[Congressional Record Volume 151, Number 121 (Monday, September 26, 2005)]
[Senate]
[Pages S10430-S10435]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ENZI (for himself, Mr. Kennedy, Mr. Alexander, Mr. Dodd, 
        Mr. Burr, Ms. Mikulski, Mr. DeWine, and Mrs. Clinton):
  S. 1769. A bill to provide re1ief to individuals and businesses 
affected by Hurricane Katrina related to healthcare and health 
insurance coverage, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. ENZI. Mr. President, I rise today to introduce a bill to provide 
solutions to the health care challenges wrought by Hurricane Katrina. 
As chairman of the Committee on Health, Education, Labor, and Pensions, 
I am proud to be joined by my friend Senator Kennedy, the ranking 
minority member of the committee, in introducing this legislation. I am 
also honored that several fellow committee members are sponsoring this 
bill as well, including Senators Alexander, Dodd, Burr, Mikulski, 
DeWine, and Clinton. This bill is truly committee product in the best 
sense of the term.
  We are introducing this legislation in response to the information 
that has been shared with us from a variety of sources. Some of the 
provisions of this bill were added as a result of the testimony that we 
received during a roundtable discussion before the Committee on Health, 
Education, Labor and Pensions. Others spring from the suggestions that 
were forwarded to us or were posted on our committee's Web site. Others 
came from our discussions with local, State and Federal officials who 
shared their firsthand knowledge and experience with us. Still others 
were added as a result of our visit to the area. This legislation will 
not accomplish everything that must be done, but it will provide 
another valuable step in the effort to provide a comprehensive package 
to address the needs of those whose lives were forever changed by the 
wrath of Hurricane Katrina.
  Just a few days ago, several of my colleagues and I traveled to the 
New Orleans area to see the damage that was done by the storm for 
ourselves. I don't think any of us were fully prepared for what we saw. 
As startling as the images were that we had seen in the paper and on 
television, they didn't fully portray what had happened and the reality 
that confronted us on the ground. The devastation that the storm had 
brought to the lives of those who lived there was readily apparent. It 
was a tragedy that was even worse than any of us had thought was 
possible. It will not be easy to use the limited resources we have at 
our disposal to meet the almost unlimited need, but we are all 
determined to try.
  Nationwide, there are people from the gulf coast region spread 
throughout the country who have had to rely on the kindness and 
goodwill of people they have never met before. Wyoming and so many 
other States have welcomed these people with open arms and open hearts. 
Seeing so many Americans, from all walks of life, respond as they have 
and reach out to other Americans in need, gives me a clearer picture 
than I have ever seen before of what is right with America. It is a 
scene that gives me confidence that we will be able to rebuild what was 
lost and breathe new life into the communities that were devastated by 
the storm.
  Now, here in Congress, we will continue to do our part, and one of 
the most important things we can do is to assure mothers and fathers 
all over the country that the health care needs of their family will be 
met, that they will not have to go without or navigate through a 
complex bureaucracy to get the care they need, and that their Federal 
Government has the necessary authority to respond to this crisis.
  The Public Health and Health Insurance Emergency Response Act of 2005 
will strengthen and improve America's ability to address the ongoing 
public health and mental health needs faced by the hundreds of 
thousands of people displaced by Hurricane Katrina. It will also help 
those evacuees and their employers continue to afford their health 
insurance premiums as they put their lives and their businesses back 
together.
  As we know, the public health emergency created by Hurricane Katrina 
will take months to resolve. That means we need to cut whatever Federal 
redtape might stand in the way of a long-term public health recovery 
effort.
  In this legislation, therefore, we strengthen the authority of the 
Secretary of Health and Human Services to waive laws that hinder the 
fullest possible response to a major disaster like Hurricane Katrina. 
These laws include vaccination eligibility laws and requirements 
related to State and local matching funds, as well laws that limit the 
Secretary's flexibility in designating health professional shortage 
areas.
  To ensure a comprehensive public health response in the months ahead, 
this critical legislation facilitates long-term Federal-State 
cooperation and coordination in a public health emergency, and assists 
with expanding and strengthening the health care safety net by 
increasing access to and resources for sites at which people displaced 
by Hurricane Katrina can receive primary and preventive care. It 
ensures immediate availability of mental health funding in the event of 
major disasters by directing special emergency mental health funding to 
affected areas, and directs additional outreach and assistance to 
individuals with disabilities, including funds to States during an 
emergency to ensure that individuals with disabilities have access to 
advocacy and support services.

  Additionally, the bill we are introducing today clarifies appropriate 
protocols for emergency response by requiring additional data 
collection and analysis for use in this and future responses to major 
disasters.
  Finally, my committee has also worked diligently to create a solution 
to another crisis created by Hurricane Katrina. This devastating 
natural disaster has changed lives and disrupted businesses all across 
the gulf coast of Louisiana, Mississippi, and Alabama. Families and 
employers are going to need our help getting the basic necessities of 
food, water, shelter, and clothing while they decide how to move 
forward and rebuild their lives and livelihoods.
  Hundreds of thousands of the gulf coast evacuees have health 
insurance that they purchased on their own or that their employer 
provided and funded. Many of these people are now without a job, and 
many of these businesses are hanging on as they clean up and wait for 
their customers to return to the region. Some people have lost almost 
everything they owned, and now

