Congressional Record, Volume 147 Issue 109 (Tuesday, July 31, 2001)

[Congressional Record Volume 147, Number 109 (Tuesday, July 31, 2001)]
[Senate]
[Pages S8466-S8482]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

By Mr. HATCH (for himself and Mrs. Feinstein):
S. 1272. A bill to assist United States veterans who were treated as
slave laborers while held as prisoners of war by Japan during World War
II, and for other purposes; to the Committee on Veterans' Affairs.
Mr. HATCH. Mr. President, I rise today with my co-sponsor, Senator
Feinstein, to introduce legislation that will help a very special cadre
of Americans, a group of Americans that, over 50 years ago, paid a very
dear price on behalf of our country. The incredible sacrifice made by
these Americans has never properly been acknowledged, and it is high
time that they receive some measure of compensation for that sacrifice.
On April 9, 1942, Allied forces in the Philippines surrendered the
Bataan Peninsula to the Japanese. Ten to twelve thousand American
soldiers were forced to march some 60 miles in broiling heat in a
deadly trek known as the Bataan Death March. Following a lengthy
internment under horrific conditions, thousands of POWs were shipped to
Japan in the holds of freighters known as ``Hell Ships.'' Once in
Japan, the survivors of the Bataan Death March were joined by hundreds
of other American POWs, POWs who had been captured by the Japanese in
actions throughout the Pacific theater of war, at Corregidor, at Guam,
at Wake Islands, and at countless other battlegrounds.
After arriving in Japan, many of the American POWs were forced into
slave labor for private Japanese steel mills and other private
companies until the end of the war. During their internment, the
American POWs were subjected to torture, and to the withholding of food
and medical treatment, in violation of international conventions
relating to the protection of prisoners of war.
More than 50 years have passed since the atrocities occurred, yet our
veterans are still waiting for accountability and justice.
Unfortunately, global political and security needs of the time often
overshadowed their legitimate claims for justice, and these former POWs
were once again asked to sacrifice for their country. Following the end
of the war, for example, our government instructed many of the POWs
held by Japan not to discuss their experiences and treatment. Some were
even asked to sign non-disclosure agreements. Consequently, many
Americans remain unaware of the atrocities that took place and the
suffering our POWs endured.

Finally, after more than 50 years, a new effort is underway to seek
compensation for the POWs from the private Japanese companies which
profited from their labor.
Let me say at the outset, that this is not a dispute with the
Japanese people and these are not claims against the Japanese
government. Rather, these are private claims against the private
Japanese companies that profited from the slave labor of our American
soldiers who they held as prisoners. These are the same types of claims
raised by survivors of the Holocaust against the private German
corporations who forced them into labor.
Here in the Senate, we have been doing what we can to help these
former prisoners of war. In June of last year, the Senate Judiciary
Committee held a hearing on the claims being made by the former
American POWs against the private Japanese companies, to determine
whether the executive branch had been doing everything in its power to
secure justice for these valiant men.
In the fall of last year, with the invaluable assistance of Senator
Feinstein, we were able to pass legislation declassifying thousands of
Japanese Imperial Army records held by the U.S. government, to assist
the POW's in the pursuit of their claims.
We can do even more. Recently, the State of California passed
legislation extending the statute of limitations, under state law, to
allow the POWs to bring monetary claims against the Japanese
corporations that unlawfully employed them. Other States are
contemplating such legislation.

[[Page S8467]]

The bill we are introducing today makes clear that any claims brought
in state court, and subsequently removed to Federal court, will still
have the benefit of the extended statute of limitations enacted by the
state legislatures.
The legislators in California, and other States, have recognized the
fairness of the allowing these claims to proceed for a decision on the
merits. In light of the tangled history of this issue, including the
role played by the U.S. government in discouraging these valiant men
from pursuing their just claims, it is simply unfair to deny these men
their day in court because their claims have supposedly grown stale.
These claims are not stale in their ability to inspire admiration for
the men who survived this ordeal. These claims are not stale in their
ability to inspire indignation against the corporations who flouted
international standards of decency.
The statute of limitations should not be permitted to cut off these
claims before they can be heard on the merits. Today's bill does
nothing more than ensure that these valiant men receive their fair day
in court.
I hope my fellow Senators will join with me, and with Senator
Feinstein, on this important legislation. These heroes of World War II
have waited too long for a just resolution of their claims.
Mrs. FEINSTEIN. Mr. President, I rise alongside my colleague from
Utah, Senator Hatch, to introduce the ``POW Assistance Act of 2001''.
This legislation makes an important statement in support of the many
members of the U.S. Armed Forces who were used as slave labor by
Japanese companies during the Second World War or subject to chemical
and biological warfare experiments in Japanese POW camps.
The core of this bill is a clarification that in any pending lawsuit
brought by former POWs against Japanese corporations, or any lawsuits
which might be filed in the future, the Federal court shall apply the
applicable statute of limitations of the State in which the action was
brought.
This legislation is important because a recently enacted California
law enables victims of WWII slave labor to seek damages up to the year
2010 against responsible Japanese companies, just as any citizen can
sue a private company. Seventeen lawsuits have been filed on behalf of
former POWs who survived forced labor, beatings, and starvation at the
hands of Japanese companies. By asking Federal judges to look to the
State statute of limitation, this legislation sends a clear message to
the courts that we believe that suits with merit should not be
precluded.
Today, too many Americans and Japanese do not know that American POWs
performed forced labor for Japanese companies during the war.
American POWs, including those who had been forced through the Bataan
Death March, were starved and denied adequate medical care and were
forced to perform slave labor for private Japanese companies. American
POWs toiled in mines, factories, shipyards, and steel mills. Many POWs
worked virtually every day for 10 hours or more, often under extremely
dangerous working conditions. They were starved and denied adequate
medical care. Even today, many survivors still suffer from health
problems directly tied to their slave labor.
It is critical that we do not forget the heroism and sacrifice of the
POWs, and that the United States government does not stand in the way
of their pursuit of recognition and compensation. They have never
received an apology or payment from the companies that enslaved them,
many of which are still in existence today.
The bill that Senator Hatch and I have introduced today does not
prejudice the outcome of the lawsuits which are pending one way or
another. The legislation we have introduced today simply holds that the
lawsuits filed in California, or any which may still be filed under the
California statute of limitations, should be allowed to go forward so
that this issue can be settled definitively, without impeding the right
of the POWs to pursue justice.
One of my most important goals in the Senate has been to see the
development of a Pacific Rim community that is peaceful and stable. And
I am pleased that the Government of Japan today is a close ally and
good friend of the United States, and a responsible member of the
international community.
And I want to clarify that this legislation is not directed at the
people or government of Japan. The POWs and veterans are only seeking
justice from the private companies that enslaved them, and this
legislation has been designed in the interest of allowing these claims
to move forward.
But I also believe that if Japan is to play a greater role in the
international community it is important for Japan, the United States,
and other countries in the Asia-Pacific region to be able to reconcile
interpretations of memory and history, especially of the Second World
War. If, as Gerrit Gong has written, Japan aspires to be a normal
country, this question of ``remembering and forgetting'' is critical if
Japan hopes to forge an environment in which its neighbors ``do not
object to that country's engaging in a full range of international
activities and capabilities.''
The goal of this legislation is to remove this outstanding issue in
U.S.-Japan relations, and to try to heal wounds that still remain. I
hope that the Senate will see fit to support this bill.
______

By Mr. HARKIN:
S. 1273. A bill to amend the Public Health Service Act to provide for
rural health services outreach, rural health network planning and
implementation, and small health care provider quality improvement
grant programs, and telehomecare demonstration projects; to the
Committee on Health, Education, Labor, and Pensions.
Mr. HARKIN. Mr. President, I have introduced the ``Improving Health
Care in Rural America Act'' that continues a rural health outreach
program that I worked to establish as a part of the fiscal year 1991
Labor, Health and Human Services appropriations bill. We began this
innovative program to demonstrate the effectiveness of outreach
programs to populations in rural areas that have trouble obtaining
health and mental health services. Too often, these people are not able
to obtain health care until they are acutely ill and need extensive and
expensive hospital care.
Indeed, rural Americans are at triple jeopardy, they are more often
poor, more often uninsured, and more often without access to health
care. Rural America is home to a disproportionately large segment of
older citizens who more often require long-term care for their
illnesses and disabilities. And rural America is not immune from the
social stresses of modern society. This is manifest by escalating needs
for mental health services to deal with necessary alcohol- and drug-
related treatment, and by the significantly higher rate of suicide in
rural areas. Yet, rural Americans are increasingly becoming commuters
for their health care. Rural Americans deserve to be treated equitably
and the legislation that I rise to describe today helps bring high
quality health care to rural communities to meet their specific needs.
This grant program has proven itself highly successful because it
responds to local community needs and is directed by the people in the
community. These innovative grants bring needed primary and preventive
care to those people who have few other options. These grants also help
link health and social services, thereby reaching the people that most
need these services.
This program has received overwhelmingly positive response from all
fifty States because it has had a tremendous impact on improving
coordination between health care providers and expanding access to
needed health care.
In Iowa, the Ida County Community Hospital receives funds to improve
the quality of life for older people who are chronically ill by making
home visits, providing pain management, and telmonitoring, and other
needed services.
In Maquoketa, IA, every school-age child is being given timely, high
quality care because the local school district used their grant to team
up with almost every health care provider in the county to provide
services.
In Mason City, IA, the North Iowa Mercy Health Center is
collaborating

[[Page S8468]]

with the Easter Seals Society of Northern Iowa, Rockwell Community
Nursing, and the Pony Express Riders of Iowa to make sure seniors have
access to physician, therapy, and dental services. This program also
recycles and repairs assistive technology equipment to help seniors
that are unable to afford new equipment.
The ``Improving Health Care in Rural America Act'' also establishes a
telehomecare demonstration program for five separate projects to allow
home health care professionals to provide some services through
telehealth technologies. This program will allow rural residents to
have better access to daily health care services and will reduce health
care costs. This program is designed to improve patient access to care,
quality of care, patient satisfaction with care while reducing the
costs of providing care. Nurses and other health care professionals
will be trained in how to use this advanced technology to provide
better, more effective care. This programs applies the highly effective
telehealth technology to an area of health care that will benefit
greatly.
As ranking member and as chairman of the Labor-HHS Appropriations
Subcommittee, I have been pleased to be able to provide funding for
this program during the previous decade. This bill will extend this
highly successful program for 5 more years and I look forward to
provide its funding. Programs that work this well deserve the support
of Congress.
I urge my colleagues to join me in supporting this important
legislation and ask unanimous consent that the text of the bill be
printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:

S. 1273

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 ``Improving Health Care in
Rural America Act''.

SEC. 2. GRANT PROGRAMS.

Section 330A of the Public Health Service Act (42 U.S.C.
254c) is amended to read as follows:

``SEC. 330A. RURAL HEALTH SERVICES OUTREACH, RURAL HEALTH
NETWORK DEVELOPMENT, AND SMALL HEALTH CARE
PROVIDER QUALITY IMPROVEMENT GRANT PROGRAMS.

``(a) Purpose.--The purpose of this section is to provide
grants for expanded delivery of health services in rural
areas, for the planning and implementation of integrated
health care networks in rural areas, and for the planning and
implementation of small health care provider quality
improvement activities.
``(b) Definitions.--
``(1) Director.--The term `Director' means the Director
specified in subsection (d).
``(2) Federally qualified health center; rural health
clinic.--The terms `Federally qualified health center' and
`rural health clinic' have the meanings given the terms in
section 1861(aa) of the Social Security Act (42 U.S.C.
1395x(aa)).
``(3) Health professional shortage area.--The term `health
professional shortage area' means a health professional
shortage area designated under section 332.
``(4) Health services.--The term `health services' includes
mental and behavioral health services and substance abuse
services.
``(5) Medically underserved area.--The term `medically
underserved area' has the meaning given the term in section
799B.
``(6) Medically underserved population.--The term
`medically underserved population' has the meaning given the
term in section 330(b)(3).
``(c) Program.--The Secretary shall establish, under
section 301, a small health care provider quality improvement
grant program.
``(d) Administration.--
``(1) Programs.--The rural health services outreach, rural
health network development, and small health care provider
quality improvement grant programs established under section
301 shall be administered by the Director of the Office of
Rural Health Policy of the Health Resources and Services
Administration, in consultation with State offices of rural
health or other appropriate State government entities.
``(2) Grants.--
``(A) In general.--In carrying out the programs described
in paragraph (1), the Director may award grants under
subsections (e), (f), and (g) to expand access to,
coordinate, and improve the quality of essential health
services, and enhance the delivery of health care, in rural
areas.
``(B) Types of grants.--The Director may award the grants--
``(i) to promote expanded delivery of health services in
rural areas under subsection (e);
``(ii) to provide for the planning and implementation of
integrated health care networks in rural areas under
subsection (f); and
``(iii) to provide for the planning and implementation of
small health care provider quality improvement activities
under subsection (g).
``(e) Rural Health Services Outreach Grants.--
``(1) Grants.--The Director may award grants to eligible
entities to promote rural health services outreach by
expanding the delivery of health services to include new and
enhanced services in rural areas. The Director may award the
grants for periods of not more than 3 years.
``(2) Eligibility.--To be eligible to receive a grant under
this subsection for a project, an entity--
``(A) shall be a rural public or nonprofit private entity;
``(B) shall represent a consortium composed of members--
``(i) that include 3 or more health care providers or
providers of services; and
``(ii) that may be nonprofit or for-profit entities; and
``(C) shall not previously have received a grant under this
subsection or section 330A for the project.
``(3) Applications.--To be eligible to receive a grant
under this subsection, an eligible entity, in consultation
with the appropriate State office of rural health or another
appropriate State entity, shall prepare and submit to the
Secretary an application, at such time, in such manner, and
containing such information as the Secretary may require,
including--
``(A) a description of the project that the applicant will
carry out using the funds provided under the grant;
``(B) a description of the manner in which the project
funded under the grant will meet the health care needs of
rural underserved populations in the local community or
region to be served;
``(C) a description of how the local community or region to
be served will be involved in the development and ongoing
operations of the project;
``(D) a plan for sustainability of the project after
Federal support for the project has ended; and
``(E) a description of how the project will be evaluated.
``(f) Rural Health Network Development Grants.--
``(1) Grants.--
``(A) In general.--The Director may award rural health
network development grants to eligible entities to promote,
through planning and implementation, the development of
integrated health care networks that have integrated the
functions of the entities participating in the networks in
order to--
``(i) achieve efficiencies;
``(ii) expand access to, coordinate, and improve the
quality of essential health services; and
``(iii) strengthen the rural health care system as a whole.
``(B) Grant periods.--The Director may award such a rural
health network development grant for implementation
activities for a period of 3 years. The Director may also
award such a rural health network development grant for
planning activities for a period of 1 year, to assist in the
development of an integrated health care networks, if the
proposed participants in the network have a history of
collaborative efforts and a 3-year implementation grant would
be inappropriate.
``(2) Eligibility.--To be eligible to receive a grant under
this subsection, an entity--
``(A) shall be a rural public or nonprofit private entity;
``(B) shall represent a network composed of members--
``(i) that include 3 or more health care providers or
providers of services; and
``(ii) that may be nonprofit or for-profit entities; and
``(C) shall not previously have received a grant (other
than a 1-year grant for planning activities) under this
subsection or section 330A for the project.
``(3) Applications.--To be eligible to receive a grant
under this subsection, an eligible entity, in consultation
with the appropriate State office of rural health or another
appropriate State entity, shall prepare and submit to the
Secretary an application, at such time, in such manner, and
containing such information as the Secretary may require,
including--
``(A) a description of the project that the applicant will
carry out using the funds provided under the grant;
``(B) an explanation of the reasons why Federal assistance
is required to carry out the project;
``(C) a description of--
``(i) the history of collaborative activities carried out
by the participants in the network;
``(ii) the degree to which the participants are ready to
integrate their functions; and
``(iii) how the local community or region to be served will
benefit from and be involved in the activities carried out by
the network;
``(D) a description of how the local community or region to
be served will experience increased access to quality health
services across the continuum of care as a result of the
integration activities carried out by the network;
``(E) a plan for sustainability of the project after
Federal support for the project has ended; and

