must, if we are to meet our
responsibilities of stewardship for the Social Security program. I
commend Senator Santorum for his effort.
______
By Ms. COLLINS (for herself, Mr. Bond, Mr. Baucus, Mr. Jeffords,
Mr. Reed, Mr. Santorum, Mr. Abraham, Mrs. Murray, Mr. Cochran,
Mrs. Feinstein, Mr. Hollings, Ms. Mikulski, Mr. Bingaman, Mr.
Murkowski, Mrs. Hutchison, Mr. Schumer, Mr. Torricelli, Mr.
Edwards, Mr. Leahy, Mr. Enzi, Mr. Lugar, Mr. Cleland, Mr.
Hagel, Ms. Snowe, Mr. Bennett, Mr. Gorton, Mr. Hutchinson, Mr.
Helms, Mr. Allard, Mrs. Lincoln, Mr. L. Chafee, Mr. DeWine, Mr.
Ashcroft, Mr. Specter, Mr. Roberts, Mr. Brownback, and Mr.
Voinovich):
S. 2365. A bill to amend title XVIII of the Social Security Act to
eliminate the 15 percent reduction in payment rates under the
prospective payment system for home health services; to the Committee
on Finance.
HOME HEALTH PAYMENT FAIRNESS ACT
Ms. COLLINS. Mr. President, I am pleased to join with 35 of my
colleagues tonight to introduce the Home Health Payment Fairness Act to
eliminate the automatic 15-percent reduction in Medicare payments to
home health agencies that is currently scheduled to go into effect on
October 1 of next year. The legislation we are introducing will provide
a measure of financial relief for home health agencies across the
country that are experiencing acute financial problems that are
inhibiting their ability to deliver much needed care to some of the
most vulnerable senior citizens in our country.
America's home health agencies provide invaluable services that have
enabled a growing number of our most frail and vulnerable Medicare
beneficiaries to avoid hospitals and nursing homes and stay where they
want to be--in the comfort and security of their own home.
Unfortunately, due to cutbacks in the Medicare program, home health
agencies in my State and others are having a very difficult time
providing services, particularly to elderly people with complex health
needs. One has only to look at the statistics from my home State of
Maine to see the impact of these very onerous budget cuts, as well as
burdensome regulations imposed by the Clinton administration.
In Maine, in just over 2 years' time, there has been a 30-percent
reduction in home health visits, which has resulted in more than 7,470
senior citizens losing their home health services in my State. There
has been a 26-percent reduction in the reimbursements that have been
provided to home health agencies in Maine. Mr. President, this
situation cannot continue. The home health industry has already made an
important contribution to reducing the rate of growth in Medicare
spending. In fact, the spending cuts have been far beyond what Congress
intended and what the CBO estimated.
In 1996, home health was the fastest growing component of Medicare
spending. The program grew at an average annual rate of more than 25
percent from 1990 to 1997. As a consequence, the number of home health
beneficiaries more than doubled and Medicare home health increased
soared from $2.5 billion in 1989 to $17.8 billion in 1997.
This rapid growth in home health spending understandably prompted
Congress and the Administration, as part of the Balanced Budget Act of
1997, to initiate changes that were intended to slow this growth in
spending and make the program more cost-effective and efficient. These
measures, however, have produced cuts in home health spending far
beyond what Congress intended. Home health spending dropped to $9.7
billion in FY 1999--just about half the 1997 amount. To cut payments by
an additional 15 percent would put our already struggling home agencies
at risk and would seriously jeopardize access to critical home health
services for millions of our nation's seniors.
It is now clear that the savings goals set for home health in the
Balanced Budget Act of 1997 have not only been met, but far surpassed.
According to the March 2000 Congressional Budget Office (CBO) baseline,
Medicare home health payments fell by almost 35 percent in FY 1999, and
this was on top of a 15 percent drop in FY 1998. In fact, the CBO cites
this ``larger than anticipated reduction in the use of home health
services'' as the primary reason that total Medicare spending dropped
by one percent last year. The CBO now projects that the post-Balanced
Budget Act reductions in home health will be about $69 billion between
fiscal years 1998 and 2002. This is over four times the $16 billion
that the CBO originally estimated for that time period and is a clear
indication that the Medicare home health cutbacks have been far deeper
and wide-reaching than Congress ever intended.
Moreover, the financial problems that home health agencies have
experienced have been exacerbated by a number of burdensome new
regulatory requirements imposed by the Health Care Financing
Administration, including the implementation of OASIS, the new outcome
and assessment information data set; new requirements for surety bonds;
IPS overpayment recoupment; and a new 15-minute increment reporting
requirement.
As a consequence of these payment cuts coupled with overly burdensome
new regulatory requirements, cost-efficient home health agencies across
the country have experienced acute financial difficulties and cash-flow
problems, which have inhibited their ability to deliver much-needed
care, particularly to the very Medicare beneficiaries who need it the
most--individuals with diabetes, wound care patients, stroke patients,
and other chronically ill individuals with complex care needs. Over
2,500 agencies--about one quarter of all home health agencies
nationwide--have either closed or stopped serving Medicare patients.
Others have laid off staff or declined to accept new patients with more
serious health problems. In addition, according to a study by the Lewin
Group for the American Hospital Association, these cutbacks have
resulted in a 30.5 percent reduction in hospital-based home health
services.
The effect of these home health cuts has been particularly
devastating in my state. The number of Medicare home health patients in
Maine dropped from 48,740 in June of 1998 to 41,269 in June of 1999, a
decline of 15 percent. This means that 7,471 fewer Maine seniors are
receiving home health services. Moreover, there was a 30 percent drop
in the number of visits, and a 26 percent cut in Medicare payments to
home health agencies in Maine.
Keep in mind that Maine's home health agencies have historically been
prudent in their use of resources and were low-cost to begin with.
Ultimately, cuts of this magnitude degrade patient care. The real
losers in this situation are our nation's seniors--particularly those
sicker Medicare patients with complex, chronic care needs who are
already experiencing difficulty in getting the home care services they
need.
The Balanced Budget Refinement Act did provide a small measure of
financial and regulatory relief for home health agencies. It did, for
example, delay the automatic 15 percent reduction in Medicare home
health payments for one year. I do not think that
[[Page S2243]]
this legislation went far enough, however: this automatic reduction
should be eliminated entirely.