[[Page S10431]]

they are in danger of losing their health insurance if they can't pay 
their premiums.
  Congress can and will help them. The bill we are introducing will 
provide short-term premium relief to people displaced by Hurricane 
Katrina so they can keep their private health insurance.
  Under this bill, the Department of Health and Human Services, in 
consultation with State insurance commissioners, will administer a 
program to provide 3 months of health insurance premium relief to 
individuals who have purchased their own policies, and to small 
businesses and their employees. Such individuals and businesses will be 
eligible if, as of the date of the hurricane, they held health 
insurance in counties federally designated major disaster areas and 
their ability to pay premiums has been severely disrupted. Enrollment 
in the program will occur automatically upon either nonpayment of 
premiums or if communication to an insurer or policyholder indicates 
distress.
  To facilitate swift enrollment, there is no prospective application 
process. However, the program does provide for a retrospective 
randomized audit process, whereby HHS may retroactively seek collection 
of premium assistance if such assistance was made in error.
  To complete this short-term protection for those individuals and 
businesses affected by Hurricane Katrina, the bill will prohibit 
insurers from canceling policies or raising rates during the 3-month 
emergency period.
  The Public Health and Health Insurance Emergency Response Act of 2005 
will provide immediate health insurance premium relief for individuals 
and businesses affected by Hurricane Katrina, and provide the Federal 
Government the authority it needs to respond effectively to the public 
health needs of people displaced by this terrible disaster.
  After we pass this bill, our work in response to Hurricane Katrina is 
not over. This is our emergency response. In the upcoming months, 
working with Senator Burr, the chairman of our Subcommittee on 
Bioterrorism and Public Health Preparedness, and my other committee 
colleagues, I want to examine fully our preparedness and response 
capabilities as they relate to public health, mental health, and health 
care. I also want to focus on how best to rebuild the critical health 
care and public health infrastructure that was destroyed as a result of 
Hurricane Katrina.
  These are some of the long-term challenges we must tackle. But in the 
short term, we must address the immediate needs and emergent challenges 
imposed by Hurricane Katrina. I urge my colleagues to join me as 
sponsors of the Public Health and Health Insurance Emergency Response 
Act of 2005, and I look forward to seeing the Senate pass this bill in 
the very 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. 1769

       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 ``Public Health and Health 
     Insurance Emergency Response Act of 2005''.

          TITLE I--CLARIFICATION OF A PUBLIC HEALTH EMERGENCY

     SEC. 101. MODIFICATION TO THE DEFINITION OF PUBLIC HEALTH 
                   EMERGENCY.

       Section 319 of the Public Health Service Act (42 U.S.C. 
     247d) is amended--
       (1) in subsection (a), by inserting before the last 
     sentence, the following: ``Any determination under this 
     section shall specify the geographic area with respect to 
     which such determination applies.''; and
       (2) by striking subsection (d) and inserting the following:
       ``(d) Statutory Waiver.--
       ``(1) In general.--Notwithstanding any other provision of 
     this Act, if the Secretary declares a public health emergency 
     pursuant to subsection (a), the Secretary may waive the 
     following statutory requirements:
       ``(A) Reporting or administrative requirements.--In any 
     case in which the Secretary determines that, wholly or 
     partially as a result of a public health emergency that has 
     been determined pursuant to subsection (a), individuals or 
     public or private entities are unable to comply with 
     deadlines for the submission to the Secretary of data, 
     reports, or other materials, or for the completion of other 
     administrative tasks required under any law administered by 
     the Secretary, the Secretary may grant such extensions of 
     such deadlines as the circumstances may reasonably require, 
     and may waive, wholly or partially, any sanctions otherwise 
     applicable to such failure to comply.
       ``(B) Vaccinations.--With respect to section 317 of this 
     Act and section 1928 of the Social Security Act, the 
     Secretary may waive requirements related to the eligibility 
     of adults and children for participation in the program for 
     those in an area with respect to which the Secretary has 
     declared a public health emergency during the period of such 
     declaration.
       ``(C) Extension of availability of funds.--If, as a result 
     of a public health emergency declared pursuant to subsection 
     (a), the Secretary determines that the Secretary is unable to 
     obligate funds for a particular fiscal year, such funds shall 
     remain available for an additional 180 days.
       ``(D) Matching requirements.--In any case in which the 
     Secretary determines that an entity in an area with respect 
     to which the Secretary has declared a public health emergency 
     pursuant to subsection (a) is unable to provide funds 
     required as a condition of Federal matching under any 
     provision of the Public Health Service Act, the Secretary may 
     grant a waiver of such funding requirement for the fiscal 
     years covered by such emergency declaration. To the extent 
     that additional amounts have been appropriated for programs 
     that have received a waiver under this subparagraph as a 
     result of Hurricane Katrina, the Secretary may make such 
     additional amounts available to entities on a pro rata basis.
       ``(E) Mobilizing resources to provide access.--If the 
     Secretary declares a public health emergency pursuant to 
     subsection (a) with respect to an area, the Secretary may 
     deem such area as a health professional shortage area (as 
     defined under section 332(a)), a medically underserved 
     population (as defined under section 330(b)(3)), or a 
     medically underserved area or community during the period of 
     such declaration.
       ``(e) Licensing and Liability Provisions.--If the Secretary 
     declares a public health emergency pursuant to subsection (a) 
     with respect to an area, the Secretary may waive the 
     application of licensing requirements applicable to 
     physicians and other health care professionals who are 
     volunteering to provide medical services (within their scope 
     of practice) within such area as part of a coordinated 
     emergency response if such physicians or health care 
     professionals have equivalent licensing in good standing in 
     another State and are not affirmatively excluded from 
     practice in that State or in any State a part of which is 
     included in the designated public health emergency area. A 
     physician or other health care professional described in 
     section 2811(d)(1) shall be covered by the provisions of 
     section 2811(d)(2), including with respect to liability.
       ``(f) FDA Waiver Authority.--If the Secretary declares a 
     public health emergency pursuant to subsection (a) with 
     respect to an area, the Secretary may--
       ``(1) waive the requirements in the second sentence of 
     section 304(h)(1)(B) of the Federal Food, Drug, and Cosmetic 
     Act;
       ``(2) waive the requirement of section 304(h)(2) of such 
     Act that limits the administrative detention of foods to not 
     more than 30 days; and
       ``(3) waive the requirement of section 304(h)(4)(A) of such 
     Act relating to the timing of an opportunity for an informal 
     hearing upon the appeal of a detention order.

