[Congressional Record Volume 147, Number 162 (Wednesday, November 28, 2001)]
[Senate]
[Pages S12101-S12109]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mrs. CLINTON (for herself, Ms. Mikulski, Mrs. Feinstein, Mr. 
        Durbin, and Mr. Schumer):
  S. 1737. A bill to provide for homeland security block grants; to the 
Committee on the Judiciary.
  Mrs. CLINTON. Madam President, I rise today to offer a helping hand 
to communities in New York and around the country experiencing fiscal 
distress as they struggle to respond to the heightened security needs 
of our country.
  Although the terrorists responsible for the September 11 attacks 
targeted two of our cities, communities thousands of miles away from 
Ground Zero now find themselves on the front lines in the war against 
terrorism. Since the attacks, towns and cities, both large and small, 
all across America have been overwhelmed by calls about potential 
biological or chemical attacks or threats to infrastructure. Along with 
this new responsibility comes a heavy burden that these communities 
should not be forced to shoulder alone.
  That is why today I am introducing legislation to provide relief to 
State and local governments in their efforts to improve emergency 
response and public safety locally. This Federal aid will ensure that 
local communities will not have to bear the burden of a strong homeland 
defense alone. Tomorrow, mayors from all around New York State will 
meet in New York City to address these very concerns. The legislation 
I'm introducing today, along with my colleagues Senators Feinstein, 
Mikulski, Durbin, and Schumer, will go a long way in helping them and 
communities across the country meet these needs.
  Since the unimaginable acts of terrorism against American civilians 
on U.S. soil that took place a few months ago, we have been forced to 
reevaluate virtually every aspect of our homeland security. One 
immediate change to emerge in post-September 11 America has been that 
local communities are now charged with an enormous responsibility: 
plugging in the gaps in our public safety system and securing our 
homeland defense.
  Our entire country witnessed it on September 11 when hundreds of 
brave men and women in uniform went rushing towards burning buildings 
to save peoples' lives. These courageous individuals were public safety 
officers and emergency response personnel, and, on that day, America 
and its towns and cities were forever changed.
  Mayor Joseph Griffo of Rome, New York described this new phenomenon, 
saying,

       The mayors have become the leaders, the first responders in 
     this new war on terrorism. The police, the firefighters and 
     the emergency personnel are the first responders. We have a 
     role and a responsibility in being more keenly aware of what 
     potentially could happen to our communities.

  Already, towns and cities in New York, and municipalities across the 
country, have seen a glimpse of what homeland security's price tag 
looks like and they are deeply concerned about how they will pay for 
it. Rome Mayor Griffo has said,

       The finances, of providing security, are going to be very 
     difficult. I think it may be tough to recoup all the costs 
     that we've incurred to date. . . . Beyond that, we have to 
     see where we can work in partnership with the feds and the 
     state.

  Bills from skyrocketing police and fire fighter overtime costs are 
saddling many local governments with unanticipated costs. Local law 
enforcement agencies are struggling with expenses from a wide range of 
security needs, including: properly securing major transportation 
infrastructure, like tunnels and bridges; stepping up security at 
facilities that store hazardous materials or drinking water; and 
providing local health personnel with the resources

[[Page S12102]]

and training they need to respond to biological and chemical attacks.
  Mayor Jerry Jennings of Albany, NY, estimates that increased patrols 
at Alcove Reservoir in Coeymans to ensure that the city's water supply 
is adequately protected will probably cost taxpayers $1 million. The 
city of Buffalo, New York, has received 139 terrorist threats since 
September 11. Buffalo Mayor Tony Masiello estimates these additional 
threats will cost the city approximately $700 an hour.
  Although the terrorist attacks of September 11 targeted New York and 
Washington, DC, every single community in our country has been affected 
by the attacks, Baltimore, for example, has incurred nearly $4 million 
in security costs since the September 11 attacks, and city budget 
officials predict that those costs could grow to $15.8 million for the 
fiscal year.
  New Orleans is contending with a $10 million budget gap due to 
security costs for the city and the New Orleans airport. Dallas, 
according to some estimates, has already spent $2 million on security 
and could end up spending $6 million by the end of the year. In 
Massachusetts, Acting Governor Jane Swift has approved $26 million for 
homeland defense related spending, which includes state police 
overtime.
  According to the National Governors' Association, over the next six 
months expenses resulting from the September 11 attacks could end up as 
high as $10 billion in the 50 States, while the National League of 
Cities projects a 4 percent decline in revenues for cities--a projected 
$11.4 billion--from the disastrous effects the attacks have had on 
local employment and tourism.
  These figures point to what mayors have been saying for some time now 
and what I repeated on this floor a few weeks ago after meeting with 
mayors from all over the country: the cost of homeland security is 
causing our cities to bleed dollars.
  Of the 214 cities polled in late October, more than half said that 
they increased spending on security after September 11 and that they 
would have to dip into surpluses and cut programs as a result. It has 
even been reported that some states are considering using their state 
lottery funds to pay for the cost of bolstering local homeland defense 
efforts.
  Our homeland security cannot be left to chance and no city or town in 
America should have to choose between adequately protecting its 
citizens and funding important programs that benefit our children, the 
most vulnerable among us. It's the responsibility of the Federal 
Government to ensure our security and we must not let our cities and 
towns bear the brunt of homeland defense alone.
  These additional fiscal demands come at a time when we are already 
facing a nationwide economic downturn and people are already 
experiencing the pain of this economic uncertainty. Over the next 18 
months, New York State will face an estimated $10 billion shortfall in 
state revenues. To counter some of these pressures and help communities 
recover more quickly from this economic slump, we must provide local 
communities with the resources they need to meet these increased 
demands.
  Under the legislation I am introducing, cities, counties, and towns 
across America will be able to access Federal funds to help make up 
these anticipated revenue shortfalls. The Homeland Security Block Grant 
Act provides $3 billion in funding to communities, with 70 percent 
going directly to more than 1,000 cities and counties across the United 
States. The remaining 30 percent will be funneled to States to direct 
to smaller communities to help them improve security and public safety 
locally.
  Cities with a population of more than 50,000 and that are within 
metropolitan areas and counties within metropolitan areas, regardless 
of the size of the county, will receive funds directly. For example, 
both Syracuse and Onondaga County will be eligible to receive grant 
funds.
  Some of my colleagues have asked whether a small state provision can 
be included in the bill, one that would guarantee that less-populated 
states would receive a minimum level funding. I am very much looking 
forward to working with my colleagues on such a provision to include in 
this bill.
  This legislation gives local communities a lot of flexibility to 
determine how grant funds will be used because local communities are 
most knowledgeable about their security needs. For example, funds can 
be used for overtime expenses for law enforcement, fire, and emergency 
personnel incurred as a result of terrorist threats or to purchase 
personal protective equipment for fire, police, and emergency 
personnel.
  Communities could also use these federal funds to acquire state-of-
the-art technology to improve communication between the first 
responders, based at myriad local agencies, so that they can work 
together closely and efficiently while responding to attacks. In 
addition, funds could also be used to improve security or water 
treatment plants, nuclear power plants, tunnels and bridges, and 
chemical plants.
  Towns and cities may also decide to use the funds to improve the 
communication system used to provide information to the public in a 
timely manner about the facts of any threat and the precautions the 
public should take.
  Finally, to encourage communities to use the homeland security block 
grants effectively, communities will be required to match by 10 percent 
the funds received from the Federal Government. Financially distressed 
communities, however, will receive a waiver from the matching 
requirement.
  I'm proud that this legislation has the support of the International 
Association of Firefighters, the International Association of Fire 
Chiefs, the National Association of Police Organizations, the National 
League of Cities, and U.S. Conference of Mayors.
  Just as our Federal Government pays for defense overseas, it is our 
duty to fund our defense at home. Our homeland defense can only be as 
strong as the weakest link at the State and local level. By providing 
our communities with the resources and tools they need to bolster 
emergency response efforts and provide for other homeland security 
initiatives, we will have a better-prepared home front and a stronger 
America.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1737

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Homeland 
     Security Block Grant Act''.
       (b) Table of Contents.--

