[Congressional Record Volume 148, Number 136 (Wednesday, October 16, 2002)]
[Senate]
[Pages S10569-S10570]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                        PETITIONS AND MEMORIALS

  The following petitions and memorials were laid before the Senate and 
were referred or ordered to lie on the table as indicated:

       POM-354. A resolution adopted by the House of the 
     Legislature of the State of Michigan relative to an 
     independent review and analysis of generic drugs; to the 
     Committee on Health, Education, Labor, and Pensions.

                        House Resolution No. 293

       Whereas, the United States Food and Drug Administration 
     (FDA) is a vital agency responsible for ensuring safety in 
     foods and medicines. The work it undertakes has a direct 
     impact on each citizen. The FDA oversees the approval of 
     drugs for the market and provides information to the health 
     care network; and
       Whereas, a key component of our health care resources is 
     the availability of generic drugs, which can offer a less 
     costly means of treatment. The use of this option, however, 
     is only as good as the level of assurance that a generic drug 
     is as safe as possible. The FDA considers generic drugs 
     submitted for approval through its Office of Generic Drugs; 
     and
       Whereas, in spite of repeated assurances from the FDA and 
     pharmaceutical companies that generic drugs are safe and are 
     identical in the ingredients to their brand-name 
     counterparts, there have been concerns over the safety of 
     some generic drugs. Any concern must be investigated 
     thoroughly to ensure that all standards of ingredients, 
     preparation, and packaging are met. We must do all we can to 
     ensure the highest standards for all prescription 
     medications. Most importantly, there can be no doubt that the 
     review of submitted medications is completely unaffected by 
     criteria other than scientific evidence and the impact of the 
     drugs in question on patients. Citizens as well as health 
     care providers must have faith in the independence and 
     reliability of all tests and determinations; Now, therefore, 
     be it
       Resolved by the House of Representatives, That we 
     memorialize the Congress of the United States and the Food 
     and Drug Administration to provide for an independent review 
     and analysis of generic drugs submitted for approval; and be 
     it further
       Resolved, That copies of this resolution be transmitted to 
     the President of the United States Senate, the Speaker of the 
     United States House of Representatives, the members of the 
     Michigan congressional delegation, and the Food and Drug 
     Administration.
                                  ____

       POM-355. A resolution adopted by the House of the 
     Legislature of the Commonwealth of Pennsylvania relative to 
     Medicare home health benefits and home health providers; to 
     the Committee on Finance.

                        House Resolution No. 576

       Whereas, there are 321 Medicare-certified agencies in 
     Pennsylvania providing critical care each year in the homes 
     of nearly half a million Pennsylvanians; and
       Whereas, home health patients receiving Medicare services 
     are typically the sickest, frailest and most vulnerable of 
     Pennsylvania's elderly population; and
       Whereas, the Congress of the United States in 1997 sought 
     to cut growth in the Medicare home health benefit by $16.2 
     billion over five years but resulted in cutting more than $72 
     billion; and
       Whereas, nearly one million fewer Medicare beneficiaries 
     qualify for Medicare-reimbursed home care than in 1997; and
       Whereas, additional cuts in the Medicare home health 
     benefit would force many low-cost, efficient agencies in 
     Pennsylvania which are struggling under the current system to 
     go out of business, thereby harming access to Medicare 
     beneficiaries; and
       Whereas, total elimination of the 15% cut has been 
     postponed for the past two years; and
       Whereas, the impending 15% cut is making it difficult for 
     home health agencies to secure lines of credit and is 
     discouraging investment in advanced technologies and staff 
     benefits; and
       Whereas, sixty-five members of the United States Senate 
     have joined in a bipartisan letter that recommends the 
     elimination of the 15% cut; and
       Whereas, one hundred thirteen members of the United States 
     House of Representatives have joined in a bipartisan letter 
     that recommends the elimination of the 15% cut; and
       Whereas, the Budget Committee of the United States Senate 
     has voted to set aside the funds necessary to do away with 
     the 15% cut; and
       Whereas, the Medicare Payment Advisory Commission (MedPAC), 
     the group established by the Congress to advise on Medicare 
     policy, has called upon the Congress to permanently eliminate 
     the 15% cut in the Medicare home health benefit; and
       Whereas, MedPAC has reported that there are three factors 
     that can lead to a cost increase for rural home health 
     providers; travel, volume of services and lack of 
     sophisticated management and patient care procedures; and
       Whereas, Medicare home health services are delivered to a 
     large rural population in Pennsylvania which often lives 
     miles apart, increasing the cost of providing home health 
     services: Therefore be it
       Resolved, That the House of Representatives of the 
     Commonwealth of Pennsylvania urge the Congress to permanently 
     eliminate the 15% cut in the Medicare home health benefit AND 
     EXTEND THE 10% RURAL ADD-ON TO MEDICARE HOME HEALTH 
     PROVIDERS; And be it further
       Resolved, That the House of Representative urge the 
     President to support the Congress in eliminating the 15% cut 
     in the Medicare home health benefit AND EXTEND THE 10% RURAL 
     ADD-ON TO MEDICARE HOME HEALTH PROVIDERS; and be it further
       Resolved, That copies of this resolution be transmitted to 
     the President of the United States, the Vice President of the 
     United States, the Speaker of the United States House of 
     Representatives and to each member of Congress from 
     Pennsylvania.
                                  ____