     Under paragraph (1), the Secretary may not waive the 
     requirements of sections 1.392 or 1.393 of title 21, Code of 
     Federal Regulations, or any successor regulations thereto.
       ``(g) Report.--Not later than 2 days after granting any 
     waiver under subsection (d), (e), or (f), the Secretary shall 
     notify the appropriate committees of Congress of such action. 
     The Secretary shall publish in the Federal Register a notice 
     of such waiver in a timely manner. Such notification shall 
     include, if applicable--
       ``(1) the specific provisions of law to be waived or 
     modified;
       ``(2) the rationale for such waiver or modification;
       ``(3) the geographic area in which the waiver or 
     modification will apply; and
       ``(4) the period of time, not to exceed the period of the 
     emergency, for which the waiver or modification will be in 
     effect.
       ``(h) Authority for Retroactive Application.--A waiver or 
     modification described in subsections (d), (e), and (f), at 
     the discretion of the Secretary, may be made retroactive to 
     the beginning of the emergency period or any subsequent date 
     in such period as specified by the Secretary.''.

     SEC. 102. SENSE OF CONGRESS CONCERNING THE HURRICANE KATRINA-
                   RELATED PUBLIC HEALTH EMERGENCY.

       It is the sense of Congress that--
       (1) with respect to the public health emergency declared 
     under section 319 of the Public Health Service Act (42 U.S.C. 
     247d) resulting from Hurricane Katrina, the Secretary of 
     Health and Human Services, in coordination with other Federal 
     entities (including the Federal Emergency Management 
     Association, the Department of Defense, the Department of 
     Veterans' Affairs, Environmental Protection Agency, and the 
     National Disaster Medical System), State and local 
     governments, and public and private sector entities, where 
     appropriate, should ensure the following:

[[Page S10432]]

       (A) grants and funding should be provided to address 
     ongoing emergency responses and recovery;
       (B) the provision of health services including medical 
     specialty services, health-related social services including 
     protection and advocacy services, other appropriate human 
     services, and appropriate auxiliary services to respond to 
     the needs of the survivors of the public health emergency;
       (C) clinicians deployed as part of the emergency response 
     efforts who are licensed and certified within their 
     respective State and in good standing within their State 
     should be afforded appropriate liability protections;
       (D) clinicians deployed as part of the emergency response 
     who are licensed or otherwise certified in their respective 
     State and in good standing within their State should not need 
     to fulfill additional licensure or certification requirements 
     in areas declared to be part of a public health emergency;
       (E) individuals within the public health emergency areas 
     should be able to access quality mental health and substance 
     abuse services including services to reduce and identify 
     individuals at risk of suicide and post-traumatic stress 
     disorder and provide appropriate interventions;
       (F) environmental teams should be deployed to provide 
     assessments and environmental controls for areas within the 
     public health emergency;
       (G) social services, including protection and advocacy 
     services and access to domestic violence shelters, should be 
     extended to those within the public health emergency areas;
       (H) communication resources should be available to those 
     displaced by the hurricane including access to 2-1-1 call 
     centers;
       (I) support services including supports, equipment, 
     supplies, medications, and other types of assistance (such as 
     those provided through the Developmental Disabilities 
     Assistance and Bill of Rights Act of 2000) should be 
     available to vulnerable populations including the elderly and 
     individuals with disabilities;
       (J) real time electronic surveillance, diagnosis, and 
     treatment of epidemic, re-emerging, and emerging diseases, 
     including a functioning diagnostic laboratory, should be 
     provided for those dislocated as a result of Hurricane 
     Katrina and first-responders;
       (K) funding should be provided to help healthcare 
     facilities, medical research facilities, community health 
     centers, and other essential public health and health care 
     infrastructure components to assist them in the ongoing 
     response efforts, to clean up their facilities, or to 
     rebuild;
       (L) coordination and minimizing the duplication of Federal, 
     State, and local response and recovery efforts;
       (M) funding should be provided to ensure that the Strategic 
     National Stockpile is able to provide and appropriately 
     deploy the necessary drugs, vaccines, and other biological 
     products, medical devices, and other supplies needed to 
     address acute exacerbations of chronic illness as well as 
     acute injuries and illness resulting from Hurricane Katrina;
       (N) funding should be provided to the Centers for Disease 
     Control and Prevention and the National Institutes of Health 
     to pay for needed communications, including public service 
     announcements on radio and television, to provide for 
     additional personnel, and to provide needed health and safety 
     training and resources to affected workers and employers;
       (O) none of the funds provided by the Secretary of Health 
     and Human Services in response to Hurricane Katrina should 
     made available to entities that have been indicted for 
     abandoning patients during the disaster period; and
       (P) the Department of Health and Human Services should 
     conduct an effective ongoing program to monitor the health of 
     survivors of Hurricane Katrina and of workers and volunteers 
     involved in rescue, response, and rebuilding efforts due to 
     Hurricane Katrina, and that such a program should include 
     screening for health conditions (including mental health 
     conditions) and appropriate referrals; and
       (2) the current public health emergency declared by 
     Secretary Leavitt relating to Hurricane Katrina under such 
     section 319 should be extended beyond 90 days.

