[Congressional Record Volume 155, Number 52 (Thursday, March 26, 2009)]
[Senate]
[Pages S3899-S3932]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. FEINGOLD (for himself and Ms. Collins):
  S. 712. A bill to amend title XVIII of the Social Security Act to 
improve the Medicare program for beneficiaries residing in rural areas; 
to the Committee on Finance.
  Mr. FEINGOLD. Mr. President, today, along with my colleague Senator 
Collins from Maine, I am introducing legislation to address the needs 
of the nearly one-quarter of all Medicare beneficiaries who live in 
rural America. These beneficiaries are systematically disadvantaged in 
the Medicare program. The beauty of Medicare is its equity, its 
universality, and its accessibility. But we have compromised these 
values by stratifying payments, by under-representing rural voices on 
the Medicare Payment Advisory Commission, and by continuing to use 
obsolete payment data that hurts rural America.
  First, we must stop indexing physician payments for work based on 
geographic differences. Rural areas already have a hard enough time 
recruiting and retaining the Nation's top talent. Currently, even 
though 25 percent of Medicare beneficiaries live in rural areas, only 
10 percent of the nation's physicians serve them. Lower payments to 
doctors in these areas only perpetuate this dangerous shortage of 
medical expertise. We should not be discouraging medical school 
graduates from moving to underserved rural areas by continuing to offer 
sub-par pay--in fact, we should be providing incentives to encourage 
them to work in underserved areas. My legislation proposes a project to 
help rural facilities to host educators and clinical practitioners in 
clinical rotations.
  Lack of dollars to rural health facilities has also prevented 
communities from investing in vital information technology. The 
Institute of Medicine published a report in 2005 detailing the ways in 
which health IT could assist isolated communities. For example, since 
rural physicians tend to be generalists rather than specialists, 
virtual libraries within physician offices would provide both doctors 
and patients with a wider and deeper source of information at their 
fingertips. Rural residents can also be quite far from health 
facilities, so technology that allows emergency room physicians to 
communicate with EMS workers in an ambulance can help patients receive 
life-saving treatment before they physically reach the hospital. These 
kinds of technologies will improve both the quality and efficiency of 
care given in rural areas. My legislation offers funding for quality 
improvement demonstration projects, to allow isolated communities to 
invest in this otherwise out of reach technology.
  Lastly, this legislation will end the disproportionately low 
representation of rural interests on the Medicare Payment Advisory 
Commission. This lack of representation has resulted in policies that 
hurt rural communities. Those policies have hurt--and continue to 
hurt--the people of my State of Wisconsin, and they hurt my colleague 
Senator Collins' constituents as well. For every dollar that Medicare 
spends on the average beneficiary in the average state in this country, 
Medicare spends only 82 cents on a beneficiary in Wisconsin. In Maine, 
Medicare spends only 80 cents per dollar it spends on the average 
beneficiary.
  How is this the case, if beneficiaries in Wisconsin and in Maine pay 
the same payroll taxes as beneficiaries in other states? Because the 
distribution of Medicare dollars among the 50 States is grossly unfair 
to Wisconsin, and to much of the Upper Midwest. Wisconsinites pay 
payroll taxes just like every American taxpayer, but the Medicare funds 
we get in return are lower than those received in many other States.
  With the guidance and support of people across my State who are 
fighting for Medicare fairness, I am introducing this legislation to 
address Medicare's discrimination against Wisconsin's seniors and 
health care providers. My bill will decrease some of the inequitable 
payments that harm rural areas. It will provide rural areas the help 
they need to grow crucial health information technology infrastructure. 
It will offer the necessary incentives to help attract the Nation's top 
medical talent to underserved rural areas. It will mandate rural 
representation on the Medicare Payment Advisory Commission. Rural 
seniors are already underserved in their communities; they should not 
be underrepresented in Washington as well.
  Rural Americans have worked hard and paid into the Medicare program 
all their lives. In return, they deserve full access to the same 
benefits as seniors throughout the country: their choice of highly 
skilled physicians, use of the latest technologies, and a strong voice 
representing their needs in Medicare policy.
  Mr. President, 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. 712

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Rural 
     Medicare Equity Act of 2009''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Elimination of geographic physician work adjustment factor from 
              geographic indices used to adjust payments under the 
              physician fee schedule.
Sec. 3. Clinical rotation demonstration project.
Sec. 4. Medicare rural health care quality improvement demonstration 
              projects.
Sec. 5. Ensuring proportional representation of interests of rural 
              areas on the Medicare Payment Advisory Commission.
Sec. 6. Implementation of GAO recommendations regarding geographic 
              adjustment indices under the Medicare physician fee 
              schedule.

     SEC. 2. ELIMINATION OF GEOGRAPHIC PHYSICIAN WORK ADJUSTMENT 
                   FACTOR FROM GEOGRAPHIC INDICES USED TO ADJUST 
                   PAYMENTS UNDER THE PHYSICIAN FEE SCHEDULE.

       (a) Findings.--Congress finds the following:
       (1) Variations in the geographic physician work adjustment 
     factors under section 1848(e) of the Social Security Act (42 
     U.S.C. 1395w-4(e)) result in inequity between localities in 
     payments under the Medicare physician fee schedule.
       (2) Beneficiaries under the Medicare program that reside in 
     areas where such adjustment factors are high have relatively 
     more access to services that are paid based on such fee 
     schedule.
       (3) There are a number of studies indicating that the 
     market for health care professionals has become nationalized 
     and historically low labor costs in rural and small urban 
     areas have disappeared.
       (4) Elimination of the adjustment factors described in 
     paragraph (1) would equalize the reimbursement rate for 
     services reimbursed under the Medicare physician fee schedule 
     while remaining budget-neutral.
       (b) Elimination.--Section 1848(e) of the Social Security 
     Act (42 U.S.C. 1395w-4(e)) is amended--
       (1) in paragraph (1)(A)(iii), by striking ``an index'' and 
     inserting ``for services provided before January 1, 2010, an 
     index''; and

[[Page S3900]]

       (2) in paragraph (2), by inserting ``, for services 
     provided before January 1, 2010,'' after ``paragraph (4)), 
     and''.
       (c) Budget Neutrality Adjustment for Elimination of 
     Geographic Physician Work Adjustment Factor.--Section 1848(d) 
     of the Social Security Act (42 U.S.C. 1395w-4(d)) is 
     amended--
       (1) in paragraph (1)(A), by striking ``The conversion'' and 
     inserting ``Subject to paragraph (10), the conversion''; and
       (2) by adding at the end the following new paragraph:
       ``(10) Budget neutrality adjustment for elimination of 
     geographic physician work adjustment factor.--Before applying 
     an update for a year under this subsection, the Secretary 
     shall (if necessary) provide for an adjustment to the 
     conversion factor for that year to ensure that the aggregate 
     payments under this part in that year shall be equal to 
     aggregate payments that would have been made under such part 
     in that year if the amendments made by section 2(b) of the 
     Rural Medicare Equity Act of 2009 had not been enacted.''.

     SEC. 3. CLINICAL ROTATION DEMONSTRATION PROJECT.

       (a) Establishment.--Not later than 6 months after the date 
     of enactment of this Act, the Secretary shall establish a 
     demonstration project that provides for demonstration grants 
     designed to provide financial or other incentives to 
     hospitals to attract educators and clinical practitioners so 
     that hospitals that serve beneficiaries under the Medicare 
     program under title XVIII of the Social Security Act (42 
     U.S.C. 1395 et seq.) who are residents of underserved areas 
     may host clinical rotations.
       (b) Duration of Project.--The demonstration project shall 
     be conducted over a 5-year period.
       (c) Waiver.--The Secretary shall waive such provisions of 
     titles XI and XVIII of the Social Security Act (42 U.S.C. 
     1301 et seq. and 1395 et seq.) as may be necessary to conduct 
     the demonstration project under this section.
       (d) Reports.--The Secretary shall submit to the appropriate 
     committees of Congress interim reports on the demonstration 
     project and a final report on such project within 6 months 
     after the conclusion of the project, together with 
     recommendations for such legislation or administrative action 
     as the Secretary determines to be appropriate.
       (e) Funding.--Out of any funds in the Treasury not 
     otherwise appropriated, there are appropriated to the 
     Secretary to carry out this section, $20,000,000.
       (f) Definitions.--In this section:
       (1) Hospital.--The term ``hospital'' means a subsection (d) 
     hospital (as defined in section 1886(d)(1)(B) of the Social 
     Security Act (42 U.S.C. 1395ww(d)(1)(B)) that had indirect or 
     direct costs of medical education during the most recent cost 
     reporting period preceding the date of enactment of this Act.
       (2) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services.
       (3) Underserved area.--The term ``underserved area'' means 
     such medically underserved urban areas and medically 
     underserved rural areas as the Secretary may specify.

     SEC. 4. MEDICARE RURAL HEALTH CARE QUALITY IMPROVEMENT 
                   DEMONSTRATION PROJECTS.

       (a) Establishment.--
       (1) In general.--Not later than 6 months after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services (in this section referred to as the ``Secretary'') 
     shall establish not more that 10 demonstration projects to 
     provide for improvements, as recommended by the Institute of 
     Medicine, in the quality of health care provided to 
     individuals residing in rural areas.
       (2) Activities.--Activities under the projects may include 
     public health surveillance, emergency room videoconferencing, 
     virtual libraries, telemedicine, electronic health records, 
     data exchange networks, and any other activities determined 
     appropriate by the Secretary.
       (3) Consultation.--The Secretary shall consult with the 
     Office of Rural Health Policy of the Health Resources and 
     Services Administration, the Agency for Healthcare Research 
     and Quality, and the Centers for Medicare & Medicaid Services 
     in carrying out the provisions of this section.
       (b) Duration.--Each demonstration project under this 
     section shall be conducted over a 4-year period.
       (c) Demonstration Project Sites.--The Secretary shall 
     ensure that the demonstration projects under this section are 
     conducted at a variety of sites representing the diversity of 
     rural communities in the United States.
       (d) Waiver.--The Secretary shall waive such provisions of 
     titles XI and XVIII of the Social Security Act (42 U.S.C. 
     1301 et seq. and 1395 et seq.) as may be necessary to conduct 
     the demonstration projects under this section.
       (e) Independent Evaluation.--The Secretary shall enter into 
     an arrangement with an entity that has experience working 
     directly with rural health systems for the conduct of an 
     independent evaluation of the demonstration projects 
     conducted under this section.
       (f) Reports.--The Secretary shall submit to the appropriate 
     committees of Congress interim reports on each demonstration 
     project and a final report on such project within 6 months 
     after the conclusion of the project. Such reports shall 
     include recommendations regarding the expansion of the 
     project to other areas and recommendations for such other 
     legislative or administrative action as the Secretary 
     determines appropriate.
       (g) Funding.--Out of any funds in the Treasury not 
     otherwise appropriated, there are appropriated to the 
     Secretary to carry out this section, $50,000,000.

     SEC. 5. ENSURING PROPORTIONAL REPRESENTATION OF INTERESTS OF 
                   RURAL AREAS ON THE MEDICARE PAYMENT ADVISORY 
                   COMMISSION.

       (a) In General.--Section 1805(c)(2) of the Social Security 
     Act (42 U.S.C. 1395b-6(c)(2)) is amended--
       (1) in subparagraph (A), by inserting ``consistent with 
     subparagraph (E)'' after ``rural representatives''; and
       (2) by adding at the end the following new subparagraph:
       ``(E) Proportional representation of interests of rural 
     areas.--In order to provide a balance between urban and rural 
     representatives under subparagraph (A), the proportion of 
     members who represent the interests of health care providers 
     and Medicare beneficiaries located in rural areas shall be no 
     less than the proportion, of the total number of Medicare 
     beneficiaries, who reside in rural areas.''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply with respect to appointments made to the Medicare 
     Payment Advisory Commission after the date of the enactment 
     of this Act.

     SEC. 6. IMPLEMENTATION OF GAO RECOMMENDATIONS REGARDING 
                   GEOGRAPHIC ADJUSTMENT INDICES UNDER THE 
                   MEDICARE PHYSICIAN FEE SCHEDULE.

       Not later than 180 days after the date of enactment of this 
     Act, the Secretary of Health and Human Services shall 
     implement the recommendations contained in the March 2005 GAO 
     report 05-119 entitled ``Medicare Physician Fees: Geographic 
     Adjustment Indices are Valid in Design, but Data and Methods 
     Need Refinement.''.
                                 ______
                                 
      By Mr. WEBB (for himself, Mr. Specter, Mr. Reid, Mr. Leahy, Mr. 
        Durbin, Mr. Graham, Mr. Schumer, Mrs. Murray, Mr. Wyden, Mr. 
        Brown, Mr. Warner, Mrs. Gillibrand, Mr. Burris, Mr. Kennedy, 
        Mr. Cardin, and Mrs. McCaskill):
  S. 714. A bill to establish the National Criminal Justice Commission; 
to the Committee on the Judiciary.
  Mr. WEBB. Today I am pleased to be introducing a piece of legislation 
designed to establish a national criminal justice commission. I do so 
with, at the moment, 12 cosponsors, including our majority leader, the 
chairman and the ranking Republican on the Senate Judiciary Committee, 
the chairman and the ranking member of the Judiciary Subcommittee on 
Crime and Drugs, and other members of our leadership. I introduce this 
bill after more than 2 years of effort here in the Senate that I will 
explain shortly; also with the prior conferral with Supreme Court 
Justice Kennedy and having discussed this matter with the President and 
the Attorney General, both of whom I think are strongly supportive of 
this concept.
  Our design, our goal in this legislation, is to create a national 
commission with an 18-month timeline, not to simply talk about the 
problems that we have in our criminal justice system but actually to 
look at all of the elements in this system, how they are interrelated 
in terms of the difficulties that we have in remedying issues of 
criminal justice in this country, and to deliver us from a situation 
that has evolved over time where we are putting far too many of the 
wrong people into prison and we are still not feeling safer in our 
neighborhoods; we are still not putting in prison or bringing to 
justice those people who are perpetrating violence and criminality as a 
way of life.
  I would like to say that, although I am not on the Judiciary 
Committee, I come to this issue as someone who first became interested 
in criminal justice issues while I was serving as a U.S. marine, 
serving on a number of courts-martial and thinking about the 
interrelationship between discipline and fairness; then after that, 
from having spent time as an attorney at one point representing, pro 
bono, a young former marine who had been convicted of murder in 
Vietnam. I represented him for 6 years pro bono. He took his life 
halfway through this process. I cleared his name 3 years later, but I 
became painfully aware of how sometimes inequities infect our process.
  Prior to joining the Senate, I spent time as a journalist, including 
a stint 25 years ago as the first American journalist to have been 
inside the Japanese prison system, where I became aware of the systemic 
difficulties and challenges

[[Page S3901]]

we have. At that time, 25 years ago, Japan was half our population, and 
had only 40,000 sentenced prisoners in jail. We had 480,000. Today, we 
have 2.38 million prisoners in our criminal justice system and another 
5 million involved in the process, either due to probation or parole 
situations.
  This is a system that is very much in need of the right sort of 
overarching examination. I do note the senior Senator from Pennsylvania 
has joined me on the Senate floor. I am very gratified he has also 
joined me as the lead Republican on this measure. I look forward to 
hearing from him as soon as I am finished with my remarks.
  The third thing I would like to say at the outset is, I believe very 
strongly, even though we are a Federal body, that there is a compelling 
national interest for us to examine this issue and reshape and reform 
our criminal justice system at the Federal, State, and local levels. I 
believe the commission I am going to present would provide us with that 
opportunity.
  I start with a premise I do think not a lot of Americans are aware 
of. We have 5 percent of the world's population. We have 25 percent of 
the world's known prison population. We have an incarceration rate in 
the United States, the world's greatest democracy, that is five times 
as high as the incarceration rate in the rest of the world.
  There are only two possibilities. Either we have the most evil people 
on Earth living in the United States or we are doing something 
dramatically wrong in terms of how we approach the issue of criminal 
justice. And I would ask my fellow Senators and my fellow citizens to 
think about the challenges that attend these kind of numbers when we 
are looking at people who have been released from prison and are 
reentering American society.
  We have hundreds and thousands of American people who are reentering 
American society without the sort of transition that would allow a 
great percentage of them to again become productive citizens.
  I think we need to look at this in terms of our own history, our own 
recent history. This is a chart that shows our incarceration rate from 
1925 until today. Beginning in about 1980, our incarceration rate 
started to skyrocket. What has happened since 1980 is not reflective of 
where our own history has been on this issue. That is another need, why 
we need to examine it fuller. We also, for a complex set of reasons, 
are warehousing the mentally ill in our prisons. We now have four times 
as many mentally ill people in our prisons than we do in mental 
institutions. There are a complex set of reasons for that, but the main 
point for all of us to consider is, these people who are in prison are 
not receiving the kind of treatment they would need in order to remedy 
the disabilities that have brought them to that situation.
  Drug incarceration has sharply increased over the past three decades. 
In 1980, we had 41,000 drug offenders in prison. Today we have more 
than 500,000. That is an increase of 112 percent.
  Those blue disks represent the numbers in 1980. The red disks 
represent the numbers in 2007. A significant percent of these 
individuals are incarcerated for possession or nonviolent drug 
offenses, and in many cases, criminal offenses that stem from drug 
addiction and those sorts of related behavioral issues.
  African Americans are about 12 percent of our population. Contrary to 
a lot of thought and rhetoric, their drug use, in terms of frequent 
drug use rate, is about the same as all other elements of our society, 
about 14 percent. But they end up being 37 percent of those arrested on 
drug charges, 59 percent of those convicted, and 74 percent of those 
sentenced to prison, by the numbers that have been provided to us and 
to the Joint Economic Committee. This is a disturbing statistic for us. 
I emphasize to my colleagues and to others that the issues we face with 
respect to criminal justice are not overall racial issues. They involve 
issues, in many cases, of how people are treated based on their ability 
to have proper counsel and other issues like that. But this is a 
statistic with respect to drugs that we all must come to terms with.
  At the same time, I say we are putting too many of the wrong people 
in prison, and we are not solving the problems that will bring safety 
to our communities. Gangs are a hot issue today. I am on the Armed 
Services Committee. I am on the Foreign Relations Committee. There has 
been a lot of back and forth in recent months about the transnational 
gangs that are emanating across the Mexican border. Approximately 1 
million gang members are currently in our country today. And I emphasis 
this is not an issue that is simply existent along the Mexican border. 
This is an issue that affects every community in the United States, and 
it is not simply an issue with respect to the Mexican drug cartels, 
although theirs are the most violent and the most visible today.
  The Mexican drug cartels are operating in more than 230 American 
cities, not simply along the border. The incidents along on the border 
illuminate the largeness of this problem and of this challenge. Gangs 
in many areas of the United States commit 80 percent of the crimes. 
They are heavily involved in drug distribution, but they are involved 
in other violent activities as well.
  There has been some talk over the past few days about how our 
position toward drugs and our gun policies feed this problem. I would 
ask my colleagues to think very hard about that. Drugs are a demand-
pull problem in the United States, there is no question about that. 
There are a lot of weapons that are going back and forth across the 
border. But we should remember the Mexican drug cartels are capable of 
very sophisticated levels of quasi-military violence.
  Many of the members who are brought into the gangs by the drug 
cartels are former Mexican military. Some of them have been trained by 
our own special forces, and the weapons they use are not the kind of 
weapons you are going to buy at a gun show. You do not get automatic 
weapons, RPGs, and grenades at a gun show.
  We have to realize these cartels have a lot of money. By some 
indications they make profit levels of about $25 billion a year. They 
can buy the weapons they want. We have to get on top of this as a 
national priority. Again, it is not simply the transnational gangs that 
come out of Mexico. Many of them are Central American.
  In Northern Virginia, right across the Potomac River, we have 
thousands of members who belong to the MS-13 gangs emanating out of 
Central America, who are very active up the I-95 corridor. There are 
Asian gangs. We have to get our arms around this problem as we address 
the other problem of mass incarceration in the United States.
  Another piece of this issue I hope we will be able to address with 
this national criminal justice commission is what happens inside our 
prisons. When I was looking at the Japanese system many years ago, 
their model in terms of prison administration was basically designed 
after a traditional military model. You could not be a warden in a 
Japanese jail unless you started as a turnkey. They had national 
examinations. They had a year of preparation, training in psychology, 
in counseling techniques, before an individual was allowed to be a 
turnkey in a jail. The promotion systems were internal, like the U.S. 
military. It provided a quality career path, and it brought highly 
trained people in at the very beginning.
  We do not have that in America. Prisons vary warden to warden; they 
vary locality to locality. We need to examine a better way to do that 
in our country.
  We also have a situation in this country with respect to prison 
violence and sexual victimization that is off the charts. We must get 
our arms around this problem.
  We also have many people in our prisons who are among what are called 
the criminally ill, people who are suffering from hepatitis and HIV who 
are not getting the sorts of treatment they deserve.
  I started, once I arrived in the Senate, working on this issue. I was 
pleased to be working with Senator Schumer on the Joint Economic 
Committee. He allowed me to chair hearings to try to get our arms 
around this problem and see what sort of legislative approach might 
help. I chaired a hearing on mass incarceration in October of 2007. I 
chaired another hearing last year on the overall impact of illegal 
drugs from point of origin through the criminal justice system. How 
does this work in terms of the underground

[[Page S3902]]

business environment? How does it work in terms of the disparity in 
treatment of people who end up incarcerated? How does it affect 
people's long-term lives? What are the costs associated with it?
  I was able to work with the George Mason University Law Center to put 
together a forum bringing people in from across the country to talk 
about our overall drug policy. Once we started talking about this, 
particularly over the last year, we started being contacted by people 
all across the country, people from every different aspect of the 
political and the philosophical areas that come into play when we talk 
about incarceration. It is a very emotional issue.
  As I said, I heard from Justice Kennedy at the Supreme Court. I have 
heard from prosecutors, judges, defense lawyers, former offenders, 
people in prison, police on the street. All of them are saying we have 
a mess; we have a mess. We have to get a holistic view of how to solve 
it. There are many good pieces of legislation that have been introduced 
in the Congress to deal with different pieces of this issue. But after 
going through this process over the past year, I have come to the 
conclusion that the way we should address this is with a national 
commission that will examine all of these pieces together and make 
specific findings so we can turn it around.
  These are examples of some of the editorial support that we have 
received. I have written a piece for Parade magazine which will be out 
this weekend to summarize the challenges we have; I hope our fellow 
citizens will take a look at it.
  As to the design of this legislation, we are looking for two things. 
One is to shape a commission with bipartisan balance: the President 
nominating the chairman; the majority and minority leaders in the 
Senate, in consultation with the Judiciary Committee, each nominating 
two members; the Speaker of the House and the House Minority Leader, in 
concert with the Judiciary Committee, each nominating two members; and 
the National Governors Association, Republican and Democrat, each 
getting one member. The idea is not to have a group of people who are 
going to sit around and simply remonstrate about the problem. It is to 
get a group of people with credibility and wide expertise to examine 
specific findings and to come up with policy recommendations on an 18-
month time period.
  This commission will be asked to investigate the reasons in our own 
history that we have seen this incredible increase in incarceration. 
What do other countries do, particularly countries that have the same 
basic governmental systems we do? How do they handle comparable types 
of crime? What should we do about prison administration policies, 
prison management? How can we bring more quality, stability, and 
predictability in terms of the prison environment itself? What are the 
costs of our current incarceration policies, not only in terms of the 
billions of dollars we spend on building prisons or the billions we 
spend on housing people in prisons but also in terms of lost 
opportunities with our post-prison systems, and how we can better 
manage that area. What is the impact of gang activities, including 
these transnational gangs, and how should we approach that issue, not 
simply in terms of incarceration but as a nation that is under duress 
from not being able to respond properly? Importantly, what are we going 
to do about drug policy, the whole area of drug policy, and how does 
that affect sentencing procedures and other alternatives we might look 
at? We need to examine the policies as they relate to the mentally ill. 
We should look at the historical role of the military when it comes to 
how we are approaching these cross-border situations, particularly on 
the Mexican border. Finally, importantly, any other area the Commission 
deems relevant.
  This is our best effort, after 2 years of coming up with the universe 
of issues that need to be examined. There are many people, including 
the senior Senator from Pennsylvania, who have worked on these areas 
for a number of years. If they have specific findings they believe the 
Commission should review, we are very happy to accommodate that.
  The first step for the commission would be to give us findings, 
factual findings. From those findings, then give us recommendations for 
policy changes. The same areas I addressed in terms of findings apply 
in terms of the policy recommendations: How we can refocus our 
incarceration policies, work toward properly reducing the incarceration 
rate in fair, cost-effective ways that still protect communities; how 
we should address the issue of prison violence in all forms; how we can 
improve prison administration; how we can establish meaningful reentry 
programs. I believe with the high volume of people coming out of 
prisons, we must, on a national level, assist local and State 
communities in figuring out a way to transition these people so those 
former offenders who are not going to become recidivists will have a 
true pathway to get away from the stigma of incarceration and move into 
a productive future.
  Again, importantly, the last category, any other aspect of the system 
the Commission or the people participating in it determine necessary.
  This is our approach. I am gratified to have had as initial 
cosponsors six members of the Senate Judiciary Committee, including the 
chairman, Senator Leahy; the ranking Republican, Senator Specter; the 
chairman of the Subcommittee on Crime and Drugs, Senator Durbin; the 
ranking Republican on that subcommittee, Senator Graham; and a number 
of others, including key Democratic leadership--most importantly, our 
leader.
  I hope we can get this legislation done this year. This is an issue 
that does not percolate up in the same way. It doesn't have a 
programmatic element to it in many cases, but it is an issue that 
threatens every community and begs for the notion of fairness.
  I see the senior Senator from Pennsylvania is on the floor. I greatly 
admire the work he has done in this area over many years, and I 
appreciate his support on this endeavor.
  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. I begin by complimenting my distinguished colleague from 
Virginia for his initiative in proposing the creation of a national 
commission to examine criminal justice. There have been many 
Commissions in recent years, recent decades. But the problems which we 
are now confronting warrant a fresh look. Senator Webb has proposed 
that. This Commission has the potential to be not just another 
Commission but to make some very significant advances on this very 
serious problem.
  The principal issue on crime is public security, protection from 
violent criminals. I have long believed the issue could be divided into 
two parts. One is the violent career criminals. They are defined as 
someone who has committed three or more serious crimes. One of the 
first bills which I authored was the armed career criminal bill, which 
was enacted in 1984, which made it a Federal offense punishable by what 
is the equivalent of a life sentence under the Federal system, 15 years 
to life, for anyone caught in possession of a firearm who has committed 
three or more offenses--a robbery, burglary, rape, arson or the sale of 
drugs. Statistics show that about 70 percent of violent crimes are 
committed by career criminals. It is my view, shared by many, that 
those people ought to be sent to jail for life. They ought to be 
separated from society. The second category involves those who have 
been convicted of crimes and who are going to be released. With respect 
to juveniles, we call that juvenile delinquency, at least in 
Pennsylvania we do, as opposed to a criminal charge. They are going to 
be released. First and second offenders are going to be released. The 
object is, how do we deal with them to, No. 1, protect society and, No. 
2, to take them out of the crime cycle so they can have productive, 
contributing lives in society? We know what to do, but we have never 
done it. The steps are to work with those who suffer from drug abuse or 
alcohol abuse. We find that 70 to 80 percent of the people arrested 
have drug or alcohol problems. They have to be treated, detoxification. 
Then they need literacy training. So many cannot read or write. Then 
they need job training so they will have a trade or skill. Then they 
need to be placed in society.
  It is no surprise, when someone who is a functional illiterate, 
without a trade or skill, gets out of jail, that the

[[Page S3903]]

odds are high they will go back to jail. There are a number of programs 
but not enough, not sufficiently carefully thought through, to place 
people. We have tax credits which will encourage employers to hire 
people. In the stimulus package for veterans or juvenile offenders, 
there is a 40-percent tax break on the first $6,000 of a job which is 
paid. That is a start. But it doesn't go very far. We have been 
unwilling to make the kind of investment to provide that kind of 
realistic rehabilitation. Therefore, we have recidivism and the 
revolving door in our jails. The public is the principal loser because 
these people come out and commit more crimes. Individuals are lost. So 
both in terms of the individual on rehabilitation, to have a productive 
role in society, a decent life, and for public safety. Candidly, you 
don't get too far on legislation looking out for the criminals on 
rehabilitation. But when you talk about the threat to society from 
repeat crimes, then people pick up their ears.
  There has been a fascinating debate recently about whether we can 
afford to have a criminal justice system that keeps people in jail and 
protects the public, whether we can afford to have the death penalty 
imposed. Is it too expensive to undertake the litigation process for 
society. I do not think we can make a decision on public safety based 
upon cost. Security is the basic purpose, fundamental first purpose of 
Government. National security on the international scene, protection 
from attacks; now we have a new form of security in terrorism. When we 
come to the domestic scene, it is a matter of having safety on the 
streets. There is a debate as to whether we ought to have the death 
penalty. That is a worthwhile debate. The Supreme Court has been moving 
in a number of areas to limit the application of the death penalty.
  From my experience as district attorney of Philadelphia, I believe 
the death penalty is a deterrent. I questioned FBI Director Mueller 
about it yesterday in the Judiciary oversight hearing. Director Mueller 
thinks the death penalty ought to be retained.
  When I was an assistant DA many years ago, I had a case in the 
Pennsylvania Supreme Court when I was chief of the appeals division. 
There were three young hoodlums, Williams, Caters, and Rivers. They 
were 19, 18, and 17. They planned a robbery. The two younger ones, 
Cater and Rivers, said to Williams, who had a gun: We are not going if 
you take the gun along. They had IQs under 100 but were smart enough to 
know that if a gun was taken, there might be a killing. That would be 
felony murder and they could get the death penalty. Williams said: I 
won't take the gun. He put it in the drawer, slammed it shut. Then, 
unbeknownst to Cater and Rivers, he took the gun back, put it in his 
pocket, went to rob a grocer in north Philadelphia, a tussle ensued. 
Williams pulled the gun and shot and killed a man named Viner. All 
three were sentenced to death in the electric chair. Williams actually 
was executed. This goes back to about 1960. Cater and Rivers got a life 
sentence.
  I argued the case in the State Supreme Court which upheld the death 
penalties and then later, when I was district attorney, I joined in the 
recommendation of a life sentence for Cater and Rivers. The point is 
that even with a marginal IQ, there was a deterrent effect. The 
critical factor in my thinking on their not having the death penalty 
was they didn't want to take the weapon. In the eyes of the law, they 
were as guilty as Williams. They were coconspirators. When you rob and 
a killing ensues, a murder ensues, it is murder in the first degree and 
calls for the death penalty.
  The commission which has been proposed here today ought to take a 
look at white-collar crime, and ought to make an evaluation of the 
sentencing which has been imposed and whether it is adequate. If you 
are dealing with a domestic quarrel, a husband-wife dispute--there are 
many homicides arising in that context--a jail sentence is not a 
deterrent. If you are dealing with white-collar crime, there is a 
deterrent.
  Today, we have--and I questioned FBI Director Mueller about this 
yesterday. He said they have many investigations being undertaken as a 
result of what has happened with corporate fraud, the misrepresentation 
of assets, leading us to the tremendous economic problems which we face 
today. There is no doubt about the deterrent effect. I urged Director 
Mueller to expedite some of the cases.
  There is great public concern about whether there will be 
accountability. I said yesterday--and repeat to--we do not want to send 
anybody to jail who does not deserve to go to jail, but you do not have 
to investigate a case for years and bring forth 100 charges, 100 counts 
of an indictment. It can be done on a much more rapid pace and have an 
appropriate trial and have a result, and it would be important to show 
the example and to show the American people there is accountability.
  When we talk about the jails, the commission ought to make a 
determination as to whether there are people in jail who ought not to 
be in jail. This morning's news has a report about the State of New 
York reexamining sentencing on drug laws. There is a lot of thought 
that the drug laws catch too many people, and many people go to jail 
who ought not to be in jail. Well, that is a question that ought to be 
examined.
  Our whole prison system in Pennsylvania is called a correctional 
system, which is a misnomer. It does not correct people. It does not 
have the facilities to correct people. What they do is warehouse.
  A related issue that considerable work has been done on recently is 
the issue of mentoring. We have some 80,000 at-risk youth in the city 
of Philadelphia, determined by a hearing which was held recently. Those 
at-risk youth can go one of two ways: They can move through the 
education system, if they have proper guidance; or they can be on the 
streets and turn into criminals, as so many of them do.
  Mentoring is a way of providing some guidance. There are so many 
single-parent homes--a working mother, nobody to give guidance. We have 
appropriated federally, recently, $25 million nationally for five 
target cities, one of which is Philadelphia, but that is a very modest 
beginning. But to be a surrogate parent, you have an opportunity. That 
is a subject which a commission ought to undertake.
  Those are some of the ideas which are current in this very complex 
field. In trying to estimate the cost of crime, it is hard to do. My 
own judgment would be, if you put a billion-dollar price figure on the 
cost of robberies, burglaries, corporate fraud, automobile thefts, to 
say nothing about the pain and suffering people have--the anxiety in 
the middle of the night when there is a loud noise in your house; the 
consolation you have, to some extent, from an alarm system that does 
not go too far--but this is a big problem in America, and it is a 
problem which has largely gone unsolved.
  Problems of crime are the same today as they were when I first 
entered the field as an assistant district attorney decades ago. There 
are ways to deal with violent crime. There are ways to deal with 
realistic rehabilitation. There are ways to deal with deterrence on 
white-collar crime--that it ought not to be only a fine, which turns 
out to be a license to do business. In the confirmation hearing of the 
new Assistant Attorney General for the Criminal Division, that point 
was emphasized.
  But what Senator Webb has had to say today, and the blueprint he has 
outlined, could be a major advance on a very complex problem, which 
needs a--I was about to say ``solution,'' but there is not going to be 
a solution--but there can be an enormous amelioration if we tackle the 
problem with the guidance that could be provided by the Webb 
commission. May I give it the name: The Webb commission? Hearing no 
objection, so ordered.
  The PRESIDING OFFICER. The Senator from Virginia.
  Mr. WEBB. I wish to express my appreciation to the senior Senator 
from Pennsylvania for joining me on this legislation and in this 
endeavor because it will be an endeavor, as the Senator knows, well 
beyond the legislative approval of the commission. I think this is 
going to take years. But I wish to express my appreciation for that, 
for his comments today, and for all the work he has done in this field.
  I wish to emphasize a couple of things, in reaction to what the 
Senator mentioned. I agree. I do believe we can

