[Congressional Record Volume 153, Number 53 (Tuesday, March 27, 2007)]
[House]
[Pages H3161-H3164]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STROKE TREATMENT AND ONGOING PREVENTION ACT
Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 477) to amend the Public Health Service Act to strengthen
education, prevention, and treatment programs relating to stroke, and
for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 477
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 ``Stroke Treatment and Ongoing
Prevention Act''.
SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT REGARDING
STROKE PROGRAMS.
(a) Stroke Education and Information Programs.--Title III
of the Public Health Service Act (42 U.S.C. 241 et seq.) is
amended by adding at the end the following:
``PART [R] S--STROKE EDUCATION, INFORMATION, AND DATA COLLECTION
PROGRAMS
``SEC. [399AA] 399FF. STROKE PREVENTION AND EDUCATION
CAMPAIGN.
``(a) In General.--The Secretary shall carry out an
education and information campaign to promote stroke
prevention and increase the number of stroke patients who
seek immediate treatment.
``(b) Authorized Activities.--In implementing the education
and information campaign under subsection (a), the Secretary
may--
``(1) make public service announcements about the warning
signs of stroke and the importance of treating stroke as a
medical emergency;
``(2) provide education regarding ways to prevent stroke
and the effectiveness of stroke treatment; and
``(3) carry out other activities that the Secretary
determines will promote prevention practices among the
general public and increase the number of stroke patients who
seek immediate care.
``(c) Measurements.--In implementing the education and
information campaign under subsection (a), the Secretary
shall--
``(1) measure public awareness before the start of the
campaign to provide baseline data that will be used to
evaluate the effectiveness of the public awareness efforts;
``(2) establish quantitative benchmarks to measure the
impact of the campaign over time; and
``(3) measure the impact of the campaign not less than once
every 2 years or, if determined appropriate by the Secretary,
at shorter intervals.
``(d) No Duplication of Effort.--In carrying out this
section, the Secretary shall avoid duplicating existing
stroke education efforts by other Federal Government
agencies.
``(e) Consultation.--In carrying out this section, the
Secretary may consult with organizations and individuals with
expertise in stroke prevention, diagnosis, treatment, and
rehabilitation.
``SEC. [399BB] 399GG. PAUL COVERDELL NATIONAL ACUTE STROKE
REGISTRY AND CLEARINGHOUSE.
``The Secretary, acting through the Centers for Disease
Control and Prevention, shall maintain the Paul Coverdell
National Acute Stroke Registry and Clearinghouse by--
``(1) continuing to develop and collect specific data
points and appropriate benchmarks for analyzing care of acute
stroke patients;
``(2) collecting, compiling, and disseminating information
on the achievements of, and problems experienced by, State
and local agencies and private entities in developing and
implementing emergency medical systems and hospital-based
quality of care interventions; and
``(3) carrying out any other activities the Secretary
determines to be useful to maintain the Paul Coverdell
National Acute Stroke Registry and Clearinghouse to reflect
the latest advances in all forms of stroke care.
``SEC. [399CC] 399HH. STROKE DEFINITION.
``For purposes of this part, the term `stroke' means a
`brain attack' in which blood flow to the brain is
interrupted or in which a blood vessel or aneurysm in the
brain breaks or ruptures.
``SEC. [399DD] 399II. AUTHORIZATION OF APPROPRIATIONS.
``There is authorized to be appropriated to carry out this
part $5,000,000 for each of fiscal years 2008 through
2012.''.
(b) Emergency Medical Professional Development.--Section
1251 of the Public Health Service Act (42 U.S.C. 300d-51) is
amended to read as follows:
``SEC. 1251. MEDICAL PROFESSIONAL DEVELOPMENT IN ADVANCED
STROKE AND TRAUMATIC INJURY TREATMENT AND
PREVENTION.
``(a) Residency and Other Professional Training.--The
Secretary may make grants to public and nonprofit entities
for the purpose of planning, developing, and enhancing
approved residency training programs and other professional
training for appropriate health professions in emergency
medicine, including emergency medical services professionals,
to improve stroke and traumatic injury prevention, diagnosis,
treatment, and rehabilitation.