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.
Sec. 4. Grants to States, units of general local government and Indian 
              tribes; authorizations.
Sec. 5. Statement of activities and review.
Sec. 6. Activities eligible for assistance.
Sec. 7. Allocation and distribution of funds.
Sec. 8. Nondiscrimination in programs and activities.
Sec. 9. Remedies for noncompliance with requirements.
Sec. 10. Reporting requirements.
Sec. 11. Consultation by Attorney General.
Sec. 12. Interstate agreements or compacts; purposes.
Sec. 13. Matching requirements; suspension of requirements for 
              economically distressed areas.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) In the wake of the September 11, 2001, terrorist 
     attacks on our country, communities all across American now 
     find themselves on the front lines in the war against 
     terrorism on United States soil.
       (2) We recognize that these communities will be forced to 
     shoulder a significant portion of the burden that goes along 
     with that responsibility. We believe that local governments 
     should not have to bear that responsibility alone.
       (3) Our homeland defense will only be as strong as the 
     weakest link at the State and local level. By providing our 
     communities with the resources and tools they need to bolster 
     emergency response efforts and provide for other emergency 
     response initiatives, we will have a better-prepared home 
     front and a stronger America.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Attorney general.--The term ``Attorney General'' means 
     the United States Attorney General.
       (2) City.--The term ``city'' means--
       (A) any unit of general local government that is classified 
     as a municipality by the United States Bureau of the Census; 
     or
       (B) any other unit of general local government that is a 
     town or township and which, in the determination of the 
     Attorney General--
       (i) possesses powers and performs functions comparable to 
     those associated with municipalities;

[[Page S12103]]

       (ii) is closely settled; and
       (iii) contains within its boundaries no incorporated places 
     as defined by the United States Bureau of the Census that 
     have not entered into cooperation agreements with such town 
     or township to undertake or to assist in the performance of 
     homeland security objectives.
       (3) Extent of poverty.--The term ``extent of poverty'' 
     means the number of persons whose incomes are below the 
     poverty level. Poverty levels shall be determined by the 
     Attorney General pursuant to criteria provided by the Office 
     of Management and Budget taking into account and making 
     adjustments, if feasible and appropriate and in the sole 
     discretion of the Attorney General, for regional or area 
     variations in income and cost of living, and shall be based 
     on data referable to the same point or period in time.
       (4) Federal grant-in-aid program.--The term ``Federal 
     grant-in-aid program'' means a program of Federal financial 
     assistance other than loans and other than the assistance 
     provided by this Act.
       (5) Indian tribe.--The term ``Indian tribe'' means any 
     Indian tribe, band, group, and nation, including Alaska 
     Indians, Aleuts, and Eskimos, and any Alaskan Native Village, 
     of the United States, which is considered an eligible 
     recipient under the Indian Self-Determination and Education 
     Assistance Act (Public Law 93-638) or was considered an 
     eligible recipient under chapter 67 of title 31, United 
     States Code, prior to the repeal of such chapter.
       (6) Metropolitan area.--The term ``metropolitan area'' 
     means a standard metropolitan statistical area as established 
     by the Office of Management and Budget.
       (7) Metropolitan city.--The term ``metropolitan city'' 
     means--
       (A) a city within a metropolitan area that is the central 
     city of such area, as defined and used by the Office of 
     Management and Budget; or
       (B) any other city, within a metropolitan area, which has a 
     population of fifty thousand or more.

     Any city that was classified as a metropolitan city for at 
     least 2 years pursuant to the first sentence of this 
     paragraph shall remain classified as a metropolitan city. Any 
     unit of general local government that becomes eligible to be 
     classified as a metropolitan city, and was not classified as 
     a metropolitan city in the immediately preceding fiscal year, 
     may, upon submission of written notification to the Attorney 
     General, defer its classification as a metropolitan city for 
     all purposes under this Act, if it elects to have its 
     population included in an urban county under subsection (d). 
     Notwithstanding the second sentence of this paragraph, a city 
     may elect not to retain its classification as a metropolitan 
     city. Any unit of general local government that was 
     classified as a metropolitan city in any year, may, upon 
     submission of written notification to the Attorney General, 
     relinquish such classification for all purposes under this 
     Act if it elects to have its population included with the 
     population of a county for purposes of qualifying for 
     assistance (for such following fiscal year) under section 
     5(e) as an urban county.
       (8) Non-qualifying community.--The term ``nonqualifying 
     community'' means an area that is not a metropolitan city or 
     part of an urban county and does not include Indian tribes.
       (9) Population.--The term ``population'' means total 
     resident population based on data compiled by the United 
     States Bureau of the Census and referable to the same point 
     or period of time.
       (10) State.--The term ``State'' means any State of the 
     United States, or any instrumentality thereof approved by the 
     Governor; and the Commonwealth of Puerto Rico.
       (11) Unit of general local government.--The term ``unit of 
     general local government'' means any city, county, town, 
     township, parish, village, or other general purpose political 
     subdivision of a State; a combination of such political 
     subdivisions is recognized by the Secretary; and the District 
     of Columbia.
       (12) Urban county.--The term ``urban county'' means any 
     county within a metropolitan area.
       (b) Basis and Modification of Definitions.--Where 
     appropriate, the definitions in subsection (a) shall be 
     based, with respect to any fiscal year, 0on the most recent 
     data compiled by the United States Bureau of the Census and 
     the latest published reports of the Office of Management and 
     Budget available ninety days prior to the beginning of such 
     fiscal year. The Attorney General may by regulation change or 
     otherwise modify the meaning of the terms defined in 
     subsection (a) in order to reflect any technical change or 
     modification thereof made subsequent to such date by the 
     United States Bureau of the Census or the Office of 
     Management and Budget.
       (c) Designation of Public Agencies.--One or more public 
     agencies, including existing local public agencies, may be 
     designated by the chief executive officer of a State or a 
     unit of general local government to undertake activities 
     assisted under this Act.
       (d) Local Governments, Inclusion in Urban County 
     Population.--With respect to program years beginning with the 
     program year for which grants are made available from amounts 
     appropriated for fiscal year 2002 under section 4, the 
     population of any unit of general local government which is 
     included in that of an urban county as provided in subsection 
     (a)(6) shall be included in the population of such urban 
     county for three program years beginning with the program 
     year in which its population was first so included and shall 
     not otherwise be eligible for a grant as a separate entity, 
     unless the urban county does not receive a grant for any year 
     during such three-year period.
       (e) Urban County.--Any county seeking qualification as an 
     urban county, including any urban county seeking to continue 
     such qualification, shall notify, as provided in this 
     subsection, each unit of general local government, which is 
     included therein and is eligible to elect to have its 
     population excluded from that of an urban county, of its 
     opportunity to make such an election. Such notification 
     shall, at a time and in a manner prescribed by the Attorney 
     General, be provided so as to provide a reasonable period for 
     response prior to the period for which such qualification is 
     sought. The population of any unit of general local 
     government which is provided such notification and which does 
     not inform, at a time and in a manner prescribed by the 
     Attorney General, the county of its election to exclude its 
     population from that of the county shall, if the county 
     qualifies as an urban county, be included in the population 
     of such urban county as provided in subsection (d).

     SEC. 4. GRANTS TO STATES, UNITS OF GENERAL LOCAL GOVERNMENT 
                   AND INDIAN TRIBES; AUTHORIZATIONS.

       The Attorney General is authorized to make grants to 
     States, units of general local government, and Indian tribes 
     to carry out activities in accordance with the provisions of 
     this Act. For purposes of assistance under section 7, there 
     is authorized to be appropriated $3,000,000,000 in fiscal 
     year 2002, and such additional sums as are authorized 
     thereafter.

     SEC. 5. STATEMENT OF ACTIVITIES AND REVIEW.

