[Congressional Record Volume 150, Number 84 (Thursday, June 17, 2004)]
[Senate]
[Pages S7000-S7023]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. GRAHAM of Florida (for himself and Mr. Durbin):
S. 2535. A bill to amend title XVIII of the Social Security Act to
modernize the medicare program by ensuring that appropriate preventive
services are covered under such program; to the Committee on Finance.
Mr. GRAHAM of Florida. Mr. President, I am very pleased to introduce
the Medicare Preventive Services Coverage Act of 2004, and to be joined
by Senator Richard Durbin.
This legislation would change the basic charter of Medicare to one
that not only diagnoses and treats, but also prevents illness.
On July 30, 1965, Medicare was created under title 18 of the Social
Security Act to provide health insurance coverage for the elderly.
The coverage provided through the program was limited to diagnostic
and treatment services that were considered reasonable and necessary.
There was little demand to cover preventive services under Medicare
or any other health plan at that time because we were not yet cognizant
of the vital role of prevention on the health and quality of human
life.
The basic charter of Medicare reflects this lack of understanding.
However, since Medicare's inception, we have learned a lot about the
enormous burden of chronic disease on our Nation.
According to the Centers for Disease Control and Prevention, CDC,
more than 1.7 million Americans die of a chronic disease each year,
accounting for about 70 percent of all deaths.
Not only does chronic disease lead to a majority of deaths and
disabilities in America, it also accounts for about 75 percent of
health care costs each year, placing a huge economic demand on our
Nation.
Medicare bears a lion's share of this cost. In 2003, Medicare spent
nearly $7,000 per beneficiary; much of this cost is attributable to
treating chronic illnesses.
The percentage of the population over age 65 has increased
dramatically and will continue to do so. This will place an even
greater economic burden on Medicare.
What is the bottom line? In short, Medicare cannot afford this
spiraling cost.
The good news is that we now have decades of research demonstrating
that although chronic diseases are the most common and costly of all
health problems, they are also the most preventable.
For example, according to the CDC regular eye exams and timely
treatment could prevent up to 90 percent of diabetes related blindness.
Eye chart screening for visual acuity is currently recommended by the
United States Preventive Services Task Force, USPSTF, but is not
covered by Meidcare.
The impact of prevention on chronic disease is well known by the
President's Secretary for Health and Human Services.
HHS Secretary Thompson said in September 2003:
There is clear evidence that the costs of chronic
conditions are enormous, as are the potential savings from
preventing them, even if there may not always be agreement on
the exact amounts of these cost savings.
He goes on to say:
. . . the Nation simply cannot afford not to step up
efforts to reverse the growing prevalence of chronic
disorders. Resources and energy need to be marshaled in all
sectors and at all levels of society.
Partnership for Prevention, a Washington, DC, think tank on health
policy takes Thompson's comments one step further. A recent Partnership
report makes the following logical assumption:
As the primary source of health insurance coverage for
millions of older Americans and persons with permanent
disabilities, Medicare has the potential to have a
substantial impact on the health of beneficiaries by
promoting and covering cost-effective preventive services.
Congress has added coverage for some preventive services over the
last two decades, including the flu vaccine, mammograms, and cancer
screening.
As HHS does not have the authority to add preventive services to
Medicare--despite the growing body of evidence that has proved their
efficacy--these benefits were only added to Medicare because of
congressional action.
The benefits that Congress have added are extremely important, and I
am glad that we have taken the steps to make them available to our
seniors.
However, the congressional process is slow, and subject to political
winds and influences that are not always based purely in science.
The legislation I am introducing would change the basic charter of
Medicare from a program focused on diagnosing and treating illnesses to
one that also prevents illnesses by giving the Department of Health and
Human Services the authority to make coverage decisions for preventive
services.
Why change the current system of passing legislation each time we
want to add coverage of preventive service to Medicare? There are some
very logical reasons.
The reliance on Congress to cover preventive services has resulted
in: Coverage for only half of clinical preventive services that experts
recommend for the 65+ age group; coverage that not only fails to keep
up with changes in scientific evidence but is often in consistent with
authoritative recommendations; a confusing array of cost sharing
requirements across covered preventive services; and lack of coverage
of some preventive services that provide great health benefits in favor
of others that do not meet current evidence standards as a result of
vocal advocacy groups.
Luckily, the fundamental reform of the program that I am proposing
does not require extensive statutory or bureaucratic change.
Medicare already has a process in place for the Secretary of Health
and Human Services to make coverage decisions on diagnostic, treatment,
and durable medical equipment options.
My bill would authorize the Secretary to make coverage decisions on
preventive services using that same process, based on the
recommendations of the federally-convened United States Preventive
Services Task Force, USPSTF, and other groups.
This authorization would not entail dramatic new administrative
expenses or a major reorganization of CMS coverage processes and staff.
My legislation would put preventive services on an equal footing with
diagnostic and treatment services by allowing the Secretary to make
coverage decisions for all services needed to prevent, diagnose, and
treat illness.
Providing beneficiaries with the most cost-effective and current
preventive services should no longer require an ``Act of Congress.''
It should, instead, require the insight of the experts in the field,
and be based on the same careful process HHS is currently using.
Let us untie their hands and improve the lives of our Medicare
beneficiaries by building coverage of preventive services into the
currently established coverage decision process.
This legislation is supported by the following groups: American
College of Preventive Medicine; HealthPartners; Deafness Research
Foundation; Partnership for Prevention; American Dietetic Association;
American Public Health Association; Families USA; American Physical
Therapy Association; American Academy of Family Physicians; United
Cerebral Palsy Association; National Mental Health Association;
Campaign for Tobacco-Free Kids, and the Emergency Department Practice
Management Association.
If Medicare were created today, it would certainly not exclude
coverage of preventive services.
Today we know how important preventive services are; they save money
and lives. Let us give Medicare the authority to do its job.
I urge my colleagues to join me in sponsoring this important piece of
legislation.
[[Page S7001]]
I ask unanimous consent to print letters of support from the above-
listed groups in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
American Public
Health Association,
Washington, DC, June 1, 2004.
Hon. Bob Graham,
U.S. Senate, Hart Senate Office Building, Washington, DC.
Dear Senator Graham: On behalf of the American Public
Health Association (APHA), the largest and oldest
organization of public health professionals in the country,
representing more than 50,000 members from over 50 public
health occupations, I write in support of the Medicare
Preventive Services Coverage Act of 2004.
As outlined in position paper 7633, ``Policy Statement on
Prevention,'' APHA has long supported measures to
increasingly utilize the fund preventive services in federal
health programs. In this vein, the Medicare Preventive
Services Coverage Act of 2004 demonstrates a significant
commitment to addressing the underlying factors responsible
for the underutilization of prevention strategies that
optimize the health and independence of the elderly by
granting the Secretary the authority to approve Medicare
coverage of preventive services based on recommendations of
the U.S. Preventive Services Task Force and other groups. By
allowing decisions about coverage of preventive services to
be made in the same timely, evidence-based manner as other
services under Medicare, the legislation would enable
Medicare to take a vital step towards focusing more on
disease prevention, which is cost-effective and has the
ability to prevent or delay the occurrence of chronic
disease.
Since the creation of Medicare, the American Public Health
Association has supported measures to protect Medicare
beneficiaries against significant financial exposure that
imposes barriers to the receipt of needed care. The
provisions of the Medicare Preventive Services Act of 2004
that aim to eliminate co-payments and deductibles from all
future preventive benefits serve to ensure that Medicare
beneficiaries will not be restricted from accessing needed
preventive medical care because of financial hardship.
Thank you for your attention to and leadership on this
important public health issue. We look forward to working
with you to move legislation forward this year.
Sincerely
Georges C. Benjamin, MD, FACP,
Executive Director.
____
June 2, 2004.
Hon. Bob Graham,
U.S. Senate,
Washington, DC.
Dear Senator Graham: Congratulations on the introduction of
your new legislation to provide a permanent solution to
Medicare's long-standing failure to cover appropriate
preventive health services. Families USA, the health consumer
advocacy organization, strongly endorses your effort.
Currently, life-saving and life-improving preventive
screening services have been covered only by an act of
Congress--and usually only after long and difficult debates.
Your proposal will place this basic scientific and technical
issue in the excellent medical staff of the Centers for
Medicare and Medicaid Services, where decisions can be made
on a more timely, professional and scientific basis. We
believe that this will help ensure that important preventive
care services will be implemented in a more timely and
rational way. The result will be an improvement in the
quality of life of Medicare beneficiaries.
Congratulations again on this proposal--one of a long-line
of creative and helpful health initiatives that you have
championed in your outstanding Senate career.
Sincerely,
Ronald F. Pollack,
Executive Director.
____
American Physical
Therapy Association,
Alexandria, VA, June 2, 2004.
Hon. Bob Graham,
U.S. Senate, Senate Hart Office Building, Washington, DC.
Dear Senator Graham: On behalf of the 64,000 members of the
American Physical Therapy Association (APTA), I commend you
for your efforts to promote the full continuum of health care
for our nation's seniors and persons with disabilities served
by the Medicare program. APTA appreciates the introduction of
your legislation, the Medicare Preventative Services Coverage
Act of 2004 and fully supports its enactment by the 108th
Congress. Prevention services are an essential part of the
health care continuum that needs better integration into the
Medicare program, and your legislation goes a long way toward
achieving that objective.
Physical therapists provide prevention services that
forestall or prevent functional decline and the need for more
intense care. Through timely and appropriate screening,
examination, evaluation, diagnosis, prognosis, and
intervention, physical therapists frequently reduce or
eliminate the need for more costly forms of care and also may
shorten or even eliminate institutional stays. Physical
therapists are actively involved in promoting health,
wellness and fitness initiatives, including the provision of
services and education of patients that stimulate the public
to engage in healthy behaviors. An example of physical
therapist involvement in preventive services is the use of
therapeutic interventions to improve strength, mobility, and
balance to reduce falls that often lead to more costly health
care and disability under Medicare.
Thank you for your commitment to improving the Medicare
program. The addition of appropriate preventative services to
the Medicare program will help our nations' seniors and
persons with disability lead more healthy and productive
lives within our communities. Please feel free to contact
Justin Moore on APTA's Government Affairs staff at
[email protected] or 703/706-3162, if you have any
questions or need additional information.
Sicnerely,
Ben F. Massey, Jr., PT, MA,
President.
____
American Academy of
Family Physicians,
Washington, DC, June 9, 2004.
Hon. Robert Graham,
Hart Senate Office Building,
U.S. Senate, Washington, DC.
Dear Senator Graham: Thank you for the opportunity to
review the draft of your legislation, the Medicare Preventive
Services Coverage Act. On behalf of the 93,700 members of the
American Academy of Family Physicians, I am pleased to inform
you that the AAFP strongly endorses the bill, and we
congratulate you for your efforts on behalf of the nation's
seniors.
This legislation would help make Medicare more responsive
to the people that it directly serves. By allowing CMS to
cover preventive services that are based on evidence and
current science and that have been reviewed and approved by
the United States Preventive Services Task Force and other
appropriate organizations, the bill helps direct Medicare
toward proven health care services that will keep seniors
healthier. The AAFP commends your commitment to evidence-
based measures that will prevent accidents and illness and
provide more effective health care. We believe that sound
science should always be the basis of medical decisions.
The Academy would urge you and your colleagues in Congress
to consider giving CMS the authority to review current
preventive services in the light of the U.S. Preventive
Services Task Force recommendations and to alter
reimbursement accordingly. And we would also suggest that
Congress might want to make more explicit the agency's
authority to review and revise payments as the evidence of
previously approved services changes.
Thank you, Senator Graham, for your commitment to the
health of Medicare patients and for your leadership in
improving this important program that serves them.
Sincerely,
James C. Martin, MD, FAAFP,
Board Chair.
____
American College of
Preventive Medicine,
June 4, 2004.
The American College of Preventive Medicine (ACPM) is very
pleased to support Senator Bob Graham's bill granting the
Secretary of Health and Human Services the authority to
approve Medicare coverage of preventive medical services from
the recommendations of the United States Preventive Services
Task Force (USPSTF) and other appropriate organizations.
As the representative organization for preventive medicine
physicians, ACPM understands the potential long-term benefits
from clinical preventive services supported by evidence to
have a beneficial impact on survival and quality of life. As
the population of the United States ages, preventive services
will become the best strategy to keep people healthy and to
conserve medical expenditures.
Therefore, the ACPM offers its full support of Senator
Graham's proposed legislation to include preventive services
under Medicare coverage.
Mike Barry,
Deputy Director.
____
American Dietetic Association,
Chicago, IL, June 2, 2004.
Hon. Bob Graham,
U.S. Senate,
Washington, DC.
Dear Senator Graham: The American Dietetic Association
(ADA) is the largest organization of food and nutrition
professionals in the U.S. We promote optimal nutrition and
well being of all people, by relying on evidence-based
practices and policies. To that end, ADA is pleased to
support the Medicare Preventive Services Coverage Act of
2004.
Nutrition is a critical element to any comprehensive health
care program and in particular preventive services. According
to the Department of Health and Human Services, 40 percent of
Americans age 40 to 74 suffer from pre-diabetes. The evidence
shows that proper nutrition and physical activity can prevent
many, if not most of these Americans from developing type II
diabetes. In cardiovascular care, the evidence shows that
proper preventive nutrition intervention can slow or reverse
conditions such as hypertension or dyslipidemia.
Unfortunately, Medicare does not recognize the importance of
preventive care in general and preventive nutrition therapy
specifically.
When Congress passed the Medicare Modernization Act last
year, it included a new provision for preventive care under
Sec. 611,
[[Page S7002]]
the Initial Preventive Physical Examination. While referral
to medical nutrition therapy is specifically mentioned in the
bill, CMS is interpreting this new language as limited to
only those diseases (diabetes and renal) that are already
eligible for MNT. As a result of this interpretation,
patients diagnosed during the initial preventive physical
exam as having pre-diabetes, must wait until their conditions
progress to type II diabetes before Medicare will cover
nutrition therapy.
Such an approach to preventive care is poor health policy
and poor fiscal management of the program. Your Medicare
Preventive Services Coverage Act if enacted, will promote
preventive care within Medicare to the status it deserves.
ADA commends your efforts and foresight.
Sincerely,
Ronald E. Smith,
Director of Government Relations.
____
Campaign for
Tobacco-Free Kids,
June 14, 2004.
Hon. Bob Graham,
U.S. Senator, Hart Senate Office Building, Washington, DC.
Dear Senator Graham: The Campaign for Tobacco-Free Kids is
pleased to lend its support to your bill, The Medicare
Preventive Services Coverage Act of 2004.
This bill will help provide the scientific foundation and
evidence-based decisions that are critical for ensuring that
the Medicare program provides the most effective preventive
services to all Medicare beneficiaries. This bill will help
shift the emphasis of the Medicare program from treating
illness to one where the focus is more on wellness, health
promotion and prevention. With nearly three-quarters of all
illnesses in this country related to preventable conditions
such as tobacco use, lack of proper nutrition and physical
fitness, obesity and diabetes, it makes perfect health and
fiscal sense to enact such changes into the Medicare program.
With the recent inclusion of prescription drug coverage to
the Medicare program, including coverage for prescription
tobacco use cessation medications such as nicotine nasal
spray and bupropion SR, this bill represents a tremendous
opportunity to enhance and compliment this new coverage
through the provision of tobacco use cessation counseling
services. According to the U.S. Preventive Services Task
Force, next to childhood immunizations, tobacco cessation
counseling is the most clinically effective preventive
service that we have. Furthermore, we know that counseling
services double the number of successful quit smoking
attempts versus people who try to quit ``cold turkey''. And
when combined with medications, there is nearly a four-fold
increase in successful quit attempts. With about 10 percent
of all Medicare beneficiaries still smoking, about 4.5
million people, such a benefit would have a tremendous impact
on the health and quality of life of our nation's seniors.
Again, the Campaign for Tobacco-Free Kids is proud to
support this important piece of public health legislation.
Sincerely,
Matthew L. Myers,
President.
____
Partnership For Prevention,
Washington, DC, June 2, 2004.
Hon. Bob Graham,
U.S. Senator, Hart Senate Office Building, Washington, DC.
Dear Senator Graham: Thank you for requesting Partnership
for Prevention's comments on Medicare policy concerning
disease prevention and health promotion.
Partnership strongly recommends that Congress modernize
Medicare by directing the Centers for Medicare and Medicaid
Services to make coverage decisions for disease prevention
and health promotion services based on evidence-based
recommendations such as those of the U.S. Preventive Services
Task Force and the Advisory Committee on Immunization
Practices. This was one of the principal policy
recommendations in Partnership's 2003 report, A Better
Medicare for Healthier Seniors: Recommendations to Modernize
Medicare's Prevention Policies. We understand that you plan
to introduce legislation that would bring about such a policy
change.
When Congress created Medicare in 1965, it designed the
program based on the knowledge of health, medicine and health
care at that time. Thus, Medicare focused on hospitalization
and visits to doctors' offices to treat or diagnose seniors
who were already showing signs of illness. Medicine has made
great progress since then, including development of proven
ways to prevent disease and promote longer, healthier lives.
But Medicare has consistently lagged behind the curve,
failing to cover proven disease prevention and health
promotion services or providing coverage years later than
private insurers.
Allowing Medicare coverage decisions for preventive
services to be made following a similar process as diagnosis
and treatment decisions is an important step in modernizing
Medicare. It is also critical that these coverage decisions
be informed by systematic reviews of evidence conducted by
independent experts, such as the U.S. Preventive Services
Task Force. We understand that your bill would address these
issues and enable Medicare to keep pace with progress in
preventive medicine and health promotion.
Partnership's Better Medicare report also noted that use
rates for most preventive services that are covered by
Medicare fall short of national targets, in part because of a
confusing array of cost sharing requirements, such as
deductibles and co-payments for these services. We understand
that your bill would eliminate these impediments for
preventive services covered in the future.
Most Americans understand that it is preferable to help
people stay healthy instead of waiting to treat them after
they become sick. It is in our nation's interest for seniors
to be healthy instead of infirm, active instead of
hospitalized, productive instead of costly, independent
instead of dependent. Cost-saving and cost-effective disease
prevention and health promotion are sound investments for our
country.
Thank you again for requesting our comments on these
important facets of Medicare policy.
Sincerely,
John M. Clymer,
President.
____
Deafness Research Foundation,
Washington, DC, June 2, 2004.
Hon. Bob Graham,
U.S. Senate,
Washington, DC.
Dear Senator Graham: On behalf of the Deafness Research
Foundation and World Council on Hearing Health, we fully
support the Amendment to Title XVII of the Social Security
Act to modernize the Medicare program so as to ensure
preventive services be covered under the program.
The Deafness Research Foundation and its public education
and advocacy arm, called the World Council on Hearing
Health's mission is to make a lifetime of hearing possible
for all people through quality research, public education and
advocacy. We espouse the program platforms of detection,
prevention, intervention and research about hearing loss.
Therefore, we fully support your draft bill that will allow
for the Secretary of Health and Human Services be granted the
authority to approve Medicare coverage of preventive services
based on recommendations of the U.S. Preventive Services Task
Force and other organizations if enacted.
Early detection of hearing loss through regular hearing
checkups (at least once every two years) from childhood to
adulthood is a key to early intervention as needed. For
babies and children it is especially important so their
educational, emotional and social development is not halted
nor compromised. In adults, early detection of hearing loss
is the best prevention against further damaging one's hearing
not to mention the impact hearing loss can have on one's
career and quality of life. In the elderly, the ability to
diagnose hearing loss early on is an imperative to combat
misdiagnoses of dementia and senility.
We commend you on taking the initiative to propose this
bill and we will tell the 40,000 donors and members of
Deafness Research Foundation to fervently follow its
progress.
Sincerely,
Susan Greco,
Executive Director.
____
June 3, 2004.
Hon. Robert Graham,
Hart Senate Office Building,
Washington, DC.
Dear Senator Graham: I am writing on behalf of
HealthPartners in support of the ``Medicare Preventive
Services Coverage Act of 2004''. HealthPartners is a
consumer-governed family of nonprofit Minnesota health care
organizations focused on improving the health of its members,
its patients and the community. HealthPartners and its
related organizations provide health care services, insurance
and HMO coverage to more than 670,000 members. The key
features of this bill would go far in helping to improve the
health of Medicare enrollees.
This bill would put disease prevention on a level playing
field with disease detection and treatment under Medicare. It
would also permit preventive service coverage decisions to be
based on evidence. We believe strongly that appropriate
preventive services should be included in the Medicare
benefit set and that those benefits should be evidence-based.
Using the United States Preventive Services Task Force (and
other appropriate organizations') recommendations as a guide
for the addition of preventive services is an excellent step.
We encourage the Secretary and Congress to continue to
focus benefits in both the Medicare and Medicaid programs on
evidence based medicine. Evidence based care provides the
structure for the right services to be delivered at the right
time in the right location for enrollees of all ages. This,
in turn, supports achieving the six aims for care as outlined
by the Institute of Medicine: care that is patient-centered,
timely, effective, efficient, equitable and safe. We support
your efforts to achieve these ends.
Sincerely,
George Isham, M.D.,
Medical Director and
Chief Health Officer.
____
Emergency Department Practice Management Association,
McLean, VA, June 16, 2004.
Hon. Senator Graham,
Hart Senate Office Building,
U.S. Senate, Washington, DC.
Dear Senator Graham: Thank you for the opportunity to
review your draft legislation, the Medicare Preventive
Services Coverage Act. On behalf of the Emergency Department
Practice Management Association's members, we congratulate
you on your efforts in
[[Page S7003]]
this area and strongly support this legislation as it
reflects sound health policy.
EDPMA members work with their hospital partners to provide
quality patient care in the emergency departments across the
country. As you know, overcrowding in emergency departments
is a serious problem. By expanding Medicare's coverage of
preventative services, we believe that Medicare patients will
have incentives to get treatment in less acute settings.