[[Page S8469]]

``(F) a description of how the project will be evaluated.
``(g) Small Health Care Provider Quality Improvement
Grants.--
``(1) Grants.--The Director may award grants to provide for
the planning and implementation of small health care provider
quality improvement activities. The Director may award the
grants for periods of 1 to 3 years.
``(2) Eligibility.--In order to be eligible for a grant
under this subsection, an entity--
``(A) shall be a rural public or nonprofit private health
care provider, such as a critical access hospital or a rural
health clinic;
``(B) shall be another rural provider or network of small
rural providers identified by the Secretary as a key source
of local care; or
``(C) shall not previously have received a grant under this
subsection for the project.
``(3) Applications.--To be eligible to receive a grant
under this subsection, an eligible entity, in consultation
with the appropriate State office of rural health or another
appropriate State entity, shall prepare and submit to the
Secretary an application, at such time, in such manner, and
containing such information as the Secretary may require,
including--
``(A) a description of the project that the applicant will
carry out using the funds provided under the grant;
``(B) an explanation of the reasons why Federal assistance
is required to carry out the project;
``(C) a description of the manner in which the project
funded under the grant will assure continuous quality
improvement in the provision of services by the entity;
``(D) a description of how the local community or region to
be served will experience increased access to quality health
services across the continuum of care as a result of the
activities carried out by the entity;
``(E) a plan for sustainability of the project after
Federal support for the project has ended; and
``(F) a description of how the project will be evaluated.
``(4) Preference.--In awarding grants under this
subsection, the Secretary shall give preference to entities
that--
``(A) are located in health professional shortage areas or
medically underserved areas, or serve medically underserved
populations; or
``(B) propose to develop projects with a focus on primary
care, and wellness and prevention strategies.
``(h) Coordination With Other Agencies.--The Secretary
shall coordinate activities carried out under grant programs
described in this section, to the extent practicable, with
Federal and State agencies and nonprofit organizations that
are operating similar grant programs, to maximize the effect
of public dollars in funding meritorious proposals.
``(i) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of fiscal years 2002
through 2006.''.

SEC. 3. CONSOLIDATION AND REAUTHORIZATION OF PROVISIONS.

Subpart I of part D of title III of the Public Health
Service Act (42 U.S.C. 254b et seq) is amended by adding at
the end the following:

``SEC. 330I. TELEHOMECARE DEMONSTRATION PROJECT.

``(a) Definitions.--In this section:
``(1) Distant site.--The term `distant site' means a site
at which a certified home care provider is located at the
time at which a health service (including a health care item)
is provided through a telecommunications system.
``(2) Telehomecare.--The term `telehomecare' means the
provision of health services through technology relating to
the use of electronic information, or through telemedicine or
telecommunication technology, to support and promote, at a
distant site, the monitoring and management of home health
services for a resident of a rural area.
``(b) Establishment.--Not later than 9 months after the
date of enactment of the Health Care Safety Net Amendments of
2001, the Secretary may establish and carry out a
telehomecare demonstration project.
``(c) Grants.--In carrying out the demonstration project
referred to in subsection (b), the Secretary shall make not
more than 5 grants to eligible certified home care providers,
individually or as part of a network of home health agencies,
for the provision of telehomecare to improve patient care,
prevent health care complications, improve patient outcomes,
and achieve efficiencies in the delivery of care to patients
who reside in rural areas.
``(d) Periods.--The Secretary shall make the grants for
periods of not more than 3 years.
``(e) Applications.--To be eligible to receive a grant
under this section, a certified home care provider shall
submit an application to the Secretary at such time, in such
manner, and containing such information as the Secretary may
require.
``(f) Use of Funds.--A provider that receives a grant under
this section shall use the funds made available through the
grant to carry out objectives that include--
``(1) improving access to care for home care patients
served by home health care agencies, improving the quality of
that care, increasing patient satisfaction with that care,
and reducing the cost of that care through direct
telecommunications links that connect the provider with
information networks;
``(2) developing effective care management practices and
educational curricula to train home care registered nurses
and increase their general level of competency through that
training; and
``(3) developing curricula to train health care
professionals, particularly registered nurses, serving home
care agencies in the use of telecommunications.
``(g) Coverage.--Nothing in this section shall be construed
to supercede or modify the provisions relating to exclusion
of coverage under section 1862(a) of the Social Security Act
(42 U.S.C 1395y(a)), or the provisions relating to the amount
payable to a home health agency under section 1895 of that
Act (42 U.S.C. 1395fff).
``(h) Report.--
``(1) Interim report.--The Secretary shall submit to
Congress an interim report describing the results of the
demonstration project.
``(2) Final report.--Not later than 6 months after the end
of the last grant period for a grant made under this section,
the Secretary shall submit to Congress a final report--
``(A) describing the results of the demonstration project;
and
``(B) including an evaluation of the impact of the use of
telehomecare, including telemedicine and telecommunications,
on--
``(i) access to care for home care patients; and
``(ii) the quality of, patient satisfaction with, and the
cost of, that care.
``(i) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section such
sums as may be necessary for each of fiscal years 2002
through 2006.''.
______

By Mr. KENNEDY (for himself, Mr. Frist Mr. Dodd, Mr. Hutchinson,
Mr. Jeffords, Ms. Collins, Mr. Bingaman, Mr. Edwards, Mrs.
Murray, and Mr. Sessions):
S. 1274. A bill to amend the Public Health Service Act to provide
programs for the prevention, treatment, and rehabilitation of stroke;
to the Committee on Health, Education, Labor, and Pensions.
1_____

By Mr. FRIST (for himself, Mr. Kennedy, Mr. Jeffords, Mr.
Hutchinson, Mr. Dodd, Ms. Collins, Mr. Bingaman, Mr. Feingold,
Mrs. Murray, Mr. Edwards, and Mr. Corzine):
S. 1275. A bill to amend the Public Health Service Act to provide
grants for public access defibrillation programs and public access
defibrillation demonstration projects, and for other purposes; to the
Committee on Health, Education, Labor, and Pensions.
Mr. FRIST. Mr. President, I rise today with Senator Kennedy to
introduce two pieces of legislation, the STOP Stroke Act and the
Community Access to Emergency Defibrillation Act. These bills represent
our next step in the battle against cardiac arrest and stroke and are
critical to increasing access to timely, quality health care.
The first bill we are introducing today focuses attention on stroke,
the third leading cause of death and the leading cause of serious,
long-term disability in the United States, through the implementation
of a prevention and education campaign, the development of the Paul
Coverdell Stroke Registry and Clearinghouse, and the provision of
grants for statewide stroke care systems and for medical professional
development. The untimely death of Senator Paul Coverdell points to the
need to provide more comprehensive stroke care and to learn more about
providing better quality care to the more than 700,000 Americans who
experience a stroke each year. Our first step in doing so is the
introduction of the Stroke Treatment and Ongoing Prevention Act (STOP
Stroke Act).
One of the most significant factors that affects stroke survival
rates is the speed with which one obtains access to health care
services. About 47 percent of stroke deaths occur out of the hospital.
Many patients do not recognize the signs of a stroke and attribute the
common symptoms, such as dizziness, loss of balance, confusion, severe
headache or numbness, to other less severe ailments. To increase
awareness of this public health problem, the Secretary of Health and
Human Services will implement a national, multimedia campaign to
promote stroke prevention and encourage those with the symptoms of
stroke to seek immediate treatment. This crucial legislation also
provides for special programs to target high risk populations. For the
professional community, continuing education grants are included to
train physicians in

[[Page S8470]]

newly-developed diagnostic approaches, technologies, and therapies for
prevention and treatment of stroke. With a more informed public and up-
to-date physicians, our ability to combat the devastating effects of a
stroke will be enhanced.
The Paul Coverdell National Acute Stroke Registry and Clearinghouse,
authorized in the STOP Stroke Act, establish mechanisms for the
collection, analysis, and dissemination of valuable information about
best practices relating to stroke care and the development of stroke
care systems. In order to facilitate the process of implementing
statewide stroke prevention, treatment, and rehabilitation systems that
reflect the research gathered by the Registry and Clearinghouse, grants
will be made available to States that will ensure that stroke patients
have access to quality care.
These legislative efforts have already proved successful. Lives are
being saved. We can do more.
Therefore, we are moving today to expand on these successes by
introducing the Community Access to Emergency Defibrillation Act. This
important legislation will provide $50 million for communities to
establish public access defibrillation programs that will train
emergency medical personnel, purchase AEDs for placement in public
areas, ensure proper maintenance of defibrillators, and evaluate the
effectiveness of the program.
Each year, over 250,000 Americans suffer sudden cardiac arrest.
Sudden cardiac arrest is a common cause of death during which the heart
suddenly stops functioning. Most frequently, cardiac arrest occurs when
the electrical impulses that regulate the heart become rapid,
ventricular tachycardia, or chaotic, ventricular fibrillation, causing
the heart to stop beating altogether. As a result, the individual
collapses, stops breathing and has no pulse. Often, the heart can be
shocked back into a normal rhythm with the aid of a defibrillator. This
is exactly what happened when I resuscitated a patient using
cardiopulmonary resuscitation, CPR, and electrical cardioversion in the
Dirksen Senate Office Building in 1995.
When a person goes into cardiac arrest, time is of the essence.
Without defibrillation, his or her chances of survival decrease by
about 10 percent with every minute that passes. Thus, having an
automated external defibrillator, AED, accessible is not only
important, but also could save lives. AEDs are portable, lightweight,
easy to use, and are becoming an essential part of administering first
aid to victims of sudden cardiac arrest.
We have seen that in places where AEDs are readily available,
survival rates can increase by 20-30 percent. In some settings,
survival rates have even reached 70 percent. Therefore, Congress has
taken several important steps to increase access to AEDs over the past
two Congresses.
In the 105th Congress, I authored the Aviation Medical Assistance
Act. This bill directed the Federal Aviation Administration to decide
whether to require AEDs on aircraft and in airports. As a result of
this law, many airlines now carry AEDs on board, and some airports have
placed AEDs in their terminals. At Chicago O'Hare, just four months
after AEDs were placed in that airport, four victims were resuscitated
using the publicly available AEDs.
In the last Congress, we passed two important bills expanding the
availability of AEDs: the Cardiac Arrest Survival Act and the Rural
Access to Emergency Devices Act. Respectively, these bills address the
placement of automated external defibrillators, AEDs, in Federal
buildings and provide liability protection to persons or organizations
who use AEDs, as well as grants to community partnerships to enable
them to purchase AEDs. The bills also provide defibrillator and basic
life support training.
I am pleased to introduce these important pieces of legislation and I
look forward to their ultimate enactment into law. I want to thank my
colleague, Senator Kennedy, for his work on these life saving
proposals.
Mr. KENNEDY. Mr. President, it is a privilege to join my colleague,
Senator Frist, to introduce the Stroke Treatment and Ongoing Prevention
Act. Stroke is a cruel affliction that takes the lives and blights the
health of millions of Americans. Senator Frist and I have worked
closely on legislation to establish new initiatives to reduce the grim
toll taken by stroke, and I commend him for his leadership. We are
joined in proposing this important legislation by our colleagues on the
Health Committee, Senators Dodd, Hutchinson, Jeffords, Collins,
Bingaman, Edwards, and Murray. The STOP Stroke Act is also supported by
a broad coalition of organizations representing patients and the health
care community.
Stroke is a national tragedy that leaves no American community
unscarred.
Stroke is the third leading cause of death in the United States.
Every minute of every day, somewhere in America, a person suffers a
stroke. Every three minutes, a person dies from one. Strokes take the
lives of nearly 160,000 Americans each year. Even for those who survive
an attack, stroke can have devastating consequences. Over half of all
stroke survivors are left with a disability.
Since few Americans recognize the symptoms of stroke, crucial hours
are often lost before patients receive medical care. The average time
between the onset of symptoms and medical treatment is a shocking 13
hours. Emergency medical technicians are often not taught how to
recognize and manage the symptoms of stroke. Rapid administration of
clot-dissolving drugs can dramatically improve the outcome of stroke,
yet fewer than 3 percent of stroke patients now receive such
medication. If this lifesaving medication were delivered promptly to
all stroke patients, as many as 90,000 Americans could be spared the
disabling aftermath of stroke.
Even in hospitals, stroke patients often do not receive the care that
could save their lives. Treatment of patients by specially trained
health care providers increases survival and reduces disability due to
stroke, but a neurologist is the attending physician for only about one
in ten stroke patients. To save lives, reduce disabilities and improve
the quality of stroke care, the Stroke Treatment and Ongoing
Prevention, STOP Stroke, Act authorizes important public health
initiatives to help patients with symptoms of stroke receive timely and
effective care.
The Act establishes a grant program for States to implement systems
of stroke care that will give health professionals the equipment and
training they need to treat this disorder. The initial point of contact
between a stroke patient and medical care is usually an emergency
medical technician. Grants authorized by the Act may be used to train
emergency medical personnel to provide more effective care to stroke
patients in the crucial first few moments after an attack.
The Act provides important new resources for States to improve the
standard of care given to stroke patients in hospitals. The legislation
will assist States in increasing the quality of stroke care available
in rural hospitals through improvements in telemedicine.
The Act directs the Secretary of Health and Human Services to conduct
a national media campaign to inform the public about the symptoms of
stroke, so that patients receive prompt medical care. The bill also
creates the Paul Coverdell Stroke Registry and Clearinghouse, which
will collect data about the care of stroke patients and assist in the
development of more effective treatments.
Finally, the STOP Stroke Act establishes continuing education
programs for medical professionals in the use of new techniques for the
prevention and treatment of stroke.
These important new initiatives can make a difference in the lives of
the thousands of American who suffer a stroke every year. For patients
experiencing a stroke, even a few minutes' delay in receiving treatment
can make the difference between healthy survival and disability or
death. The Act will help make certain that those precious minutes are
not wasted.
Increased public information on the symptoms of stroke will help
stroke patients and their families know to seek medical care promptly.
Better training of emergency medical personnel will help ensure that
stroke patients receive lifesaving medications when they are most
effective. Improved systems of stroke care will help patients receive
the quality treatment