       (a) Application.--Prior to the receipt in any fiscal year 
     of a grant under section 7(b) by any metropolitan city or 
     urban county, under section 7(d) by any State, or under 
     section 7(d)(2) by any unit of general local government, the 
     grantee shall have indicated its interest in receiving funds 
     by preparing a statement of homeland security objectives and 
     projected use of funds and shall have provided the Attorney 
     General with the certifications required in subsection (b) 
     and, where appropriate, subsection (c). In the case of 
     metropolitan cities and urban counties receiving grants 
     pursuant to section 7(b) and in the case of units of general 
     local government receiving grants pursuant to section 
     7(d)(2), the statement of projected use of funds shall 
     consist of proposed homeland security activities. In the case 
     of States receiving grants pursuant to section 7(d), the 
     statement of projected use of funds shall consist of the 
     method by which the States will distribute funds to units of 
     general local government. In preparing the statement, the 
     grantee shall consider any view of appropriate law 
     enforcement, and emergency response authorities and may, if 
     deemed appropriate by the grantee, modify the proposed 
     statement. A copy of the final statement shall be furnished 
     to the Attorney General and the Office of Homeland Security 
     together with the certifications required under subsection 
     (b) and, where appropriate, subsection (c). Any final 
     statement of activities may be modified or amended from time 
     to time by the grantee in accordance with the same procedures 
     required in this paragraph for the preparation and submission 
     of such statement.
       (b) Certification of Enumerated Criteria by Grantee to 
     Secretary.--Any grant under section 7 shall be made only if 
     the grantee certifies to the satisfaction of the Attorney 
     General that--
       (1) it has developed a homeland security plan pursuant to 
     section 5 that identifies both short- and long-term homeland 
     security needs that have been developed in accordance with 
     the primary objective and requirements of this Act; and
       (2) the grantee will comply with the other provisions of 
     this Act and with other applicable laws.
       (c) Submission of Annual Performance Reports, Audits and 
     Adjustments.--
       (1) In general.--Each grantee shall submit to the Attorney 
     General, at a time determined by the Attorney General, a 
     performance and evaluation report concerning the use of funds 
     made available under section 7, together with an assessment 
     by the grantee of the relationship of such use to the 
     objectives identified in the grantee's statement under 
     subsection (a). The Attorney General shall encourage and 
     assist national associations of grantees eligible under 
     section 7, national associations of States, and national 
     associations of units of general local government in 
     nonqualifying areas to develop and recommend to the Attorney 
     General, within 1 year after the effective date of this 
     sentence, uniform recordkeeping, performance reporting, 
     evaluation reporting, and auditing requirements for such 
     grantees, States, and units of general local government, 
     respectively. Based on the Attorney General's approval of 
     these recommendations, the Attorney General shall establish 
     such requirements for use by such grantees, States, and units 
     of general local government.
       (2) Reviews and audits.--The Attorney General shall, at 
     least on an annual basis, make such reviews and audits as may 
     be necessary or appropriate to determine--
       (A) in the case of grants made under section 7(b), whether 
     the grantee has carried out its activities and, where 
     applicable, whether the grantee has carried out those 
     activities and its certifications in accordance with the 
     requirements and the primary

[[Page S12104]]

     objectives of this Act and with other applicable laws, and 
     whether the grantee has a continuing capacity to carry out 
     those activities in a timely manner; and
       (B) in the case of grants to States made under section 
     7(d), whether the State has distributed funds to units of 
     general local government in a timely manner and in 
     conformance to the method of distribution described in its 
     statement, whether the State has carried out its 
     certifications in compliance with the requirements of this 
     Act and other applicable laws, and whether the State has made 
     such reviews and audits of the units of general local 
     government as may be necessary or appropriate to determine 
     whether they have satisfied the applicable performance 
     criteria described in subparagraph (A).
       (3) Adjustments.--The Attorney General may make appropriate 
     adjustments in the amount of the annual grants in accordance 
     with the Attorney General's findings under this subsection. 
     With respect to assistance made available to units of general 
     local government under section 7(d), the Attorney General may 
     adjust, reduce, or withdraw such assistance, or take other 
     action as appropriate in accordance with the Attorney 
     General's reviews and audits under this subsection, except 
     that funds already expended on eligible activities under this 
     Act shall not be recaptured or deducted from future 
     assistance to such units of general local government.
       (d) Audits.--Insofar as they relate to funds provided under 
     this Act, the financial transactions of recipients of such 
     funds may be audited by the General Accounting Office under 
     such rules and regulations as may be prescribed by the 
     Comptroller General of the United States. The representatives 
     of the General Accounting Office shall have access to all 
     books, accounts, records, reports, files, and other papers, 
     things, or property belonging to or in use by such recipients 
     pertaining to such financial transactions and necessary to 
     facilitate the audit.
       (e) Metropolitan City as Part of Urban County.--In any case 
     in which a metropolitan city is located, in whole or in part, 
     within an urban county, the Attorney General may, upon the 
     joint request of such city and county, approve the inclusion 
     of the metropolitan city as part of the urban county for 
     purposes of submitting a statement under section 5 and 
     carrying out activities under this Act.

     SEC. 6. ACTIVITIES ELIGIBLE FOR ASSISTANCE.

       Activities assisted under this Act may include only--
       (1) funding additional law enforcement, fire, and emergency 
     resources, including covering overtime expenses;
       (2) purchasing and refurbishing personal protective 
     equipment for fire, police, and emergency personnel and 
     acquire state-of-the-art technology to improve communication 
     and streamline efforts;
       (3) improving cyber and infrastructure security by 
     improving--
       (A) security for water treatment plants, distribution 
     systems, and other water infrastructure; nuclear power plants 
     and other power infrastructure;
       (B) tunnels and bridges;
       (C) oil and gas pipelines and storage facilities; and
       (D) chemical plants and transportation of hazardous 
     substances;
       (4) assisting Local Emergency Planning Committees so that 
     local public agencies can design, review, and improve 
     disaster response systems;
       (5) assisting communities in coordinating their efforts and 
     sharing information with all relevant agencies involved in 
     responding to terrorist attacks;
       (6) establishing timely notification systems that enable 
     communities to communicate with each other when a threat 
     emerges;
       (7) improving communication systems to provide information 
     to the public in a timely manner about the facts of any 
     threat and the precautions the public should take; and
       (8) devising a homeland security plan, including 
     determining long-term goals and short-term objectives, 
     evaluating the progress of the plan, and carrying out the 
     management, coordination, and monitoring of activities 
     necessary for effective planning implementation.

     SEC. 7. ALLOCATION AND DISTRIBUTION OF FUNDS.

       (a) Allocation and Distribution of Funds; Set-Aside for 
     Indian Tribes.--
       (1) Allocation.--For each fiscal year, of the amount 
     approved in an appropriation Act under section 4 for grants 
     in a year (excluding the amounts provided for use in 
     accordance with section 6), the Attorney General shall 
     reserve for grants to Indian tribes 1 percent of the amount 
     appropriated under such section. The Attorney General shall 
     provide for distribution of amounts under this paragraph to 
     Indian tribes on the basis of a competition conducted 
     pursuant to specific criteria for the selection of Indian 
     tribes to receive such amounts. The criteria shall be 
     contained in a regulation promulgated by the Attorney General 
     after notice and public comment.
       (2) Remaining allocation.--Of the amount remaining after 
     allocations pursuant to paragraph (1), 70 percent shall be 
     allocated by the Attorney General to metropolitan cities and 
     urban counties. Except as otherwise specifically authorized, 
     each metropolitan city and urban county shall be entitled to 
     an annual grant, to the extent authorized beyond fiscal year 
     2002, from such allocation in an amount not exceeding its 
     basic amount computed pursuant to paragraph (1) or (2) of 
     subsection (b).
       (b) Computation of Amount Allocated to Metropolitan Cities 
     and Urban Counties.--
       (1) In general.--The Attorney General shall determine the 
     amount to be allocated to each metropolitan city based on the 
     population of that metropolitan city.
       (2) Urban counties.--The Attorney General shall determine 
     the amount to be allocated to each urban county based on the 
     population of that urban county.
       (3) Exclusions.--In computing amounts or exclusions under 
     this section with respect to any urban county, there shall be 
     excluded units of general local government located in the 
     county the populations that are not counted in determining 
     the eligibility of the urban county to receive a grant under 
     this subsection, except that there shall be included any 
     independent city (as defined by the Bureau of the Census) 
     which--
       (A) is not part of any county;
       (B) is not eligible for a grant pursuant to subsection 
     (b)(1);
       (C) is contiguous to the urban county;
       (D) has entered into cooperation agreements with the urban 
     county which provide that the urban county is to undertake or 
     to assist in the undertaking of essential community 
     development and housing assistance activities with respect to 
     such independent city; and
       (E) is not included as a part of any other unit of general 
     local government for purposes of this section.