``(b) Continuing Education on Stroke and Traumatic
Injury.--
``(1) Grants.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, may make grants to qualified entities for the
development and implementation of education programs for
appropriate health care professionals in the use of newly
developed diagnostic approaches, technologies, and therapies
for health professionals involved in the prevention,
diagnosis, treatment, and rehabilitation of stroke or
traumatic injury.
``(2) Distribution of grants.--In awarding grants under
this subsection, the Secretary shall give preference to
qualified entities that will train health care professionals
that serve areas with a significant incidence of stroke or
traumatic injuries.
``(3) Application.--A qualified entity desiring a grant
under this subsection shall submit to the Secretary an
application at such time, in such manner, and containing such
information as the Secretary may require, including a plan
for the rigorous evaluation of activities carried out with
amounts received under the grant.
``(4) Definitions.--For purposes of this subsection:
``(A) The term `qualified entity' means a consortium of
public and private entities, such as universities, academic
medical centers, hospitals, and emergency medical systems
that are coordinating education activities among providers
serving in a variety of medical settings.
``(B) The term `stroke' means a `brain attack' in which
blood flow to the brain is interrupted or in which a blood
vessel or aneurysm in the brain breaks or ruptures.
``(c) Report.--Not later than 1 year after the allocation
of grants under this section, the Secretary shall submit to
the Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of the
House of Representatives a report on the results of
activities carried out with amounts received under this
section.
[[Page H3162]]
``(d) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $4,000,000 for
each of fiscal years 2008 through 2012. The Secretary shall
equitably allocate the funds authorized to be appropriated
under this section between efforts to address stroke and
efforts to address traumatic injury.''.
SEC. 3. PILOT PROJECT ON TELEHEALTH STROKE TREATMENT.
(a) Establishment.--Part D of title III of the Public
Health Service Act (42 U.S.C. 254b et seq.) is amended by
inserting after section 330L the following:
``SEC. 330M. TELEHEALTH STROKE TREATMENT GRANT PROGRAM.
``(a) Grants.--The Secretary may make grants to States, and
to consortia of public and private entities located in any
State that is not a grantee under this section, to conduct a
5-year pilot project over the period of fiscal years 2008
through 2012 to improve stroke patient outcomes by
coordinating health care delivery through telehealth
networks.
``(b) Administration.--The Secretary shall administer this
section through the Director of the Office for the
Advancement of Telehealth.
``(c) Consultation.--In carrying out this section, for the
purpose of better coordinating program activities, the
Secretary shall consult with--
``(1) officials responsible for other Federal programs
involving stroke research and care, including such programs
established by the Stroke Treatment and Ongoing Prevention
Act; and
``(2) organizations and individuals with expertise in
stroke prevention, diagnosis, treatment, and rehabilitation.
``(d) Use of Funds.--
``(1) In general.--The Secretary may not make a grant to a
State or a consortium under this section unless the State or
consortium agrees to use the grant for the purpose of--
``(A) identifying entities with expertise in the delivery
of high-quality stroke prevention, diagnosis, treatment, and
rehabilitation;
``(B) working with those entities to establish or improve
telehealth networks to provide stroke treatment assistance
and resources to health care professionals, hospitals, and
other individuals and entities that serve stroke patients;
``(C) informing emergency medical systems of the location
of entities identified under subparagraph (A) to facilitate
the appropriate transport of individuals with stroke
symptoms;
``(D) establishing networks to coordinate collaborative
activities for stroke prevention, diagnosis, treatment, and
rehabilitation;
``(E) improving access to high-quality stroke care,
especially for populations with a shortage of stroke care
specialists and populations with a high incidence of stroke;
and
``(F) conducting ongoing performance and quality
evaluations to identify collaborative activities that improve
clinical outcomes for stroke patients.
``(2) Establishment of consortium.--The Secretary may not
make a grant to a State under this section unless the State
agrees to establish a consortium of public and private
entities, including universities and academic medical
centers, to carry out the activities described in paragraph
(1).