[[Page S8471]]

needed to save lives and reduce disability.
This legislation can make a real difference to every community in
America, and I urge my colleagues to join Senator Frist and myself in
supporting the STOP Stroke Act.
I ask unanimous consent that additional material and letters of
support relating to this bill be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:

The Stroke Treatment and Ongoing Prevention Act of 2001

background and need for legislation

Stoke is the third leading cause of death in the United
States, claiming the life of one American every three and a
half minutes. Those who survive stroke are often disabled and
have extensive health care needs. The economic cost of stroke
is staggering. The United States spends over $30 billion each
year on caring for persons who have experienced stroke.
Prompt treatment of patients experiencing stroke can save
lives and reduce disability, yet thousands of stroke patients
do not receive proper therapy during the crucial window of
time when it is most effective. Rapid administration of clot-
dissolving drugs can dramatically improve the outcome of
stroke, yet fewer than 3 percent of stroke patients now
receive such medication. Treatment of patients by specially
trained health care providers increases survival and reduces
disability due to stroke, but a neurologist is the attending
physician for only about one in ten stroke patients. Most
Americans cannot identify the signs of stroke and even
emergency medical technicians are often not taught how to
recognize and manage its symptoms. Even in hospitals, stroke
patients often do not receive the care that could save their
lives. To saves lives, reduce disability and improve the
quality of stroke care, the Stroke Treatment and Ongoing
Prevention, STOP Stroke, Act authorizes the following
important public health initiatives.
Stroke prevention and education campaign
The STOP Stroke Act provides $40 million, fiscal year 2002,
for the Secretary to carry out a national, multi-media
awareness campaign to promote stroke prevention and encourage
stroke patients to seek immediate treatment. The campaign
will be tested for effectiveness in targeting populations at
high risk for stroke, including women, senior citizens, and
African-Americans. Alternative campaigns will be designed for
unique communities, including those in the nation's ``Stoke
belt,'' a region with a particularly high rate of stroke
incidence and mortality.
Paul Coverdell Stroke Registry and Clearinghouse
The STOP Stroke Act authorizes the Paul Coverdell Stroke
Registry and Clearinghouse to collect data about the care of
acute stroke patients and foster the development of effective
stroke care systems. The clearinghouse will serve as a
resource for States seeking to design and implement their own
stroke care systems by collecting, analyzing and
disseminating information on the efforts of other communities
to establish similar systems. Special consideration will be
given to the unique needs of rural facilities and those
facilities with inadequate resources for providing quality
services for stroke patients. The Secretary is also
authorized to conduct and support research on stroke care.
Where suitable research has already been conducted, the
Secretary is charged with disseminating this research to
increase its effectiveness in improving stroke care.
Grants for statewide stroke care systems
The Secretary will award grants to States to develop and
implement statewide stroke prevention, treatment, and
rehabilitation systems. These systems must ensure that stroke
patients in the State have access to quality care. The
Secretary is also authorized to award planning grants to
States to assist them in developing statewide stroke care
systems. Each State that receives a grant will: implement
curricula for training emergency medical services personnel
to provide pre-hospital care to stroke patients; curricula
may be modeled after a curriculum developed by the Secretary;
have the option of identifying acute stroke centers,
comprehensive stroke treatment centers, and/or stroke
rehabilitation centers; set standards of care and other
requirements for facilities providing services to stroke
patients; specify procedures to evaluate the statewide stroke
care system; and collect and analyze data from each facility
providing care to stroke patients in the State to improve the
quality of stroke care provided in that State.
The Act authorizes this grant program at $50 million for
fiscal year 2002, $75 million for fiscal years 2003 and 2004,
$100 million for fiscal year 2005, and $125 million for
fiscal year 2006.
Medical professional development
The STOP Stroke Act provides grant authority to the
Secretary for public and non-profit entities to develop and
implement continuing education programs in the use of new
diagnostic approaches, technologies, and therapies for the
prevention and treatment of stroke. Grant recipients must
have a plan for evaluation of activities carried out with the
funding. The Secretary must ensure that any grants awarded
are distributed equitably among the regions of the United
States and between urban and rural populations.
Secretary's role
In addition to carrying out the national education
campaign, operating the clearinghouse and registry, and
awarding grants to States, the Secretary will: develop
standards of care for stroke patients that may be taken into
consideration by States applying for grants; develop a model
curriculum that States may adopt for emergency medical
personnel; develop a model plan for designing and
implementing stroke care systems, taking into consideration
the unique needs of varying communities; report to Congress
on the implementation of the Act in participating States.
In carrying out the STOP Stroke Act, the Secretary will
consult widely with those having expert knowledge of the
needs of patients with stroke.

KEY STROKE FACTS

The devastating effects of stroke
There are roughly 700,000-750,000 strokes in the U.S. each
year.
Stroke is the 3rd leading cause of death in the U.S.
Almost 160,000 Americans die each year from stroke.
Every minute in the U.S., an individual experiences a
stroke. Every 3.3 minutes an individual dies from one.
Over the course of a lifetime, four out of every five
families in the U.S. will be touched by stroke.
Roughly 1/3 of stroke survivors have another one within
five years.
Currently, there are four million Americans living with the
effects of stroke.
15 percent to 30 percent of stroke survivors are
permanently disabled. 55 percent of stroke survivors have
some level of disability.
40 percent of these patients feel they can no longer visit
people; almost 70 percent report that they cannot read; 50
percent need day-hospital services; 40 percent need home
help; 40 percent have a visiting nurse; and 14 percent need
Meals on Wheels.
22 percent of men and 25 percent of women who have an
initial stroke die within one year.
The staggering costs of stroke
Stroke costs the U.S. $30 billion each year.
The average cost per patient for the first 90 days
following a stroke is $15,000.
The lifetime costs of stroke exceed $90,000 per patient for
ischemic stroke and over $225,000 per patient for
subarachnoid hemorrhage.
Improvements can be made
When a stroke unit was first established at Mercy General
Hospital in Sacramento, CA in December of 1990, the average
length of stay for a Medicare stroke patient in the immediate
care setting was 7 days and total hospital charges per
patient were $14,076. By June of 1994, the average length of
stay was 4.6 days and the charges per patient were $10,740.
Overall, in the three and a half years during which the
stroke unit was in operation, Mercy General's charges to
Medicare for stroke patients declined $1,621,296.
In a national survey of acute stroke teams ASTs, Duke
University researchers found that the majority of ASTs cost
only $0-$5,000, far less than the average cost for
hospitalization of stroke patients.

Stroke patients often do not receive effective treatments

Nationally, only 2 percent to 3 percent of patients with
stroke are being treated with the clot-busting drug, tPA.
In the year following FDA approval of tPA, it was
determined that only 1.5 percent of patients who might have
been candidates for tPA therapy actually received it.
In a study of North Carolina's stroke treatment facilities,
66 percent of hospitals did not have stroke protocols and 82
percent did not have rapid identification for patients
experiencing acute stroke.
A recent study of Cleveland, OH found that only 1.8 percent
of area patients with ischemic stroke received tPA.
In a 1995 study of the Reading, Ohio Emergency Medical
Services System EMS, almost half of all stroke patients who
went through the MES system were dispatched as having
something other than stroke and a quarter of all patients
identified as having stroke by paramedics were later
discovered to have another cause for their illness.
Out of 1000 hours of training for paramedics in Cincinnati,
only 1 percent is devoted to recognition and management of
acute stroke.
A 1993 study of patients who had a stroke while they were
inpatient found a median delay between stroke recognition and
neurological evaluation of 2.5 hours.
Neurologists are the attending physicians for only 11
percent of acute stroke patients.

public awareness of stroke symptoms is poor

In a 1989 survey by the American Heart Association of 500
San Francisco residents, 65 percent of those surveyed were
unable to correctly identify any of the early stroke warning
signs when given a list of symptoms.
In a national survey conducted by the American Heart
Association, 29 percent of respondents could not name the
brain as the site of a stroke and only 44 percent identified
weakness or loss of feeling in an arm or leg as a symptom of
stroke.
The International Stroke Trial found that only 4 percent of
the 19,000 patients studied presented within 3 hours of
symptom onset only 16 percent presented within 6 hours.

[[Page S8472]]

tPA facts

A seminal NIH study found an 11 to 13 percent increase in
the number of tPA-treated patients exhibiting minimal or no
neurological deficits or disabilities compared with placebo
treated patients.
That same study reported a 30 to 55 percent relative
improvement in clinical outcome for tPA-treated patients
compared with placebo-treated patients.

NATIONAL ORGANIZATIONS SUPPORTING THE STOP STROKE ACT OF 2001

American Academy of Neurology
American Academy of Physical Medicine and Rehabilitation
American Association of Neurological Surgeons
American College of Chest Physicians
American College of Emergency Physicians
American College of Preventive Medicine
American Heart Association/American Stroke Association
American Physical Therapy Association
American Society of Interventional and Therapeutic
Neuroradiology
American Society of Neuroradiology
Association of American Medical Colleges
Association of State and Territorial Chronic Disease Program
Directors
Association of State and Territorial Directors of Health
Promotion and Public Health Education
Boston Scientific
Brain Injury Association
Congress of Neurological Surgeons
Emergency Nurses Association
Genentech, Inc.
National Association of Public Hospitals and Health Systems
National Stroke Association
North American Society of Pacing and Electrophysiology
Partnership for Prevention
Society of Cardiovascular and Interventional Radiology
Stroke Belt Consortium
The Brain Attack Coalition which is made up of the following
advocacy organizations:
American Academy of Neurology
American Association of Neurological Surgeons
American Association of Neuroscience Nurses
American College of Emergency Physicians
American Heart Association/American Stroke Association
American Society of Neuroradiology
National Stroke Association
Stroke Belt Consortium
____

American Heart Association,

Dallas, TX, July 20, 2001.
Hon. Edward Kennedy,
U.S. Senate,
Washington, DC.
Dear Chairman Kennedy: On behalf of the American Heart
Association, our American Stroke Association division and our
more than 22.5 million volunteers and supporters, thank you
for leading the fight against stroke--the nation's third
leading cause of death.
It has been our privilege to work with you and your staff
to draft the Stroke Treatment and Ongoing Prevention Act
(STOP Stroke Act). This vital legislation will help raise
public awareness about stroke and dramatically improve our
nation's stroke care. More specifically, the legislation will
conduct a national stroke education campaign; provide
critical resources for states to implement statewide stroke
care systems; establish a clearinghouse to support
communities aiming to improve stroke care; offer medical
professional development programs in new stroke therapies;
and conduct valuable stroke care research.
Stroke touches the lives of almost all Americans. Today,
4.5 million Americans are stroke survivors, and as many as 30
percent of them are permanently disabled, requiring extensive
and costly care. In Massachusetts alone, stroke kills more
than 3,300 people every year. Unfortunately, most Americans
know very little about this disease. On average, stroke
patients wait 22 hours after the one set of symptoms before
receiving medical care. In addition, many health are
facilities are not equipped to treat stroke aggressively like
other medical emergencies.
Your legislation helps build upon our successful stroke
programs. In 1998, the American Hearth Association launched a
bold initiative--Operation Stroke--to improve stroke care in
targeted communities across the country by strengthening the
stroke ``Chain of Survival.'' The Chain is a series of events
that must occur to improve stroke care and includes rapid
public recognition and reaction to stroke warning signs;
rapid assessment and pre-hospital care; rapid hospital
transport; and rapid diagnosis and treatment.
The STOP Stroke Act will help ensure that the stroke Chain
of Survival is strong in every community across the nation
and that every stroke patient has access to quality care. We
strongly support this legislation and look forward to
continuing to work with you and Senator Frist to fight this
devastating disease. Thank you again for your leadership and
vision!
Sincerely,
Lawrence B. Sadwin,
Chairman of the Board.
David P. Faxon, M.D.,
President.
____