Emergency departments are a key element of the nation's
safety net. While we support expansion of Medicare benefits,
we believe it is of critical importance that Medicare's
physician fee schedule appropriately capture emergency
physician's uncompensated care costs. We look forward to
working with you to address this problem.
Like you, EPDMA is dedicated to providing quality care to
Medicare's patients. We join you in support of this
legislation and appreciate your on-going leadership in health
policy.
Sincerely,
Emily R. Wilson,
Managing Director.
____
National Mental
Health Association,
Alexandria, VA, June 16, 2004.
Hon. Bob Graham,
U.S. Senate, Hart Senate Office Building, Washington, DC.
Dear Senator Graham: On behalf of the National Mental
Health Association (NMHA), I am writing to commend you for
introducing the Medicare Preventive Services Coverage Act of
2004. Prevention and early detection of mental illness are
critical components to ensuring overall well-being that have
long been overlooked, particularly with regard to Medicare
beneficiaries. Your bill represents a major step forward in
recognizing that mental illness can be prevented and
successfully treated, especially if detected early.
Prevention services provided through this legislation will
undoubtedly lead to improved access to and utilization of
mental health treatment among a population in which mental
illness has been severely under-diagnosed.
NMHA is the nation's oldest and largest advocacy
organization addressing all aspects of mental health and
mental illness. With more than 340 affiliates nationwide, we
work to improve the mental health of all Americans through
advocacy, education, research, and service. Prevention of
mental illness is a key element of our mission, and we are
heartened by your efforts to ensure that Medicare
beneficiaries receive a full complement of preventive
services, including mental health services.
As you know, mental illness affects a very large segment of
the Medicare population, but few receive the treatment they
need. According to the Surgeon General's 1999 Report on
Mental Health, some 20 percent of those 55 and older
experience specific mental disorders that are not part of
normal aging, including phobias, obsessive-compulsive
disorder, and depression, and 40 percent of those on Medicare
because of a disability, face mental illness. Major
depression is particularly prevalent among older Americans:
in primary care settings, 37 percent of seniors display
symptoms of depression.
However, all too often seniors and people with disabilities
struggle with mental illness alone and without treatment and
support. It is estimated that only half of older adults who
acknowledge mental health problems actually are treated. A
very small percentage of older adults--less than 3 percent--
report seeing mental health professionals for treatment. This
lack of care has tragic consequences as illustrated by the
fact that Americans 65 and older have the highest rate of
suicide in the country, accounting for 20 percent of suicide
deaths.
The President's New Freedom Commission on Mental Health
found that ``[t]he number of older adults with mental
illnesses is expected to double to 15 million in the next 30
years [and that] [m]ental illnesses have a significant impact
on the health and functioning of older people and are
associated with increased health care use and higher costs.''
New Freedom Commission on Mental Health, Achieving the
Promise: Transforming Mental Health Care in America. Final
Report, p. 59. The Commission recommended that ``[a]ny effort
to strengthen or improve the Medicare and Medicaid programs
should offer beneficiaries options to effectively use the
most up-to-date [mental health] treatments and services.''
Id., p. 26.
Early detection and intervention services are essential for
preventing mental health problems from compounding and for
lessening long-term disability that can result from mental
illness. The President's Commission stated that early
assessment and treatment are critical across the life span
and found that ``[n]ew understanding of the brain indicates
that early identification and intervention can sharply
improve outcomes and that longer periods of abnormal thoughts
and behavior have cumulative effects and can limit capacity
for recovery.'' Id., p. 57. Numerous studies have indicated
that prevention and early intervention services for seniors
result in improved mental health conditions, positive
behavioral changes, and decreased use of inpatient care.
Thank you again for introducing the Medicare Preventive
Services Coverage Act of 2004. By incorporating preventive
mental health services into the Medicare program, this bill
will substantially improve access to treatment for a
population with tremendous mental health needs.
Sincerely,
Michael M. Faenza, MSSW,
President and CEO.
____
Hon. Bob Graham,
U.S. Senate, Hart Office Building, Washington, DC.
Dear Senator Graham: United Cerebral Palsy would like to
lend our wholehearted support to the Medicare Preventive
Services Coverage Act of 2004 that would amend the Social
Security Act and the Medicare Prescription Drug Improvement
and Modernization Act of 2003 to make a broad array of
preventive health care services a standard part of Medicare.
To date, the Congress has added selected preventive services
to Medicare but has not included other services that are
proven effective; nor has it encouraged Medicare to take a
comprehensive approach to disease prevention and health
promotion for American seniors and people with disabilities.
Passage of this legislation would mean that, for the first
time and to the benefit of millions of Americans, prevention
would be placed on a level playing field with disease
detection, diagnosis and treatment under Medicare.
We thank you for recognizing that prevention is a good
investment, diminishing disability and discomfort, leading to
less time spent in hospitals and in nursing homes and more
time spent at home and in the community. In many cases,
effective preventive services will generate cost savings for
Medicare, as well as providing beneficiaries with more
productive years of life.
About one in eight of Medicare's 40+ million beneficiaries,
about 5 million people, are people with disabilities under
age 65, people who have worked and become disabled, or who
are the adult dependents or survivors of eligible workers.
According to the National Economic Council, these
beneficiaries are 35 percent less likely to have any sort of
employer-based coverage, compared to elderly beneficiaries
who sometimes have coverage through retiree health plans.
Thus, access to any prevention benefits outside their
Medicare coverage is severely limited.
For individuals with disabilities, prevention is truly no
less important than medical treatment. A primary disability
can often mean that a person is extremely at risk for, or
susceptible to, secondary health or disabling conditions.
Compounding this fact is the fact that many of these
secondary conditions may be low-incidence conditions that
affect only a small population and would, therefore, not
necessarily be those that come to the attention of Congress
when new coverage decisions are made.
Additionally, as people with a wide range of disabilities
grow older, the impact of their disability may lead to
premature occurrence of age-related conditions. Clearly, the
Medicare Preventive Services Coverage Acts of 2004 would be
of great assistance to these beneficiaries by allowing
decisions about coverage of preventive services to be made in
the same manner as coverage decisions for other services,
making preventive service coverage decisions more timely,
individualized and evidence-based.
We are also pleased that the bill would eliminate co-
payments and deductibles from all future preventive benefits.
There is currently a confusing array of cost-sharing
requirements across Medicare's covered preventive benefits,
and Medicare beneficiaries with disabilities are more likely
to have lower incomes. By definition, people receiving
disability insurance often are unable to engage in full-time
work due to their conditions, and more than three-fourths of
these beneficiaries have income below 200 percent of the
poverty level, compared to half of elderly beneficiaries.
United Cerebral Palsy wishes you the best and offers our
support in gaining passage of this critical legislation.
Sincerely,
Stephen Bennett,
President and Chief Executive Officer,
United Cerebral Palsy.
______
By Ms. COLLINS (for herself and Mr. Wyden):
S. 2536. A bill to enumerate the responsibilities of the Officer for
Civil Rights and Civil Liberties of the Department of Homeland
Security, to require the Inspector General of the Department of
Homeland Security to designate a senior official to investigate civil
rights complaints, and for other purposes; to the Committee on
Governmental Affairs.
Mr. COLLINS. Mr. President, today Senator Wyden and I are introducing
the Homeland Security Civil Rights and Civil Liberties Protection Act
of 2004. It has been a pleasure to work with my colleague from Oregon
on this legislation to strengthen protections for civil rights and
civil liberties. In the wake of the terrorist attacks on September 11,
2001, during his joint address to Congress, the President called on all
Americans to ``uphold the values of America and remember why so many
have come here. We're in a fight for our principles, and our first
responsibility is to live by them.''
In response to the need to safeguard our homeland, Congress enacted
the Homeland Security Act of 2002 that
[[Page S7004]]
created the Department of Homeland Security, the most significant
government restructuring in more than 50 years. But in focusing our
attention on protecting the homeland from future terrorist attacks, we
also must ensure that we do not trample on the very values that the
terrorists seek to destroy. In enacting the Homeland Security Act,
Congress understood the importance of providing checks and balances to
protect civil rights and civil liberties. To this end, Congress created
within the Department three positions devoted wholly or in part to
ensuring respect for civil liberties as the Department carries out its
mandate to protect our homeland. These positions are the Officer for
Civil Rights and Civil Liberties, the Privacy Officer, and the
Department's Inspector General. These three officials have crucial
roles in assessing actions of the Department that may affect personal
privacy, civil rights, and civil liberties.
The nature of the mission of the Department of Homeland Security
makes safeguards especially important. The Department is now our
country's biggest law enforcement agency. It has more Federal officers
with arrest and firearm authority than the Department of Justice. In
addition, DHS law enforcement personnel have contact with thousands of
people every day. In this post 9/11 world, DHS law enforcement
personnel must be especially sensitive to maintaining civil liberties
as they work to strengthen security and detect and deter terrorist
attacks.
I am pleased that the leadership of the Department recognizes the
fundamental importance of protecting the rights of all of us while
fighting terrorism. Under the leadership of Secretary Ridge, the new
Department of Homeland Security has won praise for its commitment to
the protection of our freedoms. Secretary Ridge has provided the
Officer for Civil Rights and Civil Liberties and the Privacy Officer
with the tools they need to be effective. These officials have
functioned at the senior level, regularly providing advice to the
Secretary and his deputies. The Officer for Civil Rights and Civil
Liberties, the Privacy Officer and the Inspector General have met
regularly with organizations concerned about civil liberties, privacy,
human rights, and immigrant rights and have been responsive to their
concerns.
It is time for Congress to build on the foundation Secretary Ridge
has laid in protecting civil rights and civil liberties. I believe the
Homeland Security Civil Rights and Civil Liberties Protection Act of
2004 does exactly that.
The bill would write into law the activities of the Officer for Civil
Rights and Civil Liberties. As enacted, the Homeland Security Act did
not clearly define the duties of that position. Over the past year,
however, a strong Officer, with the support of the Department's
leadership, has charted an important course for his office. The Officer
has worked closely with the senior leadership of the Department. He has
assisted in the development of departmental policies to ensure that
civil liberties are given due consideration. He has overseen compliance
with constitutional and other requirements relating to the rights and
liberties of individuals affected by the Department's programs. He has
coordinated with the Privacy Officer to ensure that overlapping privacy
and civil rights concerns are addressed in a comprehensive way. And he
has investigated alleged abuses of civil rights and civil liberties.
None of these activities is expressly addressed in the statutory
language creating the Department, and there is no assurance in the law
that future Officers for Civil Rights and Civil Liberties will work so
energetically to carry out these vital duties. It is time for the law
to catch up with practice, and the Homeland Security Civil Rights and
Civil Liberties Protection Act ensures that goal.
The bill also clarifies that the Officer for Civil Rights and Civil
Liberties as well as the Privacy Officer should report directly to the
Secretary, and requires coordination between those officers to ensure
an integrated and comprehensive approach to the important issues they
address.
The Homeland Security Civil Rights and Civil Liberties Protection Act
of 2004 strengthens the ability of the Department's Inspector General
to safeguard civil rights and civil liberties by requiring the DHS
Inspector General to designate a senior official to coordinate
investigation of abuses, ensure public awareness of complaint
procedures, and coordinate his or her work with the Officer for Civil
Rights and Civil Liberties. This position is similar to one Congress
created in the Office of the Inspector General of the Department of
Justice.
Finally, the Homeland Security Civil Rights and Civil Liberties
Protection Act of 2004 amends the mission statement of the Department
of Homeland Security to ensure that actions taken by the Department to
protect the homeland do not diminish civil liberties and civil rights.
This important revision places into the statutory language that the
protection of civil rights and civil liberties is crucial in this time
of heightened security.
The battle against terror will last for many years, perhaps decades.
During that long struggle, we must continue to secure our nation
against future attacks, but at the same time protect those American
values that define our free society. The Homeland Security Civil Rights
and Civil Liberties Protection Act of 2004 will strengthen the
protection of civil rights and civil liberties and will help to ensure
that that protection will continue in the years to come.
Mr. President, I ask unanimous consent that the text of the bill be
printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 2536
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 ``Homeland Security Civil
Rights and Civil Liberties Protection Act of 2004''.
SEC. 2. MISSION OF DEPARTMENT OF HOMELAND SECURITY.
Section 101(b)(1) of the Homeland Security Act of 2002 (6
U.S.C. 111(b)(1)) is amended--
(1) in subparagraph (F), by striking ``and'' after the
semicolon;
(2) by redesignating subparagraph (G) as subparagraph (H);
and
(3) by inserting after subparagraph (F) the following:
``(G) ensure that the civil rights and civil liberties of
persons are not diminished by efforts, activities, and
programs aimed at securing the homeland; and''.
SEC. 3. OFFICER FOR CIVIL RIGHTS AND CIVIL LIBERTIES.
Section 705(a) of the Homeland Security Act of 2002 (6
U.S.C. 345(a)) is amended--
(1) in the matter preceding paragraph (1), by inserting
``report directly to the Secretary and shall'' after ``who
shall'';
(2) in paragraph (1), by striking ``and'' at the end;
(3) in paragraph (2), by striking the period at the end and
inserting a semicolon; and
(4) by adding at the end the following:
``(3) assist the Secretary, directorates, and offices of
the Department to develop, implement, and periodically review
Department policies and procedures to ensure that the
protection of civil rights and civil liberties is
appropriately incorporated into Department programs and
activities;
``(4) oversee compliance with constitutional, statutory,
regulatory, policy, and other requirements relating to the
civil rights and civil liberties of individuals affected by
the programs and activities of the Department;
``(5) coordinate with the Privacy Officer to ensure that--
``(A) programs, policies, and procedures involving civil
rights, civil liberties, and privacy considerations are
addressed in an integrated and comprehensive manner; and
``(B) Congress receives appropriate reports regarding such
programs, policies, and procedures; and
``(6) investigate complaints and information indicating
possible abuses of civil rights or civil liberties, unless
the Inspector General of the Department determines that any
such complaint or information should be investigated by the
Inspector General.''.
SEC. 4. PROTECTION OF CIVIL RIGHTS AND CIVIL LIBERTIES BY
OFFICE OF INSPECTOR GENERAL.
Section 8I of the Inspector General Act of 1978 (5 U.S.C.
App.) is amended by adding at the end the following:
``(f)(1) The Inspector General of the Department of
Homeland Security shall designate a senior official within
the Office of Inspector General, who shall be a career member
of the civil service at the equivalent to the GS-15 level or
a career member of the Senior Executive Service, to perform
the functions described in paragraph (2).
``(2) The senior official designated under paragraph (1)
shall--
``(A) coordinate the activities of the Office of Inspector
General with respect to investigations of abuses of civil
rights or civil liberties;
``(B) receive and review complaints and information from
any source alleging abuses of civil rights and civil
liberties by employees or officials of the Department and
employees or officials of independent contractors or grantees
of the Department;
[[Page S7005]]
``(C) initiate investigations of alleged abuses of civil
rights or civil liberties by employees or officials of the
Department and employees or officials of independent
contractors or grantees of the Department;
``(D) ensure that personnel within the Office of Inspector
General receive sufficient training to conduct effective
civil rights and civil liberties investigations;
``(E) consult with the Officer for Civil Rights and Civil
Liberties regarding--
``(i) alleged abuses of civil rights or civil liberties;
and
``(ii) any policy recommendations regarding civil rights
and civil liberties that may be founded upon an investigation
by the Office of Inspector General;
``(F) provide the Officer for Civil Rights and Civil
Liberties with information regarding the outcome of
investigations of alleged abuses of civil rights and civil
liberties;
``(G) refer civil rights and civil liberties matters that
the Inspector General decides not to investigate to the
Officer for Civil Rights and Civil Liberties;
``(H) ensure that the Office of the Inspector General
publicizes and provides convenient public access to
information regarding--
``(i) the procedure to file complaints or comments
concerning civil rights and civil liberties matters; and
``(ii) the status of investigations initiated in response
to public complaints; and
``(I) inform the Officer for Civil Rights and Civil
Liberties of any weaknesses, problems, and deficiencies
within the Department relating to civil rights or civil
liberties.''.
SEC. 5. PRIVACY OFFICER.
Section 222 of the Homeland Security Act of 2002 (6 U.S.C.
142) is amended--
(1) in the matter preceding paragraph (1), by inserting ``,
who shall report directly to the Secretary,'' after ``in the
Department'';
(2) in paragraph (4), by striking ``and'' at the end;
(3) by redesignating paragraph (5) as paragraph (6); and
(4) by inserting after paragraph (4) the following:
``(5) coordinating with the Officer for Civil Rights and
Civil Liberties to ensure that--
``(A) programs, policies, and procedures involving civil
rights, civil liberties, and privacy considerations are
addressed in an integrated and comprehensive manner; and
``(B) Congress receives appropriate reports on such
programs, policies, and procedures; and''.
Mr. WYDEN. Mr. President, the threat of terrorism is an unfortunate
fact of life today, and it is not going to go away any time soon.
Protecting American citizens against this threat will continue to be an
essential and urgent task for the foreseeable future.
However, I do not believe that fighting terrorism aggressively
requires tossing civil liberties protections into the scrap heap. This
is not an ``either or'' choice. This country's tradition of high
standards of civil rights and civil liberties should not and need not
become the first casualty of the war on terrorism.
I have made this point repeatedly in the time since the terrorist
attacks of 9/11. Still, all too often, we have seen well-meaning
government agencies take the approach of designing a security system or
program first, and worrying about the civil liberties and privacy
implications later.
I am convinced that the approach of making civil liberties an
afterthought doesn't work and isn't acceptable. Civil liberties and
privacy considerations need to be built into the DNA of the Homeland
Security Department and its various programs.
The legislation that created the Homeland Security Department
included some very positive steps in that regard, by creating an
Officer for Civil Rights and Civil Liberties and a Privacy Officer.
Today, I am joining Senator Collins in introducing new legislation to
flesh out the role and stature of these key offices within the
Department.
Specifically, the legislation would add a reference to civil
liberties to the statutory mission statement of the Department of
Homeland Security. It would provide further detail as to the duties of
the Officer for Civil Rights and Civil Liberties. It would specify that
both the Officer for Civil Rights and Civil Liberties and the Privacy
Officer shall report directly to the Secretary. And it would direct the
DHS Inspector General to designate a point person within the I.G.
office to focus expressly on civil liberties matters.
None of these items represents a radical departure from the original
Homeland Security legislation or the current practice of the
department. Rather, this new bill codifies much of what is already
going on, giving it a firm statutory basis.
I hope my colleagues will join Senator Collins and me in supporting
this legislation, and in delivering a strong message that civil
liberties matters remain a core factor in this country's homeland
security efforts. I ask unanimous consent that the text of the bill be
printed in the Record.
______
By Mr. LIEBERMAN (for himself and Mr. Dodd):
S. 2538. A bill to provide a grant program to support the
establishment and operation of Teachers Institutes; to the Committee on
Health, Education, Labor, and Pensions.
Mr. LIEBERMAN. Mr. President, today I am introducing legislation,
along with my colleague from Connecticut, Mr. Dodd, that will
strengthen the content and pedagogy knowledge of our present K-12
teacher workforce and thus ultimately raise student achievement.
My proposal would establish eight new Teacher Professional
Development Institutes throughout the Nation each year over the next
five years based on the model which has been operating at Yale
University for over 25 years. Every Teacher Institute would consist of
a partnership between an institution of higher education and the local
public school system in which a significant proportion of the students
come from low-income households. These Institutes will strengthen the
present teacher workforce by giving each participant an opportunity to
gain more sophisticated content knowledge and a chance to develop
curriculum units with other colleagues that can be directly applied in
their classrooms. We know that teachers gain confidence and enthusiasm
when they have a deeper understanding of the subject matter that they
teach and this translates into higher expectations for their students
and thus, an increase in student achievement.
The Teacher Professional Development Institutes are based on the
Yale-New Haven Teachers Institute model that has been in existence
since 1978. For over 25 years, the Institute has offered six or seven
thirteen-session seminars each year, led by Yale faculty, on topics
that teachers have selected to enhance their mastery of the
specific subject area that they teach. The subject selection process
begins with representatives from the Institutes soliciting ideas from
teachers throughout the school district for topics on which teachers
feel they need to have additional preparation, topics that will assist
them in preparing materials they need for their students, or topics
that will assist them in addressing the standards that the school
district requires. As a consensus emerges about desired seminar
subjects, the Institute director identifies university faculty members
with the appropriate expertise, interest and desire to lead the
seminar. University faculty members, especially those who have led
Institute seminars before, may sometimes suggest seminars they would
like to lead, and these ideas are circulated by the representatives as
well. The final decisions on which seminar topics are offered are
ultimately made by the teachers who participate. In this way, the
offerings are designed to respond to what teachers believe is needed
and useful for both themselves and their students.
The cooperative nature of the Institute seminar planning process
ensures its success: Institutes offer seminars and relevant materials
on topics teachers have identified and feel are needed for their own
preparation as well as what they know will motivate and engage their
students. Teachers enthusiastically take part in rigorous seminars they
have requested, and as part of the program, practice using the
materials they have obtained and developed. This helps ensure that the
experience not only increases their preparation in the subjects they
are assigned to teach, but also their participation in an Institute
seminar gives them immediate hands-on active learning materials that
can be used in the classroom. In short, by allowing teachers to
determine the seminar subjects and providing them the resources to
develop relevant curricula for their classroom and their students, the
Institutes empower teachers. Teachers know their students best and they
know what should be done to improve schools and increase student
learning. The Teacher Professional Development Institutes promote this
philosophy.
From 1999-2002, the Yale-New Haven Teachers Institute launched a
National
[[Page S7006]]
Demonstration Project to create comparable Institutes at four diverse
sites with large concentrations of disadvantaged students. These
demonstration projects are located in Pittsburgh, PA, Houston, TX,
Albuquerque, NM, and Santa Ana, CA.
