[Congressional Record Volume 152, Number 44 (Friday, April 7, 2006)]
[Senate]
[Pages S3380-S3394]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Ms. SNOWE (for herself and Ms. Collins):
  S. 2596. A bill to modify the boundaries for a certain empowerment 
zone designation; to the Committee on Finance.
  Ms. SNOWE. Mr. President, I rise today with Senator Collins to 
introduce legislation to help reverse the devastating population 
decline and economic distress that has plagued individuals and 
businesses in Aroostook County, the northernmost county in Maine. What 
the bill does is simple, it will bring all of Aroostook County under 
the Empowerment Zone (EZ) program. The legislation is identical to a 
bill that we introduced in the 108th Congress and was included in the 
FY 2004 Agriculture Appropriations bill in 2003 as passed by the 
Senate.
  To fully grasp the importance of this legislation, it is necessary to 
understand the unique situation facing the residents of Aroostook 
County. ``The County'', as it is called by Mainers, is a vast and 
remote region of Maine. As the northernmost county, it shares more of 
its border with Canada than its neighboring Maine counties. It has the 
distinction of being the largest county east of the Mississippi River. 
Its geographic isolation is even more acute when considering that the 
county's relatively small population of 73,000 people are scattered 
throughout 6,672 square miles of rural countryside. Aroostook County is 
home to 71 organized townships, as well as 125 unorganized townships 
much of which is forest land and wilderness.
  As profound as this geographic isolation may seem, it is the economic 
isolation and the recent out-migration that has had the most 
devastating impact on the region. The economy of northern Maine has a 
historical dependence upon its natural resources, particularly forestry 
and agriculture. While these industries served the region well in 
previous decades, and continue to form the underpinnings of the local 
economy, many of these sectors have experienced decline and can no 
longer provide the number and type of quality jobs that residents need.
  While officials in the region have put forward a Herculean effort to 
redevelop the region, with nearly 1,000 new jobs at the Loring Commerce 
Centre alone, Aroostook County is still experiencing a significant 
``job deficit'', and as a result continues to lose population at an 
alarming rate. Since its peak in 1960, northern Maine's population has 
declined by 30 percent. Unfortunately, the Main State Planning Office 
predicts that Aroostook County will continue losing population as more 
workers leave the area to seek opportunities and higher wages in 
southern Maine and the rest of New England.
  In January 2002, a portion of Aroostook County was one of two regions 
that received Empowerment Zone status from the USDA for out-migration. 
The entire county experienced an out-migration of 15 percent from 
86,936 in 1990 to 73,938 in 2000. Moreover, a shocking 40 percent of 15 
to 29-year-olds left during the last decade.
  The current zone boundaries were chosen based on the criteria that 
Empowerment Zones be no larger than 1,000 square miles, and have a 
maximum population of 30,000 for rural areas. The lines drawn for the 
Aroostook County Empowerment Zone were considered to be the most 
inclusive and reasonable given the constraints of the program. It 
should be noted as well that the boundaries were drawn based on the 
1990 census, making the data significantly outdated at the start and 
included the former Loring Air Force Base and its population of nearly 
8,000 people, which had closed nearly 8 years before the designation, 
taking its military and much of its civilian workforces with it. The 
Maine State Planning Office estimated that the base closure resulted in 
the loss of 3,494 jobs directly related to the base and

[[Page S3381]]

another 1,751 in associated industry sectors for a total loss of $106.9 
million annual payroll dollars.
  Some of the most distressed communities that have lost substantial 
population are not in the Empowerment Zone, and other communities like 
Houlton literally are divided simply by a road, having one business on 
the south side of the street with no Empowerment Zone designation look 
out their window to a neighboring business on the north side of the 
street with full Empowerment Zone benefits. The economic factors for 
these communities and for these neighbors are the same as those areas 
within the Empowerment Zone. This designation is not meant to cause 
divisiveness within communities, it is created to augment a partnership 
for growth and to level the playing field for all Aroostook County 
communities who have equally suffered through continuing out migration 
whether it be in Madawaska or Island Falls.
  The legislation I am introducing would provide economic development 
opportunities to all reaches of Aroostook County by extending 
Empowerment Zone status to the entire county. This inclusive approach 
recognizes that the economic decline and population out-migration are 
issues that the entire region must confront, and, as evidenced by their 
successful Round III EZ application, they are attempting to confront. I 
believe the challenges faced by Aroostook County are significant, but 
not insurmountable. This legislation would make great strides in 
improving the communities and business in northern Maine, and I urge my 
colleagues to support this bill.
  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. 2596

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

     SECTION 1. MODIFICATION OF BOUNDARY OF AROOSTOOK COUNTY 
                   EMPOWERMENT ZONE.

       (a) In General.--The Aroostook County empowerment zone 
     shall include, in addition to the area designated as of the 
     date of the enactment of this Act, the remaining area of the 
     county not included in such designation, notwithstanding the 
     size requirement of section 1392(a)(3)(A) of the Internal 
     Revenue Code of 1986 and the population requirements of 
     section 1392(a)(1)(B) of such Code.
       (b) Effective Date.--Subsection (a) shall take effect as of 
     the effective date of the designation of the Aroostook County 
     empowerment zone by the Secretary of Agriculture.
  Ms. COLLINS. Mr. President, I am pleased to join my colleague, 
Senator Olympia Snowe, in introducing legislation that will modify the 
borders of the Aroostook County Empowerment Zone to include the entire 
county so that the benefits of Empowerment Zone designation can be 
fully realized in northern Maine.
  The Department of Agriculture's Empowerment Zone program addresses a 
comprehensive range of community challenges, including many that have 
traditionally received little Federal assistance, reflecting the fact 
that rural problems do not come in standardized packages but can vary 
widely from one place to another. The Empowerment Zone program 
represents a long-term partnership between the Federal Government and 
rural communities so that communities have enough time to implement 
projects to build the capacity to sustain their development beyond the 
term of the partnership. An Empowerment Zone designation gives 
designated regions potential access to millions of dollars in Federal 
grants for social services and community redevelopment as well as tax 
relief.
  Aroostook County is the largest county east of the Mississippi River. 
Yet, despite the impressive character and work ethic of its citizens, 
the county has fallen on hard times. The 2000 Census indicated a 15-
percent loss in population since 1990. Loring Air Force Base, which was 
closed in 1994, also caused an immediate out-migration of 8,500 people 
and a further out-migration of families and businesses that depended on 
Loring for their customer base.
  In response to these developments, the Northern Maine Development 
Commission and other economic development organizations, the private 
business sector, and community leaders in Aroostook have joined forces 
to stabilize, diversify, and grow the area's economy. They have 
attracted some new industries and jobs. As a native of Aroostook 
County, I can attest to the strong community support that will ensure a 
successful partnership with the U.S. Department of Agriculture.
  Designating this region of the United States as an Empowerment Zone 
will help ensure its future economic prosperity. However, the 
restriction that the Empowerment Zone be limited to 1,000 square miles 
prevents all of Aroostook's small rural communities from benefiting 
from this tremendous program. Aroostook covers some 6,672 square miles 
but has a population of only 74,000. Including all of the county in the 
Empowerment Zone will guarantee that parts of the county will not be 
left behind as economic prosperity returns to the area. It does little 
good to have a company move from one community to another within the 
county simply to take advantage of Empowerment Zone benefits.
  Senator Snowe and I introduced this legislation during the 108th 
Congress. In fact, we were successful in getting this legislation 
passed in the Senate by attaching it to the fiscal year 2004 
Agriculture Appropriations bill. Unfortunately, this language was 
removed during conference negotiations with the House. Senator Snowe 
and I remain committed to bringing the benefits of the Empowerment Zone 
designation to all of Aroostook County's residents and will work to 
pass this legislation in both Chambers during this Congress.
                                 ______
                                 
      By Mr. VITTER (for himself, Mr. Inhofe, Mr. Enzi, Mr. Santorum, 
        Mr. Coburn, Mrs. Dole, and Mr. Sununu):
  S. 2599. A bill to amend the Robert T. Stafford Disaster Relief and 
Emergency Assistance Act to prohibit the confiscation of firearms 
during certain national emergencies; to the Committee on the Judiciary.
  Mr. VITTER. Mr. President, I rise today to introduce a bill, the 
``Disaster Recovery Personal Protection Act of 2006'' that would amend 
the Robert T. Stafford Disaster Relief and Emergency Assistance Act to 
prohibit the confiscation of firearms during certain national 
emergencies.
  The city of New Orleans confiscated more than 1,000 firearms under 
the misguided policy of a local law enforcement officer. Our Second 
Amendment rights should not be subject to the whims of individuals. My 
bill would prohibit any agency using Federal disaster relief funds from 
seizing firearms or restricting firearm possession, except under 
circumstances currently applicable under Federal or State law.
  Our law enforcement officers are under intense pressure to protect 
and serve, and I value their call to duty with great respect. The 
``Disaster Recovery Personal Protection Act of 2006'' would not prevent 
law enforcement from confiscating guns from convicted felons or other 
prohibited persons. Also, it would have no effect on law enforcement 
outside of disaster relief situations.
  The horrible tragedy that unfolded upon the State of Louisiana was 
certainly unprecedented. The devastation that occurred will last for 
generations, and yet, there is immense hope that our great State of 
Louisiana will shine better than ever before. In the days and nights 
that followed there were mistakes at all levels of government, and the 
confiscation of law-abiding citizens' personal protection was one of 
them.
  I ask my fellow Senators to support this legislation in the hope that 
in the unfortunate likelihood of another disaster our citizens will be 
able to protect themselves without fear of government intruding upon 
our second amendment rights.
                                 ______
                                 
      By Mr. WARNER (for himself and Mrs. Clinton):
  S. 2600. A bill to equalize authorities to provide allowances, 
benefits, and gratuities to civilian personnel of the United States 
Government in Iraq and Afghanistan, and for other purposes; to the 
Committee on Armed Services.
  Mr. WARNER. I would like to take a few minutes of the Senate's time 
to introduce a bill together with Senator Clinton. The bill is to 
equalize authorities to provide allowances, benefits, and gratuities to 
civilian personnel of the United States Government for their services 
in Iraq and Afghanistan and for other purposes. Throughout the hearings 
of the Armed

[[Page S3382]]

Services Committee this year and the appearance of our distinguished 
group of witnesses, and based on two--and I say this most respectfully 
and humbly--personal conversations I have had with the President of the 
United States and, indeed, the Secretary of State, I very forcefully 
said to each that we need to get the entirety of our Federal Government 
into a greater degree--they have done much--of harness in our overall 
efforts in Iraq and Afghanistan to secure a measure of democracy for 
the peoples of those countries.
  For example, the QDR so aptly states that ``success requires unified 
statecraft: the ability of the U.S. Government to bring to bear all 
elements of national power at home and to work in close cooperation 
with allies and partners abroad.''
  General Abizaid, when he appeared before our committee this year, 
stated in his posture statement:

       We need significantly more non-military personnel . . . 
     with expertise in areas such as economic development, civil 
     affairs, agriculture, and law.

  Likewise General Pace, Chairman of the Joint Chiefs of Staff, 
iterated much the same message when he appeared before our committee.
  I commend the President and the Cabinet officers. I ask unanimous 
consent to print in the Record a letter that I sent every Cabinet 
officer and agency head, asking what they had done thus far and of 
their ability to contribute even more.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:
                                                      U.S. Senate,


                                  Committee on Armed Services,

                                   Washington, DC, March 15, 2006.
     Hon. Condoleezza Rice,
     Secretary of State,
     Washington, DC.
       Dear Madam Secretary: Over the past few months, the 
     President has candidly and frankly explained what is at stake 
     in Iraq. I firmly believe that the success or failure of our 
     efforts in Iraq may ultimately lie at how well the next Iraqi 
     government is prepared to govern. For the past three years, 
     the United States and our coalition partners have helped the 
     Iraqi people prepare for this historic moment of self-
     governance.
       Our mission in Iraq and Afghanistan requires coordinated 
     and integrated action among all federal departments and 
     agencies of our government. This mission has revealed that 
     our government is not adequately organized to conduct 
     interagency operations. I am concerned about the slow pace of 
     organizational reform within our civilian departments and 
     agencies to strengthen our interagency process and build 
     operational readiness.
       In recent months, General Peter Pace, USMC, Chairman of the 
     Joint Chiefs of Staff, and General John P. Abizaid, USA, 
     Commander, United States Central Command, have emphasized the 
     importance of interagency coordination in Iraq and 
     Afghanistan. General Abizaid stated in his 2006 posture 
     statement to the Senate Armed Services Committee, ``We need 
     significantly more non-military personnel. . . with expertise 
     in areas such as economic development, civil affairs, 
     agriculture, and law.''
       Strengthening interagency operations has become the 
     foundation for the current Quadrennial Defense Review (QDR). 
     The QDR so aptly states that, ``success requires unified 
     statecraft: the ability of the U.S. Government to bring to 
     bear all elements of national power at home and to work in 
     close cooperation with allies and partners abroad.'' In the 
     years since the passage of the Goldwater-Nichols Act of 1986, 
     ``jointness'' has promoted more unified direction and action 
     of our Armed Forces. I now believe the time has come for 
     similar changes to take place elsewhere in our federal 
     government.
       I commend the President for his leadership in issuing a 
     directive to improve our interagency coordination by signing 
     the National Security Presidential Directive-44, titled 
     ``Management of Interagency Efforts Concerning Reconstruction 
     and Stabilization,'' dated December 7, 2005. I applaud each 
     of the heads of departments and agencies for working together 
     to develop this important and timely directive. Now that the 
     directive has been issued, I am writing to inquire about the 
     plan for its full implementation. In particular, what steps 
     have each federal department or agency taken to implement 
     this directive?
       I ask for your personal review of the level of support 
     being provided by your department or agency in support of our 
     Nation's objectives in Iraq and Afghanistan. Following this 
     review, I request that you submit a report to me no later 
     than April 10, 2006, on your current and projected activities 
     in both theaters of operations, as well as your efforts in 
     implementing the directive and what additional authorities or 
     resources might be necessary to carry out the 
     responsibilities contained in the directive.
       I believe it is imperative that we leverage the resident 
     expertise in all federal departments and agencies of our 
     government to address the complex problems facing the 
     emerging democracies in Iraq and Afghanistan. I am prepared 
     to work with the executive branch to sponsor legislation, if 
     necessary, to overcome challenges posed by our current 
     organizational structures and processes that prevent an 
     integrated national response.
       I look forward to continued consultation on this important 
     subject.
       With kind regards, I am
           Sincerely,
                                                      John Warner,
                                                         Chairman.