National Stroke Association,

Englewood, CO, March 8, 2001.
Hon. Edward Kennedy,
Russell Senate Office Building,
Washington, DC.
Dear Senator Kennedy: I am writing on behalf of the
national Stroke Association (NSA) to express our strong
commitment to helping you bring attention to, and secure
passage of, the ``Stroke Treatment and Ongoing Prevention Act
of 2001'' (the ``STOP Stroke Act'').
NSA is a leading independent, national nonprofit
organization which dedicates 100 percent of its resources to
stroke including prevention, treatment, rehabilitation,
research, advocacy and support for stroke survivors and their
families. Our mission is to reduce the incidence and impact
of stroke--the number one cause of adult disability and 3rd
leading cause of death in America.
NSA believes that your proposed legislation is historic--
never before has comprehensive legislation been introduced to
address this misunderstood public health problem. In fact,
stroke has not been given the level of attention, focus or
resources commensurate with the terrible toll it takes on
Americans in both human and economic terms. We are grateful
for your leadership in bringing this issue to the top of the
public health agenda.
The STOP Stroke Act clearly recognizes an urgent need to
build more effective systems of patient care and to increase
public awareness about stroke. We are hopeful that the Stroke
Prevention and Education Campaign which it authorizes will go
a long way toward disseminating the most accurate and timely
information regarding stroke prevention and the importance of
prompt treatment. NSA is encouraged that the state grant
program will facilitate the establishment of a comprehensive
network of stroke centers to reduce the overwhelming
disparity in personnel, technology, and other resources and
target assistance to some of the smaller, less advanced
facilities. We also believe that the research program is a
necessary component of the STOP Stroke Act in order to assess
and monitor barriers to access to stroke prevention,
treatment, and rehabilitation services, and to ultimately
raise the standard of care for those at risk, suffering or
recovering from stroke.
Over the past few months NSA has convened leaders in
medicine, nursing, rehabilitation, healthcare, business, and
advocacy to work with your staff on developing this important
legislation. NSA is pleased to have contributed its ideas and
expertise on this critical health issue. We look forward to
working in partnership with you and your colleagues on
getting the legislation passed by Congress.
Please count on us to work with you in any way possible to
ensure we STOP stroke.
Sincerely,
Patti Shwayder,
Executive Director/CEO.
____

American Association of Neurological Surgeons; Congress
of Neurological Surgeons,
Washington, DC, March 5, 2001.
Hon. Ted Kennedy,
U.S. Senate, Russell Senate Office Building, Washington, DC.
Dear Senator Kennedy: The American Association of
Neurological Surgeons (AANS) and the Congress of Neurological
Surgeons (CNS), representing over 4,500 neurosurgeons in the
United States, thank you for your leadership and vision in
crafting the ``STOP Stroke Act (Stroke Treatment and Ongoing
Prevention Act) of 2001.'' We strongly endorse this bill and
pledge to work with you to ensure its passage. Your
legislation would not only educate the public about the
burden of stroke and stroke-related disability, but would
encourage states to develop stroke planning systems through
the matching grant concept.
Stroke is the nation's third leading cause of death and is
the leading cause of disability in our country creating a
huge human and financial burden associated with this disease.
The advances in research and treatment related to stroke over
the last decade have been truly remarkable. For example,
surgical techniques such as carotid endarterectomy have been
proven effective and saved lives. Also, the discovery of
therapeutic drugs that can be administered within three hours
of the onset of a stroke have allowed many survivors to
recover in a way that was impossible to imagine in even
recent years.
What was once viewed as an untreatable and devastating
disease has the potential to become as commonly treatable as
heart attacks if appropriate resources are directed to the
problem. Senator Kennedy, your legislation will allow all
Americans to take advantage of these rapid advances in stroke
treatment and prevention.
Once again, we strongly endorse this legislation. On behalf
of all neurosurgeons and the patients we serve, thank you for
your leadership on this issue. Please feel free to contact us
should you need further assistance.
Sincerely,
Stewart B. Dunsker, MD,
President, American Association of Neurological Surgeons.
Issam A. Awad, MD,
President, Congress of Neurological Surgeons.

[[Page S8473]]

____
National Association of Public

Hospitals and Health Systems,

Washington, DC, March 22, 2001.
Hon. Edward M. Kennedy,
U.S. Senate,
Washington, DC.
Dear Senator Kennedy: I am writing on behalf of the
National Association of Public Hospitals & Health Systems
(NAPH) to express our support for the ``STOP Stroke Act of
2001,'' legislation to help states improve the level of
stroke care that is offered to patients and to improve public
education about the importance of seeking early emergency
care to combat the effects of stroke.
NAPH represents more than 100 of America's metropolitan
area safety net hospitals and health systems. The mission of
NAPH members is to provide health care services to all
individuals, regardless of insurance status or ability to
pay. More than 54 percent of the patients served by NAPH
systems are either Medicaid recipients or Medicare
beneficiaries; another 28 percent are uninsured.
We applaud your efforts to raise public awareness about the
signs and symptoms of this pernicious disease and to assure
that all Americans--including our nation's poorest and most
vulnerable--have access to state-of-the-art stroke treatment.
In particular, we are pleased that your legislation would:
Establish a grant program to provide funding to states--
with a particular focus on raising the level of stroke
treatment in underserved areas--to assure that all patients
have access to high-quality stroke care;
Ensure that all appropriate medical personnel are provided
access to training in newly developed approaches for
preventing and treating stroke;
Authorize a national public awareness campaign to educate
Americans about the signs and symptoms of stroke and the
importance of seeking emergency treatment as soon as symptoms
occur; and,
Create a comprehensive research program to identify best
practices, barriers to care, health disparities, and to
measure the effectiveness of public awareness efforts.
NAPH has long supported efforts to assure that all
Americans are afforded access to the highest quality health
care services and most current technology that is available.
Indeed, it is critical that facilities that provide acute
care services to stroke patients have the resources necessary
to assure patients access to a minimum standard of stroke
care. Unfortunately, uncompensated care costs and high rates
of uninsured patients often make it difficult for safety net
providers to dedicate sufficient resources to meet these
goals.
We are pleased that your legislation, through its state
grants program, attempts to direct additional resources
toward the providers that are most in need of updating their
stroke care systems. We urge you to consider amending your
legislation to allow local government and safety net
providers to participate directly in this grants program.
Allowing public hospitals and other safety net providers who
seek to improve their stroke care infrastructure to apply for
these grants will go a long way toward assuring that the
providers most in need of these resources get access to them.
As the American population ages and promising discoveries
are being made to improve the early detection and treatment
of stroke, it is becoming increasingly important that
additional resources be directed at stroke awareness,
prevention and treatment programs. And, as federal funds are
provided, it is critical that all of our citizens, in
particular those who frequently slip through the cracks, are
given access to the best available stroke-related
specialists, diagnostic equipment and life-saving treatments
and therapies.
We thank you for your ongoing leadership in developing
legislation to preserve and improve our nation's public
health systems and the healthy care safety net. We look
forward to working with you further to develop solutions to
the problems of our nation's poor and uninsured.
Sincerely,
Larry S. Gage,
President.
____

Partnership for Prevention,

Washington, DC, March 16, 2001.
Re Stroke Treatment and Ongoing Prevention Act of 2001.

Hon. Edward Kennedy,
U.S. Senate, Russell Senate Office Building, Washington, DC.
Dear Senator Kennedy: We commend the introduction of the
Stroke Treatment and Ongoing Prevention Act of 2001 (STOP
Stroke Act). As you well know, stroke is the third leading
cause of death in the United States, a principal cause of
cardiovascular disease death, and a major cause of disability
for Americans.
The STOP Stroke Act creates a framework for the nation to
begin systematically addressing some important tertiary
stroke prevention issues, namely timely diagnosis and
treatment. We concur that much more can and should be done to
ensure stroke patients are treated according to clinical
guidelines based on up-to-date scientific evidence.
Investing in primary and secondary prevention is the best
strategy for stopping stroke. Hypertension is the top
contributor to stroke, followed by heart disease, diabetes,
and cigarette smoking. According to the National Institutes
of Health and the Centers for Disease Control and Prevention
(CDC), prevention of stroke requires addressing the critical
risk factors.
To prevent or delay hypertension, experts at both agencies
recommend community-based interventions that promote healthy
diets, regular physical activity, tobacco cessation, and
limited alcohol intake. The Public Health Service's clinical
guidelines on treating tobacco use and dependence is another
resource to help Americans kick the habit. Lifestyle
modifications for hypertension prevention not only contribute
to overall cardiovascular health, but also reduce risk
factors associated with other chronic diseases (e.g.,
obesity, diabetes, and cancer).
A second essential step is to improve management of
hypertension once it develops. Recent studies indicate
effective hypertension treatment can cut stroke incidence and
fatality rates by at least a third. To advance hypertension
treatment, we must invest in disease management systems that
enable health care providers to prescribe the most effective
therapies and assist patients with pharmacological regimens
and healthy lifestyles.
The main prevention components in the STOP Stroke Act
(i.e., the proposed research program and national stroke
awareness campaign) should be coordinated with--and even
integrated into--the CDc comprehensive cardiovascular disease
program. Involving nearly every state, this program offers an
integrated network that is addressing the underlying causes
of stroke and other cardiovascular diseases.
Partnership welcomes the STOP Stroke Act and its intent to
address stroke, a serious health problem. We also encourage
strengthened primary and secondary prevention policies to
protect health before strokes happen.
Sincerely yours,
Ashley B. Coffield,
President.
____

Brain Attack Coalition,

Bethesda, MD, May 7, 2001.
Hon. Edward M. Kennedy,
U.S. Senate, Russell Senate Office Building, Washington, DC.
Dear Senator Kennedy: The Brain Attack Coalition is a group
of professional, voluntary and governmental organizations
dedicated to reducing the occurrence, disabilities and death
associated with stroke.
Stroke is our nations third leading cause of death and the
leading cause of adult long-term disability. Recent advances
in stroke treatment can lead to improved outcomes if stroke
patients are treated shortly after symptom onset. Currently
only two to three percent of stroke patients who are
candidates for thrombolytic therapy receive it. This must be
remedied.
We urgently need to educate the public about stroke
symptoms and the importance of seeking medical attention
immediately. We also need to provide training to medical
personnel in the new approaches for treating and preventing
stroke. The Stroke Treatment and Ongoing Prevention Act of
2001 (STOP Stroke Act) is designed to address these issues
and to establish a grant program to provide funding to states
to help ensure that stroke patients in each state have access
to high-quality stroke care.
The members of the Brain Attack Coalition strongly support
the STOP Stroke Act and hope for prompt enactment of this
legislation. Please not that the National Institute of
Neurological Disorders and Stroke and the Centers for Disease
Control and Prevention are not included in this endorsement
because the Administration has not taken a position on the
legislation.
Sincerely,
Michael D. Walker, M.D.,
Chair, Brain Attack Coalition.
____

American Physical

Therapy Association,

Alexandria, VA, June 13, 2001.
Hon. Edward Kennedy,
U.S. Senate,
Washington, DC.
Dear Senator Kennedy: I am writing to express the strong
support of the American Physical Therapy Association (APTA)
for the ``Stroke Treatment and Ongoing Prevention Act of
2001,'' which you plan to introduce soon.
As you know, stroke is the third leading cause of death in
the United States, and is one of the leading causes of adult
disability. APTA believes your legislation is critical to
establishing a comprehensive system for stroke prevention,
treatment and rehabilitation in the United States. We
appreciate your modification to the legislation to highlight
the important role physical therapists play in stroke
prevention and rehabilitation.
Every day, physical therapists across the nation help
approximately 1 million people alleviate pain, prevent the
onset and progression of impairment, functional limitation,
disability, or changes in physical function and health status
resulting from injury, disease, or other causes. Essential
participants in the health care delivery system, physical
therapists assume leadership roles in rehabilitation
services, prevention and health maintenance programs. They
also play important roles in developing health care policy
and appropriate standards for the various elements of
physical therapists practice to ensure availability,
accessibility, and excellence in the delivery of physical
therapy services.
Again, thank you for your leadership on this issue. Please
call upon APTA to assist in the passage of this important
legislation.
Sincerely,
Ben F. Massey, PT,
President.