An additional 15 percent cut in Medicare home health payments would
ring the death knell for the low-cost, efficient agencies which are
currently struggling to hang on and would further reduce our seniors'
access to critical home care services. Moreover, we have already far
surpassed the savings targets set by the Balanced Budget Act. Further
cuts are unnecessary. I therefore urge all of my colleagues to join
with myself and Senators Bond, Baucus, Jeffords, Reed, Santorum,
Abraham, Murray, Cochran, Feinstein, Hollings, Mikulski, Bingaman,
Murkowski, Hutchison, Schumer, Torricelli, Edwards, Leahy, Enzi, Lugar,
Cleland, Hagel, Snowe, Bennett, Gorton, Hutchinson, Helms, Allard,
Lincoln, DeWine, Chafee, Ashcroft, Specter, Roberts, Brownback, and
Voinovich in cosponsoring the Home Health Payment Fairness Act to
eliminate this additional 15 percent cut in Medicare home health
payments.
Mr. President, I hope my colleagues will join with me in providing
much needed relief to America's home health agencies. Ultimately, if we
don't act, the losers will be our senior citizens who depend so much on
this important health care service.
Thank you, Mr. President.
The PRESIDING OFFICER. The Senator from Michigan is recognized.
Mr. ABRAHAM. Mr. President, I rise to compliment the Senator from
Maine for this proposal. I am happy to join as a cosponsor of the
legislation, as I have on previous efforts on her part to address the
home health care issues.
I add my support to the legislation and compliment the Senator from
Maine. I sincerely hope that as it moves forward with a variety of
proposals before us, in the budget and elsewhere, to address Medicare
issues we make sure we don't address those reform proposals without
making sure our home health care programs are strong and of high
quality.
I yield the floor.
Mr. BOND. Mr. President, I rise to join Senator Collins to offer a
bill--the Medicare Home Health Payment Act--that will address the
crisis in home health care.
The crisis is that far too many seniors and individuals with
disabilities can't get the home health care they need. They either go
without needed care, or are forced into a medical facility such as a
nursing home. This is a travesty, because home health can serve an
extremely valuable role--it helps seniors get needed medical care while
retaining the comfort and dignity of living in their own home.
We have plenty of data that demonstrates the problem.
Over 2,000 agencies driven out of business or out of the Medicare
program. In Missouri alone, over 100 of the 300 agencies that were
around in 1997 are gone.
Independent studies that show that seniors and people with
disabilities just can't get access to the home care they need--perhaps
forcing them into nursing homes or other medical facilities.
Reports that home health agencies feel forced to refuse to care for
seniors because they fear the Medicare reimbursements won't cover their
costs.
Recent news from CBO that total Medicare home health spending has
actually fallen by 45 percent in just two years--perhaps the largest
reduction for a specific type of provider that we have ever seen in
Medicare.
Of course, last year I was also talking about the home health
crisis--and Senator Collins and I had a bill to address the issue then
as well.
But I'm here to share bad news with my colleagues--Medicare home
health is still in crisis.
While we did address home health in the Balanced Budget Refinement
Act late last year--which helped--it didn't solve everything.
That's because all we did last year to the biggest threat that's out
there for home health care providers--the 15-percent across-the-board
cuts that are in addition to all of the other cuts made thus far--was
postpone things.
What we did not do--except for one minor provision--is increase home
health reimbursement rates. Keep in mind that we did provide relief in
the form of increased payments for most other Medicare providers, like
hospitals and nursing facilities.
So what we did is simply postpone further cuts in an already-
devastated industry. That cannot be the end of the story.
So what should we do? Senator Collins and I--in the bill we are
introducing today with 34 of our colleagues--propose to eliminate
permanently the planned 15-percent home health cuts forever.
I think this initial show of support form my colleagues is
tremendous--and I look forward to working with my colleagues to make
sure this bill becomes law. The millions of Americans on Medicare--for
whom the home health benefit is so important--deserve no less.
Mr. BAUCUS. Mr. President, I rise today to introduce the Home Health
Payment Fairness Act. This bill will prevent a 15% cut to home health
care agencies and allow them to continue their critical mission of
caring for the chronically ill and the elderly.
During the first 15 years of the Medicare program, home health
spending accounted for one to two percent of all Part A expenditures.
In 1997, home health expenditures reached 14 percent of Part A
payments. Congress needed to respond to this growth. And we did so in
the Balanced Budget Act of 1997.
Congress decided to pay home health agencies under a Prospective
Payment System. In the meantime, we established an interim payment
system, or IPS, that would move agencies away from the old system.
Since then, home care agencies have undergone deep budget cuts.
Recent CBO projections show that reductions in home health care will be
about $69 billion between 1998 and 2002--over four times the original
estimate for the same time period. Clearly, home health care agencies
have had their budgets cut much more severely than Congress ever
intended.
Congress has recognized the severity of the cuts and has twice
postponed implementing the planned across-the-board 15% cut. Currently,
the 15% cut is scheduled to take effect October 1, 2001.
So what does the legislation I am introducing do? Simply put, this
bill takes the necessary step of not postponing the cut, but
eliminating it altogether. The planned cut must be eliminated because
we have achieved--in fact, far surpassed--the savings targets set by
the Balanced Budget Act. Efficient home health agencies in Montana and
across the country have experienced acute financial difficulties and
cash flow problems, inhibiting their ability to deliver much needed
care.
Over 2,500 home health agencies nationwide have closed or stopped
serving Medicare patients, and, according to a study done by the Lewin
Group for the American Hospital Association, these cutbacks have
resulted in a 30.5 percent reduction in hospital-based home health
services. Moreover, the Health Care Financing Administration estimates
that 500,000 fewer home health patient received services in 1998 than
in 1997 (the last year for which figures are available), which points
to the most central and critical issue. The real losers in this
situation are our seniors. Cuts of this magnitude simply cannot be
sustained without ultimately affecting patient care.
While patient care across the nation will be impacted if the planned
cuts are implemented, rural areas will be especially had hit. If the
planned cuts are implemented, rural health care providers will be
forced to find ways to further cut costs. Such cost-cutting measures
could include closing branches or limiting services. This means that
rural patients could face difficulties accessing quality health care.
This is especially significant because a high percentage of seniors
over the age of 65 live in rural areas; in Montana, that figure is 77%.
Thus, any reduction in home health care will directly impact our
nation's seniors.
Eliminating the 15% cut makes financial sense. If home health care
budgets are cut further, costs will increase in other areas. If
patients--especially in rural areas--are not receiving the care they
need, they will turn to other resources, such as hospital emergency
rooms, inpatient cares, and nursing homes. In the long run, this will
be more expensive and less efficient. Above all, we must ensure that
our nation's elderly and ill receive the care they need. We must not
create a situation in which cash-strapped home
[[Page S2244]]
health agencies have strong incentives to limit- or even deny-care to
the sickest.