  Mr. WARNER. In my conversations with President Bush and the Cabinet 
officers and others, there seems to be total support. The 
administration, at their initiative, asked OMB to draw up the 
legislation, which I submit today in the form of a bill.
  I hope this will garner support across the aisle--Senator Clinton has 
certainly been active in this area, as have others--and that we can 
include this on the forthcoming supplemental appropriations bill. The 
urgency is now, absolutely now. Every day it becomes more and more 
critical in the balance of those people succeeding with their message 
of 11 million on December 15 in Iraq: We want a government, a unified 
government stood up and operating. To do that, this government, 
hopefully, will utilize such assets as we can provide them from across 
the entire spectrum of our Government. Our troops have done their job 
with the coalition forces. Their families have borne the brunt of these 
conflicts now for these several years. Now it is time for every 
individual to step forward and work to make the peace secure in those 
nations so they do not revert back the lands of Iraq and Afghanistan to 
havens for terrorism and destruction to the free world.
  I yield the floor.
                                 ______
                                 
      By Mr. ALEXANDER (for himself and Mr. DeMint):
  S. 2601. A bill to amend the Social Security Act to improve choices 
available to Medicare eligible seniors by permitting them to elect 
(instead of regular Medicare benefits) to receive a voucher for a 
health savings account, for premiums for a high deductible health 
insurance plan, or both and by suspending Medicare late enrollment 
penalties between ages 65 and 70; to the Committee on Finance.
  Mr. ALEXANDER. Mr. President, I rise today to introduce the Health 
Care Choices for Seniors Act. My colleague from Tennessee, 
Representative Blackburn, has taken the lead in the House of 
Representatives, and I am proud to join with her by introducing this 
bill in the Senate. Our legislation is about giving seniors a new 
health insurance option by making it easier for them to create or 
continue using a health savings account (HSA) after they reach age 65.
  A growing number of Americans are using HSAs, which allow individuals 
to save for future medical expenses on a tax-free basis. The money you 
put into an HSA is tax-deductible, the money in your account grows tax-
free, balances can be rolled over year-to-year, and you can take money 
out of the account tax-free to pay for a wide range of health care 
expenses. Plus HSAs are portable--you can take them with you from job 
to job.
  Many members of the Baby Boom generation are not planning to retire 
at age 65 and want more health care options. But the problem under 
current law is that seniors can't continue using health savings 
accounts after turning 65 because they are penalized if they don't join 
Medicare. The first penalty is that once you join Medicare, you can no 
longer make tax-free contributions into HSAs. The second penalty is 
that if you don't join Medicare, you can't collect your Social Security 
benefits. The third penalty is that if you delay enrollment in Medicare 
to a later age, you have to pay more. So, of course, almost everyone 
joins Medicare when they turn 65 instead of using an HSA for their 
health care needs.
  At a time when health care costs are rising sharply, we need to move 
in the direction of giving Americans more options for getting health 
coverage at an affordable cost. Rather than forcing people into 
Medicare at age 65, the legislation that I am introducing today would 
make it easier for seniors to delay joining Medicare and to continue 
using health savings accounts. First, you could delay joining Medicare 
without losing the ability to make tax-free contributions into your 
HSA. Those

[[Page S3383]]

who delay enrollment in Medicare would be eligible for a monthly 
voucher of up to $200 for an HSA. Second, you could delay joining 
Medicare without losing your Social Security benefits. Third, if you 
use an HSA, you would not be penalized for putting off joining Medicare 
until age 70. With these changes, HSAs would become a real option for 
seniors in Tennessee and throughout the nation.
  I am a strong supporter of HSAs, which show the promise of holding 
down health care costs by putting more health care decisions in the 
hands of individual consumers and families. Health savings accounts 
only became available in January 2004, but they have seen significant 
growth in both individual and employer markets. A recent census by 
America's Health Insurance Plans showed that high deductible health 
insurance plans (HDHPs) offered in conjunction with HSAs covered 3.17 
million people in January 2006, up from 1.03 million in March 2005.
  This bill is an important step toward giving seniors more options to 
manage their health care and to allow greater use of health savings 
accounts. I look forward to working with Representative Blackburn to 
build support for our legislation in both Chambers of Congress.
                                 ______
                                 
      By Mr. ALLARD:
  S. 2604. A bill to address the forest and watershed emergency in the 
State of Colorado that has been exacerbated by the bark beetle 
infestation, to provide for the conduct of activities in the State to 
reduce the risk of wildfire and flooding, to promote economically 
healthy rural communities by reinvigorating the forest products 
industry in the State, to encourage the use of biomass fuels for 
energy, and for other purposes; to the Committee on Energy and Natural 
Resources.
  Mr. ALLARD. Mr. President, I rise today out of concern for the 
Western United States. The Rocky Mountain West is currently facing a 
very real threat to one of its most rare and precious resources. Out 
West there are few things more important than water, and it is this 
very important and increasingly needed resource that is in peril. This 
threat was in part brought upon us by a scourge barely larger than my 
finger tip, the bark beetle. This devious little devil has chewed its 
way through nearly 7,500,000 trees in Colorado. The beetle left these 
drought weakened trees dead and dying. This threat is exacerbated by 
the additional 6,300,000 acres of hazardous fuels that have accumulated 
throughout Colorado.
  This devastation is concerning enough on its own, but when you 
consider the fire danger that it has created, and the direct threat 
that a catastrophic fire would pose to our watersheds, the true weight 
of this situation becomes clear. Much of the precipitation that falls 
into the forests ultimately finds its way into streams, ponds, rivers 
and lakes. Changes to forested lands caused by fire can have strong and 
devastating repercussions on the quality and quantity of water in these 
bodies. A forest fire is one big chemical reaction which releases a 
myriad of chemical elements from forest materials into the ecosystem. 
These chemicals can be washed or leach into our water systems. Forest 
fires can cause immediate and lasting changes to the chemistry of 
forest water systems, this happens as a result of increases in water 
temperature and from the smoke and ash created during the burning 
process. These effects can last long after the flames have passed, 
effecting water quality for years after the initial fire.
  Colorado should be called ``the Headwaters State,'' because it is the 
origin point of major rivers flowing both east and west and the source 
of a vast amount of the water of the United States. In fact the 
Colorado Rocky Mountains create the headwaters for 4 regional 
watersheds that eventually supply water to 19 Western States. Should 
the streams and rivers flowing out of Colorado become choked and 
polluted with ash and debris from a forest fire much of the United 
States' water supply would be affected.
  The Federal agencies that manage the majority of the affected areas 
need to adopt an accelerated pace to reduce the public health and 
safety risk as soon as possible. To address this I am introducing The 
Headwater Protection and Restoration Act today that would work to help 
alleviate the pending threat to our Nation's water supply. My 
legislation takes into consideration the desperate need to create 
healthy forests in the lands around our Nation's water supply. This 
bill will not only help provide relief from this threat in the short 
term, but will help to create the necessary infrastructure to ensure 
that it does not happen again. It will give us a long term solution to 
this desperate problem. This would be achieved through steady, 
judicious, and effective forest management over time. This displays a 
much better and more cost effective strategy than dealing with the 
management of catastrophic events under emergency circumstances. Today 
we find ourselves poised in a position to take steps to help avert this 
potential disaster before it starts. It is my hope that I will be 
joined by my colleagues here in the Senate to act swiftly on my 
legislation before it is too late.
                                 ______
                                 
      By Mr. BROWNBACK (for himself and Mr. Coburn):
  S. 2606. A bill to amend title XVIII of the Social Security Act to 
make publicly available on the official Medicare Internet site Medicare 
payment rates for frequently reimbursed hospital inpatient procedures, 
hospital outpatient procedures, and physicians' services; to the 
Committee on Finance.
  Mr. BROWNBACK. Mr. President, today, I rise to introduce the Medicare 
Payment Rate Disclosure Act of 2006. This legislation tackles a key 
problem facing Americans today--that of rising health-related costs. It 
does so by empowering citizens to act as informed consumers when 
purchasing their health care. Countless examples in our Nation's 
history demonstrate that the American consumer possesses the ability to 
drive prices down and quality up by making informed decisions in the 
marketplace. Yet the cost of health care is not easily accessible to 
the American consumer, given the nature of our present system.
  The Medicare Payment Rate Disclosure Act would create price 
transparency at a consumer level, allowing Americans to choose for 
themselves health care services that are affordable within their 
region. This bill ensures that there is one location on the Internet 
where either consumers with health savings accounts or who are 
uninsured can go to view the Medicare reimbursement rates for all 
common medical procedures and physician visits, region by region. This 
information will provide a critical baseline for these individuals to 
assess health care costs.
  I believe that by removing barriers for health care consumers to 
``own their health care'' and make the best personal choices, we 
empower Americans with the knowledge to take charge of their health 
spending and to negotiate health care prices. I should note that my 
home State of Kansas is also considering price-transparency 
initiatives.
  This legislation is a good first step towards improving the quality 
of health care and lowering costs to consumers. I thank the original 
cosponsor, Senator Tom Coburn, for his support of this measure. 
Accordingly, I urge my colleagues to support the Medicare Payment Rate 
Disclosure Act of 2006.
                                 ______
                                 
      By Ms. SNOWE (for herself and Mr. Bennett):
  S. 2607 A bill to establish a 4-year small business health insurance 
information pilot program; to the Committee on Small Business and 
Entrepreneurship.
  Ms. SNOWE. Mr. President, as Chair of the Senate Committee on Small 
Business and Entrepreneurship, I have long believed that it is my 
responsibility and the duty of this chamber to help small businesses, 
as they are the driver of this Nation's economy, responsible for 
generating approximately 75 percent of net new jobs annually.
  Today, I rise with Senator Bennett to introduce legislation that 
would address the crisis that faces small businesses when it comes to 
purchasing quality, affordable health insurance. This is not a new 
crisis. Nearly 46 million Americans are currently uninsured. We've now 
experienced double digit percentage increases in health insurance 
premiums in four of the past five years. Small businesses face 
difficult choices in seeking to provide affordable health insurance to 
their employees. We must act now.