[[Page S8474]]

Mr. KENNEDY. Mr. President, today Senator Frist and I are introducing
the ``Community Access to Emergency Defibrillation Act of 2001.''
Every 2 minutes, sudden cardiac arrest strikes down another person.
Cardiac arrest can strike at any time without any warning. Without
rapid intervention, is unavoidable.
One thousand people will die today from cardiac arrest, and 200,000
people will lose their lives this year to this devastating disease. The
good news is that we know that 90 percent of cardiac arrest victims can
be saved, if immediate access is available to an automated external
defibrillator, an AED.
We could save thousands of lives every year if AEDs are available in
every public building. Yet few communities have programs to make this
technology widely accessible.
That is why Senator Frist and I today are introducing the ``Community
AED Act''. Its goal is to provide funding for programs to increase
access to emergency defibrillation. It will place AEDs in public areas
like schools, workplaces, community centers, and other locations where
people gather. It will provide training to use and maintain the
devices, and funding for coordination with emergency medical personnel.
Furthermore, it also funds the development of community-based
projects to enhance AED access and place them in unique settings where
access is more difficult to achieve. Our bill also emphasizes
monitoring cardiac arrest in children and putting AEDs in schools--so
that we can also deal with cardiac arrest when it affects our youth.
Sudden cardiac arrest is a tragedy for families all across America.
Communities that have already implemented programs to increase public
access to AEDs--like the extremely successful ``First Responder
Defibrillator Program'' in Boston--have been able to achieve survival
rates of up to 50 percent. That's 100,000 lives that we can save each
year if every community implements a program like this one. This bill
will enable communities to save lives in public buildings, in
workplaces, and in schools all across the nation, and I urge you to
stand with Senator Frist and I in support of this legislation--
legislation that will have a lifesaving impact on us all.
I ask unanimous consent that a bill summary for the ``Community
Access to Emergency Defibrillation Act of 2001'' be printed in the
Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:

The Community Access to Emergency Defibrillation Act of 2001

background and Need for Legislation

Cardiac arrest is not a heart attack--it is instant heart
paralysis for which defibrillation is the only effective
treatment. Every minute that passes after a cardiac arrest, a
person's chance of surviving decreases by 10 percent. Cardiac
arrest takes a tremendous toll on the American public; each
year, it kills over 220,000 people.
The good news is that 90 percent of cardiac arrest victims
who are treated with a defibrillator within one minute of
arrest can be saved. In addition, cardiac arrest victims who
are treated with CPR within four minutes and defibrillation
within ten minutes have up to a 40 percent chance of
survival. However, few communities have programs to make
emergency defibrillation widely accessible to cardiac arrest
victims. Communities that have implemented public access
programs have achieved average survival rates for out-of-
hospital cardiac arrest as high as 50 percent.
Automated external defibrillators, AEDs, have a 95 percent
success rate in terminating ventricular fibrillation. Wide
use of defibrillators could save as many as 50,000 lives
nationally each year, yet fewer than half of the nation's
ambulance services, 10-15 percent of emergency service fire
units, and less than 1 percent of police vehicles are
equipped with AEDs.
The Community Access to Emergency Defibrillation, Community
AED Act, provides for the following public health initiatives
to increase public awareness of emergency defibrillation and
to expand public access to lifesaving AEDs:
Community Grants Program to establish comprehensive
initiatives to increase public access to AEDs
The Community AED Act provides $50 million for communities
to establish public access defibrillation programs.
Communities receiving these grants will: train local
emergency medical services personnel to administer immediate
care, including CPR and automated external defibrillation, to
cardiac arrest victims; purchase and place automated external
defibrillators in public places where cardiac arrests are
likely to occur; train personnel in places with
defibrillators to use them properly and administer CPR to
cardiac arrest victims; inform local emergency medical
services personnel, including dispatchers, about the location
of defibrillators in their community; train members of the
public in CPR and automated external defibrillation; ensure
proper maintenance and testing of defibrillators in the
community; encourage private companies in the community to
purchase automated external defibrillators and train
employees in CPR and emergency defibrillation; and collect
data to evaluate the effectiveness of the program in
decreasing the out-of-hospital cardiac arrest survival
rate in the community.
Community demonstration projects to develop innovative AED
access programs
The Community AED Act provides $5 million for community-
based demonstration projects. Grantees will develop
innovative approaches to maximize community access to
automated external defibrillation and provide emergency
defibrillation to cardiac arrest victims in unique settings.
Communities receiving these grants must meet many of the same
requirements for equipment maintenance, public information,
and data collection included in the larger grants program.
National Clearinghouse to promote AED access in schools
The Community AED Act provides for a national information
clearinghouse to provide information to increase public
awareness and promote access to defibrillators in schools.
This center will also establish a database for information on
sudden cardiac arrest in youth and will provide assistance to
communities wishing to develop screening programs for at risk
youth.
The Community AED Act is supported by these and other
leading health care organizations:
American Heart Association; American Red Cross; Agilent
Technologies; American College of Emergency Physicians';
Cardiac Science; Citizen CPR Foundation; Congressional Fire
Services Institute; Medical Device Manufacturers Association;
Medical Research Laboratories, Inc.; Medtronic; MeetingMed:
National Center for Early Defibrillation; National Emergency
Medical Services Academy; National Fire Protection
Association; National SAFE KIDS Compaign; National Volunteer
Fire Council; and Survivalink.
______

By Mr. DOMENICI (for himself and Mr. Bingaman):
S. 1276. A bill to provide for the establishment of a new
counterintelligence polygraph program for the Department of Energy, and
for other purposes; to the Committee on Armed Services.
Mr. DOMENICI. Mr. President, I rise today to introduce a bill that
modifies the requirements for polygraphs at facilities operated by the
Department of Energy. I appreciate that Senator Bingaman joins me as a
co-sponsor.
Polygraph requirements were added by Congress in response to concerns
about security at the national laboratories. A set of mandates was
first created in the Senate Armed Services Authorization Bill for
Fiscal Year 2000, and they were expanded with broader mandates in
Fiscal Year 2001.
Security at the our national security facilities is critically
important, and General Gordon is working diligently as Administrator of
the National Nuclear Security Administration to improve security
through many initiatives. But frankly, I fear that Congress has given
the General a little too much help in this particular area.
The effect of our past legislation was to require polygraphs for very
broad categories of workers in DOE and in our DOE weapons labs and
plants. But the categories specified are really much too broad, some
don't even refer to security-related issues. They include many workers
who have no relevant knowledge or others who may be authorized to enter
nuclear facilities but have no unsupervised access to actual material.
Many of the positions within these categories already require a two-
person rule, precluding actions by any one person to compromise
protected items.
This bill provides flexibility to allow the Secretary of Energy and
General Gordon to set up a new polygraph program. Through careful
examination of the positions with enough sensitivity to warrant
polygraphs, I fully anticipate that the number of employees subject to
polygraphs will be dramatically reduced while actually improving
overall security.
My bill seeks to address other concerns. Polygraphs are simply not
viewed as scientifically credible by Laboratory staff. Those tests have
been the major contributor to substantial degradation in worker morale
at the labs. This is especially serious when the labs and plants are
struggling to cope with the new challenges imposed

[[Page S8475]]

by the absence of nuclear testing and with the need to recruit new
scientific experts to replace an aging workforce.
I should note that these staff concerns are not expressed about drug
testing, which many already must take. They simply are concerned with
entrusting their career to a procedure with questionable, in their
minds, scientific validity.
A study is in progress by the National Academy of Sciences that will
go a long ways toward addressing this question about scientific
credibility of polygraphs when they are used as a tool for screening
large populations. By way of contrast, this use of polygraphs is in
sharp contrast to their use in a targeted criminal investigation. That
Academy's study will be completed in June 2002. Therefore, this bill
sets up an interim program before the Academy's study is done and
requires that a final program be established within 6 months after the
study's completion.
This bill addresses several concerns with the way in which polygraphs
may be administered by the Department. For example, some employees are
concerned that individual privacies, like medical conditions, are not
being protected using the careful procedures developed for drug
testing. And facility managers are concerned that polygraphs are
sometimes administered without enough warning to ensure that work can
continue in a safe manner in the sudden absence of an employee. And of
greatest importance, the bill ensures that the results of a polygraph
will not be the sole factor determining an employee's fitness for duty.
With this bill, we can improve worker morale at our national security
facilities by stopping unnecessarily broad application of polygraphs,
while still providing the Secretary and General Gordon with enough
flexibility to utilize polygraphs where reasonable. In addition, we set
in motion a process, which will be based on the scientific evaluation
of the National Academy, to implement an optimized plan to protect our
national security.
Mr. BINGAMAN. Mr. President, I am pleased to cosponsor legislation
being introduced by Senator Domenici that will help correct what I
consider to be overzealous action on the part of the Congress to
address security problems at our Department of Energy national
laboratories. We're all aware of the security concerns that grew out of
the Wen Ho Lee case. That case, and other incidents that have occurred
since then, quite rightly prompted the Department of Energy and the
Congress to assess security problems at the laboratories and seek
remedies. Last year, during the conference between House and Senate on
the Defense Authorization bill, a provision was added, Section 3135,
that significantly expanded requirements for administering polygraphs
to Department of Energy and contractor employees at the laboratories.
That legislative action presumed that polygraph testing is an
effective, reliable tool to reveal spies or otherwise identify security
risks to our country.
The problem is that the Congress does not have the full story about
polygraph testing. I objected when Section 3135 was included in the
conference mark of the Defense bill last year, but it was too late in
the process to effectively protest its worthiness. It has since become
clear that the provision has had a chilling effect on current and
potential employees at the laboratories in a way that could risk the
future health of the workforce at the laboratories. The laboratory
directors have expressed to me their deep concerns about recruitment
and retention, and I'm certain that the polygraph issue is a
contributing factor. Indeed, I've heard directly from many laboratory
employees who question the viability of polygraphs and who have raised
legitimate questions about its accuracy, reliability, and usefulness.
In response to those questions and concerns, I requested that the
National Academy of Sciences undertake an effort to review the
scientific evidence regarding polygraph testing. Needless to say, there
are many difficult scientific issues to be examined, so the study will
require considerable effort and time. We are expecting results next
June. Once the Congress receives that report, I am hopeful that the
Department of Energy, the National Nuclear Security Administration, and
the national laboratories will be better able to consider the
worthiness of polygraph testing to its intended purposes and determine
whether and how to proceed with a program.
Until that time, however, the Congress has levied a burdensome
requirement on the national laboratories to use polygraph testing
broadly at the laboratories with the negative consequences to which I
have alluded. I believe the legislation that Senator Domenici and I are
introducing today will provide a more balanced, reasoned approach in
the interim until the scientific experts report to the Congress with
their findings on this very complex matter. The bill being introduced
will provide on an interim basis the security protection that many
believe is afforded by polygraphs, but will limit its application to
those Department of Energy and contractor employees at the laboratories
who have access to Restricted Data or Sensitive Compartmented
Information containing the nation's most sensitive nuclear secrets. It
specifically excludes employees who may operate in a classified
environment, but who do not have actual access to the critical security
information we are seeking to protect.
Other provisions in the bill would protect individual rights by
extending guaranteed protections included under part 40 of Title 49 of
the Code of Federal Regulations and by requiring procedures to preclude
adverse personnel action related to ``false positives'' or individual
physiological reactions that may occur during testing. The bill also
seeks to ensure the safe operations of DOE facilities by requiring
advance notice for polygraph exams to enable management to undertake
adjustments necessary to maintain operational safety.
Let me emphasize once again, that this legislation is intended as an
interim measure that will meet three critical objectives until we have
heard from the scientific community. This bill will ensure that
critical secret information will be protected, that the rights of
individual employees will be observed, and that the ability of the
laboratories to do their job will be maintained. I thank Senator
Domenici for his work on this bill, and urge my colleagues to support
its passage. I yield the floor.
______

By Mr. DOMENICI (for himself and Mr. Lugar):
S. 1277. A bill to authorize the Secretary of Energy to guarantee
loans to facilitate nuclear nonproliferation programs and activities of
the Government of the Russian Federation, and for other purposes; to
the Committee on Foreign Relations.
Mr. DOMENICI. Mr. President, I rise to introduce the Fissile Material
Loan Guarantee Act of 2001. This Act is intended to increase the suite
of programs that reduce proliferation threats from the Russian nuclear
weapons complex. I'm pleased that Senator Lugar joins me as a co-
sponsor of this Act.
This Act presents an unusual option, which I've discussed with the
leadership of some of the world's largest private banks and lending
institutions. I also am aware that discussions between Western lending
institutions and the Russian Federation are in progress and that
discussions with the International Atomic Energy Agency or IAEA have
helped to clarify their responsibilities.
This Act would enable the imposition of international protective
safeguards on new, large stocks of Russian weapons-ready materials in a
way that enables the Russian Federation to gain near-term financial
resources from the materials. These materials would be used as
collateral to secure a loan, for which the U.S. Government would
provide a loan guarantee. The Act requires that loan proceeds be used
in either debt retirement for the Russian Federation or in support of
Russian non-proliferation or energy programs. It also requires that the
weapons-grade materials used to collateralize these loans must remain
under international IAEA safeguards forevermore and thus should serve
to remove them from concern as future weapons materials.
This Act does not replace programs that currently are in place to
ensure that weapons-grade materials can never be used in weapons in the
future. Specifically, it does not displace materials already committed
under earlier

[[Page S8476]]

agreements. The Highly Enriched Uranium or HEU Agreement is moving
toward elimination of 500 tons of Russian weapons-grade uranium. The
Plutonium Disposition Agreement is similarly working on elimination of
34 tons of Russian weapons-grade plutonium, primarily by its use in MOX
fuel.
The HEU agreement removes material usable in 20,000 nuclear weapons,
while the plutonium disposition agreement similarly removes material
for more than 4,000 nuclear weapons. Both of these agreements enable
the transition of Russian materials into commercial reactor fuel,
which, after use in a reactor, destroys its ``weapons-grade''
attributes. There should be no question that both these agreements
remain of vital importance to both nations.
But estimates are that the Russian Federation has vast stocks of
weapons-grade materials in addition to the amounts they've already
declared as surplus to their weapons needs in these earlier agreements.
If we can provide additional incentives to Russia to encourage
transition of more of these materials into configurations where it is
not available for diversion or re-use in weapons, we've made another
significant step toward global stability. And furthermore, this
proposed mechanism provides a relatively low cost approach to reduction
of threats from these materials.
Senator Lugar and I introduced a similar bill near the end of the
106th Congress, to provide time for discussion of its features. Those
discussions have progressed, and this bill has some slight refinements
that grew out of those discussions. Since then, we have received
additional assurances that this bill provides a useful route to reduce
proliferation threats, and thus we are reintroducing this bill in the
107th Congress.
Within the last few months, former Senator Howard Baker and former
White House Counsel Lloyd Cutler completed an important report
outlining the importance of the non-proliferation programs accomplished
jointly with Russia. They noted, as their top recommendation, that:

The most urgent unmet national security threat to the
United States today is the danger that weapons of mass
destruction or weapons-usable material in Russia could be
stolen and sold to terrorists or hostile nation states and
used against American troops or citizens at home. This threat
is a clear and present danger to the international community
as well as to American lives and liberties.