       POM-356. A joint resolution adopted by the General Assembly 
     of the State of California relative to home health care; to 
     the Committee on Finance.

                    Assembly Joint Resolution No. 49

       Whereas, California's home health care industry has 
     suffered a loss of over one-third of licensed home health 
     agencies since 1998; and

[[Page S10570]]

       Whereas, the Medicare home health care benefit started in 
     1966 and has provided Medicare home health care insurance 
     coverage to hundreds of thousands of homebound Medicare 
     beneficiaries who need care on a part-time or intermittent 
     basis; and
       Whereas, Medicare home health care users are older, sicker, 
     poorer, and more disabled than the Medicare population 
     generally, with 26 percent over 85 years of age; and
       Whereas, in 1980, Congress changed the home health care 
     benefit by expanding access to care for beneficiaries without 
     a prior hospitalization and by eliminating visit limits; and
       Whereas, in 1981 restrictive administrative interpretations 
     of part-time or intermittent care limited spending by denying 
     access to this medically fragile population. As a result of 
     the restrictions, a class action lawsuit was filed that 
     resulted in a 1988 ruling that overturned the restrictions. 
     Duggan v. Bowen (D.C. 1988) 691 F. Supp. 1487. As a result, 
     utilization of home health services grew; and
       Whereas, the growth continued until Congress passed the 
     1997 Balanced Budget Act to restrict spending; and
       Whereas, an interim payment system (IPS) was implemented in 
     fiscal years 1998-2000 to immediately control spending; and
       Whereas, the IPS system dramatically reduced reimbursement 
     rates, which fell below 1993 payment limits and resulted in 
     284 closures of California home health care agencies during 
     1998-99; and
       Whereas, a new system, the prospective payment system 
     (PPS), was implemented to cease the IPS unprecedented 
     reductions in payments; and
       Whereas, PPS could not correct the 49 percent cut in home 
     health care outlays with further declines expected through 
     2002; and
       Whereas, during IPS implementation and before PPS, a new 
     national standard patient assessment system, the Outcomes and 
     Assessment Information Set (OASIS), was required for all 
     Medicare providers in 1999 and provided burdensome reporting 
     requirements; and
       Whereas, the implementation of IPS, PPS, and OASIS 
     collection has resulted in a 36-percent reduction in the 
     number of participating home health care providers, closure 
     of over 340 licensed home health agencies, and reduced access 
     to care for medically fragile Californians; and
       Whereas, the 1997 Balanced Budget Act has already reduced 
     utilization and home health care spending significantly below 
     the intended savings that were anticipated due to that act; 
     and
       Whereas, the Congressional Budget Office projected home 
     health expenditure reductions of $16.2 billion over five 
     years (fiscal year 1998 to fiscal year 2002), actual 
     reductions from fiscal year 1998 to fiscal year 2000 were 
     $35.8 billion, and current projected reductions for fiscal 
     years 2001 and 2002 are an additional $35.3 billion resulting 
     in $71.1 billion; and
       Whereas, California is undergoing an anticipated $20 
     billion budget deficit, which could result in Medi-Cal 
     reducing current reimbursement rates to 2000 levels, 
     resulting in a double rate reduction guaranteed to devastate 
     the 629 Medicare certified home health care agencies 
     operating California; and
       Whereas, the proposed 15 percent cut in home health care 
     reimbursement rates will negatively affect access to care, 
     and leave thousands without a home health care agency that 
     can service their medical needs: Now, therefore, be it
       Resolved by the Assembly and Senate of the State of 
     California, jointly, That the Legislature of the State of 
     California hereby respectfully memorializes the President and 
     the Congress of the United States to enact legislation that 
     contains steps to ensure that Medicare home health care 
     recipients are guaranteed the best care, and that home health 
     providers, who have undergone multiple regulation and 
     administrative changes at the hands of the federal government 
     since the 1997 Balanced Budget Act, are not further harmed; 
     and be it further
       Resolved, That the Legislature opposes the 15 percent cut 
     in home health payments scheduled for October 1, 2002; and be 
     it further
       Resolved, That the Chief Clerk of the Assembly transmit 
     copies of this resolution to the President and Vice President 
     of the United States, the Speaker of the House of 
     Representatives, the Minority Leader of the House of 
     Representatives, the Majority Leader of the Senate, the 
     Minority Leader of the Senate, to each Senator and 
     Representative from California in the Congress of the United 
     States, and to the President's commission to eliminate the 
     pending additional 15 percent cut in home health payments 
     scheduled for October 1, 2002.
                                  ____