[[Page S3384]]

  Study after study tells us that the smallest businesses are the ones 
least likely to offer insurance and most in need of assistance. 
According to the Employee Benefit Research Institute, of the working 
uninsured, who make up 83 percent of our nation's uninsured population, 
60.6 percent either work for a small business with fewer than 100 
employees or are self-employed.
  Furthermore, many of the small businesses who we meet with tell us 
how they feel like the cost and complexity of the health care system 
has moved health insurance far beyond their reach.
  That is why today we introduce the Small Business Health Education 
and Awareness Act of 2006. This bill establishes a pilot, competitive 
matching-grant program for Small Business Development Centers (SBDCs) 
to provide educational resources and materials to small businesses 
designed to increase awareness regarding health insurance options 
available in their areas. Recent research conducted by the Healthcare 
Leadership Council has found that a short, less than 10 minute 
education session, can increase small business knowledge and interest 
in offering health insurance by about 33 percent.
  For those of you who are not familiar, SBDCs are one of the greatest 
business assistance and entrepreneurial development resources provided 
to small businesses that are seeking to start, grow, and flourish. 
Currently, there are over 1,100 service locations in every state and 
territory delivering management and technical counseling to prospective 
and existing small business owners.
  Our legislation would require the Small Business Administration (SBA) 
to provide up to 20 matching grants to qualified SBDCs across the 
country. No more than two SBDCs, one per State, would be chosen from 
each of the SBA's 10 regions. The grants shall be more than $150,000, 
but less than $300,000 and shall be consistent with the matching 
requirement under current law. In creating the materials for their 
grant programs, participating SBDCs should evaluate and incorporate 
relevant portions existing health insurance options, including 
materials created by the Healthcare Leadership Council.
  In addition, SBDCs participating in the pilot program would be 
required to submit a quarterly report to the SBA.
  Enacting this legislation is an important step in the right direction 
towards assisting small businesses as they work to strengthen 
themselves, remain competitive against larger businesses that are able 
to offer affordable health insurance, and in turn bolster the entire 
economy.
  We encourage our colleagues to join us in supporting this bill, and 
to continue to work to address the issues facing the small business 
community.
  Thank you. I ask unanimous consent that the text of our bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2607

       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 ``Small Business Health 
     Education and Awareness Act of 2006''.

     SEC. 2. PURPOSE.

       The purpose of this Act is to establish a 4-year pilot 
     program to provide information and educational materials to 
     small business concerns regarding health insurance options, 
     including coverage options within the small group market.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Administration.--The term ``Administration'' means the 
     Small Business Administration.
       (2) Administrator.--The term ``Administrator'' means the 
     Administrator of the Small Business Administration, acting 
     through the Associate Administrator for Small Business 
     Development Centers.
       (3) Association.--The term ``association'' means an 
     association established under section 21(a)(3)(A) of the 
     Small Business Act (15 U.S.C. 648(a)(3)(A)) representing a 
     majority of small business development centers.
       (4) Participating small business development center.--The 
     term ``participating small business development center'' 
     means a small business development center described in 
     section 21 of the Small Business Act (15 U.S.C. 648) that--
       (A) is certified under section 21(k)(2) of the Small 
     Business Act (15 U.S.C. 648(k)(2)); and
       (B) receives a grant under the pilot program.
       (5) Pilot program.--The term ``pilot program'' means the 
     small business health insurance information pilot program 
     established under this Act.
       (6) Small business concern.--The term ``small business 
     concern'' has the same meaning as in section 3 of the Small 
     Business Act (15 U.S.C. 632).
       (7) State.--The term ``State'' means each of the several 
     States, the District of Columbia, the Commonwealth of Puerto 
     Rico, the Virgin Islands, American Samoa, and Guam.

     SEC. 4. SMALL BUSINESS HEALTH INSURANCE INFORMATION PILOT 
                   PROGRAM.

       (a) Authority.--The Administrator shall establish a pilot 
     program to make grants to small business development centers 
     to provide information and educational materials regarding 
     health insurance options, including coverage options within 
     the small group market, to small business concerns.
       (b) Applications.--
       (1) Posting of information.--Not later than 90 days after 
     the date of enactment of this Act, the Administrator shall 
     post on the website of the Administration and publish in the 
     Federal Register a guidance document describing--
       (A) the requirements of an application for a grant under 
     the pilot program; and
       (B) the types of informational and educational materials 
     regarding health insurance options to be created under the 
     pilot program, including by referencing such materials 
     developed by the Healthcare Leadership Council.
       (2) Submission.--A small business development center 
     desiring a grant under the pilot program shall submit an 
     application at such time, in such manner, and accompanied by 
     such information as the Administrator may reasonably require.
       (c) Selection of Participating SBDCs.--
       (1) In general.--The Administrator shall select not more 
     than 20 small business development centers to receive a grant 
     under the pilot program.
       (2) Selection of programs.--In selecting small business 
     development centers under paragraph (1), the Administrator 
     may not select--
       (A) more than 2 programs from each of the groups of States 
     described in paragraph (3); and
       (B) more than 1 program in any State.
       (3) Groupings.--The groups of States described in this 
     paragraph are the following:
       (A) Group 1.--Group 1 shall consist of Maine, 
     Massachusetts, New Hampshire, Connecticut, Vermont, and Rhode 
     Island.
       (B) Group 2.--Group 2 shall consist of New York, New 
     Jersey, Puerto Rico, and the Virgin Islands.
       (C) Group 3.--Group 3 shall consist of Pennsylvania, 
     Maryland, West Virginia, Virginia, the District of Columbia, 
     and Delaware.
       (D) Group 4.--Group 4 shall consist of Georgia, Alabama, 
     North Carolina, South Carolina, Mississippi, Florida, 
     Kentucky, and Tennessee.
       (E) Group 5.--Group 5 shall consist of Illinois, Ohio, 
     Michigan, Indiana, Wisconsin, and Minnesota.
       (F) Group 6.--Group 6 shall consist of Texas, New Mexico, 
     Arkansas, Oklahoma, and Louisiana.
       (G) Group 7.--Group 7 shall consist of Missouri, Iowa, 
     Nebraska, and Kansas.
       (H) Group 8.--Group 8 shall consist of Colorado, Wyoming, 
     North Dakota, South Dakota, Montana, and Utah.
       (I) Group 9.--Group 9 shall consist of California, Guam, 
     American Samoa, Hawaii, Nevada, and Arizona.
       (J) Group 10.--Group 10 shall consist of Washington, 
     Alaska, Idaho, and Oregon.
       (4) Deadline for selection.--The Administrator shall make 
     selections under this subsection not later than 6 months 
     after the later of the date on which the information 
     described in subsection (b)(1) is posted on the website of 
     the Administration and the date on which the information 
     described in subsection (b)(1) is published in the Federal 
     Register.
       (d) Use of Funds.--
       (1) In general.--A participating small business development 
     center shall use funds provided under the pilot program to--
       (A) create and distribute informational materials; and
       (B) conduct training and educational activities.
       (2) Content of materials.--In creating materials under the 
     pilot program, a participating small business development 
     center shall evaluate and incorporate relevant portions of 
     existing informational materials regarding health insurance 
     options, such as the materials created by the Healthcare 
     Leadership Council.
       (e) Grant Amounts.--Each participating small business 
     development center program shall receive a grant in an amount 
     equal to--
       (1) not less than $150,000 per fiscal year; and
       (2) not more than $300,000 per fiscal year.
       (f) Matching Requirement.--Subparagraphs (A) and (B) of 
     section 21(a)(4) of the Small Business Act (15 U.S.C. 
     648(a)(4)) shall apply to assistance made available under the 
     pilot program.

     SEC. 5. REPORTS.

       Each participating small business development center shall 
     transmit to the Administrator and the Chief Counsel for 
     Advocacy of the Administration, as the Administrator may 
     direct, a quarterly report that includes--

[[Page S3385]]

       (1) a summary of the information and educational materials 
     regarding health insurance options provided by the 
     participating small business development center under the 
     pilot program; and
       (2) the number of small business concerns assisted under 
     the pilot program.

     SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated to 
     carry out this Act--
       (1) $5,000,000 for the first fiscal year beginning after 
     the date of enactment of this Act; and
       (2) $5,000,000 for each of the 3 fiscal years following the 
     fiscal year described in paragraph (1).
       (b) Limitation on Use of Other Funds.--The Administrator 
     may carry out the pilot program only with amounts 
     appropriated in advance specifically to carry out this Act.
                                 ______
                                 
      By Ms. SNOWE (for herself and Mr. Vitter):
  S. 2608. A bill to ensure full partnership of small contractors in 
Federal disaster reconstruction efforts; to the Committee on Small 
Business and Entrepreneurship.
  Ms. SNOWE. Mr. President, as Chair of Senate Committee on Small 
Business and Entrepreneurship, I rise today to introduce The Small 
Business Partners In Reconstruction Act of 2006. This legislation, co-
sponsored by Senator David Vitter, is the product of 3 hearings held in 
my Committee in September and November 2005, and in February 2006, 
which examined the response of the Small Business Administration, the 
Army Corps of Engineers, the Department of Homeland Security and its 
Federal Emergency Management Agency, and other Federal agencies to the 
devastation wrought by the Hurricanes Katrina and Rita on our Gulf 
Coast states.
  Speaking on September 15, 2005 from New Orleans' historic Jackson 
Square, President Bush declared that ``It is entrepreneurship that 
creates jobs and opportunity; it is entrepreneurship that helps break 
the cycle of poverty; and we will take the side of entrepreneurs as 
they lead the economic revival of the Gulf region.'' Unfortunately, the 
Federal Government's performance has not matched the President's 
declaration. This is particularly true with regards to the role of 
small firms, especially Gulf Coast small firms, with regards to 
contracts and subcontracts for recovery and reconstruction. Too often, 
small contractors have been treated in the disaster contracting process 
less like the partners in disaster recovery and economic revitalization 
they are, and more like unwanted stepchildren. Eight months after 
Hurricane Katrina, it is time for this to change.
  To begin with, some Federal bureaucrats have used the Katrina and 
Rita disasters to exclude small business from contracting in the name 
of emergency and speed. Contracting with small firms, it was said, does 
not provide sufficient flexibility to the contracting officers in time 
of crisis. Quite the opposite is true. The Small Business Act contains 
flexible contracting authorities as part of the 8(a) program, the 
HUBZone program, and the service-disabled veteran-owned program, which 
allow Federal agencies to quickly buy goods and services in emergency 
situations. Indeed, on May 30, 2003, the Office of Federal Procurement 
Policy issued guidance on Emergency Procurement Flexibilities, which 
encouraged Federal agencies to use contracting flexibilities, such as 
the HUBZone flexibilities, which are part of the Small Business Act. 
This guidance was largely ignored, as billions of dollars went to large 
corporations through non-competitive mechanisms such as no-bid 
contracts or the so called micro-purchase authority, originally 
intended by Congress to cover small purchase card transactions.

  My legislation requires the Office of Federal Procurement Policy and 
the Small Business Administration (SBA) to ensure that Federal 
contracting officials have the most comprehensive and up-to-date 
guidance on the full use of available small business emergency 
procurement flexibilities, and that such guidance is published in the 
Federal Register. My legislation also ensures that the SBA provides 
government-wide training for procurement agencies on using small 
business contracting flexibilities in emergency situations, and directs 
the SBA to designate at least one advisor for small business emergency 
contracting who would help Federal agencies apply small business 
procurement flexibilities in emergency situations.
  Small contractors have also been denied access to reconstruction 
dollars by paperwork and bureaucracy. Red tape had the most serious 
effect on small disadvantaged businesses. Many of these contractors 
have been certified to do business under the Federally-funded, 
Congressionally-established Disadvantaged Business Enterprise Program 
(DBE) for transportation contracting such as highway or bridge 
construction. In the Federal procurement system, a parallel Small 
Disadvantaged Business (SDB) Program exists. According to law and the 
Memorandum of Understanding between the SBA and the U.S. Department of 
Transportation, the DBE certifications are based on the SDB 
certification requirements under the Small Business Act. Unfortunately, 
DBEs have been unable to secure recognition as SDBs by the Federal 
agencies or by Federal prime contractors. As a result, agencies and 
prime contractors had little assurance that SDB goals may be met by 
doing business with DBEs. My measure will ensure that capable small 
contractors enjoy full reciprocity among contracting programs instead 
of the red tape they currently face.
  Lack of comprehensive procurement data on Katrina and Rita 
contracting is another flaw which my bill is trying to correct. It is 
hard to believe that almost 8 months since the Hurricane Katrina 
struck, the Federal Government's disaster contracting ship is literally 
sailing blind. Both the Small Business Act and the Office of Federal 
Procurement Policy Act require that accurate and comprehensive data on 
government contracting and subcontracting, especially including small 
business participation, be collected and maintained. Although the 
government-wide procurement spending database, the Federal Procurement 
Data System (FPDS), collects the data related to Hurricane Katrina and 
Rita reconstruction, this data is demonstrably incomplete. According to 
the Government Accountability Office and admissions of Federal 
procurement officials, the FPDS data is not accurate and omits billions 
in Defense and Homeland Security contracts. As a result of these 
deficiencies, the Executive Branch made exaggerated claims concerning 
the share of reconstruction work that went to small businesses. For 
instance, last October, the Commerce Department claimed that small 
businesses received 72 percent of Katrina contracting dollars, and the 
SBA claimed the small business share to be at 45 percent. During 
hearings before my Committee, the GAO confirmed that the 
Administration's claimed numbers are unrealistic and unsubstantiated. 
My legislation directs the Administrators of the SBA and the OFPP to 
ensure that the Federal Procurement Data System reflects comprehensive 
government-wide contracting spending on Katrina and Rita 
reconstruction.
  For years, the Historically Underutilized Business Zone (HUBZone) 
program, created to direct Federal contacting dollars to small firms in 
economically distressed areas, has been recognized as a potent economic 
development stimulus. Since its inception in 1997, the HUBZone program 
stimulated the hiring of over 124,000 HUBZone residents and investment 
of over half a billion dollars in HUBZones by HUBZone-certified firms. 
With the support of the Administration, I propose extending the HUBZone 
designation to the disaster region. A HUBZone designation would enable 
small businesses located in the disaster area and employing people in 
that area to receive contracting preferences and price evaluation 
preferences to offset greater costs of doing business. Extending the 
HUBZone designation to the Gulf Coast would bring needed businesses 
development tools to affected areas of the Gulf Coast. Under my 
proposal, the SBA Administrator would have the discretion to define the 
geographic scope or duration of this designation to ensure that the 
HUBZone preference is targeted to those who need it the most.
  Small businesses vying for government contracts or subcontracts often 
must post bid or performance bonds in order to convince Federal 
contracting officials or prime contractors that small business are a 
good project risk. In turn, small firms must seek bonding from private 
bonding companies. The SBA, through its surety bond program,

[[Page S3386]]

has provided guarantees on bonds awarded to small businesses up to $2 
million. But small firms need an increase in bonds to handle larger 
projects for hurricane relief. Local small businesses in the Gulf Coast 
can use higher bonds to compensate for the damage to their assets from 
the hurricanes. My legislation would increase the maximum size of SBA 
surety bonds from $2 million to $5 million, and provide the SBA with 
authority to increase the maximum size to $10 million upon request of 
another Federal agency. In its proposal to re-build the Gulf Coast 
region, the Administration suggested making the $5 million increase.