``(3) Prohibition.--The Secretary may not make a grant
under this section to a State that has an existing telehealth
network that is or may be used for improving stroke
prevention, diagnosis, treatment, and rehabilitation, or to a
consortium located in such a State, unless the State or
consortium agrees that--
``(A) the State or consortium will use an existing
telehealth network to achieve the purpose of the grant; and
``(B) the State or consortium will not establish a separate
network for such purpose.
``(e) Priority.--In selecting grant recipients under this
section, the Secretary shall give priority to any applicant
that submits a plan demonstrating how the applicant, and
where applicable the members of the consortium described in
subsection (d)(2), will use the grant to improve access to
high-quality stroke care for populations with shortages of
stroke-care specialists and populations with a high incidence
of stroke.
``(f) Grant Period.--The Secretary may not award a grant to
a State or a consortium under this section for any period
that--
``(1) is greater than 3 years; or
``(2) extends beyond the end of fiscal year 2012.
``(g) Restriction on Number of Grants.--In carrying out the
5-year pilot project under this section, the Secretary may
not award more than 7 grants.
``(h) Application.--To seek a grant under this section, a
State or a consortium of public and private entities shall
submit an application to the Secretary in such form, in such
manner, and containing such information as the Secretary may
require. At a minimum, the Secretary shall require each such
application to outline how the State or consortium will
establish baseline measures and benchmarks to evaluate
program outcomes.
``(i) Definition.--In this section, the term `stroke' means
a `brain attack' in which blood flow to the brain is
interrupted or in which a blood vessel or aneurysm in the
brain breaks or ruptures.
``(j) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section
$10,000,000 for fiscal year 2008, $13,000,000 for fiscal year
2009, $15,000,000 for fiscal year 2010, $8,000,000 for fiscal
year 2011, and $4,000,000 for fiscal year 2012.''.
(b) Study; Reports.--
(1) Final report.--Not later than March 31, 2013, the
Secretary of Health and Human Services shall conduct a study
of the results of the telehealth stroke treatment grant
program under section 330M of the Public Health Service Act
(added by subsection (a)) and submit to the Congress a report
on such results that includes the following:
(A) An evaluation of the grant program outcomes, including
quantitative analysis of baseline and benchmark measures.
(B) Recommendations on how to promote stroke networks in
ways that improve access to clinical care in rural and urban
areas and reduce the incidence of stroke and the debilitating
and costly complications resulting from stroke.
(C) Recommendations on whether similar telehealth grant
programs could be used to improve patient outcomes in other
public health areas.
(2) Interim reports.--The Secretary of Health and Human
Services may provide interim reports to the Congress on the
telehealth stroke treatment grant program under section 330M
of the Public Health Service Act (added by subsection (a)) at
such intervals as the Secretary determines to be appropriate.
SEC. 4. RULE OF CONSTRUCTION.
Nothing in this Act shall be construed to authorize the
Secretary of Health and Human Services to establish Federal
standards for the treatment of patients or the licensure of
health care professionals.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New
Jersey (Mr. Pallone) and the gentleman from Texas (Mr. Burgess) each
will control 20 minutes.
The Chair recognizes the gentleman from New Jersey.
General Leave
Mr. PALLONE. Mr. Speaker, I ask that all Members may have 5
legislatives days to revise and extend their remarks and include
extraneous material on the bill under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New Jersey?
There was no objection.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
The bill before us, H.R. 477, the Stroke Treatment and Ongoing
Prevention Act, amends the Public Health Service Act to strengthen
education, prevention and treatment programs to improve health outcomes
for stroke patients. Stroke is the third leading cause of death in
America and a major contributor to long-term disability. The American
Heart Association reports that approximately 700,000 Americans suffer
from a stroke each year and that more than 150,000 die annually. The
AHA estimates that someone dies of a stroke every 3 minutes.
H.R. 477 would authorize the Secretary of the Department of Health
and Human Services to engage in activities designed to increase
knowledge and awareness of stroke prevention and treatment. This
legislation would require the Secretary to conduct educational
campaigns, maintain a national stroke registry and establish an
information clearinghouse related to stroke.
The bill would authorize the Secretary to make grants to public and
nonprofit entities for the purpose of planning, developing and
enhancing improved residency training programs and other professional
training for appropriate health professions in emergency medicine,
including emergency medical service professionals, to improve stroke
and traumatic injury prevention, diagnosis, treatment and
rehabilitation.