[[Page S3904]]

meaningfully address this problem. And ``solution'' is perhaps a more 
illusive word. But we can certainly meaningfully address this problem. 
I think it is very important to say that it is in the interest of every 
American we do so.
  There are a lot of people who will look at this and talk about 
specific elements of who has committed a crime and whether you should 
do the time and these sorts of things, but we do need to sort it out. 
When we have 5 percent of the world's population and 25 percent of the 
world's prison population, there are better ways. When we still have 
public safety issues in every community because of gang violence, and 
particularly transnational gang violence at this moment, there are 
better ways.
  That is the purpose of having a commission: getting the greatest 
minds in this area in the country together, with a specific timeline, 
to bring us specific findings and recommendations for the entire gamut 
of criminal justice in the country--not simply incarceration, not 
simply gang violence, not simply reentry--but all of those and other 
issues together, so we can have a much needed and long overdue 
restructuring of how we address the issue of crime in this country.
  I ask unanimous consent that Senator Kennedy be added as an original 
cosponsor on this bill.
  The PRESIDING OFFICER. Without objection, it is so ordered.
                                 ______
                                 
      By Mr. LEVIN (for himself, Ms. Snowe, Ms. Stabenow, Ms. Collins, 
        and Mr. Schumer):
  S. 715. A bill to establish a pilot program to provide for the 
preservation and rehabilitation of historic lighthouses; to the 
Committee on Energy and Natural Resources.
  Mr. LEVIN. Mr. President, today, with Senators Snowe, Stabenow, 
Collins and Schumer, I introduce The National Lighthouse Stewardship 
Act. This legislation creates a three-year competitive grant program at 
the Department of the Interior that will help to pay for the 
preservation and rehabilitation of historic lighthouses in Michigan and 
across the country. The grants will help nonprofit organizations, which 
serve as caretakers for these historic landmarks, to help them preserve 
and rehabilitate the historic lighthouses and keep them accessible to 
the public.
  This legislation complements a bill that was enacted in October 2000, 
the National Historic Lighthouse Preservation Act, which I joined Sen. 
Frank Murkowski in offering. With the Coast Guard getting out of the 
lighthouse business, the National Historic Lighthouse Preservation Act 
helped facilitate the process of transferring historic lighthouses from 
the government to non-profit historical organizations who would take 
over the responsibility for their care. It established an expedited 
process through the Government Services Agency to help ease lighthouse 
transfers by helping to cut through the bureaucratic red tape. As a 
result of the law, 46 lighthouses to date--9 in Michigan--have been 
transferred to custodians who will preserve them and keep them 
accessible to the public.
  Many of these lighthouse structures are in need of significant repair 
and rehabilitation, which is now the responsibility of their nonprofit 
custodians. Unfortunately, after obtaining custody of the lighthouses, 
many of the nonprofit organizations have struggled to raise the funds 
to adequately restore and maintain the lighthouses. To address this 
problem our legislation establishes a pilot program that would enable 
state and nonprofit groups to apply for competitive grants to help with 
restoration and maintenance efforts. This pilot program would authorize 
the secretary to distribute $20 million a year for 3 years.
  Funding for Lighthouse restoration is important to Michigan and to 
the Nation's historic preservation efforts. There are approximately 740 
lighthouses in 31 coastal states. Michigan alone has over 120 
lighthouses, more than any other State. They draw thousands of visitors 
to Michigan and other States each year and create jobs throughout our 
States. Michigan's and the Nation's lighthouses are national treasures 
that beautify our shorelines. These historic lighthouses are part of 
our Nation's rich maritime heritage. The grants are needed to help 
nonprofit organizations, which serve as caretakers for the historic 
landmarks, to maintain the beauty of the lighthouses and keep them 
accessible to the public.
  My office worked closely with lighthouse preservation groups in 
drafting this legislation. The Michigan Lighthouse Fund in my home 
state was invaluable in providing information on the needs of our 
Nation's lighthouses. This week in Washington, the American Lighthouse 
Coordinating Committee is meeting to coincide with the introduction of 
this act. These funds are desperately needed by these groups who work 
tirelessly to preserve our Nation's maritime heritage.
  This funding would help ensure our lighthouses remain cultural 
beacons for generations to come. America's lighthouses are national 
treasures that we cannot let deteriorate to the point beyond repair. I 
hope my colleagues will support the swift enactment of the National 
Lighthouse Stewardship Act.
  Mr. President, I ask unanimous consent that letters of support be 
printed in the Record.
  There being no objection, the material was ordered to be placed in 
the Record, as follows:

                                               American Lighthouse


                                       Coordinating Committee,

                                     Evanston, IL, March 26, 2009.
       Members of the United States Senate: I'm writing to urge 
     your support of the National Lighthouse Stewardship Act of 
     2009 as introduced by Senators Levin and Stabenow (MI), and 
     Snowe (ME).
       Since passage of the National Lighthouse Preservation Act 
     of 2000, responsibility for management of many historic 
     lighthouses has been transferred from the US Coast Guard to 
     the public sector. While these facilities remain the property 
     of the federal government, the cost for their preservation 
     and programming is borne by local government and nonprofit 
     organizations with very limited economic resources. As a 
     result, these agencies require assistance in meeting the 
     demands of maintaining historic lighthouses so that they are 
     safe and accessible. The proposed National Lighthouse 
     Stewardship Act of 2009 recognizes the important role of this 
     new generation of administrative organizations in properly 
     managing these facilities. And, it provides a means by which 
     some dedicated funding is made available from the US 
     Government to support projects that will maintain structural 
     integrity.
       Since this transfer program began, historic lighthouses 
     still brighten our lives and are now adaptively used for many 
     different purposes that include museums and centers of 
     education for the interpretation of U.S. maritime history; as 
     facilities to aid in environmental research of oceans and 
     Great Lakes; and to promote local and regional tourism. This 
     has resulted in an overwhelmingly positive public response 
     and is testimony to Americans' desire to preserve and use 
     these built resources.
       Passage of the National Lighthouse Stewardship Act of 2009 
     is essential to the continued success of this federal 
     transfer program and mirrors public sentiment for the 
     preservation of historic lighthouse properties to benefit 
     public interests.
       The American Lighthouse Coordinating Committee (ALCC) is a 
     consortium of organizations and individuals across the United 
     States that actively engage in the operation of historic 
     lighthouse properties and which strongly supports adoption of 
     this legislation.
       Respectfully submitted, this 26th day of March 2009.
                                                 Donald J. Terras,
     President.
                                  ____



                                 Michigan Lighthouse Alliance,

                                                   March 20, 2009.
     Senator Carl Levin,
     Russell Office Building,
     U.S. Senate, Washington, DC.
       Dear Senator Levin: We are writing to you in support of 
     your bill to redirect the nominal port fees towards 
     lighthouse restoration grant programs. The amount of money 
     your office has identified that could be coming to those of 
     us on the front lines of the restoration effort would make a 
     huge difference in the quality of our work.
       Most lighthouses are located in out of the way places. As 
     such, the number of people living around these remote 
     structures is limited, and thus the local funding available 
     for work is limited. It is difficult to keep the numbers of 
     volunteers and find resources for materials in such a 
     challenging situation.
       But to see a large increase in the available grant funds 
     not only in our home state of Michigan, but throughout the 
     US, would surely help us get these wonderful icons of our 
     collective maritime history restored and ready for the next 
     generations to learn from and support as well. Being able to 
     attract the next generations of stewards is a constant 
     subject of conversation in our circles, and having sufficient 
     funding available to make this volunteer effort attractive 
     would really help out.
       In addition, MLA would like to make a request. As you know 
     things are very tight in our state budget now, and it would 
     be extremely helpful for us if a small part of our state 
     allocation could go towards a full time MLA staff person who 
     could support the grant program by visiting our members and

[[Page S3905]]

     reaching out with education on how to fill out the grant 
     requests, and other technical support. Right now our Alliance 
     is all volunteer as well, and we love what we do, but often 
     lament the loss of the staff person we had at MI SHPO. As the 
     representative voice now for all of Michigan's lighthouse 
     groups, we can be much more supportive and effective if we 
     had funding for a full time staffer.
       Thank you as always for all you have done to advance the 
     lighthouse movement in Michigan and throughout the country. 
     You can count on the MLA and it's dozens of member groups and 
     their volunteers to be behind you on this bill, just ask for 
     what help you need!
           Sincerely,
         Buzz Hoerr, President, Harbor Beach Lighthouse 
           Preservation; Lou Schillinger, Vice President, Port 
           Austin Reef Light Association; Sally Frye, Sec'y/
           Treasurer, Fox Point Lighthouse Association; Ann Method 
           Green, DeTour Reef Light Preservation Society; John 
           Gronberg, Holland Harbor Lighthouse Historical 
           Commission; Dick Moehl, Great Lakes Lightkeepers 
           Association; Jeff Shook, Michigan Lighthouse 
           Conservancy; Susan Skibbe, Thunder Bay Island; Gail 
           Vander Stoep, Michigan State University.

  Ms. SNOWE. Mr. President, I rise in support of the National 
Lighthouse Stewardship Act, which will create a 3-year competitive 
grant program to be administered by the Department of the Interior that 
will help preserve and rehabilitate historic lighthouses across the 
country.
  In my State of Maine, we are lucky to be home to 83 lighthouses. 
Further, there are approximately 740 lighthouses in 31 other States. 
The Coast Guard has not traditionally had the resources to maintain the 
lighthouses which are now being transferred under the National 
Lighthouse Preservation Act from Federal ownership to non-profit 
historical societies who have taken on the responsibility. Helping to 
provide the resources necessary to ensure these lighthouses are not 
lost would be a boost to both tourism and jobs. Failure to do so would 
potentially harm not only the existence of an historic emblem of my 
State and our Nation--but also a key economic catalyst for tourism that 
is part and parcel of my home State and the livelihood of many of her 
citizens.
  Each lighthouse tells a different story and each one is as integral 
to the history and narrative of our State as the magnificent landscapes 
on which they proudly stand. That is why in 1995, I introduced a bill 
that would later become law to establish the Maine Lights Program. We 
succeeded in preserving this significant component of American heritage 
through collaboration among the Federal Government, the State of Maine, 
local communities, and private organizations, while at the same time, 
relieving what had become a costly strain on the U.S. Coast Guard.
  Across the country, responsibility for the care of our lighthouses 
has been assumed by non-profit historic societies--many of which are 
struggling in these uncertain economic times. This bill would authorize 
$20 million for a three-year competitive grant pilot program that would 
provide grants to stewards of historic lighthouses to help them 
preserve and rehabilitate the lighthouses under their care.
  I believe that the essential word in my previous sentence is 
``stewards''--because the structures are still federally owned 
property. It is not private property; it is not city or town property, 
or even state property; but federal property. It is also imperative to 
note that these lighthouses are operable aids to navigation. 
Lighthouses may seem a quaint relic of a bygone era, however they are 
not. Daily, lighthouses lead our nation's mariners and fishermen away 
from danger.
  Given that the maintenance of lighthouses is now being transferred 
under the National Lighthouse Preservation Act from Federal ownership 
to non-profit historical societies, the task of providing the required 
resources to ensure the longevity and viability of these lighthouses 
would also represent a welcomed economic boost both to tourism and to 
job creation.
  The fact is, tourism has become increasingly crucial to Maine's 
economy, as manufacturing jobs have fled our State, not to mention our 
Nation. In fact, in 2006, the most recent year for which statistics are 
available, approximately 1/5 of State sales tax revenues were 
attributable to tourism, and, when income and fuel taxes are added, the 
Maine State government collected $429 million tourism-related tax 
dollars in that year.
  The Maine State Planning Office, which has quantified more precisely 
the pivotal role tourism plays in the Maine economy, found that in 
2006, tourism generated $10 billion in sales of goods and services, 
140,000 jobs, and $3 billion in earnings. Tourism accounts for one in 
five dollars of sales throughout Maine's economy and supported the 
equivalent of one in six Maine jobs. The planning office also 
discovered that an estimated 10 million overnight trips and 30 million 
day trips were taken that year in Maine, with travelers spending nearly 
$1 billion on lodging, $3 billion on food, and $1 billion on 
recreational activities.
  But those statistics are from 3 years ago . . . before the economy 
began to unravel at an accelerating rate, and so given these economic 
times confronting all of us, the financial necessity of our 
lighthouses, especially to tourism, has grown, not dissipated.
  I urge my colleagues to support this bill and send a message not only 
that historic preservation of our Nation's prominent buildings and 
structures--like our lighthouses--continues to be in the national 
interest, but also that tourism--especially international tourism--is 
an industry we should be striving to support as a key component of 
reviving our ailing economy.
                                 ______
                                 
      By Mr. KENNEDY (for himself, Mrs. Hutchison, and Mrs. Feinstein):
  S. 717. A bill to modernize cancer research, increase access to 
preventative cancer services, provide cancer treatment and survivorship 
initiatives, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. KENNEDY. Mr. President, 37 years ago, a Republican President and 
Democratic Congress came together in a new commitment to find a cure 
for cancer. At the time, a cancer diagnosis meant almost certain death. 
In 1971, we took action against this deadly disease and passed the 
National Cancer Act with broad bipartisan support, and it marked the 
beginning of the War on Cancer.
  Since then, significant progress has been made. Amazing scientific 
research has led to methods to prevent cancer, and treatments that give 
us more beneficial and humane ways to deal with the illness. The 
discoveries of basic research, the use of large scale clinical trials, 
the development of new drugs, and the special focus on prevention and 
early detection have led to breakthroughs unimaginable only a 
generation ago.
  As a result, cancer today is no longer the automatic death sentence 
that it was when the war began. But despite the advances we have made 
against cancer, other changes such as aging of the population, emerging 
environmental issues, and unhealthy behavior, have allowed cancer to 
persist. The lives of vast numbers of Americans have been touched by 
the disease. In 2008, over 1.4 million Americans were diagnosed with 
some form of cancer, and more than half a million lost their lives to 
the disease.
  The solution is not easy but there are steps we can and must take 
now, if we hope to see the diagnosis rate decline substantially and the 
survival rate increase in the years ahead. The immediate challenge we 
face is to reduce the barriers that obstruct progress in cancer 
research and treatment by integrating our current fragmented and 
piecemeal system of addressing the disease.
  Last year, my colleague Senator Hutchison and I agreed that to build 
on what the nation has accomplished, we must launch a new and more 
urgent war on cancer. The 21st Century Cancer ALERT Act we are 
introducing today will accelerate our progress by using a better 
approach to fighting this relentless disease. Our goal is to break down 
the many barriers that impede cancer research and prevent patients from 
obtaining the treatment that can save their lives.
  We must do more to prevent cancer, by emphasizing scientifically 
proven methods such as tobacco cessation, healthy eating, and exercise. 
Healthy families and communities that have access to nutritious foods 
and high quality preventive health care will be our best defense 
against the disease. I

[[Page S3906]]

am confident that swift action on national health reform will make our 
vision of a healthier Nation a reality. Obviously, we cannot prevent 
all cancers, so it is also essential that the cancers that do arise be 
diagnosed at an initial, curable stage, with all Americans receiving 
the best possible care to achieve that goal.
  We cannot overemphasize the value of the rigorous scientific efforts 
that have produced the progress we have made so far. To enhance these 
efforts, our bill invests in two key aspects of cancer research--
infrastructure and collaboration of the researchers. We include 
programs that will bring resources to the types of cancer we least 
understand. We invest in scientists who are committed to translating 
basic research into clinical practice, so that new knowledge will be 
brought to the patients who will most benefit from it.
  One of the most promising new breakthroughs is in identifying and 
monitoring the biomarkers that leave enough evidence in the body to 
alert clinicians to subtle signs that cancer may be developing. 
Biomarkers are the new frontier for improving the lives of cancer 
patients because they can lead to the earliest possible detection of 
cancer, and the Cancer ALERT Act will support the development of this 
revolutionary biomarker technology.
  In addition, we give new focus to clinical trials, which have been 
the cornerstones of our progress in treating cancer in recent decades. 
Only through clinical trials are we able to discover which treatments 
truly work. Today, however, less than 5 percent of cancer patients 
currently are enrolled in clinical trials, because of the many barriers 
exist that prevent both providers and patients from participating in 
these trials. A primary goal of our bill is to begin removing these 
barriers and expanding access to clinical trials for many more 
patients.
  Further, since many cancer survivors are now living longer lives, our 
health systems must be able to accommodate these men and women who are 
successfully fighting against this deadly disease. It is imperative for 
health professionals to have the support they need to care for these 
survivors. To bring good lifelong care to cancer survivors, we must 
invest more in research to understand the later effects of cancer and 
how treatments affect survivors' health and the quality of their lives.
  We stand today on the threshold of unprecedented new advances in this 
era of extraordinary discoveries in the life sciences, especially in 
personalized medicine, early diagnosis of cancer at the molecular 
level, and astonishing new treatments based on a patient's own DNA. To 
make the remarkable promise of this new era a reality, we must make 
sure that patients can take DNA tests, free of the fear that their 
genetic information will somehow be used to discriminate against them. 
We took a major step toward unlocking the potential of this new era by 
approving strong protections against genetic discrimination in health 
insurance and employment when the Genetic Nondiscrimination Act was 
signed into law last year.
  In sum, we need a new model for research, prevention and treatment of 
cancer, and we are here today to start that debate in Congress. We must 
move from a magic bullet approach to a broad mosaic of care, in which 
survivorship is also a key part of our approach to cancer. By doing so, 
we can take a giant step toward reducing or even eliminating the burden 
of cancer in our Nation and the world. It is no longer an impossible 
dream, but a real possibility for the future.
  Mr. President, I ask by 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. 717

       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 ``21st Century Cancer ALERT 
     (Access to Life-Saving Early detection, Research and 
     Treatment) Act''.

     SEC. 2. FINDINGS AND PURPOSE.

       (a) Findings.--Congress makes the following findings:
       (1) One in 2 men and one in 3 women are expected to develop 
     cancer in their lifetimes.
       (2) Cancer is the leading cause of death for people under 
     the age of 85 and is expected to claim more than 1,500 lives 
     per day in 2008.
       (3) At least 30 percent of all cancer deaths and 87 percent 
     of lung cancer deaths are attributed to smoking.
       (4) The National Institutes of Health estimates that in 
     2007 alone, the overall cost of cancer to the United States 
     was more than $219,000,000,000.
       (5) In recent decades, the biomedical research enterprise 
     has made considerable advances in the knowledge required to 
     understand, prevent, diagnose, and treat cancer; however, it 
     still takes 17 years, on average, to translate these 
     discoveries into viable treatment options.
       (6) While clinical trials are vital to the discovery and 
     implementation of new preventative, diagnostic, and treatment 
     options, only 3 to 5 percent of the more than 10,000,000 
     adults with cancer in the United States participate in cancer 
     clinical trials.
       (7) Where people reside should not determine whether they 
     live, yet women in rural areas are less likely to obtain 
     preventative cancer screenings than those residing in urban 
     areas.
       (8) Two-thirds of childhood cancer survivors are likely to 
     experience at least one late effect from treatment and one-
     fourth are expected to experience a late effect that is life 
     threatening.
       (9) In 1971, there were only 3,000,000 cancer survivors. 
     Today, cancer survivors account for 3 percent of the United 
     States population, approximately 12,000,000.
       (10) The National Cancer Act of 1971 (Public Law 92-218) 
     advanced the ability of the United States to develop new 
     scientific leads and help increase the rate of cancer 
     survivorship.
       (11) Yet in the 37 years since the national declaration of 
     the War on Cancer, the age adjusted mortality rate for cancer 
     is still extraordinarily high. Eight forms of cancer have a 
     5-year survival rate of less than 50 percent (pancreatic, 
     liver, lung, esophageal, stomach, brain, multiple myeloma, 
     and ovarian).
       (12) While there have been substantial achievements since 
     the crusade began, we are far from winning the war on cancer.
       (13) Many obstacles have hindered our progress in cancer 
     prevention, research, and treatment.
       (b) Purposes.--The purposes of this Act are as follows:
       (1) To reauthorize the National Cancer Institute and 
     National Cancer Program in order to enhance and improve the 
     cancer research conducted and supported by the National 
     Cancer Institute and the National Cancer Program in order to 
     benefit cancer patients.
       (2) To recognize that with an increased understanding of 
     cancer as more than 200 different diseases with genetic and 
     molecular variations, there is a need for increased 
     coordination and greater flexibility in how cancer research 
     is conducted and coordinated in order to maximize the return 
     the United States receives on its investment in such 
     research.
       (3) To prepare for the looming impact of an aging 
     population of the United States and the anticipated financial 
     burden associated with medical treatment and lost 
     productivity, along with the toll of human suffering that 
     accompanies a cancer diagnosis.
       (4) To support the National Cancer Institute in 
     establishing relationships and scientific consortia with an 
     emphasis on public-private partnership development, which 
     will further the development of advanced technologies that 
     will improve the prevention, diagnosis, and treatment of 
     cancer.

     SEC. 3. ADVANCEMENT OF THE NATIONAL CANCER PROGRAM.

       Section 411 of the Public Health Service Act (42 U.S.C. 
     285a) is amended to read as follows:

     ``SEC. 411. NATIONAL CANCER PROGRAM.

       ``(a) In General.--There shall be established a National 
     Cancer Program (referred to in this section as the `Program') 
     that shall consist of--
       ``(1) an expanded, intensified, and coordinated cancer 
     research program encompassing the research programs conducted 
     and supported by the Institute and the related research 
     programs of the other national research institutes, including 
     an expanded and intensified research program for the 
     prevention of cancer caused by occupational or environmental 
     exposure to carcinogens; and
       ``(2) the other programs and activities of the Institute.
       ``(b) Collaboration.--In carrying out the Program--
       ``(1) the Secretary and the Director of the Institute shall 
     identify relevant Federal agencies that shall collaborate 
     with respect to activities conducted under the Program 
     (including the Institute, the other Institutes and Centers of 
     the National Institutes of Health, the Office of the Director 
     of the National Institutes of Health, the Food and Drug 
     Administration, the Centers for Medicare & Medicaid Services, 
     the Centers for Disease Control and Prevention, the 
     Department of Defense, the Department of Energy, the Agency 
     for Healthcare Research and Quality, the Office for Human 
     Research Protections, the Health Resources and Services 
     Administration, and the Office for Human Research 
     Protections); and
       ``(2) the Secretary shall ensure that the policies related 
     to the promotion of cancer research of all agencies within 
     the Department of Health and Human Services (including the 
     Institute, the Food and Drug Administration, and the Centers 
     for Medicare & Medicaid Services) are harmonized, and shall

[[Page S3907]]

     ensure that such agencies collaborate with regard to cancer 
     research and development.
       ``(c) Transparency and Efficiency.--
       ``(1) Budgeting.--In carrying out the Program, the Director 
     of the Institute shall, in preparing and submitting to the 
     President the annual budget estimate for the Program--
       ``(A) develop the budgetary needs of the entire Program and 
     submit the budget estimate relating to such needs to the 
     National Cancer Advisory Board for review prior to submitting 
     such estimate to the President; and
       ``(B) submit such budget estimate to the Committee on the 
     Budget and the Committee on Appropriations of the Senate and 
     the Committee on the Budget and Committee on Appropriations 
     of the House of Representatives at the same time that such 
     estimate is submitted to the President.
       ``(2) National cancer advisory board.--In establishing the 
     priorities of the Program, the National Cancer Advisory Board 
     shall provide for increased coordination by increasing the 
     participation of representatives (to the extent practicable, 
     representatives who have appropriate decision making 
     authority) of appropriate Federal agencies, including--
       ``(A) the Centers for Medicare & Medicaid Services;
       ``(B) the Health Resources and Services Administration;
       ``(C) the Centers for Disease Control and Prevention; and
       ``(D) the Agency for Healthcare Research and Quality.
       ``(d) Programs to Encourage Early Detection Research.--The 
     Director of the Institute shall develop a standard process 
     through which Federal agencies, including the Department of 
     Defense, and administrators of federally funded programs may 
     engage in early cancer detection research.
       ``(e) Identification of Promising Translational Research 
     Opportunities.--
       ``(1) In general.--The Director of the Institute, acting 
     through the Program and in accordance with the NIH Reform Act 
     of 2007, shall continue to identify promising translational 
     research opportunities across all disease sites, populations, 
     and pathways to clinical goals through a transparent, 
     inclusive process by--
       ``(A) continuing to support efforts to develop a robust 
     number of public or nonprofit entities to carry out early 
     translational research activities;
       ``(B) emphasizing the role of the young researcher in the 
     program under this section; and
       ``(C) modifying guidelines for multiproject, collaborative, 
     early translational research awards to focus research and 
     reward collaborative team science.
       ``(2) Matching funds for research.--
       ``(A) In general.--The Secretary may provide assistance to 
     eligible entities to match the amount of non-Federal funds 
     made available by such entity for translational research of 
     the type described in paragraph (1) relating to cancer.
       ``(B) Eligibility.--To be eligible to receive assistance 
     under subparagraph (A), an entity shall submit to the 
     Secretary an application at such time, in such manner, and 
     containing such information as the Secretary may require.
       ``(C) Recommendations and prioritization.--In providing 
     assistance under subparagraph (A), the Secretary shall--
       ``(i) select entities based on the recommendations of--

       ``(I) the Director of NIH; and
       ``(II) a peer review process; and

       ``(ii) give priority to those entities submitting 
     applications under subparagraph (B) that demonstrate that the 
     research involved is high risk or translational research (as 
     determined by the Secretary).
       ``(D) Amount.--The amount of assistance to be provided to 
     an entity under subparagraph (A) shall be at the discretion 
     of the Secretary but shall not exceed an amount equal to 100 
     percent of the amount of non-Federal funds ($1 for each $2 of 
     non-Federal funds) made available for research described in 
     subparagraph (A).
       ``(E) Determination of amount of non-federal 
     contribution.--Non-Federal funds to be matched under 
     subparagraph (A) may be in cash or in kind, fairly evaluated, 
     including plant, equipment, or services. Amounts provided by 
     the Federal Government, and any portion of any service 
     subsidized by the Federal Government, may not be included in 
     determining the amount of such non-Federal funds.
       ``(f) Biological Resource Coordination and Advancement of 
     Technologies for Cancer Research.--
       ``(1) Establishment.--The Director of the Institute, acting 
     through the Program, shall establish an entity within the 
     Institute to augment ongoing efforts to advance new 
     technologies in cancer research, support the national 
     collection of tissues for cancer research purposes, and 
     ensure the quality of tissue collection.
       ``(2) Goals.--The entity established under paragraph (1) 
     shall--
       ``(A) be designed to expand the access of researchers to 
     biospecimens for cancer research purposes;
       ``(B) establish uniform standards for the handling and 
     preservation of patient tissue specimens by entities 
     participating in the network established under paragraph (3);
       ``(C) require adequate annotation of all relevant clinical 
     data while assuring patient privacy;
       ``(D) facilitate the linkage of public and private entities 
     into the national network under paragraph (3);
       ``(E) provide for the linkage of cancer registries to other 
     administrative Federal Government data sources, including the 
     Centers for Medicare & Medicaid Services, the Social Security 
     Administration, and the Centers for Disease Control and 
     Prevention, with the goal of understanding the determinants 
     of cancer treatment, care, and outcomes by allowing economic, 
     social, genetic, and other factors to be analyzed in an 
     independent manner; and
       ``(F) develop strategies to ensure patient rights and 
     privacy, including an assessment of the regulations 
     promulgated pursuant to part C of title XI of the Social 
     Security Act and section 264(c) of the Health Insurance 
     Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2 
     note) (referred to in this section as the `HIPAA Privacy 
     Rule'), while facilitating advances in medical research.
       ``(3) Advancement of new technologies for cancer research 
     and expansion of cancer biorepository networks.--
       ``(A) In general.--As part of the entity established under 
     paragraph (1), the Director of the Institute shall build upon 
     existing initiatives to establish an interconnected network 
     of biorepositories (referred to in this subsection as the 
     `Network') with consistent, interoperable systems for the 
     collection and storage of tissues and information, the 
     annotation of such information, and the sharing of such 
     information through an interoperable information system.
       ``(B) Guidelines.--A biorepository in the Network that 
     receives Federal funds shall adopt the Institute's Best 
     Practices for Biospecimen Resources for Institute-supported 
     biospecimen resources (as published by the Institute and 
     including any successor guidelines) for the collection of 
     biospecimens and any accompanying data.
       ``(C) Representation.--The composition of any leadership 
     entity of the Network shall be determined by the Director of 
     the Institute and shall, at a minimum, include a 
     representative of--
       ``(i) private sector entities and individuals, including 
     cancer researchers and health care providers;
       ``(ii) the Centers for Disease Control and Prevention;
       ``(iii) the Agency for Healthcare Research and Quality;
       ``(iv) the Office of National Coordination of Health 
     Information Technology;
       ``(v) the National Library of Medicine;
       ``(vi) the Office for the Protection of Research Subjects; 
     and
       ``(vii) the National Science Foundation.
       ``(D) Partnerships with tissue source sites.--The Director 
     of the Institute may enter into contracts with tissue source 
     sites to acquire data from such sites. Any such data shall be 
     acquired through the use of protocols and closely monitored, 
     transparent procedures within appropriate ethical and legal 
     frameworks.
       ``(4) Collection of data.--
       ``(A) Hospitals.--A hospital or ambulatory cancer center 
     that receives Federal funds shall offer patients the 
     opportunity to contribute their biospecimens and clinical 
     data to the entity established under paragraph (1).
       ``(B) Clinical trial data.--Clinical trial data relating to 
     cancer care and treatment shall be provided to the entity 
     established under paragraph (1).''.

     SEC. 4. COMPREHENSIVE AND RESPONSIBLE ACCESS TO RESEARCH, 
                   DATA, AND OUTCOMES.

       (a) In General.--Not later than 180 days after the date of 
     enactment of this Act, the Director of the Office for Human 
     Research Protections shall issue guidance to National 
     Institutes of Health grantees concerning use of the 
     facilitated review process in conjunction with the central 
     institutional review board of the National Cancer Institute 
     as the preferred mechanism to satisfy regulatory requirements 
     to review ethical or scientific issues for all National 
     Cancer Institute-supported translational and clinical 
     research.
       (b)  Improved Privacy Standards in Clinical Research.--
       (1) Permitted disclosure under the privacy rule.--For 
     purposes of the Privacy Rule (as referred to in section 
     411(f)(2)(F) of the Public Health Service Act, as amended by 
     this Act), a covered entity (as defined for purposes of such 
     Rule) shall be in compliance with such Rule relating to the 
     disclosure of de-identified patient information if such 
     disclosure is--
       (A) pursuant to a waiver that had been granted by an 
     institutional review board or privacy board relating to such 
     disclosure; and
       (B) the entity informs patients when they make first 
     patient contact with the entity that the entity is a research 
     institution that may conduct research using their de-
     identified medical records.
       (2) Synchronization of standards.--
       (A) In general.--The Secretary of Health and Human Services 
     shall study the advantages and disadvantages of the 
     synchronization of the standards for research under the 
     Common Rule (under part 46 of title 45, Code of Federal 
     Regulations) and the Privacy Rule (as defined in section 
     411(f)(2)(F) of the Public Health Service Act, as amended by 
     this Act) in order to determine the appropriate data elements 
     that should be omitted under the strict de-identification 
     standards relating to personal information.