Follow-up evaluations have earned very positive results from the
teacher participants in the Yale-New Haven Institute, as well as the
four demonstration sites. The data strongly support the conclusion that
virtually all teachers felt substantially strengthened in their mastery
of content knowledge and they also developed increased expectations for
what their students could achieve. In addition, because of their
involvement in the course selection and curriculum development process,
teacher participants have found these seminars to be especially
relevant and useful in their classroom practices. Ninety-five percent
of all participating teachers reported that the seminars were useful.
These Institutes have also served to foster teacher leadership, to
develop supportive teacher networks, to heighten university faculty
commitments to improving K-12 public education, and to foster more
positive partnerships between school districts and institutions of
higher education.
By some studies, teacher quality is the single most important school-
related factor in determining student achievement. In support of this,
the No Child Left Behind Act requires a ``highly qualified'' teacher to
be in every classroom by the end of 2005-2006. Effective teacher
professional development programs that focus on subject and pedagogy
knowledge are a proven method for enhancing the success of a teacher in
the classroom and in helping them meet the highly qualified criteria.
Though a K-12 teacher shortage is forecast in the near-term and many
new teachers will be entering our schools, those teachers who are
presently on the job will do the majority of teaching in the classrooms
in the very near future. For this reason, it is imperative to invest in
methods to strengthen our present teaching workforce. Like many
professions, the quality of our teachers could diminish if their
professional development is neglected. Research has shown that positive
educational achievements occur when coursework in a teachers' specific
content area is combined with pedagogy techniques. This is what the
Teacher Professional Development Institutes Act strives to accomplish.
The Yale-New Haven Institutes have already proven to be a successful
model for teacher professional development as demonstrated by the high
caliper curriculum unit plans that teacher participants have developed
and placed on the web and by the evaluations that support the
conclusion that virtually all the teacher participants felt
substantially strengthened in their mastery of content knowledge and
their teaching skills. My proposal would open this opportunity to many
more urban teachers throughout the nation.
I urge my colleagues to act favorably on this measure. 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. 2538
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. TEACHER PROFESSIONAL DEVELOPMENT INSTITUTES.
Title II of the Higher Education Act of 1965 (20 U.S.C.
1021 et seq.) is amended by adding at the end the following:
``PART C--TEACHER PROFESSIONAL DEVELOPMENT INSTITUTES
``SEC. 241. SHORT TITLE.
``This part may be cited as the `Teacher Professional
Development Institutes Act'.
``SEC. 242. FINDINGS AND PURPOSE.
``(a) Findings.--Congress makes the following findings:
``(1) The ongoing professional development of teachers in
the subjects the teachers teach is essential for improved
student learning.
``(2) Attaining the goal of the No Child Left Behind Act of
2001, of having a teacher who is highly qualified in every
core subject classroom, will require innovative and effective
approaches to improving the quality of teaching.
``(3) The Teachers Institute Model is an innovative
approach that encourages a collaboration between urban school
teachers and university faculty. The Teachers Institute Model
focuses on the continuing academic preparation of school
teachers and the application of what the teachers study to
their classrooms and potentially to the classrooms of other
teachers.
``(4) The Teachers Institute Model has also been
successfully demonstrated over a 3-year period in a National
Demonstration Project (hereafter in this part referred to as
the `National Demonstration Project') in several cities.
``(b) Purpose.--The purpose of this part is to provide
Federal assistance to support the establishment and operation
of Teachers Institutes for local educational agencies that
serve significant low-income populations in States throughout
the Nation--
``(1) to improve student learning; and
``(2) to enhance the quality of teaching by strengthening
the subject matter mastery of current teachers through
continuing teacher preparation.
``SEC. 243. DEFINITIONS.
``In this part:
``(1) Poverty line.--The term `poverty line' means the
poverty line (as defined by the Office of Management and
Budget, and revised annually in accordance with section
673(2) of the Community Services Block Grant Act) applicable
to a family of the size involved.
``(2) Significant low-income population.--The term
`significant low-income population' means a student
population of which not less than 25 percent are from
families with incomes below the poverty line.
``(3) State.--The term `State' means each of the several
States of the United States, the District of Columbia, and
the Commonwealth of Puerto Rico.
``(4) Teachers institute.--The term `Teachers Institute'
means a partnership or joint venture between or among 1 or
more institutions of higher education, and 1 or more local
educational agencies serving a significant low-income
population, which partnership or joint venture--
``(A) is entered into for the purpose of improving the
quality of teaching and learning through collaborative
seminars designed to enhance both the subject matter and the
pedagogical resources of the seminar participants; and
``(B) works in collaboration to determine the direction and
content of the collaborative seminars.
``SEC. 244. GRANT AUTHORITY.
``(a) In General.--The Secretary is authorized--
``(1) to award grants to Teachers Institutes to encourage
the establishment and operation of Teachers Institutes; and
``(2) to provide technical assistance, either directly or
through existing Teachers Institutes, to assist local
educational agencies and institutions of higher education in
preparing to establish and in operating Teachers Institutes.
``(b) Selection Criteria.--In selecting a Teachers
Institute for a grant under this part, the Secretary shall
consider--
``(1) the extent to which the proposed Teachers Institute
will serve a community with a significant low-income
population;
``(2) the extent to which the proposed Teachers Institute
will follow the Understandings and Necessary Procedures that
have been developed following the National Demonstration
Project;
``(3) the extent to which the local educational agency
participating in the proposed Teachers Institute has a high
percentage of teachers who are unprepared or under prepared
to teach the core academic subjects the teachers are assigned
to teach; and
``(4) the extent to which the proposed Teachers Institute
will receive a level of support from the community and other
sources that will ensure the requisite long-term commitment
for the success of a Teachers Institute.
``(c) Consultation.--
``(1) In general.--In evaluating applications under
subsection (b), the Secretary may request the advice and
assistance of existing Teachers Institutes.
``(2) State agencies.--If the Secretary receives 2 or more
applications for new Teachers Institutes that propose serving
the same State, the Secretary shall consult with the State
educational agency regarding the applications.
``(d) Fiscal agent.--For the purpose of this part, an
institution of higher education participating in a Teachers
Institute shall serve as the fiscal agent for the receipt of
grant funds under this part.
``(e) Limitations.--A grant under this part--
``(1) shall be awarded for a period not to exceed 5 years;
and
``(2) shall not exceed 50 percent of the total costs of the
eligible activities, as determined by the Secretary.
``SEC. 245. ELIGIBLE ACTIVITIES.
``(a) In General.--Grant funds awarded under this part may
be used--
``(1) for the planning and development of applications for
the establishment of Teachers Institutes;
``(2) to provide assistance to the Teachers Institutes
established during the National Demonstration Project to
enable the Teachers Institutes--
``(A) to develop further the Teachers Institutes; or
``(B) to support the planning and development of
applications for new Teachers Institutes;
``(3) for the salary and necessary expenses of a full-time
director to plan and manage the Teachers Institute and to act
as liaison
[[Page S7007]]
between the local educational agency and the institution of
higher education participating in the Teachers Institute;
``(4) to provide suitable office space, staff, equipment,
and supplies, and to pay other operating expenses, for the
Teachers Institute;
``(5) to provide a stipend for teachers participating in
collaborative seminars in the sciences and humanities, and to
provide remuneration for those members of the faculty of the
institution of higher education participating in the Teachers
Institute who lead the seminars; and
``(6) to provide for the dissemination through print and
electronic means of curriculum units prepared in the seminars
conducted by the Teachers Institute.
``(b) Technical Assistance.--The Secretary may use not more
than 50 percent of the funds appropriated to carry out this
part to provide technical assistance to facilitate the
establishment and operation of Teachers Institutes. For the
purpose of this subsection, the Secretary may contract with
existing Teachers Institutes to provide all or a part of the
technical assistance under this subsection.
``SEC. 246. APPLICATION, APPROVAL, AND AGREEMENT.
``(a) In General.--To receive a grant under this part, a
Teachers Institute shall submit an application to the
Secretary that--
``(1) meets the requirement of this part and any
regulations under this part;
``(2) includes a description of how the Teachers Institute
intends to use funds provided under the grant;
``(3) includes such information as the Secretary may
require to apply the criteria described in section 244(b);
``(4) includes measurable objectives for the use of the
funds provided under the grant; and
``(5) contains such other information and assurances as the
Secretary may require.
``(b) Approval.--The Secretary shall--
``(1) promptly evaluate an application received for a grant
under this part; and
``(2) notify the applicant within 90 days of the receipt of
a completed application of the Secretary's approval or
disapproval of the application.
``(c) Agreement.--Upon approval of an application, the
Secretary and the Teachers Institute shall enter into a
comprehensive agreement covering the entire period of the
grant.
``SEC. 247. REPORTS AND EVALUATIONS.
``(a) Report.--Each Teachers Institute receiving a grant
under this part shall report annually on the progress of the
Teachers Institute in achieving the purpose of this part and
the purposes of the grant.
``(b) Evaluation and Dissemination.--
``(1) Evaluation.--The Secretary shall evaluate the
activities funded under this part and submit an annual report
regarding the activities to the Committee on Health,
Education, Labor, and Pensions of the Senate and the
Committee on Education and the Workforce of the House of
Representatives.
``(2) Dissemination.--The Secretary shall broadly
disseminate successful practices developed by Teachers
Institutes.
``(c) Revocation.--If the Secretary determines that a
Teachers Institute is not making substantial progress in
achieving the purpose of this part and the purposes of the
grant by the end of the second year of the grant under this
part, the Secretary may take appropriate action, including
revocation of further payments under the grant, to ensure
that the funds available under this part are used in the most
effective manner.
``SEC. 248. AUTHORIZATION OF APPROPRIATIONS.
``There are authorized to be appropriated to carry out this
part--
``(1) $4,000,000 for fiscal year 2005;
``(2) $5,000,000 for fiscal year 2006;
``(3) $6,000,000 for fiscal year 2007;
``(4) $7,000,000 for fiscal year 2008; and
``(5) $8,000,000 for fiscal year 2009.''.
______
By Mr. CAMPBELL (for himself, Mr. Inouye, Mr. Domenici, and Mr.
Smith):
S. 2539. A bill to amend the Tribally Controlled Colleges or
University Assistance Act and the Higher Education Act to improve
Tribal Colleges and Universities, and for other purposes; to the
Committee on Indian Affairs.
Mr. CAMPBELL. Mr. President, today I am pleased to introduce
legislation to update and improve the Tribally Controlled Colleges or
University Assistance Act and amend the Indian sections of the Higher
Education Act.
Indian tribal colleges were first created about 30 years ago in
response to the higher education needs of Native populations living in
remote and isolated areas of the country where access to higher
education is extremely difficult.
There are 33 tribally- or Federally-chartered Indian colleges in the
Nation and they do a superb job despite the many obstacles they face.
In recent years the cost of higher education has far exceeded the
rate of inflation. Tribal colleges face other problems as well: a
growing population and growing demand for services; increased demand
for additional facilities; geographical isolation; and difficulty
attracting quality professors to teach.
Tribal colleges not only provide a quality higher education but also
enhance the cultural knowledge, knowledge depositories, college
preparatory work, and other important educational needs of Indian
communities.
Tribal colleges also enhance the economies of tribes. The national
unemployment rate in the U.S. today is about 5.6 percent, while the
rate for Native Americans is many times that and in some parts of
Indian country hovers above 50 percent.
Tribal colleges serve as centers for business incubation and small
business development in order to encourage private business development
and job creation.
Tribal colleges are also being called on to help Indian communities
in the often-difficult transition from welfare to work. These
institutions also provide education and training to people ready to
join the workforce.
To continue the vital work of these colleges, the bill I am
introducing will provide additional resources and means to develop
facilities, increase quality faculty and improve the overall education
of Indian people within their reservations.
I urge my colleagues to join me in supporting this important bill.
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. 2539
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
TITLE I--TRIBAL COLLEGES AND UNIVERSITIES
SEC. 101. TRIBALLY CONTROLLED COLLEGE OR UNIVERSITY ACT OF
1978.
(a) Formula.--Section 108(a)(2) of the Tribally Controlled
College or University Assistance Act of 1978 (25 U.S.C. 1808)
is amended by striking ``$6,000'' and inserting ``$8,000''.
(b) Title I Reauthorization.--Section 110(a) of the
Tribally Controlled College or University Assistance Act of
1978 (25 U.S.C. 1810(a)) is amended--
(1) in paragraphs (1), (2), (3), and (4), by striking
``1999'' and inserting ``2004'';
(2) in paragraphs (1), (2), and (3), by striking ``4
succeeding'' and inserting ``5 succeeding'';
(3) in paragraph (2), by striking ``$40,000,000'' and
inserting ``$55,000,000'';
(4) in paragraph (3), by striking ``$10,000,000'' and
inserting ``$20,000,000''; and
(5) in paragraph (4), by striking ``succeeding 4'' and
inserting ``5 succeeding''.
(c) Title III Reauthorization.--Section 306(a) of the
Tribally Controlled College or University Assistance Act of
1978 (25 U.S.C. 1836(a)) is amended--
(1) by striking ``1999'' and inserting ``2004''; and
(2) by striking ``4 succeeding'' and inserting ``5
succeeding''.
(d) Title IV Reauthorization.--Section 403 of the Tribal
Economic Development and Technology Related Education
Assistance Act of 1990 (25 U.S.C. 1852) is amended--
(1) by striking ``$2,000,000 for fiscal year 1999'' and
inserting ``$5,000,000 for fiscal year 2004''; and
(2) by striking ``4 succeeding'' and inserting ``5
succeeding''.
(e) Clarification of the Definition of National Indian
Organization.--Section 2(a)(6) of the Tribally Controlled
College or University Assistance Act of 1978 (25 U.S.C.
1801(a)(6)) is amended by striking ``in the field of Indian
education'' and inserting ``in the field of Tribal Colleges
and Universities and Indian higher education''.
(f) Indian Student Count.--Section 2(a) of the Tribally
Controlled College or University Assistance Act (25 U.S.C.
1801(a)) is amended--
(1) by redesignating paragraphs (7) and (8) as paragraphs
(8) and (9), respectively; and
(2) by inserting after paragraph (6) the following:
``(7) `Indian student' means a person who is--
``(A) a member of an Indian tribe; or
``(B) a biological child of a member of an Indian tribe,
living or deceased;''.
(g) Continuing Education.--Section 2(b) of the Tribally
Controlled College or University Assistance Act (25 U.S.C.
1801(b)) is amended by striking paragraph (5) and inserting
the following:
``(5) Determination of credits.--Eligible credits earned in
a continuing education program--
``(A) shall be determined as 1 credit for every 10 contact
hours in the case of an institution on a quarter system, or
15 contact hours in the case of an institution on a semester
system, of participation in an organized continuing education
experience under responsible sponsorship, capable direction,
and qualified instruction, as described in the criteria
established by the International Association for Continuing
Education and Training; and
``(B) shall be limited to 10 percent of the Indian student
count of a tribally controlled college or university.''.
[[Page S7008]]
(h) Accreditation Requirement.--Section 103 of the Tribally
Controlled College or University Assistance Act (25 U.S.C.
1804) is amended--
(1) in paragraph (2), by striking ``and'' at the end;
(2) in paragraph (3), by striking the period at the end and
inserting ``; and''; and
(3) by inserting after paragraph (3), the following:
``(4)(A) is accredited by a nationally recognized
accrediting agency or association determined by the Secretary
of Education to be a reliable authority with regard to the
quality of training offered; or
``(B) is, according to such an agency or association,
making reasonable progress toward accreditation.''.
(i) Technical Assistance Contract Awards.--Section 105 of
the Tribally Controlled College or University Assistance Act
(25 U.S.C. 1805) is amended in the second sentence by
striking ``In the awarding of contracts for technical
assistance, preference shall be given'' and inserting ``The
Secretary shall direct that contracts for technical
assistance be awarded''.
SEC. 102. TITLE III GRANTS FOR AMERICAN INDIAN TRIBALLY
CONTROLLED COLLEGES AND UNIVERSITIES.
(a) Definition of Tribal College or University.--Section
316(b) of the Higher Education Act of 1965 (20 U.S.C.
1059c(b)) is amended by striking paragraph (3) and inserting
the following:
``(3) Tribal college or university.--
``(A) In general.--The term `Tribal College or University'
means an institution that meets the definition of tribally
controlled college or university in section 2 of the Tribally
Controlled College or University Assistance Act of 1978 (25
U.S.C. 1801).
``(B) Inclusions.--The term `Tribal College or University'
includes Bay Mills Community College; Blackfeet Community
College; Cankdeska Cikana Community College; Chief Dull Knife
College; College of Menominee Nation; Crownpoint Institute of
Technology; Dine College; D-Q University; Fond Du Lac Tribal
and Community College; Fort Belknap College; Fort Berthold
Community College; Fort Peck Community College; Haskell
Indian Nations University; Institute of American Indian and
Alaska Native Culture and Arts Development; Lac Courte
Oreilles Ojibwa Community College; Leech Lake Tribal College;
Little Big Horn College; Little Priest Tribal College;
Nebraska Indian Community College; Northwest Indian College;
Oglala Lakota College; Saginaw Chippewa Tribal College;
Salish Kootenai College; Si Tanka University-Eagle Butte
Campus; Sinte Gleska University; Sisseton Wahpeton Community
College; Sitting Bull College; Southwestern Indian
Polytechnic Institute; Stone Child College; Tohono O'odham
Community College; Turtle Mountain Community College; United
Tribes Technical College; and White Earth Tribal and
Community College.''.
(b) Distance Learning.--Section 316(c)(2) of the Higher
Education Act of 1965 (20 U.S.C. 1059c(c)(2)) is amended--
(1) in subparagraph (B), by inserting before the semicolon
at the end the following: ``and the acquisition of real
property adjacent to the campus of the institution on which
to construct such facilities'';
(2) in subparagraph (K), by striking ``and'' at the end;
(3) by redesignating subparagraph (L) as subparagraph (M);
and
(4) by inserting after subparagraph (K) the following:
``(L) developing or improving facilities for Internet use
or other distance learning academic instruction capabilities;
and''.
(c) Application, Plan, and Allocation.--Section 316 of the
Higher Education Act of 1965 (20 U.S.C. 1059c) is amended by
striking subsection (d) and inserting the following:
``(d) Application, Plan, and Allocation.--
``(1) Institutional eligibility.--To be eligible to receive
assistance under this section, a Tribal College or University
shall be an eligible institution under section 312(b).
``(2) Application.--
``(A) In general.--A Tribal College or University desiring
to receive assistance under this section shall submit an
application to the Secretary at such time, and in such
manner, as the Secretary may reasonably require.
``(B) Streamlined process.--The Secretary shall establish
application requirements in such a manner as to simplify and
streamline the process for applying for grants.
``(3) Allocations to institutions.--
``(A) Construction grants.--
``(i) In general.--Of the amount appropriated to carry out
this section for any fiscal year, the Secretary shall reserve
30 percent for the purpose of awarding 1-year grants of not
less than $1,000,000 to address construction, maintenance,
and renovation needs at eligible institutions.
``(ii) Preference.--In providing grants under clause (i),
the Secretary shall give preference to eligible institutions
that have not yet received an award under this section.
``(B) Allotment of remaining funds.--
``(i) In general.--Except as provided in clause (ii), the
Secretary shall distribute the remaining funds appropriated
for any fiscal year to each eligible institution as follows:
``(I) 60 percent of the remaining appropriated funds shall
be distributed among the eligible Tribal Colleges and
Universities pro rata basis, based on the respective Indian
student counts (as defined in section 2(a) of the Tribally
Controlled College or University Assistance Act of 1978 (25
U.S.C. 1801(a)) of the Tribal Colleges and Universities; and
``(II) the remaining 40 percent shall be distributed in
equal shares to eligible Tribal Colleges and Universities.
``(ii) Minimum grant.--The amount distributed to a Tribal
College or University under clause (i) shall not be less than
$500,000.
``(4) Special rules.--
``(A) Concurrent funding.--For the purposes of this part,
no Tribal College or University that is eligible for and
receives funds under this section shall concurrently receive
funds under other provisions of this part or part B.
``(B) Exemption.--Section 313(d) shall not apply to
institutions that are eligible to receive funds under this
section.''.
SEC. 103. LOAN REPAYMENT OR CANCELLATION FOR INDIVIDUALS WHO
TEACH IN TRIBAL COLLEGES OR UNIVERSITIES.
(a) Perkins Loans.--
(1) Amendment.--Section 465(a) of the Higher Education Act
of 1965 (20 U.S.C. 1087ee(a)) is amended--
(A) in paragraph (2)--
(i) in subparagraph (H), by striking ``or'' at the end;
(ii) in subparagraph (I), by striking the period at the end
and inserting ``; or''; and
(iii) by adding at the end the following:
``(J) as a full-time teacher at a Tribal College or
University (as defined in section 316(b)).''; and
(B) in paragraph (3)(A)(i), by striking ``or (I)'' and
inserting ``(I), or (J)''.
(2) Effective date.--The amendments made by paragraph (1)
shall be effective for service performed during academic year
1998-1999 and succeeding academic years, notwithstanding any
contrary provision of the promissory note under which a loan
under part E of title IV of the Higher Education Act of 1965
(20 U.S.C. 1087aa et seq.) was made.
(b) FFEL and Direct Loans.--Part G of title IV of the
Higher Education Act of 1965 (20 U.S.C. 1088 et seq.) is
amended by adding at the end the following:
``SEC. 493. LOAN REPAYMENT OR CANCELLATION FOR INDIVIDUALS
WHO TEACH IN TRIBAL COLLEGES OR UNIVERSITIES.
``(a) Definition of Year.--In this section, the term
`year', as applied to employment as a teacher, means an
academic year (as defined by the Secretary).