                     TITLE II--HEALTHCARE RESPONSE

     SEC. 201. ASSISTANCE TO STATES IN A PUBLIC HEALTH EMERGENCY.

       Section 311(c)(2) of the Public Health Service Act (42 
     U.S.C. 243(c)(2)) is amended--
       (1) by striking ``(2) The'' and inserting the following:
       ``(2)(A) Except as provided in subparagraph (B), the''; and
       (2) by adding at the end the following:
       ``(B) If the Secretary declares a public health emergency 
     under section 319, the 6 month period described in the first 
     sentence of subparagraph (A) may be extended for a period of 
     not to exceed 18 months with respect to assistance to 
     geographic areas that are the subject of such declaration.''.

     SEC. 202. STRENGTHENING THE HEALTHCARE SAFETY NET.

       Notwithstanding any other provision of law, the Secretary 
     of Health and Human Services may temporarily provide (for the 
     period for which a determination of public health emergency 
     is in effect under section 319 of the Public Health Service 
     Act (42 U.S.C. 247d)) with respect to Hurricane Katrina that 
     any health center or facility providing primary and 
     preventive care that--
       (1) is located in an area to which such determination 
     applies, and
       (2) treats individuals displaced by Hurricane Katrina;

     shall receive reimbursement for such treatment from Federal 
     health programs at the same rate at which a Federally 
     qualified health center (as defined in section 1905(l)(2)(B) 
     of the Social Security Act (42 U.S.C. 1596d(l)(2)(B))) would 
     receive such reimbursement and shall be eligible to receive 
     funds under section 330 of the Public Health Service Act (42 
     U.S.C. 245b) with respect to services furnished to 
     individuals displaced by Hurricane Katrina if additional 
     funds are made available under such section for Hurricane 
     Katrina response efforts.

     SEC. 203. MENTAL HEALTH NEEDS.

       (a) Ensuring Funding for Mental Health in Times of National 
     Crisis.--Section 501(m) of the Public Health Service Act (42 
     U.S.C. 290aa(m)) is amended by adding at the end the 
     following:
       ``(4) Existing funding.--For purposes of carrying out this 
     subsection, amounts appropriated under this title for 
     emergency response, as provided for in this section, for 
     fiscal years 2005 and 2006 shall remain available until 
     expended or until a public health emergency as declared by 
     the Secretary no longer exists.''.
       (b) Strengthening Access to Mental Health Services in an 
     Emergency.--Section 520F of the Public Health Service Act (42 
     U.S.C. 290bb-37) is amended--
       (1) by striking subsection (b) and inserting the following:
       ``(b) Health Center.--In this section, the term `health 
     center' has the meaning given such term in section 330, and 
     includes community health centers and community mental health 
     centers.'';
       (2) in subsection (c), by adding at the end the following: 
     ``With respect to a declaration of a public health emergency 
     under section 319, the Secretary shall, in awarding such 
     grants, ensure that priority is given to States and 
     localities that are most affected by such emergency.'';
       (3) in subsection (e)(2)--
       (A) in clause (i), by striking ``individuals'' and all that 
     follows through the semicolon and inserting ``individuals, 
     including children, who may be in need of emergency mental 
     health services, including individuals at risk of developing 
     a mental illness, including Post Traumatic Stress 
     Disorder;''; and
       (B) in clause (iii), by inserting ``or at risk of 
     developing'' after ``individual with''; and
       (4) in subsection (g), by striking ``2003'' and inserting 
     ``2006''.

     SEC. 204. ASSISTANCE FOR INDIVIDUALS WITH DISABILITIES.

       (a) Assessment and Response.--
       (1) Definitions.--
       (A) Emergency shelter.--The term ``emergency shelter'' 
     means an emergency shelter for persons described in 
     subparagraph (C)(ii).
       (B) Individual with a disability.--The term ``individual 
     with a disability'' has the meaning given the term in section 
     3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 
     12102).
       (C) Individual affected by hurricane katrina.--The term 
     ``individual with a disability affected by Hurricane 
     Katrina'' means a person who is--
       (i) an individual with a disability, or a family member of 
     an individual with a disability; and
       (ii) a person who resided on August 22, 2005, in an area in 
     which the President has declared that a major disaster 
     exists, in accordance with section 401 of the Robert T. 
     Stafford Disaster Relief and Emergency Assistance Act (42 
     U.S.C. 5170), related to Hurricane Katrina.
       (2) Assistance.--An entity that receives financial 
     assistance under title I of the Developmental Disabilities 
     Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15001 et 
     seq.) may use a portion of such financial assistance to--
       (A) determine the location and status of individuals 
     affected by Hurricane Katrina, who are transferred from 
     emergency shelters to long-term care facilities (including 
     nursing homes and group homes), intermediate care facilities 
     for individuals with mental retardation, hospitals, 
     correctional institutions, and other similar locations; and
       (B) assess and respond to the needs of individuals affected 
     by Hurricane Katrina to ensure that the individuals receive 
     necessary services, supports, and other types of assistance.
       (b) Oversight and Disaster Assistance.--Subtitle C of title 
     I of the Developmental Disabilities Assistance and Bill of 
     Rights Act of 2000 (42 U.S.C. 15041 et seq.) is amended by 
     inserting after section 144 the following:

     ``SEC. 144A. OVERSIGHT AND DISASTER ASSISTANCE.