[[Page S3908]]

       (B) Review of recommendations.--In carrying out 
     subparagraph (A), the Secretary of Health and Human Services 
     shall conduct a review of recommendations made by the 
     Advisory Committee on Human Research Protections as well as 
     recommendations from the appropriate leadership of the 
     National Committee on Vital and Health Statistics.
       (C) Additional areas.--In carrying out subparagraph (A), 
     the Secretary of Health and Human Services shall--
       (i) make recommendations concerning the conduct of 
     international research to determine the boundaries and 
     applications of extraterritorially under the Privacy Rule (as 
     referred to in section 411(f)(2)(F) of the Public Health 
     Service Act, as amended by this Act); and
       (ii) include biorepository storage information when 
     obtaining patient consent.
       (D) Report.--Not later than 180 days after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall submit to the appropriate committee of 
     Congress, a report concerning the recommendations made under 
     this paragraph.
       (3) Application of privacy rule to external researchers.--
       (A) In general.--Notwithstanding any other provision of 
     law, the Privacy Rule (as defined in section 411(f)(2)(F) of 
     the Public Health Service Act, as amended by this Act) shall 
     apply to external researchers.
       (B) Definition.--
       (i) In general.--In this paragraph, the term ``external 
     researcher'' means a researcher who is on the staff of a 
     covered entity (as defined in the Privacy Rule) but who is 
     not actually employed by such covered entity.
       (ii) Internal and external researchers.--With respect to 
     determining the distinction of whether or not a researcher 
     has the ability to use protected health information under the 
     provisions of this paragraph, such determination shall be 
     based on whether the covered entity involved exercises 
     effective control over that researcher's activities. For 
     purposes of the preceding sentence, effective control may 
     include membership and privileges of staff or the ability to 
     terminate staff membership or discipline staff.
       (c) Liability.--The Director of the Office of Human 
     Research Protection, the Director of the National Institutes 
     of Health, and the Director of the National Cancer Institute 
     shall issue guidance for entities awarded grants by such 
     Federal agencies to provide instruction on how such entities 
     may best address concerns or issues relating to the liability 
     that institutions or researchers may incur as a result of 
     using the facilitated review process.

     SEC. 5. ENHANCED FOCUS AND REPORTING ON CANCER RESEARCH.

       Part C of title IV of the Public Health Service Act (42 
     U.S.C. 285 et seq.) is amended by inserting after section 
     417A the following:

     ``SEC. 417B. ENHANCED FOCUS AND REPORTING ON CANCER RESEARCH.

       ``(a) Annual Independent Report.--
       ``(1) In general.--The Director of the Institute shall 
     complete an annual independent report that shall be submitted 
     to Congress on the same date that the annual budget estimate 
     described in section 413(b)(9) is submitted to the President.
       ``(2) Contents of report.--
       ``(A) Cancer categories.--The report required under 
     paragraph (1) shall address the following categories of 
     cancer:
       ``(i) Cancers that result in a 5-year survival rate of less 
     than 50 percent.
       ``(ii) Cancers in which the incidence rate is less than 15 
     cases per 100,000 people, or fewer than 40,000 new cases per 
     year.
       ``(B) Information.--With regard to each of the categories 
     of cancer described in subparagraph (A), the report shall 
     contain information regarding--
       ``(i) a strategic plan for reducing the mortality rate for 
     the annual year, including specific research areas of 
     interest and budget amounts;
       ``(ii) identification of any barriers to implementing the 
     strategic plan described in clause (i) for the annual year;
       ``(iii) if the report for the prior year contained a 
     strategic plan described in clause (i), an assessment of the 
     success of such plan;
       ``(iv) the total amount of grant funding, including the 
     total dollar amount awarded per grant and per funding year, 
     under--

       ``(I) the National Cancer Institute; and
       ``(II) the National Institutes of Health;

       ``(v) the percentage of grant applications favorably 
     reviewed by the Institute that the Institute funded in the 
     previous annual year;
       ``(vi) the total number of grant applications, with greater 
     than 50 percent relevance to each of the categories of cancer 
     described in subparagraph (A), received by the Institute for 
     awards in the previous annual year;
       ``(vii) the total number of grants awarded, with greater 
     than 50 percent relevance to each of the categories of cancer 
     described in subparagraph (A), for the previous annual year 
     and the number of awards per grant type, including the Common 
     Scientific Outline designation specific to each such grant; 
     and
       ``(viii) the total number of primary investigators that 
     received grants from the Institute for projects with greater 
     than 50 percent relevance to each of the categories of cancer 
     described in paragraph (1), including the total number of 
     awards granted to experienced investigators and the total 
     number of awards granted to investigators receiving their 
     first grant from the National Institutes of Health.
       ``(3) Definition.--In this section, the term `annual year' 
     means the year for which the strategic plan described in 
     paragraph (2)(B)(i) applies, which shall be the same fiscal 
     year for which the Director of the Institute submits the 
     annual budget estimate described in section 413(b)(9) for 
     that year.
       ``(b) Grant Program.--
       ``(1) In general.--The Director of the Institute, in 
     cooperation with the Director of the Fogarty International 
     Center for Advanced Study in the Health Sciences and the 
     Directors of other Institutes, as appropriate, shall award 
     grants to researchers to conduct research regarding cancers 
     for which--
       ``(A) the incidence is fewer than 40,000 new cases per 
     year; and
       ``(B) the 5-year survival rate is less than 50 percent.
       ``(2) Prioritization.--In awarding grants for research 
     regarding cancers described in paragraph (1)(A), the Director 
     of the Institute shall give priority to collaborative 
     research projects between adult and pediatric cancer 
     research, with preference for projects building upon existing 
     multi-institutional research infrastructures.
       ``(3) Tissue samples.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     the Director of the Institute shall require each recipient 
     receiving a grant under this subsection to submit tissue 
     samples to designated tumor banks.
       ``(B) Waiver.--The Director of the Institute may grant a 
     waiver of the requirement described in subparagraph (A) to a 
     recipient who receives a grant for research described in 
     paragraph (1)(B) and who submits an application for such 
     waiver to the Director of the Institute, in the manner in 
     which such Director may require.''.

     SEC. 6. CONTINUING ACCESS TO CARE FOR PREVENTION AND EARLY 
                   DETECTION.

       (a) Colorectal Cancer Screening Program.--Part B of title 
     III of the Public Health Service Act is amended by inserting 
     after section 317D (42 U.S.C. 247b-5) the following:

     ``SEC. 317D-1. COLORECTAL CANCER SCREENING PROGRAM.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     may award competitive grants to eligible entities to carry 
     out programs--
       ``(1) to provide screenings for colorectal cancer to 
     individuals according to screening guidelines set by the 
     United States Preventive Services Task Force;
       ``(2) to provide appropriate referrals for medical 
     treatment of individuals screened pursuant to paragraph (1) 
     and to ensure, to the extent practicable, the provision of 
     appropriate follow-up services and support services such as 
     case management;
       ``(3) to develop and disseminate public information and 
     education programs for the detection and control of colon 
     cancer;
       ``(4) to improve the education, training, and skills of 
     health professionals (including allied health professionals) 
     in the detection and control of colon cancer;
       ``(5) to establish mechanisms through which eligible 
     entities can monitor the quality of screening procedures for 
     colon cancer, including the interpretation of such 
     procedures; and
       ``(6) to evaluate activities conducted under paragraphs (1) 
     through (5) through appropriate surveillance or program-
     monitoring activities.
       ``(b) Eligibility.--
       ``(1) In general.--To be eligible to receive a grant under 
     this section an entity shall--
       ``(A) be--
       ``(i) a State; or
       ``(ii) an Indian tribe or tribal organization (as such 
     terms are defined in section 4 of the Indian Self-
     Determination and Education Assistance Act);
       ``(B) submit to the Secretary as application, at such time, 
     in such manner, and containing such information as the 
     Secretary may require, including--
       ``(i) a description of the purposes for which the entity 
     intends to expend amounts under the grant; and
       ``(ii) a description of the populations, areas, and 
     localities with a need for the services or activities 
     described in clause (i);
       ``(C) provide matching funds in accordance with paragraph 
     (2);
       ``(D) provide assurances that the entity will--
       ``(i) establish such fiscal control and fund accounting 
     procedures as may be necessary to ensure the proper disbursal 
     of, and accounting for, amounts received under subsection 
     (a);
       ``(ii) upon request, provide records maintained pursuant to 
     clause (i) to the Secretary or the Comptroller General of the 
     United States for purposes of auditing the expenditures of 
     the grant by the eligible entity; and
       ``(iii) submit to the Secretary such reports as the 
     Secretary may require with respect to the grant; and
       ``(E) provide assurances that the entity will comply with 
     the restrictions described in subsection (e).
       ``(2) Matching requirement.--
       ``(A) In general.--The Secretary may not award a grant to 
     an eligible entity under this section unless the eligible 
     entity involved agrees, with respect to the costs to be 
     incurred by the eligible entity in carrying out the purpose 
     described in the application under paragraph (1)(B)(i), to 
     make available non-Federal contributions (in cash or in kind 
     under subparagraph (B)) toward such costs in an amount equal 
     to not less than $1 for each $3 of Federal funds provided in 
     the grant.

[[Page S3909]]

     Such contributions may be made directly or through donations 
     from public or private entities.
       ``(B) Determination of amount of non-federal 
     contribution.--
       ``(i) In general.--Non-Federal contributions required in 
     subparagraph (A) may be in cash or in kind, fairly evaluated, 
     including equipment or services (and excluding indirect or 
     overhead costs). Amounts provided by the Federal Government, 
     or services assisted or subsidized to any significant extent 
     by the Federal Government, may not be included in determining 
     the amount of such non-Federal contributions.
       ``(ii) Maintenance of effort.--In making a determination of 
     the amount of non-Federal contributions for purposes of 
     subparagraph (A), the Secretary may include only non-Federal 
     contributions in excess of the average amount of non-Federal 
     contributions made by the eligible entity involved toward the 
     purpose described in subsection (a) for the 2-year period 
     preceding the first fiscal year for which the eligible entity 
     is applying to receive a grant under such section.
       ``(iii) Inclusion of relevant non-federal contributions for 
     medicaid.--In making a determination of the amount of non-
     Federal contributions for purposes of subparagraph (A), the 
     Secretary shall, subject to clauses (i) and (ii), include any 
     non-Federal amounts expended pursuant to title XIX of the 
     Social Security Act by the eligible entity involved toward 
     the purpose described in paragraphs (1) and (2) of subsection 
     (a).
       ``(c) Prioritization.--
       ``(1) In general.--In awarding grants under this section, 
     the Secretary shall give priority to recipients that are 
     safety-net providers.
       ``(2) Definition.--In this section, the term `safety-net 
     provider' means a health care provider--
       ``(A) that by legal mandate or explicitly adopted mission, 
     offers care to individuals without regard to the individual's 
     ability to pay for such services; or
       ``(B) for whom a substantial share of the patients are 
     uninsured, receive Medicaid, or are otherwise vulnerable.
       ``(d) Use of Funds.--
       ``(1) In general.--An eligible entity may, subject to 
     paragraphs (2) and (3), expend amounts received under a grant 
     under subsection (a) to carry out the purposes described in 
     such subsection through the awarding of grants to public and 
     nonprofit private entities and through contracts entered into 
     with public and private entities.
       ``(2) Certain application.--If a nonprofit private entity 
     and a private entity that is not a nonprofit entity both 
     submit applications to a grantee under subsection (a) for a 
     grant or contract as provided for in paragraph (1), the 
     grantee may give priority to the application submitted by the 
     nonprofit private entity in any case in which the grantee 
     determines that the quality of such application is equivalent 
     to the quality of the application submitted by the other 
     private entity.
       ``(3) Payments for screenings.--The amount paid by a 
     grantee under subsection (a) to an entity under this 
     subsection for a screening procedure as described in 
     subsection (a)(1) may not exceed the amount that would be 
     paid under part B of title XVIII of the Social Security Act 
     if payment were made under such part for furnishing the 
     procedure to an individual enrolled under such part.
       ``(e) Restriction on Use of Fund.--The Secretary may not 
     award a grant to an eligible entity under subsection (a) 
     unless the entity agrees that--
       ``(1) in providing screenings under subsection (a)(1), the 
     eligible entity will give priority to low-income individuals 
     who lack adequate coverage under health insurance and health 
     plans with respect to screenings for colorectal cancer;
       ``(2) initially and throughout the period during which 
     amounts are received pursuant to the grant, not less than 60 
     percent of the grant shall be expended to provide each of the 
     services or activities described in subsections (a)(1) and 
     (a)(2);
       ``(3) not more than 10 percent of the grant will be 
     expended for administrative expenses with respect to the 
     activities funded under the grant;
       ``(4) funding received under the grant will supplement, and 
     not supplant, the expenditures of the eligible entity and the 
     value for in-kind contributions for carrying out the 
     activities for which the grant was awarded;
       ``(5) funding will not be expended to make payment for any 
     item or service to the extent that payment has been made, or 
     can reasonably be expected to be made, with respect to such 
     item or service--
       ``(A) under any State compensation program, under an 
     insurance policy, or under any Federal or State health 
     benefits program; or
       ``(B) by an entity that provides health services on a 
     prepaid basis; and
       ``(6) funds will not be expended to provide inpatient 
     hospital services for any individual.
       ``(f) Limitation on Imposition of Fees for Services.--The 
     Secretary may not award a grant to an eligible entity under 
     this section unless the eligible entity involved agrees that, 
     if a charge is imposed for the provision of services or 
     activities under the grant, such charge--
       ``(1) will be made according to a schedule of charges that 
     is made available to the public;
       ``(2) will be adjusted to reflect the income of the 
     individual involved; and
       ``(3) will not be imposed on any individual with an income 
     of less than 100 percent of the official poverty line, as 
     established by the Director of the Office of Management and 
     Budget and revised by the Secretary in accordance with 
     section 673(2) of the Community Services Block Grant Act (42 
     U.S.C. 9902(2)), including any revision required by such 
     section.
       ``(g) Requirement Regarding Medicare.--The Secretary may 
     not award a grant to an eligible entity under this section 
     unless the eligible entity involved provides, as applicable, 
     the following assurances:
       ``(1) Screenings under subsection (a)(1) will be carried 
     out as preventive health measures in accordance with 
     evidence-based screening guidelines and procedures as 
     specified in section 1861(pp)(1) of the Social Security Act.
       ``(2) An individual will be considered high risk for 
     purposes of subsection (a)(1) only if the individual is high 
     risk within the meaning of section 1861(pp)(2) of such Act.
       ``(h) Requirement Regarding Medicaid.--The Secretary may 
     not award a grant to an eligible entity under subsection (a) 
     unless the State plan under title XIX of the Social Security 
     Act for the State includes the screening procedures and 
     referrals specified in subsections (a)(1) and (a)(2) as 
     medical assistance provided under the plan.
       ``(i) Technical Assistance and Provision of Supplies and 
     Services in Lieu of Grant Funds.--
       ``(1) Technical assistance.--The Secretary may provide 
     training and technical assistance with respect to the 
     planning, development, and operation of any program funded by 
     a grant under subsection (a). The Secretary may provide such 
     technical assistance directly to eligible entities or through 
     grants to, or contracts with, public and private entities.
       ``(2) Provision of supplies and services in lieu of grant 
     funds.--
       ``(A) In general.--Subject to subparagraph (B), upon the 
     request of an eligible entity receiving a grant under 
     subsection (a), the Secretary, for the purpose of aiding the 
     eligible entity to carry out a program under this section--
       ``(i) may provide supplies, equipment, and services to the 
     eligible entity; and
       ``(ii) may detail to the eligible entity any officer or 
     employee of the Department of Health and Human Services.
       ``(B) Corresponding reduction in payments.--With respect to 
     a request made by an eligible entity under subparagraph (A), 
     the Secretary shall reduce the amount of payments made under 
     the grant under subsection (a) to the eligible entity by an 
     amount equal to the fair market value of any supplies, 
     equipment, or services provided by the Secretary and the 
     costs of detailing personnel (including pay, allowances, and 
     travel expenses) under subparagraph (A). The Secretary shall, 
     for the payment of expenses incurred in complying with such 
     request, expend the amounts withheld.
       ``(j) Evaluations and Report.--
       ``(1) Evaluations.--The Secretary shall, directly or 
     through contracts with public or private entities, provide 
     for annual evaluations of programs carried out pursuant to 
     this section. Such evaluations shall include evaluations of 
     the extent to which eligible entities carrying out such 
     programs are in compliance with subsection (a)(2).
       ``(2) Report to congress.--The Secretary shall, not later 
     than 1 year after the date on which amounts are first 
     appropriated to carry out this section, and annually 
     thereafter, submit to Congress, a report summarizing 
     evaluations carried out pursuant to paragraph (1) during the 
     preceding fiscal year and making such recommendations for 
     administrative and legislative initiatives with respect to 
     this section as the Secretary determines to be 
     appropriate.''.
       (b) Optional Medicaid Coverage of Certain Persons Screened 
     and Found to Have Colorectal Cancer.--
       (1) Coverage as optional categorically needy group.--
       (A) In general.--Section 1902(a)(10)(A)(ii) of the Social 
     Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
       (i) in subclause (XVIII), by striking ``or'' at the end;
       (ii) in subclause (XIX), by adding ``or'' at the end; and
       (iii) by adding at the end the following:
       ``(XX) who are described in subsection (gg) (relating to 
     certain persons screened and found to need treatment from 
     complications from screening or have colorectal cancer);''.
       (B) Group described.--Section 1902 of the Social Security 
     Act (42 U.S.C. 1396a) is amended by adding at the end the 
     following:
       ``(gg) Individuals described in this subsection are 
     individuals who--
       ``(1) are not described in subsection (a)(10)(A)(i);
       ``(2) have not attained age 65;
       ``(3) have been screened for colorectal cancer and need 
     treatment for complications due to screening or colorectal 
     cancer; and
       ``(4) are not otherwise covered under creditable coverage, 
     as defined in section 2701(c) of the Public Health Service 
     Act.''.
       (C) Limitation on benefits.--Section 1902(a)(10) of the 
     Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in 
     the matter following subparagraph (G)--
       (i) by striking ``and (XIV)'' and inserting ``(XIV)''; and
       (ii) by inserting ``, and (XV) the medical assistance made 
     available to an individual described in subsection (gg) who 
     is eligible

[[Page S3910]]

     for medical assistance only because of subparagraph 
     (A)(10)(ii)(XX) shall be limited to medical assistance 
     provided during the period in which such an individual 
     requires treatment for complications due to screening or 
     colorectal cancer'' before the semicolon.
       (D) Conforming amendments.--Section 1905(a) of the Social 
     Security Act (42 U.S.C. 1396d(a)) is amended in the matter 
     preceding paragraph (1)--
       (i) in clause (xii), by striking ``or'' at the end;
       (ii) in clause (xiii), by adding ``or'' at the end; and
       (iii) by inserting after clause (xiii) the following:

       ``(xiv) individuals described in section 1902(gg),''.

       (2) Presumptive eligibility.--
       (A) In general.--Title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.) is amended by inserting after section 
     1920B the following:


   ``optional application of presumptive eligibility provisions for 
                 certain persons with colorectal cancer

       ``Sec. 1920C.  A State may elect to apply the provisions of 
     section 1920B to individuals described in section 1902(gg) 
     (relating to certain colorectal cancer patients) in the same 
     manner as such section applies to individuals described in 
     section 1902(aa) (relating to certain breast or cervical 
     cancer patients).''.
       (B) Conforming amendments.--
       (i) Section 1902(a)(47) of the Social Security Act (42 
     U.S.C. 1396a(a)(47)) is amended--

       (I) by striking ``and'' after ``section 1920'' and 
     inserting a comma;
       (II) by striking ``and'' after ``with such section'' and 
     inserting a comma; and
       (III) by inserting before the semicolon at the end the 
     following: ``, and provide for making medical assistance 
     available to individuals described in section 1920C during a 
     presumptive eligibility period in accordance with such 
     section''.

       (ii) Section 1903(u)(1)(d)(v) of such Act (42 U.S.C. 
     1396b(u)(1)(d)(v)) is amended--

       (I) by striking ``or for'' and inserting ``, for''; and
       (II) by inserting before the period the following: ``, or 
     for medical assistance provided to an individual described in 
     section 1920C during a presumptive eligibility period under 
     such section''.

       (3) Enhanced match.--The first sentence of section 1905(b) 
     of the Social Security Act (42 U.S.C. 1396d(b)) is amended--
       (A) by striking ``and'' before ``(4)''; and
       (B) by inserting before the period at the end the 
     following: ``, and (5) the Federal medical assistance 
     percentage shall be equal to the enhanced FMAP described in 
     section 2105(b) with respect to medical assistance provided 
     to individuals who are eligible for such assistance only on 
     the basis of section 1902(a)(10)(A)(ii)(XX)''.
       (4) Effective date.--The amendments made by this subsection 
     apply to medical assistance for items and services furnished 
     on or after the date that is 1 year after the date of 
     enactment of this Act, without regard to whether final 
     regulations to carry out such amendments have been 
     promulgated by such date.
       (c) Mobile Medical Van Grant Program.--
       (1) In general.--The Secretary of Health and Human Services 
     (referred to in this subsection as the ``Secretary''), acting 
     through the Administrator of the Health Resources and 
     Services Administration, shall award grants to eligible 
     entities for the development and implementation of a mobile 
     medical van program that shall provide cancer screening 
     services that receive an ``A'' or ``B'' recommendation by the 
     U.S. Preventative Services Task Force of the Agency for 
     Healthcare Research and Quality to communities that are 
     underserved and suffer from barriers to access to high 
     quality cancer prevention care.
       (2) Eligible entities.--To be eligible to receive a grant 
     under paragraph (1), and entity shall--
       (A) be a consortium of public and private entities (such as 
     academic medical centers, universities, hospitals, and non 
     profit organizations);
       (B) submit to the Secretary an application at such time, in 
     such manner, and containing such information as the Secretary 
     shall require, including--
       (i) a description of the manner in which the applicant 
     intends to use funds received under the grant;
       (ii) a description of the manner in which the applicant 
     will evaluate the impact and effectiveness of the health care 
     services provided under the program carried out under the 
     grant;
       (iii) a plan for sustaining activities and services funded 
     under the grant after Federal support for the program has 
     ended;
       (iv) a plan for the referral of patients to other health 
     care facilities if additional services are needed;
       (v) a protocol for the transfer of patients in the event of 
     a medical emergency;
       (vi) a plan for advertising the services of the mobile 
     medical van to the communities targeted for health care 
     services; and
       (vii) a plan to educate patients about the availability of 
     federally funded medical insurance programs for which such 
     patients, or their children, may qualify; and
       (C) agree that amounts under the grant will be used to 
     supplement, and not supplant, other funds (including in-kind 
     contributions) used by the entity to carry out activities for 
     which the grant is awarded.
       (3) Use of funds.--An entity shall use amounts received 
     under a grant under this subsection to do any of the 
     following:
       (A) Purchase or lease a mobile medical van.
       (B) Make repairs and provide maintenance for a mobile 
     medical van.
       (C) Purchase or lease telemedicine equipment that is 
     reasonable and necessary to operate the mobile medical van.
       (D) Purchase medical supplies and medication that are 
     necessary to provide health care services on the mobile 
     medical van.
       (E) Retain medical professionals with expertise and 
     experience in providing cancer screening services to 
     underserved communities to provide health care services on 
     the mobile medical van.
       (4) Matching requirements.--
       (A) In general.--With respect to the costs of a mobile 
     medical van program to be carried out under a grant under 
     this subsection, the grantee shall make available (directly 
     or through donations from public or private entities) non-
     Federal contributions toward such costs in an amount that is 
     not less than the amount of the Federal funds provided under 
     this grant.
       (B) Determination of amount contributed.--Non-Federal 
     contributions required under subparagraph (A) may be in cash 
     or in kind, fairly evaluated, including plant, equipment, or 
     services. Amounts provided by the Federal Government, or 
     services assisted or subsidized to any significant extent by 
     the Federal Government, may not be included in determining 
     the amount of such non-Federal contributions.
       (C) Waiver.--The Secretary may waive the requirement 
     established in subparagraph (A) if--
       (i) the Secretary determines that such waiver is justified; 
     and
       (ii) the Secretary publishes the rationale for such waiver 
     in the Federal Register.
       (D) Return of funds.--An entity that receives a grant under 
     this section that fails to comply with subparagraph (A) shall 
     return to the Secretary an amount equal to the difference 
     between--
       (i) the amount provided under the grant; and
       (ii) the amount of matching funds actually provided by the 
     grantee.
       (5) Considerations in making grants.--In awarding grants 
     under this subsection, the Secretary shall give preference to 
     eligible entities--
       (A) that will provide cancer screening services in 
     underserved areas; and
       (B) that on the date on which the grant is awarded, have a 
     mobile medical van that is nonfunctioning due to the need for 
     necessary mechanical repairs.
       (6) Limitation on duration and amount of grant.--A grant 
     under this subsection shall be for a 2-year period, except 
     that the Secretary may waive such limitation and extend the 
     grant period by an additional year. The amount awarded to an 
     entity under such grant for a fiscal year shall not exceed 
     $200,000.
       (7) Evaluation.--Not later than 1 year after the date on 
     which a grant awarded to an entity under this subsection 
     expires, the entity shall submit to the Secretary the results 
     of an evaluation to be conducted by the entity concerning the 
     effectiveness of the program carried out under the grant.
       (8) Report.--Not later than 18 months after grants are 
     first awarded under this subsection, the Secretary shall 
     submit to the Committee on Appropriations of the Senate and 
     the Committee on Appropriations of the House of 
     Representatives a report on the results of activities carried 
     out with amounts received under such grants.
       (9) Definitions.--In this section:
       (A) Mobile medical van.--The term ``mobile medical van'' 
     means a mobile vehicle that is equipped to provide non-urgent 
     medical services and health care counseling to patients in 
     underserved areas.
       (B) Underserved area.--The term ``underserved area'', with 
     respect to the location of patients receiving medical 
     treatment, means a ``medically underserved community'' as 
     defined in section 799B(6) of the Public Health Service Act 
     (42 U.S.C. 295p(6)).
       (d) Access to Prevention and Early Detection for Certain 
     Cancers.--
       (1) Cancer genome atlas.--The Secretary of Health and Human 
     Services, acting through the National Cancer Institute, shall 
     provide for the inclusion of cancers with survival rates of 
     less than 25 percent at 5 years in the Cancer Genome Atlas.
       (2) Phase in.--The Director of the National Cancer 
     Institute shall phase in the participation of cancers 
     described in paragraph (1) in the Cancer Genome Atlas 
     Consortium.
       (3) Working groups.--The Secretary of Health and Human 
     Services, acting through the National Cancer Institute, shall 
     establish formal working groups for cancers with survival 
     rates of less than 25 percent at 5 years within the Early 
     Detection Research Network.
       (4) Computer assisted diagnostic, surgical, treatment and 
     drug testing innovations to reduce mortality from cancers.--
     The Director of the National Institute of Biomedical Imaging 
     and Bioengineering shall ensure that the Quantum Grant 
     Program and the Image Guided Interventions programs expedite 
     the development of computer assisted diagnostic, surgical, 
     treatment and drug testing innovations to reduce mortality 
     from cancers with survival rates of less than 25 percent at 5 
     years.

[[Page S3911]]

     SEC. 7. EARLY RECOGNITION AND TREATMENT OF CANCER THROUGH USE 
                   OF BIOMARKERS.

       (a) Promotion of the Discovery and Development of 
     Biomarkers.--
       (1) In general.--The Secretary of Health and Human Services 
     (referred to in this section as the ``Secretary''), in 
     consultation with appropriate Federal agencies including the 
     National Institutes of Health, the National Cancer Institute, 
     the Food and Drug Administration, and the National Institute 
     of Standards and Technology, and extramural experts as 
     appropriate, shall establish and coordinate a program to 
     award contracts to eligible entities to support the 
     development of innovative biomarker discovery technologies. 
     All activities under this section shall be consistent with 
     and complement the ongoing efforts of the Oncology Biomarker 
     Qualification Initiative and the Reagan-Udall Foundation of 
     the Food and Drug Administration.
       (2) Lead agency.--Not later than 2 years after the date of 
     enactment of this Act, the Secretary shall designate a lead 
     Federal agency to administer and coordinate the program 
     established under paragraph (1).
       (3) Eligibility.--To be eligible to enter into a contract 
     under paragraph (1), an entity shall submit to the Secretary 
     an application at such time, in such manner, and containing 
     such information as the Secretary may require. Such 
     information shall be sufficient to enable the Secretary to--
       (A) promote the scientific review of such contracts in a 
     timely fashion; and
       (B) contain the capacity to perform the necessary analysis 
     of contract applications, including determinations as to the 
     intellectual expertise of applicants.
       (4) Requirement.--In awarding contracts under this 
     subsection, the lead agency shall consider whether the 
     research involved will result in the development of 
     quantifiable biomarkers of cell signaling pathways that will 
     have the broadest applicability across different tumor types 
     or different diseases.
       (5) International consortia.--The Secretary shall designate 
     one of the Federal entities described in paragraph (1) to 
     establish an international private-public consortia to 
     develop and share methods and precompetitive data on the 
     validation and qualification of cancer biomarkers for 
     specific uses.
       (b) Clinical Study Guidelines.--Not later than 1 year after 
     the date of enactment of this Act, the Commissioner of Food 
     and Drugs, the Administrator of the Centers for Medicare & 
     Medicaid Services, and the Director of the National Cancer 
     Institute shall jointly develop guidelines for the conduct of 
     clinical studies designed to generate clinical data relating 
     to cancer care and treatment biomarkers that is adequate for 
     review by each such Federal entity. Such guidelines shall be 
     designed to assist in optimizing clinical study design and to 
     strengthen the evidence base for evaluations of studies 
     related to cancer biomarkers.
       (c) Demonstration Project.--
       (1) In general.--The Secretary, in consultation with the 
     Commissioner of Food and Drugs and the Administrator of the 
     Agency for Healthcare Research and Quality, shall carry out a 
     demonstration project that provides for a limited regional 
     assessment of biomarker tests to facilitate the controlled 
     and limited use of a risk assessment measure with an 
     intervention that may consist of a biomarker test.
       (2) Procedures.--As a component of the demonstration 
     project under paragraph (1), the Commissioner of Food and 
     Drugs, in consultation with other relevant agencies, shall 
     establish procedures that independent research entities shall 
     follow in conducting high quality assessments of efficacy of 
     biomarker tests.
       (d) Postmarket Surveillance.--The Food and Drug 
     Administration and the Centers for Medicare & Medicaid 
     Services shall assess quality and accuracy of biomarker tests 
     through appropriate postmarket surveillance and other means, 
     as necessary and appropriate to the mission of each such 
     agency.
       (e) Sense of the Senate.--It is the sense of the Senate 
     that the Commissioner of Food and Drugs and the Director of 
     the National Cancer Institute should continue to place high 
     priority upon the identification and use of biomarkers to--
       (1) determine the role of genetic polymorphisms on drug 
     activity and toxicity;
       (2) establish effective strategies for selecting patients 
     for treatment with specific drugs; and
       (3) identify early biomarkers of clinical benefit.
       (f) Definition.--In this section, the term ``biomarker'' 
     means any characteristic that can be objectively measured and 
     evaluated as an indicator of normal biologic processes, 
     pathogenic processes, or pharmacological responses to 
     therapeutic interventions.

     SEC. 8. CANCER CLINICAL TRIALS.

       (a) Coverage for Individuals Participating in Approved 
     Cancer Clinical Trials.--
       (1) ERISA amendment.--Subpart B of part 7 of subtitle B of 
     title I of the Employee Retirement Income Security Act of 
     1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end 
     the following:

     ``SEC. 715. COVERAGE FOR INDIVIDUALS PARTICIPATING IN 
                   APPROVED CANCER CLINICAL TRIALS.