Finally, the bill would authorize the Secretary to make grants to
States and public and other private entities to make medical
professional training programs and telehealth networks that seek to
coordinate stroke care and improve patient outcomes.
The legislation has 86 cosponsors and is supported by the American
Heart Association, the American Stroke Association, the American
Physical Therapy Association and the STOP Stroke Coalition.
I would like to personally thank Representative Capps and
Representative Pickering for all their hard work on this life-saving
legislation. I particularly want to thank Representative Capps. I know
how hard she has worked on this. I know, because of her background as a
nurse, she brings to our attention on the subcommittee so
[[Page H3163]]
many bills and so many issues that are really important. I would thank
her not only for this bill but for so many other initiatives.
I would urge all of my colleagues to join me in support of H.R. 477.
Mr. Speaker, I reserve the balance of my time.
Mr. BURGESS. Mr. Speaker, I am pleased to rise in support of H.R.
477, the STOP Stroke Act. By passing this legislation, we are drawing
attention to the dangers of stroke and heart disease. As we have
already heard, stroke is the third leading cause of death in this
country, preceded by cardiovascular disease and cancer, but clearly an
important cause of death in this country. It is the most common cause
of adult disability. As we have already heard, each year, more than
700,000 Americans suffer stroke, and 160,000 die from stroke-related
causes.
It is important to increase awareness and knowledge about stroke and
stroke prevention. One of the key components of this legislation is
that it allows the Secretary of HHS to establish programs for education
about stroke prevention.
Additionally, the STOP Stroke Act provides federally funded grants to
health care professionals at qualified entities to help educate them
about the need for prevention, diagnosis, treatment and rehabilitation.
Lastly, the legislation before us today includes a 5-year pilot
program that provides grants to States and public-private entities for
coordination of health care through telehealth networks.
I want to thank Congresswoman Capps and Congressman Pickering for
their work in bringing this legislation to the floor tonight. I urge my
colleagues to support the STOP Stroke Act.
Mr. Speaker, I reserve the balance of my time.
Mr. PALLONE. Mr. Speaker, I yield to the sponsor of the bill, Mrs.
Capps, such time as she may consume.
Mrs. CAPPS. I thank my colleague from New Jersey for yielding and for
your leadership on this and the other health bills that we have been
dealing with lately.
Mr. Speaker, I rise in strong support of the Stroke Treatment and
Ongoing Prevention Act, known as the STOP Stroke bill. I have been very
proud to work on this legislation over several years with my colleague,
Chip Pickering; and I am thrilled that it has come before the House
today. I thank our staffs for all of us and those who have supported
this legislation in the past, particularly calling to mind the groups
that Mr. Chairman mentioned in support of the legislation, groups
across the country made up of survivors of stroke and those who are
very interested in what we do here today.
It has been mentioned that stroke is the Nation's number three
killer, a leading cause of long-term disability, and it's also known
but not widely understood that stroke affects all age groups, not just
the very elderly. It cuts through every socioeconomic and ethnic group.
It really is a very significant destroyer of lives and homes and
families, as it has such devastating results as it affects people.
{time} 2045
Across this country, someone suffers a stroke every 45 seconds.
In my State of California, stroke accounts for approximately 7
percent of deaths. In 2004, that amounted to nearly 17,000 individuals.
So many of these deaths due to stroke are preventable. Others are
treatable.
The staggering numbers of death and long-term disability due to
stroke means that it is now time that we pass into law a comprehensive
plan for preventing, for diagnosing, and for treating stroke. H.R. 477
would accomplish this goal by authorizing the resources needed to
implement coordinated stroke systems.
The bill's first initiative would create a national awareness
campaign that would educate both patients and providers. Not enough
people know the symptoms of stroke when it impacts them.
We must standardize prevention and early treatment in order to
achieve real results in our fight against stroke. In order to further
improve education about stroke prevention, diagnosis and treatment,
this bill will authorize grants for qualified health professional
programs so that providers are equipped with the most up-to-date
information and technologies.
H.R. 477 would also maintain the Paul Coverdell Registry, which
serves as a clearinghouse of information about stroke care and best
practices.