  My legislation also directs the SBA to create a contracting outreach 
program for small businesses located or willing to locate in the 
Katrina disaster area for the next five years. Federal contracts and 
subcontracts can provide critical assistance to small businesses 
located in the areas devastated by the hurricanes in the form of solid 
business opportunities and prompt, steady pay. In addition, government 
procurement would open doors for many local small businesses to 
participate in the long-term reconstruction work in the Gulf Coast 
areas. While many small businesses would benefit from other forms of 
disaster assistance, many of them want to get back to work and into 
business as soon as possible. Technical assistance and outreach through 
the SBA, the Procurement Technical Assistance Centers, the Federal 
Offices of Small and Disadvantaged Business Utilizations, and other 
organizations could prove invaluable to these firms.
  Yet, outreach alone would not ensure fair participation of small 
businesses in Gulf Coast reconstruction contracts. To promote jobs 
creation and development in the disaster region, the Federal Government 
must set and follow definitive goals for small business participation. 
Prior to the disaster, small construction companies in Alabama, 
Mississippi, and Louisiana received nearly $500 million in Federal 
contracts a year. Total small business contracts in the Gulf Coast 
region exceeded $3 billion a year. With the Federal cost of hurricane 
relief and rebuilding estimated at over $100 billion, small businesses, 
particularly those located in the disaster area and that employ 
individuals in the affected areas, should receive their fair share of 
Federal contracting and subcontracting dollars. My legislation 
establishes a 30 percent prime contracting goal and a 40 percent 
subcontracting goal on each agency's hurricane-related reconstruction 
contracts. These goals are compatible with the Department of Homeland 
Security's and the Army Corps of Engineers' history of small business 
achievements.
  My legislation would also address two unfortunate provisions in the 
Second Katrina Supplemental Appropriations that unwisely changed the 
emergency procurement authority Congress granted to contracting 
officers in the aftermath of 9/11 and reclassified many reconstruction 
contracts into categories that excluded small firms from prime 
contracting or subcontracting. I spoke out against these provisions, 
and Congress ultimately repealed them last year. Nonetheless, this bill 
puts in place safeguards to ensure that small firms do not fall prey to 
such actions again. My legislation protects the Small Business 
Reservation (SBR) for disaster-related contracts below the Simplified 
Acquisition Threshold (SAT). The SAT and the SBR are normally set at 
$100,000. The Federal Acquisition Streamlining Act allowed Federal 
agencies to use simplified procedures for all contracts below the SAT, 
but only if they attempt to place, or ``reserve'', these contracts to 
qualified small businesses. Many small businesses qualify for contracts 
under expedited procedures under the Small Business Act, which would 
help to move the reconstruction process forward. The SBR does not delay 
relief contracting. If no qualified small business is available to do 
the job, agencies can place the contract with any qualified supplier. 
This provision restores the parity between the SBR and the SAT any time 
the SAT is increased for disaster-related contracts.
  My legislation also restores small business subcontracting 
requirements in emergency procurements. The Second Katrina Supplemental 
abolished small business subcontracting requirements for all Katrina-
related contracts by treating contracts for hundreds of millions of 
dollars as purchases of commercial items, like contracts for office 
supplies. This is an improper and unjustified procurement practice. The 
Army Corps of Engineers currently imposes a 73 percent subcontracting 
requirement on hurricane-related contracts, demonstrating that the 
subcontracting requirements are not onerous. Under the Small Business 
Act, only a ``good faith effort'' to provide subcontracting 
opportunities is required. The legislation allows a grace period of 30 
days to negotiate an acceptable plan (subject to a 50 percent payment 
limitation until the plan is concluded).
  Looking forward, my legislation directs the Administrators of the 
OFPP and the SBA to work with other Federal agencies to ensure creation 
of multiple-award contracts for disaster recovery which are set aside 
for small business concerns. As the GAO testified before the Senate 
Committee on Small Business and Entrepreneurship last year, Federal 
agencies lacked adequate acquisition planning for hurricane disaster 
relief. This measure would reverse this practice both for ongoing and 
for future disaster recovery efforts.
  I am a firm believer that the reconstruction acquisition process must 
be not only efficient, but also transparent. In this regard, the 
Federal Government provides central website postings for all Katrina-
related opportunities through the SBA's Sub-NET. Unfortunately, the 
SBA's Sub-NET subcontracting database, though recommended by the 
Government, has been until recently unused by the Katrina prime 
contractors. My legislation directs all prime contractors which 
received substantial Federal contracts related to the Hurricanes 
Katrina and Rita for which subcontracting plans are required to post 
subcontracting announcements on the SBA's Sub-NET online database.
  Finally, my legislation addresses the government's failure to direct 
contract dollars to those who need them the most--local small 
businesses. During the hearings in my Committee last November, I was 
deeply troubled to discover that Federal agencies failed to grant 
business opportunities to qualified Gulf Coast small firms. These 
shocking practices make a mockery of our national commitment to rebuild 
the Gulf Coast. For instance, while investigating Hurricane Katrina 
contracts at my request, the GAO found a memorandum from an official in 
the Army Corps of Engineers informing the SBA that the Corps has 
successfully concealed the information about millions of dollars in 
upcoming contracts for mobile classrooms in Mississippi from, among 
others, local small businesses. The Corps requested that SBA approve 
giving this work to an out-of-state company without any prior 
experience. As a result, the Corps excluded a local small business, 
licensed by the Mississippi Department of Education, from bidding. 
Incredibly, the SBA obliged and approved the contract three times, 
eventually increasing its value from $10 million to $47 million.
  Practices such as these violate Section 15 of the Small Business Act, 
which unequivocally directs priority in government contracts ``to small 
business concerns which shall perform a substantial proportion of the 
production on those contracts and subcontracts within areas of 
concentrated unemployment or underemployment or within labor surplus 
areas.'' It is hard to imagine a clearer example of an ``area of 
concentrated unemployment or underemployment'' or a area with labor 
surplus than the devastated Gulf Coast region. Nonetheless, some have 
ignored the clear command of the statute. My legislation would 
designate the Gulf Coast disaster area as a labor surplus area for 
purposes of the Small Business Act's preference for labor surplus area 
contractors. In addition, this provision authorizes Federal agencies to 
use contractual set-asides, incentives, and penalties to enhance 
participation of local small business concerns in disaster recovery 
contracts and subcontracts.
  Finally, my legislation suspends the application of the Small 
Business Competitiveness Demonstration (Comp Demo) program to Gulf 
Coast disaster contracts. The Comp Demo Program denies the protections 
of the Small Business Act like set-asides to small businesses involved 
in construction and

[[Page S3387]]

specialty trade contracting, refuse systems and related services, 
landscaping, pest control, non-nuclear ship repair, and architectural 
and engineering services, including surveying and mapping. 
Historically, small businesses have been the backbone of these 
industries, and these industries are in heavy demand for disaster 
recovery efforts. The Comp Demo Program, ostensibly a test program, 
denies Federal agencies likes the Departments of Defense and nine other 
agencies the ability to do small business set-asides. Essentially, the 
Comp Demo Program reserves whole industries for big business. Last 
year, at the request of the Department of Defense, I supported an 
amendment to terminate the Comp Demo Program. The Senate agreed that 
small businesses in all industries should receive the full protections 
of the Small Business Act, and unanimously voted to repeal this 
Program. Suspending this Program for Katrina and Rita contracts would 
go a long way towards restoring fair treatment for small businesses 
affected by this disaster.
  I believe this legislation will find broad support in this body. 
Indeed, the HUBZone designation, the outreach programs, and the surety 
bonding increase have already been adopted by the Senate on a vote of 
96-0 as part of my amendment to the Science, State, Commerce, and 
Justice Appropriations Act for Fiscal Year 2006. The provisions dealing 
with the small business reservation offset and retention of small 
business subcontracting in emergency procurements were cosponsored by a 
bi-partisan group of Senators as part of my bi-partisan disaster relief 
bill, S. 1807. With the Senate leadership and every Senator of both 
parties on the record in support of greater access of small businesses 
to Federal contracts, I look forward to speedy consideration of this 
legislation and its support by the Senate.
                                 ______
                                 
      By Mr. THUNE (for himself and Mr. Obama):
  S. 2614. A bill to amend the Solid Waste Disposal Act to establish a 
program to provide reimbursement for the installation of alternative 
energy refueling systems; to the Committee on Finance.
  Mr. THUNE. Mr. President, I rise today to introduce legislation along 
with my colleague from Illinois, Senator Obama, concerning what we 
believe is yet another important step in reducing our Nation's 
dependence on petroleum fuels.
  S. 264, the Alternative Energy Refueling System Act of 2006 would 
provide an incentive for gas station owners across the country to 
install alternative refueling systems for automobiles. This legislation 
builds upon the existing tax credit that gas station owners can receive 
for installing alternative energy tanks. Most importantly, I would like 
to point out to my colleagues that this legislation does not require 
any additional taxes.
  Currently, as a result of the Energy Policy Act of 2005, a tax credit 
of up to $30,000 is available through 2009 for gas station owners who 
install an alternative refueling system. Eligible alternative fuels 
include those that contain 85 percent by volume of ethanol, natural 
gas, compressed natural gas, liquefied natural gas, liquefied petroleum 
gas, hydrogen, or any mixture of biodiesel or diesel fuel that is 
composed of at least 20 percent biodiesel.
  Our legislation basically allows gas station owners and operators to 
be reimbursed for 30 percent of the costs--not to exceed $30,000--of 
installing an alternative energy system.
  One of the primary benefits of this legislation is that it can be 
used for up to two alternative refueling systems per gas station. This 
is important because under the tax credit that was part of last year's 
energy bill, a gas station owner can only utilize the $30,000 tax 
credit one time--even for those individuals who own multiple refueling 
stations.
  For example, if a gas station owner in South Dakota, Illinois, or 
elsewhere wanted to install three new alternative refueling systems at 
his or her gas station, under the current system that owner would be 
limited to the $30,000 tax credit for a single alternative fuel system.
  Under our legislation, that same gas station owner would continue to 
receive the tax credit for the first alternative fuel system. However, 
the station owner could also be reimbursed for 30 percent of the 
costs--not to exceed $30,000--for up to two additional alternative 
refueling systems. Therefore, the legislation we have introduced today 
would drastically increase the incentives for gas station owners to 
install additional alternative fuel systems.
  I am hopeful that if this bill is signed into law, gas station owners 
across the country will be able to use this reimbursement mechanism to 
help consumers who already own or are thinking of purchasing an 
alternative fuel vehicle.
  Senator Obama and I are both strong supporters of alternative fuels. 
In fact, South Dakota and Illinois are leaders in the production of 
ethanol--our Nation's leading renewable fuel. The legislation we are 
introducing today in no way preferences ethanol over other alternative 
fuels. In fact, they are all treated equally under our bill.
  Alternative fuels such as E-85, which is composed of 85 percent 
ethanol, are starting to gain popularity. However, while automakers 
such as Ford and General Motors are producing an increasing number of 
flex fuel vehicles, which can run on either E-85 or gasoline, there is 
a critical need for more alternative refueling sites across the 
country. Many individuals would be shocked to know that of the 180,000 
gas stations across the country, only 600--far less than 1 percent--
offer alternative fuels such as E-85.
  There are approximately 5 million flexible fuel vehicles on the road 
today. The addition of alternative refueling systems--such as E-85, 
compressed natural gas, biodiesel, and hydrogen--will allow American 
consumers the ability to refuel their vehicles with alternative fuels 
that are better for both the environment and our Nation's security.
  As President Bush noted in his State of the Union Address earlier 
this year, ``America is addicted to oil, which is often imported from 
unstable parts of the world.'' Since being elected to Congress I have 
worked hard in promoting the development of alternative energy sources. 
In fact, last year's energy bill marked an important milestone due to 
the 7.5 billion gallon renewable fuels standard that I and others 
advocated.
  S. 2614 utilizes the interest earned from the Leaking Underground 
Storage Tank Trust Fund, which currently has a $2.6 billion surplus, to 
reimburse eligible gas station owners who add alternative refueling 
systems.
  This trust fund continues to grow from a portion of the Federal gas 
tax--one-tenth of a cent per gallon--which amounted to roughly $190 
million last year. The fund also continues to grow from the interest 
that is earned on the balance of the fund, which amounted to roughly 
$67 million in 2005.
  I firmly believe that the Leaking Underground Storage Tank program 
serves an important function in keeping our land and water safe from 
storage tank releases. Our legislation simply seeks to use a portion of 
the interest earned annually to reimburse gas station owners for a 
portion of the costs associated with the installation of new 
alternative refueling systems.
  An added benefit of using a portion of the interest from this trust 
fund is that the installation of alternative refueling systems reduces 
the overall number of petroleum tanks that can cause leaks.
  Additionally, this bill ensures that States are not required to use 
their annual allocation of appropriated funding to reimburse gas 
station owners for the installation of alternative refueling systems. 
Such reimbursement would come directly from the EPA Administrator.
  Mr. President, this bill would help to lessen our Nation's dependence 
on foreign sources of oil and--increase the use of alternative fuels. 
It is a step in the right direction, and is something I hope my 
colleagues will support.
  Mr. OBAMA. I am pleased to join my distinguished colleague from South 
Dakota, Mr. Thune, in introducing the Alternative Energy Refueling 
System Act of 2006. I applaud his work in crafting this bill and I hope 
my colleagues will provide their full support and work towards its 
swift enactment.
  As members of the Senate Environment and Public Works Committee, the 
Senator from South Dakota and I have worked to promote the expansion of 
alternative fuels production capacity in the United States--most 
notably