       ``(a) Definitions.--In this section:
       ``(1) Emergency shelter.--The term `emergency shelter' 
     means an emergency shelter for persons described in paragraph 
     (3)(B).
       ``(2) Individual with a disability.--The term `individual 
     with a disability' has the meaning given the term in section 
     3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 
     12102).
       ``(3) Individual affected by a major disaster.--The term 
     `individual affected by a major disaster' means a person who 
     is--
       ``(A) an individual with a disability; and
       ``(B) a person who resided in an area in which the 
     Secretary has declared a public health emergency under 
     section 319 of the Public Health Service Act, 7 days before 
     the declaration.

[[Page S10433]]

       ``(4) Public health emergency.--The term `public health 
     emergency' means a public health emergency as designated 
     under section 319 of the Public Health Service Act.
       ``(b) Oversight.--
       ``(1) Grants.--
       ``(A) In general.--In a case in which the Secretary of 
     Health and Human Services has declared that a public health 
     emergency exists for a geographic area, and as a result 
     individuals affected by a major disaster are placed in an 
     emergency shelter in a State, the Secretary may make a grant 
     to the system for that State.
       ``(B) Use of funds.--A system that receives a grant under 
     subparagraph (A) shall use the funds made available through 
     the grant to--
       ``(i) establish a registry to identify and maintain 
     information about such individuals who are in such emergency 
     shelter;
       ``(ii) track the transfers of such individuals from such 
     emergency shelter to community and non-community settings; 
     and
       ``(iii) provide oversight at such emergency shelter to 
     assure that such individuals are receiving necessary 
     services, supports, and other types of assistance.
       ``(2) Coordination.--In carrying out activities under 
     paragraph (1), the system shall coordinate the activities 
     with the Under Secretary for Emergency Preparedness and 
     Response in the Department of Homeland Security, and with any 
     nonprofit agency (such as the American Red Cross) providing 
     assistance through an emergency shelter described in 
     paragraph (1).
       ``(c) Access.--As soon as practicable after the Secretary 
     of Health and Human Services has declared a public health 
     emergency for an area, and as a result individuals affected 
     by the emergency are placed in an emergency shelter in a 
     State, the Commissioner of the Administration on 
     Developmental Disabilities shall notify each emergency 
     shelter in the State receiving such individuals that staff of 
     the system for the State shall have authority to enter the 
     shelter, and shall have access to the individuals affected by 
     the emergency residing in that shelter, to provide 
     information related to services, supports, and other types of 
     assistance for, and to protect the human, service, and legal 
     rights of, individuals affected by the emergency residing in 
     that shelter.
       ``(d) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out subsection (b) 
     $2,000,000 for fiscal year 2006 and such sums as may be 
     necessary for fiscal year 2007.''.

     SEC. 205. LIABILITY AND LICENSURE AWARENESS PROMOTION FOR 
                   HEALTH VOLUNTEERS.

       (a) In General.--The Secretary of Health and Human Services 
     shall utilize the Internet and other appropriate means to 
     disseminate to the public information on health professional 
     liability coverage and licensure requirements for 
     intermittent disaster response personnel (as described in 
     section 2811(d)(1) of the Public Health Service Act (42 
     U.S.C. 300hh-11(d)(1))) in areas in which a public health 
     emergency have been declared under section 319 of such Act 
     (42 U.S.C. 247d).
       (b) Type of Information.--The information to be provided 
     under subsection (a) shall, in the case of a State where 
     health professional licensure requirements have been waived, 
     include--
       (1) whether and how intermittent disaster response 
     personnel may be able to receive certain liability 
     protections as described in section 2811(d)(2) of the Public 
     Health Service Act (42 U.S.C. 300hh-(d)(2)), or under 
     applicable provisions of State law;
       (2) the possible limitations of such coverage and 
     protections; and
       (3) other information needed to enable health professionals 
     to make an informed decision about providing volunteer health 
     services.

                    TITLE III--RESEARCH AND REPORTS

     SEC. 301. MONITORING THE HEALTHCARE, MENTAL HEALTH, AND 
                   PUBLIC HEALTH RESPONSE.

       (a) In General.--The Secretary of Health and Human 
     Services, acting through a public service non-profit research 
     and analysis firm, shall provide for an immediate and 
     independent review (through the immediate collection of data 
     and conduct of analyses) of the lessons learned from the 
     Federal, State and local public health, mental health, and 
     medical care planning, preparedness, and response to 
     Hurricane Katrina.
       (b) Purpose.--The purpose of the study under subsection (a) 
     is to collect available relevant data, through site visits, 
     reviews of medical and epidemiological records, interviews 
     with individuals residing in an area in which a public health 
     emergency has been declared under section 319 of the Public 
     Health Service Act as a result of Hurricane Katrina, and 
     interviews with Federal, State, and local public health, 
     mental health services, and medical officials. Such 
     interviews shall be conducted in a manner that, to the extent 
     practicable, does not interfere with the delivery of patient 
     care and services.
       (c) Report.--Not later than 120 days after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall submit to the Committee on Health, Education, 
     Labor, and Pensions of the Senate and the Committee on 
     Emergency and Commerce of the House of Representatives, a 
     report concerning the lessons learned (as described in 
     subsection (a)).
       (d) Authorization of Appropriations.--There are authorized 
     to be appropriated $2,000,000 to carry out this section.

     SEC. 302. REPORT ON REGULATORY REQUIREMENTS AND FUNDING 
                   FORMULAS.