       POM-357. A resolution adopted by the Legislative of Guam 
     relative to supporting efforts for a Constitutional amendment 
     to limit the authority of the federal court system to 
     appropriate money through judicial orders; to the Committee 
     on Finance.

                         Resolution No. 6 (LS)

       Whereas, concerns among state legislatures across the 
     Nation have been raised relative to incursions by the Federal 
     Judicial Branch into areas are clearly defined as powers of 
     the Legislative Branch of government, more specifically, 
     instance where members of the Federal judiciary have 
     exercised the power to levy or increase taxes; and
       Whereas, it is incumbent on all Legislative Branches of 
     government, from the U.S. Congress to each state 
     jurisdiction, to insure that the Separation of Powers 
     Doctrine, its spirit, intent and integrity are inviolate; and
       Whereas, the Judicial Branch of the Federal Government has 
     ignored constitutional restrictions on its powers to levy or 
     increase taxes, a power clearly reserved and limited to the 
     Legislative Branch; and
       Whereas, the only resolution to this threat to the 
     integrity of and challenge to the Separation of Powers 
     Doctrine, must emanate from the U.S. Congress in the form of 
     a Constitutional amendment: Now therefore, be it
       Resolved, That I Mina'Bente Sais Na Liheslatuan Guahan does 
     hereby, on behalf of the people of Guam, call upon the U.S. 
     Congress to initiate the adoption of an amendment to the 
     Constitution of the United States which would more clearly 
     define and state the restriction upon the power of the 
     Judicial Branch of the Federal Government to levy or increase 
     taxes in any manner, means or form; and be it further
       Resolved, That Mina'Bente Sais Na Liheslaturan Guahan does 
     hereby, on behalf of the people of Guam, suggest that the 
     form of the amendment to the United Constitutional shall 
     read: ``Neither the Supreme Court nor any inferior court of 
     the United States shall have the power to instruct or order a 
     state or political subdivision thereof, or any official of 
     such state or political subdivision, to levy or increase 
     taxes''; and be it further
       Resolved, That the Speaker certify, and the Legislative 
     Secretary attests to, the adoption hereof and that copies of 
     the same be thereafter transmitted to the Honorable George W. 
     Bush, President of the United States of America; to the 
     Honorable Richard B. Cheney, President of the United States 
     Senate; to the Honorable J. Dennis Hastert, Speaker of the 
     United States House of Representatives; to Missouri State 
     Senator Walter Mueller; to Mr. John R. Stoeffler, President, 
     The Madison Forum; to the Honorable Robert A. Underwood, 
     Member of Congress, U.S. House of Representatives; and to the 
     Honorable Carl T.C. Gutierrez, I Maga'lahen Guahan.

                          ____________________