And, finally, it would make up to seven grants available to conduct
pilot projects on how we may be able to improve stroke outcomes through
telehealth networks.
I am very proud of this bill's comprehensive approach to improve our
ability to manage stroke in the United States.
Only when we tackle this disease from all angles, from prevention,
from treatment, from coordination of care, can we really make progress.
So I urge my colleagues to vote in favor of H.R. 477. And I look
forward to seeing it finally signed into law.
Mr. BURGESS. Mr. Speaker, through the course of these three bills
being brought by the Energy and Commerce Committee tonight, we have
heard a number of stories. People have shared with us their personal
stories.
I saw on the news wires just this evening where a good friend of our
committee, Jack Valenti, had been hospitalized with a stroke earlier
this week.
My own father suffered a stroke, May 23 of 1989. He, unfortunately,
died 2 years ago this week. He spent the last 16 years of his life
living with a disability as a result of that stroke. The day that it
happened, he lost the ability to speak and never regained it prior to
his death.
Stroke treatment is so important and it has evolved over time. It
wasn't too many years ago where it was just simply a question of being
certain about the diagnosis, making certain the stroke patient was
stable, and then making arrangements for their rehabilitation. But so
much more can be done now.
And we heard about the golden hour when talking about the trauma
bill. Actually, for stroke victims, if treatment is rendered within the
first 3 hours of a clot occurring, anti-clot medications, clot-busting
medications, thrombolytic agents can be administered to restore
significant function to that and prevent injury to that part of the
brain that has been injured by, or been placed in jeopardy by, the
presence of a clot.
Other strokes are caused by bleeding and blood vessel malformations
within the brain; and one of our colleagues in the other body, indeed,
suffered such an injury earlier this year. The treatment is vastly
different. Clearly, those patients should not be treated with clot-
inhibiting agents because they would be placed at greater risk.
So the diagnosis of the type of stroke at the time of the stroke
becomes critical, and that is where the funding placed for the
education and the medical research becomes so important. Further, it is
my feeling that, as time goes forward, we will indeed improve the
ability to help individuals who have been afflicted by a stroke.
Additionally, the bill calls for the Secretary of Health and Human
Services to establish programs educating the public about stroke
prevention. And thanks to my good friends at mayoclinic.com, I would
like to take just a moment to run through, to enumerate those things
that should be done for stroke prevention. And the number one issue is,
if a person has hypertension, that hypertension needs to be controlled.
If a person has high cholesterol, that needs to be lowered, either by
modifying diet, a diet low in fat or a cholesterol lowering medication
such as a statin. No one should smoke in the United States today. If
you are diabetic, control your blood sugar. Maintain a healthy weight.
Exercise regularly. Avoid stress. Don't serve in Congress. Oh, that
wasn't on the list. Avoid stress. And if you do use alcohol or illicit
drugs, perhaps you ought to think of another activity.
These are very commonsense recommendations. They have been developed
by, again, our good friends at Mayo Clinic. And I urge all Americans to
consider incorporating those into their lifestyle.
This is important legislation. I urge my colleagues to support the
legislation.
Mr. Speaker, I yield back the balance of my time.
[[Page H3164]]
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Oregon (Ms. Hooley).
Ms. HOOLEY. Mr. Speaker, as a strong proponent of the American Heart
Association's GO-Red campaign aimed at educating women about heart
disease and stroke, I am proud to be a cosponsor of the Stroke
Treatment and Ongoing Prevention Act.
This legislation will help reduce the 150,000 deaths that occur each
year from stroke. Every 3 minutes someone dies of a stroke according to
the American Heart Association. To a stroke victim, delay means more
dead brain cells. The most common type of strokes kills 1.9 million
brain cells every minute. One study estimated that for every 12 minutes
a stroke victim delays treatment, a pea-sized portion of the brain
dies.
Fortunately, educating people about when to seek treatment makes a
difference. And I want to tell a story about a friend of mine. About 6
months ago, young woman, she happened to have another friend visiting
her. And she woke up one morning and said, I don't feel very good. I
can hardly lift my arm. And her friend that was visiting said, we are
going straight to the hospital. She is doing very well in recovery, not
only because she is a very determined person, but she can also thank
her friend for recognizing what was happening and getting her to a
hospital immediately.