       ``(a) Coverage.--
       ``(1) In general.--If a group health plan (or a health 
     insurance issuer offering health insurance coverage in 
     connection with the plan) provides coverage to a qualified 
     individual (as defined in subsection (b)), the plan or 
     issuer--
       ``(A) may not deny the individual participation in the 
     clinical trial referred to in subsection (b)(2);
       ``(B) subject to subsection (c), may not deny (or limit or 
     impose additional conditions on) the coverage of routine 
     patient costs for items and services furnished in connection 
     with participation in the trial; and
       ``(C) may not discriminate against the individual on the 
     basis of the individual's participation in such trial.
       ``(2) Exclusion of certain costs.--For purposes of 
     paragraph (1)(B), subject to subparagraph (B), routine 
     patient costs include all items and services consistent with 
     the coverage provided in the plan (or coverage) that is 
     typically covered for a qualified individual who is not 
     enrolled in a clinical trial and that was not necessitated 
     solely because of the trial, except--
       ``(A) the investigational item, device or service, itself; 
     or
       ``(B) items and services that are provided solely to 
     satisfy data collection and analysis needs and that are not 
     used in the direct clinical management of the patient.
       ``(3) Use of in-network providers.--If one or more 
     participating providers is participating in a clinical trial, 
     nothing in paragraph (1) shall be construed as preventing a 
     plan or issuer from requiring that a qualified individual 
     participate in the trial through such a participating 
     provider if the provider will accept the individual as a 
     participant in the trial.
       ``(b) Qualified Individual Defined.--For purposes of 
     subsection (a), the term `qualified individual' means an 
     individual who is a participant or beneficiary in a group 
     health plan and who meets the following conditions:
       ``(1)(A) The individual has been diagnosed with cancer.
       ``(B) The individual is eligible to participate in an 
     approved clinical trial according to the trial protocol with 
     respect to treatment of such illness.
       ``(2) Either--
       ``(A) the referring health care professional is a 
     participating health care provider and has concluded that the 
     individual's participation in such trial would be appropriate 
     based upon the individual meeting the conditions described in 
     paragraph (1); or
       ``(B) the participant or beneficiary provides medical and 
     scientific information establishing that the individual's 
     participation in such trial would be appropriate based upon 
     the individual meeting the conditions described in paragraph 
     (1).
       ``(c) Limitations on Coverage.--This section shall not be 
     construed to require a group health plan, or a health 
     insurance issuer in connection with a group health plan, to 
     provide benefits for routine patient care services provided 
     outside of the plan's (or coverage's) health care provider 
     network unless out-of-network benefits are otherwise provided 
     under the plan (or coverage).
       ``(d) Approved Clinical Trial Defined.--
       ``(1) In general.--In this section, the term `approved 
     clinical trial' means a phase I, phase II, phase III, or 
     phase IV clinical trial that relates to the prevention and 
     treatment of cancer (including related symptoms) and is 
     described in any of the following subparagraphs:
       ``(A) Federally funded trials.--The study or investigation 
     is approved or funded (which may include funding through in-
     kind contributions) by one or more of the following:
       ``(i) The National Institutes of Health.
       ``(ii) The Centers for Disease Control and Prevention.
       ``(iii) The Agency for Health Care Research and Quality.
       ``(iv) The Centers for Medicare & Medicaid Services.
       ``(v) cooperative group or center of any of the entities 
     described in clauses (i) through (iv) or the Department of 
     Defense or the Department of Veterans Affairs.
       ``(vi) A qualified non-governmental research entity 
     identified in the guidelines issued by the National 
     Institutes of Health for center support grants.
       ``(vii) Any of the following if the conditions described in 
     paragraph (2) are met:

       ``(I) The Department of Veterans Affairs.
       ``(II) The Department of Defense.
       ``(III) The Department of Energy.

       ``(B) The study or investigation is conducted under an 
     investigational new drug application reviewed by the Food and 
     Drug Administration.
       ``(C) The study or investigation is a drug trial that is 
     exempt from having such an investigational new drug 
     application.
       ``(2) Conditions for departments.--The conditions described 
     in this paragraph, for a study or investigation conducted by 
     a Department, are that the study or investigation has been 
     reviewed and approved through a system of peer review that 
     the Secretary determines--
       ``(A) to be comparable to the system of peer review of 
     studies and investigations used by the National Institutes of 
     Health, and
       ``(B) assures unbiased review of the highest scientific 
     standards by qualified individuals who have no interest in 
     the outcome of the review.
       ``(e) Construction.--Nothing in this section shall be 
     construed to limit a plan's or issuer's coverage with respect 
     to clinical trials.

[[Page S3912]]

       ``(f) Preemption.--Notwithstanding any other provision of 
     this Act, nothing in this section shall preempt State laws 
     that require a clinical trials policy for State regulated 
     health insurance plans.''.
       (2) Clerical amendments.--
       (A) Section 732(a) of such Act (29 U.S.C. 1191a(a)) is 
     amended by striking ``section 711'' and inserting ``sections 
     711 and 715''.
       (B) The table of contents in section 1 of such Act is 
     amended by inserting after the item relating to section 714 
     the following new item:

``Sec. 715. Coverage for individuals participating in approved cancer 
              clinical trials.''.

       (b) Clinical Trials.--The Director of the National Cancer 
     Institute shall--
       (1) collaborate with the Director of the National 
     Institutes of Health to engage in a campaign to educate the 
     public on the value of clinical trials for oncology patients, 
     which shall be implemented on the local level and focus on 
     patient populations that traditionally are underrepresented 
     in clinical trials;
       (2) conduct an educational campaign for health care 
     professionals to educate them to consider clinical trials as 
     treatment options for their patients; and
       (3) conduct research to document and demonstrate promising 
     practices in cancer clinical trial recruitment and retention 
     efforts, particularly for patient populations that 
     traditionally are underrepresented in clinical trials.

     SEC. 9. HEALTH PROFESSIONS WORKFORCE.

       (a) Increase Nurse Faculty.--Section 811(f)(2) of the 
     Public Health Service Act (42 U.S.C. 296j(f)(2)) is amended 
     to read as follows:
       ``(2) Benefits for retiring nurse officers qualified as 
     faculty.--
       ``(A) In general.--The Secretary of Defense shall provide 
     to any individual described in subparagraph (B) the payment 
     of retired or retirement pay without reduction based on 
     receipt of pay or other compensation from the institution of 
     higher education concerned.
       ``(B) Covered individuals.--An individual described in this 
     subparagraph is an individual who--
       ``(i) is retired from the Armed Forces after service as a 
     commissioned officer in the nurse corps of the Armed Forces;
       ``(ii) holds a graduate degree in nursing; and
       ``(iii) serves as a part- or full-time faculty member of an 
     accredited school of nursing.
       ``(C) Nurse corps.--Any accredited school of nursing that 
     employs a retired nurse officer as faculty under this 
     paragraph shall agree to provide financial assistance to 
     individuals undertaking an educational program at such school 
     leading to a degree in nursing who agree, upon completion of 
     such program, to accept a commission as an officer in the 
     nurse corps of the Armed Forces.''.
       (b) Oncology Workforce.--
       (1) Study.--The Secretary of Health and Human Services 
     (referred to in this subsection as the ``Secretary'') shall 
     conduct a study on the current and future cancer care 
     workforce needs in the following areas:
       (A) Cancer research.
       (B) Care and treatment of cancer patients and survivors.
       (C) Quality of life, symptom management, and pain 
     management.
       (D) Early detection and diagnosis.
       (E) Cancer prevention.
       (F) Genetic testing, counseling, and ethical considerations 
     related to such testing.
       (G) Diversity and appropriate care for disparity 
     populations.
       (H) Palliative and end-of-life care.
       (2) Report.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary shall submit to Congress 
     a report that describes the findings of the study conducted 
     under paragraph (2).

     SEC. 10. PATIENT NAVIGATOR PROGRAM.

       Section 340A of the Public Health Service Act (42 U.S.C. 
     256a) is amended--
       (1) in subsection (e), by adding at the end the following:
       ``(3) Minimum core proficiencies.--The Secretary shall not 
     award a grant to an entity under this section unless such 
     entity provides assurances that patient navigators recruited, 
     assigned, trained, or employed using grant funds meet minimum 
     core proficiencies that are tailored for the main focus or 
     intervention of the navigation program involved.''; and
       (2) in subsection (m)--
       (A) in paragraph (1), by inserting before the period the 
     following ``, and such sums as may be necessary for each of 
     fiscal years 2011 through 2015.''; and
       (B) in paragraph (2), by striking ``2010'' and replacing 
     with ``2015.''

     SEC. 11. CANCER CARE AND COVERAGE UNDER MEDICAID AND 
                   MEDICARE.

       (a) Coverage of Routine Costs Associated With Clinical 
     Trials Under Medicare.--
       (1) Coverage under part a.--Section 1814 of the Social 
     Security Act (42 U.S.C. 1395f) is amended by adding at the 
     end the following new subsection:
       ``(m) Coverage of Routine Costs Associated With Clinical 
     Trials.--The Secretary shall not exclude from payment for 
     items and services provided under a clinical trial payment 
     for coverage of routine costs of care (as defined by the 
     Secretary) furnished to an individual entitled to benefits 
     under this part who participates in such a trial to the 
     extent the Secretary provides payment for such costs as of 
     the date of enactment of this subsection.''.
       (2) Coverage under part b.--Section 1833(w) of the Social 
     Security Act (42 U.S.C. 1395l(w)), as added by section 184 of 
     the Medicare Improvements for Patients and Providers Act of 
     2008 (Public Law 110-275), is amended--
       (A) by striking ``Payment.--The Secretary'' and inserting 
     ``Payment and Coverage of Routine Costs Associated With 
     Clinical Trials.--
       ``(1) Methods of payment.--Subject to paragraph (2), the 
     Secretary''; and
       (B) by adding at the end the following new paragraph:
       ``(2) Coverage of routine costs associated with clinical 
     trials.--The Secretary shall not exclude from payment for 
     items and services provided under a clinical trial payment 
     for coverage of routine costs of care (as defined by the 
     Secretary) furnished to an individual enrolled under this 
     part who participates in such a trial to the extent the 
     Secretary provides payment for such costs as of the date of 
     enactment of this subsection.''.
       (3) Provider outreach.--The Secretary of Health and Human 
     Services, acting through the Administrator of the Centers for 
     Medicare & Medicaid Services, shall conduct an outreach 
     campaign to providers of services and suppliers under the 
     Medicare program under title XVIII of the Social Security Act 
     regarding coverage of routine costs of care furnished to 
     Medicare beneficiaries participating in clinical trials in 
     accordance with sections 1814(m) and 1833(w)(2) of the Social 
     Security Act (as added by paragraphs (1) and (2), 
     respectively).
       (b) Demonstration Project to Provide Comprehensive Cancer 
     Care Planning Services Under Medicare.--
       (1) In general.--Beginning not later than 180 days after 
     the date of enactment of this Act, the Secretary of Health 
     and Human Services (referred to in this subsection as the 
     ``Secretary'') shall conduct a 3-year demonstration project 
     (referred to in this subsection as the ``demonstration 
     project'') under title XVIII of the Social Security Act (42 
     U.S.C. 1395 et seq.) under which payment for comprehensive 
     cancer care planning services furnished by eligible entities 
     shall be made.
       (2) Comprehensive cancer care planning services.--For 
     purposes of this subsection, the term ``comprehensive cancer 
     care planning services'' means--
       (A) with respect to an individual who is diagnosed with 
     cancer, the development of a plan of care that--
       (i) details, to the greatest extent practicable, all 
     aspects of the care to be provided to the individual, with 
     respect to the treatment of such cancer, including any 
     curative treatment and comprehensive symptom management (such 
     as palliative care) involved;
       (ii) is documented in the patient's medical record and 
     furnished to the individual in person within a period 
     specified by the Secretary that is as soon as practicable 
     after the date on which the individual is so diagnosed;
       (iii) is furnished, to the greatest extent practicable, in 
     a form that appropriately takes into account cultural and 
     linguistic needs of the individual in order to make the plan 
     accessible to the individual; and
       (iv) is in accordance with standards determined by the 
     Secretary to be appropriate;
       (B) with respect to an individual for whom a plan of care 
     has been developed under subparagraph (A), the revision of 
     such plan of care as necessary to account for any substantial 
     change in the condition of the individual, if such revision--
       (i) is in accordance with clauses (i) and (iii) of such 
     subparagraph; and
       (ii) is documented in the patient's medical record and 
     furnished to the individual within a period specified by the 
     Secretary that is as soon as practicable after the date of 
     such revision;
       (C) with respect to an individual who has completed the 
     primary treatment for cancer, as defined by the Secretary 
     (such as completion of chemotherapy or radiation treatment), 
     the development of a follow-up cancer care plan that--
       (i) describes the elements of the primary treatment, 
     including symptom management, furnished to such individual;
       (ii) provides recommendations for the subsequent care of 
     the individual with respect to the cancer involved;
       (iii) identifies, to the greatest extent possible, a 
     healthcare provider to oversee subsequent care and follow-up 
     as needed and to whom the individual may direct questions or 
     concerns;
       (iv) is documented in the patient's medical record and 
     furnished to the individual in person within a period 
     specified by the Secretary that is as soon as practicable 
     after the completion of such primary treatment;
       (v) is furnished, to the greatest extent practicable, in a 
     form that appropriately takes into account cultural and 
     linguistic needs of the individual in order to make the plan 
     accessible to the individual; and
       (vi) is in accordance with standards determined by the 
     Secretary to be appropriate; and
       (D) with respect to an individual for whom a follow-up 
     cancer care plan has been developed under subparagraph (C), 
     the revision of such plan as necessary to account for any 
     substantial change in the condition of the individual, if 
     such revision--
       (i) is in accordance with clauses (i), (ii), and (iv) of 
     such subparagraph; and

[[Page S3913]]

       (ii) is documented in the patient's medical record and 
     furnished to the individual within a period specified by the 
     Secretary that is as soon as practicable after the date of 
     such revision.
       (3) Qualifications and selection of eligible entities.--
       (A) Qualifications.--For purposes of this subsection, the 
     term ``eligible entity'' means a physician office, hospital, 
     outpatient department, or community health center. Qualified 
     providers include physicians, nurse practitioners, and other 
     health care professionals who develop or revise a 
     comprehensive cancer care plan.
       (B) Selection.--The Secretary shall select at least 6 
     eligible entities to participate in the demonstration 
     project. Such entities shall be selected so that the 
     demonstration project is conducted in different regions 
     across the United States, in urban and rural locations, and 
     across various sites of care.
       (4) Evaluation and report.--
       (A) Evaluation.--The Secretary shall conduct a 
     comprehensive evaluation of the demonstration project to 
     determine--
       (i) the effectiveness of the project in improving patient 
     outcomes and increasing efficiency and reducing error in the 
     delivery of cancer care;
       (ii) the cost of providing comprehensive cancer care 
     planning services; and
       (iii) the potential savings to the Medicare program 
     demonstrated by the project, including the utility of the 
     demonstration project in reducing duplicative cancer care 
     services and decreasing the use of unnecessary medical 
     services for cancer patients.
       (B) Report.--
       (i) In general.--Not later than the date that is 1 year 
     after the date on which the demonstration project concludes, 
     the Secretary shall submit to Congress a report on the 
     evaluation conducted under subparagraph (A).
       (ii) Prevention of fraudulent billing.--The Secretary shall 
     consult with the Medicare Fraud Task Force in the design of 
     the demonstration project to identify and address concerns 
     about fraudulent billing of comprehensive cancer care 
     planning services. The Secretary's actions on prevention of 
     fraud shall be included in the report under this 
     subparagraph.
       (iii) Demonstration of substantial benefit.--If the 
     evaluation conducted under subparagraph (A) indicates 
     substantial benefit from the demonstration project, as 
     measured by improved patient outcomes and more efficient 
     delivery of healthcare services, such report shall include a 
     legislative proposal to Congress for coverage of 
     comprehensive cancer care planning services under the 
     Medicare program, developed on the basis of information from 
     the demonstration project and in consultation with the 
     Administrator of the Agency for Healthcare Research and 
     Quality, the Director of the Institute of Medicine, and the 
     Director of the Centers for Disease Control and Prevention.
       (iv) No substantial benefit.--If the evaluation conducted 
     under subparagraph (A) does not indicate substantial benefit 
     from the demonstration project, as measured by improved 
     patient outcomes and more efficient delivery of healthcare 
     services, such report shall document, to the extent possible, 
     the reasons why the demonstration project did not result in 
     substantial benefit, and such report--

       (I) shall include a legislative proposal for Medicare 
     coverage of comprehensive cancer care planning services in a 
     manner that will lead to substantial benefit; or
       (II) shall include recommendations for additional 
     demonstration projects or studies to evaluate the delivery of 
     comprehensive cancer care planning services in a manner that 
     will lead to substantial benefit and eventual Medicare 
     coverage.

       (5) Funding.--The Secretary shall provide for the transfer 
     from the Federal Supplementary Medical Insurance Trust Fund 
     established under section 1841 of the Social Security Act (42 
     U.S.C. 1395t) of the amount necessary to carry out the 
     demonstration project and report under this subsection.
       (c) Promoting Cessation of Tobacco Use Under Medicaid.--
       (1) Services described.--Section 1905 of the Social 
     Security Act (42 U.S.C. 1396d) is amended by adding at the 
     end the following new subsection:
       ``(y)(1) Subject to paragraph (2), for purposes of this 
     title, the term `counseling and pharmacotherapy for cessation 
     of tobacco use' means diagnostic, therapy, and counseling 
     services and pharmacotherapy (including the coverage of 
     prescription and nonprescription tobacco cessation agents 
     approved by the Food and Drug Administration) for cessation 
     of tobacco use for individuals who use tobacco products or 
     who are being treated for tobacco use which are furnished--
       ``(A) by or under the supervision of a physician; or
       ``(B) by any other health care professional who--
       ``(i) is legally authorized to furnish such services under 
     State law (or the State regulatory mechanism provided by 
     State law) of the State in which the services are furnished; 
     and
       ``(ii) is authorized to receive payment for other medical 
     assistance under this title or is designated by the Secretary 
     for this purpose.
       ``(2) Such term is limited to--
       ``(A) services recommended in `Treating Tobacco Use and 
     Dependence: A Clinical Practice Guideline', published by the 
     Public Health Service in June 2000, or any subsequent 
     modification of such Guideline; and
       ``(B) such other services that the Secretary recognizes to 
     be effective.''.
       (2) Dropping exception from medicaid prescription drug 
     coverage for tobacco cessation medications.--Section 
     1927(d)(2) of the Social Security Act (42 U.S.C. 1396r-
     8(d)(2)) is amended--
       (A) by striking subparagraph (E);
       (B) by redesignating subparagraphs (F) through (K) as 
     subparagraphs (E) through (J), respectively; and
       (C) in subparagraph (F) (as redesignated by subparagraph 
     (B)), by inserting before the period at the end the 
     following: ``, except agents approved by the Food and Drug 
     Administration for purposes of promoting, and when used to 
     promote, tobacco cessation''.
       (3) Requiring coverage of tobacco cessation counseling and 
     pharmacotherapy services for pregnant women.--Section 
     1905(a)(4) of the Social Security Act (42 U.S.C. 1396d(a)(4)) 
     is amended--
       (A) by striking ``and'' before ``(C)''; and
       (B) by inserting before the semicolon at the end the 
     following: ``; and (D) counseling and pharmacotherapy for 
     cessation of tobacco use for pregnant women''.
       (4) Removal of cost-sharing for tobacco cessation 
     counseling and pharmacotherapy services for pregnant women.--
       (A) In general.--Section 1916 of the Social Security Act 
     (42 U.S.C. 1396o) is amended in each of subsections (a)(2)(B) 
     and (b)(2)(B), by inserting ``, and counseling and 
     pharmacotherapy for cessation of tobacco use'' after 
     ``complicate the pregnancy''.
       (B) Conforming amendment.--Section 1916A(b)(3)(B)(iii) of 
     such Act (42 U.S.C. 1396o-1(b)(3)(B)(iii)) is amended by 
     inserting ``, and counseling and pharmacotherapy for 
     cessation of tobacco use'' after ``complicate the 
     pregnancy''.
       (5) Effective date.--The amendments made by this subsection 
     take effect 1 year after the date of enactment of this Act 
     and apply to medical assistance provided under a State 
     Medicaid program on or after that date.

     SEC. 12. CANCER SURVIVORSHIP AND COMPLETE RECOVERY 
                   INITIATIVES.

       (a) Cancer Survivorship Programs.--Subpart 1 of part C of 
     title IV of the Public Health Service Act (42 U.S.C. 285 et 
     seq.), as amended by subsection (c), is amended by adding at 
     the end the following:

     ``SEC. 417E. EXPANSION OF CANCER SURVIVORSHIP ACTIVITIES.

       ``(a) Expansion of Activities.--The Director of the 
     Institute shall coordinate the activities of the National 
     Institutes of Health with respect to cancer survivorship, 
     including childhood cancer survivorship.
       ``(b) Priority Areas.--In carrying out subsection (a), the 
     Director of the Institute shall give priority to the 
     following:
       ``(1) Comprehensive assessment of the prevalence and 
     etiology of late effects of cancer treatment, including 
     physical, neurocognitive, and psychosocial late effects. Such 
     assessment shall include--
       ``(A) development of a system for patient tracking and 
     analysis;
       ``(B) establishment of a system of tissue collection, 
     banking, and analysis for childhood cancers, using guidelines 
     from the Office of Biorepositories and Biospecimen Research; 
     and
       ``(C) coordination of, and resources for, assessment and 
     data collection.
       ``(2) Identification of risk and protective factors related 
     to the development of late effects of cancer.
       ``(3) Identification of predictors of neurocognitive and 
     psychosocial outcomes, including quality of life, in cancer 
     survivors and identification of qualify of life and other 
     outcomes in family members.
       ``(4) Development and implementation of intervention 
     studies for cancer survivors and their families, including 
     studies focusing on--
       ``(A) preventive interventions during treatment;
       ``(B) interventions to lessen the impact of late effects of 
     cancer treatment;
       ``(C) rehabilitative or remediative interventions following 
     cancer treatment;
       ``(D) interventions to promote health behaviors in long-
     term survivors; and
       ``(E) interventions to improve health care utilization and 
     access to linguistically and culturally competent long-term 
     follow-up care for childhood cancer survivors in minority and 
     other medically underserved populations.
       ``(c) Grants for Research on Causes of Health Disparities 
     in Childhood Cancer Survivorship.--
       ``(1) Grants.--The Director of NIH, acting through the 
     Director of the Institute, shall make grants to entities to 
     conduct research relating to--
       ``(A) needs and outcomes of pediatric cancer survivors 
     within minority or other medically underserved populations; 
     and
       ``(B) health disparities in cancer survivorship outcomes 
     within minority or other medically underserved populations.
       ``(2) Balanced approach.--In making grants for research 
     under paragraph (1)(A) on pediatric cancer survivors within 
     minority populations, the Director of NIH shall ensure that 
     such research addresses both the physical and the 
     psychological needs of such survivors.
       ``(3) Health disparities.--In making grants for research 
     under paragraph (1)(B) on

[[Page S3914]]

     health disparities in cancer survivorship outcomes within 
     minority populations, the Director of NIH shall ensure that 
     such research examines each of the following:
       ``(A) Key adverse events after childhood cancer.
       ``(B) Assessment of health and quality of life in childhood 
     cancer survivors.
       ``(C) Barriers to follow-up care to childhood cancer 
     survivors.
       ``(D) Data regarding the type of provider and treatment 
     facility where the patient received cancer treatment and how 
     the provider and treatment facility may impact treatment 
     outcomes and survivorship.
       ``(d) Research To Evaluate Follow-up Care for Childhood 
     Cancer Survivors.--The Director of NIH shall conduct or 
     support research to evaluate systems of follow-up care for 
     childhood cancer survivors, with special emphasis given to--
       ``(1) transitions in care for childhood cancer survivors;
       ``(2) those professionals who should be part of care teams 
     for childhood cancer survivors;
       ``(3) training of professionals to provide linguistically 
     and culturally competent follow-up care to childhood cancer 
     survivors; and
       ``(4) different models of follow-up care.''.
       (b) Complete Recovery Care.--
       (1) Definition.--In this subsection, the term ``complete 
     recovery care'' means care intended to address the secondary 
     effects of cancer and its treatment, including late, 
     psychosocial, neurocognitive, psychiatric, psychological, 
     physical, and other effects associated with cancer and cancer 
     survivorship beyond the impairment of bodily function 
     directly caused by the disease, as described in the report by 
     the Institute of Medicine of the National Academies entitled 
     ``Cancer Care for the Whole Patient''.
       (2) Expansion of activities.--The Secretary of Health and 
     Human Services (referred to in this subsection as the 
     ``Secretary'') shall--
       (A) coordinate the activities of Federal agencies, 
     including the National Institutes of Health, the National 
     Cancer Institute, the National Institute of Mental Health, 
     the Centers for Medicare and Medicaid Services, the Veterans 
     Health Administration, the Centers for Disease Control and 
     Prevention, the Food and Drug Administration, the Agency for 
     Healthcare Research and Quality, the Office for Human 
     Research Protections, and the Health Resources and Services 
     Administration to improve the provision of complete recovery 
     care in the treatment of cancer; and
       (B) solicit input from professional and patient 
     organizations, payors, and other relevant institutions and 
     organizations regarding the status of provision of complete 
     recovery care in the treatment of cancer.
       (3) Improving the complete recovery care workforce.--
       (A) Chronic disease workforce development collaborative.--
     The Secretary shall, not later than 1 year after the date of 
     enactment of this Act, convene a Workforce Development 
     Collaborative on Psychosocial Care During Chronic Medical 
     Illness (referred to in this paragraph as the 
     ``Collaborative''). The Collaborative shall be a cross-
     specialty, multidisciplinary group composed of educators, 
     consumer and family advocates, and providers of psychosocial 
     and biomedical health services.
       (B) Goals and report.--The Collaborative shall submit to 
     the Secretary a report establishing a plan to meet the 
     following objectives for psychosocial care workforce 
     development:
       (i) Identifying, refining, and broadly disseminating to 
     healthcare educators information about workforce 
     competencies, models, and preservices curricula relevant to 
     providing psychosocial services to persons with chronic 
     medical illnesses and their families.
       (ii) Adapting curricula for continuing education of the 
     existing workforce using efficient workplace-based learning 
     approaches.
       (iii) Developing the skills of faculty and other trainers 
     in teaching psychosocial health care using evidence-based 
     teaching strategies.
       (iv) Strengthening the emphasis on psychosocial healthcare 
     in educational accreditation standards and professional 
     licensing and certification exams by recommending revisions 
     to the relevant oversight organizations.
       (c) Technical Amendment.--
       (1) In general.--Section 3 of the Hematological Cancer 
     Research Investment and Education Act of 2002 (Public Law 
     107-172; 116 Stat. 541) is amended by striking ``section 
     419C'' and inserting ``section 417C''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall take effect as if included in section 3 of the 
     Hematological Cancer Research Investment and Education Act of 
     2002 (Public Law 107-172; 116 Stat. 541).

     SEC. 13. ACTIVITIES OF THE FOOD AND DRUG ADMINISTRATION.

       It is the sense of the Senate that the Food and Drug 
     Administration should--
       (1) integrate policies and structures to facilitate the 
     concurrent development of drugs and diagnostics for cancer 
     diagnosis, prevention, and therapy;
       (2) consider alternatives or surrogates to traditional 
     clinical trial endpoints (for example, other than survival) 
     that are acceptable for regulatory approval as evidence of 
     clinical benefit to patients; and
       (3) modernize the Office of Oncology Drug Products by 
     examining and addressing internal barriers that exist within 
     the current organizational structure.

  Mrs. HUTCHISON. I rise to talk about legislation that has been 
introduced today. My colleague and friend, Senator Ted Kennedy, and I 
and Senator Feinstein are introducing a bill that we hope will help 
advance America's efforts to find cures for cancer.
  We all know that cancer is a relentless disease. It does not 
discriminate between men and women, wealthy or poor, elderly or young.
  In 2008, over 1.4 million Americans were diagnosed with some form of 
cancer. It may have been you, it may have been a friend, it may have 
been a coworker, a parent, a sibling, a spouse or even a child. More 
than half a million Americans lost their battle with cancer last year.
  During the last session of Congress, Senator Kennedy and I began 
working on what we would say would be the next generation of the war on 
cancer. Senator Feinstein has been a leader in this area as well. She 
is vice chairman of C-Change, which is an organization that is led by 
President George Bush--the 41st--and his wife Barbara. Dianne has been 
very active in the cancer cause for a long time, having lost her 
husband to cancer.
  All of us have been touched by it. We know very poignantly what 
happened in our body last year; that Senator Kennedy himself was 
diagnosed with a brain tumor. We have watched him valiantly fight off 
the scourge of this disease. I know in my own family my mother died 
from a brain tumor, and my brothers have also had cancer. It is such a 
reminder to all of us, especially when we see one of our own family 
members or one of our beloved colleagues fighting this disease. Arlen 
Specter has had amazing feats of living through brain tumors, and he 
has been so valiant. He, too, is one of the leaders in the cause we are 
trying to fight today, and that is to win against cancer.
  After Senator Kennedy's diagnosis was announced, I stood on the floor 
and said I would have an absolute commitment to introduce legislation 
with him, which we had already been working on for months. We were 
working with many of the groups that have come together to fight 
cancer. There are so many in our country that are banding together to 
try to put all our resources and all our experiences and all of what we 
have learned to work to do that magic thing that will finally bring 
about a cure for this disease.
  Today, we are keeping the promise we made. We waited, of course, for 
Senator Kennedy to go through surgery and to be in treatment before we 
introduced it, and he is back with us today. He is part of introducing 
this bill today. So we are calling the bill the 21st Century Cancer 
ALERT Act. Here is why we must start again and renew our efforts.
  Since the war on cancer was declared in 1971, we have amassed a 
wealth of knowledge, but our success in battling the disease has not 
been as great as with some of the other health concerns we have faced 
in our country, such as heart disease. When we adjust the mortality 
rate of cancer by age, it is still extraordinarily high when compared 
to mortality from other chronic diseases.
  The impact that cancer has on all lives cannot and should not be 
underestimated. Today, one out of every two men and one out of every 
three women in our country will develop cancer in their lifetimes. That 
is an incredible statistic, and it shows how important it is that we 
get a handle on how we can either find the cure or, the next best 
thing, to be able to treat it and be able to live with the disease.
  Let me tell you about some of the women who have fought with this 
disease. A woman named Elayne in Corinth, TX, is 44 years old and 
fighting cancer for the second time in her life. She says:

       I would like to see more research and options, especially 
     for people like me who tend to have few options left as a 
     stage 4 cancer patient. I think there is great hope in 
     targeted therapies, and this should be a continued area of 
     research and development.

  The Kennedy-Hutchison-Feinstein bill will do several things: It will, 
first of all, promote cancer diagnosis at an early and more curable 
stage. We must encourage the discovery and advancement of early 
recognition and treatment. One promising research method is the use of 
biomarkers.
  Biomarkers leave evidence within the body that alert clinicians to 
the

[[Page S3915]]

hidden activity that indicates cancer may be developing. Identifying 
biomarkers could represent the earliest possible detection of cancer in 
patients where it might otherwise be a long time before the person 
would see or feel any symptoms.
  However, even if we strengthen our ability to diagnose cancer, 
impediments remain that prevent many Americans from undergoing routine 
screening for cancer. With early screening, the chances of catching the 
disease at a treatable stage are greater and improve the rate of 
survival.
  No. 2, our bill will adopt a cooperative, coordinated approach to 
cancer research. By establishing a network of biorepositories, we will 
enable investigators to share information and samples. An integrated 
approach will accelerate the progress of lifesaving research.
  Furthermore, finding cures should be a collaborative goal. Great 
research is being done by so many researchers who are not aware of 
advancements in the trials. We have the research that might be 
concentrated in one area, but people don't have the communication they 
need to know what is going on in another area that might be helpful in 
furthering the research going on in a different area.
  The culture of isolated career research must shift toward cooperative 
strides to achieve breakthroughs. We must encourage all the 
stakeholders in the war on cancer to work in concert. This is perhaps 
going to be a difficult hurdle, but we must do it. If our researchers 
are just involved in their own microscope, they are not going to be 
able to have the full body of knowledge that might contain that one 
thing that triggers the end to cancer as we know it.
  Next, our bill will increase enrollment in clinical trials. Clinical 
trials expand treatment options for patients while enabling researchers 
to explore new methods in prevention, diagnosis, and therapy. This is 
so valuable because these are the experimental stages of treatment 
where people who sign up--who know there are risks here but are willing 
to try--can help us learn what works and what might not work. This is 
essential for us to make real strides in this war on cancer.
  One woman who understands the importance of clinical trials is Maria 
from El Paso. She is participating in a clinical trial, but she says:

       Every day we encounter women who are either unaware of the 
     option for clinical trials or who want to participate but do 
     not have access to them. It's not right that some of us have 
     access to the most cutting-edge treatments, while others are 
     shut out and left mired in a web of confusion.

  Less than 5 percent of the 10 million adults with cancer in the 
United States participate in clinical trials. We need to raise 
awareness about clinical trials so more cancer patients will know they 
are available and have the full information of what they could do. 
Disincentives in the health insurance market to enrolling in clinical 
trials must be eliminated.
  Last, as our knowledge of cancer advances and survivors live longer, 
we must move toward establishing a process of providing comprehensive 
care planning services. There is great value in arming patients with a 
treatment plan and a summary of their care once they enter remission. 
This can help ensure continuity of therapy and prevent costly 
duplicative or unnecessary services.
  Together, Senator Kennedy, Senator Feinstein, and I hope this will be 
a bipartisan effort to reinvigorate this fight by enacting these 
necessary changes through legislation. One of the people who will 
benefit from our bill is Suzanne. After 10 years of treatment for 
cancer, at a cost of over $3 million, Suzanne came to my office this 
week to show her support for this bill. She said:

       I don't want my two daughters to go through what I went 
     through. Screening saves lives and money.