       (a) In General.--Not later than 120 days after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall submit to Congress a report on the specific 
     regulatory requirements and funding formulas under the Public 
     Health Service Act (42 U.S.C. 201 et seq.) that would assist 
     the Secretary in responding to a public health emergency (as 
     declared under section 319 of such Act (42 U.S.C. 247d)).
       (b) Authorization of Appropriations.--There are authorized 
     to be appropriated such sums as may be necessary to carry out 
     this section.

     SEC. 303. DEPARTMENT OF HEALTH AND HUMAN SERVICES INSPECTOR 
                   GENERAL AUDIT AND REPORT.

       (a) In General.--The Inspector General of the Department of 
     Health and Human Services (referred to in this section as the 
     ``Inspector General'') shall conduct an audit and 
     investigation of each program carried out by the Department 
     of Health and Human Services that includes response and 
     recovery activities related to Hurricane Katrina.
       (b) Weekly Report.--Not less frequently than once a week, 
     the Inspector General shall provide a report to the Committee 
     on Health, Education, Labor, and Pensions of the Senate and 
     the Committee on Energy and Commerce of the House of 
     Representatives listing the audits and investigations 
     initiated pursuant to subsection (a).
       (c) Status Report.--Not later than 6 months after the date 
     of enactment of this section, and biannually thereafter until 
     the audits and investigations described in subsection (a) are 
     complete, the Inspector General shall report to the Committee 
     on Health, Education, Labor, and Pensions of the Senate and 
     the Committee on Energy and Commerce of the House of 
     Representatives on the full status of the activities of the 
     Inspector General under this section.
       (d) Cooperative Ventures.--In carrying out this section, 
     the Inspector General is encouraged to enter into cooperative 
     ventures with Inspectors General of other Federal agencies.

                  TITLE IV--HEALTH INSURANCE COVERAGE

     SEC. 401. TEMPORARY EMERGENCY HEALTH COVERAGE ASSISTANCE FOR 
                   BUSINESS AND INDIVIDUALS.

       (a) In General.--The Secretary of Health and Human Services 
     (referred to in this section as the ``Secretary''), in 
     consultation with the insurance commissioners of those States 
     contained in whole or in part in the Hurricane Katrina 
     disaster area, shall establish a program to provide emergency 
     health coverage continuation relief through the provision of 
     direct payments of health insurance premiums or continuation 
     assistance on behalf of eligible businesses and their 
     employees and purchasers of individual health insurance 
     coverage.
       (b) Definitions.--In this section:
       (1) Eligible individuals.--The term ``eligible individual'' 
     means an individual (and the family dependents of such 
     individual as may be covered under the health insurance 
     coverage in which such individual is enrolled)--
       (A) who is a citizen, national, or qualified alien as 
     defined in section 431(b) of the Personal Responsibility and 
     Work Opportunity Reconciliation Act of 1996 (8 U.S.C. 
     1641(b));
       (B) whose permanent residence as of August 29, 2005 was 
     located in a Hurricane Katrina disaster area;
       (C) who was covered under individual (non-group) health 
     insurance coverage, including a policy operated pursuant to a 
     qualified high risk pool (as defined in section 2744 of the 
     Public Health Service Act (42 U.S.C. 300gg-44)), on August 
     29, 2005; and
       (D) whose ability to continue such coverage was severely 
     impaired as a result of hurricane-related disruption in a 
     Hurricane Katrina disaster area.
       (2) Eligible businesses.--The term ``eligible business'' 
     means a corporation, sole proprietorship, or partnership that 
     employs not more than 50 employees and that--
       (A) operated as of August 29, 2005 in a Hurricane Katrina 
     disaster area;
       (B) offered coverage under a group health plan (as defined 
     in section 733(a)(1) of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1191b(a)(1))) on August 29, 
     2005 to employees in a Hurricane Katrina disaster area; and
       (C) had its ability to continue coverage under such plan 
     severely impaired as a result of disruption of the sponsor's 
     business activity in the Hurricane Katrina disaster area.
       (3) Continuation assistance.--The term ``continuation 
     assistance'' means, in the case of an eligible business that 
     offers health insurance coverage under a self-insured 
     arrangement, assistance in paying administrative services 
     fees, claims costs, stop-loss premiums, and any amounts 
     required to be paid by employees to participate in the 
     arrangement.
       (4) Hurricane katrina disaster area.--The term ``Hurricane 
     Katrina disaster area'' means a parish in the State of 
     Louisiana, a county in the State of Mississippi, or a county 
     in the State of Alabama, for which a major disaster has been 
     declared in accordance with section 401 of the Robert T. 
     Stafford Disaster Relief and Emergency Assistance Act (42 
     U.S.C. 5170) as a result of Hurricane Katrina and which the 
     President has determined, before September 11, 2005, warrants 
     both individual and public assistance from the Federal 
     Government under such Act.
       (c) Health Coverage Continuation Relief.--

[[Page S10434]]