[[Page S3388]]

with the enactment of the Renewable Fuels Standard (RFS) included in 
last year's Energy Policy Act of 2005. The RFS states that 7.5 billion 
gallons of ethanol must be phased into the 140-billion-gallon annual 
national gasoline pool during the next 6 years.
  That's a bold step in reducing our reliance on foreign oil, but we 
can't just rely on greater production of alternative fuels if we also 
don't make sure those fuels are available at gas stations. We need to 
make sure that when American drivers want to ``fill `er up'' with 
something other than petroleum, they can.
  Last year, I introduced S. 918, a bill to provide a tax credit for 
the cost of installing alternative fuel pumps. I was pleased that this 
tax credit was enacted as part of the Energy Policy Act of 2005. Soon 
hundreds more ethanol and biodiesel pumps throughout the United States 
will be installed as a result of this new policy.
  But if we are serious about reducing our reliance on foreign oil in 
an expeditious fashion, we must intensify our efforts. We must double, 
triple, and quadruple our efforts. And that's exactly the purpose of 
our bill today, which simply provides a partial Federal reimbursement 
for the installation of alternative fuel pumps that otherwise are 
ineligible or have received the new tax credit.
  Many more alternative refueling properties will be established by 
this bill--a strong complement to the tax credit passed last year. And 
this bill is fully offset in that it is financed by using just a small 
slice of the approximately $70 million in annual interest generated by 
the Leaking Underground Storage Tank (LUST) Trust Fund. We don't ask to 
use that small slice in perpetuity, but just for the next several years 
until enough alternative fuel refueling capacity is established across 
the country.
  The total principal of the LUST fund is more than $2.5 billion--none 
of which we propose to draw down. And given that this fund has been 
capitalized by a one-tenth-of-a-penny fee for every gallon of petro-gas 
or petro-diesel purchased by the American people, it is altogether 
appropriate that any interest generated by any unused fractions-of-
pennies be reinvested in infrastructure that weans our Nation from its 
dependence on the Middle East. All of this can be accomplished, while 
ensuring that the integrity of the LUST fund--which is used to clean up 
underground storage tanks--remains fully intact and untouched. In fact, 
I hope my colleagues on the Appropriations Committee will take note and 
will increase funding for LUST fund activities to the level it has long 
needed and deserved.
  The Thune-Obama bill is a good bill that will accomplish good things 
for our national energy dependence, but even if enacted, this bill 
cannot by itself guarantee more alternative fuel refueling stations. As 
my colleagues are aware, alternative fuel refueling stations make up 
only a tiny fraction of the nationwide network of gas stations. And 
while that fraction is growing by leaps and bounds, the vast majority 
of stations within that small fraction are independently owned and 
operated.
  By comparison, the big oil companies--the Exxons, the BPs, or the 
ConocoPhillips of the American petroleum industry--have not installed 
alternative fuel pumps. Rather, the evidence is accumulating that these 
companies have used institutional policies to deter the installation of 
alternative fuel pumps despite their retailers asking to sell these new 
fuels to meet growing consumer demand.
  I think these practices must end. It is time for these companies to 
demonstrate leadership and reinvest in America. Until that day comes, 
however, I pledge to continue my work in Congress with like-minded 
colleagues to ensure that this Nation invests in a 21st Century 
refueling structure. The bill we are introducing today is part of that 
investment. I thank my colleague from South Dakota for his authorship 
on this bill.
                                 ______
                                 
      By Mr. LAUTENBERG (for himself, Mr. Hagel, Mr. Kerry, Mr. 
        Menendez, Mrs. Lincoln, and Mr. DeWine):
  S. 2617. A bill to amend title 10, United States Code, to limit 
increases in the costs to retired members of the Armed Forces of health 
care services under the TRICARE program, and for other purposes; to the 
Committee on Armed Services.
  Mr. LAUTENBERG. Mr. President, I rise to introduce the Military 
Retirees' Health Care Protection Act along with my colleagues, Senators 
Hagel, Kerry, Menendez, Lincoln, and DeWine.
  This important legislation will keep the Pentagon from dramatically 
raising health care fees on military retirees.
  Our bill will limit increases to TRICARE military health insurance 
premiums, deductibles, and co-payments for those in the National Guard 
and Reserves who are enrolled in TRICARE. Under this legislation, 
increases in health care fees cannot exceed the rate of growth in 
uniformed services beneficiaries' military compensation, thereby 
protecting beneficiaries from an undue financial burden.
  In February, officials at the Department of Defense (DOD) announced 
plans to double fees on senior enlisted retirees and triple them for 
officer retirees. If enacted this would mean increases of up to $1,000 
annually for some military retirees. While the Department of Defense 
has since temporarily halted plans to raise fees, it still has 
authority to implement steep increases in the future and may do so. We 
must pass legislation now that limits the amount of any health care 
increase and protects beneficiaries from extreme health care fee 
increases in the future.
  Senator Hagel and I want to demonstrate our commitment to our troops 
and future veterans by assuring them that just as they protected us, we 
will take care of them when their service ends. Just as our men and 
women in uniform vow never to leave a soldier behind in battle, so 
should we commit never to leave a veteran behind when he or she needs 
health care.
  For three years, Congress has rejected a $250 Veterans Administration 
health fee increase for non-disabled veterans--doubling and tripling 
fees for career military is equally inappropriate.
  I urge my colleagues on both sides of the aisle to support our troops 
by supporting this important bill.
  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. 2617

       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 ``Military Retirees Health 
     Care Protection Act''.

     SEC. 2. FINDINGS AND SENSE OF CONGRESS.

       (a) Findings.--Congress makes the following findings:
       (1) Career members of the Armed Forces and their families 
     endure unique and extraordinary demands, and make 
     extraordinary sacrifices, over the course of 20-year to 30-
     year careers in protecting freedom for all Americans.
       (2) The nature and extent of these demands and sacrifices 
     are never so evident as in wartime, not only during the 
     current Global War on Terrorism, but also during the wars of 
     the last 60 years when current retired members of the Armed 
     Forces were on continuous call to go in harm's way when and 
     as needed.
       (3) The demands and sacrifices are such that few Americans 
     are willing to bear or accept them for a multi-decade career.
       (4) A primary benefit of enduring the extraordinary 
     sacrifices inherent in a military career is a range of 
     extraordinary retirement benefits that a grateful Nation 
     provides for those who choose to subordinate much of their 
     personal life to the national interest for so many years.
       (5) One effect of such curtailment is that retired members 
     of the Armed Forces are turning for health care services to 
     the Department of Defense, and its TRICARE program, for the 
     health care benefits in retirement that they earned by their 
     service in the Armed Forces.
       (6) In some cases, civilian employers establish financial 
     incentives for employees who are also eligible for 
     participation in the TRICARE program to receive health care 
     benefits under that program rather than under the health care 
     benefits programs of such employers.
       (7) While the Department of Defense has made some efforts 
     to contain increases in the cost of the TRICARE program, a 
     large part of those efforts has been devoted to shifting a 
     larger share of the costs of benefits under that program to 
     retired members of the Armed Forces.
       (8) The cumulative increase in enrollment fees, 
     deductibles, and copayments being proposed by the Department 
     of Defense for

[[Page S3389]]

     health care benefits under the TRICARE program far exceeds 
     the 31 percent increase in military retired pay since such 
     fees, deductibles, and copayments were first required on the 
     part of retired members of the Armed Forces 10 years ago.
       (9) Proposals of the Department of Defense for increases in 
     the enrollment fees, deductibles, and copayments of retired 
     members of the Armed Forces who are participants in the 
     TRICARE program fail to recognize adequately that such 
     members paid the equivalent of enormous in-kind premiums for 
     health care in retirement through their extended sacrifices 
     by service in the Armed Forces.
       (10) Some of the Nation's health care providers refuse to 
     accept participants in the TRICARE program as patients 
     because that program pays them significantly less than 
     commercial insurance programs, and imposes unique 
     administrative requirements, for health care services.
       (11) The Department of Defense has chosen to count the 
     accrual deposit to the Department of Defense Military Retiree 
     Health Care Fund against the budget of the Department of 
     Defense, contrary to the requirements of section 1116 of 
     title 10, United States Code, as amended section 725 of 
     Ronald W. Reagan National Defense Authorization Act for 
     Fiscal Year 2005 (Public Law 108-375; 118 Stat. 1991).
       (12) Senior officials of the Department of Defense leaders 
     have reported to Congress that counting such deposits against 
     the budget of the Department of Defense is impinging on other 
     readiness needs of the Armed Forces, including weapons 
     programs, an inappropriate situation which section 1116 of 
     title 10, United States Code, was intended expressly to 
     prevent.
       (b) Sense of Congress.--It is the sense of Congress that--
       (1) the Department of Defense and the Nation have a 
     committed obligation to provide health care benefits to 
     retired members of the Armed Forces that exceeds the 
     obligation of corporate employers to provide health care 
     benefits to their employees;
       (2) the Department of Defense has many additional options 
     to constrain the growth of health care spending in ways that 
     do not disadvantage retired members of the Armed Forces who 
     participate or seek to participate in the TRICARE program and 
     should pursue any and all such options rather than seeking 
     large increases for enrollment fees, deductibles, and 
     copayments for such retirees, and their families or 
     survivors, who do participate in that program;
       (3) any percentage increase in fees, deductibles, and 
     copayments that may be considered under the TRICARE program 
     for retired members of the Armed Forces and their families or 
     survivors should not in any case exceed the percentage 
     increase in military retired pay; and
       (4) any percentage increase in fees, deductibles, and 
     copayments under the TRICARE program that may be considered 
     for members of the Armed Forces who are currently serving on 
     active duty or in the Selected Reserve, and for the families 
     of such members, should not exceed the percentage increase in 
     basic pay or compensation for such members.

     SEC. 3. LIMITATIONS ON CERTAIN INCREASES IN HEALTH CARE COSTS 
                   FOR MEMBERS OF THE UNIFORMED SERVICES.