``(b) Program.--The Secretary shall carry out a program,
through the holder of a loan, of assuming or canceling the
obligation to repay a qualified loan amount, in accordance
with subsection (c), for any new borrower on or after the
date of enactment of this section, who--
``(1) has been employed as a full-time teacher at a Tribal
College or University (as defined in section 316(b)); and
``(2) is not in default on a loan for which the borrower
seeks repayment or cancellation.
``(c) Qualified Loan Amounts.--
``(1) Percentages.--Subject to paragraph (2), the Secretary
shall assume or cancel the obligation to repay under this
section--
``(A) 15 percent of the amount of all loans made, insured,
or guaranteed after the date of enactment of this section to
a student under part B or D, for the first or second year of
employment described in subsection (b)(1);
``(B) 20 percent of such total amount, for the third or
fourth year of such employment; and
``(C) 30 percent of such total amount, for the fifth year
of such employment.
``(2) Maximum.--The Secretary shall not repay or cancel
under this section more than $15,000 in the aggregate of
loans made, insured, or guaranteed under parts B and D for
any student.
``(3) Treatment of consolidation loans.--A loan amount for
a loan made under section 428C may be a qualified loan amount
for the purposes of this subsection only to the extent that
the loan amount was used to repay a loan made, insured, or
guaranteed under part B or D for a borrower who meets the
requirements of subsection (b), as determined in accordance
with regulations promulgated by the Secretary.
``(d) Regulations.--The Secretary may promulgate such
regulations as are necessary to carry out this section.
``(e) Effect of Section.--Nothing in this section
authorizes any refunding of any repayment of a loan.
``(f) Prevention of Double Benefits.--No borrower may, for
the same service, receive a benefit under both this section
and subtitle D of title I of the National and Community
Service Act of 1990 (42 U.S.C. 12571 et seq.).''.
(c) Amounts Forgiven Not Treated as Gross Income.--Rules
similar to the rules under section 108(f) of the Internal
Revenue Code of 1986 shall apply to the amount of any loan
that is assumed or canceled under this section.
TITLE II--NAVAJO HIGHER EDUCATION
SEC. 201. SHORT TITLE.
This title may be cited as the ``Navajo Nation Higher
Education Act of 2004''.
SEC. 202. CONGRESSIONAL FINDINGS.
Congress finds that--
(1) the Treaty of 1868 between the United States of America
and the Navajo Tribe of Indians (15 Stat. 667) provides for
the education of the citizens of the Navajo Nation;
(2) in 1998, the Navajo Nation created and chartered the
Navajo Community College by Resolution CN-95-68 as a wholly
owned educational entity of the Navajo Nation;
(3) in 1971, Congress enacted the Navajo Community College
Act (25 U.S.C. 640a et seq.);
[[Page S7009]]
(4) in 1997, the Navajo Nation officially changed the name
of the Navajo Community College to Dine College by Resolution
CAP-35-97;
(5) the purpose of Dine College is to provide educational
opportunities to the Navajo people and others in areas
important to the economic and social development of the
Navajo Nation;
(6) the mission of Dine College is to apply the principles
of Sa'ah Naaghi Bik'eh Hozhoon (Dine Philosophy) to advance
student learning through training of the mind and heart--
(A) through Nitshkees (Thinking), Nahat (Planning), Iin
(Living), and Sihasin (Assurance);
(B) in study of the Dine language, history, philosophy, and
culture;
(C) in preparation for further studies and employment in a
multicultural and technological world; and
(D) in fostering social responsibility, community service,
and scholarly research that contribute to the social,
economic, and cultural well-being of the Navajo Nation;
(7) the United States has a trust and treaty responsibility
to the Navajo Nation to provide for the educational
opportunities for Navajo people;
(8) significant portions of the infrastructure of the
College are dilapidated and pose a serious health and safety
risk to students, employees and the public; and
(9) the purposes and intent of this Act--
(A) are consistent with--
(i) Executive Order 13270 (3 C.F.R. 242 (2002); relating to
tribal colleges and universities)); and
(ii) Executive Order 13336 (69 Fed. Reg. 25295; relating to
American Indian and Alaska Native education), issued on April
30, 2004; and
(B) fulfill the responsibility of the United States to
serve the education needs of the Navajo people.
SEC. 203. DEFINITIONS.
In this title:
(1) College.--The term ``College'' means Dine College.
(2) Costs of operation and maintenance.--The term
``operation and maintenance'' means all costs and expenses
associated with the customary daily operation of the College
and necessary maintenance costs.
(3) Infrastructure.--
(A) In general.--The term ``infrastructure'' means College
buildings, water and sewer facilities, roads, foundation,
information technology, and telecommunications.
(B) Inclusions.--The term ``infrastructure'' includes--
(i) classrooms; and
(ii) external structures, such as walkways.
(4) Nation.--The term ``Nation'' means the Navajo Nation.
(5) Renovations and repairs.--The term ``renovations and
repairs'' means modernization and improvements to the
infrastructure.
(6) Secretary.--The term ``Secretary'' means the Secretary
of the Interior.
SEC. 204. REAUTHORIZATION OF DINE COLLEGE.
Congress authorizes the College to receive all Federal
funding and resources under this Act and other laws for the
operation, improvement, and growth of the College,
including--
(1) provision of programs of higher education for citizens
of the Nation and others;
(2) provision of vocational and technical education for
citizens of the Nation and others;
(3) preservation and protection of the Navajo language,
philosophy, and culture for citizens of the Nation and
others;
(4) provision of employment and training opportunities to
Navajo communities and people;
(5) provision of economic development and community
outreach for Navajo communities and people; and
(6) provision of a safe learning, working, and living
environment for students, employees, and the public.
SEC. 205. FACILITIES AND CAPITAL PROJECTS.
The College may expend money received under section 209(c)
to undertake all renovations and repairs to the
infrastructure of the College, as identified by a strategic
plan approved by the College and submitted to the Secretary.
SEC. 206. STATUS OF FUNDS.
Funds provided to the College under this title may be
treated as non-Federal, private funds of the College for
purposes of any provision of Federal law that requires that
non-Federal or private funds of the College be used in a
project for a specific purpose.
SEC. 207. SURVEY, STUDY, AND REPORT.
(a) Report.--The Secretary shall--
(1) conduct a detailed study of all capital projects and
facility needs of the College; and
(2) submit to Congress a report that --
(A) describes the results of the study not later than
October 31, 2009; and
(B) includes detailed recommendations of the Secretary and
any recommendations or views submitted by the College and the
Nation.
(b) Administrative Expenses.--Funds to carry out this
section may be drawn from general administrative
appropriations to the Secretary.
SEC. 208. CONTINUING ELIGIBILITY FOR OTHER FEDERAL FUNDS.
Except as explicitly provided for in other Federal law,
nothing in this Act precludes the eligibility of the College
to received Federal funding and resources under any program
authorized under--
(1) the Higher Education Act of 1965 (20 U.S.C. 1001 et
seq.); and
(2) the Equity in Educational Land Grant Status Act (Title
V, Part C, of Public Law 103-382; 7 U.S.C. 301 note); or
(3) any other applicable program for the benefit of
institutions of higher education, community colleges, or
postsecondary educational institutions.
SEC. 209. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--There are authorized to be appropriated
for each fiscal year such amounts as are necessary to pay the
costs of operation and maintenance.
(b) Budget Placement.--The Secretary shall fund the costs
of operation and maintenance of the College separately from
tribal colleges and universities recognized and funded by the
Tribally Controlled College or University Assistance Act of
1978 (25 U.S.C. 1801 et seq.).
(c) Facilities and Capital Projects.--
(1) In general.--In addition to amounts made available
under subsection (a), there are authorized to be appropriated
to carry out section 205 $15,000,000 for each of fiscal years
2005 through 2009.
(2) Agencies.--Amounts made available under paragraph (1)
may be funded through any 1 or more of--
(A) the Department of the Interior;
(B) the Department of Education;
(C) the Department of Heath and Human Services;
(D) the Department of Housing and Urban Development;
(E) the Department of Commerce;
(F) the Environmental Protection Agency;
(G) the Department of Veterans Affairs;
(H) the Department of Agriculture;
(I) the Department of Homeland Security;
(J) the Department of Defense;
(K) the Department of Labor; and
(L) the Department of Transportation.
SEC. 210. REPEAL OF NAVAJO COMMUNITY COLLEGE ACT.
This Act supersedes the Navajo Community College Act (25
U.S.C. 640a et seq.).
______
By Ms. CANTWELL:
S. 2540. A bill to protect educational FM radio stations providing
public service broadcasting from commercial encroachment; to the
Committee on Commerce, Science, and Transportation.
Ms. CANTWELL. Mr. President, I stand today to offer a bill to protect
educational radio stations.
Broadcaster Linda Ellerbee has compared radio to a national campfire:
a place where a variety of voices bring us stories, news, opinion,
culture and entertainment. But it seems these days that those
representing the biggest business interests have the best seats at that
campfire.
Current regulations allow commercial broadcasters to move into the
spaces of some, lower-powered educational stations.
Last year the FCC ordered an educational station at a high school in
Pennsylvania to be closed because a commercial broadcaster wanted to
move into that space. That high school station had been serving the
students and the community in Havertown, PA for fifty years. But no
more. The high school station's voice was silenced. And that same FCC
order also closed a radio station operated by a school district in
Princeton, NJ. Both stations lost their licenses so a commercial
broadcaster could get a frequency closer to the very profitable radio
market in Philadelphia.
In my State of Washington, a high school station that has served a
Seattle community for 35 years is now threatened with closure. That's
because a commercial broadcaster located in another State wants to
relocate to a larger city to increase its profits at the expense of the
students of Mercer Island High School and the community the station
serves. And in this case, the school's station also serves an important
tool in the lives of those working in the local music community. The
station focuses on introducing new and local bands to the airways.
These artists are frequently later picked up for airplay by other radio
stations. Few stations across the U.S. perform this role in the music
industry. No other station serves this role so well in the Seattle
music community.
If the FCC allows this move, it could be worth millions to the
commercial broadcasters. But what is the cost to the local community
when this voice is silenced? What is the educational cost to the
students at this high school? What benefits and experiences will they
be losing in the future?
This is a classic example of commercial interests trumping the public
service interest in preserving local educational broadcasters. These
small public service stations usually don't have
[[Page S7010]]
anyone to stand up for them. Since the 1970's, we have seen more than a
hundred of these stations disappear, to be replaced by larger, often
national broadcasters, with little if any connection to the local
community.
The examples I've given you here today are not the only ones. Radio
stations run by universities in Pittsburgh and North Carolina are also
vulnerable to similar attempts.
This is why I am introducing the Educational Radio Protection Act.
My legislation is very simple: educational stations that are able to
meet certain qualifying standards, similar to the requirements for
primary, Class A, stations on FM radio, will be given the same
protected status that these primary stations receive.
This is an important measure to protect community broadcasters. And
the bottom line is that commercial broadcasters won't be able to bump
these educational stations off the radio dial.
I thank you for the time today to discuss an issue that really is a
cornerstone of democracy. For only in a democracy are the voices of the
many heard to bring about a functioning government. I urge my
colleagues to support this bill, and yield the floor.
______
By Mr. McCAIN (for himself, Mr. Brownback, Mrs. Hutchison, and
Mr. Allen):
S. 2541. A bill to reauthorize and restructure the National
Aeronautics and Space Administration, and for other purposes; to the
Committee on Commerce, Science, and Transportation.
Mr. McCAIN. Mr. President, I am pleased to be joined today by
Senators Brownback, Hutchison, and Allen in introducing legislation to
re-authorize the National Aeronautics and Space Administration. This
legislation marks the beginning of a new age of exploration, and the
extension of humanity's quest for knowledge to a manned mission to
Mars.
NASA is currently responsible for a number of programs that create
greater knowledge about the Earth and the universe around us. As we
speak today, the two robots, Spirit and Opportunity, are exploring
craters on Mars in search of ancient lake beds. The Hubble telescope
continues to show us new discoveries about the universe. NASA
satellites also help us to develop a better scientific understanding of
the Earth's atmosphere and its response to natural and human-induced
changes. NASA is in the process of developing airplanes with morphing
wings that will change shape during flight.
Despite all of these wondrous achievements, NASA is an agency in
search of a new mission. For many Americans, the Apollo landings remain
a moment of inspiration, but also a fading memory of the past. Many
space enthusiasts have complained that the manned space program has
been stuck in low Earth orbit and harnessed to a costly space station
and aging Space Shuttle infrastructure. Just last year, we again
witnessed the inherent danger in manned spaceflight, and some
questioned the need for such a risky and expensive program.
To his credit, President Bush announced on the day of the Columbia
tragedy that ``our journey into space will go on.'' In January, the
President offered a bold new space vision and made a firm commitment to
return the Space Shuttle to flight, finish construction of the
International Space Station, and return astronauts to the Moon in
preparation for a manned mission to Mars. This bill would authorize
these activities consistent with the President's overall requested
budget amounts, and set the nation firmly on a course for manned
exploration beyond low Earth orbit.
However, we also have learned from the mistakes of the past.
Unfortunately, NASA's recent history of managing projects, such as the
X-33 and X-34, has been full of disappointment and failure. Many
Members have seen the wisdom of President Reagan's adage to ``trust,
but verify,'' when analyzing NASA's budget numbers. With these lessons
in mind, the bill contains a number of provisions to ensure that NASA
stays on track.
The bill would require the submission of a baseline technical
requirements document and life cycle cost estimate, so that Congress
can find out exactly what is required to implement the President's
vision and begin to determine its cost. The bill also would require an
industrial assessment of the private sector's ability to support manned
missions to the Moon and Mars, and a commercialization plan to identify
opportunities for the private sector to participate in future missions.
Most importantly, the bill would require quarterly life cycle reports
on major systems of the new initiative, and include cost-control
measures when the cost overruns of these systems exceed 15 percent and
25 percent over the total life cycle cost of the system.
The bill also would codify many of the recommendations of the
Columbia Accident Investigation Board (CAIB). Admiral Gehman and the
other board members did an admirable job in thoroughly investigating
the causes of this tragic accident. The bill would establish a lessons-
learned and best practices program to ensure that NASA does not repeat
the mistakes of the past. In addition, the Office of Safety and Mission
Assurance is given independent funding and direct line authority over
the entire Space Shuttle Safety organization. An Independent Technical
Engineering Authority is established within NASA with its own budgetary
line to maintain technical standards, be the sole waiver-granting
authority for technical standards, and perform other tasks. The bill
also would ensure that the Independent Technical Engineering Authority
would recertify the Space Shuttle orbiters for operation prior to any
operations beyond 2010. The bill would include an assessment of NASA's
culture and organization, and an action plan to fix the cultural and
organizational problems that the CAIB identified as a major cause of
the accident. The men and women of the Columbia gave their lives to
further America's knowledge of the Earth and the stars, and we should
honor their memory by ensuring that such an accident never occurs
again.
In addition, the bill would address the problems concerning the
Hubble Space Telescope. As my colleagues know, NASA has indicated that
it cannot use the Space Shuttle for another human mission to service
this national treasure. Both NASA and the National Academy of Sciences
are reviewing options for using robots and other means to save the
telescope. Sixty days after the National Academy releases its report,
the Administrator would be directed to report to Congress on the future
servicing options for Hubble and how much it will cost.
I realize that concerns have been raised regarding some of the cuts
that NASA is proposing to pay for the President's exploration vision.
In order to pay for this new program, we must realize that there is
limited funding and that NASA funding has to be re-allocated. However,
this bill should not be construed as supporting each and every proposed
reduction. Instead, the bill simply would authorize the funding levels
buy the major budget accounts.
Curiosity and a drive to explore have always been quintessential
American traits. This has been most evident in the space program, which
continues to show great advances in human knowledge. However, we are
fully aware of the inherent risks and costs of space exploration, and
the need to mitigate them wherever possible. Based on this knowledge,
let us now embark upon this great journey into the stars to find
whatever may await us.
I urge my colleagues to support this legislation, and look forward to
working with them to ensure passage of this bill this year.
______
By Mr. KENNEDY (for himself and Mr. Edwards):
S. 2542. A bill to provide for review of determinations on whether
schools and local educational agencies made adequate yearly progress
for the 2002-2003 school year taking into consideration subsequent
regulations and guidance applicable to those determinations, and for
other purposes; to the Committee on Health, Education, Labor, and
Pensions.
Mr. KENNEDY. Mr. President, it's a privilege to join my colleagues in
introducing the No Child Left Behind Fairness Act. Our goal is to
achieve accurate and fair determinations of accountability in current
law. The bill does not change the accountability provisions of the law,
but it does require the Department of Education to play by its own
rules in considering the progress of each school.
[[Page S7011]]
The accountability provisions in the No Child Left Behind Act are
critical to accomplishing the goal of closing the achievement gap.
Before its enactment, many communities ignored the gaps between some
children and others in school, even though some groups of students were
consistently falling behind. Communities are now beginning to provide
the help those schools need to meet higher standards for all students,
such as better teacher training, better curriculums, and better support
and attention.
It makes sense to identify schools as needing improvement. There's
nothing wrong with shining a light on areas that need improvement--even
in the best schools. That doesn't mean they are failures.
But for the accountability provisions in the law to be useful, they
must be accurate. We need accurate determinations of whether schools
are making progress.
A full two years after passage of the No Child Left Behind Act, the
Department of Education finally issued the regulations and guidance
that schools need to accurately calculate accountability under the law.
Those rules were a step in the right direction. They specifically
addressed the achievement of children with disabilities and limited
English proficient children.
The Department's rules were effective immediately, but many schools
had already made their evaluations for the year as best they could.
They shouldn't have had to make these assessments and calculations
without adequate guidance. They certainly shouldn't be penalized for
the Department's delay in issuing this guidance.
So far, 28,000 schools have been identified by States as failing to
make adequate yearly progress. Many of those schools were identified in
the 2002-2003 school year, before the new rule were released. A number
of schools and districts identified as failing to make adequate yearly
progress might have succeeded if the new rules had been in effect from
the start. The Department's delay in issuing adequate rules and
guidance has created unnecessary confusion, caused a potential
mislabeling of schools, and misdirected resources from the schools and
students who actually need them.
Some States have asked the Department of Education for permission to
review their scores from last year under the new rules, and submit a
more accurate calculation of accountability. Many of us in Congress
have urged the Secretary of Education to apply the new regulations
retroactively, so that States, school districts, and schools can review
last year's data
On accountability and correct it if necessary. The Secretary of
Education has refused, stating that he lacks the authority to do so.
This bill provides that authority. It enables the new regulations to
be applied retroactively, so that schools will be judged on the same
standards for the past year as they will be in the future, not by
different criteria for different years.
Schools across the country are struggling to comply with the
requirements of the No Child Left Behind Act. If we want schools to be
held accountable, we need to make the process fair. I urge my
colleagues to pass this legislation s soon as possible. Schools are
waiting for our response. They don't deserve an unfair burden in
complying with the act and improving their schools.
I ask unanimous consent that the text of this bill be printed in the
Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 2542
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 ``No Child Left Behind
Fairness Act of 2004''.
SEC. 2. REVIEW OF ADEQUATE YEARLY PROGRESS DETERMINATIONS FOR
SCHOOLS FOR THE 2002-2003 SCHOOL YEAR.
(a) In General.--The Secretary shall require each local
educational agency to provide each school served by the
agency with an opportunity to request a review of a
determination by the agency that the school did not make
adequate yearly progress for the 2002-2003 school year.
(b) Final Determination.--Not later than 30 days after
receipt of a request by a school for a review under this
section, a local educational agency shall issue and make
publicly available a final determination on whether the
school made adequate yearly progress for the 2002-2003 school
year.
(c) Evidence.--In conducting a review under this section, a
local educational agency shall--
(1) allow the principal of the school involved to submit
evidence on whether the school made adequate yearly progress
for the 2002-2003 school year; and
(2) consider that evidence before making a final
determination under subsection (b).
(d) Standard of Review.--In conducting a review under this
section, a local educational agency shall revise, consistent
with the applicable State plan under section 1111 of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
6311), the local educational agency's original determination
that a school did not make adequate yearly progress for the
2002-2003 school year if the agency finds that the school
made such progress taking into consideration--
(1) the amendments made to part 200 of title 34 of the Code
of Federal Regulations on December 9, 2003 (68 Fed. Reg.
68698) (relating to accountability for the academic
achievement of students with the most significant cognitive
disabilities); or
(2) any regulation or guidance that, subsequent to the date
of such original determination, was issued by the Secretary
relating to--
(A) the assessment of limited English proficient children;
(B) the inclusion of limited English proficient children as
part of the subgroup described in section
1111(b)(2)(C)(v)(II)(dd) of the Elementary and Secondary
Education Act of 1965 (20 U.S.C. 6311(b)(2)(C)(v)(II)(dd))
after such children have obtained English proficiency; or
(C) any requirement under section 1111(b)(2)(I)(ii) of the
Elementary and Secondary Education Act of 1965 (20 U.S.C.
6311(b)(2)(I)(ii)).
(e) Effect of Revised Determination.--
(1) In general.--If pursuant to a review under this section
a local educational agency determines that a school made
adequate yearly progress for the 2002-2003 school year, upon
such determination--
(A) any action by the Secretary, the State educational
agency, or the local educational agency that was taken
because of a prior determination that the school did not make
such progress shall be terminated; and
(B) any obligations or actions required of the local
educational agency or the school because of the prior
determination shall cease to be required.
(2) Exceptions.--Notwithstanding paragraph (1), a
determination under this section shall not affect any
obligation or action required of a local educational agency
or school under the following:
(A) Section 1116(b)(13) of the Elementary and Secondary
Education Act of 1965 (20 U.S.C. 6316(b)(13)) (requiring a
local educational agency to continue to permit a child who
transferred to another school under such section to remain in
that school until completion of the highest grade in the
school).