       (1) In general.--The Secretary shall design and implement 
     the program under subsection (a) in a manner that enables 
     eligible individuals and eligible businesses to be eligible 
     for direct premium reimbursement or continuation assistance 
     to be paid by the Secretary on behalf of such individual or 
     business directly to the health insurance issuer or 
     administrative services provider involved. In the case of an 
     eligible business, premium reimbursement shall include the 
     premium shares of both the employer and employees, as 
     applicable.
       (2) Limitation.--Subject to paragraph (3), in no case shall 
     the value of the assistance provided under the program under 
     this section, with respect to an individual or business, 
     exceed 100 percent of the applicable premium for coverage or 
     continuation assistance for the period of coverage involved, 
     including, with respect to employer coverage, the employer 
     and employees' share of premiums, if applicable.
       (3) Enrollment.--
       (A) In general.--The Secretary shall establish an expedited 
     process for the enrollment of eligible individuals and 
     eligible businesses in the program under this section.
       (B) Duty of secretary upon receipt of notice.--The 
     Secretary, upon receipt of a notice under subsection (f)(2), 
     shall enroll the eligible individual or eligible business 
     involved in the program under this section.
       (C) Duty of issuer.--A group health plan, or health 
     insurance insurer with respect to such a plan, shall make a 
     reasonable effort to notify an eligible individual or 
     eligible business--
       (i) of the automatic enrollment of such individual or 
     business in the program under subparagraph (B);
       (ii) that, if it is later determined that the means of 
     support of such individual, or the ability of such business 
     to continue health insurance coverage, was not severely 
     disrupted (as determined subject to a randomized 
     retrospective audit process), such individual or business may 
     be required at a later date to repay the program for the 
     amount of premiums or continuation assistance paid on its 
     behalf; and
       (iii) that such individual or business may elect to decline 
     enrollment, or cancel enrollment, in the program by notifying 
     the health insurance issuer or administrative service 
     provider involved.
       (d) Retrospective Audit Authority.--
       (1) In general.--The Secretary shall provide for the 
     application of a randomized retrospective auditing process to 
     the program under this section by a date that is not earlier 
     than November 1, 2005.
       (2) Repayment of funds.--If the Secretary determines, 
     pursuant to the audit process under paragraph (1), that an 
     individual or business that was enrolled in the program under 
     this section did not meet the disruption or other eligibility 
     requirements provided for in paragraph (1) or (2) of 
     subsection (b), the Secretary shall seek the repayment of 
     funds paid on behalf of such individual or business. Such 
     repayments shall be made with no interest or late penalty to 
     accrue prior to the commencement of a repayment period which 
     shall begin not earlier than the date that is 3 months after 
     the date on which a determination and notice of non-
     eligibility is provided.
       (3) No double payments.--The Secretary shall take 
     appropriate actions to ensure that health insurance issuers 
     do not retain double payments in instances where businesses 
     or individuals pay premiums for any period for which payments 
     have already been made under the program under this section.
       (e) Emergency Period.--Payments under the program under 
     this section shall be made only for premiums due during the 
     period beginning on August 29, 2005 and expiring 3 months 
     after such date. Prior to the expiration of such period, the 
     Secretary may make recommendations to Congress regarding any 
     reasonably determined need to extend such emergency period.
       (f) Non-Cancellation of Health Insurance Coverage.--
       (1) In general.--During the 3-month emergency period 
     described in subsection (e), health insurance issuers that 
     accept payments under the program under this section shall be 
     prohibited from canceling or terminating health insurance 
     coverage or, in the case of administrative services 
     providers, refusing to process claims under a self-insured 
     arrangement. Such health insurance issuers and administrative 
     service providers shall be prohibited during such period from 
     increasing any amounts due pursuant to such coverage or 
     arrangements that were not previously scheduled pursuant to a 
     contract prior to August 29, 2005.
       (2) Notification.--To be eligible to receive payments under 
     ths program under this section, a health insurance issuer or 
     administrative services provider shall notify the Secretary--
       (A) not earlier than 31 days following the nonpayment of a 
     scheduled premium payment from an individual or business 
     policyholder in a Hurricane Katrina disaster area, of the 
     fact of such nonpayment (or nonreimbursement of claims under 
     a self-insured arrangement); or
       (B) following a communication to the health insurance 
     insurer or administrative service provider by an individual 
     or business reasonably indicating eligibility for assistance 
     under such program, of the fact of such communication.
       (g) Expedited Rulemaking.--The Secretary shall utilize 
     expedited rulemaking procedures to carry out this section.
       (h) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $1,000,000,000 
     for fiscal year 2006.

     SEC. 402. AUTHORITY TO POSTPONE CERTAIN DEADLINES RELATED TO 
                   INDIVIDUAL HEALTH COVERAGE BY REASON OF 
                   PRESIDENTIALLY DECLARED DISASTER OR TERRORISTIC 
                   OR MILITARY ACTION.

       (a) In General.--Title XXVII of the Public Health Service 
     Act (42 U.S.C. 300gg et seq.) is amended by adding at the end 
     the following:

     ``SEC. 2793. AUTHORITY TO POSTPONE CERTAIN DEADLINES BY 
                   REASON OF PRESIDENTIALLY DECLARED DISASTER OR 
                   TERRORISTIC OR MILITARY ACTION.

       ``In the case of a plan offered through the individual 
     market, or any health insurance issuer, participant, 
     beneficiary, or other person with respect to such plan, 
     affected by a Presidentially declared disaster (as defined in 
     section 1033(h)(3) of the Internal Revenue Code of 1986) or a 
     terroristic or military action (as defined in section 
     692(c)(2) of such Code), the Secretary may, notwithstanding 
     any other provision of law, prescribe, by notice or 
     otherwise, a period of up to 1 year which may be disregarded 
     in determining the date by which any action is required or 
     permitted to be completed under this title. No plan shall be 
     treated as failing to be operated in accordance with the 
     terms of the plan solely as a result of disregarding any 
     period by reason of the preceding sentence.''.
       (b) Application of Amendment.--The Secretary of Health and 
     Human Services shall implement the amendment made by 
     subsection (a) in the same manner in which the Secretary of 
     Labor implements section 518 of the Employee Retirement 
     Income Security Act of 1974 (29 U.S.C. 1148) with respect to 
     group health plans.