This new Act provides another tool toward reducing these threats to
national, as well as global, security.
______

By Mrs. LINCOLN (for herself, Ms. Snowe, Mr. Durbin, Mr. Breaux,
and Ms. Landrieu):
S. 1278. A bill to amend the Internal Revenue Code of 1986 to allow a
United States independent film and television production wage credit;
to the Committee on Finance.
Mrs. LINCOLN. Mr. President, I rise today to introduce the U.S.
Independent Film and Television Production Incentive Act of 2001, a
bill designed to address the problem of ``runaway'' film and television
production. I am joined by Senators Snowe, Durbin, Breaux, and
Landrieu.
Over the past decade, production of American film projects has fled
our borders for foreign locations, migration that results in a massive
loss for the U.S. economy. My legislation will encourage producers to
bring feature film and television production projects to cities and
towns across the United States, thereby stemming that loss.
In recent years, a number of foreign governments have offered tax and
other incentives designed to entice production of U.S. motion pictures
and television programs to their countries. Certain countries, such as
Australia, Canada, New Zealand, and several European countries, have
been particularly successful in luring film projects to their towns and
cities through offers of large tax subsidies.
These governments understand that the benefits of hosting such
productions do not flow only to the film and television industry. These
productions create ripple effects, with revenues and jobs generated in
a variety of other local businesses. Hotels, restaurants, catering
companies, equipment rental facilities, transportation vendors, and
many others benefit from these ripple effects.
What began as a trickle has become a flood, a significant trend
affecting both the film and television industry as well as the smaller
businesses that they support.
Many specialized trades involved in film production and many of the
secondary industries that depend on film production, such as equipment
rental companies, require consistent demand in order to operate
profitably. This production migration has forced many small- and
medium-sized companies out of business during the last ten years.
Earlier this year, a report by the U.S. Department of Commerce
estimated that runaway production drains as much as $10 billion per
year from the U.S. economy.
These losses have been most pronounced in made-for-television movies
and miniseries productions. According to the report, out of the 308
U.S.-developed television movies produced in 1998, 139 were produced
abroad. That's a significant increase from the 30 produced abroad in
1990.
The report makes a compelling case that runaway film and television
production has eroded important segments of a vital American industry.
According to official labor statistics, more than 270,000 jobs in the
U.S. are directly involved in film production. By industry estimates,
70 to 80 percent of these workers are hired at the location where the
production is filmed.
And while people may associate the problem of runaway production with
California, the problem has seriously affected the economies of cities
and States across the country, given that film production and
distribution have been among the highest growth industries in the last
decade. It's an industry with a reach far beyond Hollywood and the west
coast.
For example, my home State of Arkansas has been proud to host the
production of a number of feature and television films, with benefits
both economic and cultural. Our cinematic history includes the opening
scenes of ``Gone With the Wind,'' and civil war epics like ``the Blue
and the Gray'' and ``North and South.'' It also includes ``A Soldier's
Story,'' ``Biloxi Blues,'' ``the Legend of Boggy Creek,'' and, most
recently, ``Sling Blade,'' an independent production written by,
directed by, and starring Arkansas' own Billy Bob Thornton. So even in
our rural State, there is a great deal of local interest and support
for the film industry. My bill will make it possible for us to continue
this tradition, and we hope to encourage more of these projects to come
to Arkansas.
But to do this, we need to level the playing field. This bill will
assist in that effort. It will provide a two-tiered wage tax credit,
equal to 25 percent of the first $25,000 of qualified wages and
salaries and 35 percent of such costs if incurred in a ``low-income
community'', for productions of films, television or cable programming,
mini-series, episodic television, pilots or movies of the week that are
substantially produced in the United States.
This credit is targeted to the segment of the market most vulnerable
to the impact of runaway film and television production. It is,
therefore, only available if total wage costs are more than $20,000 and
less than $10 million (indexed for inflation). The credit is not
available to any production subject to reporting requirements of 18 USC
2257 pertaining to films and certain other media with sexually explicit
conduct.
My legislation enjoys the support of a broad alliance of groups
affected by the loss of U.S. production, including the following:
national, State and local film commissions, under the umbrella
organization Film US as well as the Entertainment Industry Development
Corporation; film and television producers, Academy of Television Arts
and Sciences, the Association of Independent Commercial Producers, the
American Film Marketing Association, the Producers Guild; organizations
representing small businesses such as the post-production facilities,
The Southern California Chapter of the Association of Imaging
Technology and Sound, and equipment rental companies (Production
Equipment Rental Association); and organizations representing the
creative participants in the entertainment industry, Directors Guild of
America, the Screen Actors Guild and Recording Musicians Association.
In addition, the United States Conference

[[Page S8477]]

of Mayors formally adopted the ``Runaway Film Production Resolution''
at their annual conference in June.
Leveling the playing field through targeted tax incentives will keep
film production, and the jobs and revenues it generates, in the United
States. I urge my colleagues to join me in supporting this bill in
order to prevent the further deterioration of one of our most American
of industries and the thousands of jobs and businesses that depend on
it.
______

By Mr. BREAUX:
S. 1279. A bill to amend the Internal Revenue Code of 1986 to modify
the active business definition under section 355; to the Committee on
Finance.
Mr. BREAUX. Mr. President, I rise today to introduce tax legislation
which proposes only a small technical modification of current law, but,
if enacted, would provide significant simplification of routine
corporate reorganizations. The legation is identical to S. 773 which I
introduced on April 13 of last year.
This proposed change is small but very important. It would not alter
the substance of current law in any way. It would, however, greatly
simplify a common corporate transaction. This small technical change
will alone save corporations millions of dollars in unnecessary
expenses and economic costs that are incurred when they divide their
businesses.
Past Treasury Departments have agreed, and I have no reason to
believe the current Treasury Department will feel any differently, that
this change would bring welcome simplification to section 355 of the
Internal Revenue Code. Indeed, the Clinton Administration in its last
budget submission to the Congress had proposed this change. The last
scoring of this proposal showed no loss of revenue to the U.S.
Government, and I am aware of no opposition to its enactment.
Corporations, and affiliated groups of corporations, often find it
advantageous, or even necessary, to separate two or more businesses.
The division of AT&T from its local telephone companies is an example
of such a transaction. The reasons for these corporate divisions are
many, but probably chief among them is the ability of management to
focus on one core business.
At the end of the day, when a corporation divides, the stockholders
simply have the stock of two corporations, instead of one. The Tax Code
recognizes this is not an event that should trigger tax, as it includes
corporate divisions among the tax-free reorganization provisions.
One requirement the Tax Code imposes on corporate divisions is very
awkwardly drafted, however. As a result, an affiliated group of
corporations that wishes to divide must often engage in complex and
burdensome preliminary reorganizations in order to accomplish what, for
a single corporate entity, would be a rather simple and straightforward
spinoff of a business to its shareholders. The small technical change I
propose today would eliminate the need for these unnecessary
transactions, while keeping the statue true to Congress's original
purpose.
More specifically, section 355, and related provision of the Code,
permits a corporation or an affiliated group of corporations to divide
on a tax-free basis into two or more separate entities with separate
businesses. There are numerous requirements for tax-free treatment of a
corporate division, or ``spinoff,'' including continuity of historical
shareholder interest, continuity of the business enterprises, business
purpose, and absence of any device to distribute earning and profits.
In addition, section 355 requires that each of the divided corporate
entities be engaged in the active conduct of a trade or business. The
proposed change would alter none of these substantive requirements of
the Code.
Section 355 (b)(2)(A) currently provides an attribution or ``look
through'' rule for groups of corporations that operate active
businesses under a holding company, which is necessary because a
holding company, by definition, is not itself engaged in an active
business.
This lookthrough rule inexplicably requires, however, that
``substantially all'' of the assets of the holding company consist of
stock of active controlled subsidiaries. The practical effect of this
language is to prevent holding companies from engaging in spinoffs if
they own almost any other assets. This is in sharp contrast to
corporations that operate businesses directly, which can own
substantial assets unrelated to the business and still engage in tax-
free spinoff transactions.
In the real world, of course, holding companies may, for many sound
business reasons, hold other assets, such as non-controlling, less than
80 percent, interests in subsidiaries, controlled subsidiaries that
have been owned for less than five years, which are not considered
``active businesses'' under section 355, or a host of non-business
assets. Such holding companies routinely undertake spinoff
transactions, but because of the awkward language used in section 355
(b)(2)(A), they must first undertake one or more, often a series of,
preliminary reorganizations solely for the purpose of complying with
this inexplicable language of the Code.
Such preliminary reorganizations are at best costly, burdensome, and
without any business purpose, and at worst, they seriously interfere
with business operations. In a few cases, they may be so costly as to
be prohibitive, and cause the company to abandon an otherwise sound
business transaction that is clearly in the best interest of the
corporation and the businesses it operates.
There is no tax policy reasons, tax advisors agree, to require the
reorganization of a consolidated group that is clearly engaged in the
active conduct of a trade or business, as a condition to a spinoff. Nor
is there any reason to treat affiliated groups differently than single
operating companies. Indeed, no one had ever suggested one. The
legislative history indicates Congress was concerned about non-
controlled subsidiaries, which is elsewhere adequately addressed, no
consolidated groups.
For many purposes, the Tax Code treats affiliated groups as a single
corporation. Therefore, the simple remedy I am proposing today for the
problem created by the awkward language of section 355 (b)(2)(A) is to
apply the active business test to an affiliated group as if it were a
single entity.
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. 1279

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

SECTION 1. MODIFICATION OF ACTIVE BUSINESS DEFINITION UNDER
SECTION 355.

(a) In General.--Section 355(b) of the Internal Revenue
Code of 1986 (defining active conduct of a trade or business)
is amended by adding at the end the following new paragraph:
``(3) Special rules relating to active business
requirement.--
``(A) In general.--For purposes of determining whether a
corporation meets the requirement of paragraph (2)(A), all
members of such corporation's separate affiliated group shall
be treated as one corporation. For purposes of the preceding
sentence, a corporation's separate affiliated group is the
affiliated group which would be determined under section
1504(a) if such corporation were the common parent and
section 1504(b) did not apply.
``(B) Control.--For purposes of paragraph (2)(D), all
distributee corporations which are members of the same
affiliated group (as defined in section 1504(a) without
regard to section 1504(b)) shall be treated as one
distributee corporation.''.
(b) Conforming Amendments.--
(1) Subparagraph (A) of section 355(b)(2) of the Internal
Revenue Code of 1986 is amended to read as follows:
``(A) it is engaged in the active conduct of a trade or
business,''.
(2) Section 355(b)(2) of such Code is amended by striking
the last sentence.
(c) Effective Date.--
(1) In general.--The amendments made by this section shall
apply to distributions after the date of the enactment of
this Act.
(2) Transition rule.--The amendments made by this section
shall not apply to any distribution pursuant to a transaction
which is--
(A) made pursuant to an agreement which was binding on such
date and at all times thereafter,
(B) described in a ruling request submitted to the Internal
Revenue Service on or before such date, or
(C) described on or before such date in a public
announcement or in a filing with the Securities and Exchange
Commission.
(3) Election to have amendments apply.--Paragraph (2) shall
not apply if the distributing corporation elects not to have
such paragraph apply to distributions of such corporation.
Any such election, once made, shall be irrevocable.

[[Page S8478]]

______

By Mr. CLELAND:
S. 1280. A bill to authorize the Secretary of Veterans Affairs to
carry out construction projects for the purpose of improving,
renovating, and updating patient care facilities at Department of
Veterans Affairs medical centers; to the Committee on Veterans'
Affairs.
Mr. CLELAND. Mr. President. I am very proud to be a Vietnam veteran
and to have served as director of the Department of Veterans Affairs,
VA, from 1977 to 1980. The VA has continued to provide high quality
health care to our Nation's veterans and is a health care system leader
on patient safety tracking, long-term care, Post-Traumatic Stress
disorder treatment and dozens of other innovative health care programs.
The VA Health Care System has also enhanced its access to veterans with
the development of approximately 600 community-based outpatient
clinics, CBOC's, across the Nation.
But as I visit the VA medical centers in Georgia and across the
Nation, I am very alarmed to see patient care areas which look as if
they have not been renovated or upgraded in decades. These VA medical
centers serve as the hub for all major health care activities and can
not be compromised without affecting veterans' care. The president's
annual budget for the VA has not requested crucial funding for major
medical facility construction. The VA is currently reevaluating their
present VA facility infrastructure needs through a process known as
CARES or the ``Capital Assets Realignment for Enhanced Services.''
Veteran health care and safety may pay the price as this process may
take years to complete. With the increasing numbers of female veterans,
many inpatient rooms and bathrooms continue to be inadequate to provide
needed space and privacy. Many VA facilities, like the VA Spinal Cord
Injury Center in Augusta, Georgia, which serves veterans from Alabama,
Georgia, South Carolina, North Carolina, and Tennessee have long waits
for care. At least 25 VA construction projects across the Nation would
be appropriate for consideration. A Price Waterhouse report recommended
that VA spend from 2 to 4 percent of its plant replacement value, PRV,
on upkeep and replacement of current medical centers. Based on a PRV of
$35 billion, for fiscal year 2001, VA would need approximately $170
million to meet these basic safety and upkeep needs. The VA health care
system is the largest health care provider in the nation, yet we are
not maintaining these essential medical centers. I urge my colleagues
to support the Veterans Hospitals Emergency Repair Act and to provide
the crucial assistance needed now for our veterans. This proposal would
give the VA Secretary limited authority to complete identified medical
facility projects thus helping to preserve the VA health care system
until the CARES process can be completed.
I ask unanimous consent that the text of the bill be printed in the
Record.
There being no objection, bill was ordered to be printed in the
Record, as follows:

S. 1280

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 ``Veterans' Hospital Emergency
Repair Act''.