(B) Section 1116(e)(8) of the Elementary and Secondary
Education Act of 1965 (20 U.S.C. 6316(e)(8)) (requiring a
local educational agency to continue to provide supplemental
educational services under such section until the end of the
school year).
(3) Subsequent determinations.--In determining whether a
school is subject to school improvement, corrective action,
or restructuring as a result of not making adequate yearly
progress, the Secretary, a State educational agency, or a
local educational agency may not take into account a
determination that the school did not make adequate yearly
progress for the 2002-2003 school year if such determination
was revised under this section and the school received a
final determination of having made adequate yearly progress
for the 2002-2003 school year.
(f) Notification.--The Secretary--
(1) shall require each State educational agency to notify
each school served by the agency of the school's ability to
request a review under this section; and
(2) not later than 30 days after the date of the enactment
of this section, shall notify the public by means of the
Department of Education's website of the review process
established under this section.
SEC. 3. REVIEW OF ADEQUATE YEARLY PROGRESS DETERMINATIONS FOR
LOCAL EDUCATIONAL AGENCIES FOR THE 2002-2003
SCHOOL YEAR.
(a) In General.--The Secretary shall require each State
educational agency to provide each local educational agency
in the State with an opportunity to request a review of a
determination by the State educational agency that the local
educational agency did not make adequate yearly progress for
the 2002-2003 school year.
(b) Application of Certain Provisions.--Except as
inconsistent with, or inapplicable to, this section, the
provisions of section 2 shall apply to review by a State
educational agency of a determination described in subsection
(a) in the same manner and to the same extent as such
provisions apply to review by a local educational agency of a
determination described in section 2(a).
SEC. 4. DEFINITIONS.
In this Act:
(1) The term ``adequate yearly progress'' has the meaning
given to that term in section 1111(b)(2)(C) of the Elementary
and Secondary Education Act of 1965 (20 U.S.C.
6311(b)(2)(C)).
(2) The term ``local educational agency'' means a local
educational agency (as that
[[Page S7012]]
term is defined in section 9101 of the Elementary and
Secondary Education Act of 1965 (20 U.S.C. 7801)) receiving
funds under part A of title I of such Act (20 U.S.C. 6311 et
seq.).
(3) The term ``Secretary'' means the Secretary of
Education.
(4) The term ``school'' means an elementary school or a
secondary school (as those terms are defined in section 9101
of the Elementary and Secondary Education Act of 1965 (20
U.S.C. 7801)) served under part A of title I of such Act (20
U.S.C. 6311 et seq.).
(5) The term ``State educational agency'' means a State
educational agency (as that term is defined in section 9101
of the Elementary and Secondary Education Act of 1965 (20
U.S.C. 7801)) receiving funds under part A of title I of such
Act (20 U.S.C. 6311 et seq.).
______
By Mr. THOMAS (for himself and Mr. Burns):
S. 2543. A bill to establish a program and criteria for National
Heritage Areas in the United States, and for other purposes; to the
Committee on Energy and Natural Resources.
Mr. THOMAS: Mr. President, I rise today to introduce the ``National
Heritage Partnership Act.'' The first Heritage area was created on
August 24, 1984--the Illinois and Michigan National Heritage Corridor.
Little or no growth occurred in this program for the first 10 years.
However, in the last couple of years the Congress has added 23 more
Heritage areas!
The Park Service provides technical assistance and funding but
Heritage areas are not National Parks. About 30 bills have been
introduced this Congress to study or designate new areas. There are no
Federal guidelines requiring what a heritage bill must contain, the
program has very little requirements and it is out of control.
As a result, I have conducted two oversight hearings in the National
Parks Subcommittee. I also had the General Accounting Office conduct a
review of Heritage Areas. The following concerns were identified:
individual areas are designated with specific legislation, but a
National Heritage Area Program does not exist in the National Park
Service; there are no official standards or criteria; existing heritage
areas range in scope and size from ``Rivers of Steel'' in Pennsylvania
to the entire State of Tennessee; the potential exists for unlimited
designations which are impacting funding for other Park Service
programs; and oversight and accountability of funding is lacking.
Today, I am introducing legislation with the Chairman of the Interior
Appropriations Subcommittee which will establish National Heritage Area
guidelines and criteria. The bill considers the recommendations from
the GAO report about Heritage Areas and raises the standard for
designation and requires specific criteria for national significance
before an area can be designated. In addition, a cap has been placed on
annual funding for the Heritage Area Program to avoid impacting other
National Park Service programs.
This program is out of control. We are continuing to put unnecessary
fiscal and resource demands on the Park Service. We have no established
criteria to ensure the recognition of truly nationally significant
areas. Consequently, we have compromised the integrity of all existing
and future National Heritage Areas. I am pleased Senator Burns has
joined me in this effort and I look forward to moving this bill through
the Senate in the near future.
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. 2543
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 ``National
Heritage Partnership Act''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents..
Sec. 2. Definitions..
Sec. 3. National Heritage Areas program..
Sec. 4. Suitability-feasibility studies..
Sec. 5. Management plans..
Sec. 6. Local coordinating entities..
Sec. 7. Relationship to other Federal agencies..
Sec. 8. Private property and regulatory protections..
Sec. 9. Authorization of appropriations..
SEC. 2. DEFINITIONS.
In this Act:
(1) Local coordinating entity.--The term ``local
coordinating entity'' means the entity designated by
Congress--
(A) to develop, in partnership with others, the management
plan for a National Heritage Area; and
(B) to act as a catalyst for the implementation of projects
and programs among diverse partners in the National Heritage
Area.
(2) Management plan.--The term ``management plan'' means
the plan prepared by the local coordinating entity for a
National Heritage Area designated by Congress that specifies
actions, policies, strategies, performance goals, and
recommendations to meet the goals of the National Heritage
Area, in accordance with section 5.
(3) National heritage area.--The term ``National Heritage
Area'' means an area designated by Congress that is
nationally significant to the heritage of the United States
and meets the criteria established under section 4(a).
(4) National significance.--The term ``national
significance'' means possession of--
(A) unique natural, historical, cultural, educational,
scenic, or recreational resources of exceptional value or
quality; and
(B) a high degree of integrity of location, setting, or
association in illustrating or interpreting the heritage of
the United States.
(5) Program.--The term ``program'' means the National
Heritage Areas program established under section 3(a).
(6) Proposed national heritage area.--The term ``proposed
National Heritage Area'' means an area under study by the
Secretary or other parties for potential designation by
Congress as a National Heritage Area.
(7) Secretary.--The term ``Secretary'' means the Secretary
of the Interior.
(8) Suitability-feasibility study.--The term ``suitability-
feasibility study'' means a study conducted by the Secretary,
or conducted by 1 or more other interested parties and
reviewed by the Secretary, in accordance with the criteria
and processes established under section 4, to determine
whether an area meets the criteria to be designated as a
National Heritage Area by Congress.
SEC. 3. NATIONAL HERITAGE AREAS PROGRAM.
(a) In General.--Subject to the availability of funds, the
Secretary shall establish a National Heritage Areas program
under which the Secretary shall provide technical and
financial assistance to local coordinating entities to
support the establishment of National Heritage Areas.
(b) Duties.--Under the program, the Secretary shall--
(1)(A) conduct suitability-feasibility studies, as directed
by Congress, to assess the suitability and feasibility of
designating proposed National Heritage Areas; or
(B) review and comment on suitability-feasibility studies
undertaken by other parties to make such assessment;
(2) provide technical assistance, on a reimbursable or non-
reimbursable basis (as determined by the Secretary), for the
development and implementation of management plans for
designated National Heritage Areas;
(3) enter into cooperative agreements with interested
parties to carry out this Act;
(4) provide information, promote understanding, and
encourage research on National Heritage Areas in partnership
with local coordinating entities;
(5) provide national oversight, analysis, coordination, and
technical assistance and support to ensure consistency and
accountability under the program; and
(6) submit annually to the Committee on Resources of the
House of Representatives and the Committee on Energy and
Natural Resources of the Senate a report describing the
allocation and expenditure of funds for activities conducted
with respect to National Heritage Areas under this Act.
SEC. 4. SUITABILITY-FEASIBILITY STUDIES.
(a) Criteria.--In conducting or reviewing a suitability-
feasibility study, the Secretary shall apply the following
criteria to determine the suitability and feasibility of
designating a proposed National Heritage Area:
(1) An area--
(A) has an assemblage of natural, historic, cultural,
educational, scenic, or recreational resources that together
are nationally significant to the heritage of the United
States;
(B) represents distinctive aspects of the heritage of the
United States worthy of recognition, conservation,
interpretation, and continuing use;
(C) is best managed as such an assemblage through
partnerships among public and private entities at the local
or regional level;
(D) reflects traditions, customs, beliefs, and folklife
that are a valuable part of the heritage of the United
States;
(E) provides outstanding opportunities to conserve natural,
historical, cultural, or scenic features;
(F) provides outstanding recreational or educational
opportunities; and
(G) has resources and traditional uses that have national
significance.
(2) Residents, business interests, nonprofit organizations,
and governments (including relevant Federal land management
agencies) within the proposed area are involved in the
planning and have demonstrated significant support through
letters and other means for National Heritage Area
designation and management.
(3) The local coordinating entity responsible for preparing
and implementing the management plan is identified.
(4) The proposed local coordinating entity and units of
government supporting the designation are willing and have
documented a
[[Page S7013]]
significant commitment to work in partnership to protect,
enhance, interpret, fund, manage, and develop resources
within the National Heritage Area.
(5) The proposed local coordinating entity has developed a
conceptual financial plan that outlines the roles of all
participants (including the Federal Government) in the
management of the National Heritage Area.
(6) The proposal is consistent with continued economic
activity within the area.
(7) A conceptual boundary map has been developed and is
supported by the public and participating Federal agencies.
(b) Consultation.--In conducting or reviewing a
suitability-feasibility study, the Secretary shall consult
with the managers of any Federal land within the proposed
National Heritage Area and secure the concurrence of the
managers with the findings of the suitability-feasibility
study before making a determination for designation.
(c) Transmittal.--On completion or receipt of a
suitability-feasibility study for a National Heritage Area,
the Secretary shall--
(1) review, comment, and make findings (in accordance with
the criteria specified in subsection (a)) on the feasibility
of designating the National Heritage Area;
(2) consult with the Governor of each State in which the
proposed National Heritage Area is located; and
(3) transmit to the Committee on Resources of the House of
Representatives and the Committee on Energy and Natural
Resources of the Senate, the suitability-feasibility study,
including--
(A) any comments received from the Governor of each State
in which the proposed National Heritage Area is located; and
(B) a finding as to whether the proposed National Heritage
Area meets the criteria for designation.
(d) Disapproval.--
(1) In general.--If the Secretary determines that any
proposed National Heritage Area does not meet the criteria
for designation, the Secretary shall include within the
suitability-feasibility study submitted under subsection
(c)(3) a description of the reasons for the determination.
(2) Other factors.--A finding by the Secretary that a
proposed National Heritage Area meets the criteria for
designation shall not preclude the Secretary from
recommending against designation of the proposed National
Heritage Area based on the budgetary impact of the
designation or any other factor unrelated to the criteria.
(e) Designation.--The designation of a National Heritage
Area shall be--
(1) by Act of Congress; and
(2) contingent on the prior completion of a suitability-
feasibility study and an affirmative determination by the
Secretary that the area meets the criteria established under
subsection (a).
SEC. 5. MANAGEMENT PLANS.
(a) Requirements.--The management plan for any National
Heritage Area shall--
(1) describe comprehensive policies, goals, strategies, and
recommendations for telling the story of the heritage of the
area covered by the National Heritage Area and encouraging
long-term resource protection, enhancement, interpretation,
funding, management, and development of the National Heritage
Area;
(2) include a description of actions and commitments that
governments, private organizations, and citizens will take to
protect, enhance, interpret, fund, manage, and develop the
natural, historical, cultural, educational, scenic, and
recreational resources of the National Heritage Area;
(3) specify existing and potential sources of funding or
economic development strategies to protect, enhance,
interpret, fund, manage, and develop the National Heritage
Area;
(4) include an inventory of the natural, historical,
cultural, educational, scenic, and recreational resources of
the National Heritage Area related to the national
significance and themes of the National Heritage Area that
should be protected, enhanced, interpreted, managed, funded,
and developed;
(5) recommend policies and strategies for resource
management, including the development of intergovernmental
and interagency agreements to protect, enhance, interpret,
fund, manage, and develop the natural, historical, cultural,
educational, scenic, and recreational resources of the
National Heritage Area;
(6) describe a program for implementation for the
management plan, including--
(A) performance goals;
(B) plans for resource protection, enhancement,
interpretation, funding, management, and development; and
(C) specific commitments for implementation that have been
made by the local coordinating entity or any government
agency, organization, business, or individual;
(7) include an analysis of, and recommendations for, means
by which Federal, State, and local programs may best be
coordinated (including the role of the National Park Service
and other Federal agencies associated with the National
Heritage Area) to further the purposes of this Act; and
(8) include a business plan that--
(A) describes the role, operation, financing, and functions
of the local coordinating entity and of each of the major
activities contained in the management plan; and
(B) provides adequate assurances that the local
coordinating entity has the partnerships and financial and
other resources necessary to implement the management plan
for the National Heritage Area.
(b) Deadline.--
(1) In general.--Not later than 3 years after the date on
which funds are first made available to develop the
management plan after designation as a National Heritage
Area, the local coordinating entity shall submit the
management plan to the Secretary for approval.
(2) Termination of funding.--If the management plan is not
submitted to the Secretary in accordance with paragraph (1),
the local coordinating entity shall not qualify for any
additional financial assistance under this Act until such
time as the management plan is submitted to and approved by
the Secretary.
(c) Approval of Management Plan.--
(1) Review.--Not later than 180 days after receiving the
plan, the Secretary shall review and approve or disapprove
the management plan for a National Heritage Area on the basis
of the criteria established under paragraph (3).
(2) Consultation.--The Secretary shall consult with the
Governor of each State in which the National Heritage Area is
located before approving a management plan for the National
Heritage Area.
(3) Criteria for approval.--In determining whether to
approve a management plan for a National Heritage Area, the
Secretary shall consider whether--
(A) the local coordinating entity represents the diverse
interests of the National Heritage Area, including
governments, natural and historic resource protection
organizations, educational institutions, businesses,
recreational organizations, community residents, and private
property owners;
(B) the local coordinating entity--
(i) has afforded adequate opportunity for public and
governmental involvement (including through workshops and
hearings) in the preparation of the management plan; and
(ii) provides for at least semiannual public meetings to
ensure adequate implementation of the management plan;
(C) the resource protection, enhancement, interpretation,
funding, management, and development strategies described in
the management plan, if implemented, would adequately
protect, enhance, interpret, fund, manage, and develop the
natural, historic, cultural, educational, scenic, and
recreational resources of the National Heritage Area;
(D) the management plan would not adversely affect any
activities authorized on Federal land under public land laws
or land use plans;
(E) the local coordinating entity has demonstrated the
financial capability, in partnership with others, to carry
out the plan;
(F) the Secretary has received adequate assurances from the
appropriate State and local officials whose support is needed
to ensure the effective implementation of the State and local
elements of the management plan; and
(G) the management plan demonstrates partnerships among the
local coordinating entity, Federal, State, and local
governments, regional planning organizations, nonprofit
organizations, or private sector parties for implementation
of the management plan.
(4) Disapproval.--
(A) In general.--If the Secretary disapproves the
management plan, the Secretary--
(i) shall advise the local coordinating entity in writing
of the reasons for the disapproval; and
(ii) may make recommendations to the local coordinating
entity for revisions to the management plan.
(B) Deadline.--Not later than 180 days after receiving a
revised management plan, the Secretary shall approve or
disapprove the revised management plan.
(5) Amendments.--
(A) In general.--An amendment to the management plan that
substantially alters the purposes of the National Heritage
Area shall be reviewed by the Secretary and approved or
disapproved in the same manner as the original management
plan.
(B) Implementation.--The local coordinating entity shall
not use Federal funds authorized by this Act to implement an
amendment to the management plan until the Secretary approves
the amendment.
SEC. 6. LOCAL COORDINATING ENTITIES.
(a) Duties.--To further the purposes of the National
Heritage Area, the local coordinating entity shall--
(1) prepare a management plan for the National Heritage
Area, and submit the management plan to the Secretary, in
accordance with section 5;
(2) submit an annual report to the Secretary for each
fiscal year for which the local coordinating committee
receives Federal funds under this Act, specifying--
(A) the specific performance goals and accomplishments of
the local coordinating committee;
(B) the expenses and income of the local coordinating
committee;
(C) the amounts and sources of matching funds;
(D) the amounts leveraged with Federal funds and sources of
the leveraging; and
(E) grants made to any other entities during the fiscal
year;
(3) make available for audit for each fiscal year for which
the local coordinating entity receives Federal funds under
this Act, all information pertaining to the expenditure of
the funds and any matching funds; and
[[Page S7014]]
(4) encourage economic viability and sustainability that is
consistent with the purposes of the National Heritage Area.
(b) Authorities.--For the purposes of preparing and
implementing the approved management plan for the National
Heritage Area, the local coordinating entity may use Federal
funds made available under this Act to--
(1) make grants to political jurisdictions, nonprofit
organizations, and other parties within the National Heritage
Area;
(2) enter into cooperative agreements with or provide
technical assistance to political jurisdictions, nonprofit
organizations, Federal agencies, and other interested
parties;
(3) hire and compensate staff, including individuals with
expertise in--
(A) natural, historical, cultural, educational, scenic, and
recreational resource conservation;
(B) economic and community development; and
(C) heritage planning;
(4) obtain funds or services from any source, including
other Federal laws or programs;
(5) contract for goods or services; and
(6) support activities of partners and any other activities
that further the purposes of the National Heritage Area and
are consistent with the approved management plan.
(c) Prohibition on Acquisition of Real Property.--The local
coordinating entity may not use Federal funds authorized
under this Act to acquire any interest in real property.
SEC. 7. RELATIONSHIP TO OTHER FEDERAL AGENCIES.
(a) In General.--Nothing in this Act affects the authority
of a Federal agency to provide technical or financial
assistance under any other law.
(b) Consultation and Coordination.--The head of any Federal
agency planning to conduct activities that may have an impact
on a National Heritage Area is encouraged to consult and
coordinate the activities with the Secretary and the local
coordinating entity to the maximum extent practicable.
(c) Other Federal Agencies.--Nothing in this Act--
(1) modifies, alters, or amends any law or regulation
authorizing a Federal agency to manage Federal land under the
jurisdiction of the Federal agency;
(2) limits the discretion of a Federal land manager to
implement an approved land use plan within the boundaries of
a National Heritage Area; or
(3) modifies, alters, or amends any authorized use of
Federal land under the jurisdiction of a Federal agency.
SEC. 8. PRIVATE PROPERTY AND REGULATORY PROTECTIONS.
Nothing in this Act--
(1) abridges the rights of any property owner (whether
public or private), including the right to refrain from
participating in any plan, project, program, or activity
conducted within the National Heritage Area;
(2) requires any property owner to permit public access
(including access by Federal, State, or local agencies) to
the property of the property owner, or to modify public
access or use of property of the property owner under any
other Federal, State, or local law;
(3) alters any duly adopted land use regulation, approved
land use plan, or other regulatory authority of any Federal,
State or local agency, or conveys any land use or other
regulatory authority to any local coordinating entity;
(4) authorizes or implies the reservation or appropriation
of water or water rights;
(5) diminishes the authority of the State to manage fish
and wildlife, including the regulation of fishing and hunting
within the National Heritage Area; or
(6) creates any liability, or affects any liability under
any other law, of any private property owner with respect to
any person injured on the private property.
SEC. 9. AUTHORIZATION OF APPROPRIATIONS.
(a) Suitability-Feasibility Studies.--There is authorized
to be appropriated to conduct and review suitability-
feasibility studies under section 4 $750,000 for each fiscal
year, of which not more than $250,000 for any fiscal year may
be used for any individual suitability-feasibility study for
a proposed National Heritage Area.
(b) Local Coordinating Entities.--
(1) In general.--There is authorized to be appropriated to
carry out section 6 $15,000,000 for each fiscal year, of
which not more than--
(A) $1,000,000 may be made available for any fiscal year
for any individual National Heritage Area, to remain
available until expended; and
(B) a total of $10,000,000 may be made available for all
such fiscal years for any individual National Heritage Area.
(2) Termination date.--
(A) In general.--The authority of the Secretary to provide
financial assistance to an individual local coordinating
entity under this Act (excluding technical assistance and
administrative oversight) shall terminate on the date that is
15 years after the date of the initial receipt of the
assistance by the local coordinating committee.
(B) Designation.--A National Heritage Area shall retain the
designation as a National Heritage Area after the termination
date prescribed in subparagraph (A).
(3) Administration.--Not more than 5 percent of the amount
of funds made available under paragraph (1) for a fiscal year
may be used by the Secretary for technical assistance,
oversight, and administrative purposes.
(c) Matching Funds.--
(1) In general.--As a condition of receiving a grant under
this Act, the recipient of the grant shall provide matching
funds in an amount that is equal to the amount of the grant.
(2) Administration.--The recipient matching funds--
(A) shall be derived from non-Federal sources; and
(B) may be made in the form of in-kind contributions of
goods or services fairly valued.
______
By Ms. STABENOW (for herself, Mrs. Lincoln, and Mr. Levin):
S. 2544. A bill to provide for the certification of programs to
provide uninsured employees of small businesses access to health
coverage, and for other purposes; to the Committee on Finance.
Ms. STABENOW. Mr. President, today I rise to introduce the Health
Care Access for Small Businesses Act of 2004. I am pleased to be joined
in this endeavor by my colleagues, Senator Lincoln and Michigan's
senior Senator Levin. My bill would help small businesses provide
health coverage for their employees, an important first step in
providing access to health care for all Americans.