                     TITLE V--EMERGENCY DESIGNATION

     SEC. 501. EMERGENCY DESIGNATION.

       Any amount provided under this Act is designated as an 
     emergency requirement pursuant to section 402 of H. Con. Res. 
     95 (109th Congress).

  Mr. KENNEDY. Mr. President, today, I join Senator Enzi in introducing 
a relief bill that will bring aid to hundreds of thousands of people 
affected by Hurricane Katrina. I commend Chairman Enzi and our 
colleagues on the Committee for moving so quickly to meet the many 
urgent health needs of the victims.
  We have all seen the images of despair of those who felt so abandoned 
by their government in their time of need. We have also seen hope 
reborn in the faces of families reunited after surviving this massive 
catastrophe. We have seen great heroism too, not only in the 
spectacular images of rescues by helicopter, but in the quiet courage 
of neighbors helping neighbors survive the heavy winds and rising 
waters.
  It's been three weeks since Hurricane Katrina brought havoc to the 
Gulf Coast. Every day, we have a clearer picture of physical 
destruction of beloved American communities, and a deeper understanding 
of what our fellow citizens have lost. Survivors have begun the slow 
and difficult process of rebuilding their lives. Most have , only the 
clothing they wore as they tried to cope with the hurricane.
  Another picture is also emerging--a report card filled with failing 
grades for government at every level in the preparations and response 
for such an emergency. The natural disaster was compounded many fold by 
the inadequate response, despite the bravery and sacrifice of relief 
workers, rescue personnel, and the hurricane survivors themselves.
  With new destruction in Texas and Louisiana from Hurricane Rita, we 
had little time to learn from these past lessons. Already, we responded 
sooner by insisting on the evacuation of people in flood-prone areas 
and shipping food and supplies quickly into the hard hit areas. 
Unfortunately, this means that many Hurricane Katrina evacuees had to 
relocate again. They halted their individual rebuilding processes, and 
once again, now find themselves in unfamiliar surroundings dealing with 
anguish, fear, loss, and uncertainty.
  The recent evacuations reveal additional lessons to be learned. 
Massive gridlock on evacuation routes, gasoline shortages, and 
overwhelmed airports are just the beginning of many challenges that lie 
ahead. We need to learn faster and learn better, so that we can prepare 
more effectively before disasters happen, react more effectively as 
they take place, and respond more effectively in the aftermath.
  I commend Chairman Enzi for convening two roundtable discussions that 
provided impressive expertise about what can be done immediately to 
protect the health of those affected by the hurricane and help them 
begin to rebuild their lives.

[[Page S10435]]

  Our committee listened carefully and prepared a relief package to 
address the immediate health needs of the survivors for the next 90 
days. We have a long road ahead of us, but this bill is an important 
start. As the aftermath of Hurricanes Katrina and Rita continues to 
unfold, we will learn of additional needs, and be reminded again and 
again that we have much more to do to improve the nation's ability to 
respond to disasters, whether man-made or natural.
  In this legislation, we are focusing on what we can do to immediately 
remove the perennial red tape and make sure that each and every 
survivor has access to good health care. For those with health 
insurance, the bill provides temporary assistance on premiums, so that 
individuals and small businesses affected by the hurricanes maintain 
their existing coverage. I'm hopeful we can work together to extend 
similar help to persons in larger firms who need temporary assistance.
  We also authorize the Secretary of Health and Human Services to 
extend insurance deadlines, so that hurricane survivors have time to 
make important decisions about their coverage.
  In preventing disease outbreaks and epidemics, time is of the 
essence. The bill removes barriers to existing public health programs, 
such as by allowing the Vaccines for Children Program to contribute to 
the vaccination campaign already under way, in order to prevent 
outbreaks of disease in responders and in persons relying on the same 
shelter.
  It is especially urgent to monitor the survivors and responders, in 
order to identify both the short-term and the long-term risks they 
face. I will continue to work with my colleagues to authorize the 
Secretary of Health and Human Services to work closely with other 
agencies, including the Environmental Protection Agency, to begin 
monitoring health outcomes and exposure to environmental toxins, and to 
develop a registry of people screened, so that we can identify long-
term consequences.
  As we focus on preventing and treating physical illness, we must not 
ignore the emotional challenges ahead for both survivors and 
responders. Thousands are facing the silent battle of coping with 
bereavement and catastrophe. All are at risk for post-traumatic stress 
disorder. Today, we are reauthorizing the emergency mental health 
services program of the Substance Abuse and Mental Health Services 
Administration's and giving priority to awarding its grants to states 
and areas most affected by the hurricanes.
  This measure is only the beginning. It ends restrictions on existing 
Federal programs, so that we can help immediately with the relief 
efforts and expand access to health care for the survivors.
  I'm encouraged by how well our colleagues have worked together to 
rapidly develop this relief package, and I urge the Majority Leader and 
the full Senate to make passing this legislation a priority and bring 
help to the thousands affected by the hurricane.
  I'm also optimistic that our bipartisan cooperation here will lead to 
further relief measures that fully address the longer term health needs 
of the victims, and prevent the kind of mistakes that happened in 
connection with Katrina and Rita from happening again.
  Congress has a major responsibility to help the survivors of this 
tragic ordeal rebuild their communities and their lives. Today, we make 
a clear commitment to the survivors. Our promise to them should not 
simply be to turn back the clock a month or two--it should be to 
fulfill the true promise of the American Dream by committing ourselves 
to better health, better education and better job opportunities for 
survivors, and for all Americans as well.
                                 ______