     Any independent city that is included in any fiscal year for 
     purposes of computing amounts pursuant to the preceding 
     sentence shall not be eligible to receive assistance under 
     subsection (d) with respect to such fiscal year.
       (4) Inclusions.--In computing amounts under this section 
     with respect to any urban county, there shall be included all 
     of the area of any unit of local government which is part of, 
     but is not located entirely within the boundaries of, such 
     urban county if the part of such unit of local government 
     which is within the boundaries of such urban county would 
     otherwise be included in computing the amount for such urban 
     county under this section, and if the part of such unit of 
     local government that is not within the boundaries of such 
     urban county is not included as a part of any other unit of 
     local government for the purpose of this section. Any amount 
     received by such urban county under this section may be used 
     with respect to the part of such unit of local government 
     that is outside the boundaries of such urban county.
       (5)Population.--(A) Where data are available, the amount 
     determined under paragraph (1) for a metropolitan city that 
     has been formed by the consolidation of one or more 
     metropolitan cities with an urban county shall be equal to 
     the sum of the amounts that would have been determined under 
     paragraph (1) for the metropolitan city or cities and the 
     balance of the consolidated government, if such consolidation 
     had not occurred. This paragraph shall apply only to any 
     consolidation that--
       (i) included all metropolitan cities that received grants 
     under this section for the fiscal year preceding such 
     consolidation and that were located within the urban county;
       (ii) included the entire urban county that received a grant 
     under this section for the fiscal year preceding such 
     consolidation; and
       (iii) took place on or after January 1, 2002.
       (B) The population growth rate of all metropolitan cities 
     referred to in section 3 shall be based on the population 
     of--
       (i) metropolitan cities other than consolidated governments 
     the grant for which is determined under this paragraph; and
       (ii) cities that were metropolitan cities before their 
     incorporation into consolidated governments. For purposes of 
     calculating the entitlement share for the balance of the 
     consolidated government under this paragraph, the entire 
     balance shall be considered to have been an urban county.
       (c) Reallocation.--
       (1) In general.--Except as provided in paragraph (2), any 
     amounts allocated to a metropolitan city or an urban county 
     pursuant to the preceding provisions of this section that are 
     not received by the city or county for a fiscal year because 
     of failure to meet the requirements of subsections (a) and 
     (b) of section 5, or that otherwise became available, shall 
     be reallocated in the succeeding fiscal year to the other 
     metropolitan cities and urban counties in the same 
     metropolitan area that certify to the satisfaction of the 
     Attorney General that they would be adversely affected by the 
     loss of such amounts from the metropolitan area. The amount 
     of the share of funds reallocated under this paragraph for 
     any metropolitan city or urban county shall bear the same 
     ratio to the total of such reallocated funds in the 
     metropolitan area as the amount of funds awarded to the city 
     or county for the fiscal year in which the reallocated funds 
     become available bears to the total amount of funds awarded 
     to all metropolitan cities and urban counties in the same 
     metropolitan area for that fiscal year.
       (2) Transfer.--Notwithstanding the provisions of paragraph 
     (1), the Attorney General may upon request transfer 
     responsibility to any metropolitan city for the 
     administration of any amounts received, but not obligated, by 
     the urban county in which such city is located if--
       (A) such city was an included unit of general local 
     government in such county prior

[[Page S12105]]

     to the qualification of such city as a metropolitan city;
       (B) such amounts were designated and received by such 
     county for use in such city prior to the qualification of 
     such city as a metropolitan city; and
       (C) such city and county agree to such transfer of 
     responsibility for the administration of such amounts.
       (d) Allocation to States on Behalf of Non-qualifying 
     Communities.--
       (1) In general.--Of the amount approved in an appropriation 
     Act under section 4 that remains after allocations pursuant 
     to paragraphs (1) and (2) of subsection (a), 30 percent shall 
     be allocated among the States for use in nonqualifying areas. 
     The allocation for each State shall be based on the 
     population of that State, factoring in the population of 
     qualifying communities in that State, and the population of 
     qualifying communities of all States. The Attorney General 
     shall, in order to compensate for the discrepancy between the 
     total of the amounts to be allocated under this paragraph and 
     the total of the amounts available under such paragraph, make 
     a pro rata reduction of each amount allocated to the 
     nonqualifying communities in each State under such paragraph 
     so that the nonqualifying communities in each State will 
     receive an amount that represents the same percentage of the 
     total amount available under such paragraph as the percentage 
     which the nonqualifying areas of the same State would have 
     received under such paragraph if the total amount available 
     under such paragraph had equaled the total amount which was 
     allocated under such paragraph.
       (2) Distribution.--(A) Amounts allocated under paragraph 
     (1) shall be distributed to units of general local government 
     located in nonqualifying areas of the State to carry out 
     activities in accordance with the provisions of this Act--
       (i) by a State that has elected, in such manner and at such 
     time as the Attorney General shall prescribe, to distribute 
     such amounts consistent with the statement submitted under 
     section 5(a); or
       (ii) by the Attorney General, in any case described in 
     subparagraph (B), for use by units of general local 
     government in accordance with paragraph (3)(B).
       (B) The Attorney General shall distribute amounts allocated 
     under paragraph (1) if the State has not elected to 
     distribute such amounts.
       (C) To receive and distribute amounts allocated under 
     paragraph (1), the State must certify that it, with respect 
     to units of general local government in nonqualifying areas--
       (i) provides or will provide technical assistance to units 
     of general local government in connection with homeland 
     security initiatives;
       (ii) will not refuse to distribute such amounts to any unit 
     of general local government on the basis of the particular 
     eligible activity selected by such unit of general local 
     government to meet its homeland security objectives, except 
     that this clause may not be considered to prevent a State 
     from establishing priorities in distributing such amounts on 
     the basis of the activities selected; and
       (iii) has consulted with local elected officials from among 
     units of general local government located in nonqualifying 
     areas of that State in determining the method of distribution 
     of funds required by subparagraph (A).
       (D) To receive and distribute amounts allocated under 
     paragraph (1), the State shall certify that each unit of 
     general local government to be distributed funds will be 
     required to identify its homeland security objectives, and 
     the activities to be undertaken to meet such objectives.
       (3) Administration.-- (A) If the State receives and 
     distributes such amounts, it shall be responsible for the 
     administration of funds so distributed. The State shall pay 
     from its own resources all administrative expenses incurred 
     by the State in carrying out its responsibilities under this 
     Act, except that from the amounts received for distribution 
     in nonqualifying areas, the State may deduct an amount to 
     cover such expenses and its administrative expenses not to 
     exceed the sum of $150,000 plus 50 percent of any such 
     expenses under this Act in excess of $150,000. Amounts 
     deducted in excess of $150,000 shall not exceed 2 percent of 
     the amount so received.
       (B) If the Attorney General distributes such amounts, the 
     distribution shall be made in accordance with determinations 
     of the Attorney General pursuant to statements submitted and 
     the other requirements of section 5 (other than subsection 
     (c)) and in accordance with regulations and procedures 
     prescribed by the Attorney General.
       (C) Any amounts allocated for use in a State under 
     paragraph (1) that are not received by the State for any 
     fiscal year because of failure to meet the requirements of 
     subsection (a) or (b) of section 5 shall be added to amounts 
     allocated to all States under paragraph (1) for the 
     succeeding fiscal year.
       (D) Any amounts allocated for use in a State under 
     paragraph (1) that become available as a result of the 
     closeout of a grant made by the Attorney General under this 
     section in nonqualifying areas of the State shall be added to 
     amounts allocated to the State under paragraph (1) for the 
     fiscal year in which the amounts become so available.
       (4) Single unit.--Any combination of units of general local 
     governments may not be required to obtain recognition by the 
     Attorney General pursuant to section 3(2) to be treated as a 
     single unit of general local government for purposes of this 
     subsection.
       (5) Deduction.--From the amounts received under paragraph 
     (1) for distribution in nonqualifying areas, the State may 
     deduct an amount, not to exceed 1 percent of the amount so 
     received, to provide technical assistance to local 
     governments.
       (6) Applicability.--Any activities conducted with amounts 
     received by a unit of general local government under this 
     subsection shall be subject to the applicable provisions of 
     this Act and other Federal law in the same manner and to the 
     same extent as activities conducted with amounts received by 
     a unit of general local government under subsection (a).
       (e) Qualifications and Determinations.--The Attorney 
     General may fix such qualification or submission dates as he 
     determines are necessary to permit the computations and 
     determinations required by this section to be made in a 
     timely manner, and all such computations and determinations 
     shall be final and conclusive.
       (f) Pro Rata Reduction and Increase.--If the total amount 
     available for distribution in any fiscal year to metropolitan 
     cities and urban counties under this section is insufficient 
     to provide the amounts to which metropolitan cities and urban 
     counties would be entitled under subsection (b), and funds 
     are not otherwise appropriated to meet the deficiency, the 
     Attorney General shall meet the deficiency through a pro rata 
     reduction of all amounts determined under subsection (b). If 
     the total amount available for distribution in any fiscal 
     year to metropolitan cities and urban counties under this 
     section exceeds the amounts to which metropolitan cities and 
     urban counties would be entitled under subsection (b), the 
     Attorney General shall distribute the excess through a pro 
     rata increase of all amounts determined under subsection (b).

     SEC. 8. NONDISCRIMINATION IN PROGRAMS AND ACTIVITIES.