This bill prevents such a scenario, while respecting Congress'
original intention of reducing home health care spending, I think that
most of us agree that our seniors and the ill deserve quality home
health care. This is a common sense measure that will allow us to
realize our original intention of reducing home health care spending,
while at the same time protecting the right of our elderly and ill to
quality care.
Mr. JEFFORDS. Mr. President, I am here today to join in
introducing the Home Health Payment Fairness Act of 2000. This
important bill has been crafted to protect the Medicare home health
services that our seniors depend upon. I want to recognize the
leadership of Senators Collins, Bond, Baucus, Reed, and the many others
who are original cosponsors of this effort to protect access to home
health services.
My own state of Vermont is a model for providing high-quality,
comprehensive care with a low price tag. For most of the 1990's, the
average Medicare expenditure for home health care in Vermont has been
the lowest in the nation. Vermont's home care system was designed to
efficiently meet the needs of frail and elderly citizens in our largely
rural state, but it, like home care across the country, has been put
under tremendous pressure.
Since the enactment of the Balanced Budget Act of 1997 (BBA) and
imposition of the interim payment system (IPS), the Medicare home
health benefit has been seriously eroded. The BBA failed to recognize
how the new home health reimbursement would affect small, rural home
health care providers. The IPS has caused such significant cash flow
problems, that many agencies are struggling to make meet their payroll
needs. Now, because of the BBA, agencies are facing the prospect of 15
% cut in Medicare funding in October of 2001. With providers already
struggling to survive, any further cuts could spell disaster for low-
cost, efficient providers, non-profit agencies, and patients.
That is why we are introducing the Home Health Payment Fairness Act
to eliminate the 15% reduction. The original budget target for home
health expenditures from the BBA has already been far exceeded. The
Congressional Budget Office now estimates that the total home health
cuts from BBA will total $69 billion in five years. That's more than
four times what was originally estimated when BBA was passed.
The Balanced Budget Refinement Act of 1999 contained a provision
requiring the Secretary of Health and Human Services to report to
Congress in 2001 on whether the 15% reduction is still considered
necessary. I think the answer is becoming more and more clear. We don't
need it, and the Home Health Payment Fairness Act is designed to stop
it.
Adequate home health care services cannot survive any further
reductions. Seniors depend on the home health benefit offered by the
Medicare program, and we must make sure it will be there for them. Once
again, I want to thank all the cosponsors for giving this legislation
such broad, bipartisan support. Our seniors are depending on that kind
of support more than ever before.
Mr. REED. Mr. President, I rise today to join Senator Collins,
Senator Bond, Senator Jeffords and 32 others in introducing the Home
Health Payment Fairness Act. The intent of this important legislation
is quite simple--to eliminate the 15 percent reduction in home health
payments that is scheduled to go into effect in October 2001. Last
year, Senator Jeffords and I introduced a more broad home health bill,
called the Preserve Access to Care in the Home, or PATCH Act, which
among other things, would have eliminated this potentially devastating
payment reduction. Although we were not able to get this provision
included in the 1999 Balanced Budget Refinement Act (BBRA), we were
successful in getting a delay in the implementation of this reduction.
However, we must see to it that the 15 percent cut is eliminated--and I
hope we can achieve that goal this year.
Over the past thirty years, there has been a tremendous shift in the
location where health care is actually provided. Increasingly, older
and sicker patients are able to receive care in the comfort of their
own home, instead of a hospital or nursing home. This incredible change
can be attributed to four primary causes: greater reliance on
alternative care settings because of the growing cost of inpatient
care; technological improvements that have enhanced the capacity to
provide sophisticated medical treatments in the home setting; the
growing aging population; and the increasing popularity of home- and
community-based care as an alternative to the institutional care of a
nursing home. Indeed, home health care is an integral part of the
spectrum of long term care.
As a result, by the mid-1990's the average annual growth rate for
Medicare home health spending was 5.3%. The 1997 Balanced Budget Act
(BBA) sought to restrain the unbounded growth in outlays for this
benefit. Originally, the Congressional Budget Office (CBO) anticipated
that savings through changes in the benefit would total $16.1 billion
over five years. In reality, we have saved a total of $19.7 billion in
just two years, and are expected to reduce outlays by $69 billion over
the five year period--four times what was originally projected. Not
surprisingly, since the BBA's enactment, there has been a remarkable 48
percent decline in Medicare home health expenditures.
These dramatic reductions have all too often been borne on the backs
of small, nonprofit home health agencies and the elderly and disabled
beneficiaries they serve. Home health care agencies in my home state of
Rhode Island have been especially hard hit by these changes. We have
seen a significant decline in the number of beneficiaries served and
access to care for more medically complex patients threatened by these
cuts. These reductions have clearly had negative impact on patients who
heavily rely on home health services. In one instance, a woman from
Pawtucket, Rhode Island had to wait 112 days after being discharged
from the hospital before getting home health services. In the
wealthiest nation in the world, this kind of situation is simply
unacceptable.
Mr. President, nationally, between 1997 and 1998, the number of
Medicare beneficiaries receiving home health services has fallen 14
percent, while the total number of home health visits has fallen by 40
percent. We have seen a similar trend in Rhode Island, where over 3,000
fewer beneficiaries are receiving home health care--representing a
decline of 16 percent--and the total number of visits has fallen 38
percent. These individuals are either being forced to turn to more
expensive alternatives, such as institutional-based nursing homes and
skilled nursing facilities for their care, or these individuals are
simply going without care, which places an immeasurable burden on the
family and friends of vulnerable beneficiaries.
I truly do not believe this is the path we want to remain on when it
comes to home health care. In light of the impending ``senior boom''
that will be hitting our entitlement programs in a few short years, we
should be doing what we can to preserve and strengthen the Medicare
home health benefit. We can begin to do this by eliminating the 15
percent reduction in home health payments. By taking this step, we will
alleviate an enormous burden that has been looming over financially
strapped home health agencies and the frail and vulnerable Medicare
beneficiaries who rely on these critical services.
I urge my colleagues to join us in enacting legislation that will
repeal this unnecessary and inappropriate reduction. I look forward to
working with Senator Collins, Senator Jeffords and my other colleagues
on this critical issue.
______
By Mr. FRIST (for himself, Mr. Jeffords, Mr. Gregg, Mr. Enzi, Mr.