  She is right. Another woman who has been in touch with my office is 
Jodie. At the age of 36, she was diagnosed with cancer. After 5 years 
of treatment, she said: ``It is a gift to be here.''
  The Kennedy-Hutchison-Feinstein bill, through screening programs, 
research, and clinical trials, will give people such as Suzanne, Maria, 
Elayne, Jodie, and many others in our country more time to spend with 
their loved ones.
  This bill we are introducing today is not a finished product. There 
may need to be changes to this bill. It is not perfect. I already have 
had some point out the need for us to sit down and try to come up with 
the absolute right approach. The HELP Committee will be looking at this 
bill. They will be marking it up. We have already had hearings last 
year, but there will be more of a look and it will be important that 
this happen.

  We want a bipartisan and resounding victory. We want this to be a 
victory for all of our country--a victory over this disease. It is the 
kind of bill that can be bipartisan, that should be bipartisan, and 
should have overwhelming support from this Congress and from the 
American people.
  I am wearing today the ``Live Strong'' bracelet. This is from the 
Lance Armstrong Foundation. We all know Lance Armstrong is a cancer 
survivor. He is also a hero to many of us because of his wins of the 
Tour de France. He is the premier bicyclist in the world. 
Unfortunately, Lance is in the hospital right now--or he might be just 
getting out. He doesn't have cancer. That is the good news. He broke 
his collar bone--in about six places, apparently--and because he has 
insisted he is going back into cycling, he is recovering from that 
injury.
  But we know the grit and determination of this man. After his Tour de 
France wins, and setting the ``straight record'' for Tour de France 
wins, he came home and decided to take on cancer for everyone. He has 
been a role model in showing us it can be defeated, because after his 
bout with cancer, he went on to win these grueling bicycle races all 
over the world. So he has been a role model in that regard, but he has 
also, through his foundation, been a champion of making sure other 
people have the same chance for survival that he has had. So while we 
wish him well on the mending of his collar bone, we already owe him a 
debt of gratitude, and I am going to wear his bracelet as we introduce 
the bill today to show what one person can do to defeat cancer.
  We can all come together to help Lance get the message out throughout 
the world that we can defeat cancer, and no one is a better leader in 
this cause on the Senate floor today than Senator Edward Kennedy. He 
not only helped craft the legislation--even as he was in treatment he 
was making edits to this bill--but he also is another person who has 
shown courage, as Lance Armstrong has, by not giving up, by coming 
right back to the Senate after his cancer treatments and showing us 
that he, too, is joining with Lance Armstrong to make sure everyone has 
the same chance he has for early detection and for a chance to live a 
full life. That is what we want for every American.
  I am very proud to be standing here for Senator Kennedy to say we are 
going to fight for this together. We are going to work together, and we 
are going to try to have a resounding bipartisan victory on this bill. 
Working with the HELP Committee and utilizing their input, we will win 
a victory for all Americans. Maybe we will make Americans see that we 
can work together here in Washington. Maybe that will be the change in 
how things are done in Washington that we have all been looking for. It 
would be a change for the better.
                                 ______
                                 
      By Mr. HARKIN (for himself, Mr. Kennedy, Mr. Leahy, Mr. Cardin, 
        Ms. Mikulski, Mr. Kerry, Mr. Durbin, Mr. Lautenberg, Mr. 
        Merkley, and Mrs. McCaskill):
  S. 718. A bill to amend the Legal Services Corporation Act to meet 
special needs of eligible clients, provide for technology grants, 
improve corporate practices of the Legal Services Corporation, and for 
other purposes; to the Committee on the Judiciary.
  Mr. HARKIN. Mr. President, today, I am proud to introduce the Civil 
Access to Justice Act of 2009, which will expand and improve vital 
civil legal services to our most vulnerable Americans.
  This is an issue that is very personal with me. Before I was elected 
to Congress, I practiced law with Polk County legal aid. I know first-
hand how crucial legal assistance is to struggling families who have no 
place else to turn

[[Page S3916]]

when they have lost a job and are facing a foreclosure. I know the 
invaluable assistance that legal aid provides to battered women trying 
to leave abusive marriages while fearing for their safety and the 
safety of their children. I know that, without access to an attorney, 
the poor are often powerless against the injustices they suffer. I can 
honestly say that the work I did with legal aid is some of the most 
rewarding work of my career.
  The type of assistance I was able to provide needy clients in Iowa 
occurs throughout the country every day. Much of that assistance is the 
direct result of a commitment the federal government first made over 
forty years ago. In 1965, the Office of Economic Opportunity created 
269 local legal services programs around the country. Ten years later, 
in 1974, Congress--with bipartisan support, including that of President 
Nixon--established the Legal Service Corporation, LSC, to be a major 
source of funding for civil legal aid in this country. LSC is a 
private, non-profit corporation, funded by Congress, with the mission 
to ensure equal access to justice under the law for all Americans by 
providing civil legal assistance to those who otherwise would be unable 
to afford it. LSC distributes 95 percent of its annual Federal 
appropriations to 137 local legal aid programs, with more than 900 
offices serving all 50 states and every congressional district.
  These LSC funding programs make a crucial difference to millions of 
Americans. Recipients help clients secure basic human needs, such as 
access to wrongly denied benefits including social security, pensions 
and needed health care. Just in the past decade, families of 9-11 
victims, flood victims, and hurricane evacuees have received crucial 
legal assistance in obtaining permanent housing, unemployment 
compensation and government benefits. Further, members of our Armed 
Forces and their families receive help with estate planning, consumer 
and landlord/tenant problems and family law.
  It is LSC-funded attorneys who help parents obtain and keep custody 
of their children, help family members obtain guardianship for children 
without parents, assist parents in enforcing child support payments and 
help women who are victims of domestic violence. In fact, three out of 
four legal aid clients are women, and legal aid programs identify 
domestic violence as one of their top priorities. Recent studies 
confirm, moreover, that the only public service that reduces domestic 
abuse in the long term is a woman's access to legal assistance.
  Unfortunately, as the economy continues to wane, those needing legal 
assistance increase. Yet, the Federal commitment to legal services and 
LSC is not as effective as it needs to be. LSC has not been authorized 
since 1981, and since 1995 Congress has slashed funding for legal 
services for the poor, from $415 million to $350 million in fiscal year 
2008, with only a recent increase to $390 million for fiscal year 2009. 
Further, severe restrictions on LSC funded attorneys impede the ability 
of legal aid attorneys to provide the most meaningful legal 
representation to low-income Americans. The result is that access to 
justice and quality representation has become far from a reality for 
too many of our citizens.

  In many parts of the country, more than 80 percent of those who need 
legal representation are unable to obtain it. Nationally, 50 percent of 
eligible applicants who request legal assistance from LSC funded 
programs are turned away largely because such programs lack adequate 
funding. That translates into over one million eligible cases per year.
  Bear in mind, to be eligible for Federal legal assistance, one must 
live at or below 125 percent Federal poverty level--an income of about 
$25,000 a year for a family of four. This means that we are turning 
away half of the families in America who need and seek civil legal help 
who make less than $25,000 a year. That is wrong and it makes a mockery 
of the principle of equal justice under the law.
  Unfortunately, a combination of limited federal funding, state budget 
cuts and an increased demand for services due to the recession has 
exacerbated the problem. As the Chief Justice of the Texas Supreme 
Court recently noted, legal aid programs have reached a ``crisis of 
epic proportions.'' This year, requests for services have risen by 30 
percent or more across the country while cutbacks in staffing are 
expected to reach 20 percent or more over the coming months. 
Connecticut Legal Services expects to lose as many as 150 legal 
positions. Boston's legal aid expects to lay off one-fifth of its 
lawyers. Two whole offices in New Jersey recently had to shut their 
doors. When legal aid lawyers lose their jobs and when offices close, 
unfortunately it is our most vulnerable citizens who suffer as their 
legal needs go unmet.
  The housing crisis highlights this problem. Today, millions of 
Americans are struggling to meet their housing needs, including making 
their mortgage payments, in many cases traceable to predatory lending 
practices. Foreclosures are at a historic high and continue to soar. As 
more and more people face the devastating prospect of losing their 
home--their most prized possession--legal assistance is necessary to 
help renegotiate terms of loans or enforce truth-in-lending protections 
in court. The result is that many legal aid offices have seen a drastic 
increase in those seeking help. Between 2007 and 2008, for example, 
Iowa Legal Aid saw a 300 percent increase in foreclosure related cases. 
The Legal Aid Society of San Diego saw a 250 percent increase. Yet, 
legal aid is too often unavailable. A recent study, for example, 
revealed that in New Jersey, 99 percent of defendants in housing 
eviction cases go to court without an attorney.
  Given these needs, the Civil Access to Justice Act of 2009, which I 
am proud to introduce today with Senators Kennedy, Leahy, Mikulski, 
Cardin, Kerry, Durbin, Lautenberg, McCaskill and Merkley, renews our 
commitment to equal justice for all Americans and will improve both the 
quantity and quality of legal assistance in this country.
  The bill is supported by, among others, the American Bar Association, 
Brennan Center for Justice, National Legal Aid & Defender Association, 
National Organization of Legal Service Workers and United Auto Workers.
  First, this bill authorizes funding for LSC at $750 million, which is 
approximately the amount appropriated in 1981, adjusted for inflation, 
the high water mark for LSC funding. That year, Congress allocated 
$321.3 million to LSC. At the time, that was seen as the level 
sufficient to provide a minimum level of access to legal aid in every 
county. Adjusted for inflation, this ``minimum access'' level of 
funding would need to be about $750 million in 2009 dollars.
  Second, this bill lifts many of the restrictions Congress imposed in 
1996 on federally funded attorneys. That year, Congress significantly 
limited whom federally funded attorneys could represent and the types 
of legal tools these attorneys could use in representing their clients. 
Proponents of these restrictions argued that LSC funded lawyers had 
overreached and were using federal funds to pursue what some considered 
an ideological political agenda through the courts, while neglecting 
basic legal work for poor Americans.
  I vigorously disagreed with this characterization of legal aid 
attorneys and opposed the restrictions at the time; and I continue to 
do so. The restrictions have harmed our neediest Americans and in many 
instances prevent legal counsel from doing what attorneys are ethically 
bound to do--provide zealous representation for their clients. Further, 
the restrictions, by limiting the range of tools that legal aid 
attorneys can employ compared to other members of the bar, have created 
a system of second-class legal representation. That is why this 
legislation lifts limits on the legal tools that LSC-funded attorneys 
can use to represent their clients--for example, prohibitions on 
attorneys seeking court-ordered attorneys' fees, lobbying with 
nonfederal funds or representing clients in class action law suits.
  With respect to attorney fees, Congress and state legislatures have 
recognized that such fees are an important remedy, and are critical in 
ensuring that civil rights and consumer protection suits are brought. 
As Congress stated in enacting the Civil Rights Attorneys' Fees Awards 
Act of 1976, ``fee awards have proved an essential remedy if private 
citizens are to have a

[[Page S3917]]

meaningful opportunity to vindicate the important Congressional 
policies which these laws contain.'' That is why Congress has enacted 
nearly 200 statutes, and states have enacted approximately 4,000 
statutes, that provide for attorney fees. The current restriction 
preventing LSC-funded attorneys from receiving attorney fees has the 
effect of weakening the effectiveness of these statutes.
  Lifting the restriction on attorney fees makes sense for additional 
reasons. First, because of the restriction, defendants who otherwise 
would pay attorney fees are unjustly enriched because they happen to 
face LSC-funded attorneys as opposed to a private counsel. Second, the 
potential for attorney fees is important leverage for attorneys as they 
negotiate settlements, leverage now not available to LSC-funded 
attorneys. Finally, by prohibiting collecting attorney fees, Congress 
has needlessly limited potential resources that can be used to provide 
legal aid to other clients.
  The bill also lifts the restriction on LSC-funded attorneys' ability 
to lobby with non-federal funds for changes in the law that would 
benefit disadvantaged clients. Legal service attorneys are immersed in 
the day-to-day legal issues faced by low-income communities and, as a 
result, are often most knowledgeable about the true impact of state and 
Federal laws on low income Americans. Yet, LSC-funded attorneys may not 
participate legislative and administrative efforts unless they are 
responding to a written request from a legislator or other official.
  When legal aid attorneys' input is requested, the results are 
telling. For example, Maryland Legal Aid Bureau was recently invited by 
the legislature to testify on an overhaul of state foreclosure and 
lending laws. Although the lending, mortgage and banking industries 
were well represented, the legal aid attorney was the only person there 
representing borrowers' views. While the attorney's voice was critical 
in ensuring appropriate consumer protections, it is significant that 
that voice was only heard because legislators chose to seek input from 
legal aid. Because of the current restrictions, absent an invitation, 
the experiences and knowledge of that attorney would be silenced, 
leaving a one-sided debate.
  Let me be clear, I disagree with those who advocated for and enacted 
the 1996 restrictions. However, in the spirit of compromise and 
bipartisanship, and with the intent to avoid a repeat of the 
contentious debates of the 1990s, this legislation does not lift all of 
the restrictions. Illustrative is the present restriction on LSC-funded 
attorneys pursuing class action suits. Such cases are often the most 
efficient and cost-effective lawsuits, not only for clients but for the 
judicial system. As Congress found in enacting the Class Action 
Fairness Act in 2005, ``class action lawsuits are an important and 
valuable part of the legal system when they permit the fair and 
efficient resolution of legitimate claims of numerous parties by 
allowing the claims to be aggregated into a single action against a 
defendant that has allegedly caused harm.''
  When the procedural requirements of State or Federal law are met, 
LSC-funded attorneys and their clients, like all others, should be able 
to utilize this essential litigation tool. That is why the bill lifts 
the restriction on the ability of legal aid programs to bring such 
suits. At the same time, again while I disagree, I acknowledge the 
concern that led to the restriction--that prior to the restriction some 
felt that LSC-funded attorneys were using class action suits to ``push 
the envelope'' and have courts establish ``new law.'' To allay this 
concern, the bill permits only class action suits that are grounded in 
``established'' law. This will enable, for example, LSC-funded 
attorneys to represent as a class multiple families who are victims of 
predatory lending, but will not permit LSC-funded attorneys to attempt 
to achieve a novel interpretation of the law that lacks statutory 
support or judicial precedent.
  Moreover, again in the spirit of compromise, the bill maintains many 
of the limits on who LSC-funded programs can represent, including the 
current exclusion of illegal immigrants, with limited exceptions, such 
as victims of domestic violence, prisoners challenging prison 
conditions, and people charged with illegal drug possession in public 
housing eviction proceedings. Also, consistent with current law, the 
legislation prohibits LSC-funded programs from participating in 
abortion-related cases.
  Third, this legislation lifts all the restrictions, except those 
related to abortion litigation, on the use of state and local funds and 
private donations to Federal funded legal services programs that 
Congress also imposed in 1996. That year, Congress determined that for 
programs that receive federal funds, the same restrictions applicable 
to federal funds apply to non-federal funds a program receives.
  The result is that millions of dollars in non-federal funds are 
encumbered by the same restrictions that drastically limit the tools 
available to legal aid attorneys, to the detriment of their clients. 
Through direct state and local funding, money from state Interest on 
Lawyers' Trust Accounts, IOLTA, and private sources, over $450 million 
in non-federal funds currently is provided for civil legal assistance. 
The restrictions place unnecessary and costly hurdles on the use of 
these non-federal funds. The only way a program and its donors can free 
themselves from federal restrictions is by diverting non-federal funds 
into a separate program--with separate staff members, offices and 
equipment. This is burdensome and wasteful.

  Whatever one thinks of placing conditions on the receipt of federal 
funds, states, cities and private donors should have the ability to 
determine for themselves how best to spend their money to ensure access 
to justice for their citizens. It is one thing to attach conditions on 
the use of the federal funds, but to impose conditions on the use of 
non-federal funds is wrong.
  Fourth, in addition to providing further tools and support for LSC 
grantees, better corporate governance--something that is critically 
needed--is a central feature of this legislation. Last year, the 
Government Accountability Office, GAO, reported on troubling management 
practices and lack of oversight by LSC. The reports found that there 
had been questionable expenditures by LSC management and that LSC 
lacked a ``properly implemented governance and accountability 
structure'' needed to prevent problems. GAO included in its report a 
series of recommendations as to how LSC should address these 
shortcomings and prevent similar problems in the future.
  No one was more upset about the GAO reports than I. That is why I 
personally made it clear to LSC management, in no uncertain terms, that 
they needed to act immediately to address the GAO recommendations, and 
why a central feature of this bill is provisions to ensure better 
corporate governance. LSC acted quickly to address the issues GAO 
raised, and both LSC management and its Board of Directors have 
publicly accepted all of GAO's recommendations and have worked 
diligently to implement them. Nevertheless, I believe it is important 
to lock the recommendations into statute.
  Finally, the bill authorizes a grant program from the Department of 
Education to expand law school clinics. A recent study found that 
students in law school clinics serve approximately 90,000 civil clients 
every school year, excluding summer semesters, and provide over 1.8 
million hours of legal service. These legal clinics are a significant 
resource for legal services. But they are much more. For many students, 
these programs are stepping stones towards careers in legal service and 
public interest law following graduation. Recent studies demonstrate 
that law students who participate in law school clinics are more likely 
to work in public service jobs and do more pro bono than their peers 
who do not.
  We need to do all we can to encourage young lawyers to make legal aid 
a career. One important way of doing this is by exposing them to the 
challenges, and more importantly the rewards, of representing people 
who otherwise would not have the legal assistance they deserve.
  Our promise of ``equal justice under law'' rings hollow if those who 
are most vulnerable are denied access to representation. As former 
Justice Lewis Powell said, ``[e]qual justice under law is not merely a 
caption on the facade of the Supreme Court building. It is perhaps the 
most inspiring ideal of our society . . . it is fundamental that 
justice should be the same,

[[Page S3918]]

in substance and availability, without regard to economic status.'' 
Legal aid attorneys across the country protect the safety, security, 
and health of low-income citizens. When a senior citizen is the victim 
of a financial scam, when a family faces the loss of their home, or, 
all too often, when a woman seeks protection from abuse, legal aid can 
help--but only if it has the funds and the tools needed to do so.
  As our former colleague Senator Domenici once declared: ``I do not 
know what is wrong with the United States of America saying to the 
needy people of this country that the judicial system is not only for 
the rich. What is wrong with that? . . . That is what America is all 
about.''
  That is the aim of this bill. After years of grossly underfunding 
this essential program, denying legal representation to millions of 
low-income citizens, and denying legal aid lawyers the full panoply of 
tools they need to represent their clients effectively, this bill will 
fulfill the promise of our Constitution. ``Equal Justice Under Law'' 
will be more than an ideal chiseled on a marble facade, it will be a 
concrete reality for millions of our citizens, who, today, are denied 
it. I urge my colleagues to support this important bill.
  I am proud to join Senator Harkin, along with Senator Kennedy, 
Senator Kerry, Senator Mikulski, Senator Durbin, Senator Lautenberg, 
Senator McCaskill, and Senator Merkley on this important legislation to 
reauthorize the Legal Services Corporation, LSC. I thank Senator Harkin 
for his hard work and dedication to this issue. Along with 
reauthorizing the funding for the LSC, the bill also removes several 
restrictions that have encumbered the efforts of legal services 
providers around the country.
  The funding authorization in this legislation will help ensure that 
in future years, the Legal Services Corporation, and all of the state 
legal aid organizations it assists, will continue the critical work 
they do to help lower-income American citizens who need legal 
assistance. Similar to the Sixth Amendment's requirement that an 
indigent criminal defendant be provided counsel, the voice that legal 
aid attorneys give to the less fortunate among us is an indispensable 
component of a fair justice system. What Justice Hugo Black called the 
``noble ideal'' of a fair and impartial trial is extended through the 
work of those around the country who serve their fellow citizens in our 
courts. This reauthorization will continue the policy of the Federal 
Government to provide assistance to those who seek access to the courts 
in civil matters.
  As part of this reauthorization, and in an effort to support the 
integrity of the LSC, the bill codifies recommendations made by the 
Government Accountability Office, GAO, related to the LSC's corporate 
governance. The Senate Judiciary Committee held a hearing in May 2008 
in part to shed light on these recommendations, and to give the LSC an 
opportunity to respond about plans to address the problems identified 
by the GAO. The LSC's leadership has been open and responsive to making 
improvements, and including these recommendations in the bill will 
assist the LSC in strengthening its governance practices for the 
future.
  This legislation also takes the long-overdue step of removing several 
of the restrictions that have hindered legal aid organizations for too 
long. But I wish to make clear that the restrictions on both state and 
Federal funds prohibiting litigation involving reproductive rights 
remain in place. Several restrictions on Federal funds remain: the use 
of Federal funds for litigation concerning unlawful immigrants, prison 
conditions, and certain eviction cases involving the sale of illegal 
drugs in public housing, will remain prohibited. But many of the 
restrictions this bill finally lifts are the product of an ideology 
long since rejected by the American people. It is time for Congress to 
reconsider the usefulness of these restrictions in providing the 
services that so many Americans desperately need.
  All Americans should understand the effects of these restrictions on 
the provision of legal services for lower-income citizens. Chief among 
them is the overarching requirement prohibiting the use of non-Federal 
funds for enumerated purposes when legal aid organizations accept 
Federal funding from the LSC. Currently, non-federal funds received by 
legal aid providers that also accept LSC funding are subject to the 
same restrictions that Federal funds are. This has resulted in a waste 
of resources that providers can ill afford. For example, a legal aid 
provider that wishes to use state, foundation, or other private funding 
as it sees fit must physically segregate its operations so that funds 
from the two sources are administered separately through duplicated 
processes. In this era of economic difficulty, the impact of every 
Federal and state dollar provided to help Americans must be maximized. 
This requirement has resulted in little more than wasted resources. 
Legal aid providers are capable of honoring Federal restrictions 
without the necessity of such an onerous approach.
  The legislation also removes restrictions that currently prohibit 
legal aid attorneys from receiving attorney's fees, as authorized by 
law, in cases in which they prevail. Contrary to arguments that claim 
such a practice would cause legal aid attorneys to act unethically or 
out of an interest divergent from the legitimate needs of their 
clients, allowing these fees to be retained would help shift the cost 
of wrongdoing from the Federal Government to the wrongdoer. Moreover, 
allowing legal aid attorneys to retain these fees when merited would 
provide increased assistance to the organizations for which they work. 
In an effort to monitor the effect of removing this restriction, the 
legislation requires all fees received to be reported to the LSC.
  The bill removes restrictions on class action suits by legal aid 
providers. Contrary to the popular rhetoric, in some cases class action 
suits can maximize the benefits provided by legal aid organizations by 
allowing similarly situated plaintiffs to pursue their rights in a 
single case. The legislation does restrict class action suits to 
actions based on established law, and thus is intended to discourage 
truly frivolous suits. Additionally, the legislation removes the 
restriction prohibiting legal aid providers from lobbying their elected 
officials. Allowing legal aid providers to advocate on behalf of those 
they serve will advance civil justice issues and raise the awareness of 
lawmakers in matters affecting many Americans. And I would remind those 
who would disparage this practice on the part of legal aid providers 
that many of the financial institutions that the American taxpayers 
have recently bailed out continue to lobby extensively in Washington. 
If banks that have been bailed out with taxpayer money can freely 
access their elected officials, so too should those who represent the 
least politically powerful among us.
  I hope all Senators will give serious consideration to reauthorizing 
the Legal Services Corporation and ending many of the restrictions that 
have burdened the provision of legal services to so many American 
citizens. Lawyers across the U.S. have dedicated their lives to helping 
the least fortunate among us gain access to the courts that serve us 
all. These lawyers play a critical role in ensuring that justice is 
carried out in a manner consistent with the Constitution's promise, and 
when justice is served fairly, it benefits us all. I hope all Senators 
will join us in support of this legislation.
                                 ______
                                 
      By Mr. UDALL, of Colorado (for himself and Mr. Bennet):
  S. 720. A bill to provide a source of funds to carry out restoration 
activities on Federal land under the jurisdiction of the Secretary of 
the Interior or the Secretary of Agriculture, and for other purposes; 
to the Committee on Energy and Natural Resources.
  Mr. UDALL of Colorado. Mr. President, I am today introducing a bill 
to provide additional resources for use by the Federal land-managing 
agencies to restore lands damaged as a result of legal violations and 
to promote public education about the use of the Federal lands. This 
bill is similar to one I introduced in the U.S. House of 
Representatives in the 110th Congress, H.R. 1463. I would like to thank 
Sen. Bennet for joining me as a cosponsor.
  The large majority of people who use and enjoy our national public 
lands respect those lands and facilities and do not deliberately damage 
them. They abide by our laws and regulations that

[[Page S3919]]

are designed to preserve and protect these lands and facilities for 
future generations to enjoy and appreciate. Unfortunately, there are 
some who violate those laws and regulations and in so doing damage the 
lands and facilities. Violators who are caught can face fines and 
penalties. This bill would direct the Federal public land agencies to 
apply the funds collected as fines to help restore the lands and 
facilities that may have been damaged due to the violations.
  The purpose of this bill is to assist the land-managing agencies--the 
Bureau of Land Management, National Park Service, and the Fish and 
Wildlife Service in the Interior Department as well as the Forest 
Service in the Agriculture Department--by allowing the money collected 
as fines to be used for repairing damage caused by the actions that 
lead to the fines or by similar actions instead of going to the U.S. 
Treasury. It would also allow them to use the money to increase public 
awareness of regulations and other requirements regarding use of 
Federal lands. It provides that any of the money not needed for those 
purposes would be credited to the Crime Victims Fund in the Treasury.
  Allowing these funds to be used in this manner will not likely repair 
the all of the damage caused by illegal activities in most instances, 
but it will at least provide some assistance.
  The genesis for this bill stemmed from a number of illegal activities 
that created significant damage to Federal public lands and facilities. 
Let me highlight just a couple of these.
  As many may remember, Colorado experienced one of its worst fires in 
2002, the Hayman Fire. This fire torched over 130,000 acres in the 
watershed of the Denver metropolitan area. It also destroyed 133 homes 
and forced the evacuation of over 5,000 people. After the fire, which 
was exceedingly hot and fast moving, a major thunderstorm pummeled the 
then-barren ground and washed debris and sediment into the Strontia 
Springs Reservoir, a major drinking water supply for Denver, hampering 
its capacity. Tragically, one person died of a heart attack during this 
fire, five firefighters were killed in a car crash on the way to the 
fire, and two people were killed during the subsequent thunderstorm and 
flooding. It was later learned that the fire was caused by the illegal 
actions of a former Forest Service employee. That person was later 
fined and jailed. This bill would allow the Forest Service to apply 
those fines collected to help restore the lands damaged by this fire.
  Other examples involve off-road vehicles. Throughout the west, and 
especially in Colorado, increased growth and development has resulted 
in an increase in recreational use of our public lands. These 
recreational uses have, in some cases, stressed the capacity of the 
public land agencies to adequately control and manage such use. As a 
result, areas of our public lands are being damaged. These impacts can 
include: damage to wildlife habitat; increased run-off and sediment 
pollution in rivers and streams,; damage to sensitive high-altitude 
tundra, desert soils, and wetlands; creation of ruts and other visual 
impacts on the landscape; loss of quiet and secluded areas of the 
public lands; and adverse effects on wildlife.

  Recreational off-road vehicle use on our public lands should be 
allowed to continue, but it must be managed to minimize or avoid these 
problems by appropriate restrictions and putting some sensitive areas 
off-limits to vehicle use. Again, most vehicle users are responsible--
they stay on designated roads and trails, they are respectful of the 
landscape and they endeavor to tread lightly. However, there are a 
number of such users who do not obey the rules. Given the nature of 
this use, large, powerful motorized vehicles that are able to penetrate 
deeper and deeper into previously secluded areas, even a relatively few 
who violate management requirements can create serious damage to public 
land resources.
  For example, in the summer of 2000 two recreational off-road vehicle 
users ignored closure signs while four-wheel driving on Bureau of Land 
Management land high above Silverton, Colorado. As a result, they got 
stuck for five days on a 70 percent slope at 12,500 feet along the 
flanks of Houghton Mountain. At first, they abandoned their vehicles. 
Then, they returned with other vehicles to pull their vehicles out of 
the mud and off the mountain. The result was significant damage to the 
high alpine tundra, a delicate ecosystem that may take thousands of 
years to recover. As noted in a Denver Post story about this incident, 
``alpine plant life has evolved to withstand freezing temperatures, 
nearly year-round frost, drought, high winds and intense solar 
radiation, but it is helpless against big tires.'' The violators at 
this incident were fined. Again, this bill would allow those fines to 
be applied to address the specific damage that resulted.
  These are but two examples. Regrettably, there have been many more 
such examples not only in Colorado but also throughout the west. These 
examples underscore the nature of the problem that this bill would 
address. This bill would give the Federal public land agencies the 
ability to apply resources to recover damaged lands from illegal 
activities.
  This is a modest bill but an important one. I think it deserves the 
support of our colleagues and I will do all I can to achieve its 
enactment into law.
  Mr. President, 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. 720

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

     SECTION 1. SHORT TITLE AND FINDINGS.

       (a) Short Title.--This Act may be cited as the ``Federal 
     Land Restoration, Enhancement, Public Education, and 
     Information Resources Act'' or the ``Federal Land REPAIR 
     Act''.
       (b) Findings.--Congress finds that--
       (1) violations of laws (including regulations) applicable 
     to the use of Federal land under the jurisdiction of the 
     Secretary of the Interior or the Secretary of Agriculture 
     often result in damages to the Federal land that require 
     expenditures for restoration activities to mitigate the 
     damages;
       (2) increased public information and education regarding 
     the laws (including regulations) applicable to the use of the 
     Federal land can help to reduce the frequency of 
     unintentional violations; and
       (3) it is appropriate that fines and other monetary 
     penalties paid as a result of violations of laws (including 
     regulations) applicable to the use of Federal land be used to 
     defray the costs of the restoration activities and to provide 
     public information and education.

     SEC. 2. USE OF FINES FROM VIOLATIONS OF LAWS AND REGULATIONS 
                   APPLICABLE TO PUBLIC LAND FOR RESTORATION AND 
                   INFORMATIONAL ACTIVITIES.

       (a) Land Under Jurisdiction of Bureau of Land Management.--
     Section 305 of the Federal Land Policy and Management Act of 
     1976 (43 U.S.C. 1735) is amended by adding at the end the 
     following:
       ``(d) Use of Collected Fines.--
       ``(1) Availability and authorized use.--Any amounts 
     received by the United States as a result of a fine imposed 
     under section 3571 of title 18, United States Code, for a 
     violation of a regulation prescribed under section 303(a) 
     shall be available to the Secretary, without further 
     appropriation and until expended--
       ``(A) to cover the cost to the United States of any 
     improvement, protection, or rehabilitation work on public 
     land rendered necessary by the action that led to the fine or 
     by similar actions; and
       ``(B) to increase public awareness of regulations and other 
     requirements regarding the use of public land.
       ``(2) Treatment of excess funds.--Amounts referred to in 
     paragraph (1) that the Secretary determines are in excess of 
     the amounts necessary to carry out the purposes specified in 
     that paragraph shall be transferred to the Crime Victims Fund 
     established by section 1402 of the Victims of Crime Act of 
     1984 (42 U.S.C. 10601).''.
       (b) National Park System Lands.--Section 3 of the National 
     Park Service Organic Act (16 U.S.C. 3), is amended--
       (1) by striking ``That the Secretary'' the first place it 
     appears and inserting ``(a) Regulations for Use and 
     Management of National Park System; Enforcement.--The 
     Secretary'';
       (2) by striking ``He may also'' the first place it appears 
     and inserting the following:
       ``(b) Special Management Authorities.--
       ``(1) In general.--The Secretary of the Interior may'';
       (3) by striking ``He may also'' the second place it appears 
     and inserting the following:
       ``(2) Detrimental animals and plants.--The Secretary 
     may;''.
       (4) by striking ``No natural,'' and inserting the 
     following:
       ``(c) Lease and Permit Authorities.--No natural''; and
       (5) by adding at the end the following:

[[Page S3920]]

       ``(d) Use of Collected Fines.--
       ``(1) Availability and authorized use.--Any amounts 
     received by the United States as a result of a fine imposed 
     under section 3571 of title 18, United States Code, for a 
     violation of a rule or regulation prescribed under this 
     section shall be available to the Secretary of the Interior, 
     without further appropriation and until expended--
       ``(A) to cover the cost to the United States of any 
     improvement, protection, or rehabilitation work on the 
     National Park System land rendered necessary by the action 
     that led to the fine or by similar actions; and
       ``(B) to increase public awareness of rules, regulations, 
     and other requirements regarding the use of National Park 
     System land.
       ``(2) Treatment of excess funds.--Amounts referred to in 
     paragraph (1) that the Secretary determines are in excess of 
     the amounts necessary to carry out the purposes specified in 
     that paragraph shall be transferred to the Crime Victims Fund 
     established by section 1402 of the Victims of Crime Act of 
     1984 (42 U.S.C. 10601).''.
       (c) National Wildlife Refuge System Lands.--Section 4(f) of 
     the National Wildlife Refuge System Administration Act of 
     1966 (16 U.S.C. 668dd(f)) is amended by adding at the end the 
     following:
       ``(3) Use of collected fines.--Any amounts received by the 
     United States as a result of a fine imposed under section 
     3571 of title 18, United States Code, for a violation of this 
     Act (including a regulation issued under this Act) shall be 
     available to the Secretary, without further appropriation and 
     until expended--
       ``(A) to cover the cost to the United States of any 
     improvement, protection, or rehabilitation work on System 
     land rendered necessary by the action that led to the fine or 
     by similar actions; and
       ``(B) to increase public awareness of rules, regulations, 
     and other requirements regarding the use of System land.
       ``(4) Treatment of excess funds.--Amounts referred to in 
     paragraph (3) that the Secretary determines are in excess of 
     the amounts necessary to carry out the purposes specified in 
     that paragraph shall be transferred to the Crime Victims Fund 
     established by section 1402 of the Victims of Crime Act of 
     1984 (42 U.S.C. 10601).''.
       (d) National Forest System Land.--The eleventh undesignated 
     paragraph under the heading ``surveying the public lands'' of 
     the Act of June 4, 1897 (16 U.S.C. 551), is amended--
       (1) by striking ``The Secretary'' and inserting the 
     following:

     ``SEC. 3. PROTECTION OF NATIONAL FOREST SYSTEM LAND; 
                   REGULATIONS.