Last month, thousands of Americans participated in the annual Cover
the Uninsured week, a discussion about the urgent need to cover the
uninsured. The sheer breadth of the groups that participated in the
unprecedented effort demonstrates the urgency of this issue. Labor
unions were united with business groups, doctors with nurses, and
charity health care providers with for-profit hospitals and insurance
companies.
And yesterday, the consumer group Families USA and the governors of
Iowa, Kansas, and Maine released even more disturbing news. Using
Census Bureau data, they found that approximately 81.8 million
Americans--one out of three people under 65 years of age--were
uninsured at some point of time for the past two years. Almost two-
thirds were uninsured for six months or more; and over half were
uninsured for at least nine months.
We need to stop having discussions and start finding solutions. Too
many hard working Americans are going without health insurance. There
is a great misconception that uninsured Americans are largely
unemployed or on welfare. That is simply not the case. More than 80
percent of uninsured Americans are part of working families, and almost
half work for small businesses. If we can help small businesses cover
their employees, we will have made great progress in covering the
uninsured.
The bill I am introducing today is aimed at making coverage more
affordable for employees of small businesses through what is called a
``three-share'' program. It would not impose any new funding mandates
on state or local governments nor would it create new bureaucracy. It
is an innovative community-based approach that could work throughout
the country.
And it's aimed at ensuring primary care services are more available.
We know that the primary care model through federally qualified health
centers has been a tremendous success. This would build on this success
by empowering communities--health care providers, small businesses,
churches, civic groups--to form their own health care programs.
The three-share model is an innovative community-based idea that has
been working across the U.S. from California to Arkansas to Maryland
and, of course, Michigan. The name ``three-share'' stems from the
program's payment structure. Premiums are shared between the employer
who pays 30 percent, the employee who pays 30 percent, and the
community which covers the remaining 40 percent of the cost.
In a three share model, a non-profit or local government entity
serves as the manager of the plan. They design a benefit package by
negotiating directly with providers or contracting through an insurance
company. Then, they recruit small businesses that have not offered
insurance coverage to their employees for the past year. The average
cost for coverage is about $1,800 per year, much lower than the
national average for commercial insurance, which on average costs about
$3,400 for a single person and $9,000 for a family, according to the
2003 Kaiser survey of
[[Page S7015]]
employer benefits. Of the $1,800, the employer and employee would each
pay approximately $540 and the community would pay about $720.
And they have been successful. For example, in Muskegon, Michigan,
the three-share program Access Health has been working with about 400
small businesses to cover some 1,500 uninsured full and part-time
employees. Wayne County has operated Health Choice for a decade.
Although it is undergoing some changes, it has nearly 1,300 businesses
enrolled and covers everyone from cab drivers, nail salon technicians,
and nursing aides. Kent County, where Grand Rapids is located, began
enrolling small businesses and employees in their program in 2002 and
hope to grow to cover 2,500 individuals this year.
Different three share plans have received funds for the community
portion from various places. In Michigan, most of the money has come
from Medicaid funds. A plan in California uses money from the tobacco
settlement, while a plan in Arkansas raises funds through church events
and other community initiatives.
Unfortunately, despite the nuances that distinguish three share plans
from one another, they all share a common challenge: they all lack a
stable and sustainable funding source for the community share. This
bill will help provide a steady stream of funding and analyze what
three shares do right and how communities can develop their own three
share model programs.
Insuring more working families will also take the pressure off state
Medicaid budgets. Adequate care for those presently uninsured will also
help slash the billions that is spent on uncompensated care.
Providing health care for these families fulfills a moral commitment.
No one in America who gets up in the morning and goes to work should go
to sleep at night fearful that an illness or injury in the family could
wipe out everything they have worked hard for. This is a great nation,
and together we can ensure that no American has to go without health
care again.
I ask unanimous consent that the text of the bill be printed in the
Record.
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:
S. 2544
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 ``Health Care Access for Small
Businesses Act of 2004''.
SEC. 2. THREE-SHARE PROGRAMS.
The Social Security Act (42 U.S.C. 301 et seq.) is amended
by adding at the end the following:
``TITLE XXII--PROVIDING FOR THE UNINSURED
``SEC. 2201. THREE-SHARE PROGRAMS.
``(a) Pilot Programs.--The Secretary, acting through the
Administrator, shall award grants under this section for the
startup and operation of 50 eligible three-share pilot
programs for a 5-year period.
``(b) Grants for Three-Share Programs.--
``(1) Establishment.--The Administrator may award grants to
eligible entities--
``(A) to establish three-share programs;
``(B) to provide for contributions to the premiums assessed
for coverage under a three-share program as provided for in
subsection (c)(2)(B)(iii); and
``(C) to establish risk pools.
``(2) Three-share program plan.--Each entity desiring a
grant under this subsection shall develop a plan for the
establishment and operation of a three-share program that
meets the requirements of paragraphs (2) and (3) of
subsection (c).
``(3) Application.--Each entity desiring a grant under this
subsection shall submit an application to the Administrator
at such time, in such manner and containing such information
as the Administrator may require, including--
``(A) the three-share program plan described in paragraph
(2); and
``(B) an assurance that the eligible entity will--
``(i) determine a benefit package;
``(ii) recruit businesses and employees for the three-share
program;
``(iii) build and manage a network of health providers or
contract with an existing network or licensed insurance
provider;
``(iv) manage all administrative needs; and
``(v) establish relationships among community, business,
and provider interests.
``(4) Priority.--In awarding grants under this section the
Secretary shall give priority to an applicant--
``(A) that is an existing three-share program;
``(B) that is an eligible three-share program that has
demonstrated community support; or
``(C) that is located in a State with insurance laws and
regulations that permit three-share program expansion.
``(c) Grant Eligibility.--
``(1) In general.--The Secretary, acting through the
Administrator, shall promulgate regulations providing for the
eligibility of three-share programs for participation in the
pilot program under this section.
``(2) Three-share program requirements.--
``(A) In general.--To be determined to be an eligible
three-share program for purposes of participation in the
pilot program under this section a three-share program
shall--
``(i) be either a non-profit or local governmental entity;
``(ii) define the region in which such program will provide
services;
``(iii) have the capacity to carry out administrative
functions of managing health plans, including monthly
billings, verification/enrollment of eligible employers and
employees, maintenance of membership rosters, development of
member materials (such as handbooks and identification
cards), customer service, and claims processing; and
``(iv) have demonstrated community involvement.
``(B) Payment.--To be eligible under paragraph (1), a
three-share program shall pay the costs of services provided
under subparagraph (A)(ii) by charging a monthly premium for
each covered individual to be divided as follows:
``(i) Not more than 30 percent of such premium shall be
paid by a qualified employee desiring coverage under the
three-share program.
``(ii) Not more than 30 percent of such premium shall be
paid by the qualified employer of such a qualified employee.
``(iii) At least 40 percent of such premium shall be paid
from amounts provided under a grant under this section.
``(iv) Any remaining amount shall be paid by the three-
share program from other public, private, or charitable
sources.
``(C) Program flexibility.--A three-share program may set
an income eligibility guideline for enrollment purposes.
``(3) Coverage.--
``(A) In general.--To be an eligible three-share program
under this section, the three-share program shall provide at
least the following benefits:
``(i) Physicians services.
``(ii) In-patient hospital services.
``(iii) Out-patient services.
``(iv) Emergency room visits.
``(v) Emergency ambulance services.
``(vi) Diagnostic lab fees and x-rays.
``(vii) Prescription drug benefits.
``(B) Limitation.--Nothing in subparagraph (A) shall be
construed to require that a three-share program provide
coverage for services performed outside the region described
in paragraph (2)(A)(i).
``(C) Preexisting conditions.--A program described in
subparagraph (A) shall not be an eligible three-share program
under paragraph (1) if any individual can be excluded from
coverage under such program because of a preexisting health
condition.
``(d) Grants for Existing Three-Share Programs To Meet
Certification Requirements.--
``(1) In general.--The Administrator may award grants to
three-share programs that are operating on the date of
enactment of this section.
``(2) Application.--Each eligible entity desiring a grant
under this subsection shall submit an application to the
Administrator at such time, in such manner, and containing
such information as the Administrator may require.
``(e) Application of State Laws.--Nothing in this section
shall be construed to preempt State law.
``(f) Distressed Business Formula.--
``(1) In general.--Not later than 60 days after the date of
enactment of this section, the Administrator of the Health
Resources and Services Administration shall develop a formula
to determine which businesses qualify as distressed
businesses for purposes of this section.
``(2) Effect on insurance market.--Granting eligibility to
a distressed business using the formula under paragraph (1)
shall not interfere with the insurance market. Any business
found to have reduced benefits to qualify as a distressed
business under the formula under paragraph (1) shall not be
eligible to be a three-share program for purposes of this
section.
``(g) Definitions.--In this section:
``(1) Administrator.--The term `Administrator' means the
Administrator of the Health Resources and Services
Administration.
``(2) Covered individual.--The term `covered individual'
means--
``(A) a qualified employee; or
``(B) a child under the age of 23 or a spouse of such
qualified employee who--
``(i) lacks access to health care coverage through their
employment or employer;
``(ii) lacks access to health coverage through a family
member;
``(iii) is not eligible for coverage under the medicare
program under title XVIII or the medicaid program under title
XIX; and
``(iv) does not qualify for benefits under the State
Children's Health Insurance Program under title XXI.
``(3) Distressed business.--The term `distressed business'
means a business that--
[[Page S7016]]
``(A) in light of economic hardship and rising health care
premiums may be forced to discontinue or scale back its
health care coverage; and
``(B) qualifies as a distressed business according to the
formula under subsection (g).
``(4) Eligible entity.--The term `eligible entity' means an
entity that meets the requirements of subsection (a)(2)(A).
``(5) Qualified employee.--The term `qualified employee'
means any individual employed by a qualified employer who
meets certain criteria including--
``(A) lacking access to health coverage through a family
member or common law partner;
``(B) not being eligible for coverage under the medicare
program under title XVIII or the medicaid program under title
XIX; and
``(C) agreeing that the share of fees described in
subsection (a)(2)(B)(i) shall be paid in the form of payroll
deductions from the wages of such individual.
``(6) Qualified employer.--The term `qualified employer'
means an employer as defined in section 3(d) of the Fair
Labor Standards Act of 1938 (29 U.S.C. 203(d)) who--
``(A) is a small business concern as defined in section
3(a) of the Small Business Act (15 U.S.C. 632);
``(B) is located in the region described in subsection
(a)(2)(A)(i); and
``(C) has not contributed to the health care benefits of
its employees for at least 12 months consecutively or
currently provides insurance but is classified as a
distressed business.
``(g) Evaluation.--Not later than 90 days after the end of
the 5-year period during which grants are available under
this section, the General Accounting Office shall submit to
the Secretary and the appropriate committees of Congress a
report concerning--
``(1) the effectiveness of the programs established under
this section;
``(2) the number of individuals covered under such
programs;
``(3) any resulting best practices; and
``(4) the level of community involvement.
``(h) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$100,000,000 for each of fiscal years 2005 through 2010.''.
______
By Mr. NELSON of Florida (for himself and Mr. Rockefeller):
S. 2545. A bill to amend title XVIII and XIX of the Social Security
Act and title III of the Public Health Service Act to improve access to
information about individual's health care options and legal rights for
care near the end of life, to promote advance care planning and
decisionmaking so that individuals' wishes are known should they become
unable to speak for themselves, to engage health care providers in
disseminating information about and assisting in the preparation of
advance directives, which include living wills and durable powers of
attorney for health care, and for other purposes; to the Committee on
Finance.
Mr. NELSON of Florida. Mr. President, I am pleased to be joined by my
colleague and cosponsor Senator Jay Rockefeller as we introduce the
Advance Directives Improvement and Education Act of 2004. Senators
Rockefeller and Collins, along with Senator Wyden, sponsored a bill
with similar goals in the 107th Congress and have provided invaluable
support and counsel in drafting the bill we introduce today.
The Advance Directives Improvement and Education Act of 2004 has a
simple purpose: to encourage all adults in America, especially those 65
and older, to think about, talk about and write down their wishes for
medical care near the end-of-life should they become unable to make
decisions for themselves. Advance directives, which include a living
will, stating the individual's preferences for care, and a power of
attorney for health care, are critical documents that each of us should
have. The goal is clear, but reaching it requires that we educate the
public about the importance of advance directives, offer opportunities
for discussion of the issues, and reinforce the requirement that health
care providers honor patients' wishes. This bill is designed to do just
that.
Americans are afraid of death. We don't like to think about it, talk
about it, or plan for it. Any yet, we will all face it. Not only our
own deaths, but our parents, siblings, friends, and sometimes,
tragically, children. Today, most Americans face death unprepared.
Family members frequently end up making critical medical decisions for
incapacitated patients, yet they, too, are unprepared. Only 15 to 20
percent of adults have advance directives. Among this group, many have
not discussed the contents of these important documents with their
families or even the person named as the health care proxy.
It is time to bring this discussion into the mainstream. Too much is
at stake to continue to deny our mortality. You all know about the
tragic situation going on in Florida with Terri Schiavo. Here is a
young woman in a persistent vegetative state who is the subject of a
debate about her treatment between her husband and her parents, a
debate that has now become a court case and a legislative quagmire.
Why? Because she didn't write down what type of care she would want in
the event an accident, illness or other medical condition caused her to
be in an incapacitated state. She is young and didn't think about death
or dying. If she had an advance directive that made her wishes clear
and named a health care proxy to make decisions for her should she be
unable to do so for herself, the treatment debate might continue, but
there would be no question as to who could decide. The Supreme Court
has clearly affirmed that competent adults have the right to refuse
unwanted medical treatment Washington v. Glucksburg and Vacco v. Quill,
1997, but it also stressed that advance directives are a means of
safeguarding that right should adults become incapable of deciding for
themselves.
Fortunately, situations like Mrs. Schiavo's are rare. Of the 2.5
million people who die each year 83 percent are Medicare beneficiaries.
In fact, 27 percent of Medicare expenditures cover care in the last
year of life. Remember, everyone who enrolls in Medicare will die on
Medicare. The Advance Directives Improvement and Education Act
encourages all Medicare beneficiaries to prepare advance directives by
providing a free physician office visit for the purpose of discussing
end-of-life care choices and other issues around medical decision-
making in a time of incapacitation. Physicians will be reimbursed for
spending time with their patients to help them understand situations in
which an advance directive would be useful, medical options, the
Medicare hospice benefit and other concerns. The conversation will also
enable phyisicans to learn about their patients' wishes, fears,
religious beliefs, and life experiences that might influence their
medical care wishes. These are important aspects of a physician-patient
relationship that are too often unaddressed.
Another part of our bill will provide funds for the Department of
Health and Human Services to conduct a public education campaign to
raise awareness of the importance of planning for care near the end of
life. This campaign would explain what advance directives are, where
they are available, what questions need to be asked and answered, and
what to do with the executed documents. HHS, directly or through
grants, would also establish an information clearinghouse where
consumers could receive state-specific information and consumer-
friendly documents and publications.
State-specific information is needed because in addition to the
federal Patients Self-Determination Act passed in 1990, most states
also have enacted advance directive laws. Because the state laws
differ, some states may be reluctant to honor advance directives that
were executed in another state. The bill we introduce today contains
language that would make all advance directives ``portable,'' that is,
useful from one state to another. As long as the documents were
lawfully executed in the state of origin, they must be accepted and
honored in the state in which they are presented, unless to do so would
violate state law.
All of the provisions in the Advance Directives Improvement and
Education Act of 2004 are there for one reason: to increase the number
of people in the United States who have advance directives, who have
discussed their wishes with their physicians and families, and who have
given copies of the directives to their loved ones, health care
providers, and legal representatives.
Senator Rockefeller and I all believe that as our Medicare population
grows and life expectancy lengthens, improving care near the end of
life must be a priority. Helping people complete these critical
documents is an essential part of making the final journey as
meaningful and peaceful as possible.
Over the next decade or two our elderly population will grow. Baby-
boomers, used to having control of
[[Page S7017]]
their lives and demanding the best, will be stunned to discover that
good end-of-life care is hard to find. I recommend to all of you a
report called Means to a Better End: A Report on Dying in America Today
that was published in November 2002 by Last Acts Partnership. In it,
every state and the District of Columbia was rated on eight different
criteria to assess the state of end-of-life care in this country. Not
one state--not mine, not yours--received a high grade. Some did well in
one or two areas, but none did well in half or more of the measures;
all were mediocre at best. The researchers found that too many people
end their days in hospitals and nursing homes, attached to machines,
alone, in pain. Doctors, not wanting to admit ``failure,'' as many of
them see death, urge aggressive treatments such as chemotherapy on
patients who have little chance of responding to it. Pain medication is
often underprescribed or withheld for fear that the dying patient--
dying patient--might become addicted to the drug.
The good news is that growing numbers of health care providers,
nonprofit organizations and consumer advocates recognize the need for
change. New palliative care programs, pain protocols and hospice
services are being instituted in facilities around the country. Another
Last Acts Partnership publication, On the Road from Theory to Practice
highlights the best programs and practices for others to emulate.
This body is a legislative institution not a medical one--with the
exception of the distinguished majority leader, of course. We cannot
legislate good medical care or compassion. What we can do, what I hope
we will do, is to enact this bill so that the American public can
participate in improving end-of-life care--first, by filling out their
own advice directives and talking to their families about them; and by
raising their voices to demand that our health care systems honor their
wishes and improve the way they care for people who are near the end of
life. If we can do that, we will have done a great deal.
I ask unanimous consent that the full text of the bill be printed in
the Record.
Mr. President, I also ask that a letter of support for this
legislation from the Last Acts Partnership also be printed in the
Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
S. 2545
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 ``Advance
Directives Improvement and Education Act of 2004''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings and purposes.
Sec. 3. Medicare coverage of end-of-life planning consultations.
Sec. 4. Improvement of policies related to the use and portability of
advance directives.
Sec. 5. Increasing awareness of the importance of end-of-life planning.
Sec. 6. GAO studies and reports on end-of-life planning issues.
SEC. 2. FINDINGS AND PURPOSES.
(a) Findings.--Congress makes the following findings:
(1) Every year 2,500,000 people die in the United States.
Eighty percent of those people die in institutions such as
hospitals, nursing homes, and other facilities. Chronic
illnesses, such as cancer and heart disease, account for 2
out of every 3 deaths.
(2) In January 2004, a study published in the Journal of
the American Medical Association concluded that many people
dying in institutions have unmet medical, psychological, and
spiritual needs. Moreover, family members of decedents who
received care at home with hospice services were more likely
to report a favorable dying experience.
(3) In 1997, the Supreme Court of the United States, in its
decisions in Washington v. Glucksberg and Vacco v. Quill,
reaffirmed the constitutional right of competent adults to
refuse unwanted medical treatment. In those cases, the Court
stressed the use of advance directives as a means of
safeguarding that right should those adults become incapable
of deciding for themselves.
(4) A study published in 2002 estimated that the overall
prevalence of advance directives is between 15 and 20 percent
of the general population, despite the passage of the Patient
Self-Determination Act in 1990, which requires that health
care providers tell patients about advance directives.
(5) Competent adults should complete advance care plans
stipulating their health care decisions in the event that
they become unable to speak for themselves. Through the
execution of advance directives, including living wills and
durable powers of attorney for health care according to the
laws of the State in which they reside, individuals can
protect their right to express their wishes and have them
respected.
(b) Purposes.--The purposes of this Act are to improve
access to information about individuals' health care options
and legal rights for care near the end of life, to promote
advance care planning and decisionmaking so that individuals'
wishes are known should they become unable to speak for
themselves, to engage health care providers in disseminating
information about and assisting in the preparation of advance
directives, which include living wills and durable powers of
attorney for health care, and for other purposes.
SEC. 3. MEDICARE COVERAGE OF END-OF-LIFE PLANNING
CONSULTATIONS.
(a) Coverage.--Section 1861(s)(2) of the Social Security
Act (42 U.S.C. 1395x(s)(2)), as amended by section 642(a) of
the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (Public Law 108-173; 117 Stat.
2322), is amended--
(1) in subparagraph (Y), by striking ``and'' at the end;
(2) in subparagraph (Z), by inserting ``and'' at the end;
and
(3) by adding at the end the following new subparagraph:
``(AA) end-of-life planning consultations (as defined in
subsection (bbb));''.
(b) Services Described.--Section 1861 of the Social
Security Act (42 U.S.C. 1395x), as amended by section 706(b)
of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (Public Law 108-173; 117 Stat.
2339), is amended by adding at the end the following new
subsection:
``End-of-Life Planning Consultation
``(bbb) The term `end-of-life planning consultation' means
physicians' services--
``(1) consisting of a consultation between the physician
and an individual regarding--
``(A) the importance of preparing advance directives in
case an injury or illness causes the individual to be unable
to make health care decisions;
``(B) the situations in which an advance directive is
likely to be relied upon;
``(C) the reasons that the development of a comprehensive
end-of-life plan is beneficial and the reasons that such a
plan should be updated periodically as the health of the
individual changes;
``(D) the identification of resources that an individual
may use to determine the requirements of the State in which
such individual resides so that the treatment wishes of that
individual will be carried out if the individual is unable to
communicate those wishes, including requirements regarding
the designation of a surrogate decision maker (health care
proxy); and
``(E) whether or not the physician is willing to follow the
individual's wishes as expressed in an advance directive; and
``(2) that are furnished to an individual on an annual
basis or immediately following any major change in an
individual's health condition that would warrant such a
consultation (whichever comes first).''.
(c) Waiver of Deductible and Coinsurance.--
(1) Deductible.--The first sentence of section 1833(b) of
the Social Security Act (42 U.S.C. 1395l(b)) is amended--
(A) by striking ``and'' before ``(6)''; and
(B) by inserting before the period at the end the
following: ``, and (7) such deductible shall not apply with
respect to an end-of-life planning consultation (as defined
in section 1861(bbb))''.