SEC. 2. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECTS FOR
PATIENT CARE IMPROVEMENTS.

(a) In General.--(1) The Secretary of Veterans Affairs is
authorized to carry out major medical facility projects in
accordance with this section, using funds appropriated for
fiscal year 2002 or fiscal year 2003 pursuant to section 3.
The cost of any such project may not exceed $25,000,000.
(2) Projects carried out under this section are not subject
to section 8104(a)(2) of title 38, United States Code.
(b) Purpose of Projects.--A project carried out pursuant to
subsection (a) may be carried out only at a Department of
Veterans Affairs medical center and only for the purpose of
improving, renovating, and updating to contemporary standards
patient care facilities. In selecting medical centers for
projects under subsection (a), the Secretary shall select
projects to improve, renovate, or update facilities to
achieve one or more of the following:
(1) Seismic protection improvements related to patient
safety.
(2) Fire safety improvements.
(3) Improvements to utility systems and ancillary patient
care facilities.
(4) Improved accommodation for persons with disabilities,
including barrier-free access.
(5) Improvements to facilities carrying out specialized
programs of the Department, including the following:
(A) Blind rehabilitation centers.
(B) Facilities carrying out inpatient and residential
programs for seriously mentally ill veterans, including
mental illness research, education, and clinical centers.
(C) Facilities carrying out residential and rehabilitation
programs for veterans with substance-use disorders.
(D) Facilities carrying out physical medicine and
rehabilitation activities.
(E) Facilities providing long-term care, including
geriatric research, education, and clinical centers, adult
day care centers, and nursing home care facilities.
(F) Facilities providing amputation care, including
facilities for prosthetics, orthotics programs, and sensory
aids.
(G) Spinal cord injury centers.
(H) Facilities carrying out traumatic brain injury
programs.
(I) Facilities carrying out women veterans' health programs
(including particularly programs involving privacy and
accommodation for female patients).
(J) Facilities for hospice and palliative care programs.
(c) Review Process.--(1) Before a project is submitted to
the Secretary with a recommendation that it be approved as a
project to be carried out under the authority of this
section, the project shall be reviewed by an independent
board within the Department of Veterans Affairs constituted
by the Secretary to evaluate capital investment projects. The
board shall review each such project to determine the
project's relevance to the medical care mission of the
Department and whether the project improves, renovates, and
updates patient care facilities of the Department in
accordance with this section.
(2) In selecting projects to be carried out under the
authority of this section, the Secretary shall consider the
recommendations of the board under paragraph (1). In any case
in which the Secretary selects a project to be carried out
under this section that was not recommended for approval by
the board under paragraph (1), the Secretary shall include in
the report of the Secretary under section 4(b) notice of such
selection and the Secretary's reasons for not following the
recommendation of the board with respect to the project.

SEC. 3. AUTHORIZATION OF APPROPRIATIONS.

(a) In General.--There are authorized to be appropriated to
the Secretary of Veterans Affairs for the Construction, Major
Projects, account for projects under section 2--
(1) $250,000,000 for fiscal year 2002; and
(2) $300,000,000 for fiscal year 2003.
(b) Limitation.--Projects may be carried out under section
2 only using funds appropriated pursuant to the authorization
of appropriations in subsection (a).

SEC. 4. REPORTS.

(a) GAO Report.--Not later than April 1, 2003, the
Comptroller General shall submit to the Committees on
Veterans' Affairs and on Appropriations of the Senate and
House of Representatives a report evaluating the advantages
and disadvantages of congressional authorization for projects
of the type described in section 2(b) through general
authorization as provided by section 2(a), rather than
through specific authorization as would otherwise be
applicable under section 8104(a)(2) of title 38, United
States Code. Such report shall include a description of the
actions of the Secretary of Veterans Affairs during fiscal
year 2002 to select and carry out projects under section 2.
(b) Secretary Report.--Not later than 120 days after the
date on which the site for the final project under section 2
is selected, the Secretary shall submit to the committees
referred to in subsection (a) a report on the authorization
process under section 2. The Secretary shall include in the
report the following:
(1) A listing by project of each project selected by the
Secretary under that section, together with a prospectus
description of the purposes of the project, the estimated
cost of the project, and a statement attesting to the review
of the project under section 2(c), and, if that project was
not recommended by the board, the Secretary's justification
under section 2(d) for not following the recommendation of
the board.
(2) An assessment of the utility to the Department of
Veterans Affairs of the authorization process.
(3) Such recommendations as the Secretary considers
appropriate for future congressional policy for
authorizations of major and minor medical facility
construction projects for the Department.
(4) Any other matter that the Secretary considers to be
appropriate with respect to oversight by Congress of capital
facilities projects of the Department.
______

By Mr. HATCH:

S. 1282. A bill to amend the Internal Revenue Code of 1986 to exclude
from gross income of individual taxpayers discharges of indebtedness
attributable to certain forgiven residential mortgages obligations; to
the Committee on Finance.
Mr. HATCH. Mr. President, I rise today to introduce the Mortgage
Cancellation Act of 2001. This bill would fix

[[Page S8479]]

a flaw in the tax code that unfairly harms homeowners who sell their
home at a loss.
Today, our Nation has achieved an amazing 67.5 percent rate of
homeownership, the highest rate in our history. It is notable that in
recent years, the largest category of first-time homebuyers has been
comprised of immigrants and minorities. This is a great success story.
Homeownership is still the most important form of wealth accumulation
in our society.
From time to time, however, the value of housing in a whole market
goes down through no fault of the homeowner. A plant closes,
environmental degradations are found nearby, a regional economic slump
hits hard. This happened during the 1980s in the oil patch and in
Southern California and New England at the beginning of the 1990s. A
general housing market downturn can be devastating to what is very
often a family's largest asset. Unfortunately, a loss in value to the
family home may not be the worst of it. Sometimes when people must sell
their homes during a downturn, they get a nasty surprise from the tax
law.
For example, suppose Keith and Mary Turner purchased a home for
$120,000 with a five percent down payment and a mortgage of $114,000.
Four years later, the local housing market experiences a downturn.
While the market is down, the Turners must sell the home because Keith
was laid off and has accepted a job in another city. The house sells
for $105,000. However, the Turners still owe $112,000 on their
mortgage. They are $7,000 short on what they owe on the mortgage, but
have no equity and received no cash.
Often, homeowners who must sell their home at a loss are able to
negotiate with their mortgage holder to forgive all or part of the
mortgage balance that exceeds the selling price. However, under current
tax law, the amount forgiven is taxable income to the seller, taxed at
ordinary rates.
In the case of the Turner family, the mortgage holder agreed to
forgive the $7,000 excess of the mortgage balance over the sales price.
However, under current law, this means the Turners will have to
recognize this $7,000 as taxable income at a time when they can least
afford it. This is true even though the family suffered a $15,000 loss
on the sale of the home.
I find this predicament both ironic and unfair. If this same family,
under better circumstances, had been able to sell their house for
$150,000 instead of $105,000, then they would owe nothing in tax on the
gain under current tax law because gains on a principal residence are
tax-exempt up to $500,000. I believe that this discrepancy creates a
tax inequity that begs for relief.
It is simply unfair to tax people right at the time they have had a
serious loss and have no cash with which to pay the tax. The bill I
introduce today, the Mortgage Cancellation Relief Act, will relieve
this unfair tax burden so that in the case where the lender forgives
part of the mortgage, there will be no taxable event.
Who are the people that are most vulnerable to this mortgage
forgiveness tax dilemma? Unfortunately, people who have a very small
amount of equity in their homes are most likely to experience this
problem. Today, about 4.6 million households have low equity in their
homes. Of those, about 2 million have no equity in their homes, which
is defined as less than 10 percent of the value of the home. In a
housing value downturn, these people would be wiped out first if they
had to sell.
Sixty-seven percent of these low-equity owners are first-time
homebuyers, and 26 percent of them have less than $30,000 of annual
family income. The median value of their homes is $70,000, while the
median value of all homes nationally is $108,000. More than half of
these low equity owners live in the South or in the West.
I want to emphasize that now is the time to correct this inequity.
Today, the National Association of Realtors reports that there are no
markets that are in the woeful condition of having homes lose value.
Still, in our slowing economy, families are vulnerable. Because today's
real estate market is strong, now is the optimal time to correct this
fundamental unfairness. The bill applies only to the circumstance in
which a lender actually forgives some portion of a mortgage debt and is
not intended to be an insurance policy against economic loss. My bill
provides safeguards against abuse and will help families at a time when
they are most in need of relief.
The estimated revenue effect of this bill is not large. The Joint
Committee on Taxation last year estimated that this correction would
result in a loss to the Treasury of only about $27 million over five
years and $64 million over ten years. Again, it is important to note
that if we wait to correct this problem until it becomes more
widespread, and thus more expensive, it will be much more difficult to
find the necessary offset.
I hope my colleagues will take a close look at this small, but
important, bill, and join me in sponsoring it and pushing for its
inclusion in the next appropriate tax cut bill the Senate considers.
I ask unanimous consent that a copy of the bill be printed in the
Record.
There being no objection, bill was ordered to be printed in the
Record, as follows:

S. 1282

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 ``Mortgage Cancellation Relief
Act of 2001''.

SEC. 2. EXCLUSION FROM GROSS INCOME FOR CERTAIN FORGIVEN
MORTGAGE OBLIGATIONS.

(a) In General.--Paragraph (1) of section 108(a) of the
Internal Revenue Code of 1986 (relating to exclusion from
gross income) is amended by striking ``or'' at the end of
both subparagraphs (A) and (C), by striking the period at the
end of subparagraph (D) and inserting ``, or'', and by
inserting after subparagraph (D) the following new
subparagraph:
``(E) in the case of an individual, the indebtedness
discharged is qualified residential indebtedness.''.
(b) Qualified Residential Indebtedness Shortfall.--Section
108 of the Internal Revenue Code of 1986 (relating to
discharge of indebtedness) is amended by adding at the end
the following new subsection:
``(h) Qualified Residential Indebtedness.--
``(1) Limitations.--The amount excluded under subparagraph
(E) of subsection (a)(1) with respect to any qualified
residential indebtedness shall not exceed the excess (if any)
of--
``(A) the outstanding principal amount of such indebtedness
(immediately before the discharge), over
``(B) the sum of--
``(i) the amount realized from the sale of the real
property securing such indebtedness reduced by the cost of
such sale, and
``(ii) the outstanding principal amount of any other
indebtedness secured by such property.
``(2) Qualified residential indebtedness.--
``(A) In general.--The term `qualified residential
indebtedness' means indebtedness which--
``(i) was incurred or assumed by the taxpayer in connection
with real property used as the principal residence of the
taxpayer (within the meaning of section 121) and is secured
by such real property,
``(ii) is incurred or assumed to acquire, construct,
reconstruct, or substantially improve such real property, and
``(iii) with respect to which such taxpayer makes an
election to have this paragraph apply.
``(B) Refinanced indebtedness.--Such term shall include
indebtedness resulting from the refinancing of indebtedness
under subparagraph (A)(ii), but only to the extent the
refinanced indebtedness does not exceed the amount of the
indebtedness being refinanced.
``(C) Exceptions.--Such term shall not include qualified
farm indebtedness or qualified real property business
indebtedness.''.
(c) Conforming Amendments.--
(1) Paragraph (2) of section 108(a) of the Internal Revenue
Code of 1986 is amended--
(A) in subparagraph (A) by striking ``and (D)'' and
inserting ``(D), and (E)'', and
(B) by amending subparagraph (B) to read as follows:
``(B) Insolvency exclusion takes precedence over qualified
farm exclusion, qualified real property business exclusion,
and qualified residential shortfall exclusion.--Subparagraphs
(C), (D), and (E) of paragraph (1) shall not apply to a
discharge to the extent the taxpayer is insolvent.''.
(2) Paragraph (1) of section 108(b) of such Code is amended
by striking ``or (C)'' and inserting ``(C), or (E)''.
(3) Subsection (c) of section 121 of such Code is amended
by adding at the end the following new paragraph:
``(3) Special rule relating to discharge of indebtedness.--
The amount of gain which (but for this paragraph) would be
excluded from gross income under subsection (a) with respect
to a principal residence shall be reduced by the amount
excluded from gross income under section 108(a)(1)(E) with
respect to such residence.''.

