Congressional Record, Volume 152 Issue 44 (Friday, April 7, 2006)

[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.

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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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