(2) Coinsurance.--Section 1833(a)(1) of the Social Security
Act (42 U.S.C. 1395l(a)(1)) is amended--
(A) in clause (N), by inserting ``(or 100 percent in the
case of an end-of-life planning consultation, as defined in
section 1861(bbb))'' after ``80 percent''; and
(B) in clause (O), by inserting ``(or 100 percent in the
case of an end-of-life planning consultation, as defined in
section 1861(bbb))'' after ``80 percent''.
(d) Payment for Physicians' Services.--Section 1848(j)(3)
of the Social Security Act (42 U.S.C. 1395w-4(j)(3)), as
amended by section 611(c) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (Public Law 108-
173; 117 Stat. 2304), is amended by inserting ``(2)(AA),''
after ``(2)(W),''.
(e) Frequency Limitation.--Section 1862(a)(1) of the Social
Security Act (42 U.S.C. 1395y(a)(1)), as amended by section
613(c) of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (Public Law 108-173; 117 Stat.
2306), is amended--
(1) by striking ``and'' at the end of subparagraph (L);
(2) by striking the semicolon at the end of subparagraph
(M) and inserting ``, and''; and
(3) by adding at the end the following new subparagraph:
``(N) in the case of end-of-life planning consultations (as
defined in section 1861(bbb)), which are performed more
frequently than is covered under paragraph (2) of such
section;''.
(f) Effective Date.--The amendments made by this section
shall apply to services furnished on or after January 1,
2005.
[[Page S7018]]
SEC. 4. IMPROVEMENT OF POLICIES RELATED TO THE USE AND
PORTABILITY OF ADVANCE DIRECTIVES.
(a) Medicare.--Section 1866(f) of the Social Security Act
(42 U.S.C. 1395cc(f)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (B), by inserting ``and if presented by
the individual (or on behalf of the individual), to include
the content of such advance directive in a prominent part of
such record'' before the semicolon at the end;
(B) in subparagraph (D), by striking ``and'' after the
semicolon at the end;
(C) in subparagraph (E), by striking the period at the end
and inserting ``; and''; and
(D) by inserting after subparagraph (E) the following new
subparagraph:
``(F) to provide each individual with the opportunity to
discuss issues relating to the information provided to that
individual pursuant to subparagraph (A) with an appropriately
trained professional.'';
(2) in paragraph (3), by striking ``a written'' and
inserting ``an''; and
(3) by adding at the end the following new paragraph:
``(5)(A) In addition to the requirements of paragraph (1),
a provider of services, Medicare Advantage organization, or
prepaid or eligible organization (as the case may be) shall
give effect to an advance directive executed outside the
State in which such directive is presented, even one that
does not appear to meet the formalities of execution, form,
or language required by the State in which it is presented to
the same extent as such provider or organization would give
effect to an advance directive that meets such requirements,
except that a provider or organization may decline to honor
such a directive if the provider or organization can
reasonably demonstrate that it is not an authentic expression
of the individual's wishes concerning his or her health care.
Nothing in this paragraph shall be construed to authorize the
administration of medical treatment otherwise prohibited by
the laws of the State in which the directive is presented.
``(B) The provisions of this paragraph shall preempt any
State law to the extent such law is inconsistent with such
provisions. The provisions of this paragraph shall not
preempt any State law that provides for greater portability,
more deference to a patient's wishes, or more latitude in
determining a patient's wishes.''.
(b) Medicaid.--Section 1902(w) of the Social Security Act
(42 U.S.C. 1396a(w)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (B)--
(i) by striking ``in the individual's medical record'' and
inserting ``in a prominent part of the individual's current
medical record''; and
(ii) by inserting ``and if presented by the individual (or
on behalf of the individual), to include the content of such
advance directive in a prominent part of such record'' before
the semicolon at the end;
(B) in subparagraph (D), by striking ``and'' after the
semicolon at the end;
(C) in subparagraph (E), by striking the period at the end
and inserting ``; and''; and
(D) by inserting after subparagraph (E) the following new
subparagraph:
``(F) to provide each individual with the opportunity to
discuss issues relating to the information provided to that
individual pursuant to subparagraph (A) with an appropriately
trained professional.'';
(2) in paragraph (4), by striking ``a written'' and
inserting ``an''; and
(3) by adding at the end the following paragraph:
``(6)(A) In addition to the requirements of paragraph (1),
a provider or organization (as the case may be) shall give
effect to an advance directive executed outside the State in
which such directive is presented, even one that does not
appear to meet the formalities of execution, form, or
language required by the State in which it is presented to
the same extent as such provider or organization would give
effect to an advance directive that meets such requirements,
except that a provider or organization may decline to honor
such a directive if the provider or organization can
reasonably demonstrate that it is not an authentic expression
of the individual's wishes concerning his or her health care.
Nothing in this paragraph shall be construed to authorize the
administration of medical treatment otherwise prohibited by
the laws of the State in which the directive is presented.
``(B) The provisions of this paragraph shall preempt any
State law to the extent such law is inconsistent with such
provisions. The provisions of this paragraph shall not
preempt any State law that provides for greater portability,
more deference to a patient's wishes, or more latitude in
determining a patient's wishes.''.
(c) Effective Dates.--
(1) In general.--Subject to paragraph (2), the amendments
made by subsections (a) and (b) shall apply to provider
agreements and contracts entered into, renewed, or extended
under title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.), and to State plans under title XIX of such Act (42
U.S.C. 1396 et seq.), on or after such date as the Secretary
of Health and Human Services specifies, but in no case may
such date be later than 1 year after the date of enactment of
this Act.
(2) Extension of effective date for state law amendment.--
In the case of a State plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) which the Secretary of
Health and Human Services determines requires State
legislation in order for the plan to meet the additional
requirements imposed by the amendments made by subsection
(b), the State plan shall not be regarded as failing to
comply with the requirements of such title solely on the
basis of its failure to meet these additional requirements
before the first day of the first calendar quarter beginning
after the close of the first regular session of the State
legislature that begins after the date of enactment of this
Act. For purposes of the previous sentence, in the case of a
State that has a 2-year legislative session, each year of the
session is considered to be a separate regular session of the
State legislature.
SEC. 5. INCREASING AWARENESS OF THE IMPORTANCE OF END-OF-LIFE
PLANNING.
Title III of the Public Health Service Act is amended by
adding at the end the following new part:
``PART R--PROGRAMS TO INCREASE AWARENESS OF ADVANCE DIRECTIVE PLANNING
ISSUES
``SEC. 399Z-1. ADVANCE DIRECTIVE EDUCATION CAMPAIGNS AND
INFORMATION CLEARINGHOUSES.
``(a) Advance Directive Education Campaign.--The Secretary
shall, directly or through grants awarded under subsection
(c), conduct a national public education campaign--
``(1) to raise public awareness of the importance of
planning for care near the end of life;
``(2) to improve the public's understanding of the various
situations in which individuals may find themselves if they
become unable to express their health care wishes;
``(3) to explain the need for readily available legal
documents that express an individual's wishes, through
advance directives (including living wills, comfort care
orders, and durable powers of attorney for health care); and
``(4) to educate the public about the availability of
hospice care and palliative care.
``(b) Information Clearinghouse.--The Secretary, directly
or through grants awarded under subsection (c), shall provide
for the establishment of a national, toll-free, information
clearinghouse as well as clearinghouses that the public may
access to find out about State-specific information regarding
advance directive and end-of-life decisions.
``(c) Grants.--
``(1) In general.--The Secretary shall use at least 60
percent of the funds appropriated under subsection (d) for
the purpose of awarding grants to public or nonprofit private
entities (including States or political subdivisions of a
State), or a consortium of any of such entities, for the
purpose of conducting education campaigns under subsection
(a) and establishing information clearinghouses under
subsection (b).
``(2) Period.--Any grant awarded under paragraph (1) shall
be for a period of 3 years.
``(d) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$25,000,000.''.
SEC. 6. GAO STUDIES AND REPORTS ON END-OF-LIFE PLANNING
ISSUES.
(a) Study and Report on Compliance With Advance Directives
and Other Advance Planning Documents.--
(1) Study.--The Comptroller General of the United States
shall conduct a study on the effectiveness of advance
directives in making patients' wishes known and honored by
health care providers.
(2) Report.--Not later than the date that is 18 months
after the date of enactment of this Act, the Comptroller
General shall submit to Congress a report on this study
conducted under paragraph (1) together with recommendations
for such legislation and administrative action as the
Comptroller General determines to be appropriate.
(b) Study and Report on Establishment of National Advance
Directive Registry.--
(1) Study.--The Comptroller General of the United States
shall conduct a study on the implementation of the amendments
made by section 3 (relating to medicare coverage of end-of-
life planning consultations).
(2) Report.--Not later than 2 years after the date of
enactment of this Act, the Comptroller General shall submit
to Congress a report on this study conducted under paragraph
(1) together with recommendations for such legislation and
administrative action as the Comptroller General determines
to be appropriate.
(c) Study and Report on Establishment of National Advance
Directive Registry.--
(1) Study.--The Comptroller General of the United States
shall conduct a study on the feasibility of a national
registry for advance directives, taking into consideration
the constraints created by the privacy provisions enacted as
a result of the Health Insurance Portability and
Accountability Act.
(2) Report.--Not later than 18 months after the date of
enactment of this Act, the Comptroller General shall submit
to Congress a report on this study conducted under paragraph
(1) together with recommendations for such legislation and
administrative action as the Comptroller General determines
to be appropriate.
____
Last Acts Partnership,
Washington, DC, June 17, 2004.
Senator Bill Nelson,
U.S. Senate,
Washington, DC.
Dear Senator Nelson: On behalf of Last Acts Partnership, a
national nonprofit organization dedicated to improving care
and
[[Page S7019]]
caring near the end of life, I thank you for introducing the
``Advance Directives Improvement and Education Act of 2004.''
Your recognition of the importance of advance care planning
and your leadership in crafting this legislation is greatly
appreciated. We applaud your commitment to educating
Americans about the need for these critical documents and
support the goal of encouraging all Medicare beneficiaries to
discuss advance directives with their physicians and
families.
A life-threatening or terminal illness or a tragic accident
takes its toll not only on the patient but on his or her
family as well. After more than 60 years of working in the
end-of-life care field, Last Acts Partnership (formerly
Partnership for Caring and Choice in Dying) knows full well
how much worse it is when people are asked to make decisions
for a loved one having never discussed his or her wishes for
care at the end of life. Advance directives and the necessary
conversations that should accompany them are a gift to guide
those who find themselves responsible for another's care.
Ensuring that each of us receives the kind of care we want
if we are incapacitated or approaching death must be a policy
priority as we look to the future of health care. The
portability provision in your bill is another necessary step
toward that goal. Providing an information clearinghouse is
also key because too many people, including health care
providers, are unaware of options such as hospice and
palliative care, home care, spiritual counseling and other
resources.
Again, Senator, we thank you, your cosponsors, and all of
the senators who join in support of this important
legislation. Last Acts Partnership looks forward to assisting
you and your staff as it moves through the legislative
process. Our membership and our collegial organizations will
be working to support the passage of the ``Advance Directives
Improvement and Education Act of 2004'' and, more
importantly, to assure that the health care wishes of our
loved ones and ourselves will be honored.
Sincerely,
Karen Orloff Kaplan,
MSW, MPH, ScD,
President and CEO.
______
By Mr. DURBIN:
S. 2546. A bill to amend the Federal Food, Drug, and Cosmetic Act to
require premarket consultation and approval with respect to genetically
engineered foods, and for other purposes; to the Committee on
Agriculture, Nutrition, and Forestry.
Mr. DURBIN. Mr. President, today I am introducing legislation that
will strengthen consumer confidence in the safety of genetically
engineered food and genetically engineered animals that may enter the
food supply. This bill, known as the Genetically Engineered Food Act
(GEFA) of 2004, requires the Federal Food and Drug Administration (FDA)
to conduct an environmental and safety review of all genetically
engineered plants and animals that may enter the food supply.
Our country has been blessed with one of the safest and most abundant
food supplies in the world but we can do better. Genetically engineered
foods have become a major portion of the American food supply and
promise to become a larger part in the future. The next generation of
genetically engineered foods will be more complex, will possess more
novel genetic variations and will challenge regulatory agencies'
ability to assess and manage their food safety and potential
environmental effects.
Currently, the FDA screens genetically engineered foods through a
voluntary consultation program. Despite assurances from the FDA for the
past two years that the proposed and more stringent ``pre-market
biotechnology notification'' (PBN) rules governing genetically
engineered foods were imminent, those rules have yet to appear.
The Genetically Engineered Food Act of 2004 will create a transparent
process that promotes public participation as decisions are made
regarding the safety and environmental impact of genetically engineered
plants and animals.
This bill will make the review process mandatory in place of the
current voluntary system, which will reduce the chance that a
potentially harmful product could bypass or receive inadequate
regulatory oversight. The measure will establish unambiguous and
predictable pathways for developers of genetically modified foods to
gain approval to go to market and will ensure consumer confidence in
the integrity of the system through a fully transparent review process.
An improved regulatory system for genetically engineered foods will
boost consumer confidence in biotechnology derived foods, give federal
agencies clear legal authority to deal with new technology and provide
a process to detect problems even after genetically engineered foods
are approved.
The Genetically Engineered Food Act of 2004 will strengthen
government oversight in several important ways.
Mandatory Review: Producers of genetically engineered foods will be
required to receive approval from the FDA before introducing their
products into interstate commerce. The FDA will ensure, based on the
best scientific evidence, that genetically engineered foods are just as
safe as comparable food products before allowing them on the market.
Public Involvement and Transparency: In order for our country to gain
the benefits that genetically engineered plants and animals can offer
as additional sources of food, public confidence must be maintained in
the safety of these products. My bill will provide for public
involvement in the approval process by providing information to
consumers, and giving them the opportunity to provide comments. Adding
transparency will increase the public's understanding and confidence in
the safety of these animals as they enter the food supply.
Scientific studies and other materials submitted to the FDA as part
of the mandatory review of genetically engineered foods will be made
available for public review and comment. Members of the public will be
able to submit any new information on genetically engineered foods not
previously available to the FDA and request a new review of a
particular genetically engineered food product even if that food is
already on the market.
Testing: The FDA, in conjunction with other Federal agencies, will be
given the authority to conduct scientifically-sound testing to
determine whether genetically engineered foods are inappropriately
entering the food supply.
Communication: The FDA and other Federal agencies will establish a
registry of genetically engineered foods for easy access to information
about those foods that have been cleared for market. The genetically
engineered food review process will be fully transparent to give the
public access to all non-confidential information.
Environmental Review with Respect to Animals: While genetically
engineered foods such as corn and soybeans are already part of our food
supply, genetically engineered animals will also soon be ready for
market approval. These animals hold much promise as an additional
source of food for our nation. However, we must ensure not only the
safety of these genetically engineered animals as they enter the food
supply, but also the impact of these animals as they come in contact
with the environment.
The provisions of my bill are consistent with the recommendations
made in the 2004 National Academy of Sciences report, ``Biological
Confinement of Genetically Engineered Organisms''; the Pew Initiative
on Food and Biotechnology 2004 report, ``Issues in the Regulation of
Genetically Engineered Plants and Animals''; and the 2004 report from
the Ecological Society of America, ``Genetically Engineered Organisms
and the Environment''.
The FDA has a mandatory review process in place that is used to
review the food safety of genetically engineered animals before they
enter the food supply. However, this bill will provide the FDA with
additional oversight authorities to address the potential environmental
impact of genetically engineered animals prior to their safety
approval.
Environmental issues have been identified as a major science-based
concern associated with genetically engineered animals. Therefore, to
obtain approval to market a genetically engineered animal, the
developer must include an environmental assessment that analyzes the
potential effects of the genetically engineered animal on the
environment. A plan must also be in place to reduce or eliminate any
negative effects. If the environmental assessment is not adequate,
approval will not be granted.
I urge my colleagues to join me in this effort to strengthen consumer
confidence in the safety of genetically engineered foods and
genetically engineered animals that may enter the food supply. The
Genetically Engineered Foods Act of 2004 will help provide the public
with the added assurance that
[[Page S7020]]
genetically engineered foods and animals are safe to produce and
consume. I ask unanimous consent that the text of the legislation be
printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 2546
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 ``Genetically Engineered Foods
Act''.
SEC. 2. FINDINGS.
Congress finds that--
(1) genetically engineered food is rapidly becoming an
integral part of domestic and international food supplies;
(2) the potential positive effects of genetically
engineered foods are enormous;
(3) the potential for both anticipated and unanticipated
effects exists with genetic engineering of foods;
(4) genetically engineered food not approved for human
consumption has, in the past, entered the human food supply;
(5) environmental issues have been identified as a major
science-based concern associated with animal biotechnology;
(6) it is essential to maintain--
(A) public confidence in--
(i) the safety of the food supply; and
(ii) the ability of the Federal Government to exercise
adequate oversight of genetically engineered foods; and
(B) the ability of agricultural producers and other food
producers of the United States to market, domestically and
internationally, foods that have been genetically engineered;
(7) public confidence can best be maintained through
careful review and formal determination of the safety of
genetically engineered foods, and monitoring of the positive
and negative effects of genetically engineered foods as the
foods become integrated into the food supply, through a
review and monitoring process that--
(A) is scientifically sound, open, and transparent;
(B) fully involves the general public; and
(C) does not subject most genetically engineered foods to
the lengthy food additive approval process; and
(8) because genetically engineered foods are developed
worldwide and imported into the United States, it is
imperative that imported genetically engineered food be
subject to the same level of oversight as domestic
genetically engineered food.
SEC. 3. DEFINITIONS.
(a) This Act.--In this Act, the terms ``genetic engineering
technique'', ``genetically engineered animal'', ``genetically
engineered food'', ``interstate commerce'', ``producer'',
``safe'', and ``Secretary'' have the meanings given those
terms in section 201 of the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 321) (as amended by subsection (b)).
(b) Federal Food, Drug, and Cosmetic Act.--Section 201 of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321) is
amended--
(1) in subsection (v)--
(A) by striking ``(v) The term'' and inserting the
following:
``(v) New Animal Drug.--
``(1) In general.--The term'';
(B) by striking ``(1) the composition'' and inserting ``(A)
the composition'';
(C) by striking ``(2) the composition'' and inserting ``(B)
the composition''; and
(D) by adding at the end the following:
``(2) Inclusion.--The term `new animal drug' includes--
``(A) a genetic engineering technique intended to be used
to produce an animal; and
``(B) a genetically engineered animal.''; and
(2) by adding at the end the following:
``(nn) Genetically Engineered Animal.--
(1) In general.--The term `genetically engineered animal'
means an animal that--
``(A) is intended to be used--
``(i) in the production of a food or dietary supplement; or
``(ii) for any other purpose;
``(B)(i) is produced in the United States; or
``(ii) is offered for import into the United States; and
``(C) is produced using a genetic engineering technique.
``(2) Exclusion.--The term `genetically engineered animal'
does not include an established line of a genetically
modified animal that--
``(A) is used solely in scientific research; and
``(B) is not intended or expected--
``(i) to enter the food supply; or
``(ii) to be released into the environment.
``(oo) Genetically Engineered Food.--
``(1) In general.--The term `genetically engineered food'
means a food or dietary supplement, or a seed, microorganism,
or ingredient intended to be used to produce a food or
dietary supplement, that--
``(A)(i) is produced in the United States; or
``(ii) is offered for import into the United States; and
``(B) is produced using a genetic engineering technique.
``(2) Inclusion.--The term `genetically engineered food'
includes a split use food.
``(3) Exclusion.--The term `genetically engineered food'
does not include a genetically engineered animal.
``(pp) Genetic Engineering Technique.--The term `genetic
engineering technique' means the use of a transformation
event to derive food from a plant or animal or to produce an
animal.
``(qq) Producer.--The term `producer', with respect to a
genetically engineered animal, genetically engineered food,
or genetic engineering technique, means a person that--
``(1) develops, manufactures, or imports the genetically
engineered animal or genetically engineered food;
``(2) uses the genetic engineering technique; or
``(3) takes other action to introduce the genetically
engineered animal, genetically engineered food, or genetic
engineering technique into interstate commerce.
``(rr) Safe.--The term `safe', with respect to a
genetically engineered food, means--
``(1) as safe as comparable food that is not produced using
a genetic engineering technique; or
``(2) if there is no such comparable food, having a
reasonable certainty of causing no harm.
``(ss) Split Use Food.--The term `split use food' means a
product that--
``(1)(A) is produced in the United States; or
``(B) is offered for import into the United States;
``(2) is produced using a genetic engineering technique;
and
``(3) could be used as food by both humans and animals but
that the producer does not intend to market as food for
humans.
``(tt) Transformation Event.--The term `transformation
event' means the introduction into a plant or an animal of
genetic material that has been manipulated in vitro.''.
SEC. 4. GENETICALLY ENGINEERED FOODS.
Chapter IV of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 341 et seq.) is amended--
(1) by inserting after the chapter heading the following:
``Subchapter A--General Provisions''; and
(2) by adding at the end the following:
``Subchapter B--Genetically Engineered Foods
``SEC. 421. PREMARKET CONSULTATION AND APPROVAL.
``(a) In General.--A producer of genetically engineered
food, before introducing a genetically engineered food into
interstate commerce, shall first obtain approval through the
use of a premarket consultation and approval process.