       No person in the United States shall on the ground of race, 
     color, national origin, religion, or sex be excluded from 
     participation in, be denied the benefits of, or be subjected 
     to discrimination under any program or activity funded in 
     whole or in part with funds made available under this Act. 
     Any prohibition against discrimination on the basis of age 
     under the Age Discrimination Act of 1975 (42 U.S.C. 6101 et 
     seq.) or with respect to an otherwise qualified handicapped 
     individual as provided in section 504 of the Rehabilitation 
     Act of 1973 (29 U.S.C. 794) shall also apply to any such 
     program or activity.

     SEC. 9. REMEDIES FOR NONCOMPLIANCE WITH REQUIREMENTS.

       If the Attorney General finds after reasonable notice and 
     opportunity for hearing that a recipient of assistance under 
     this Act has failed to comply substantially with any 
     provision of this Act, the Attorney General, until he is 
     satisfied that there is no longer any such failure to comply, 
     shall--
       (1) terminate payments to the recipient under this Act;
       (2) reduce payments to the recipient under this Act by an 
     amount equal to the amount of such payments which were not 
     expended in accordance with this Act; or
       (3) limit the availability of payments under this Act to 
     programs, projects, or activities not affected by such 
     failure to comply.

     SEC. 10. REPORTING REQUIREMENTS.

       (a) In General.--Not later than 180 days after the close of 
     each fiscal year in which assistance under this Act is 
     furnished, the Attorney General shall submit to Congress a 
     report which shall contain--
       (1) a description of the progress made in accomplishing the 
     objectives of this Act;
       (2) a summary of the use of such funds during the preceding 
     fiscal year; and
       (3) a description of the activities carried out under 
     section 7.
       (b) Reports to the Attorney General.--The Attorney General 
     is authorized to require recipients of assistance under this 
     Act to submit to him such reports and other information as 
     may be necessary in order for the Attorney General to make 
     the report required by subsection (a).

     SEC. 11. CONSULTATION BY ATTORNEY GENERAL.

       In carrying out the provisions of this Act including the 
     issuance of regulations, the Attorney General shall consult 
     with the Office of Homeland Security and other Federal 
     departments and agencies administering Federal grant-in-aid 
     programs.

     SEC. 12. INTERSTATE AGREEMENTS OR COMPACTS; PURPOSES.

       The consent of the Congress is hereby given to any two or 
     more States to enter into agreements or compacts, not in 
     conflict with any law of the United States, for cooperative 
     effort and mutual assistance in support of homeland security 
     planning and programs carried out under this Act as they 
     pertain to interstate areas and to localities within such 
     States, and to establish such agencies, joint or otherwise, 
     as they may deem desirable for making such agreements and 
     compacts effective.

     SEC. 13. MATCHING REQUIREMENTS; SUSPENSION OF REQUIREMENTS 
                   FOR ECONOMICALLY DISTRESSED AREAS.

       (a) Requirement.--Grant recipients shall contribute from 
     funds, other than those received under this Act, 10 percent 
     of the total funds received under this Act. Such funds shall 
     be used in accordance with the grantee's statement of 
     homeland security objectives.

[[Page S12106]]

       (b) Economic Distress.--Grant recipients that are deemed 
     economically distressed shall be waived from the matching 
     requirement set forth in this section.
                                 ______
                                 
      By Mr. KERRY (for himself, Mr. Murkowski, Mr. Baucus, Mr. 
        Grassley, Mr. Jeffords, Mr. Thompson, Mr. Breaux, Mr. 
        Hutchinson, Mr. Daschle, Mr. Craig, Mr. Bingaman, Mr. Inhofe, 
        Mrs. Lincoln, Mr. Hollings, Mrs. Murray, Mr. Carper, Mr. 
        Johnson, and Mr. Hatch):
  S. 1738. A bill to amend title XVIII of the Social Security Act to 
provide regulatory relief appeals process reforms, contracting 
flexibility, and education improvements under the Medicare Program, and 
for other purposes; to the Committee on Finance.
  Mr. KERRY. Madam President, I am pleased to join my colleagues 
Senators Murkowski, Baucus and Grassley in introducing the Medicare 
Appeals, Regulatory and Contracting Improvement Act, MARCIA. This 
legislation will give health care providers relief from unnecessary and 
burdensome government regulations that threaten to interfere with the 
delivery of health care to our nation's Medicare beneficiaries.
  Medicare provides health care coverage for over 40 million senior and 
disabled Americans, relying on thousands of health care providers, 
including doctors, nurses, hospitals, nursing homes, home care 
agencies, and hospices, to deliver services, and more than fifty 
private health insurance companies to process millions of claims. While 
this public-private partnership forms the linchpin of the Medicare 
program, it is not as strong as it could be.
  Health care providers rightfully complain that Medicare has become 
too complex, with changes to claims payment systems made so frequently 
that they can not keep up. Today, Medicare providers are subjected to 
over 100,000 pages of regulations that are continuously being modified. 
Many providers complain that they have less time to spend on patient 
care because they are spending more time trying to understand how to 
comply with massive amounts of paperwork and constantly evolving 
regulatory requirements.
  The current Medicare appeals process is also problematic. It takes 
far too long to appeal an incorrect Medicare decision, often taking 
several years to complete. This system, coupled with some of the 
tactics used by the Federal Government and its contractors in 
collecting Medicare overpayments, leaves providers feeling frustrated, 
confused, and besieged. Regulations necessary to ensuring the integrity 
and efficiency of the Medicare program must be maintained and enforced, 
however, the occasionally aggressive means through which these 
regulations are administered has discouraged many providers from 
wanting to participate in the Medicare program.
  The Medicare Appeals, Regulatory and Contracting Improvement Act, 
MARCIA, will strengthen the Medicare public-private partnership. The 
bill has five primary components. First, it relieves burdens on 
beneficiaries and providers by requiring the Centers for Medicare and 
Medicaid Services, CMS, to issue new rules and policies in an orderly 
and reasonable manner. Second, it provides new appeals protections for 
all Medicare fee-for-service providers and beneficiaries. Third, it 
allows CMS to use competition to select the best available 
administrative contractors to serve beneficiaries and providers. 
Fourth, it requires Medicare contractors and CMS to place a greater 
emphasis on provider education and outreach. Finally, it makes the 
Medicare overpayment collection and extrapolation process more fair. 
The bill accomplishes all of these objectives without undermining the 
False Claims Act or other Medicare fraud recovery efforts, and I urge 
my colleagues to join with me to secure its passage.
  Mr. MURKOWSKI. Madam President, right now, all across America, 
Medicare beneficiaries are seeking medical care from a flawed health 
care system. Reduced benefit packages, ever escalating costs, and 
limited access in rural areas are just a few of the problems our system 
faces on a daily basis. For these reasons, Congress must continue to 
move towards the modernization of Medicare. But as we address the needs 
of beneficiaries, we must not turn our back upon the very providers 
that seniors rely upon for their care.
  Who are providers? They are the physicians, the hospitals, the 
nursing homes, and others who deliver quality care to our needy 
Medicare population. They are the backbone of our complex health care 
network. When our Nation's seniors need care, it is the provider who 
heals, not the health insurer--and certainly not the federal 
government.
  But more, and more often, seniors are being told by providers that 
they don't accept Medicare. This is becoming even more common in rural 
areas, where the number of physicians is limited and access to quality 
care is extremely restricted. Quite simply, beneficiaries are being 
told that their insurance is simply not wanted. Why? Well it's not as 
simple as low reimbursement rates. In fact it's much more complex.
  The infrastructure that manages the Medicare program, the Centers for 
Medicare and Medicaid Services, CMS, and its network of contractors, 
are working with a system that was designed to block care and micro-
manage independent practices. Providers simply cannot afford to keep up 
with the seemingly endless number of complex, redundant, and 
unnecessary regulations. And if providers do participate? Well, a 
simple administrative error in submitting a claim could subject them to 
heavy-handed audits and the financial devastation of their practice. 
Should we force providers to choose between protecting their practice 
and caring for seniors?
  I believe the answer is no. For this reason, I am pleased to 
introduce the ``Medicare Appeals, Regulatory and Contracting 
Improvements Act of 2001.'' I am joined by my colleagues Senator Kerry, 
Senator Baucus, and Senator Grassley. This legislation is a bipartisan 
compromise, based upon legislation I offered earlier this year. It will 
allow providers to practice medicine without fearing the threats, 
intimidation, and aggressive tactics of a faceless bureaucratic 
machine.
  Most importantly, this bill will reform the flawed appeals process 
within CMS. Currently, a provider who allegedly has received an 
overpayment is forced to choose between three options: admit the 
overpayment, submit additional information to mitigate the charge, or 
appeal the decision. However, providers who choose to submit additional 
evidence must subject their entire practice to review and waive their 
appeal rights. That's right, to submit additional evidence you must 
waive your right to an appeal!
  And what is the result of this maddening system that runs contrary to 
our Nation's history of fair and just administrative decisions? Often, 
providers are intimidated into accepting the arbitrary decision of an 
auditor employed by a CMS contractor. Sometimes, they are even forced 
to pull out of the Medicare program. In the end, our senior population 
suffers.
  To bring additional fairness to the system, the bill provides new 
appeal protections for all Medicare fee-for-service providers and 
beneficiaries. It also requires the Medicare administrative contractors 
and CMS to place a greater emphasis on provider education and outreach. 
And most importantly, it reforms the Medicare overpayment collection 
and extrapolation process. All of this is accomplished without 
undermining the False Claims Act or current Medicare fraud enforcement 
efforts.
  It is with the goal of protecting our Medicare population, and the 
providers who tend care, that leads us to introduce this bipartisan 
compromise. This bill will ensure that providers are treated with the 
respect that they deserve, and that Medicare beneficiaries aren't told 
that their health insurance isn't wanted. We owe it to our nation's 
seniors. I urge immediate action on this worthy bill.
  Mr. BAUCUS. Madam President, I rise today as a cosponsor of the 
Medicare Appeals, Regulatory and Contracting Improvements Act of 2001.
  Medicare is one of the Federal Government's greatest successes. It 
provides health care for nearly 40 million seniors and disabled 
beneficiaries. Medicare is often considered the gold-standard of health 
insurance programs around the nation and the world. And it has lifted 
millions of individuals out of poverty since its enactment in 1965.
  Medicare's success is due to its public-private partnership, which is 
the