Hutchinson, Ms. Collins, Mr. Brownback, Mr. Hagel, and Mr.
Sessions):
S. 2366. A bill to amend the Public Health Service Act to revise and
extend provisions relating to the Organ Procurement Transplantation
Network; to the Committee on Health, Education, Labor, and Pensions.
the organ procurement and transplantation network amendments act of
2000
Mr. FRIST. Mr. President, I ask unanimous consent that the
text of the bill be printed in the Record.
[[Page S2245]]
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 2366
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 ``Organ Procurement and
Transplantation Network Amendments Act of 2000''.
SEC. 2. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK.
(a) In General.--Section 372 of the Public Health Service
Act (42 U.S.C. 274) is amended to read as follows:
``SEC. 372. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK.
``(a) Establishment of Network.--
``(1) In general.--An Organ Procurement and Transplantation
Network (in this section referred to as the `Network' or the
`OPTN') is established as a private network and shall operate
under this section.
``(2) Requirements.--The Network shall--
``(A) in accordance with criteria developed under
subsection (c)(1)(B), include as members of the Network
qualified organ procurement organizations (as described in
section 371(b)), transplant centers, and other entities that
have a demonstrated interest in the fields of organ donation
or transplantation (such members shall be referred to in this
section as `Network participants'); and
``(B) have a policy board (referred to in this section as
the `OPTN Board') that meets the requirements of subsection
(b).
``(b) OPTN Policy Board.--
``(1) Composition.--The OPTN Board shall be composed of not
more than 36 voting members to be elected under paragraph (2)
and 5 nonvoting, ex officio members appointed under paragraph
(3).
``(2) Elected members.--
``(A) In general.--The voting members of the OPTN Board
shall be elected by the members of the Network described in
subsection (a)(2)(A), from among the nominees submitted under
subparagraph (B), through a fair and open process.
``(B) Nominating committee.--The nominating committee
established under paragraph (5) shall, prior to each election
of OPTN Board members under this paragraph, develop a list of
nominees for such election. Such list shall reflect the
diversity of Network members described in subsection
(a)(2)(A), including factors such as program type and size
and geographic location. Recommendations may be submitted to
the nominating committee by the Secretary, the members of the
Network described in subsection (a)(2)(A), or the general
public.
``(C) Qualifications.--The OPTN Board shall be composed
of--
``(i) transplant surgeons and transplant physicians;
``(ii) representatives of qualified organ procurement
organizations, transplant centers, voluntary health
associations, or the general public, including patients
awaiting a transplant or transplant recipients or individuals
who have donated an organ, or the family members of such
patients, recipients or donors; and
``(iii) individuals distinguished in the fields of ethics,
basic, clinical and health services research, biostatistics,
health care policy, or health care economics or financing.
``(D) Representation requirement.--The OPTN Board shall be
structured to ensure that--
``(i) at least 50 but not more than 55 percent of the
members elected under this paragraph are transplant surgeons
and transplant physicians; and
``(ii) at least 20 but not more than 25 percent of the
members elected under this paragraph are transplant
candidates, transplant recipients, organ donors and family
members of such individuals.
Nothing in this subparagraph shall be construed to preclude
an individual voting member of the OPTN Board from being a
representative described in each of clauses (i) and (iii) or
(ii) and (iii) of subparagraph (C) so long as the limitation
described in clause (i) of this subparagraph is complied
with.
``(3) Appointed members.--
``(A) In general.--The Secretary shall appoint as ex
officio, nonvoting members of the OPTN Board, 1
representative from each of the following:
``(i) The Health Resources and Services Administration.
``(ii) The National Institutes of Health.
``(iii) The Health Care Financing Administration.
``(iv) The Agency for Healthcare Research and Quality.
``(B) Network administrator.--The Network Administrator
shall appoint an ex officio nonvoting member of the OPTN
Board.
``(4) Terms of elected members.--
``(A) In general.--Except as provided for in this
paragraph, members of the OPTN Board elected under paragraph
(2) shall serve for a term of 3 years and may be re-elected.
``(B) New members.--To ensure the staggered rotation of \1/
3\ of the elected members of the OPTN Board each year, the
initial members of the OPTN Board elected under paragraph (2)
shall serve for terms of 1, 2, or 3 years respectively as
designated by the nominating committee.
``(C) Transition.--Consistent with subsection (c)(3), the
voting members of the OPTN Board who are serving on the date
of enactment of the Organ Procurement and Transplantation
Network Amendments Act of 2000 may continue to serve until
the expiration of their terms. Upon such termination, the
nominating committee, in submitting nominations to fill such
vacancies, shall ensure the staggered rotation of \1/3\ of
the members elected under paragraph (2) every 3 years.
``(D) Contract status.--A change in the status of a
contract under subsection (f), or a change in the contractor,
shall not affect the terms of the members of the OPTN Board.
``(5) Chairperson and committees.--The OPTN Board shall
have a chairperson, an executive committee, a nominating
committee, a membership committee, and such other committees
as the OPTN Board determines to be appropriate.
``(c) General Functions of the OPTN Board.--
``(1) Establishment of network policies and criteria.--The
OPTN Board shall--
``(A) after consultation with Network participants and the
Network Administrator, establish and carry out the policies
and functions described in this section for the Network;
``(B) establish membership criteria for participating in
the Network;
``(C) establish medical criteria for allocating organs and
for listing and de-listing patients on the national lists
maintained under paragraph (2); and
``(D) establish performance criteria for transplant
programs.
``(2) National system.--The OPTN Board shall maintain a
national system to match organs and individuals who need
organ transplants. The national system shall--
``(A) have 1 or more lists of individuals who are in need
of organ transplants; and
``(B) be operated in accordance with Network policies and
criteria established under paragraph (1).
``(3) No fiduciary responsibility.--The OPTN Board shall
have no voting member who has any fiduciary responsibility to
the entity that holds the contract provided for under this
section.
``(4) OPTN board requirements.--The OPTN Board shall
cooperate with the Network Administrator to ensure compliance
with the requirements of this section including the contract
entered into under subsection (f).