       ``(a) Regulations for Use and Protection of National Forest 
     System.--
       ``(1) In general.--The Secretary'';
       (2) by striking ``continued; and he may'' and inserting the 
     following: ``continued.
       ``(2) Regulations.--The Secretary may'';
       (3) by striking ``destruction; and any violation'' and 
     inserting the following: ``destruction.
       ``(b) Violations; Penalties.--
       ``(1) In general.--Any violation'';
       (4) by striking ``Any person'' and inserting the following:
       ``(2) Magistrate judge.--Any person'';
       (5) by adding at the end the following:
       ``(c) Use of Collected Fines.--
       ``(1) Availability and authorized use.--Any amounts 
     received by the United States as a result of a collateral 
     payment in lieu of appearance or a fine imposed under section 
     3571 of title 18, United States Code, for a violation of a 
     regulation issued under subsection (a) shall be available to 
     the Secretary of Agriculture, without further appropriation 
     and until expended--
       ``(A) to cover the cost to the United States of any 
     improvement, protection, or rehabilitation work on National 
     Forest System land rendered necessary by the action that led 
     to the fine or payment; and
       ``(B) to increase public awareness of rules, regulations, 
     and other requirements regarding the use of National Forest 
     System land.
       ``(2) Treatment of excess funds.--Amounts referred to in 
     paragraph (1) that the Secretary of Agriculture determines 
     are in excess of the amounts necessary to carry out the 
     purposes specified in that paragraph shall be transferred to 
     the Crime Victims Fund established by section 1402 of the 
     Victims of Crime Act of 1984 (42 U.S.C. 10601).''; and
       (6) by moving section 3 (as designated by paragraph (1)) so 
     as to appear at the end of that Act.
                                 ______
                                 
      By Mrs. MURRAY (for herself and Ms. Cantwell):
  S. 721. A bill to expand the Alpine Lakes Wilderness in the State of 
Washington, to designate the Middle Fork Snoqualmie Ricer and Pratt 
River as wild and scenic rivers, and for other purposes; to the 
Committee on Energy and Natural Resources.
  Mrs. MURRAY. Mr. President, 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 
placed in the Record, as follows:

                                 S. 721

       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 ``Alpine Lakes Wilderness 
     Additions and Pratt and Middle Fork Snoqualmie Rivers 
     Protection Act''.

     SEC. 2. EXPANSION OF ALPINE LAKES WILDERNESS.

       (a) In General.--There is designated as wilderness and as a 
     component of the National Wilderness Preservation System 
     certain Federal land in the Mount Baker-Snoqualmie National 
     Forest in the State of Washington comprising approximately 
     22,100 acres, as generally depicted on the map entitled 
     ``Proposed Alpine Lakes Wilderness Additions'' and dated 
     March 23, 2009, which is incorporated in and shall be 
     considered to be a part of the Alpine Lakes Wilderness.
       (b) Administration.--
       (1) Management.--Subject to valid existing rights, the land 
     designated as wilderness by subsection (a) shall be 
     administered by the Secretary of Agriculture (referred to in 
     this section as the ``Secretary''), in accordance with the 
     Wilderness Act (16 U.S.C. 1131 et seq.), except that any 
     reference in that Act to the effective date of that Act shall 
     be considered to be a reference to the date of enactment of 
     this Act.
       (2) Map and description.--
       (A) In general.--As soon as practicable after the date of 
     enactment of this Act, the Secretary shall file a map and a 
     legal description of each wilderness area designated by 
     subsection (a) with--
       (i) the Committee on Natural Resources of the House of 
     Representatives; and
       (ii) the Committee on Energy and Natural Resources of the 
     Senate.
       (B) Force of law.--A map and legal description filed under 
     subparagraph (A) shall have the same force and effect as if 
     included in this Act, except that the Secretary may correct 
     errors in the map and legal description.
       (C) Public availability.--Each map and legal description 
     filed under subparagraph (A) shall be filed and made 
     available for public inspection in the appropriate office of 
     the Secretary.
       (c) Incorporation of Acquired Land and Interest.--Any land 
     within the boundary of the land designated as wilderness by 
     subsection (a) that is acquired by the United States shall--
       (1) become part of the wilderness area; and
       (2) be managed in accordance with subsection (b)(1).

     SEC. 3. WILD AND SCENIC RIVER DESIGNATIONS.

       Section 3(a) of the Wild and Scenic Rivers Act (16 U.S.C. 
     1274(a)) is amended by adding at the end the following:
       ``(171) Middle fork snoqualmie, washington.--The 27.4-mile 
     segment from the headwaters of the Middle Fork Snoqualmie 
     River near La Bohn Gap in NE \1/4\ sec. 20, T. 24 N., R. 13 
     E., to the northern boundary of sec.11, T. 23 N., R. 9 E., to 
     be administered by the Secretary of Agriculture in the 
     following classifications:
       ``(A) The approximately 6.4-mile segment from the 
     headwaters of the Middle Fork Snoqualmie River near La Bohn 
     Gap in NE \1/4\ sec. 20, T. 24 N., R. 13 E., to the west 
     section line of sec. 3, T. 23 N., R. 12 E., as a wild river.
       ``(B) The approximately 21-mile segment from the west 
     section line of sec. 3, T. 23 N., R. 12 E., to the northern 
     boundary of sec. 11, T. 23 N., R. 9 E., as a scenic river.
       ``(172) Pratt river, washington.--The entirety of the Pratt 
     River in the State of Washington, located in the Mount Baker-
     Snoqualmie National Forest, to be administered by the 
     Secretary of Agriculture as a wild river.''.
                                 ______
                                 
      By Mr. BAUCUS (for himself, Mr. Rockefeller, and Mr. Schumer):
  S. 722. A bill to amend the Internal Revenue Code of 1986 to provide 
for permanent alternative minimum tax relief, middle class tax relief, 
and estate tax relief, and to permanently extend certain expiring 
provisions, and for other purposes; to the Committee on Finance.
  Mr. BAUCUS. Mr. President, there is a storm brewing. This storm is 
not an act of God. It is man-made. It is coming to a head next year.
  The 2001 tax cut law gave much-needed tax relief to families with 
children. It gave much-needed tax relief to families with college 
students. It gave much-needed relief to family-owned businesses.
  I worked on those tax cuts. I believed in them.
  But the provisions in that bill expire on December 31, 2010.
  Since the day that we passed that bill, we have passed others. These 
other bills expanded and enhanced some of the 2001 provisions that help 
America's families.
  Next year, all that we have done disappears. American families are 
left in a state of uncertainty. This uncertainty undermines confidence 
in the Government and the future.
  That is why, today, I am introducing the Taxpayer Certainty and 
Relief Act of 2009.
  This bill would make permanent several expiring provisions that help 
families.

[[Page S3921]]

  This bill would make permanent the tax cuts for the 10 percent, 15 
percent, 25 percent, and 25 percent tax brackets. Without this change, 
taxpayers would experience up to a $5,000 tax increase. This bill would 
make permanent the lower capital gains rates for taxpayers in these 
brackets.
  This bill would makes permanent the marriage penalty relief enacted 
in 2001. This would guaranty that married couples would not be 
penalized when they take their wedding vows.
  This bill would also make permanent the $1,000 child tax credit. It 
would also make permanent the refundable child tax credit, with a 
threshold of $3,000, that was recently passed as part of the American 
Recovery and Reinvestment Act.
  This is important because prior to the 2001 bill, this credit was 
$500 and not refundable.
  This bill would make permanent the expansion of the earned income tax 
credit. As a result, married couples would get more relief and families 
with three or more children would get a larger credit.
  The bill would help working men and women by making permanent the 
changes to the dependent and child care credit. This credit helps cover 
the increased expenses of providing child care during a time when 
everyone is struggling to stay employed and weather this economic 
downturn.
  This bill would also make permanent the increased credit for 
adoption. Giving a child a home and love is expensive. Families that 
adopt children have a lot of expenses. This bill would continue to give 
a $10,000 credit for adoption expenses.
  These provisions recognize the increased cost of raising children. 
Congress values families and wants every family to succeed.
  Another problem that Congress has to tackle every year is the 
Alternative Minimum Tax, or the AMT. This tax creeps up on millions of 
taxpayers every year. Every year, Congress holds this monster at bay, 
making sure no new taxpayers pay this horrible tax.
  As a result, the number of taxpayers paying the AMT remains at just 
over 4 million. Without Congress's action, 26 million people would have 
to pay this tax.
  This bill would permanently fix the AMT. It sets the exemption at 
2009 levels and indexes it for future years. It also allows the AMT 
against the nonrefundable credits.
  Finally, this bill would offer certainty on the estate tax. This is 
something that I have tried to get done over and over again. The 
Finance Committee held several hearings discussing this tax. This bill 
makes permanent current law. This bill would set the exemption at $3.5 
million, or $7 million for married couples. It would also set the tax 
rate at 45 percent.
  We have also made some other needed fixes. This bill would unify the 
gift and estate taxes. This bill would also allow a decedent spouse to 
transfer any unused exemption to the surviving spouse. This is known as 
portability.
  I believe that this bill is just the beginning. I realize there are 
other tax cuts that need to be made permanent. For example, I hope to 
address education issues later this year.
  But today, let us begin to give working families some shelter from 
the coming storm.
  Mr. President, 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. 722

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

     SECTION 1. SHORT TITLE, ETC.

       (a) Short Title.--This Act may be cited as the ``Taxpayer 
     Certainty and Relief Act of 2009''.
       (b) Amendment of 1986 Code.--Except as otherwise expressly 
     provided, whenever in this Act an amendment or repeal is 
     expressed in terms of an amendment to, or repeal of, a 
     section or other provision, the reference shall be considered 
     to be made to a section or other provision of the Internal 
     Revenue Code of 1986.
       (c) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title, etc.

           TITLE I--PERMANENT ALTERNATIVE MINIMUM TAX RELIEF

Sec. 101. Exemption amounts made permanent.
Sec. 102. Exemption amounts indexed for inflation.
Sec. 103. Alternative minimum tax relief for nonrefundable credits.

              TITLE II--PERMANENT MIDDLE CLASS TAX RELIEF

Sec. 201. Permanent reduction in tax rates for lower-income and middle-
              income individuals.
Sec. 202. Permanent reduction in rates on capital gains for lower-
              income and middle-income taxpayers.
Sec. 203. Modifications to child tax credit.
Sec. 204. Repeal of sunset on marriage penalty relief.
Sec. 205. Repeal of sunset on expansion of dependent care credit.
Sec. 206. Repeal of sunset on expansion of adoption credit and adoption 
              assistance programs.
Sec. 207. Expansion of earned income tax credit.

                 TITLE III--PERMANENT ESTATE TAX RELIEF

Sec. 301. Permanent extension of estate tax as in effect in 2009.
Sec. 302. Unified credit increased by unused unified credit of deceased 
              spouse.

           TITLE I--PERMANENT ALTERNATIVE MINIMUM TAX RELIEF

     SEC. 101. EXEMPTION AMOUNTS MADE PERMANENT.

       (a) In General.--Paragraph (1) of section 55(d) is 
     amended--
       (1) by striking ``$45,000 ($70,950 in the case of taxable 
     years beginning in 2009)'' in subparagraph (A) and inserting 
     ``$70,950 in the case of'',
       (2) by striking ``$33,750 ($46,700 in the case of taxable 
     years beginning in 2009)'' in subparagraph (B) and inserting 
     ``$46,700 in the case of an individual who'', and
       (3) by striking ``paragraph (1)(A)'' in subparagraph (C) 
     and inserting ``subparagraph (A)''.
       (b) Repeal of EGTRRA Sunset.--Title IX of the Economic 
     Growth and Tax Relief Reconciliation Act of 2001 (relating to 
     sunset of provisions of such Act) shall not apply to section 
     701 of such Act (relating to increase in alternative minimum 
     tax exemption).
       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2009.

     SEC. 102. EXEMPTION AMOUNTS INDEXED FOR INFLATION.

       (a) In General.--Subsection (d) of section 55 is amended by 
     adding at the end the following new paragraph:
       ``(4) Inflation adjustment.--
       ``(A) In general.--In the case of any taxable year 
     beginning in a calendar year after 2009, each of the dollar 
     amounts contained in subsection (b)(1)(A)(i) and paragraphs 
     (1)(A), (1)(B), (1)(D), (3)(A), and (3)(B) of this subsection 
     shall be increased by an amount equal to--
       ``(i) such dollar amount, multiplied by
       ``(ii) the cost-of-living adjustment determined under 
     section 1(f)(3) for the calendar year in which the taxable 
     year begins, determined by substituting `calendar year 2008' 
     for `calendar year 1992' in subparagraph (B) thereof.
       ``(B) Rounding.--Any increase determined under subparagraph 
     (A) shall be rounded to the nearest multiple of $100.''.
       (b) Conforming Amendments.--
       (1) Clause (iii) of section 55(b)(1)(A) is amended by 
     striking ``by substituting'' and all that follows through 
     ``appears.'' and inserting ``by substituting 50 percent of 
     the dollar amount otherwise applicable under subclause (I) 
     and subclause (II) thereof''.
       (2) Paragraph (3) of section 55(d) is amended--
       (A) by striking ``or (2)'' in subparagraph (A),
       (B) by striking ``and'' at the end of subparagraph (B), and
       (C) by striking subparagraph (C) and inserting the 
     following new subparagraphs:
       ``(C) 50 percent of the dollar amount applicable under 
     subparagraph (A) in the case of a taxpayer described in 
     subparagraph (C) or (D) of paragraph (1), and
       ``(D) $150,000 in the case of a taxpayer described in 
     paragraph (2).''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2009.

     SEC. 103. ALTERNATIVE MINIMUM TAX RELIEF FOR NONREFUNDABLE 
                   CREDITS.

       (a) In General.--Subsection (a) of section 26 is amended to 
     read as follows:
       ``(a) Limitation Based on Amount of Tax.--The aggregate 
     amount of credits allowed by this subpart for the taxable 
     year shall not exceed the sum of--
       ``(1) the taxpayer's regular tax liability for the taxable 
     year reduced by the foreign tax credit allowable under 
     section 27(a), and
       ``(2) the tax imposed by section 55(a) for the taxable 
     year.''.
       (b) Conforming Amendments.--
       (1) Adoption credit.--
       (A) Section 23(b) is amended by striking paragraph (4).
       (B) Section 23(c) is amended by striking paragraphs (1) and 
     (2) and inserting the following:
       ``(1) In general.--If the credit allowable under subsection 
     (a) for any taxable year exceeds the limitation imposed by 
     section 26(a) for such taxable year reduced by the sum of the 
     credits allowable under this subpart (other than this section 
     and sections 25D and 1400C), such excess shall be carried to 
     the succeeding taxable year and added to the

[[Page S3922]]

     credit allowable under subsection (a) for such taxable 
     year.''.
       (C) Section 23(c) is amended by redesignating paragraph (3) 
     as paragraph (2).
       (2) Child tax credit.--
       (A) Section 24(b) is amended by striking paragraph (3).
       (B) Section 24(d)(1) is amended--
       (i) by striking ``section 26(a)(2) or subsection (b)(3), as 
     the case may be,'' each place it appears in subparagraphs (A) 
     and (B) and inserting ``section 26(a)'', and
       (ii) by striking ``section 26(a)(2) or subsection (b)(3), 
     as the case may be'' in the second last sentence and 
     inserting ``section 26(a)''.
       (3) Credit for interest on certain home mortgages.--Section 
     25(e)(1)(C) is amended to read as follows:
       ``(C) Applicable tax limit.--For purposes of this 
     paragraph, the term `applicable tax limit' means the 
     limitation imposed by section 26(a) for the taxable year 
     reduced by the sum of the credits allowable under this 
     subpart (other than this section and sections 23, 25D, and 
     1400C).''.
       (4) Savers' credit.--Section 25B is amended by striking 
     subsection (g).
       (5) Residential energy efficient property.--Section 25D(c) 
     is amended to read as follows:
       ``(c) Carryforward of Unused Credit.--If the credit 
     allowable under subsection (a) exceeds the limitation imposed 
     by section 26(a) for such taxable year reduced by the sum of 
     the credits allowable under this subpart (other than this 
     section), such excess shall be carried to the succeeding 
     taxable year and added to the credit allowable under 
     subsection (a) for such succeeding taxable year.''.
       (6) Certain plug-in electric vehicles.--Section 30(c)(2) is 
     amended to read as follows:
       ``(2) Personal credit.--For purposes of this title, the 
     credit allowed under subsection (a) for any taxable year 
     (determined after application of paragraph (1)) shall be 
     treated as a credit allowable under subpart A for such 
     taxable year.''.
       (7) Alternative motor vehicle credit.--Section 30B(g)(2) is 
     amended to read as follows:
       ``(2) Personal credit.--For purposes of this title, the 
     credit allowed under subsection (a) for any taxable year 
     (determined after application of paragraph (1)) shall be 
     treated as a credit allowable under subpart A for such 
     taxable year.''.
       (8) New qualified plug-in electric vehicle credit.--Section 
     30D(c)(2) is amended to read as follows:
       ``(2) Personal credit.--For purposes of this title, the 
     credit allowed under subsection (a) for any taxable year 
     (determined after application of paragraph (1)) shall be 
     treated as a credit allowable under subpart A for such 
     taxable year.''.
       (9) Cross references.--Section 55(c)(3) is amended by 
     striking ``26(a), 30C(d)(2),'' and inserting ``30C(d)(2)''.
       (10) Foreign tax credit.--Section 904 is amended by 
     striking subsection (i) and by redesignating subsections (j) 
     , (k), and (l) as subsections (i), (j), and (k), 
     respectively.
       (11) First-time home buyer credit for the district of 
     columbia.--Section 1400C(d) is amended to read as follows:
       ``(d) Carryforward of Unused Credit.--If the credit 
     allowable under subsection (a) exceeds the limitation imposed 
     by section 26(a) for such taxable year reduced by the sum of 
     the credits allowable under subpart A of part IV of 
     subchapter A (other than this section and section 25D), such 
     excess shall be carried to the succeeding taxable year and 
     added to the credit allowable under subsection (a) for such 
     taxable year.''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2009.

              TITLE II--PERMANENT MIDDLE CLASS TAX RELIEF

     SEC. 201. PERMANENT REDUCTION IN TAX RATES FOR LOWER-INCOME 
                   AND MIDDLE-INCOME INDIVIDUALS.

       (a) In General.--Paragraph (2) of section 1(i) is amended 
     to read as follows:
       ``(2) Reduction in rates.--The tables under subsections 
     (a), (b), (c), (d), and (e) shall be applied--
       ``(A) in the case of taxable years beginning after 2008--
       ``(i) by substituting `25%' for `28%' each place it appears 
     (before the application of clause (ii)), and
       ``(ii) by substituting `28%' for `31%' each place it 
     appears, and
       ``(B) in the case of taxable years beginning in 2009 and 
     2010--
       ``(i) by substituting `33%' for `36%' each place it 
     appears, and
       ``(ii) by substituting `35%' for `39.6%' each place it 
     appears.''.
       (b) Repeal of EGTRRA Sunset.--Title IX of the Economic 
     Growth and Tax Relief Reconciliation Act of 2001 (relating to 
     sunset of provisions of such Act) shall not apply to section 
     101 of such Act (relating to reduction in income tax rates 
     for individuals).
       (c) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after December 31, 
     2008.

     SEC. 202. PERMANENT REDUCTION IN RATES ON CAPITAL GAINS FOR 
                   LOWER-INCOME AND MIDDLE-INCOME TAXPAYERS.

       (a) In General.--
       (1) Regular tax.--Section 1(h)(1) is amended by 
     redesignating subparagraphs (D) and (E) as subparagraphs (E) 
     and (F), respectively, and by striking subparagraph (C) and 
     inserting the following:
       ``(C) 15 percent of the lesser of--
       ``(i) so much of the adjusted net capital gain (or, if 
     less, taxable income) as exceeds the amount on which a tax is 
     determined under subparagraph (B), or
       ``(ii) the excess (if any) of--

       ``(I) amount of taxable income which would (without regard 
     to this paragraph) be taxed at a rate below the second 
     highest tax rate, over
       ``(II) the greater of the amounts determined under clauses 
     (i) and (ii) of subparagraph (B);

       ``(D) 20 percent of the adjusted net capital gain (or, if 
     less, taxable income) in excess of the sum of the amounts on 
     which tax is determined under subparagraphs (B) and (C);''.
       (2) Minimum tax.--Section 55(b)(3) is amended by 
     redesignating subparagraph (D) as subparagraphs (E) and by 
     striking subparagraph (C) and inserting the following:
       ``(C) 15 percent of the lesser of--
       ``(i) so much of the adjusted net capital gain (or, if 
     less, taxable excess) as exceeds the amount on which tax is 
     determined under subparagraph (B), or
       ``(ii) the excess described in section 1(h)(1)(C)(ii), plus
       ``(D) 20 percent of the adjusted net capital gain (or, if 
     less, taxable excess) in excess of the sum of the amounts on 
     which tax is determined under subparagraphs (B) and (C), 
     plus''.
       (3) Conforming amendments.--
       (A) The following sections are each amended by striking 
     ``15 percent'' and inserting ``20 percent'':
       (i) Section 1445(e)(1).
       (ii) The second sentence of section 7518(g)(6)(A).
       (iii) Section 53511(f)(2) of title 46, United States Code.
       (B) Section 1(h)(1)(B) is amended by striking ``5 percent 
     (0 percent in the case of taxable years beginning after 
     2007)'' and inserting ``0 percent''.
       (C) Section 55(b)(3)(B) is amended by striking ``5 percent 
     (0 percent in the case of taxable years beginning after 
     2007)'' and inserting ``0 percent''.
       (D) Section 1445(e)(6) is amended by striking ``15 percent 
     (20 percent in the case of taxable years beginning after 
     December 31, 2010)'' and inserting ``20 percent''.
       (b) Effective Dates.--
       (1) In general.--Except as provided in paragraph (2), the 
     amendments made by this section shall apply to taxable years 
     beginning after December 31, 2010.
       (2) Withholding.--The amendment made by subsection 
     (a)(3)(A)(i) shall apply to amounts paid on or after January 
     1, 2011.
       (c) Repeal of JGTRRA Sunset.--Section 303 of the Jobs and 
     Growth Tax Relief Reconciliation Act of 2003 is repealed.

     SEC. 203. MODIFICATIONS TO CHILD TAX CREDIT.

       (a) Repeal of EGTRRA Sunset.--Title IX of the Economic 
     Growth and Tax Relief Reconciliation Act of 2001 (relating to 
     sunset of provisions of such Act) shall not apply to sections 
     201 (relating to modifications to child tax credit) and 203 
     (relating to refunds disregarded in the administration of 
     federal programs and federally assisted programs) of such 
     Act.
       (b) Modification of Threshold Amount.--
       (1) In general.--Clause (i) of section 24(d)(1)(B) is 
     amended by striking ``$10,000'' and inserting ``$3,000''.
       (2) Repeal of inflation adjustment to earned income base.--
     Subsection (d) of section 24 (relating to portion of credit 
     refundable) is amended by striking paragraph (3).
       (3) Conforming amendment.--Section 24(d) is amended by 
     striking paragraph (4).
       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2010.

     SEC. 204. REPEAL OF SUNSET ON MARRIAGE PENALTY RELIEF.

       Title IX of the Economic Growth and Tax Relief 
     Reconciliation Act of 2001 (relating to sunset of provisions 
     of such Act) shall not apply to sections 301, 302, and 303(a) 
     of such Act (relating to marriage penalty relief).

     SEC. 205. REPEAL OF SUNSET ON EXPANSION OF DEPENDENT CARE 
                   CREDIT.

       Title IX of the Economic Growth and Tax Relief 
     Reconciliation Act of 2001 (relating to sunset of provisions 
     of such Act) shall not apply to section 204 of such Act 
     (relating to dependent care credit).

     SEC. 206. REPEAL OF SUNSET ON EXPANSION OF ADOPTION CREDIT 
                   AND ADOPTION ASSISTANCE PROGRAMS.

       Title IX of the Economic Growth and Tax Relief 
     Reconciliation Act of 2001 (relating to sunset of provisions 
     of such Act) shall not apply to section 202 of such Act 
     (relating to expansion of adoption credit and adoption 
     assistance programs).

     SEC. 207. EXPANSION OF EARNED INCOME TAX CREDIT.

       (a) Repeal of EGTRRA Sunset.--Title IX of the Economic 
     Growth and Tax Relief Reconciliation Act of 2001 (relating to 
     sunset of provisions of such Act) shall not apply to 
     subsections (b) through (h) of section 303 of such Act 
     (relating to earned income tax credit).
       (b) Increase in Credit Percentage for Families With 3 or 
     More Children.--Paragraph (1) of section 32(b) is amended by 
     striking subparagraphs (B) and (C) and inserting the 
     following new subparagraph:
       ``(B) Increased credit percentage for families with 3 or 
     more qualifying children.--In the case of an eligible 
     individual with 3 or more qualifying children, the table in 
     subparagraph (A) shall be applied by substituting `45' for 
     `40' in the second column thereof.''.

[[Page S3923]]

       (c) Joint Returns.--
       (1) In general.--Subparagraph (B) of section 32(b)(2) is 
     amended by striking ``increased by'' and all that follows and 
     inserting ``increased by $5,000.''
       (2) Inflation adjustments.--Clause (ii) of section 
     32(j)(1)(B) is amended--
       (A) by striking ``$3,000'' and inserting ``$5,000'', and
       (B) by striking ``calendar year 2007'' and inserting 
     ``calendar year 2008''.
       (d) Conforming Amendment.--Section 32(b) is amended by 
     striking paragraph (3).
       (e) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2009.

                 TITLE III--PERMANENT ESTATE TAX RELIEF

     SEC. 301. PERMANENT EXTENSION OF ESTATE TAX AS IN EFFECT IN 
                   2009.

       (a) Restoration of Unified Credit Against Gift Tax.--
     Paragraph (1) of section 2505(a) (relating to general rule 
     for unified credit against gift tax), after the application 
     of subsection (g), is amended by striking ``(determined as if 
     the applicable exclusion amount were $1,000,000)''.
       (b) Exclusion Equivalent of Unified Credit Equal to 
     $3,500,000.--Subsection (c) of section 2010 (relating to 
     unified credit against estate tax) is amended to read as 
     follows:
       ``(c) Applicable Credit Amount.--
       ``(1) In general.--For purposes of this section, the 
     applicable credit amount is the amount of the tentative tax 
     which would be determined under section 2001(c) if the amount 
     with respect to which such tentative tax is to be computed 
     were equal to the applicable exclusion amount.
       ``(2) Applicable exclusion amount.--
       ``(A) In general.--For purposes of this subsection, the 
     applicable exclusion amount is $3,500,000.
       ``(B) Inflation adjustment.--In the case of any decedent 
     dying in a calendar year after 2010, the dollar amount in 
     subparagraph (A) shall be increased by an amount equal to--
       ``(i) such dollar amount, multiplied by
       ``(ii) the cost-of-living adjustment determined under 
     section 1(f)(3) for such calendar year by substituting 
     `calendar year 2009' for `calendar year 1992' in subparagraph 
     (B) thereof.

     If any amount as adjusted under the preceding sentence is not 
     a multiple of $10,000, such amount shall be rounded to the 
     nearest multiple of $10,000.''.
       (c) Maximum Estate Tax Rate Equal to 45 Percent.--
       (1) In general.--Subsection (c) of section 2001 (relating 
     to imposition and rate of tax) is amended--
       (A) by striking ``but not over $2,000,000'' in the table 
     contained in paragraph (1),
       (B) by striking the last 2 items in such table,
       (C) by striking ``(1) in general.--'', and
       (D) by striking paragraph (2).
       (2) Conforming amendment.--Paragraphs (1) and (2) of 
     section 2102(b) are amended to read as follows:
       ``(1) In general.--A credit in an amount that would be 
     determined under section 2010 as the applicable credit amount 
     if the applicable exclusion amount were $60,000 shall be 
     allowed against the tax imposed by section 2101.
       ``(2) Residents of possessions of the united states.--In 
     the case of a decedent who is considered to be a `nonresident 
     not a citizen of the United States' under section 2209, the 
     credit allowed under this subsection shall not be less than 
     the proportion of the amount that would be determined under 
     section 2010 as the applicable credit amount if the 
     applicable exclusion amount were $175,000 which the value of 
     that part of the decedent's gross estate which at the time of 
     the decedent's death is situated in the United States bears 
     to the value of the decedent's entire gross estate, wherever 
     situated.''.
       (d) Modifications of Estate and Gift Taxes to Reflect 
     Differences in Unified Credit Resulting From Different Tax 
     Rates.--
       (1) Estate tax.--
       (A) In general.--Section 2001(b)(2) (relating to 
     computation of tax) is amended by striking ``if the 
     provisions of subsection (c) (as in effect at the decedent's 
     death)'' and inserting ``if the modifications described in 
     subsection (g)''.
       (B) Modifications.--Section 2001 is amended by adding at 
     the end the following new subsection:
       ``(g) Modifications to Gift Tax Payable to Reflect 
     Different Tax Rates.--For purposes of applying subsection 
     (b)(2) with respect to 1 or more gifts, the rates of tax 
     under subsection (c) in effect at the decedent's death shall, 
     in lieu of the rates of tax in effect at the time of such 
     gifts, be used both to compute--
       ``(1) the tax imposed by chapter 12 with respect to such 
     gifts, and
       ``(2) the credit allowed against such tax under section 
     2505, including in computing--
       ``(A) the applicable credit amount under section 
     2505(a)(1), and
       ``(B) the sum of the amounts allowed as a credit for all 
     preceding periods under section 2505(a)(2).

     For purposes of paragraph (2)(A), the applicable credit 
     amount for any calendar year before 1998 is the amount which 
     would be determined under section 2010(c) if the applicable 
     exclusion amount were the dollar amount under section 
     6018(a)(1) for such year.''.
       (2) Gift tax.--Section 2505(a) (relating to unified credit 
     against gift tax) is amended by adding at the end the 
     following new flush sentence:

     ``For purposes of applying paragraph (2) for any calendar 
     year, the rates of tax in effect under section 2502(a)(2) for 
     such calendar year shall, in lieu of the rates of tax in 
     effect for preceding calendar periods, be used in determining 
     the amounts allowable as a credit under this section for all 
     preceding calendar periods.''.
       (e) Increase in Aggregate Reduction in Fair Market Value 
     Allowed Under Special Use Valuation.--Section 2032A(a) 
     (relating to value based on use under which property 
     qualifies) is amended--
       (1) by striking ``$750,000'' in paragraph (2) and inserting 
     ``$3,500,000,
       (2) by striking ``1998'' in paragraph (3) and inserting 
     ``2010'',
       (3) by striking ``$750,000'' in paragraph (3) and inserting 
     ``$3,500,000'', and
       (4) by striking ``1997'' in paragraph (3) and inserting 
     ``2009''.
       (f) Effective Date.--The amendments made by this section 
     shall apply to estates of decedents dying, generation-
     skipping transfers, and gifts made, after December 31, 2009.
       (g) Additional Modifications to Estate Tax.--
       (1) In general.--The following provisions of the Economic 
     Growth and Tax Relief Reconciliation Act of 2001, and the 
     amendments made by such provisions, are hereby repealed:
       (A) Subtitles A and E of title V.
       (B) Subsection (d), and so much of subsection (f)(3) as 
     relates to subsection (d), of section 511.
       (C) Paragraph (2) of subsection (b), and paragraph (2) of 
     subsection (e), of section 521.
     The Internal Revenue Code of 1986 shall be applied as if such 
     provisions and amendments had never been enacted.
       (2) Sunset not to apply to title v of egtrra.--Section 901 
     of the Economic Growth and Tax Relief Reconciliation Act of 
     2001 shall not apply to title V of such Act.
       (3) Repeal of deadwood.--
       (A) Sections 2011, 2057, and 2604 are hereby repealed.
       (B) The table of sections for part II of subchapter A of 
     chapter 11 is amended by striking the item relating to 
     section 2011.
       (C) The table of sections for part IV of subchapter A of 
     chapter 11 is amended by striking the item relating to 
     section 2057.
       (D) The table of sections for subchapter A of chapter 13 is 
     amended by striking the item relating to section 2604.