[[Page S12107]]

foundation of the program. While Medicare is almost entirely federally 
financed, it relies on thousands of private hospitals, private 
physicians, and other health care providers and suppliers to deliver 
health care services. Moreover, it relies on more than 50 private 
health insurance companies to process millions of claims every year.
  Every so often Congress needs to evaluate this public-private 
partnership to see how its working. And this past year, Senator Kerry, 
Senator Murkowski, Senator Grassley, and I have undertaken this 
evaluation.
  I have heard from hundreds of health care providers who have levied 
legitimate complaints about the operation of Medicare. They argue that 
Medicare has become too complex. Changes to the claims payment systems 
are made every day, and health care organization simply cannot keep up. 
This is especially true for small rural hospitals and other health care 
providers in my state of Montana. They do not have the staff to stay 
abreast of the constant changes to the Medicare payment systems.
  I have also heard from providers about the current Medicare appeals 
process. The Medicare appeals process is broken. It takes too long to 
appeal an incorrect Medicare decision. Providers often have to file 
lengthy and expensive appeals, sometimes taking several years to 
settle.
  And finally, I have heard from health care providers about the 
aggressive tactics that are sometimes used by Federal Government and 
its contractors in collecting Medicare overpayments. Medicare needs to 
realize that mistakes happen, especially with this very complex 
program. When providers make honest mistakes, they should be treated as 
mistakes, not criminal fraud.
  Earlier this year, my colleagues Senators Kerry and Murkowski 
introduced a version of this bill, the ``Medicare Education and 
Regulatory Fairness Act of 2001.'' I commend Senators Kerry and 
Murkowski for their hard work on this bill; it made a very important 
contribution to our understanding of this issue and the need for 
reform. However, I had some concerns with their original bill, namely 
that it unintentionally created some new loopholes for truly dishonest 
providers to commit fraud.
  Rather than oppose their bill, I asked my staff along with Senator 
Grassley's staff to work with Senator Kerry and Senator Murkowki's 
office to redraft their bill to address some of my concerns. And I am 
proud to say that we have developed a bill that everyone can support.
  The Medicare Appeals, Regulatory and Contracting Improvements Act of 
2001 will make necessary and overdue improvements to the Medicare 
public-private partnership. The bill does five things. First, it 
improves the CMS rule-making process, for example, by requiring CMS to 
publish its regulations on one business day of each month. Second, It 
provides new appeal protections for all Medicare fee-for-service 
providers and beneficiaries. Third, it grants new competitive 
administrative contracting authority to CMS. Fourth, it requires the 
Medicare administrative contractors and CMS to place a greater emphasis 
on provider education and outreach. And fifth, it reforms the Medicare 
overpayment collection and extrapolation process.
  The bill accomplishes all five of these important objectives without 
undermining the False Claims Act of current Medicare fraud enforcement 
efforts. We have received assurances from the Department of Justice, 
the HHS Office of Inspector General, and the CMS that this is so.
  This is a good bill, a bill that will receive the support of provider 
groups and the support of the Federal agencies that oversee the 
Medicare program.
  While this bill is primarily focused on health care provider issues, 
I agree with my colleagues in the Senate and House that Congress also 
needs to ensure that beneficiaries are able to navigate and understand 
Medicare. I commend current efforts in the House to include provisions 
that would guarantee that beneficiaries have the right to find out 
whether Medicare services are covered before they become financially 
liable for them. Currently, when a doctor informs a patient that a 
service may not be covered by Medicare, the patient has no way to 
verify if this is the case. I will work to include these provisions in 
any enacted legislation.
  I commend my colleagues Senator Kerry, Senator Murkowski, and Senator 
Grassley for their commitment and their hard work on this bill. As 
chairman of the Finance Committee, I remain committed to quick 
consideration of this bill in my committee. I urge all of my colleagues 
to support it.
  Mr. CRAIG. Madam President, I am pleased to join today as an original 
cosponsor of the Medicare Appeals, Regulatory and Contracting 
Improvements Act, MARCIA. This legislation represents a clear and 
useful first step toward serious reform of the way Medicare does 
business with America's health care professionals and Medicare 
beneficiaries.
  I have heard from literally hundreds of doctors, hospitals, and other 
health care professionals in Idaho about the truly appalling paperwork 
and regulatory burdens imposed by the Medicare program, and even more 
troubling, about how these mounting regulatory burdens are causing many 
doctors to limit their participation in Medicare or to leave the 
program altogether.
  Also, as ranking member on the Senate's Special Committee on Aging, I 
have made examination of Medicare's paperwork and provider enforcement 
systems a key priority. In July, our committee held the first of what I 
hope may be a series of hearings looking into these problems, and this 
fall, members of my Aging Committee staff traveled across Idaho, 
talking with more than 60 Idaho providers about their concerns with 
Medicare.
  Most recently, I was pleased to have Tom Scully, the energetic and 
thoughtful new administrator of the Centers for Medicare and Medicaid 
Services, CMS, join me in Boise to talk about Medicare with Idaho 
health professionals and senior citizens. We heard a great deal of 
frustration, and not a little anger.
  At the same time, it was very clear to me that Tom Scully and the 
Bush administration are serious about tackling Medicare's many 
shortcomings. Indeed, Tom Scully and the administration have worked 
closely with Congress to help develop the legislation we are 
introducing today.
  Today, the number of pages of Medicare rules and regulations is 
now more than 110,000, approximately three times that of Federal tax 
laws and regulations. Moreover, for every hour spent on Medicare 
patient care in outpatient settings, doctors and their staffs now spend 
approximately 36 minutes on Medicare-related paperwork. And in hospital 
emergency care settings, that ratio is now 1 hour of paperwork for 
every 1 hour of patient care.