``(d) Organ Transplant Policy.--The OPTN Board shall
establish organ transplant policies, including organ
allocation policies for potential organ recipients and
policies that affect patient outcomes. Such policies shall--
``(1) be based on sound medical principles;
``(2) be based on valid scientific data;
``(3) be equitable;
``(4) seek to achieve the best use of donated organs;
``(5) be designed to avoid wasting organs, to avoid futile
transplants and reduce the risk of retransplantation, to
promote patient access to transplantation, and to promote the
efficient management of organ placement;
``(6) be specific for each organ type or combination of
organ types;
``(7) be based on standardized medical criteria for listing
and de-listing candidates from organ transplant waiting
lists;
``(8) determine priority rankings (within categories as
appropriate) for candidates who are medically suitable for
transplantation, such rankings shall be based on standardized
medical criteria and ordered according to medical urgency and
medical appropriateness;
``(9) seek distribution of organs as appropriate based on
paragraphs (1) through (8);
``(10) develop and apply appropriate performance
indicators, including patient-focused indicators, to assess
transplant program performance and reduce inter-transplant
program variance to improve program performance; and
``(11) seek to reduce disparities in transplantation
resulting from socioeconomic status, race, ethnicity, or
being medically underserved.
``(e) Enforcement of Organ Transplant Policy.--
``(1) In general.--
``(A) Proposed policy.--This paragraph shall apply to any
proposed transplant policy that is developed by the OPTN
Board that the Board or the Secretary determines should be
enforced under this section or under section 1138 of the
Social Security Act.
``(B) Submission of policy.--Not later than 60 days prior
to the implementation of a proposed policy described in
subparagraph (A), the OPTN Board shall submit such proposed
policy to the Secretary.
``(C) Publication.--Upon receipt of a proposed policy under
subparagraph (B), the Secretary shall publish the policy in
the Federal Register for a 60-day public comment period.
``(D) Action by secretary.--Not later than 90 days after
receipt of a proposed policy under subparagraph (B), the
Secretary shall consider public comments received under
subparagraph (C) and shall--
``(i) notify the OPTN Board that the policy is consistent
with this section and therefore enforceable; or
``(ii) notify the OPTN Board that the policy is
inconsistent with this section and direct the Board to
reconsider and revise the policy consistent with the
recommendations of the Secretary.
``(E) Reconsideration.--
``(i) In general.--Not later than 30 days after receiving a
notice from the Secretary under subparagraph (D)(ii), the
OPTN Board
[[Page S2246]]
shall reaffirm the proposed policy or revise and submit such
revised policy to the Secretary.
``(ii) Action by secretary.--Not later than 30 days after
receiving a revised policy under clause (i), the Secretary
shall--
``(I) notify the OPTN Board that the revised policy is
consistent with this section and therefore enforceable; or
``(II) notify the OPTN Board that the revised policy is
inconsistent with this section and submit the revised policy,
with the comments and proposed revisions of the Secretary, to
the Scientific Advisory Committee on Organ Transplantation
(referred to in this subsection as the `Committee')
established under paragraph (2).
``(iii) Action by committee.--Not later than 30 days after
the submission of a revised policy to the Committee under
clause (ii), the Committee may, by a majority vote,
disapprove the comments or revision of the Secretary. If the
Committee disapproves such comments or revisions, the revised
policy shall not take effect until a majority of the
Committee approves the policy or the revisions to such
policy.
``(2) Scientific advisory committee on organ
transplantation.--
``(A) Establishment.--The Secretary shall establish an
advisory committee to be known as the Scientific Advisory
Committee on Organ Transplantation. Consistent with the
requirements of sections 5 and 10 of the Federal Advisory
Committee Act--
``(i) the deliberations of the Committee shall not be
inappropriately influenced by the Secretary or by any special
interest and shall only be the result of the independent
judgment of the Committee; and
``(ii) the meetings of the Committee shall be open to the
public, advance notice of meetings shall be published in the
Federal Register, and records or minutes of meetings shall be
made available to the public.
``(B) Duties.--The Committee shall make recommendations
with respect to policy matters related to reviews conducted
under paragraph (1)(E)(ii)(II).
``(C) Membership.--The Committee shall be composed of 15
members, of which--
``(i) five members shall be appointed by the Secretary from
nominations submitted by the OPTN Board under subparagraph
(D);
``(ii) five members shall be appointed by the Secretary
from nominations submitted by the Institute of Medicine under
subparagraph (D); and
``(iii) five members shall be appointed by the Secretary.
``(D) Nominations.--The OPTN Board and the Institute of
Medicine shall each nominate, in an independent manner, 5
qualified individuals to serve on the Committee.
``(E) Qualifications.--In appointing individuals to serve
on the Committee under subparagraph (C), the Secretary shall
ensure that--
``(i) nine members are transplant physicians or transplant
surgeons of whom--
``(I) 3 shall be selected from the nominations submitted by
the OPTN Board; and
``(II) 3 shall be selected from the nominations submitted
by the Institute of Medicine; and
``(ii) the remaining members are individuals who are--
``(I) distinguished in the fields of ethics, basic,
clinical or health services research, biostatistics, or
health care policy, economics or financing; or
``(II) transplant candidates, transplant recipients, organ
donors or family members of such individuals.
``(F) Experts.--The Committee shall seek advice from
appropriate experts, as needed, to evaluate the proposed
policy and revisions under review.
``(G) Chairperson.--The members of the Committee shall
elect a member to serve as the chairperson of the Committee.
``(H) Terms.--Members of the Committee shall serve for a
term of 5 years. Vacancies shall be filled in the same manner
as the original appointment was made.
``(f) Network Administration and Operation.--The Secretary
shall contract with a nonprofit private entity (referred to
in this section as the `Network Administrator') for the
administration and operation of the Network. The Network
Administrator shall administer and operate the OPTN Board in
accordance with subsection (b). The Network Administrator
shall, pursuant to the policies and criteria established by
the OPTN Board--
``(1) maintain and operate a national system as established
by the OPTN Board to match organs and individuals who need
organ transplants;
``(2) operate in accordance with medical criteria
established by the OPTN Board, and administer the national
system established under subsection (c)(2);
``(3) maintain 1 or more lists of individuals who need
organ transplants as provided for under subsection (c)(2)(A);
``(4) maintain a 24-hour communication service to
facilitate matching organs with individuals included on the
list or lists;
``(5) assist organ procurement organizations in obtaining
and distributing organs in accordance with the policies
established by the OPTN Board;
``(6) adopt and use standards of quality for the
acquisition and transportation of donated organs, including
standards regarding the transmission of infectious diseases;
``(7) prepare and distribute, on a regionalized basis (and,
to the extent practicable, among regions or on a national
basis), samples of blood sera from individuals who are
included on the list in order to facilitate matching the
compatibility of such individuals with organ donors;
``(8) coordinate, as appropriate, the transportation of
organs from organ procurement organizations to transplant
centers;
``(9) provide information to physicians, health care
professionals, and the general public regarding organ
donation;
``(10) carry out studies and demonstration projects for the
purpose of improving procedures for organ procurement and
allocation; and
``(11) work actively with organ procurement organizations,
transplant centers, health care providers, and the public to
increase the supply of donated organs.