     SEC. 302. UNIFIED CREDIT INCREASED BY UNUSED UNIFIED CREDIT 
                   OF DECEASED SPOUSE.

       (a) In General.--Section 2010(c), as amended by section 
     301(b), is amended by striking paragraph (2) and inserting 
     the following new paragraphs:
       ``(2) Applicable exclusion amount.--For purposes of this 
     subsection, the applicable exclusion amount is the sum of--
       ``(A) the basic exclusion amount, and
       ``(B) in the case of a surviving spouse, the aggregate 
     deceased spousal unused exclusion amount.
       ``(3) Basic exclusion amount.--
       ``(A) In general.--For purposes of this subsection, the 
     basic exclusion amount is $3,500,000.
       ``(B) Inflation adjustment.--In the case of any decedent 
     dying in a calendar year after 2010, the dollar amount in 
     subparagraph (A) shall be increased by an amount equal to--
       ``(i) such dollar amount, multiplied by
       ``(ii) the cost-of-living adjustment determined under 
     section 1(f)(3) for such calendar year by substituting 
     `calendar year 2009' for `calendar year 1992' in subparagraph 
     (B) thereof.

     If any amount as adjusted under the preceding sentence is not 
     a multiple of $10,000, such amount shall be rounded to the 
     nearest multiple of $10,000.
       ``(4) Aggregate deceased spousal unused exclusion amount.--
     For purposes of this subsection, the term `aggregate deceased 
     spousal unused exclusion amount' means the lesser of--
       ``(A) the basic exclusion amount, or
       ``(B) the sum of the deceased spousal unused exclusion 
     amounts computed with respect to each deceased spouse of the 
     surviving spouse.
       ``(5) Deceased spousal unused exclusion amount.--For 
     purposes of this subsection, the term `deceased spousal 
     unused exclusion amount' means, with respect to the surviving 
     spouse of any deceased spouse dying after December 31, 2009, 
     the excess (if any) of--
       ``(A) the basic exclusion amount of the deceased spouse, 
     over
       ``(B) the amount with respect to which the tentative tax is 
     determined under section 2001(b)(1) on the estate of such 
     deceased spouse.
       ``(6) Special rules.--
       ``(A) Election required.--A deceased spousal unused 
     exclusion amount may not be taken into account by a surviving 
     spouse under paragraph (5) unless the executor of the estate 
     of the deceased spouse files an estate tax return on which 
     such amount is computed and makes an election on such return 
     that such amount may be so taken into account. Such election, 
     once made, shall be irrevocable. No election may be made 
     under this subparagraph if such return is filed after the 
     time prescribed by law (including extensions) for filing such 
     return.
       ``(B) Examination of prior returns after expiration of 
     period of limitations with

[[Page S3924]]

     respect to deceased spousal unused exclusion amount.--
     Notwithstanding any period of limitation in section 6501, 
     after the time has expired under section 6501 within which a 
     tax may be assessed under chapter 11 or 12 with respect to a 
     deceased spousal unused exclusion amount, the Secretary may 
     examine a return of the deceased spouse to make 
     determinations with respect to such amount for purposes of 
     carrying out this subsection.
       ``(7) Regulations.--The Secretary shall prescribe such 
     regulations as may be necessary or appropriate to carry out 
     this subsection.''.
       (b) Conforming Amendments.--
       (1) Paragraph (1) of section 2505(a), as amended by section 
     301(a), is amended to read as follows:
       ``(1) the applicable credit amount in effect under section 
     2010(c) which would apply if the donor died as of the end of 
     the calendar year, reduced by''.
       (2) Section 2631(c) is amended by striking ``the applicable 
     exclusion amount'' and inserting ``the basic exclusion 
     amount''.
       (3) Section 6018(a)(1) is amended by striking ``applicable 
     exclusion amount'' and inserting ``basic exclusion amount''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to estates of decedents dying, generation-
     skipping transfers, and gifts made, after December 31, 2009.
                                 ______
                                 
      By Mr. WYDEN (for himself, Ms. Collins, Mr. Dodd, and Mr. 
        Carper):
  S. 723. A bill to prohibit the introduction or delivery for 
introduction into interstate commerce of novelty lighters, and for 
other purposes; to the Committee on Commerce, Science, and 
Transportation.
  Mr. WYDEN. Mr. President, today, I am joining my colleagues from 
Maine, Connecticut, and Delaware, in introducing the Protect Children 
from Dangerous Lighters Act, a ban on novelty cigarette lighters.
  Novelty lighters, also known as toy-like lighters, are cigarette 
lighters that look like small children's toys or regular household 
items. In the hands of small children they can be very dangerous. 
Because they are so well disguised as toys, a child could easily pick 
one up to play with it without realizing that it could be very 
hazardous.
  The result of this mistake can be deadly: In Oregon, two boys were 
playing with a novelty lighter disguised as a toy dolphin and 
accidently started a serious fire, causing the death of one boy and the 
permanent brain damage of the other. Also in Oregon, a mother suffered 
third degree burns on her foot when her child was playing with a 
novelty lighter shaped like a small toy Christmas tree and set a bed on 
fire.
  Incidents like these happen all over the country. In Maine, a young 
boy took a miniature baseball bat off a shelf at a convenience store, 
accidentally ignited a flame and seared his eyebrow. In North Carolina, 
a boy sustained second degree burns after playing with a novelty 
lighter that looked like a toy cell phone. In one of the most tragic 
examples, a 2-year-old and a 15-month-old from Arkansas were killed in 
a fire they accidently started while playing with a novelty lighter 
shaped like a toy motorcycle.
  These injuries and deaths cry out to us to take action and remove 
these dangerous lighters from shelves everywhere.
  A ban on novelty lighters would require the Consumer Product Safety 
Commission to treat novelty lighters as a banned hazardous substance. 
That means novelty lighters will not be manufactured, imported, sold, 
or given away as promotional gifts anywhere in this country. This 
measure will keep novelty lighters out of the hands of children and 
prevent injuries like those that have already brought tragedy to too 
many families.
  A number of states and cities have taken it upon themselves to ban 
these dangerous lighters. Oregon and four other States have already 
enacted such bans, and thirteen other states are currently considering 
similar measures. It is clear that this is an important safety issue, 
and it is time for the Federal Government to pass this bill so that 
children in all states will be protected.
  A Federal ban on novelty lighters has widespread, nationwide support. 
Along with the Oregon Fire Marshal, the National Association of Fire 
Marshals supports a federal ban on these lighters and has been active 
in promoting public awareness on this issue. I want to thank the 
Congressional Fire Services Institute for their leadership in building 
support for this bill. The cigarette lighter industry, represented by 
the Lighter Association, is a partner in supporting a ban on novelty 
lighters. Finally, consumer groups, such as Safe Kids USA and others 
have endorsed this approach.
  Congress should act now to avoid the suffering caused by the 
senseless deaths and serious injuries that result from novelty lighters 
being mistaken for toys. Dangerous tools containing flammable fuel 
should not be dressed up in packages that are attractive to children; 
especially when young children do not have the capacity to 
differentiate these lighters from common toys. Please join me in 
banning dangerous novelty lighters by cosponsoring the Protect Children 
from Dangerous Lighters Act.
  Mr. President, 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. 723

       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 ``Protect Children from 
     Dangerous Lighters Act of 2009''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Lighters are inherently dangerous products containing 
     flammable fuel.
       (2) If lighters are used incorrectly or used by children, 
     dangerous and damaging consequences may result.
       (3) Novelty lighters are easily mistaken by children and 
     adults as children's toys or as common household items.
       (4) Novelty lighters have been the cause of many personal 
     injuries to children and adults and property damage 
     throughout the United States.

     SEC. 3. NOVELTY LIGHTER DEFINED.

       (a) In General.--In this Act, the term ``novelty lighter'' 
     means a device typically used for the igniting or lighting of 
     cigarettes, cigars, or pipes that has a toy-like appearance, 
     has entertaining audio or visual effects, or resembles in any 
     way in form or function an item that is commonly recognized 
     as appealing, attractive, or intended for use by children of 
     10 years of age or younger, including such a device that 
     takes toy-like physical forms, including toy animals, cartoon 
     characters, cars, boats, airplanes, common household items, 
     weapons, cell phones, batteries, food, beverages, musical 
     instruments, and watches.
       (b) Exclusion.--Such term does not include standard 
     disposable and refillable lighters that are printed or 
     decorated with logos, labels, decals, artwork, or heat 
     shrinkable sleeves.

     SEC. 4. BAN ON NOVELTY LIGHTERS.

       (a) Banned Hazardous Substance.--A novelty lighter shall be 
     treated as a banned hazardous substance as defined in section 
     2 of the Federal Hazardous Substances Act (15 U.S.C. 1261) 
     and the prohibitions set out in section 4 of such Act (15 
     U.S.C. 1263) shall apply to novelty lighters.
       (b) Application.--Subsection (a) applies to a novelty 
     lighter--
       (1) manufactured on or after January 1, 1980; and
       (2) that is not considered by the Consumer Product Safety 
     Commission to be an antique or an item with significant 
     artistic value.

  Ms. COLLINS. Mr. President, I rise to join Senator Wyden in 
introducing a bill that will ban the sale of certain novelty lighters 
that children can mistake for toys, often with tragic consequences for 
themselves and their families.
  In Arkansas in 2007, two boys, ages 15 months and 2 years, died when 
the toddler accidentally started a fire with a lighter shaped like a 
motorcycle. In Oregon, in 2000, a fire started with a dolphin-shaped 
lighter left one child dead and another brain-damaged. In North 
Carolina, a 6-year-old boy was badly burned by a lighter shaped like a 
cell phone.
  Sadly, the U.S. Fire Administration has other stories of the hazards 
presented by novelty lighters. When you learn that one looks like a 
rubber duck toy, and actually quacks, you can imagine the potential for 
harm.
  As a co-chair of the Congressional Fire Services Caucus, I am proud 
to note that last year, my home State of Maine became the first State 
to outlaw the sale of novelty lighters.
  Maine's pioneering law stems from a tragic 2007 incident in a 
Livermore, Maine, grocery store. While his mother was buying 
sandwiches, 6-year-old Shane St. Pierre picked up what appeared to be a 
toy flashlight in the form of a baseball bat. When he flicked the 
switch, a flame shot out and burned his face. Shane's dad, Norm St. 
Pierre, a fire chief in nearby West Paris, began advocating for the 
novelty-lighter ban that became Maine law in March 2008.
  The Maine State Fire Marshal's office supported that legislation, and 
a

[[Page S3925]]

national ban has the support of the Congressional Fire Services 
Institute, the National State Fire Marshals Association, and the 
National Volunteer Fire Council.
  The bill is straightforward. It treats novelty lighters manufactured 
after January 1, 1980, as banned hazardous substances unless the 
Consumer Product Safety Commission determines a particular lighter has 
antique or significant artistic value. Otherwise, sale of lighters with 
toy-like appearance, special audio or visual features, or other 
attributes that would appeal to children under 10 would be banned.
  The novelty lighters targeted in this legislation serve no functional 
need. But they are liable to attract the notice and curiosity of 
children, whose play can too easily turn into a scene of horror and 
death. The sale of lighters that look like animals, cartoon characters, 
food, toys, or other objects is simply irresponsible and an invitation 
to tragedy.
  I urge all of my colleagues to join me in supporting this simple 
measure that can save children from disfigurement and death.
                                 ______
                                 
      By Mr. BINGAMAN (for himself and Mr. Hatch):
  S. 725. A bill to amend the Internal Revenue Code of 1986 to allow 
self-employed individuals to deduct health insurance costs in computing 
self-employment taxes; to the Committee on Finance.
  Mr. BINGAMAN. Mr. President, I rise today along with Senator Hatch to 
reintroduce the Equity for Our Nation's Self-Employed Act of 2009. This 
important legislation corrects an inequity that currently exists in our 
tax code that forces the self-employed to pay payroll taxes on the 
funds used to purchase their health insurance while larger businesses 
do not. Because of this inequity, health insurance is more expensive 
for the self-employed. At a time when the number of people uninsured is 
growing at an alarming rate, we need to find ways to reduce the cost of 
health insurance. This legislation is a first logical step.
  Under current law, corporations and other business entities are able 
to deduct health insurance premiums as a business expense and to forego 
payroll taxes on these costs. However, sole-proprietors are not allowed 
this same deduction and thus, are required to pay self-employment tax, 
their payroll tax, on health insurance premiums. The self-employed are 
the only segment of the business population that is additionally taxed 
on health insurance. The legislation we are introducing today would 
stop this inequitable tax treatment and allow sole proprietors to 
deduct the amount they pay for health insurance from their calculation 
of payroll taxes, leveling the playing field for the over 20 million 
self-employed in our Nation.
  This problem affects all self-employed who provide health insurance 
to their families. According to the IRS, there are almost 130,000 sole-
proprietors in New Mexico. While we do not know how many of these 
people in New Mexico have health insurance, we do know that roughly 3.8 
million working families in the U.S. paid self-employment tax on their 
health insurance premiums. Estimates indicate that roughly 60 percent 
of our Nation's uninsured are either self-employed or work for a small 
business. According to the Kaiser Family Foundation, self-employed 
workers spent upwards of $12,000 per year in 2006 to provide health 
insurance for their families. Because they cannot deduct this as an 
ordinary business expense, those that spend this amount will pay a 15.3 
percent payroll tax on their premiums, resulting in over $1,800 of 
taxes annually.
  This problem was identified by the National Taxpayer Advocate in 
several of her annual reports to Congress and our legislation to 
correct it is supported by over 40 national and State organizations 
including the National Association for the Self-Employed, the National 
Small Business Association, the National Federation of Independent 
Business, National Association of Realtors, the U.S. Chamber of 
Commerce, and the U.S. Hispanic Chamber of Commerce. I look forward to 
working with my colleagues to get this important legislation passed.
  Mr. President, 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 
placed in the Record, as follows:

                                 S. 725

       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 ``Equity for Our Nation's Self 
     Employed Act of 2009''.

     SEC. 2. DEDUCTION FOR HEALTH INSURANCE COSTS IN COMPUTING 
                   SELF-EMPLOYMENT TAXES.

       (a) In General.--Section 162(l) of the Internal Revenue 
     Code of 1986 (relating to special rules for health insurance 
     costs of self-employed individuals) is amended by striking 
     paragraph (4) and by redesignating paragraph (5) as paragraph 
     (4).
       (b) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after the date of the 
     enactment of this Act.
                                 ______
                                 
      By Ms. LANDRIEU (for herself, Mr. Ensign, Mr. Cardin, Mrs. Boxer, 
        Mr. Graham, Ms. Collins, Mr. McCain, Mr. Lautenberg, Mr. 
        Menendez, Mr. Levin, Mr. Carper, Mr. Lieberman, Mr. Byrd, Mr. 
        Kerry, and Mr. Leahy):
  S. 727. A bill to amend title 18, United States Code, to prohibit 
certain conduct relating to the use of horses for human consumption; to 
the Committee on the Judiciary.
  Ms. LANDRIEU. I rise today to introduce a piece of legislation that 
this body has seen before, and actually we have passed a version of it 
by an overwhelming majority. But we have had difficulty as this bill 
has left this body and moved across the Capitol, and the efforts to 
pass this bill have actually been thwarted--not so much on the floors 
of the Congress or the Senate, but in committee rooms and conference 
committees--sometimes out of full public view. It has become an issue 
that must be dealt with on its substance, but also the way that 
sometimes bills find themselves coming to dead ends, in my view in 
inappropriate ways.
  The record of this subject has been long discussed on the floor. But 
the bill attempts to end the transport of horses for slaughter to 
Canada and to Mexico.
  This Congress, both Democrats and Republicans, a majority, has gone 
on record saying that the practice of inhumane slaughter of these 
majestic and very noble animals has no place in America. We do not use 
their meat for human consumption. It is no longer used even in our pet 
foods. This is not true in other parts of the world but it is true here 
in America. So we want to have a better system to handle the breeding, 
the raising, and the disposal of horses that are old, infirm, and sick. 
But taking a perfectly healthy animal and slitting its throat and then 
cutting it up with hatchets and saws and moving equipment while it is 
still alive is not what people in America would like to believe is 
going on. In fact it is--or was until a few years ago, until some of us 
got together with a great coalition and ended the practice of slaughter 
in the United States.
  There were only three plants operating--two in Texas, one in 
Illinois. Those State legislators and the leaders in those States 
stepped up and closed down those plants. But the problem is now the 
100,000 or so horses out of 900,000 that die naturally every year. We 
have about 9 million horses in America, 900,000 die, approximately, 
every year. And the great part of this story is that 95 percent of all 
horses die a natural and humane death because the owners are very good, 
they are very responsible.
  Most people do what is right. That is what happens in most places, on 
most subjects. But there is always that small group that, for whatever 
reason, proceeds down a path that is wholly inappropriate, although 
right now legal--we hope to solve that problem--and inhumanely 
slaughters horses.
  The USDA and our own investigation show that 98 percent of the horses 
that are inhumanely transported over our borders now to places that 
are, of course, unregulated by our Government and very modestly 
regulated, if at all, by the Governments of Canada and Mexico, 94 
percent of these animals--92, I am sorry, 92.3 percent of those horses 
being sent to slaughter are healthy. They are not sick and they are not 
infirm and they are not old.
  People say to me: Well, Senator, do you not think we have to find a 
way to

[[Page S3926]]

get rid of horses that are sick or too old? I say: Absolutely. There 
are humane ways to get rid of horses. But the myth and the lie and the 
shame of this slaughtering that is going on is that 92 percent of those 
animals are healthy. Many of them are young. Many of them have a great 
future. But because there is a loophole in our law right now, they are 
being treated in this way.
  So I am introducing this bill with my good friend and colleague John 
Ensign, Senator Ensign from Nevada, the leading cosponsor, also with 
Senators Cardin, Boxer, Graham, Collins, McCain, Lautenberg, Menendez, 
Levin, Carper, Lieberman, Byrd, Kerry, and Leahy as cosponsors, 
original cosponsors of this legislation, entitled the Prevention of 
Equine Cruelty Act.
  The way this bill would be put into place, should it be passed and 
signed by the President into law, is if a person is found in violation 
of this act, they are found to knowingly transport or sell or purchase 
a horse with the intent to slaughter it for human consumption, they 
will be fined, and there will be criminal penalties associated with 
this practice. If a defendant is found guilty, he or she could be 
sentenced up to 1 year of prison if he or she has no prior convictions. 
If he or she does have prior convictions, the penalty will be 
increased.
  As I have said, although U.S. slaughterhouses have been closed, 
thousands of horses are inhumanely, every day, 1,500 a week, 
transported across our borders to this deplorable fate. Sometime horses 
are shipped as many as 600 miles with limited food and water. I could 
show you dozens of pictures. I will spare those who are on the floor 
and those watching from the horror of some of these pictures. But if 
you want to see them, there are ample pictures and evidence on the 
Internet available for what is a mindless and barbaric practice we want 
to stop.
  When people say to me: Senator, how are farmers and ranchers going to 
afford it? It is expensive to put down a horse. It costs about $225 to 
humanely euthanize a horse. It costs $225 to feed a horse for 1 month. 
So if you can afford to purchase an animal, if you can afford to 
maintain an animal, you most certainly can afford the price of putting 
it down humanely, for the work that is done on your behalf, for the 
pleasure it has provided you or the transportation it has provided you.
  Horses are used in our country for many different and very necessary 
purposes. I want to say this has been a long battle. It started many 
years ago. But in September of 2007, the U.S. Court of Appeals upheld 
the Illinois statute that banned the slaughterhouse from continuing.
  In April of that same year, the Senate Commerce Committee voted 15 to 
7 to ban slaughter. In 2007, in January, the U.S. Court of Appeals for 
the Fifth Circuit declared the slaughter of horses for food illegal in 
Texas, upholding a law that dated back to 1949. And on September 7--you 
might have still been there--the House passed H.R. 503, the American 
Horse Slaughter Prevention Act. Unfortunately, that Congress adjourned 
before the Senate could take it up, and the Senate did, in October, 
take up this matter in the agriculture appropriations bill, only to 
have it scuttled again.
  So I submit to you that there is a broad base of bipartisan support 
for this legislation. I submit to you that the practice is cruel and 
inhumane. I submit to you that I have every court, both at the district 
and appellate level, that has weighed in has weighed in on the side of 
our efforts here today. And it is my intention, working with Senator 
John Ensign from Nevada, to finally get this bill passed, so we will 
have, once and for all, ended inhumane slaughter and created a way for 
horses to be put down or to die naturally and to be disposed of 
properly in this country, which we think will be a great testimony to 
the rising awareness of animal care in this Nation.
  Now, when people say: She has gone too far and we are going to do the 
same thing for cows and goats and chickens--horses are not raised for 
the same purpose as cows and goats and chickens. They are never raised 
for slaughter. They are raised for companionship, for partnership, and 
that is where the line, I hope, will be drawn.
  Mr. President, 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 
placed in the Record, as follows:

                                 S. 727

       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 ``Prevention of Equine Cruelty 
     Act of 2009''.

     SEC. 2. SLAUGHTER OF HORSES FOR HUMAN CONSUMPTION.

       (a) In General.--Chapter 3 of title 18, United States Code, 
     is amended by adding at the end the following:

     ``Sec. 50. Slaughter of horses for human consumption

       ``(a) Except as provided in subsection (b), whoever 
     knowingly--
       ``(1) possesses, ships, transports, purchases, sells, 
     delivers, or receives, in or affecting interstate commerce or 
     foreign commerce, any horse with the intent that it is to be 
     slaughtered for human consumption; or
       ``(2) possesses, ships, transports, purchases, sells, 
     delivers, or receives, in or affecting interstate commerce or 
     foreign commerce, any horse flesh or carcass or part of a 
     carcass, with the intent that it is to be used for human 
     consumption;
     shall be fined under this title or imprisoned not more than 
     three years or both.
       ``(b) If--
       ``(1) the defendant engages in conduct that would otherwise 
     constitute an offense under subsection (a);
       ``(2) the defendant has no prior conviction under this 
     section; and
       ``(3) the conduct involves less than five horses or less 
     than 2000 pounds of horse flesh or carcass or part of a 
     carcass;
     the defendant shall, instead of being punished under that 
     subsection, be fined under this title or imprisoned not more 
     than one year, or both.
       ``(c) As used in this section, the term `horse' means any 
     member of the family Equidae.''.
       (b) Clerical Amendment.--The table of sections for chapter 
     3 of title 18, United States Code, is amended by adding at 
     the end the following new item:

``50. Slaughter of horses for human consumption.''.
                                 ______
                                 
      By Mr. AKAKA:
  S. 728. A bill to amend title 38, United States Code, to enhance 
veterans' insurance benefits, and for other purposes; to the Committee 
on Veterans' Affairs.
  Mr. AKAKA. Mr. President, I am pleased to introduce the Veterans' 
Insurance and Benefits Enhancement Act of 2009. This comprehensive 
legislation, much of which was considered and passed by the Senate in 
the last Congress, would improve benefits and services for veterans 
both young and old.
  This legislation would make several important improvements in 
insurance programs for disabled veterans. It would establish a new 
program of insurance for service-connected disabled veterans that would 
provide up to a maximum of $50,000 in level premium term life insurance 
coverage. This new program would be available to service-connected 
disabled veterans who are less than 65 years of age at the time of 
application. More importantly, unlike VA's Service-Disabled Veterans 
Insurance program, the premium rates for this program would be based on 
an updated mortality table, meaning that premiums under this program 
would be fairer to veterans.
  This legislation would also expand eligibility for retroactive 
benefits from traumatic injury protection coverage under the 
Servicemembers' Group Life Insurance program. This insurance program 
went into effect on December 1, 2005. All insured servicemembers under 
SGLI from that point forward are covered by traumatic injury protection 
regardless of where their injuries occur. However, individuals 
sustaining traumatic injuries between October 7, 2001, and November 30, 
2005, that were not incurred as a direct result of Operations Enduring 
or Iraqi Freedom are not eligible for a retroactive payment under the 
traumatic injury protection program. This legislation would expand 
eligibility to these individuals.
  This bill would also increase the maximum amount of Veterans' 
Mortgage Life Insurance that a service-connected disabled veteran may 
purchase from the current maximum of $90,000 up to $200,000. In the 
event of the veteran's death, the veteran's family is protected because 
VA will pay the balance of the mortgage owed up to the maximum amount 
of insurance purchased. The need for this increase is obvious in 
today's housing market.
  In addition, this legislation would increase the amount of 
supplemental life

[[Page S3927]]

insurance available to totally disabled veterans from $20,000 to 
$30,000. Many totally disabled veterans find it difficult to obtain 
commercial life insurance. This legislation would provide these 
veterans with a reasonable amount of life insurance coverage.
  This bill would also increase certain benefits for veterans and their 
survivors that have not been updated for many years. The minimum 
benefit rate for low-income parents of children who have died during 
military service, or as the result of a service-connected disability, 
has remained at only $5.00 per month since 1975. This is unacceptable. 
Therefore, this bill would increase the minimum Parent's DIC benefit to 
$100 per month, and also increase the basic benefit for a parent with 
no income to the same level as that provided to low-income spouses of 
wartime veterans. In addition, this bill would increase the amount of 
pension paid to VA pensioners who receive Medicaid benefits from $90.00 
per month, which was set in 1989, to $100 per month. In addition, all 
of these benefits and benefits for surviving spouses with children 
would be adjusted by cost-of-living allowances so that these VA 
benefits would never again become so outdated.
  Another provision included in this bill would reaffirm Congress's 
intent with regard to who should be eligible for a special monthly 
pension. Low income, nondisabled wartime veterans 65 and older qualify 
for a VA service pension benefit. Those who are totally and permanently 
disabled are eligible to receive a disability pension with additional 
monies if they are housebound, blind, or need help in everyday living 
activities. In a 2006 decision, the U.S. Court of Appeals for Veterans 
Claims ruled that an older veteran no longer had to have a disability 
rated permanent and total in order to receive housebound benefits. The 
legislative history is clear that Congress intended that only those 
veterans with a permanent and total disability would qualify for 
housebound benefits. This provision would require VA to provide this 
benefit as Congress originally intended.
  This is not a comprehensive recitation of all the provisions within 
this important veterans' legislation. However, I hope that I have 
provided an appropriate overview of the benefits this legislation would 
provide for America's veterans and servicemembers. I urge our 
colleagues to support the legislation.
  Mr. President, 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 
placed in the Record, as follows:

                                 S. 728

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Veterans' 
     Insurance and Benefits Enhancement Act of 2009''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Reference to title 38, United States Code.

                       TITLE I--INSURANCE MATTERS

Sec. 101. Level-premium term life insurance for veterans with service-
              connected disabilities.
Sec. 102. Supplemental insurance for totally disabled veterans.
Sec. 103. Expansion of individuals qualifying for retroactive benefits 
              from traumatic injury protection coverage under 
              Servicemembers' Group Life Insurance.
Sec. 104. Enhancement of veterans' mortgage life insurance.
Sec. 105. Adjustment of coverage of dependents under Servicemembers' 
              Group Life Insurance.

               TITLE II--COMPENSATION AND PENSION MATTERS

Sec. 201. Cost-of-living increase for temporary dependency and 
              indemnity compensation payable for surviving spouses with 
              dependent children under the age of 18.
Sec. 202. Eligibility of veterans 65 years of age or older for service 
              pension for a period of war.
Sec. 203. Adjustments in amounts of dependency and indemnity 
              compensation payable to disabled surviving spouses and to 
              parents of deceased veterans.
Sec. 204. Increase and annual adjustment in limitation on pension 
              payable to hospitalized veterans and others.

                 TITLE III--BURIAL AND MEMORIAL MATTERS

Sec. 301. Supplemental benefits for veterans for funeral and burial 
              expenses.
Sec. 302. Supplemental plot allowances.

                        TITLE IV--OTHER MATTERS

Sec. 401. Eligibility of disabled veterans and members of the Armed 
              Forces with severe burn injuries for automobiles and 
              adaptive equipment.
Sec. 402. Supplemental assistance for providing automobiles or other 
              conveyances to certain disabled veterans.

     SEC. 2. REFERENCE TO TITLE 38, UNITED STATES CODE.

       Except as otherwise expressly provided, whenever in this 
     Act an amendment or repeal is expressed in terms of an 
     amendment to, or repeal of, a section or other provision, the 
     reference shall be considered to be made to a section or 
     other provision of title 38, United States Code.

                       TITLE I--INSURANCE MATTERS

     SEC. 101. LEVEL-PREMIUM TERM LIFE INSURANCE FOR VETERANS WITH 
                   SERVICE-CONNECTED DISABILITIES.

       (a) In General.--Chapter 19 is amended by inserting after 
     section 1922A the following new section:

     ``Sec. 1922B. Level-premium term life insurance for veterans 
       with service-connected disabilities

       ``(a) In General.--In accordance with the provisions of 
     this section, the Secretary shall grant insurance to each 
     eligible veteran who seeks such insurance against the death 
     of such veteran occurring while such insurance is in force.
       ``(b) Eligible Veterans.--For purposes of this section, an 
     eligible veteran is any veteran less than 65 years of age who 
     has a service-connected disability.
       ``(c) Amount of Insurance.--(1) Subject to paragraph (2), 
     the amount of insurance granted an eligible veteran under 
     this section shall be $50,000 or such lesser amount as the 
     veteran shall elect. The amount of insurance so elected shall 
     be evenly divisible by $10,000.
       ``(2) The aggregate amount of insurance of an eligible 
     veteran under this section, section 1922 of this title, and 
     section 1922A of this title may not exceed $50,000.
       ``(d) Reduced Amount for Veterans Age 70 or Older.--In the 
     case of a veteran insured under this section who turns age 
     70, the amount of insurance of such veteran under this 
     section after the date such veteran turns age 70 shall be the 
     amount equal to 20 percent of the amount of insurance of the 
     veteran under this section as of the day before such date.
       ``(e) Premiums.--(1) Premium rates for insurance under this 
     section shall be based on the 2001 Commissioners Standard 
     Ordinary Basic Table of Mortality and interest at the rate of 
     4.5 per centum per annum.
       ``(2) The amount of the premium charged a veteran for 
     insurance under this section may not increase while such 
     insurance is in force for such veteran.
       ``(3) The Secretary may not charge a premium for insurance 
     under this section for a veteran as follows:
       ``(A) A veteran who has a service-connected disability 
     rated as total and is eligible for a waiver of premiums under 
     section 1912 of this title.
       ``(B) A veteran who is 70 years of age or older.
       ``(4) Insurance granted under this section shall be on a 
     nonparticipating basis and all premiums and other collections 
     therefor shall be credited directly to a revolving fund in 
     the Treasury of the United States, and any payments on such 
     insurance shall be made directly from such fund. 
     Appropriations to such fund are hereby authorized.
       ``(5) Administrative costs to the Government for the costs 
     of the program of insurance under this section shall be paid 
     from premiums credited to the fund under paragraph (4), and 
     payments for claims against the fund under paragraph (4) for 
     amounts in excess of amounts credited to such fund under that 
     paragraph (after such administrative costs have been paid) 
     shall be paid from appropriations to the fund.
       ``(f) Application Required.--An eligible veteran seeking 
     insurance under this section shall file with the Secretary an 
     application therefor. Such application shall be filed not 
     later than the earlier of--
       ``(1) the end of the two-year period beginning on the date 
     on which the Secretary notifies the veteran that the veteran 
     has a service-connected disability; and
       ``(2) the end of the 10-year period beginning on the date 
     of the separation of the veteran from the Armed Forces, 
     whichever is earlier.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 19 is amended by inserting after the 
     item related to section 1922A the following new item:

``1922B. Level-premium term life insurance for veterans with service-
              connected disabilities.''.
       (c) Exchange of Service Disabled Veterans' Insurance.--
     During the one-year period beginning on the effective date of 
     this section under subsection (d), any veteran insured under 
     section 1922 of title 38, United States Code, who is eligible 
     for insurance under section 1922B of such title (as added by 
     subsection (a)), may exchange insurance coverage under such 
     section 1922 for insurance coverage under such section 1922B.
       (d) Effective Date.--This section, and the amendments made 
     by this section, shall take effect on April 1, 2010.