  These problems are genuinely daunting, and today's legislation is not 
a panacea. Rather, it is a promising beginning in what I hope will be 
an ongoing cooperative effort to make Medicare more responsive, more 
rational, and more efficient.
  Finally, let me be crystal clear: We must continue to devote 
significant resources to combating fraud and abuse in the Medicare 
program. Those who violate the public trust must be punished to the 
fullest extent of the law, and this legislation would in no way 
undercut these critical efforts.
  Rather, this bill would relieve complex and unreasonable burdens on 
providers and beneficiaries by requiring CMS to issue new rules in an 
orderly and reasonable manner, and would provide new appeal protections 
for many Medicare providers and beneficiaries. Further, this 
legislation would require CMS to use competition to select the best 
administrative contractors, and it would require CMS and its 
contractors to place greater emphasis on provider education and 
outreach. In addition, the bill would implement needed improvements in 
the way Medicare oversees alleged provider overpayments, principally by 
reforming current Medicare overpayment collection and extrapolation 
processes.
  I am pleased to join my colleagues in sponsoring this much needed 
legislation, and I look forward to continuing progress on these 
important issues in the coming year.
                                 ______
                                 
      By Mr. CLELAND:
  S. 1739. A bill to authorize grants to improve security on over-the-
road buses; to the Committee on Commerce, Science, and Transportation.
  Mr. CLELAND. Madam President, I rise today to introduce a bill to 
help

[[Page S12108]]

secure an often overlooked mode of passenger transportation, intercity 
buses.
  In the wake of the current challenge to our Nation's security, it is 
the duty of Congress to ensure that all modes of passenger 
transportation, especially mass transportation vehicles including 
buses, are safe and secure. Already, buses have been assaulted, and 
innocent passengers have died. While these attacks have not so far been 
directly linked to the tragic events of September 11, I believe 
Congress would be negligent if we do not act on this issue while we 
have this opportunity. Additionally, in many cities, bus terminals 
share facilities with rail and/or air terminals. The Congress has 
addressed airport security and the Senate is working on rail security, 
but this work will not be complete without securing the third 
component. Therefore, I urge my colleagues to support my legislation to 
accomplish this goal.
  Clearly, bus service, which transports almost 800 million passengers 
annually, deserves Congress's attention. For many people throughout the 
country, motorcoaches are the only viable means of transportation. 
Greyhound, the largest carrier, and its interline partners serve over 
4,000 communities, roughly 8 times more than either the airlines or 
Amtrak. Many of the other bus companies that serve these communities 
are small businesses with fewer than ten motorcoaches, and these 
businesses, in particular, are more affected by the decrease in 
passenger demand due to concerns over safety. While many of these 
companies have already spent their own funds to upgrade security, they 
need help to finish the job so that people will feel comfortable 
returning to bus travel.
  One of the main elements of my legislation provides grants for the 
installation of adequate communications equipment to alert law 
enforcement personnel if there is an onboard problem. Not only would an 
alarm be sounded to law enforcement but also current technology would 
be employed to report the precise location of the bus in question. 
Speedy deployment to deal with problems as they are happening could 
save lives. The Commercial Vehicle Safety Alliance, CVSA, an 
association of State, provincial and Federal law enforcement officials, 
believes that improved communication capability is among the top goals 
to improve the safety and security of passenger buses.
  The legislation also will provide grants for research into methods to 
protect the drivers. Some of the recent security incidents involve 
compromising the safety of the driver. We must find out what options 
are available to protect and secure the drivers so that a bus can be 
stopped safely if there are problems. Additionally, these grants can be 
used to maintain the integrity of bus terminals, facilities, and 
coaches, and conduct passenger screening, among other things.
  This legislation also dedicates $3-5 million annually in funding to 
the Secretary of Transportation to evaluate and coordinate current 
public and private efforts to improve bus security and safety by 
establishing ``best practices,'' including efforts to isolate the 
driver and to detect potential chemical and biological elements. 
Portions of this funding could also be used to support additional 
research and development initiatives, and the recommendations developed 
could be applied to both over-the-road and transit buses.
  This funding is not a government ``handout'' to an industry that has 
not been acting on its own to improve its facilities, but rather it 
will supplement ongoing efforts. Since September 11, Greyhound has 
spent at least $5 million on enhanced security. Steps taken include 
screening of passengers and baggage at selected terminals; requiring 
ticket identification; providing cell phones to drivers as an interim 
emergency communications system; increasing security personnel in 
terminals; prohibiting passengers from sitting in the first row of 
seats behind the driver, and establishing information and 
communications systems to aid and coordinate with law enforcement. My 
legislation would supplement and expand these initial efforts and 
assist with implementing these measures at additional terminals.
  My legislation also provides needed assistance to an industry that is 
struggling along with other segments of the travel and tourism sector. 
After the October 3 Nashville accident that resulted in 7 passenger 
fatalities, Greyhound's passenger sales dropped 15 percent and remain 
well below last year's levels. According to a survey conducted by the 
Travel Business Roundtable, intercity bus transportation is the only 
mode of transportation that dropped in ``safety perception'' when 
compared with air, auto, rail, and cruise travel. Incorporating the new 
security costs, which are necessary to bring passengers back, while 
revenue is down, will make it difficult for bus companies to maintain 
current service levels. This Federal support will allow bus companies 
to dedicate resources to continuing service to smaller communities 
rather than reducing schedules to cut costs.
  Additionally, this legislation instructs the Department of Labor to 
ensure that grants under this section are certified in an expeditious 
manner in accordance with its guidelines for processing grants to bus 
operators. As provided for under the Department's existing guidelines, 
previously certified arrangements for assistance to intercity bus 
operators applicable to applicants for security improvement grants, 
shall be the basis for processing such grants by the Department. The 
Secretary of Transportation will have the discretion to administer this 
program directly or through a security administration that may be 
established at the Department of Transportation.
  This bus security legislation is supported by the American Bus 
Association, Greyhound, the Commercial Vehicle Safety Alliance, Coach 
USA, and the Amalgamated Transit Union. Protecting bus passengers is a 
vital part of ensuring a vibrant transportation industry, and it is the 
third component to the safe passenger transportation equation. I urge 
my Senate colleagues, all of whom have many communities in your state 
served by intercity buses, to support this legislation.
  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. 1739

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

     SECTION 1. EMERGENCY OVER-THE-ROAD BUS SECURITY ASSISTANCE.

       (a) In General.--Subchapter I of chapter 311 of title 49, 
     United States Code, is amended by adding at the end the 
     following:

     ``Sec.  31109. Over-the-road bus security grant program

       ``(a) In General.--
       ``(1) Fund established.--The Secretary of the Treasury 
     shall establish an Over-the-road Bus Security Fund account in 
     the Treasury into which the Secretary of the Transportation 
     shall deposit amounts appropriated under paragraph (2).
       ``(2) Authorization of appropriations.--There are 
     authorized to be appropriated to the Secretary of 
     Transportation $200,000,000 for fiscal year 2002, and 
     $200,000,000 for fiscal year 2003, for deposit into the 
     account established under paragraph (1). Amounts deposited 
     into the account shall remain available until expended.
       ``(b) Grant Program.--Without further appropriation, 
     amounts in the Over-the-road Bus Security Fund account are 
     available to the Secretary of Transportation for direct 
     grants to persons engaged in the business of providing over-
     the-road bus transportation for system-wide security 
     upgrades, including the reimbursement of extraordinary 
     security-related costs determined by the Secretary to have 
     been incurred by such operators since September 11, 2001, 
     including--
       ``(1) establishing an emergency communications and 
     notification system linked to law enforcement or emergency 
     response personnel;
       ``(2) protecting or isolating the driver;
       ``(3) implementing and operating passenger screening 
     programs at terminals and on over-the-road buses (as defined 
     in section 3038(a)(3) of the Transportation Equity Act for 
     the 21st Century (49 U.S.C. 5310 nt));
       ``(4) acquiring, upgrading, installing, or operating 
     equipment, software, or accessorial services for collection, 
     storage, or exchange of passenger and driver information 
     through ticketing systems or otherwise, and information links 
     with government agencies;
       ``(5) constructing or modifying terminals, garages, 
     facilities, or over-the-road buses to assure their security;
       ``(6) training employees in recognizing and responding to 
     terrorist threats, evacuation procedures, passenger screening 
     procedures, and baggage inspection;
       ``(7) hiring and training security officers;
       ``(8) installing cameras and video surveillance equipment 
     on over-the-road buses and at terminals, garages and over-
     the-road bus facilities; and

[[Page S12109]]

       ``(9) creating a program for employee identification and 
     background investigation.
       ``(c) Applications.--To receive a grant under subsection 
     (b), an applicant shall submit an application, at such time, 
     in such manner, in such form, and containing such 
     information, as the Secretary may require, and a plan that 
     meets the requirements of subsection (c) for the project to 
     be funded, in whole or in part, by the grant.
       ``(d) Plan Required.--The Secretary may not make a grant 
     under subsection (b) for a system-wide security upgrade 
     project until the applicant has submitted to the Secretary, 
     and the Secretary has approved, a plan for the project, and 
     the applicant has submitted to the Secretary such additional 
     information as the Secretary may require in order to ensure 
     full accountability for the obligation or expenditure of 
     grant amounts.
       ``(e) Federal Standards.--Section 5333 of this title 
     applies to any work financed with a grant under this section 
     to the same extent as if it were financed with a grant under 
     chapter 53 of this title. The application of that section 
     does not affect or discharge any other responsibility of the 
     Secretary under this title with respect to work financed by a 
     grant under this section.''.
       (b) Conforming Amendments.--
       (1) The chapter analysis for chapter 311 of title 49, 
     United States Code, is amended--
       (A) by striking ``state'' in the heading for subchapter I; 
     and
       (B) by inserting after the item relating to section 31108 
     the following:

``31109. Over-the-road bus security grant program.''.