       (a) Pharmacy Benefits Program.--Section 1074g of title 10, 
     United Stated Code, is amended by adding at the end the 
     following new subparagraph:
       ``(C) The amount of any cost sharing requirements under 
     this paragraph shall not be increased in any year by a 
     percentage that exceeds the percentage increase of the most 
     current previous adjustment to retired pay for members of the 
     armed forces under section 1401a(b)(2) of this title. To the 
     extent that such increase for any year is less than one 
     dollar, the accumulated increase may be carried over from 
     year to year, rounded to the nearest dollar.''.
       (b) Premiums for TRICARE Standard for Reserve Component 
     Members Who Commit to Service in the Selected Reserve After 
     Active Duty.--Section 1076d(d)(3) of such title is amended--
       (1) by striking ``The monthly amount'' and inserting ``(A) 
     Except as provided in subparagraph (B), the monthly amount''; 
     and
       (2) by adding at the end the following new subparagraph:
       ``(B) In any year after 2006, the percentage increase in 
     the amount of the premium in effect for a month for TRICARE 
     Standard coverage under this section may not exceed a 
     percentage equal to the percentage of the most recent 
     increase in the rate of basic pay authorized for members of 
     the uniformed services for a year.''.
       (c) Copayments Under CHAMPUS.--Section 1086(b)(3) of such 
     title is amended in the first sentence by inserting before 
     the period at the end the following: ``, except that in no 
     event may such charges exceed $535 per day''.
       (d) Prohibition on Enrollment Fees Under CHAMPUS.--Section 
     1086(b) of such title is further amended by adding at the end 
     the following new paragraph:
       ``(5) A person covered by subsection (c) may not be charged 
     an enrollment fee for coverage under this section.''.
       (e) Premiums and Other Charges Under TRICARE.--Section 
     1097(e) of such title is amended--
       (1) by inserting ``(1)'' before ``The Secretary of 
     Defense''; and
       (2) by adding at the end the following new paragraph:
       ``(2) In any year after 2006, the percentage increase in 
     the amount of any premium, deductible, copayment or other 
     charge established by the Secretary of Defense under this 
     section may not exceed the percentage increase of the most 
     current previous adjustment of retired pay for members and 
     former members of the armed forces under section 1041a(b)(2) 
     of this title.''.
  Mr. DeWINE. Mr. President, I rise today to express my support for 
Senator LAUTENBERG's and Senator HAGEL's bill, the Military Retirees 
Health Care Protection Act, which I have co-sponsored. We must ensure 
that our military personnel and military retirees, as well as their 
families, have access to affordable, quality health insurance.
  Over the past 10 years, military health care benefits have been 
greatly expanded to include Medicare eligible retirees, Reservists, and 
their families. Additionally, new options for health care have been 
added for active duty families, including an elimination of co-pays if 
the families use military treatment facilities instead of civilian 
doctors. Since 1995, health insurance costs have increased in the 
civilian sector, but TRICARE rates have not increased. If fees aren't 
increased and other avenues for funding TRICARE aren't explored, 
defense health care costs, alone, may rise to as much as $64 billion by 
2015.
  As part of the fiscal year 2007 budget request, the Department of 
Defense proposed a significant increase to the enrollment and 
prescription drug prices for military retirees under age 65 and 
survivors. This increase would more than double enrollment fees. In 
almost every case, that's an unfathomable single-year increase for 
families who live on a very tight budget. This is particularly 
troublesome when the Department of Defense has many other options that 
it may pursue to limit the mounting costs of medicine.
  In addition, last year I worked to extend military health insurance 
to every dependent child of a deceased servicemember at no cost as if 
that parent were still alive and serving our Nation. The Department of 
Defense indicates that this important benefit could save dependents as 
much as $15,000 per year compared to the cost of private health 
insurance premiums. This cost-free extension of TRICARE Prime medical 
insurance to surviving minor children will alleviate one of the biggest 
worries on families today--and that's health care costs. However, if 
premiums and fees are increased drastically for the surviving spouse, 
worries about health care costs will still weigh heavily on these 
families. TRICARE Prime premium increases would undo the good we have 
accomplished on this front.
  The legislation we are introducing today would begin to address the 
need for premiums and other health care fees to keep pace with the rise 
in health care costs, while keeping in mind the effect such increases 
would have on the yearly budget for our military retirees, survivors, 
and their families.
  This proposal calls for a yearly increase in premiums that is 
equivalent to the cost of living increase that military retirees 
receive. For instance, if the cost of living increase is 2 percent, 
TRICARE Prime premiums will increase by 2 percent. Similarly, under 
this proposal, fees for TRICARE Reserve Select--which I have fought for 
with many of my colleagues--would increase by the same percent as the 
basic pay raise. I believe that these represent fair fee increases for 
the men, women, and families who have selflessly served our country.
  Unfortunately, I understand that these modest fee increases will not 
completely solve the rising costs of providing superior military health 
care. I encourage the Department of Defense to explore other options 
for reducing the overall cost to taxpayers of delivering this benefit. 
For instance, the DoD should negotiate with drug manufacturers for 
discounts in the TRICARE retail pharmacy network and encourage 
beneficiaries to use the mail-order pharmacy. There are many more 
options available to DoD to fund this health care system, which I 
strongly urge them to explore.
  I believe we owe a great debt of gratitude to those men, women, and 
families who served our country in the armed services in uniform and on 
the home front. It is essential that we

[[Page S3390]]

honor our commitment and investigate all available options for funding 
our military health care system, rather than strap the bill on the 
backs of those who already have paid for their health insurance with 
their blood, sweat, and tears. I will continue to work with Senators 
Lautenberg and Hagel to ensure fair treatment of these men and women.
                                 ______
                                 
      By Mr. HARKIN (for himself and Mr. Grassley):
  S. 2618. A bill to permit an individual to be treated by a health 
care practitioner with any method of medical treatment such individual 
requests, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. HARKIN. Mr. President, I am pleased to join with Senator Grassley 
today to introduce the Access to Medical Treatment Act. The idea behind 
this legislation is to allow greater freedom of choice and increased 
access in the realm of medical treatments, while preventing abuses of 
unscrupulous entrepreneurs. The Access to Medical Treatment Act allows 
individual patients and their properly licensed health care providers 
to use certain alternative and complementary therapies not approved by 
the Food and Drug Administration (FDA), but that may be approved 
elsewhere. As more Americans seek out alternative and complimentary 
treatments for their health care, we need to be responsive. We need to 
see what works and what does not, but we also need to make sure that 
patients are protected, and are not misled about the potential benefits 
and risks of alternative treatments. The Access to Medical Treatment 
Act presents one option to help Americans make better choices, and it 
is my hope that this legislation can help spur a dialogue about the 
best way to promote access to safe and effective alternative medical 
treatments.
  Importantly, the bill contains an informed consent protection for 
patients, modeled after the National Institutes of Health's, NIH, human 
subject protection regulations. Under the protections provided for in 
the legislation, a patient must be fully informed, orally and in 
writing of the following: the nature, content and methods of the 
medical treatment; that the treatment is not approved by the FDA; the 
anticipated benefits and risks of the treatment; any reasonably 
foreseeable side effects that may result; the results of past 
applications of the treatment by the health care provider and others; 
the comparable benefits and risks of any available FDA-approved 
treatment conventionally used for the patient's condition; and any 
financial interest the provider has in the product. The consent 
documents will then become part of the patient's medical record.
  Providers and manufacturers are required to report to the Centers for 
Disease Control and Prevention, CDC, any adverse effects from 
alternative treatments, and must immediately cease use and manufacture 
of the product, pending a CDC investigation. The CDC is required to 
conduct an investigation of any adverse effects, and if the product is 
shown to cause any danger to patients, the physician and manufacturers 
are required to immediately inform all providers who have been using 
the product of the danger.
  Our legislation ensures the public's access to reliable information 
about complementary and alternative therapies by requiring providers 
and manufacturers to report the results of the use of their product to 
the National Center for Complementary and Alternative Medicine at NIH, 
which is then required to compile and analyze the information for an 
annual report. The bill also stipulates that the provider and 
manufacturer may make no advertising claims regarding the safety and 
effectiveness of the treatment of therapy, and grants FDA the authority 
to guarantee that the labeling of the treatment is not false or 
misleading.
  Mr. President, the goal of this legislation is to preserve the 
consumer's freedom to choose alternative therapies while addressing the 
fundamental concern of protecting patients from dangerous treatments 
and those who would advocate unsafe and ineffective therapies. I hope 
that we have struck the appropriate balance, and I welcome feedback 
from interested parties.
  It wasn't long ago that William Roentgen was afraid to publish his 
discovery of X-rays as a diagnostic tool. He knew they would be 
considered an alternative medical practice and widely rejected by the 
medical establishment. As everyone knows, X-rays are a common 
diagnostic tool today. Well into this century, many scientists resisted 
basic antiseptic techniques as quackery because they refused to accept 
the germ theory of disease. I think we can all be thankful the medical 
profession came around on that one.
  The underlying point is this: today's consumers want alternatives in 
many medical situations for them and their families. They want less 
invasive, less expensive preventive options. Americans want to stay 
healthy. And they are speaking with their feet and their pocketbooks. 
Mr. President, Americans spend $30 billion annually on unconventional 
therapies. That is one of the reasons we established the National 
Center for Complimentary and Alternative Medicine, NCCAM, at NIH in 
1998. As more Americans look for alternative courses of treatment, we 
needed to provide a way to see what works and what does not. This bill 
is another step in that direction.
  This legislation simply provides patients the freedom to use--with 
strong consumer protections--the complementary and alternative 
therapies and treatments that have the potential to relieve pain and 
cure disease. And it provides a means to see what works and what does 
not. I thank Senator Grassley for his continued leadership on this 
issue, and urge my colleagues to consider this bill.
                                 ______
                                 
      By Mrs. CLINTON:
  S. 2620. A bill to amend the Older Americans Act of 1965 to authorize 
the Assistant Secretary for Aging to provide older individuals with 
financial assistance to select a flexible range of home and community-
based long-term care services or supplies, provided in a manner that 
respects the individuals' choices and preferences; to the Committee on 
Health, Education, Labor, and Pensions.
  Mrs. CLINTON. Mr. President, I am pleased today to introduce the 
Community-Based Choices for Older Americans Act of 2006. This 
legislation would take several important steps toward helping older 
Americans meet their long-term care needs.
  Issues related to long-term care are of growing concern to many in 
New York and around the country, especially as baby boomers begin to 
require more of these important services. Older Americans are 
struggling to afford costly care and to maintain dignity and choice 
regarding these services.
  As I talk with seniors around the State of New York and throughout 
the country, what I hear most is that people want to stay in their 
homes for as long as they can. However, too many individuals struggle 
to afford quality home and community-based care and, as a result, are 
forced into institutional care: A more costly outcome they do not 
desire and that places additional burden on the Medicaid program.
  That is why I am introducing this legislation today. The Community-
Based Choices for Older Americans Act will assist individuals age 60 or 
older who grapple with daily living activities or with a disability, 
yet are above a State's Medicaid eligibility threshold, in meeting 
their long-term care needs.
  This bill will establish a matching grant program to States to help 
these individuals pay for a broad range of health, social, and 
supportive services based on the individuals' personal choices and 
preferences in collaboration with a service coordinator. Eligible 
individuals will be able to purchase services and supports that would 
be provided in home or community-based settings, such as home 
modifications like a wheelchair or ramp, assistance with grocery 
shopping or meal preparation, or adult day services.
  This legislation is based on the Cash and Counseling model 
successfully used in demonstration projects in 15 States. This 
consumer-directed approach offers individuals more choice, flexibility, 
and control in managing their daily lives.
  Through this bill, State Agencies on Aging throughout the country 
will be given the tools to develop a community-based, long-term care 
system where seniors choose the services and the providers they want so 
they are able to maintain independence and dignity while they age in 
place in the

[[Page S3391]]

homes and communities where they have often lived for decades.
  This year marks the first year that the baby boom population turns 
60. Development of a consumer-friendly, home and community-based system 
of long-term care is a critical step in planning services for this 
population.
  I look forward to working with all of my colleagues to ensure passage 
of this bill to help our seniors choose the long-term care resources 
and services they need to remain independent.
  I ask unanimous consent that the text of this 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. 2620

       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 ``Community-Based Choices for 
     Older Americans Act of 2006''.

     SEC. 2. PURPOSE.

       The purpose of this Act is to provide grants to States in 
     order to achieve the following:
       (1) To enable eligible individuals to make informed choices 
     about the long-term care services and supplies that best meet 
     their needs and preferences.
       (2) To provide financial assistance to older individuals to 
     purchase a flexible range of long-term care services or 
     supplies in a manner that respects the individuals' cultural, 
     ethnic, and lifestyle preferences in the least restrictive 
     settings possible.
       (3) To make the purchase of long-term care services and 
     supplies delivered in a home or community-based setting, such 
     as a naturally occurring retirement community, more 
     affordable for individuals with financial need.
       (4) To help families continue to care for their older 
     relatives with long-term care needs, including older 
     individuals with physical and cognitive impairments, and to 
     help reduce the number of older individuals who are forced to 
     impoverish themselves in order to pay for the long-term care 
     services and supplies they need.
       (5) To help relieve financial pressure on the medicaid 
     program by delaying or preventing older individuals from 
     spending down their income and assets to medicaid eligibility 
     thresholds.
       (6) To concentrate the resources made available under this 
     Act to those individuals with the greatest economic need for 
     long-term care services and supplies.