``(g) Data Collection, Analysis and Distribution.--
``(1) In general.--The Network Administrator shall analyze,
maintain, verify, make available and publish timely data to
the extent necessary to--
``(A) enable the OPTN Board to fulfill its responsibilities
under this section;
``(B) assess the compliance of members of the Network with
performance and other criteria developed pursuant to
subsection (c)(1);
``(C) evaluate the quality of care provided to transplant
candidates and patients generally and in an individual
program;
``(D) provide data needed by the Scientific Registry
maintained pursuant to section 373;
``(E) provide transplant candidates and patients,
physicians and others with information needed to evaluate or
select a transplant program;
``(F) provide a member of the Network with data about the
member, including results of analysis or other processing of
data originally supplied by the member;
``(G) enable the OPTN Board, the Network Administrator and
the Secretary to fulfill respective enforcement and oversight
responsibilities under subsections (j) and (k); and
``(H) comply with the requirements under subsection (l).
``(2) Types of data.--Data provided under paragraph (1)
shall include--
``(A) data on transplant candidates, transplant recipients,
organ donors, donated organs, and transplant programs; and
``(B) as appropriate, data, graft- and patient-survival
rates (actual and adjusted to reflect program-specific
population disease severity), program specific data, and
aggregate data.
``(h) Contract.--The contract under subsection (f) shall--
``(1) be awarded through a process of competitive bidding
as determined by the Secretary; and
``(2) be awarded for a period of no longer than 5 years.
``(i) Network Membership and Patient Registration Fee.--
``(1) In general.--The Network Administrator may assess a
fee, to be collected by the Network Administrator, for
membership in the Network (to be known as the `Network
membership fee'), and for the listing of each potential
transplant recipient on the national organ matching system
maintained by the Network Administrator (to be known as the
`patient registration fee'), in an amount determined under
paragraph (2).
``(2) Amount.--The amounts of the fees to be assessed under
paragraph (1) shall be calculated so as to be--
``(A) reasonable and customary; and
``(B) sufficient to cover the Network's reasonable costs of
operation in accordance with this section.
``(3) Annual recalculation.--
``(A) In general.--The fees calculated under paragraph (2)
shall be annually recalculated, based on--
``(i) changes in the level or cost of contract tasks and
other activities related to organ procurement and
transplantation; and
``(ii) changes in expected revenues from contract funds,
Network membership fees and patient registration fees
available to the Network Administrator.
``(B) Procedure.--
``(i) Proposal.--The Network Administrator shall submit to
the Secretary a written proposal for, and justification of, a
recalculated fee under subparagraph (A).
``(ii) Determination.--The proposal of the Network
Administrator for a recalculated fee under clause (i) shall
take effect unless the Secretary, within 60 days of receiving
the proposal, provides the Network Administrator with a
written determination, with justification, that the proposed
fee level does not meet the requirement of subparagraph (A).
``(4) Use of fees.--
``(A) In general.--All fees collected by the Network
Administrator under this subsection shall be available to the
Network, without fiscal year limitation, for use in carrying
out the functions described in subsection (f).
``(B) Restriction.--Fees collected under this subsection
may not be used for any activity for which contract funds may
not be used under this section.
``(5) Rule of construction.--Nothing in this subsection
shall be construed as prohibiting the Network Administrator
from collecting or accepting other fees, donations or gifts
or for using such other fees, donations or gifts to carry out
activities other than those authorized under the contract
under this section.
``(j) Oversight of Network Participants.--
``(1) Monitoring.--
[[Page S2247]]
``(A) In general.--The OPTN Board and the Network
Administrator shall, on an ongoing and periodic basis, or as
requested by the Secretary, monitor the operations of Network
participants to determine whether the participants are
maintaining compliance with the criteria and policies
established by the OPTN Board.
``(B) Procedures.--
``(i) Notice.--In monitoring a Network participant under
subparagraph (A), the OPTN Board or the Administrator--
``(I) shall inform the participant and the Secretary upon
initiating a compliance review of a Network participant; and
``(II) shall inform the participant and the Secretary of
any findings indicating noncompliance by the participant with
such criteria and policies.
``(ii) Appeals.--The Network Administrator shall establish
procedures for appealing noncompliance determinations. Such
procedures shall ensure due process and shall allow for
corrective action.
``(2) Peer review proceedings.--
``(A) In general.--The OPTN Board shall establish a peer
review system and conditions for the application of peer
review requirements to ensure that members of the Network
comply with policies and criteria established by the OPTN
Board under this section. Such peer review system may include
prospective reviews and shall be administered by the Network
Administrator and overseen by the OPTN Board.
``(B) Policies, review and evaluation.--As part of the peer
review system established under subparagraph (A), the OPTN
Board shall establish such policies, and the Network
Administrator shall conduct such ongoing and periodic reviews
and evaluations of members of the Network, as necessary to
ensure compliance with the policies and criteria established
by the OPTN Board under this section.
``(C) Emerging issues.--As part of such peer review system
established under subparagraph (A), the OPTN Board shall
establish policies to work with and direct the Network
Administrator to respond to emerging issues and problems.
``(k) Enforcement.--
``(1) Recommendations.--The OPTN Board or the Network
Administrator shall provide advice, and make recommendations
for appropriate action, to the Secretary concerning the
results of any reviews or evaluations that, in the opinion of
the OPTN Board or the Network Administrator, indicate--
``(A) noncompliance by Network participants with--
``(i) the policies or criteria established by the OPTN
Board; or
``(ii) the operating procedures of the Network
Administrator; or
``(B) a risk to the health of organ transplant patients or
to public safety.
``(2) Enforcement by network.--
``(A) In general.--If the OPTN Board determines that one of
the members of the network has violated a requirement
established by this section or by the Network, the OPTN Board
may impose on the member 1 or more of the sanctions described
in subparagraph (B), or may recommend that the Secretary take
enforcement action under paragraph (3).