By educating people about stroke symptoms and strengthening training
programs for physicians, this legislation will save lives and limit the
damage to stroke survivors.
I urge my colleagues to support H.R. 477.
Mr. PICKERING. Mr. Speaker, I rise today in support of the Stroke
Treatment and Ongoing Prevention Act.
As the original cosponsor of the STOP Stroke Act, I would like to
extend a special thanks to my colleague and the bill's sponsor,
Congresswoman Capps for her tireless efforts to move this important
legislation.
Despite significant advances in its diagnosis, treatment, and
prevention, stroke remains the nation's number three killer and a
leading cause of long-term disability. An estimated 700,000 U.S.
residents have a new or recurrent stroke each year, and about 160,000
of them die, according to statistics compiled by the American Heart
Association. On average, every 45 seconds, someone in the United States
has a stroke, and someone dies of a stroke every 3 to 4 minutes. Stroke
is the number four killer in my home state of Mississippi. In 2004,
1,651 people in Mississippi died of stroke. Mississippi ranks first in
the nation for the highest death rate from heart disease, stroke, and
other cardiovascular diseases.
Today 5.7 million Americans are stroke survivors. As many as 30
percent of them are permanently disabled, requiring extensive and
costly care. It is expected that stroke will cost the nation $62.7
billion in 2007.
Prompt treatment of patients experiencing stroke can save lives and
reduce disability, yet thousands of stroke patients do not receive the
care they need. Additionally, most Americans cannot identify the signs
of stroke, and even emergency medical technicians are often not taught
how to recognize and manage its symptoms. Even in hospitals, stroke
patients often do not receive the care that could save their lives.
Rapid administration of clot-dissolving drugs dramatically improves the
outcome of stroke, yet fewer than 3 percent of stroke patients now
receive such medication.
The STOP Stroke Act is a first step toward removing these barriers to
quality stroke care, thereby saving lives and reducing disability. The
legislation addresses a number of significant hindrances to quality
stroke care including low public awareness, lack of necessary
infrastructure, low awareness among medical professionals, and lack of
adequate data collection.
The legislation will coordinate these various components. According
to the American Heart Association, developing coordinated systems of
care is essential to improving prevention, treatment, and
rehabilitation for stroke patients.
The STOP Stroke Act authorizes a national public information campaign
to educate the public about stroke, including how to reduce risk,
recognize the warning signs, and seek emergency treatment as soon as
symptoms occur.
This legislation also authorizes the Paul Coverdell Stroke Registry
and Clearinghouse to collect data about the care of acute stroke
patients and foster the development of effective stroke care systems.
The clearinghouse will serve as a resource for States seeking to design
and implement their own stroke care systems by collecting, analyzing
and disseminating information on the efforts of other communities to
establish similar systems.
The STOP Stroke Act also provides grants for public and non-profit
entities to develop and implement continuing education programs in the
use of new diagnostic approaches, technologies, and therapies for the
prevention and treatment of stroke. Stroke support can be delivered to
smaller, underserved facilities by relying more heavily on innovative
telemedicine approaches that overcome the boundaries of time and
distance to help rural hospitals tap into otherwise unattainable
resources.
Finally, this bill authorizes a telehealth stroke treatment pilot
project to support states' efforts to develop comprehensive networks to
improve stroke prevention, treatment, and rehabilitation. These grants
will allow states to identify stroke centers, improve communication
networks that bring stroke care to rural areas, and decease response
time.
The time has come for a bill such as the STOP Stroke Act. In fact,
the time is past due. We are in a situation where stroke rates are on
the rise, and we must address the issues that are going to help us
match resources with the growing need to prevent and treat this
devastating illness.
I look forward to working with my colleagues in both Chambers to
promptly move this legislation that has actually passed previously in
both the House and the Senate.
Mr. PALLONE. Mr. Speaker, I have no further requests for time, and I
would yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from New Jersey (Mr. Pallone) that the House suspend the
rules and pass the bill, H.R. 477, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
____________________