     SEC. 3. ESTABLISHMENT OF THE NATIONAL LONG-TERM CARE CHOICE 
                   PROGRAM.

       The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is 
     amended by adding at the end the following:

          ``TITLE VIII--NATIONAL LONG-TERM CARE CHOICE PROGRAM

     ``SEC. 801. DEFINITIONS.

       ``In this title:
       ``(1) Caregiver.--The term `caregiver' means an adult 
     family member, or another individual, who is a paid or unpaid 
     provider of home or community-based care to an eligible 
     individual.
       ``(2) Consumer choice.--The term `consumer choice' means 
     the opportunity for an eligible individual--
       ``(A) to have greater control over the covered long-term 
     care services and supplies the individual receives; and
       ``(B) to elect--
       ``(i) to receive a payment under this title through a 
     fiscal intermediary as described in section 806(b)(2)(B) for 
     the purpose of purchasing covered long-term care services or 
     supplies; or
       ``(ii) to receive such services or supplies from a provider 
     paid by the State involved (or its designee) as described in 
     section 806(b)(2)(A).
       ``(3) Covered long-term care services or supplies.--
       ``(A) In general.--Subject to subparagraph (B), the term 
     `covered long-term care services or supplies' means any of 
     the following services or supplies, but only if, with respect 
     to an eligible individual, such services or supplies are not 
     available or not eligible for payment by any entity carrying 
     out a program described in section 804(b)(8) or a similar 
     third party:
       ``(i) Adult day services (including health and social day 
     care services).
       ``(ii) Bill paying.
       ``(iii) Care-related supplies and equipment.
       ``(iv) Companion services.
       ``(v) Congregate meals.
       ``(vi) Environmental modifications.
       ``(vii) Fiscal intermediary services.
       ``(viii) Home-delivered meals.
       ``(ix) Home health services.
       ``(x) Homemaker services (including chore services).
       ``(xi) Mental and behavioral health services.
       ``(xii) Nutritional counseling.
       ``(xiii) Personal care services.
       ``(xiv) Personal emergency response systems.
       ``(xv) Respite care.
       ``(xvi) Telemedicine devices.
       ``(xvii) Transition services for individuals who have a 
     plan that meets such requirements as a State shall establish, 
     to relocate from a nursing home to a home or community-based 
     setting within 60 days.
       ``(xviii) Transportation.
       ``(xix) Any service or supply that a State describes in its 
     State plan and is approved by the Assistant Secretary.
       ``(xx) Any service or supply that is requested by an 
     eligible individual (in coordination with the individual's 
     service coordinator) and that is approved by the State.
       ``(B) Exclusions.--
       ``(i) Service coordination.--Such term does not include a 
     service directly provided by the service coordinator for an 
     eligible individual as part of service coordination under 
     this title.
       ``(ii) Services for nursing home residents.--Such term does 
     not include any service for a resident of a nursing home, 
     except a service described in subparagraph (A)(xvii).
       ``(4) Eligible individual.--The term `eligible individual' 
     means an individual--
       ``(A) who is age 60 or older;
       ``(B) who is not eligible for medical assistance under the 
     medicaid program established under title XIX of the Social 
     Security (42 U.S.C. 1396 et seq.);
       ``(C) who meets such income eligibility and total asset 
     criteria as a State may establish;
       ``(D) who--
       ``(i)(I) is unable to perform (without substantial 
     assistance from another individual) at least 2 activities of 
     daily living (such as eating, toileting, transferring, 
     bathing, dressing, and continence); or
       ``(II) at the option of the State, is unable to perform at 
     least 3 such activities without such assistance;
       ``(ii) has a level of disability similar (as determined by 
     the State) to the level of disability described in clause 
     (i); or
       ``(iii) requires substantial supervision due to cognitive 
     or mental impairment; and
       ``(E) who satisfies such other eligibility criteria as the 
     State may establish in accordance with such guidance as the 
     Assistant Secretary may provide.
       ``(5) Eligible state.--The term `eligible State' means a 
     State with an approved State plan under section 804.
       ``(6) Fiscal intermediary.--The term `fiscal intermediary' 
     means an entity that--
       ``(A) assists individuals who choose to employ providers of 
     covered long-term care services or supplies directly, to--
       ``(i) carry out employer-related responsibilities, as 
     designated by a State with the approval of the Assistant 
     Secretary;
       ``(ii) assure compliance with Federal, State, and local 
     law; and
       ``(iii) assure compliance with other requirements 
     designated by the State; and
       ``(B) receives and disburses, as described in section 
     806(b)(2)(B), payments described in section 806(b).
       ``(7) Fiscal intermediary service.--The term `fiscal 
     intermediary service' means a service to enable an eligible 
     individual to carry out a responsibility described in 
     subparagraph (A)(i) or (B) of paragraph (6) or assure 
     compliance with Federal, State, or local law, or another 
     requirement designated by the State.
       ``(8) Long-term care.--The term `long-term care' means a 
     wide range of supportive social, health, and mental health 
     services for individuals who do not have the capacity for 
     self-care due to illness or frailty.
       ``(9) Naturally occurring retirement community.--The term 
     `naturally occurring retirement community' means a 
     residential area (such as an apartment building, housing 
     complex or development, or neighborhood) not originally built 
     for older individuals but in which a substantial number of 
     individuals have aged in place and become older individuals.
       ``(10) Nursing home.--The term `nursing home' means--
       ``(A) a nursing facility, as defined in section 1919(a) of 
     the Social Security Act (42 U.S.C. 1396r(a));
       ``(B) a skilled nursing facility, as defined in section 
     1819(a) of such Act (42 U.S.C. 1395i-3(a)); and
       ``(C) a residential care facility that directly provides 
     care or services described in paragraph (1) of section 
     1919(a) of the Social Security Act (42 U.S.C. 1396r(a)) but 
     does not receive payment for such care or services under the 
     medicare or medicaid programs established under titles XVIII 
     and XIX, respectively, of the Social Security Act (42 U.S.C. 
     1395 et seq., 1396 et seq.).
       ``(11) Qualified provider.--The term `qualified provider' 
     means a provider of covered long-term care services or 
     supplies who meets such licensing, quality, and other 
     standards as the State may establish.
       ``(12) Representative.--The term `representative' means a 
     person appointed by the eligible individual, or legally 
     acting on the individual's behalf, to represent or advise the 
     individual in financial or service coordination matters.
       ``(13) Service coordination.--The term `service 
     coordination' means a service that--
       ``(A) is provided to an eligible individual, at the 
     direction of the eligible individual or a representative of 
     the eligible individual (as appropriate); and
       ``(B) consists of facilitating consumer choice or carrying 
     out--
       ``(i) a function described in section 805; or
       ``(ii) a function described in section 804(9), as 
     determined appropriate by the State involved.
       ``(14) Service coordinator.--The term `service coordinator' 
     means an individual who--

[[Page S3392]]

       ``(A) provides service coordination for an eligible 
     individual; and
       ``(B) is trained or experienced in the skills that are 
     required to facilitate consumer choice and carry out the 
     functions described in paragraph (13)(B).
       ``(15) State.--The term `State' means each of the 50 
     States, the District of Columbia, the Commonwealth of Puerto 
     Rico, Guam, the United States Virgin Islands, American Samoa, 
     and the Commonwealth of the Northern Mariana Islands.

     ``SEC. 802. ALLOTMENTS TO ELIGIBLE STATES.

       ``(a) Allotments.--
       ``(1) In general.--The Assistant Secretary shall make an 
     allotment to each eligible State for a fiscal year, to enable 
     the State to carry out a program that pays for the Federal 
     share of the cost of providing covered long-term care 
     services and supplies for eligible individuals under this 
     title. The Assistant Secretary shall make the allotment in an 
     amount determined under section 803.
       ``(2) Limitations.--From an allotment made under paragraph 
     (1) for a program carried out in a State under this title for 
     a fiscal year, not more than 15 percent may be used to pay 
     for administrative costs (other than service coordination) of 
     the program.
       ``(b) Federal Share.--From that allotment for that fiscal 
     year--
       ``(1) funds from the allotment shall be available to such 
     State for paying a Federal share equal to such percentage as 
     the State determines to be appropriate, but not more than 75 
     percent, of the cost of administration of the program carried 
     out in the State under this title; and
       ``(2) the remainder of such allotment shall be available to 
     such State only for paying a Federal share equal to such 
     percentage as the State determines to be appropriate, but not 
     more than 85 percent, of the cost of providing covered long-
     term care services and supplies through the program.
       ``(c) Supplement, Not Supplant.--Allotments made to a State 
     under this section shall supplement and not supplant other 
     Federal or State payments that are made for the provision of 
     long-term care services or supports under--
       ``(1) the medicaid program carried out under title XIX of 
     the Social Security Act (42 U.S.C. 1396 et seq.);
       ``(2) a program funded under title XX of such Act (42 
     U.S.C. 1397 et seq.);
       ``(3) a program funded under title III of this Act; or
       ``(4) any other Federal or State program.

     ``SEC. 803. ALLOTMENTS.

       ``(a) Allotments.--
       ``(1) In general.--Subject to subsection (b), from sums 
     appropriated for a fiscal year to carry out this title, the 
     Assistant Secretary shall allot to each eligible State an 
     amount that bears the same relationship to such sums as the 
     number of individuals who are age 60 or older and whose 
     income does not exceed 100 percent of the poverty line who 
     reside in the State bears to the total number of such 
     individuals who reside in all States.
       ``(2) Data.--For purposes of paragraph (1), the number of 
     individuals described in that paragraph shall be determined 
     on the basis of the most recent available data from the 
     Bureau of the Census.
       ``(3) Definition.--In paragraph (1), the term `State' does 
     not include a State specified in subsection (b).
       ``(b) Allotments to Territories.--Of the sums appropriated 
     for a fiscal year to carry out this title, the Assistant 
     Secretary shall allot an amount equal to 0.25 percent of such 
     sums among the following commonwealths and territories 
     according to the percentage specified for each such 
     commonwealth or territory:
       ``(1) The Commonwealth of Puerto Rico, 91.6 percent.
       ``(2) Guam, 3.5 percent.
       ``(3) The United States Virgin Islands, 2.6 percent.
       ``(4) American Samoa, 1.2 percent.
       ``(5) The Commonwealth of the Northern Mariana Islands, 1.1 
     percent.
       ``(c) Availability of Amounts Allotted.--
       ``(1) In general.--Except as provided in paragraph (2), an 
     amount allotted to an eligible State for a fiscal year shall 
     remain available for expenditure by the State for the 2 
     succeeding fiscal years.
       ``(2) Availability of redistributed amounts.--An amount 
     redistributed to an eligible State under subsection (d) in a 
     fiscal year shall be available for expenditure by the State 
     for the succeeding fiscal year.
       ``(d) Redistribution of Unspent Funds.--An amount that is 
     not expended by an eligible State during the period in which 
     such amount is available under subsection (c) shall be 
     redistributed by the Assistant Secretary according to a 
     formula determined by the Assistant Secretary that takes into 
     account the extent to which an eligible State has exhausted, 
     or is likely to exhaust, its allotment for that fiscal year.

     ``SEC. 804. STATE PLANS.