     SEC. 2. BUS SECURITY RECOMMENDATIONS.

       (a) In General.--The Secretary of Transportation may use 
     not less than $3,000,000 and not more than $5,000,000 of the 
     amounts deposited in the Over-the-road Bus Security Fund 
     account established under section 31109 of title 49, United 
     States Code, for research and development of security 
     recommendations for over-the-road buses (as defined in 
     section 3038(a)(3) of the Transportation Equity Act for the 
     21st Century (49 U.S.C. 5310 nt)), including--
       (1) a review of actions already taken to address identified 
     security issues by both public and private entities;
       (2) research on engine shut-off mechanisms, chemical and 
     biological weapon detection technology, and the feasibility 
     of compartmentalization of the driver; and
       (3) compilation, review, and dissemination of industry best 
     practices.
       (b) Consultation With Industry, Labor, and Other Groups.--
     In carrying out this section, the Secretary shall consult 
     with over-the-road bus management and labor representatives, 
     public safety and law enforcement officials, and the National 
     Academy of Sciences.
                                 ______
                                 
      By Mr. BINGAMAN (for himself, Mr. McCain, Mr. Daschle, Mr. 
        Baucus, Mrs. Clinton, Mr. Domenici, Mr. Feingold, Mr. Kennedy, 
        Mr. Johnson, Mrs. Murray, Ms. Stabenow, Mr. Wellstone, Mr. 
        Harkin, Mr. Miller, Ms. Snowe, Mr. Inouye, Mr. Smith of Oregon, 
        Ms. Cantwell, Mr. Inhofe, Ms. Landrieu, Mr. Cochran, Mrs. 
        Boxer, Mr. Murkowski, Ms. Mikulski, and Mr. Grassley):
  S. 1741. A bill to amend title XIX of the Social Security Act to 
clarify that Indian women with breast or cervical cancer who are 
eligible for health services provided under a medical care program of 
the Indian Health Service or of a tribal organization are included in 
the optional Medicaid eligibility category of breast or cervical cancer 
patients added by the Breast and Cervical Prevention and Treatment Act 
of 2000; considered and passed.
  Mr. BINGAMAN. Madam President, due to a jurisdiction concern raised 
with the committee referral of S. 535, I am reintroducing the Native 
American Breast and Cervical Cancer Treatment Technical Amendment Act 
of 2001 today with Senator McCain and 23 other bipartisan cosponsors.
  To ensure the availability of life-saving breast and cervical cancer 
treatment to American Indian and Alaska Native women, I urge the bill's 
immediate passage.
  I request unanimous consent that a fact sheet and 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. 1741

       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 ``Native American Breast and 
     Cervical Cancer Treatment Technical Amendment Act of 2001''.

     SEC. 2. CLARIFICATION OF INCLUSION OF INDIAN WOMEN WITH 
                   BREAST OR CERVICAL CANCER IN OPTIONAL MEDICAID 
                   ELIGIBILITY CATEGORY.

       (a) Technical Amendment.--The subsection (aa) of section 
     1902 of the Social Security Act (42 U.S.C. 1396a) added by 
     section 2(a)(2) of the Breast and Cervical Cancer Prevention 
     and Treatment Act of 2000 (Public Law 106-354; 114 Stat. 
     1381) is amended in paragraph (4) by inserting ``, but 
     applied without regard to paragraph (1)(F) of such section'' 
     before the period at the end.
       (b) BIPA Technical Amendments.--
       (1) Section 1902 of the Social Security Act (42 U.S.C. 
     1396a), as amended by section 702(b) of the Medicare, 
     Medicaid, and SCHIP Benefits Improvement and Protection Act 
     of 2000 (114 Stat. 2763A-572) (as enacted into law by section 
     1(a)(6) of Public Law 106-554), is amended by redesignating 
     the subsection (aa) added by such section as subsection (bb).
       (2) Section 1902(a)(15) of the Social Security Act (42 
     U.S.C. 1396a(a)(15)), as added by section 702(a)(2) of the 
     Medicare, Medicaid, and SCHIP Benefits Improvement and 
     Protection Act of 2000 (114 Stat. 2763A-572) (as so enacted 
     into law), is amended by striking ``subsection (aa)'' and 
     inserting ``subsection (bb)''.
       (3) Section 1915(b) of the Social Security Act (42 U.S.C. 
     1396n(b)), as amended by section 702(c)(2) of the Medicare, 
     Medicaid, and SCHIP Benefits Improvement and Protection Act 
     of 2000 (114 Stat. 2763A-574) (as so enacted into law), is 
     amended by striking ``1902(aa)'' and inserting ``1902(bb)''.
       (c) Effective Dates.--
       (1) Bccpta technical amendment.--The amendment made by 
     subsection (a) shall take effect as if included in the 
     enactment of the Breast and Cervical Cancer Prevention and 
     Treatment Act of 2000 (Public Law 106-354; 114 Stat. 1381).
       (2) Bipa technical amendments.--The amendments made by 
     subsection (b) shall take effect as if included in the 
     enactment of section 702 of the Medicare, Medicaid, and SCHIP 
     Benefits Improvement and Protection Act of 2000 (114 Stat. 
     2763A-572) (as enacted into law by section 1(a)(6) of Public 
     Law 106-554).
                                  ____


   Fact Sheet--Native American Breast and Cervical Cancer Treatment 
                    Technical Amendment Act of 2001

       Sens. Jeff Bingaman (D-NM), John McCain (R-AZ), and 23 
     additional bipartisan cosponsors are reintroducing the 
     ``Native American Breast and Cervical Cancer Treatment 
     Technical Amendment Act of 2001.'' The bill is identical to 
     the original bill, S. 535, and makes a simple but extremely 
     important technical change to the ``Breast and Cervical 
     Cancer Treatment and Prevention Act'' (P.L. 106-354) to 
     ensure the coverage of breast and cervical cancer treatment 
     for American Indian and Alaska Native women.


                          Need for Legislation

       The ``Breast and Cervical Cancer Treatment and Prevention 
     Act,'' which passed the Senate by unanimous consent and had 
     76 cosponsors, gives states the option to extend coverage to 
     certain women who have been screened by programs operated 
     under Title XV of the Public Health Service Act (the National 
     Breast and Cervical Cancer Early Detection program) and who 
     have no ``creditable coverage.'' The term ``creditable 
     coverage'' was established by the Health Insurance 
     Portability and Accountability Act of 1996 (HIPPA). Under the 
     HIPPA definition, creditable coverage includes a reference to 
     the medical care program of the Indian Health Service (IHS). 
     In short, the reference to ``creditable coverage'' in the law 
     effectively excludes Indian women from receiving Medicaid 
     breast and cervical cancer treatment as provided for under 
     this Act.
       The Indian health reference to IHS/tribal care was 
     originally included in HIPPA so that members of Indian Tribes 
     eligible for IHS would not be treated as having a break in 
     coverage (and thus subject to pre-existing exclusions and 
     waiting periods when seeking health insurance) simply because 
     they had received care through Indian health programs, rather 
     than through a conventional health insurance program. Thus, 
     in the HIPPA context, the inclusion of the IHS/tribal 
     provision was intended to benefit American Indians and Alaska 
     Natives, not penalize them.
       However, use of the HIPPA definition in the recent ``Breast 
     and Cervical Cancer Treatment and Prevention Act'' has the 
     exact opposite effect. In fact, the many Indian women, who 
     rely on IHS/tribal programs for basic health care, are 
     excluded from the new law's eligibility for Medicaid. Not 
     only does the definition deny coverage to Indian women, but 
     the provision runs counter to the general Medicaid rule 
     treating IHS facilities as full Medicaid providers.
       The legislation would resolve these problems by clarifying 
     that, for purposes of the ``Breast and Cervical Cancer 
     Prevention and Treatment Act,'' the term ``creditable 
     coverage'' shall not include IHS-funded care so that American 
     Indian and Alaska Native women can be covered by Medicaid for 
     breast and cervical cancer treatment. Since a number of 
     states are currently moving forward to provide Medicaid 
     coverage under the state option, the need for this 
     legislation is immediate to ensure that American Indian and 
     Alaska Native women are not denied from receiving life-saving 
     breast and cervical cancer treatment.


     

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