``(b) Regulations.--The Secretary shall promulgate
regulations that describe--
``(1) all information that is required to be submitted for
the premarketing approval process, including--
``(A) specification of the species or other taxonomic
classification of plants for which approval is sought;
``(B) identification of the genetically engineered food;
``(C)(i) a description of each type of genetic manipulation
made to the genetically engineered food;
``(ii) identification of the manipulated genetic material;
and
``(iii) the techniques used in making the manipulation;
``(D) the effect of the genetic manipulation on the
composition of the genetically engineered food (including
information describing the specific substances that were
expressed, removed, or otherwise manipulated);
``(E) a description of the actual or proposed applications
and uses of the genetically engineered food;
``(F) information pertaining to--
``(i) the safety of the genetically engineered food as a
whole; and
``(ii) the safety of any specific substances introduced,
altered, or produced as a result of the genetic manipulation
(including information on allergenicity and toxicity);
``(G) test methods for detection of the genetically
engineered ingredients in food;
``(H) a summary and overview of information and issues that
have been or will be addressed by other regulatory programs
for the review of genetically engineered food;
``(I) procedures to be followed to initiate and complete
the premarket approval process (including any preconsultation
and consultation procedures); and
``(J) any other matters that the Secretary determines to be
necessary.
``(2) Split use food.--
``(A) In general.--The regulations under paragraph (1)
shall provide for the approval of--
``(i) split use foods that are not approved for human
consumption;
``(ii) split use foods that are intended for human use but
are marketed under restricted conditions; and
``(iii) other categories of split use food.
``(B) Issues.--For each category of split use food, the
regulations shall address--
``(i)(I) whether a protocol is needed for segregating a
restricted split use food from the food supply; and
``(II) if so, what the protocol shall be;
``(ii)(I) whether action is needed to ensure the purity of
any seed to prevent unintended introduction of a genetically
engineered trait into a seed that is not designed for that
trait; and
``(II) if so, what action is needed and what industry
practices represent the best practices for maintaining the
purity of the seed;
``(iii)(I) whether a tolerance level should exist regarding
cross-mixing of segregated split use foods; and
``(II) if so, the means by which the tolerance level shall
be determined;
[[Page S7021]]
``(iv) the manner in which the food safety analysis under
this section should be conducted, specifying different
standards and procedures that are permitted to be applied for
nonfood products grown in food crops depending on the degree
of containment for that product and the likelihood of the
product to enter the food supply;
``(v)(I) the kinds of surveillance that are needed to
ensure that appropriate segregation of split use foods is
being maintained;
``(II) the manner in which and by whom the surveillance
shall be conducted; and
``(III) the manner in which the results of surveillance
shall be reported; and
``(vi) clarification of responsibility in cases of
breakdown of segregation of a split use food.
``(C) Recall authority.--The regulations shall provide
that, in addition to other authority that the Secretary has
regarding split use food, the Secretary may order a recall of
any split use food (whether or not the split use food has
been approved under this section) that--
``(i) is not approved, but has entered the food supply; or
``(ii) has entered the food supply in violation of a
condition of restriction under an approval.
``(c) Application.--The regulations shall require that, as
part of the consultation and approval process, a producer
submit to the Secretary an application that includes a
summary and a complete copy of each research study, test
result, or other information referenced by the producer.
``(d) Review.--
``(1) In general.--After receiving an application under
subsection (c), the Secretary shall--
``(A) determine whether the producer submitted information
that appears to be adequate to enable the Secretary to fully
assess the safety of the genetically engineered food, and
make a description of the determination publicly available;
and
``(B) if the Secretary determines that the producer
submitted adequate information--
``(i) provide public notice regarding the initiation of the
consultation and approval process;
``(ii) make the notice, application, summaries submitted by
the producer, and research, test results, and other
information referenced by the producer publicly available,
including, to the maximum extent practicable, publication in
the Federal Register and on the Internet; and
``(iii) provide the public with an opportunity, for not
less than 45 days, to submit comments on the application.
``(2) Exception.--The Secretary may withhold information in
an application from public dissemination to protect a trade
secret (not including any information disclosing the results
of testing to determine whether the genetically engineered
food is safe) if--
``(A) the information is exempt from disclosure under
section 522 of title 5, United States Code, or applicable
trade secret law;
``(B) the applicant--
``(i) identifies with specificity the trade secret
information in the application; and
``(ii) provides the Secretary with a detailed justification
for each trade secret claim; and
``(C) the Secretary--
``(i) determines that the information qualifies as a trade
secret subject to withholding from public dissemination; and
``(ii) makes the determination available to the public.
``(3) Determination.--Not later than 180 days after
determining adequacy of an application under paragraph
(1)(A), the Secretary shall issue and make publicly available
a determination that--
``(A) summarizes the information referenced by the producer
in light of the public comments; and
``(B) contains a finding that the genetically engineered
food--
``(i) is safe and may be introduced into interstate
commerce;
``(ii) is safe under specified conditions of use and may be
introduced into interstate commerce if those conditions are
met; or
``(iii) is not safe and may not be introduced into
interstate commerce, because the genetically engineered
food--
``(I) contains genes that confer antibiotic resistance;
``(II) contains an allergen; or
``(III) presents 1 or more other safety concerns described
by the Secretary.
``(4) Extension.--The Secretary may extend the period
specified in paragraph (3) if the Secretary determines that
an extension of the period is necessary to allow the
Secretary to--
``(A) review additional information; or
``(B) address 1 or more issues or concerns of unusual
complexity.
``(e) Rescission of Approval.--
``(1) Reconsideration.--On the petition of any person, or
on the Secretary's own motion, the Secretary may reconsider
an approval of a genetically engineered food on the basis of
information that was not available before the approval.
``(2) Finding for reconsideration.--The Secretary shall
conduct a reconsideration on the basis of the information
described in paragraph (1) if the Secretary finds that the
information--
``(A) is scientifically credible;
``(B) represents significant information that was not
available before the approval; and
``(C)(i) suggests potential impacts relating to the
genetically engineered food that were not considered in the
earlier review; or
``(ii) demonstrates that the information considered before
the approval was inadequate for the Secretary to make a
safety finding.
``(3) Information from the producer.--
``(A) In general.--In conducting the reconsideration, the
Secretary may require the producer to provide, within a
reasonable period of time specified by the Secretary,
information needed to facilitate the reconsideration.
``(B) Information not provided.--If a producer fails to
provide information required under subparagraph (A) within
the period specified by the Secretary, the Secretary shall
take 1 or more of the actions described in paragraph (5).
``(4) Determination.--After reviewing the information by
the petitioner and the producer, the Secretary shall issue a
determination that--
``(A) revises the finding made in connection with the
approval with respect to the safety of the genetically
engineered food; or
``(B) states that, for reasons stated by the Secretary, no
revision of the finding is needed.
``(5) Action by the secretary.--If, based on a
reconsideration under this section, the Secretary determines
that the genetically engineered food is not safe, the
Secretary shall--
``(A) rescind the approval of the genetically engineered
food for introduction into interstate commerce;
``(B) recall the genetically engineered food; or
``(C) take such other action as the Secretary determines to
be appropriate.
``SEC. 422. MARKETPLACE TESTING AND POST-MARKETING OVERSIGHT.
``(a) Testing.--
``(1) In general.--The Secretary, in consultation with the
Secretary of Agriculture and the Administrator of the
Environmental Protection Agency, shall establish a program to
conduct testing that the Secretary determines to be necessary
to detect, at all stages of production and distribution (from
agricultural production to retail sale), the presence of
genetically engineered ingredients in food.
``(2) Permissible testing.--Under the program, the
Secretary may conduct tests on foods to detect genetically
engineered ingredients--
``(A) that have not been approved for use under this Act,
including foods that are developed in foreign countries that
have not been approved for marketing in the United States
under this Act; or
``(B) the use of which is restricted under this Act
(including approval for use as animal feed only, approval
only if properly labeled, and approval for growing or
marketing only in certain regions).
``(b) Post-Market Oversight.--
``(1) In general.--The Secretary shall establish a program
to monitor and evaluate the continued safety after
commercialization of genetically engineered foods approved
under section 421.
``(2) Activities.--Under the program, the Secretary shall--
``(A) take appropriate actions to ensure that each split-
use food complies with any restriction or other condition on
the approval of the split-use food; and
``(B) conduct inspections and monitoring of genetically
engineered foods and facilities that produce genetically
engineered foods to ensure that only approved genetically
engineered foods are marketed to humans.
``SEC. 423. REGISTRY.
``(a) Establishment.--The Secretary, in consultation with
the Secretary of Agriculture, the Administrator of the
Environmental Protection Agency, and the heads of other
agencies, as appropriate, shall establish a registry for
genetically engineered food that contains a description of
the regulatory status of all genetically engineered foods
approved under section 421.
``(b) Requirements.--The registry under subsection (a)
shall contain, for each genetically engineered food--
``(1) the technical and common names of the genetically
engineered food;
``(2) a description of the regulatory status, under all
Federal programs pertaining to the testing and approval of
genetically engineered foods, of the genetically engineered
food;
``(3) a technical and nontechnical summary of the type of,
and a statement of the reason for, each genetic manipulation
made to the genetically engineered food;
``(4) the name, title, address, and telephone number of an
official at each producer of the genetically engineered food
whom members of the public may contact for information about
the genetically engineered food;
``(5) the name, title, address, and telephone number of an
official at each Federal agency with oversight responsibility
over the genetically engineered food whom members of the
public may contact for information about the genetically
engineered food; and
``(6) such other information as the Secretary determines
should be included.
``(c) Public Availability.--The registry under subsection
(a) shall be made available to the public, including
availability on the Internet.''.
SEC. 5. GENETICALLY ENGINEERED ANIMALS.
Chapter V of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 351 et seq.) is amended by inserting after section 512
the following:
[[Page S7022]]
``SEC. 512A. GENETICALLY ENGINEERED ANIMALS.
``(a) In General.--Section 512 shall apply to genetic
engineering techniques intended to be used to produce an
animal, and to genetically engineered animals, as provided in
this section.
``(b) Application.--An application under section 512(b)(1)
shall include--
``(1) specification of the species or other taxonomic
classification of the animal for which approval is sought;
``(2) an environmental assessment that analyzes the
potential effects of the genetically engineered animal on the
environment, including the potential effect on any
nongenetically engineered animal or other part of the
environment as a result of any intentional or unintentional
exposure of the genetically engineered animal to the
environment; and
``(3) a plan to eliminate or mitigate the potential effects
to the environment from the release of the genetically
engineered animal.
``(c) Dissemination of Application and Opportunity for
Public Comment.--
``(1) In general.--On receipt of an application under
section 512(b)(1), the Secretary shall--
``(A) provide public notice regarding the application,
including making the notice available on the Internet;
``(B) make the application and all supporting material
available to the public, including availability on the
Internet; and
``(C) provide the public with an opportunity, for not less
than 45 days, to submit comments on the application.
``(2) Exception.--
``(A) In general.--The Secretary may withhold information
in an application from public dissemination to protect a
trade secret (not including any information disclosing the
results of testing to determine whether the genetically
engineered food is safe) if--
``(i) the information is exempt from disclosure under
section 522 of title 5, United States Code, or applicable
trade secret law;
``(ii) the applicant--
``(I) identifies with specificity the trade secret
information in the application; and
``(II) provides the Secretary with a detailed justification
for each trade secret claim; and
``(iii) the Secretary--
``(I) determines that the information qualifies as a trade
secret subject to withholding from public dissemination; and
``(II) makes the determination available to the public.
``(B) Risk assessment information.--This paragraph does not
apply to information that assesses risks from the release
into the environment of a genetically engineered animal
(including any environmental assessment or environmental
impact statement performed to comply with the National
Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.)).
``(d) Denial of Application.--Under section 512(d)(1), the
Secretary shall deny an application if--
``(1) the environmental assessment for a genetically
engineered animal is not adequate; or
``(2) the plan to eliminate or mitigate the potential
environmental effects to the environment from the release of
the genetically engineered animal does not adequately protect
the environment.
``(e) Environmental Assessment.--
``(1) In general.--Before determining whether to approve an
application under section 512 for approval of a genetic
engineering technique intended to be used to produce an
animal, or of a genetically engineered animal, the Secretary
shall--
``(A) conduct an environmental assessment to evaluate the
potential effects of such a genetically engineered animal on
the environment; and
``(B) determine that the genetically engineered animal will
not have an unreasonable adverse effect on the environment.
``(2) Consultation.--In conducting an environmental
assessment under paragraph (1), the Secretary shall--
``(A) consult, as appropriate, with the Department of
Agriculture, the United States Fish and Wildlife Service, and
any other Federal agency that has expertise relating to the
animal species that is the subject of the application; and
``(B) disclose the results of the consultation in the
environmental assessment.
``(f) Safety Determination.--In determining the safety of a
genetic engineering technique or genetically engineered
animal, the Secretary shall consider the potential effects of
the genetically engineered animal on the environment,
including the potential effect on nongenetically engineered
animals.
``(g) Progeny.--If an application for approval of a genetic
engineering technique to produce an animal of a species or
other taxonomic classification, or genetically engineered
animal, has been approved, no additional application shall be
required for animals of that species or other taxonomic
classification produced using that genetic engineering
technique or for the progeny of that genetically engineered
animal.
``(h) Scope of Approval.--The scope of the genetic
engineering technique that the Secretary may approve shall be
limited to the precise procedures described in the
application for approval.
``(i) Conditions of Approval.--The Secretary may require as
a condition of approval of an application that any producer
of a genetically engineered animal that is the subject of the
application--
``(1) take specified actions to eliminate or mitigate any
potential harm to the environment that would be caused by a
release of the genetically engineered animal, including
actions specified in the plan submitted by the applicant; and
``(2) conduct post-approval monitoring for environmental
effects of any release of the genetically engineered animal.
``(j) Recall; Suspension of Approval.--
``(1) Recall.--The Secretary may order a recall of any
genetically engineered animal (whether or not the genetically
engineered animal, or a genetic engineering technique used to
produce the genetically engineered animal, has been approved)
that the Secretary determines is harmful to--
``(A) humans;
``(B) the environment;
``(C) any animal that is subjected to a genetic engineering
technique; or
``(D) any animal that is not subjected to a genetic
engineering technique.
``(2) Suspension of approval.--If the Secretary determines
that a genetically engineered animal is harmful to the health
of humans or animals or to the environment, the Secretary
may--
``(A) immediately suspend the approval of application for
the genetically engineered animal;
``(B) give the applicant prompt notice of the action; and
``(C) afford the applicant an opportunity for an expedited
hearing.
``(k) Rescission of Approval.--
``(1) Reconsideration.--On the motion of any person, or on
the Secretary's own motion, the Secretary may reconsider an
approval of a genetic engineering technique or genetically
engineered animal on the basis of information that was not
available during an earlier review.
``(2) Finding for reconsideration.--The Secretary shall
conduct a reconsideration on the basis of the information
described in paragraph (1) if the Secretary finds that the
information--
``(A) is scientifically credible;
``(B) represents significant information that was not
available before the approval; and
``(C)(i) suggests potential impacts relating to the
genetically engineered animal that were not considered before
the approval; or
``(ii) demonstrates that the information considered before
the approval was inadequate for the Secretary to make a
safety finding.
``(3) Information from the producer.--
``(A) In general.--In conducting the reconsideration, the
Secretary may require the producer to provide, within a
reasonable period of time specified by the Secretary,
information needed to facilitate the reconsideration.
``(B) Information not provided.--If a producer fails to
provide information required under subparagraph (A) within
the period specified by the Secretary, the Secretary shall
take 1 or more of the actions described in paragraph (5).
``(4) Determination.--After reviewing the information by
the petitioner and the producer, the Secretary shall issue a
determination that--
``(A) revises the finding made in connection with the
approval with respect to the safety of the genetically
engineered animal; or
``(B) states that, for reasons stated by the Secretary, no
revision of the finding is needed.
``(5) Action by the secretary.--If, based on a review under
this subsection, the Secretary determines that the
genetically engineered animal is not safe, the Secretary
shall--
``(A) rescind the approval of the genetic engineering
technique or genetically engineered animal for introduction
into interstate commerce;
``(B) recall the genetically engineered animal; or
``(C) take such other action as the Secretary determines to
be appropriate.
``(l) Animals Used in Development.--An animal that is used
in connection with an investigation intended to support
approval of an application under section 512 and this section
or that is otherwise used in connection with the development
of a genetic engineering technique or production of a
genetically engineered animal for which approval is sought
shall be deemed unsafe for the purposes of sections 501(a)(5)
and 402(a)(2)(C)(ii) unless--
``(1) the applicant submits information required by the
Secretary that addresses the food safety of the animal;
``(2) the Secretary publishes the information in the
Federal Register and provides a public comment period of not
less than 60 days; and
``(3) based on the information provided under paragraph
(1), any public comment, and other information available to
the Secretary, the Secretary--
``(A) makes a determination that the animal is safe; and
``(B) publishes the determination in the Federal Register
and on the Internet.''.
SEC. 6. PROHIBITED ACTS.
(a) Unlawful Use of Trade Secret Information.--Section
301(j) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
331(j)) is amended in the first sentence--
(1) by inserting ``421,'' after ``414,''; and
(2) by inserting ``512A,'' after ``512,''.
(b) Adulterated Food.--Section 402 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 342) is amended by adding
at the end the following:
[[Page S7023]]
``(i) Genetically Engineered Animals.--If it is a
genetically engineered animal, or is a genetically engineered
animal produced using a genetic engineering technique, that
is not approved under sections 512 and 512A.
``(j) Genetically Engineered Foods.--
``(1) In general.--If it is a genetically engineered food,
or is a genetically engineered food produced using a genetic
engineering technique, that is not approved under section
421.
``(2) Split use foods.--If it is a split use food that does
not maintain proper segregation as required under regulations
promulgated under section 421.''.
SEC. 7. TRANSITION PROVISION.
(a) In General.--A genetic engineering technique,
genetically engineered animal, or genetically engineered food
that entered interstate commerce before the date of enactment
of this Act shall not require approval under the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 301 et seq.), but
shall be considered to have been so approved, if--
(1) the producer, not later than 90 days after the date of
enactment of this Act, submits to the Secretary--
(A) a notice stating that the genetic engineering
technique, genetically engineered animal, or genetically
engineered food entered interstate commerce before the date
of enactment of this Act, providing such information as the
Secretary may require; and
(B) a request that the Secretary conduct a review of the
genetic engineering technique, genetically engineered animal,
or genetically engineered food under subsection (b); and
(2) the Secretary does not issue, on or before the date
that is 2 years after the date of enactment of this Act, a
notice under subsection (b)(2) that an application for
approval is required.
(b) Review by the Secretary.--
(1) In general.--Not later than 21 months after the date on
which the Secretary receives a notice and request for review
under subsection (a), the Secretary shall review all relevant
information in the possession of the Secretary, all
information provided by the producer, and other relevant
public information to determine whether a review of new
scientific information is necessary to ensure that the
genetic engineering technique, genetically engineered animal,
or genetically engineered food is safe.
(2) Notice that application is required.--If the Secretary
determines that new scientific information is necessary to
determine whether a genetic engineering technique,
genetically engineered animal, or genetically engineered food
is safe, the Secretary, not later than 2 years after the date
of enactment of this Act, shall issue to the producer a
notice stating that the producer is required to submit an
application for approval of the genetic engineering
technique, genetically engineered animal, or genetically
engineered food under the Federal Food, Drug, and Cosmetic
Act (21 U.S.C. 301 et seq.).
(c) Failure To Submit Application.--
(1) In general.--Except as provided in paragraph (2), a
genetically engineered animal or genetically engineered food
with respect to which the Secretary issues a notice that an
application is required under subsection (b)(2) shall be
considered adulterated under section 402 or 501, as the case
may be, of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 342, 351) unless--
(A) not later than 45 days after the producer receives the
notice, the producer submits an application for approval; and
(B) the Secretary approves the application.
(2) Pending application.--A genetically engineered animal
or genetically engineered food with respect to which the
producer submits an application for approval shall not be
considered to be adulterated during the pendency of the
application.
SEC. 8. GENETICALLY ENGINEERED CROPS.
To the maximum extent practicable, the Secretary of
Agriculture shall ensure that standards for the regulation of
genetically engineered field test crops to prevent cross-
pollenation with non-genetically engineered crops and prevent
adverse effects on the environment are based on the most
recent scientific knowledge available.
SEC. 9. REPORTS.
(a) In General.--Not later than 2 years, 4 years, and 6
years after the date of enactment of this Act, the Secretary
and the heads of other Federal agencies, as appropriate,
shall jointly submit to Congress a report on genetically
engineered animals, genetically engineered foods, and genetic
engineering techniques.
(b) Contents.--A report under subsection (a) shall
contain--
(1) information on the types and quantities of genetically
engineered foods being offered for sale or being developed,
domestically and internationally;
(2) a summary (including discussion of new developments and
trends) of the legal status and acceptability of genetically
engineered foods in major markets, including the European
Union and Japan;
(3) information on current and emerging issues of concern
relating to genetic engineering techniques, including issues
relating to--
(A) the ecological impact of, antibiotic markers for,
insect resistance to, nongerminating or terminator seeds for,
or cross-species gene transfer for genetically engineered
foods;
(B) foods from genetically engineered animals;
(C) nonfood crops (such as cotton) produced using a genetic
engineering technique; and
(D) socioeconomic concerns (such as the impact of
genetically engineered animals and genetically engineered
foods on small farms);
(4) a response to, and information concerning the status of
implementation of, the recommendations contained in the
reports entitled ``Genetically Modified Pest Protected
Plants'', ``Environmental Effects of Transgenic Plants'',
``Animal Biotechnology Identifying Science-Based Concerns'',
and ``Biological Containment of Genetically Engineered
Organisms (2004)'', issued by the National Academy of
Sciences;
(5) an assessment of the need for data relating to
genetically engineered animals and genetically engineered
foods;
(6) a projection of--
(A) the number of genetically engineered animals,
genetically engineered foods, and genetic engineering
techniques that will require regulatory review during the 5-
year period following the date of the report; and
(B) the adequacy of the resources of the Food and Drug
Administration; and
(7) an evaluation of the national capacity to test foods
for the presence of genetically engineered ingredients in
food.
SEC. 10. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated such sums as are
necessary to carry out this Act and the amendments made by
this Act.
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