[[Page S8480]]

(d) Effective Date.--The amendments made by this section
shall apply to discharges after the date of the enactment of
this Act.
______

By Mr. KENNEDY (for himself, Mr. Specter, Mr. Jeffords, Mr.
Lieberman, Mr. Daschle, Mr. Akaka, Mr. Baucus, Mr. Bayh, Mr.
Biden, Mr. Bingaman, Mrs. Boxer, Ms. Cantwell, Mr. Carper, Mr.
Chafee, Mr. Cleland, Mrs. Clinton, Mr. Corzine, Mr. Dayton, Mr.
Dodd, Mr. Durbin, Mr. Edwards, Mr. Feingold, Mrs. Feinstein,
Mr. Harkin, Mr. Inouye, Mr. Kerry, Mr. Kohl, Ms. Landrieu, Mr.
Leahy, Mr. Levin, Ms. Mikulski, Mrs. Murray, Mr. Nelson of
Florida, Mr. Reed, Mr. Reid, Mr. Sarbanes, Mr. Schumer, Mr.
Smith of Oregon, Ms. Stabenow, Mr. Torricelli, Mr. Wellstone,
and Mr. Wyden):
S. 1284. A bill to prohibit employment discrimination on the basis of
sexual orientation; to the Committee on Health, Education, Labor, and
Pensions.
Mr. KENNEDY. Mr. President, it's a privilege to introduce the
Employment Non-Discrimination Act.
Civil rights is the unfinished business of the Nation. The Civil
Rights Act of 1964 has long prohibited job discrimination based on
race, ethnic background, gender, or religion. It is long past time to
prohibit such discrimination based on sexual orientation, and that is
what the Employment Non-Discrimination Act will do.
Its provisions are straight-forward and limited. It prohibits
employers from discriminating against individuals because of their
sexual orientation when making decisions about hiring, firing,
promotion and compensation. It does not require employers to provide
domestic partnership benefits, and it does not apply to the armed
forces or to religious organizations. It also prohibits the use of
quotas and preferential treatment.
Too many hard-working Americans are being judged today on their
sexual orientation, rather than their ability and qualifications. For
example, after working at Red Lobster for several years and receiving
excellent reviews, Kendall Hamilton applied for a promotion at the
urging of the general manager who knew he was gay. The application was
rejected after a co-worker disclosed Kendall's sexual orientation to
the management team, and the promotion went instead to an employee of
nine months whom Kendall had trained. Kendall was told that his sexual
orientation ``was not compatible with Red Lobster's belief in family
values,'' and that being gay had destroyed his chances of becoming a
manager. Feeling he had no choice, Kendall left the company.
Fireman Steve Morrison suffered similar discrimination. His co-
workers saw him on the local news protesting an anti-gay initiative,
and incorrectly assumed he was gay. He soon lost workplace
responsibilities and was the victim of harassment, including hate mail.
After lengthy administrative proceedings, he was finally able to have
the false charges removed from his record, but he was transferred to
another station.
The overwhelming majority of Americans oppose this kind of flagrant
discrimination. Businesses of all sizes, labor unions, and a broad
religious coalition all strongly support the Employment Non-
Discrimination Act. America will not achieve its promise of true
justice and equal opportunity for all until we end all forms of
discrimination.
Mr. LIEBERMAN. Mr. President, I am delighted to join with Senators
Kennedy, Specter, Jeffords and many other colleagues as an original
cosponsor of this important legislation, the Employment Non-
Discrimination Act of 2001. By guaranteeing that American workers
cannot lose their jobs simply because of their sexual orientation, this
bill would extend the bedrock American values of fairness and equality
to a group of our fellow citizens who too often have been denied the
benefit of those most basic values.
Two hundred and twenty-five years ago this month, Thomas Jefferson
laid out a vision of America as dedicated to the simple idea that all
of us are created equal, endowed by our Creator with the inalienable
rights to life, liberty and the pursuit of happiness. As Jefferson
knew, our society did not in his time live up to that ideal, but since
his time, we have been trying to. In succeeding generations, we have
worked ever harder to ensure that our society removes unjustified
barriers to individual achievement and that we judge each other solely
on our merits and not on characteristics that are irrelevant to the
task at hand. We are still far from perfect, but we have made much
progress, especially over the past few decades, guaranteeing equality
and fairness to an increasing number of groups that traditionally have
not had the benefits of those values and of those protections. To
African- Americans, to women, to disabled Americans, to religious
minorities and to others we have extended a legally enforceable
guarantee that, with respect to their ability to earn a living at
least, they will be treated on their merits and not on characteristics
unrelated to their ability to do their jobs.
It is time to extend that guarantee to gay men and lesbians, who too
often have been denied the most basic of rights: the right to obtain
and maintain a job. A collection of one national survey and twenty city
and State surveys found that as many as 44 percent of gay, lesbian and
bisexual workers faced job discrimination in the workplace at some time
in their careers. Other studies have reported even greater
discrimination, as much as 68 percent of gay men and lesbians reporting
employment discrimination. The fear in which these workers live was
clear from a survey of gay men and lesbians in Philadelphia. Over
three-quarters told those conducting the survey that they sometimes or
always hide their orientation at work out of fear of discrimination.
The toll this discrimination takes extends far beyond its effect on
the individuals who live without full employment opportunities. It also
takes an unacceptable toll on America's definition of itself as a land
of equality and opportunity, as a place where we judge each other on
our merits, and as a country that teaches its children that anyone can
succeed here as long as they are willing to do their job and work hard.
This bill provides for equality and fairness, that and no more. It
says only what we already have said for women, for people of color and
for others: that you are entitled to have your ability to earn a living
depend only on your ability to do the job and nothing else.
This bill would bring our Nation one large step closer to realizing
the vision that Thomas Jefferson so eloquently expressed 225 years ago
when he wrote that all of us have a right to life, liberty and the
pursuit of happiness. I urge my colleagues to join me in supporting
this important legislation.
Mr. SMITH of Oregon. Mr. President, I rise today to give my support
for the Employment Non Discrimination Act of 2001 or ENDA. I believe
that every American should have the opportunity to work and should not
be denied that opportunity for jobs they are qualified to fill. In both
my private and public life I have hired without regard to sexual
orientation and have found both areas to be enriched by this decision.
ENDA would provide basic protection against job discrimination based
on sexual orientation. Civil Rights progress over the years has slowly
extended protection against discrimination in the workplace based on
race, gender, national origin, age, religion and disability. It is time
now to extend these protections to cover sexual orientation, the next
logical step to achieve equality of opportunity in the workplace.
As a Republican, I do not believe that this discrimination in the
workplace can be categorized as a conservative/liberal issue. Barry
Goldwater once wrote:

I am proud that the Republican Party has always stood for
individual rights and liberties. The positive role of limited
government has always been the defense of these fundamental
principles. Our Party has led the way in the fight for
freedom and a free market economy, a society where
competition and the Constitution matter, and sexual
orientation should not . . .

Indeed my Republican predecessor in this seat, Mark Hatfield was also
a strong supporter of ENDA and viewed discrimination as a serious
societal injustice, in both human and economic terms:

As this Nation turns the corner toward the 21st century,
the global nature of our economy is becoming more and more
apparent. If

[[Page S8481]]

we are to compete in this marketplace, we must break down the
barriers to hiring the most qualified and talented person for
the job. Prejudice is such a barrier. It is intolerable and
irrational for it to color decisions in the workplace.

I believe that ENDA is a well thought-out approach to rectifying
discrimination in the workplace. ENDA contains broad exemptions for
religious organizations, the military and small businesses. It
specifically rules out preferential treatment or ``quotas'' and does
not affect our nation's armed services. I am confident that this bill
will pass this Senate by a bipartisan majority.
ENDA is a simple, narrowly-crafted solution to a significant omission
in our civil rights law. I strongly believe that no one should be
denied employment on the basis of sexual orientation or any other
factor not related to ability to do a particular job. I look forward to
working with my colleagues to pass ENDA and strengthen fundamental
fairness in our society.
______

By Mr. CORZINE:
S. 1285. A bill to provide the President with flexibility to set
strategic nuclear delivery system levels to meet United States national
security goals; to the Committee on Armed Services.
Mr. CORZINE. Mr. President, today I am introducing legislation, the
Strategic Arms Flexibility Act of 2001, that would restore the
President's authority to manage the size of our Nation's nuclear
stockpile by repealing an obsolete law that now prevents him from
reducing the number of nuclear weapons. The Strategic Arms Flexibility
Act of 2001 would reduce the risk of a catastrophic accident or
terrorist incident, reduce tensions throughout the world, and save
substantial taxpayer dollars.
We have far more nuclear weapons than would ever be necessary to win
a war. Based on START counting rules, we have 7,300 strategic nuclear
weapons. Yet, as Secretary of State Colin Powell has said, we could
eliminate more than half of these weapons and still, ``have the
capability to deter any actor.'' Furthermore, the U.S. nuclear arsenal
is equipped with sophisticated guidance and information systems that
make our nuclear weapons much more accurate and effective than those of
our adversaries. This is one reason why we should not be overly
influenced by calls for maintaining strict numerical parity.
While the huge number of nuclear arms in our arsenal is not necessary
to fight a war, maintaining these weapons actually presents significant
risks to national security.
First, it increases the risk of a catastrophic accident. The more
weapons that exist, the greater chance that a sensor failure or other
mechanical problem, or an error in judgment, will lead to the
detonation of a nuclear weapon. In fact, there have been many times
when inaccurate sensor readings or other technical problems have forced
national leaders to decide within minutes whether to launch nuclear
weapons. In one incident, a Russian commander deviated from standard
procedures by refusing to launch, even though an early detection system
was reporting an incoming nuclear attack, a report that was inaccurate.
The second reason why maintaining excessive numbers of nuclear
weapons poses national security risks is that it encourages other
nations to maintain large stockpiles, as well. The more weapons held by
other countries, the greater the risk that a rogue faction in one such
country could gain access to nuclear weapons and either threaten to use
them, actually use them, or transfer them to others. Such a faction
could obtain weapons through force. For example, there are many poorly
guarded intercontinental ballistic missiles that are easy targets for
terrorists. Senator Bob Kerrey, who introduced this legislation in the
last Congress, speculated that a relatively small, well-trained group
could overtake the few personnel who guard some of the smaller
installations in Russia.
Alternatively, a hostile group might be able simply to purchase
ballistic missiles on the black market. This risk may be especially
relevant in Russia, where many military personnel are poorly paid and a
few may feel financial pressure to collaborate with those hostile to
the United States. In addition, some have speculated that the high cost
of maintaining a large nuclear stockpile could encourage some nuclear
powers themselves to sell weapon technologies as a mean of financing
their nuclear infrastructure.
By reducing our own stockpile, we can encourage Russia to reduce its
stockpile and discourage other nuclear states from expanding theirs. In
particular, Russia is faced with the exorbitant annual cost of
maintaining thousands of unnecessary ICBMs. The present state of
Russia's economy leaves it ill-equipped to handle these costs, a fact
readily admitted by Russian Defense Minister Igor Sergeyev. Russia has
expressed an interest in reducing its stockpile dramatically, from
about 6,000 weapons to fewer than 1,000. However, Russia is unlikely to
make such reductions without a commensurate reduction by the United
States. If the United States takes the first step, it would provide
Russia with a face-saving way to do the same, without waiting for START
II, which now appears unlikely to be ratified in the short term.
Beyond the benefits to national security of reducing our nuclear
stockpile, such a reduction also would save taxpayers significant
amounts of money. According to the Center for Defense Information, in
FY 01, the United States spent $26.7 billion on operations,
maintenance, and development related the United States' nuclear
program. Of that $26.7 billion, $12.4 billion, just under half, goes to
build, maintain, and operate our arsenal of tactical and strategic
nuclear weapons. Although a precise cost estimate is not available, it
seems clear that reducing the stockpile of nuclear weapons would
provide major cost savings.
While a reduction in the nuclear stockpile would improve national
security and reduce costs, the 1998 defense authorization act now
prevents the President from reducing such weapons until the Russian
Duma approves the START II treaty. The Bush Administration has made it
clear that it wants this law repealed, and would like the authority to
unilaterally reduce the nuclear stockpile. In hearings before various
Senate Committees, Secretary of Defense Donald Rumsfeld and Deputy
Secretary of Defense Paul Wolfowitz, have expressed the
Administration's desire to retire immediately 50 unnecessary MX
peacekeeper missiles with some 500 warheads. The Administration is
still conducting a more comprehensive review and may well propose
additional reductions. However, as Secretary Wolfowitz has testified,
``we will need the support of the Congress to remove the current
restrictions that prohibit us from getting rid of a nuclear system that
we no longer need.''
Some might question whether it is appropriate to reduce the United
States stockpile without a direct assurance that other nations would
reduce theirs by the same amount. However, this is flawed Cold War
thinking. As Secretary Powell has stated, we have far more weapons than
necessary to devastate any opponent, real or imagined, many times over.
Clearly, we can reduce our stockpile without in any way reducing our
nuclear deterrent, or our national security.
Having said this, reducing the stockpile is not enough. We also need
to encourage and assist others in doing so. In particular, it is
important that we help Russia by providing aid for dismantling weapons
and by offering other economic assistance. We also need to continue to
negotiate arms reductions and non-proliferation agreements with other
countries, including, but not limited to Russia. Unilateral action can
provide many benefits, but we need multilateral agreements to more
fully reduce the nuclear threat, and prevent the spread of nuclear
technology. Ultimately, the nuclear threat is a threat to all of
humanity, and all nations need to be part of a coordinated effort to
reduce that threat.

In recent months, we have renewed a long-standing debate about
whether to deploy a national missile defense. Proponents of such a
system argue that it would reduce the threat posed by nuclear weapons
by giving us the capacity to deflect incoming nuclear weapons. However,
many have raised serious concerns about this approach, and the risk
that it actually could reduce our national security by creating a new
arms race and heightening international tensions.
The bill I am introducing today offers a proven way to reduce the
nuclear

[[Page S8482]]

threat that can be accomplished quickly and without the controversy
associated with a national missile defense system.
There are few issues more important than reducing the risks posed by
nuclear weapons. For the past half century, the world has lived with
these weapons, and it is easy to underestimate the huge threat they
represent. Yet it is critical that we remain vigilant and do everything
in our power to reduce that threat. The fate of the world, quite
literally, is at stake.
I urge my colleagues to support this simple but powerful measure.

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