``(B) Types of sanctions.--The sanctions described in this
subparagraph may include--
``(i) the loss of any or all privileges of membership in
good standing in the Network;
``(ii) the imposition upon the member of additional or more
frequent reviews or evaluations under subsection (j)(1)(A),
and assessments of the reasonable costs of such additional or
more frequent reviews or evaluations; and
``(iii) such other sanctions as the Secretary may permit
the OPTN Board to impose.
``(3) Enforcement by the secretary.--
``(A) In general.--If the Secretary, after consultation
with the OPTN Board or Network Administrator, determines that
a member of the Network has violated a requirement
established by this section or a requirement of a policy that
is enforceable under subsection (f), the Secretary may impose
on the member 1 or more of the sanctions described in
subparagraph (B).
``(B) Types of sanctions.--The sanctions described in this
subparagraph shall include--
``(i) requiring the member to follow a directed plan of
correction;
``(ii) imposing upon the member a monetary assessment (to
be paid to the General Fund of the Treasury) in an amount not
to exceed $10,000 for each violation or for each day of
violation;
``(iii) requiring the member to pay to the Network
Administrator the costs of onsite monitoring of the member;
``(iv) the loss of any or all privileges of membership in
the Network; and
``(v) in cases where the violation creates a risk to
patient health or to public health, such other action as the
Secretary determines to be necessary.
``(C) Procedures.--The Secretary shall develop and
implement procedures for the imposition of sanctions under
clauses (i) through (v) of subparagraph (B). Such procedures
shall include--
``(i) the provision of reasonable notice to the Network
member and the OPTN Board that the Secretary is considering
imposing a sanction;
``(ii) affording the member a reasonable opportunity to be
heard in response to the notice;
``(iii) the provision of notice to the member that the
Secretary has decided to impose a sanction; and
``(iv) the opportunity for the Network member to appeal
such sanction.
``(l) Annual Report.--
``(1) In general.--Not later than September 30 of each
year, the Network Administrator shall prepare and submit to
the Secretary an annual report on the performance and
policies of the Network. The report shall include additional
items as specified in the contract under this section or
requested in a timely manner by the Secretary.
``(2) Requirement of optn board approval.--The OPTN Board
shall review and approve the report required under paragraph
(1) prior to the submission of such report to the Secretary.
``(3) Submission to congress.--
``(A) In general.--Not later than December 31 of each year,
the Secretary shall transmit the report submitted under
paragraph (1) and the comments of the Secretary concerning
such report, to the appropriate committees of Congress.
``(B) Clarifying information.--The Secretary may, upon the
receipt of the report under paragraph (1), but prior to
transmission of the report to Congress under subparagraph
(A), request that the Network Administrator submit clarifying
information or an addenda as needed to fulfill the
requirements of this subsection.
``(m) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, such sums as
may be necessary for each of fiscal years 2001 through
2005.''.
SEC. 3. SCIENTIFIC REGISTRY
Section 373 of the Public Health Service Act (42 U.S.C.
274a) is amended to read as follows:
``SEC. 373. SCIENTIFIC REGISTRY.
``The Secretary shall by contract, develop and maintain a
scientific registry of the recipients of organ transplants.
The registry shall include information, with respect to organ
transplant patients and transplant procedures, as the
Secretary determines to be necessary to an ongoing evaluation
of the scientific and clinical status of organ
transplantation.''.
SEC. 4. ORGAN DONATION.
Part H of title III of the Public Health Service Act (42
U.S.C. 273 et seq.) is amended--
(1) by redesignating section 378 (42 U.S.C. 274g) as
section 379; and
(2) by inserting after section 377 (42 U.S.C. 274f) the
following:
``SEC. 378. ORGAN DONATION AND RESEARCH.
``(a) Inter-Agency Task Force on Organ Donation and
Research.--
``(1) In general.--The Secretary shall establish an inter-
agency task force on organ donation and research (referred to
in this section as the `task force') to improve the
coordination and evaluation of--
``(A) federally supported or conducted organ donation
efforts and policies; and
``(B) federally supported or conducted basic, clinical and
health services research (including research on preservation
techniques and organ rejection and compatibility).
``(2) Composition.--The task force shall be composed of--
``(A) the Surgeon General, who shall serve as the
chairperson;
``(B) representatives to be appointed by the Secretary from
relevant agencies within the Department of Health and Human
Services (including the Health Resources and Services
Administration, Health Care Financing Administration,
National Institutes of Health, and Agency for Healthcare
Research and Quality);
``(C) a representative from the Department of
Transportation;
``(D) a representative from the Department of Defense;
``(E) a representative from the Department of Veterans
Affairs;
``(F) a representative from the Office of Personnel
Management; and
``(G) representatives of other Federal agencies or
departments as determined to be appropriate by the Secretary.
``(3) Annual report.--In addition to activities carried out
under paragraph (1), the task force shall support the
development of the annual report under subsection (d)(2).
``(4) Termination.--The task force may be terminated at the
discretion of the Secretary following the completion of at
least 2 annual reports under subsection (d). Upon such
termination, the Secretary shall provide for the on-going
coordination of federally supported or conducted organ
donation and research activities.
``(b) Education.--
``(1) Public education and awareness.--The Secretary shall,
directly or through grants or contracts, carry out a
comprehensive and effective national public education program
to increase organ donation, including living donation.
``(2) Development of curricula and other education
activities.--
``(A) In general.--The Secretary shall support the
development and dissemination of model curricula to train
health care professionals and other appropriate professionals
(including religious leaders in the community and law
enforcement officials) in issues surrounding organ donation,
including methods to approach patients and their families,
cultural sensitivities, and other relevant issues.
[[Page S2248]]
``(B) Health care professionals.--For purposes of
subparagraph (A), the term `health care professionals'
includes--
``(i) medical students, residents and fellows, attending
physicians (through continuing medical education courses and
other methods), nurses, social workers, and other allied
health professionals; and
``(ii) hospital- or other health care-facility based
chaplains; and
``(iii) emergency medical personnel.
``(c) Grants.--The Secretary shall award peer-reviewed
grants to public and non-profit private entities, including
States, to carry out studies and demonstration projects to
increase organ donation rates, including living donation. The
Secretary shall ensure that activities carried out by
grantees under this subsection are evaluated for
effectiveness and that such findings are disseminated.
``(d) Reports.--
``(1) IOM report on best practices.--
``(A) In general.--The Secretary shall enter into a
contract with the Institute of Medicine to conduct an
evaluation of the organ donation practices of organ
procurement organizations, States, other countries, and other
appropriate organizations that have achieved a higher than
average organ donation rate.
``(B) Barriers.--In conducting the evaluation under
subparagraph (A), the Institute of Medicine shall examine
existing barriers to organ donation.
