[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

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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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