       ``(a) In General.--In order to receive an allotment made 
     under section 802 for an eligible State for a fiscal year, 
     the State shall submit to the Assistant Secretary for 
     approval a State plan that includes the information and 
     assurances described in subsection (b).
       ``(b) Contents.--
       ``(1) Eligibility.--The plan shall include descriptions of 
     the eligibility criteria and methodologies that the State 
     will apply, consistent with section 801(4), to determine 
     whether an individual is an eligible individual for the 
     program carried out in the State under this title.
       ``(2) Priority for eligible individuals with greatest 
     economic need.--The plan shall include an assurance that, in 
     establishing and applying the eligibility criteria and 
     methodologies described in paragraph (1), the State will give 
     priority to providing assistance to those eligible 
     individuals who have the greatest economic need, as defined 
     by the State.
       ``(3) Needs and preferences of eligible individuals.--The 
     plan shall include a description of how the State will ensure 
     that the needs and preferences of an eligible individual are 
     addressed in all aspects of the program.
       ``(4) Payments for services.--The plan shall include an 
     assurance that the State will make payments, at the election 
     of an eligible individual, in accordance with section 
     806(b)(2), and will provide a fiscal intermediary for each 
     eligible individual electing to receive a payment as 
     described in section 806(b)(2)(B).
       ``(5) Services and supplies.--The plan shall describe the 
     services and supplies that the State will make available to 
     an eligible individual, consistent with the definition of 
     covered long-term services or supplies specified in section 
     801(3).
       ``(6) Cost-sharing.--The plan shall include a description 
     of the methodologies to be used--
       ``(A) to calculate the ability of an eligible individual to 
     pay for covered long-term care services or supplies without 
     assistance under the program carried out under this title;
       ``(B) based on the calculation of ability to pay, to 
     determine the amount of cost-sharing that the eligible 
     individual will be responsible for under the program, set on 
     a sliding scale based on income;
       ``(C) to collect cost-sharing amounts, both in cases in 
     which the State makes payments directly to a qualified 
     provider as described in section 806(b)(2)(A), and in cases 
     in which the State makes payments to a fiscal intermediary on 
     behalf of an eligible individual, as described in section 
     806(b)(2)(B); and
       ``(D) to track expenditures by eligible individuals for the 
     purchase of covered long-term care services or supplies.
       ``(7) Cost-sharing requirements for providers.--The plan 
     shall provide an assurance that the State will require each 
     provider involved in the program carried out in the State 
     under this title--
       ``(A) to protect the privacy and confidentiality of each 
     eligible individual with respect to the income, and any cost-
     sharing amount determined under paragraph (6), of an eligible 
     individual;
       ``(B) to establish appropriate procedures to account for 
     cost-sharing amounts; and
       ``(C) to widely distribute State-created written materials 
     in languages reflecting the reading abilities of eligible 
     individuals that describe the criteria for cost-sharing, and 
     the State's sliding scale described in paragraph (6)(B).
       ``(8) Coordination with other programs.--The plan shall 
     include a description of the methods by which the State will, 
     as appropriate, refer individuals who apply for assistance 
     under a program carried out under this title for eligibility 
     determinations under--
       ``(A) the State medicaid program carried out under title 
     XIX of the Social Security Act (42 U.S.C. 1396 et seq.);
       ``(B) the medicare program carried out under title XVIII of 
     such Act (42 U.S.C. 1395 et seq.);
       ``(C) a program funded under title XX of such Act (42 
     U.S.C. 1397 et seq.);
       ``(D) other programs funded under this Act; and
       ``(E) other Federal or State programs that provide long-
     term care.
       ``(9) Entities and procedures.--The plan shall include a 
     description of the entities and procedures that the State 
     will use to carry out the following functions:
       ``(A) Establishing eligibility for the program carried out 
     under this title.
       ``(B) Assessing the need of an eligible individual for 
     covered long-term care services or supplies.
       ``(C) Determining the amount of payments described in 
     section 806(b) to be made for the eligible individual under 
     the program.
       ``(D) Evaluating the cost-sharing by the eligible 
     individual under the program.
       ``(E) In the case of an eligible individual who elects to 
     receive payments as described in section 806(b)(2)(B), 
     helping the eligible individual or the eligible individual's 
     representative (as appropriate) identify, retain, and 
     negotiate and terminate agreements with, qualified providers 
     of covered long-term services or supplies.
       ``(F) Monitoring payments made for an eligible individual 
     to ensure that--
       ``(i) the cost-sharing amounts that the eligible individual 
     is responsible for under the State plan are paid;
       ``(ii) the payments made by the State for the eligible 
     individual--

       ``(I) are made in a timely fashion; and
       ``(II) do not exceed the annual assistance amount 
     established for the eligible individual under section 806(a); 
     and

       ``(iii) when appropriate, the payments are made by the 
     State in an expedited manner to account for health status 
     changes of an eligible individual that require rapid 
     responses.
       ``(G) Establishing a quality assurance system that assesses 
     the covered long-term services or supplies provided for the 
     eligible individual to ensure that the qualified provider of 
     such services or supplies meets such

[[Page S3393]]

     licensing, quality, or other standards as the State may 
     establish in accordance with paragraph (11).
       ``(H) Providing information to eligible individuals about 
     average market rates for covered long-term care services or 
     supplies.
       ``(I) Administering payments in a timely fashion and in 
     accordance with a written care plan described in section 
     805(1) for an eligible individual (that takes into account 
     payment rates established by the eligible individual or a 
     representative of the eligible individual (as appropriate)), 
     including the methods for--
       ``(i) making payments directly to a qualified provider as 
     described in section 806(b)(2)(A);
       ``(ii) making payments to a fiscal intermediary on behalf 
     of an eligible individual, as described in section 
     806(b)(2)(B), for the purchase of such services or supplies; 
     and
       ``(iii) making payments (when appropriate) in an expedited 
     manner to account for health status changes of the eligible 
     individual that require rapid responses.
       ``(J) Carrying out such other activities as the eligible 
     State determines are appropriate with respect to the eligible 
     individual or the program carried out under this title.
       ``(10) Service coordinators.--The plan shall include a 
     description of how the State will--
       ``(A) provide a service coordinator (directly or by 
     contract) for each eligible individual receiving assistance 
     under the program carried out under this title; and
       ``(B) ensure that the service coordinator carries out the 
     responsibilities described in section 805, including any 
     responsibilities assigned by the State under section 805(5).
       ``(11) Qualified providers.--The plan shall include a 
     description of any licensing, quality, or other standards for 
     qualified providers (including both providers paid directly 
     by the State as described in section 806(b)(2)(A) or through 
     payments made to a fiscal intermediary on behalf of an 
     eligible individual, as described in section 806(b)(2)(B).
       ``(12) Quality assurance.--The plan shall include a 
     description of the procedures to be used to ensure the 
     quality and appropriateness of the covered long-term care 
     services or supplies provided to an eligible individual and 
     the program carried out under this title, which shall 
     include--
       ``(A) a quality assessment and improvement strategy that 
     establishes--
       ``(i) standards that provide for access to covered long-
     term care services or supplies within reasonable time frames 
     and that are designed to ensure the continuity and adequacy 
     of such services or supplies; and
       ``(ii) procedures for monitoring and evaluating the quality 
     and appropriateness of the covered long-term care services or 
     supplies provided to eligible individuals under the program 
     carried out under this title; and
       ``(B) a mechanism for obtaining feedback from eligible 
     individuals and others regarding their experiences with, and 
     recommendations for improvement of, the program carried out 
     under this title.
       ``(13) Outreach.--The plan shall include a description of 
     the procedures by which the State will conduct outreach for 
     enrollment (including outreach to persons residing in 
     naturally occurring retirement communities) in the program 
     carried out under this title.
       ``(14) Indians.--The plan shall include a description of 
     the procedures by which the State will ensure the provision 
     of assistance under the program carried out under this title 
     to eligible individuals who are Indians (as defined in 
     section 4(c) of the Indian Health Care Improvement Act (25 
     U.S.C. 1603(c))) or Native Hawaiians, as defined in section 
     625.
       ``(15) Data collection.--The plan shall include an 
     assurance that the State will annually collect and report to 
     the Assistant Secretary such data and information related to 
     the program carried out under this title as the Assistant 
     Secretary may require, including the information required 
     under section 807(a)(1)(B).

     ``SEC. 805. RESPONSIBILITIES OF SERVICE COORDINATORS.

       ``Each eligible State shall ensure that the service 
     coordinator for an eligible individual receiving assistance 
     under the program carried out under this title, at a minimum, 
     carries out the following responsibilities:
       ``(1)(A) Assisting an eligible individual and the eligible 
     individual's representative (as appropriate) with the 
     development of a written care plan for the eligible 
     individual that--
       ``(i) specifies the covered long-term care services or 
     supplies that best meet the needs and preferences of the 
     eligible individual; and
       ``(ii) takes into account the ability of caregivers to 
     provide adequate and safe care.
       ``(B) Assuring that the care plan is coordinated with other 
     care plans that may be developed for the eligible individual 
     under other Federal or State programs (including care plans 
     applicable to naturally occurring retirement communities).
       ``(2) Reassessing and, as appropriate, assisting with 
     revising the care plan for the eligible individual--
       ``(A) not less than annually; and
       ``(B) whenever there is a change of health status or other 
     event that requires a reassessment of the care plan.
       ``(3) Educating--
       ``(A) an eligible individual who elects to receive payments 
     as described in section 806(b)(2)(B) about available 
     qualified providers of covered long-term care services or 
     supplies; and
       ``(B) an eligible individual about specific covered long-
     term care services or supplies.
       ``(4) Recommending, as appropriate, methods for community 
     integration for an eligible individual who resides in a 
     nursing home and who is relocating to a home or community-
     based setting.
       ``(5) Carrying out any other responsibilities assigned to 
     the service coordinator by the State.

     ``SEC. 806. PAYMENTS FOR COVERED LONG-TERM CARE SERVICES OR 
                   SUPPLIES.

       ``(a) Annual Assistance Amount.--
       ``(1) In general.--Subject to paragraph (2), an eligible 
     State shall establish an annual assistance amount for each 
     eligible individual enrolled in the program carried out under 
     this title based on an assessment of the eligible individual.
       ``(2) Cost-sharing amount.--The State shall subtract from 
     the annual assistance amount the individual's cost-sharing 
     amount determined under section 804(b)(6) to obtain the 
     amount of the payments described in subsection (b).
       ``(3) Limitation.--The annual assistance amount made for an 
     eligible individual under a program carried out under this 
     title may not exceed--
       ``(A) in the case of fiscal year 2007, $8,000; and
       ``(B) in the case of any subsequent fiscal year, the amount 
     described in this paragraph for the preceding fiscal year 
     increased by the percentage increase in the Consumer Price 
     Index for all urban consumers (all items: U.S. city average) 
     for the preceding fiscal year.
       ``(b) Payments.--
       ``(1) Written care plans.--Under a program carried out 
     under this title, an eligible State (or its designee) shall 
     make payments for the provision or purchase of covered long-
     term care services or supplies for eligible individuals in 
     accordance with the written care plans established for such 
     individuals.
       ``(2) Elections.--At the election of an eligible 
     individual, the payments shall be made by the State (or its 
     designee)--
       ``(A) directly to a qualified provider of covered long-term 
     care services or supplies; or
       ``(B) to a fiscal intermediary on behalf of the eligible 
     individual, to enable the fiscal intermediary to disburse the 
     payments for the purchase of such services or supplies--
       ``(i) in advance to the provider or the eligible 
     individual; or
       ``(ii) as reimbursement for the eligible individual.
       ``(c) Limitations.--In making payments under this section, 
     a State shall ensure that not more than 10 percent of the 
     funds made available to the State under section 802(a) shall 
     be used to pay for service coordination.
       ``(d) Exclusion From Income.--Payments made for an eligible 
     individual under this section for a program carried out under 
     this title shall not be--
       ``(1) included in the gross income of the eligible 
     individual for purposes of the Internal Revenue Code of 1986; 
     or
       ``(2) treated as income, assets, or benefits, or otherwise 
     be taken into account, for purposes of determining the 
     individual's eligibility for, the amount of benefits under, 
     or the amount of cost-sharing required by, any other Federal 
     or State program.

     ``SEC. 807. ANNUAL REPORTS.

       ``(a) State Reports.--
       ``(1) In general.--Each eligible State shall--
       ``(A) evaluate the establishment and operation of the State 
     plan under this title in each fiscal year for which the State 
     receives allotments under section 802; and
       ``(B) prepare and submit to the Assistant Secretary, not 
     later than January 1 of the succeeding fiscal year, a report 
     that includes the following:
       ``(i) The number of total unduplicated eligible individuals 
     and the amount of expenditures made for the individuals, 
     analyzed by type of payment specified in subparagraph (A) or 
     (B) of section 806(b)(2) in the program carried out under 
     this title in the State.
       ``(ii) The number of eligible individuals in the program 
     that received each of the categories of covered long-term 
     care services or supplies described in clauses (i) through 
     (xx) of section 801(3)(A), analyzed, for each category by 
     type of payment specified in subparagraph (A) or (B) of 
     section 806(b)(2).
       ``(iii) The total amount of cost-sharing amounts that the 
     State received from eligible individuals in the program.
       ``(iv) Information on the age and income of the eligible 
     individuals.
       ``(2) Format.--The Assistant Secretary shall provide 
     guidance to eligible States regarding the format for the 
     information included in the report required under paragraph 
     (1) in such manner as to allow for comparison of the 
     information provided across such States.
       ``(3) Public availability.--The Assistant Secretary shall 
     make the State reports submitted under paragraph (1) 
     available to the public.
       ``(b) Reports by Fiscal Intermediaries and Qualified 
     Providers.--The State shall require fiscal intermediaries and 
     qualified providers participating in the program carried out 
     in the State under this title to prepare and submit to the 
     State, not less often than twice a year, reports containing 
     such information as is necessary for the State to meet the 
     reporting requirements described in subsection (a) and as is 
     necessary for the administration of the program.

[[Page S3394]]

       ``(c) Report to Congress.--At the end of each fiscal year, 
     the Assistant Secretary shall prepare and submit to the 
     Committee on Education and the Workforce of the House of 
     Representatives and the Committee of Health, Education, 
     Labor, and Pensions of the Senate a report that contains a 
     summary of the data submitted under subsection (a)(1)(B) and 
     a description of any implementations issues with the programs 
     carried out under this title.

     ``SEC. 808. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated to the Secretary 
     to carry out this title, such sums as may be necessary for 
     each of fiscal years 2007 through 2012.''.

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