``(C) Report.--Not later than 18 months after the date of
enactment of this section, the Institute of Medicine shall
submit to the Secretary a report concerning the evaluation
conducted under this paragraph. Such report shall include
recommendations for administrative actions and, if necessary,
legislation in order to replicate the best practices
identified in the evaluation and to otherwise increase organ
donation and procurement rates.
``(2) Annual report on donation.--
``(A) In general.--Not later than 1 year after the date on
which the report is submitted under paragraph (1)(C), and
annually thereafter, the Secretary shall prepare and submit
to Congress a report concerning federally supported or
conducted organ donation and procurement activities,
including donation and procurement activities evaluated or
conducted under subsection (a) to increase organ donation.
``(B) Requirements.--To the extent practicable, each annual
report under subparagraph (A) shall--
``(i) evaluate the effectiveness of activities, identify
best practices, and make recommendations regarding broader
adoption of best practices with respect to organ donation and
procurement;
``(ii) assess organ donation and procurement activities
that are recently completed, current or planned.
``(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $15,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of fiscal years 2002 through 2005.''.
______
By Mr. ABRAHAM (for himself, Mr. Kennedy, Mr. Leahy, Mr. DeWine,
Mr. Jeffords, Mr. Akaka, Mr. Graham, and Mr. Inouye):
S. 2367. A bill to amend the Immigration and Nationality Act to make
improvements to, and permanently authorize, the visa waiver pilot
program under the Act; to the Committee on the Judiciary.
TRAVEL, TOURISM, AND JOBS PRESERVATION ACT
Mr. ABRAHAM. Mr. President, I rise today to introduce the Travel,
Tourism, and Jobs Preservation Act. This bill makes the Visa Waiver
Pilot Program permanent and strengthens the documentation and reporting
requirements established under the pilot program.
This legislation is important not only because it facilitates travel
and tourism in the United States, thereby creating many American jobs,
but also because it benefits American tourists who wish to travel
abroad, since visa requirements are generally waived on a reciprocal
basis.
The Visa Waiver Pilot Program authorizes the Attorney General to
waive visa requirements for foreign nationals traveling from certain
designated countries as temporary visitors for business or pleasure.
Aliens from the participating countries complete an admission form
prior to arrival and are admitted to stay for up to 90 days.
The criteria for being designated as a Visa Waiver country are as
follows: First, the country must extend reciprocal visa-free travel for
U.S. citizens. Second, they must have a nonimmigrant refusal rate for
B-1/B-2 visitor visas at U.S. consulates that is low, averaging less
than 2 percent the previous two full fiscal years, with the refusal
rate less than 2.5 percent in either year, or less than 3 percent the
previous full fiscal year. Third, the countries must have or be in the
process of developing a machine-readable passport program. Finally, the
Attorney General must conclude that entry into the Visa Waiver Pilot
Program will not compromise U.S. law enforcement interests.
Countries are designated by the Attorney General in consultation with
the Secretary of State. Nations currently designated as Visa Waiver
participants are Andorra, Argentina, Australia, Austria, Belgium,
Brunei, Denmark, Finland, France, Germany, Iceland, Ireland, Italy,
Japan, Liechtenstein, Luxembourg, Monaco, Netherlands, New Zealand,
Norway, Portugal, San Marino, Singapore, Slovenia, Spain, Sweden,
Switzerland, United Kingdom, and Uruguay. Greece has been proposed for
participation in the program.
The Visa Waiver Pilot Program was established by law in 1986 and
became effective in 1988, with 8 countries participating for a period
of three years. The program has been considered successful and as such
has been expanded to include 29 participating countries. Since 1986,
Visa Waiver has been reauthorized on 6 different occasions for periods
of one, two, or three years at a time.
The time has come to make the Visa Waiver Pilot Program permanent,
and, in the process, to strengthen further current requirements. Its
status is no longer truly experimental. No serious disagreement exists
that the program should continue in place for the foreseeable future,
and no significant problems have been raised with the fundamentals of
how it has been operating for the past 14 years. To the contrary,
failure to continue the program would cause enormous staffing problems
at U.S. consulates, which would have to be suddenly increased
substantially to resume issuance of visitor visas. It would also be
extremely detrimental to American travelers, who would most certainly
find that, given reciprocity, they now would be compelled to obtain
visas to travel to Europe and elsewhere. Finally, there are costs to
continuing to reauthorize the program on a short-term rather than a
permanent basis, as it periodically creates considerable uncertainty in
the United States and around the world about what documents travelers
planning their foreign travel have to obtain.
Accordingly, I am today introducing the Travel, Tourism, and Jobs
Preservation Act. This legislation eliminates the need for frequent
extensions of Visa Waiver by making the program permanent. I am pleased
to see that the House bill on Visa Waiver also makes the program
permanent. Second, the current requirement that countries be in the
process of developing a program for issuing machine-readable passports
will be replaced with a stricter requirement that all countries in the
program as of May 1, 2000 certify by October 1, 2001 that they will
have an operational machine-readable passport program by 2003 and that
new countries have a machine-readable passport program in place before
becoming eligible for designation as a Visa Waiver country. The bill
also establishes a deadline of October 1, 2008 by which time all
travelers must have machine-readable passports to come to the United
States under Visa Waiver. The judgment of everyone involved in these
issues is that the technology is now sufficient that it is time for
everyone to move from the concept and planning to the prompt
implementation of these requirements.
Finally, under the Travel, Tourism, and Jobs Preservation Act, the
Attorney General must submit a written report at least once every five
years evaluating ``the effect of each program country's continued
designation on the law enforcement and national security interests of
the United States.'' This will ensure that the operation of the program
is periodically reviewed. I should note that under current law the
Attorney General, in consultation with the Secretary of State, may for
any reason (including national security) refrain from waiving the visa
requirement in respect to nationals of any country which may otherwise
qualify for designation or may, at any time, rescind any waiver or
designation previously granted'' under Visa Waiver.
I think the additions in the bill strengthen the program while
preserving the significant job creation benefits Americans gain from
the Visa
[[Page S2249]]
Waiver program. International travel generates $95 billion in
expenditures and created one million U.S. jobs last year, according to
the Travel Industry Association of America. An estimated half of all
visitors to the United States enter the country under Visa Waiver.
I would like to thank my cosponsors Senators Kennedy, Leahy, DeWine,
Jeffords, Akaka, Graham, and Inouye for supporting this important
legislation.
____________________