[[Page S3928]]

     SEC. 102. SUPPLEMENTAL INSURANCE FOR TOTALLY DISABLED 
                   VETERANS.

       (a) In General.--Section 1922A(a) is amended by striking 
     ``$20,000'' and inserting ``$30,000''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect on January 1, 2010.

     SEC. 103. EXPANSION OF INDIVIDUALS QUALIFYING FOR RETROACTIVE 
                   BENEFITS FROM TRAUMATIC INJURY PROTECTION 
                   COVERAGE UNDER SERVICEMEMBERS' GROUP LIFE 
                   INSURANCE.

       (a) In General.--Paragraph (1) of section 501(b) of the 
     Veterans' Housing Opportunity and Benefits Improvement Act of 
     2006 (Public Law 109-233; 120 Stat. 414; 38 U.S.C. 1980A 
     note) is amended by striking ``, if, as determined by the 
     Secretary concerned, that loss was a direct result of a 
     traumatic injury incurred in the theater of operations for 
     Operation Enduring Freedom or Operation Iraqi Freedom''.
       (b) Conforming Amendment.--The heading of such section is 
     amended by striking ``in Operation Enduring Freedom and 
     Operation Iraqi Freedom''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on January 1, 2010.

     SEC. 104. ENHANCEMENT OF VETERANS' MORTGAGE LIFE INSURANCE.

       Section 2106(b) is amended by striking ``$90,000'' and 
     inserting ``$150,000, or $200,000 after January 1, 2012,''.

     SEC. 105. ADJUSTMENT OF COVERAGE OF DEPENDENTS UNDER 
                   SERVICEMEMBERS' GROUP LIFE INSURANCE.

       Clause (ii) of section 1968(a)(5)(B) is amended to read as 
     follows:
       ``(ii) 120 days after the date of the member's separation 
     or release from the uniformed services; or''.

               TITLE II--COMPENSATION AND PENSION MATTERS

     SEC. 201. COST-OF-LIVING INCREASE FOR TEMPORARY DEPENDENCY 
                   AND INDEMNITY COMPENSATION PAYABLE FOR 
                   SURVIVING SPOUSES WITH DEPENDENT CHILDREN UNDER 
                   THE AGE OF 18.

       Section 1311(f) is amended by adding at the end the 
     following new paragraph:
       ``(5) Whenever there is an increase in benefit amounts 
     payable under title II of the Social Security Act (42 U.S.C. 
     401 et seq.) as a result of a determination made under 
     section 215(i) of such Act (42 U.S.C. 415(i)), the Secretary 
     shall, effective on the date of such increase in benefit 
     amounts, increase the amount payable under paragraph (1), as 
     such amount was in effect immediately prior to the date of 
     such increase in benefit amounts, by the same percentage as 
     the percentage by which such benefit amounts are increased. 
     Any increase in a dollar amount under this paragraph shall be 
     rounded down to the next lower whole dollar amount.''.

     SEC. 202. ELIGIBILITY OF VETERANS 65 YEARS OF AGE OR OLDER 
                   FOR SERVICE PENSION FOR A PERIOD OF WAR.

       (a) In General.--Section 1513 is amended--
       (1) in subsection (a), by striking ``by section 1521'' and 
     all that follows and inserting ``by subsection (b), (c), 
     (f)(1), (f)(5), or (g) of that section, as the case may be 
     and as increased from time to time under section 5312 of this 
     title.'';
       (2) by redesignating subsection (b) as subsection (c); and
       (3) by inserting after subsection (a) the following new 
     subsection (b):
       ``(b) The conditions in subsections (h) and (i) of section 
     1521 of this title shall apply to determinations of income 
     and maximum payments of pension for purposes of this 
     section.''.
       (b) Application.--The amendments made by this section shall 
     apply with respect to claims for pensions filed on or after 
     the date of the enactment of this Act.

     SEC. 203. ADJUSTMENTS IN AMOUNTS OF DEPENDENCY AND INDEMNITY 
                   COMPENSATION PAYABLE TO DISABLED SURVIVING 
                   SPOUSES AND TO PARENTS OF DECEASED VETERANS.

       (a) Increase in DIC Payable to Disabled Surviving 
     Spouses.--Section 1311 is amended--
       (1) in subsection (c), by striking ``$271'' and inserting 
     ``$325''; and
       (2) in subsection (d), by striking ``$128'' and inserting 
     ``$146''.
       (b) Increase in Certain DIC Amounts Payable to Parents.--
       (1) In general.--Section 1315 is amended--
       (A) in subsection (b)--
       (i) in paragraph (1), by striking ``$163'' and inserting 
     ``$661''; and
       (ii) in paragraph (2), by striking ``$5 monthly'' and 
     inserting ``$100 monthly, as increased from time to time 
     under section 5312 of this title''; and
       (B) in subsection (c)(2), by striking ``$5 monthly'' and 
     inserting ``$100 monthly, as increased from time to time 
     under section 5312 of this title'';
       (C) in subsection (d)(2), by striking ``$5 monthly'' and 
     inserting ``$100 monthly, as increased from time to time 
     under section 5312 of this title''; and
       (D) in subsection (g), by striking ``$85'' and inserting 
     ``$395''.
       (2) Additional amount payable to housebound parents.--Such 
     section is further amended by adding at the end the following 
     new subsection:
       ``(h) The monthly rate of dependency and indemnity 
     compensation payable to a parent shall be increased by $146, 
     as increased from time to time under section 5312 of this 
     title, if such parent--
       ``(1) is, by reason of disability, permanently housebound; 
     and
       ``(2) does not qualify for an increase in dependency and 
     indemnity compensation under subsection (g) of this 
     section.''.
       (c) Codification of Increase in Rates of DIC Payable to 
     Parents.--Section 1315 is further amended--
       (1) in subsection (b)(3), by striking ``$4,038'' and 
     inserting ``$13,456'';
       (2) in subsection (c)--
       (A) in paragraph (1), by striking ``$115'' and inserting 
     ``$412''; and
       (B) in paragraph (3), by striking ``$4,038'' and inserting 
     ``$13,456''; and
       (3) in subsection (d)--
       (A) in paragraph (1), by striking ``$109'' and inserting 
     ``$387''; and
       (B) in paragraph (3), by striking ``$5,430'' and inserting 
     ``$18,087''.
       (d) Technical Amendment.--Subsection (f)(1)(A) of such 
     section 1315 is amended by striking ``the six-months' death 
     gratuity'' and inserting ``death gratuity payments by the 
     Secretary concerned under sections 1475 through 1480 of title 
     10 (including payments under section 307 of the Persian Gulf 
     Conflict Supplemental Authorization and Personnel Benefits 
     Act of 1991 (Public Law 102-25; 105 Stat. 82; 10 U.S.C. 1478 
     note))''.
       (e) Cost-of-Living Adjustments.--Section 5312(b)(1) is 
     amended by striking ``the monthly rate provided in subsection 
     (g), of section 1315 of this title'' and inserting ``the 
     monthly rates provided in subsections (g) and (h), of section 
     1315 of this title, the minimum monthly amounts of dependency 
     and indemnity compensation payable to parents under 
     subsections (b)(2), (c)(2), and (d)(2) of such section,''.
       (f) Effective Date.--
       (1) In general.--The amendments made by this section shall 
     take effect on October 1, 2009, and shall apply with respect 
     to dependency and indemnity compensation payable for months 
     beginning on or after that date.
       (2) Prohibition on cola in fiscal year 2010.--No increase 
     shall be made under section 5312(b)(1) of title 38, United 
     States Code, in the minimum monthly amounts of dependency and 
     indemnity compensation payable under subsections (b)(2), 
     (c)(2), and (d)(2) of section 1315 of such title (as amended 
     by subsection (b)(1) of this section) during fiscal year 
     2010.

     SEC. 204. INCREASE AND ANNUAL ADJUSTMENT IN LIMITATION ON 
                   PENSION PAYABLE TO HOSPITALIZED VETERANS AND 
                   OTHERS.

       (a) Increase and Annual Adjustment.--
       (1) In general.--Section 5503 is amended--
       (A) in subsection (a)(1)--
       (i) in subparagraph (A), by striking ``$90 per month'' and 
     inserting ``$100 per month, as increased from time to time 
     under section 5312 of this title,''; and
       (ii) in subparagraphs (B) and (C), by striking ``$90 per 
     month'' each place it appears and inserting ``$100 per month, 
     as so increased,''; and
       (B) in subsection (d)(2), by striking ``$90 per month'' and 
     inserting ``$100 per month, as increased from time to time 
     under section 5312 of this title,''.
       (2) Annual adjustment.--Section 5312(b)(1) is amended by 
     striking ``5507(c)(2)(D) and'' and inserting ``5503, 
     5507(c)(2)(D), and''.
       (b) Applicability of Limitation to Pension Payable to 
     Certain Children of Veterans of a Period of War.--Section 
     5503(d)(5) is amended--
       (1) by inserting ``(A)'' after ``(5)''; and
       (2) by adding at the end the following new subparagraph:
       ``(B) The provisions of this subsection shall also apply 
     with respect to a child entitled to pension under section 
     1542 of this title in the same manner as they apply to a 
     veteran having neither spouse nor child.''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect October 1, 2009. However no adjustment 
     shall be made during fiscal year 2010 under section 
     5312(b)(1) of title 38, United States Code (as amended by 
     subsection (a)(2)), in the limitation under section 5503 of 
     title 38, United States Code (as amended by subsections 
     (a)(1) and (b)), on amounts of pension payable to veterans 
     and others.

                 TITLE III--BURIAL AND MEMORIAL MATTERS

     SEC. 301. SUPPLEMENTAL BENEFITS FOR VETERANS FOR FUNERAL AND 
                   BURIAL EXPENSES.

       (a) Funeral Expenses.--
       (1) In general.--Chapter 23 is amended by inserting after 
     section 2302 the following new section:

     ``Sec. 2302A. Funeral expenses: supplemental benefits

       ``(a) In General.--(1) Subject to the availability of funds 
     specifically provided for purposes of this subsection in 
     advance in an appropriations Act, whenever the Secretary 
     makes a payment for the burial and funeral of a veteran under 
     section 2302(a) of this title, the Secretary is also 
     authorized and directed to pay the recipient of such payment 
     a supplemental payment under this section for the cost of 
     such burial and funeral.
       ``(2) No supplemental payment shall be made under this 
     subsection if the Secretary has expended all funds that were 
     specifically provided for purposes of this subsection in an 
     appropriations Act.
       ``(b) Amount.--The amount of the supplemental payment 
     required by subsection (a) for any death is $900 (as adjusted 
     from time to time under subsection (c)).
       ``(c) Adjustment.--With respect to deaths that occur in any 
     fiscal year after fiscal year

[[Page S3929]]

     2009, the supplemental payment described in subsection (b) 
     shall be equal to the sum of--
       ``(1) the supplemental payment in effect under subsection 
     (b) for the preceding fiscal year (determined after 
     application of this subsection), plus
       ``(2) the sum of the amount described in section 2302(a) of 
     this title and the amount under paragraph (1), multiplied by 
     the percentage by which--
       ``(A) the Consumer Price Index (all items, United States 
     city average) for the 12-month period ending on the June 30 
     preceding the beginning of the fiscal year for which the 
     increase is made, exceeds
       ``(B) such Consumer Price Index for the 12-month period 
     preceding the 12-month period described in subparagraph (A).
       ``(d) Estimates.--(1) From time to time, the Secretary 
     shall make an estimate of--
       ``(A) the amount of funding that would be necessary to 
     provide supplemental payments under this section to all 
     eligible recipients for the remainder of the fiscal year in 
     which such an estimate is made; and
       ``(B) the amount that Congress would need to appropriate to 
     provide all eligible recipients with supplemental payments 
     under this section in the next fiscal year.
       ``(2) On the dates described in paragraph (3), the 
     Secretary shall submit to the appropriate committees of 
     Congress the estimates described in paragraph (1).
       ``(3) The dates described in this paragraph are the 
     following:
       ``(A) April 1 of each year.
       ``(B) July 1 of each year.
       ``(C) September 1 of each year.
       ``(D) The date that is 60 days before the date estimated by 
     the Secretary on which amounts appropriated for the purposes 
     of this section for a fiscal year will be exhausted.
       ``(e) Appropriate Committees of Congress Defined.--In this 
     section, the term `appropriate committees of Congress' 
     means--
       ``(1) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the Senate; and
       ``(2) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the House of Representatives.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item related to section 2302 the following new item:

``2302A. Funeral expenses: supplemental benefits.''.
       (3) Authorization of appropriations.--There are authorized 
     to be appropriated to the Secretary of Veterans Affairs such 
     sums as may be necessary to carry out the provisions of 
     section 2302A of title 38, United States Code (as added by 
     this subsection).
       (b) Death From Service-Connected Disability.--
       (1) In general.--Chapter 23 is amended by inserting after 
     section 2307 the following new section:

     ``Sec. 2307A. Death from service-connected disability: 
       supplemental benefits for burial and funeral expenses

       ``(a) In General.--(1) Subject to the availability of funds 
     specifically provided for purposes of this subsection in 
     advance in an appropriations Act, whenever the Secretary 
     makes a payment for the burial and funeral of a veteran under 
     section 2307(1) of this title, the Secretary is also 
     authorized and directed to pay the recipient of such payment 
     a supplemental payment under this section for the cost of 
     such burial and funeral.
       ``(2) No supplemental payment shall be made under this 
     subsection if the Secretary has expended all funds that were 
     specifically provided for purposes of this subsection in an 
     appropriations Act.
       ``(b) Amount.--The amount of the supplemental payment 
     required by subsection (a) for any death is $2,100 (as 
     adjusted from time to time under subsection (c)).
       ``(c) Adjustment.--With respect to deaths that occur in any 
     fiscal year after fiscal year 2009, the supplemental payment 
     described in subsection (b) shall be equal to the sum of--
       ``(1) the supplemental payment in effect under subsection 
     (b) for the preceding fiscal year (determined after 
     application of this subsection), plus
       ``(2) the sum of the amount described in section 2307(1) of 
     this title and the amount under paragraph (1), multiplied by 
     the percentage by which--
       ``(A) the Consumer Price Index (all items, United States 
     city average) for the 12-month period ending on the June 30 
     preceding the beginning of the fiscal year for which the 
     increase is made, exceeds
       ``(B) such Consumer Price Index for the 12-month period 
     preceding the 12-month period described in subparagraph (A).
       ``(d) Estimates.--(1) From time to time, the Secretary 
     shall make an estimate of--
       ``(A) the amount of funding that would be necessary to 
     provide supplemental payments under this section to all 
     eligible recipients for the remainder of the fiscal year in 
     which such an estimate is made; and
       ``(B) the amount that Congress would need to appropriate to 
     provide all eligible recipients with supplemental payments 
     under this section in the next fiscal year.
       ``(2) On the dates described in paragraph (3), the 
     Secretary shall submit to the appropriate committees of 
     Congress the estimates described in paragraph (1).
       ``(3) The dates described in this paragraph are the 
     following:
       ``(A) April 1 of each year.
       ``(B) July 1 of each year.
       ``(C) September 1 of each year.
       ``(D) The date that is 60 days before the date estimated by 
     the Secretary on which amounts appropriated for the purposes 
     of this section for a fiscal year will be exhausted.
       ``(e) Appropriate Committees of Congress Defined.--In this 
     section, the term `appropriate committees of Congress' 
     means--
       ``(1) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the Senate; and
       ``(2) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the House of Representatives.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item related to section 2307 the following new item:

``2307A. Death from service-connected disability: supplemental benefits 
              for burial and funeral expenses.''.
       (3) Authorization of appropriations.--There are authorized 
     to be appropriated to the Secretary of Veterans Affairs such 
     sums as may be necessary to carry out the provisions of 
     section 2307A of title 38, United States Code (as added by 
     this subsection).
       (c) Effective Date.--The amendments made by this section 
     shall take effect on October 1, 2009, and shall apply with 
     respect to deaths occurring on or after that date.

     SEC. 302. SUPPLEMENTAL PLOT ALLOWANCES.

       (a) In General.--Chapter 23 is amended by inserting after 
     section 2303 the following new section:

     ``Sec. 2303A. Supplemental plot allowance

       ``(a) In General.--(1) Subject to the availability of funds 
     specifically provided for purposes of this subsection in 
     advance in an appropriations Act, whenever the Secretary 
     makes a payment for the burial and funeral of a veteran under 
     section 2303(a)(1)(A) of this title, or for the burial of a 
     veteran under paragraph (1) or (2) of section 2303(b) of this 
     title, the Secretary is also authorized and directed to pay 
     the recipient of such payment a supplemental payment under 
     this section for the cost of such burial and funeral or 
     burial, as applicable.
       ``(2) No supplemental plot allowance payment shall be made 
     under this subsection if the Secretary has expended all funds 
     that were specifically provided for purposes of this 
     subsection in an appropriations Act.
       ``(b) Amount.--The amount of the supplemental payment 
     required by subsection (a) for any death is $445 (as adjusted 
     from time to time under subsection (c)).
       ``(c) Adjustment.--With respect to deaths that occur in any 
     fiscal year after fiscal year 2009, the supplemental payment 
     described in subsection (b) shall be equal to the sum of--
       ``(1) the supplemental payment in effect under subsection 
     (b) for the preceding fiscal year (determined after 
     application of this subsection), plus
       ``(2) the sum of the amount described in section 
     2303(a)(1)(A) of this title and the amount under paragraph 
     (1), multiplied by the percentage by which--
       ``(A) the Consumer Price Index (all items, United States 
     city average) for the 12-month period ending on the June 30 
     preceding the beginning of the fiscal year for which the 
     increase is made, exceeds
       ``(B) such Consumer Price Index for the 12-month period 
     preceding the 12-month period described in subparagraph (A).
       ``(d) Estimates.--(1) From time to time, the Secretary 
     shall make an estimate of--
       ``(A) the amount of funding that would be necessary to 
     provide supplemental plot allowance payments under this 
     section to all eligible recipients for the remainder of the 
     fiscal year in which such an estimate is made; and
       ``(B) the amount that Congress would need to appropriate to 
     provide all eligible recipients with supplemental plot 
     allowance payments under this section in the next fiscal 
     year.
       ``(2) On the dates described in paragraph (3), the 
     Secretary shall submit to the appropriate committees of 
     Congress the estimates described in paragraph (1).
       ``(3) The dates described in this paragraph are the 
     following:
       ``(A) April 1 of each year.
       ``(B) July 1 of each year.
       ``(C) September 1 of each year.
       ``(D) The date that is 60 days before the date estimated by 
     the Secretary on which amounts appropriated for the purposes 
     of this section for a fiscal year will be exhausted.
       ``(e) Appropriate Committees of Congress Defined.--In this 
     section, the term `appropriate committees of Congress' 
     means--
       ``(1) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the Senate; and
       ``(2) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the House of Representatives.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item related to section 2303 the following new item:

``2303A. Supplemental plot allowance.''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on October 1, 2009, and shall apply with 
     respect to deaths occurring on or after that date.
       (d) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Secretary of Veterans Affairs such 
     sums as may be necessary to carry out the provisions of 
     section 2303A of title 38, United States Code (as added by 
     subsection (a)).

[[Page S3930]]

                        TITLE IV--OTHER MATTERS

     SEC. 401. ELIGIBILITY OF DISABLED VETERANS AND MEMBERS OF THE 
                   ARMED FORCES WITH SEVERE BURN INJURIES FOR 
                   AUTOMOBILES AND ADAPTIVE EQUIPMENT.

       (a) Eligibility.--Paragraph (1) of section 3901 is 
     amended--
       (1) in subparagraph (A)--
       (A) in the matter preceding clause (i), by striking ``or 
     (iii) below'' and inserting ``(iii), or (iv)''; and
       (B) by adding at the end the following new clause:
       ``(iv) A severe burn injury (as determined pursuant to 
     regulations prescribed by the Secretary).''; and
       (2) in subparagraph (B), by striking ``or (iii)'' and 
     inserting ``(iii), or (iv)''.
       (b) Stylistic Amendments.--Such section is further 
     amended--
       (1) in the matter preceding paragraph (1), by striking 
     ``chapter--'' and inserting ``chapter:'';
       (2) in paragraph (1)--
       (A) in the matter preceding subparagraph (A), by striking 
     ``means--'' and inserting ``means the following:'';
       (B) in subparagraph (A)--
       (i) in the matter preceding clause (i), by striking ``any 
     veteran'' and inserting ``Any veteran'';
       (ii) in clauses (i) and (ii), by striking the semicolon at 
     the end and inserting a period; and
       (iii) in clause (iii), by striking ``or'' and inserting a 
     period; and
       (C) in subparagraph (B), by striking ``any member'' and 
     inserting ``Any member''.

     SEC. 402. SUPPLEMENTAL ASSISTANCE FOR PROVIDING AUTOMOBILES 
                   OR OTHER CONVEYANCES TO CERTAIN DISABLED 
                   VETERANS.

       (a) In General.--Chapter 39 is amended by inserting after 
     section 3902 the following new section:

     ``Sec. 3902A. Supplemental assistance for providing 
       automobiles or other conveyances

       ``(a) In General.--(1) Subject to the availability of funds 
     specifically provided for purposes of this subsection in 
     advance in an appropriations Act, whenever the Secretary 
     makes a payment for the purchase of an automobile or other 
     conveyance for an eligible person under section 3902 of this 
     title, the Secretary is also authorized and directed to pay 
     the recipient of such payment a supplemental payment under 
     this section for the cost of such purchase.
       ``(2) No supplemental payment shall be made under this 
     subsection if the Secretary has expended all funds that were 
     specifically provided for purposes of this subsection in an 
     appropriations Act.
       ``(b) Amount of Supplemental Payment.--Supplemental payment 
     required by subsection (a) is equal to the excess of--
       ``(1) the payment which would be determined under section 
     3902 of this title if the amount described in section 3902 of 
     this title were increased to the adjusted amount described in 
     subsection (c), over
       ``(2) the payment determined under section 3902 of this 
     title without regard to this section.
       ``(c) Adjusted Amount.--The adjusted amount is $22,484 (as 
     adjusted from time to time under subsection (d)).
       ``(d) Adjustment.--(1) Effective on October 1 of each year 
     (beginning in 2009), the Secretary shall increase the 
     adjusted amount described in subsection (c) to an amount 
     equal to 80 percent of the average retail cost of new 
     automobiles for the preceding calendar year.
       ``(2) The Secretary shall establish the method for 
     determining the average retail cost of new automobiles for 
     purposes of this subsection. The Secretary may use data 
     developed in the private sector if the Secretary determines 
     the data is appropriate for purposes of this subsection.
       ``(e) Estimates.--(1) From time to time, the Secretary 
     shall make an estimate of--
       ``(A) the amount of funding that would be necessary to 
     provide supplemental payment under this section for every 
     eligible person for the remainder of the fiscal year in which 
     such an estimate is made; and
       ``(B) the amount that Congress would need to appropriate to 
     provide every eligible person with supplemental payment under 
     this section in the next fiscal year.
       ``(2) On the dates described in paragraph (3), the 
     Secretary shall submit to the appropriate committees of 
     Congress the estimates described in paragraph (1).
       ``(3) The dates described in this paragraph are the 
     following:
       ``(A) April 1 of each year.
       ``(B) July 1 of each year.
       ``(C) September 1 of each year.
       ``(D) The date that is 60 days before the date estimated by 
     the Secretary on which amounts appropriated for the purposes 
     of this section for a fiscal year will be exhausted.
       ``(f) Appropriate Committees of Congress Defined.--In this 
     section, the term `appropriate committees of Congress' 
     means--
       ``(1) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the Senate; and
       ``(2) the Committee on Appropriations and the Committee on 
     Veterans' Affairs of the House of Representatives.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item related to section 3902 the following new item:

``3902A. Supplemental assistance for providing automobiles or other 
              conveyances.''.
       (c) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Secretary of Veterans Affairs such 
     sums as may be necessary to carry out the provisions of 
     section 3902A of title 38, United States Code (as added by 
     subsection (a)).
       (d) Effective Date.--The amendments made by this section 
     shall take effect on October 1, 2009, and shall apply with 
     respect to payments made in accordance with section 3902 of 
     title 38, United States Code, on or after that date.
                                 ______
                                 
      By Mr. DURBIN (for himself, Mr. Lugar, Mr. Reid, Mr. Martinez, 
        Mr. Leahy, Mr. Lieberman, Mr. Kennedy, and Mr. Feingold):
  S. 729. A bill to amend the Illegal Immigration Reform and Immigrant 
Responsibility Act of 1996 to permit States to determine State 
residency for higher education purposes and to authorize the 
cancellation of removal and adjustment of status of certain alien 
students who are long-term United States residents and who entered the 
United States as children, and for other purposes; to the Committee on 
the Judiciary.
  Mr. DURBIN. Mr. President, 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 
placed in the Record, as follows:

                                 S. 729

       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 ``Development, Relief, and 
     Education for Alien Minors Act of 2009'' or the ``DREAM Act 
     of 2009''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) Institution of higher education.--The term 
     ``institution of higher education'' has the meaning given 
     that term in section 101 of the Higher Education Act of 1965 
     (20 U.S.C. 1001).
       (2) Uniformed services.--The term ``uniformed services'' 
     has the meaning given that term in section 101(a) of title 
     10, United States Code.

     SEC. 3. RESTORATION OF STATE OPTION TO DETERMINE RESIDENCY 
                   FOR PURPOSES OF HIGHER EDUCATION BENEFITS.

       (a) In General.--Section 505 of the Illegal Immigration 
     Reform and Immigrant Responsibility Act of 1996 (8 U.S.C. 
     1623) is repealed.
       (b) Effective Date.--The repeal under subsection (a) shall 
     take effect as if included in the enactment of the Illegal 
     Immigration Reform and Immigrant Responsibility Act of 1996 
     (division C of Public Law 104-208; 110 Stat. 3009-546).

     SEC. 4. CANCELLATION OF REMOVAL AND ADJUSTMENT OF STATUS OF 
                   CERTAIN LONG-TERM RESIDENTS WHO ENTERED THE 
                   UNITED STATES AS CHILDREN.

       (a) Special Rule for Certain Long-Term Residents Who 
     Entered the United States as Children.--
       (1) In general.--Notwithstanding any other provision of law 
     and except as otherwise provided in this Act, the Secretary 
     of Homeland Security may cancel removal of, and adjust to the 
     status of an alien lawfully admitted for permanent residence, 
     subject to the conditional basis described in section 5, an 
     alien who is inadmissible or deportable from the United 
     States, if the alien demonstrates that--
       (A) the alien has been physically present in the United 
     States for a continuous period of not less than 5 years 
     immediately preceding the date of enactment of this Act, and 
     had not yet reached the age of 16 years at the time of 
     initial entry;
       (B) the alien has been a person of good moral character 
     since the time of application;
       (C) the alien--
       (i) is not inadmissible under paragraph (2), (3), (6)(E), 
     or (10)(C) of section 212(a) of the Immigration and 
     Nationality Act (8 U.S.C. 1182(a)); and
       (ii) is not deportable under paragraph (1)(E), (2), or (4) 
     of section 237(a) of the Immigration and Nationality Act (8 
     U.S.C. 1227(a));
       (D) the alien, at the time of application, has been 
     admitted to an institution of higher education in the United 
     States, or has earned a high school diploma or obtained a 
     general education development certificate in the United 
     States;
       (E) the alien has never been under a final administrative 
     or judicial order of exclusion, deportation, or removal, 
     unless the alien--
       (i) has remained in the United States under color of law 
     after such order was issued; or
       (ii) received the order before attaining the age of 16 
     years; and
       (F) the alien had not yet reached the age of 35 years on 
     the date of the enactment of this Act.
       (2) Waiver.--Notwithstanding paragraph (1), the Secretary 
     of Homeland Security may waive the ground of ineligibility 
     under section 212(a)(6)(E) of the Immigration and Nationality 
     Act and the ground of deportability under paragraph (1)(E) of 
     section 237(a) of that Act for humanitarian purposes or 
     family unity or when it is otherwise in the public interest.

[[Page S3931]]

       (3) Procedures.--The Secretary of Homeland Security shall 
     provide a procedure by regulation allowing eligible 
     individuals to apply affirmatively for the relief available 
     under this subsection without being placed in removal 
     proceedings.
       (b) Termination of Continuous Period.--For purposes of this 
     section, any period of continuous residence or continuous 
     physical presence in the United States of an alien who 
     applies for cancellation of removal under this section shall 
     not terminate when the alien is served a notice to appear 
     under section 239(a) of the Immigration and Nationality Act 
     (8 U.S.C. 1229(a)).
       (c) Treatment of Certain Breaks in Presence.--
       (1) In general.--An alien shall be considered to have 
     failed to maintain continuous physical presence in the United 
     States under subsection (a) if the alien has departed from 
     the United States for any period in excess of 90 days or for 
     any periods in the aggregate exceeding 180 days.
       (2) Extensions for exceptional circumstances.--The 
     Secretary of Homeland Security may extend the time periods 
     described in paragraph (1) if the alien demonstrates that the 
     failure to timely return to the United States was due to 
     exceptional circumstances. The exceptional circumstances 
     determined sufficient to justify an extension should be no 
     less compelling than serious illness of the alien, or death 
     or serious illness of a parent, grandparent, sibling, or 
     child.
       (d) Exemption From Numerical Limitations.--Nothing in this 
     section may be construed to apply a numerical limitation on 
     the number of aliens who may be eligible for cancellation of 
     removal or adjustment of status under this section.
       (e) Regulations.--
       (1) Proposed regulations.--Not later than 180 days after 
     the date of enactment of this Act, the Secretary of Homeland 
     Security shall publish proposed regulations implementing this 
     section. Such regulations shall be effective immediately on 
     an interim basis, but are subject to change and revision 
     after public notice and opportunity for a period for public 
     comment.
       (2) Interim, final regulations.--Within a reasonable time 
     after publication of the interim regulations in accordance 
     with paragraph (1), the Secretary of Homeland Security shall 
     publish final regulations implementing this section.
       (f) Removal of Alien.--The Secretary of Homeland Security 
     may not remove any alien who has a pending application for 
     conditional status under this Act.

     SEC. 5. CONDITIONAL PERMANENT RESIDENT STATUS.

       (a) In General.--
       (1) Conditional basis for status.--Notwithstanding any 
     other provision of law, and except as provided in section 6, 
     an alien whose status has been adjusted under section 4 to 
     that of an alien lawfully admitted for permanent residence 
     shall be considered to have obtained such status on a 
     conditional basis subject to the provisions of this section. 
     Such conditional permanent resident status shall be valid for 
     a period of 6 years, subject to termination under subsection 
     (b).
       (2) Notice of requirements.--
       (A) At time of obtaining permanent residence.--At the time 
     an alien obtains permanent resident status on a conditional 
     basis under paragraph (1), the Secretary of Homeland Security 
     shall provide for notice to the alien regarding the 
     provisions of this section and the requirements of subsection 
     (c) to have the conditional basis of such status removed.
       (B) Effect of failure to provide notice.--The failure of 
     the Secretary of Homeland Security to provide a notice under 
     this paragraph--
       (i) shall not affect the enforcement of the provisions of 
     this Act with respect to the alien; and
       (ii) shall not give rise to any private right of action by 
     the alien.
       (b) Termination of Status.--
       (1) In general.--The Secretary of Homeland Security shall 
     terminate the conditional permanent resident status of any 
     alien who obtained such status under this Act, if the 
     Secretary determines that the alien--
       (A) ceases to meet the requirements of subparagraph (B) or 
     (C) of section 4(a)(1);
       (B) has become a public charge; or
       (C) has received a dishonorable or other than honorable 
     discharge from the uniformed services.
       (2) Return to previous immigration status.--Any alien whose 
     conditional permanent resident status is terminated under 
     paragraph (1) shall return to the immigration status the 
     alien had immediately prior to receiving conditional 
     permanent resident status under this Act.
       (c) Requirements of Timely Petition for Removal of 
     Condition.--
       (1) In general.--In order for the conditional basis of 
     permanent resident status obtained by an alien under 
     subsection (a) to be removed, the alien must file with the 
     Secretary of Homeland Security, in accordance with paragraph 
     (3), a petition which requests the removal of such 
     conditional basis and which provides, under penalty of 
     perjury, the facts and information so that the Secretary may 
     make the determination described in paragraph (2)(A).
       (2) Adjudication of petition to remove condition.--
       (A) In general.--If a petition is filed in accordance with 
     paragraph (1) for an alien, the Secretary of Homeland 
     Security shall make a determination as to whether the alien 
     meets the requirements set out in subparagraphs (A) through 
     (E) of subsection (d)(1).
       (B) Removal of conditional basis if favorable 
     determination.--If the Secretary determines that the alien 
     meets such requirements, the Secretary shall notify the alien 
     of such determination and immediately remove the conditional 
     basis of the status of the alien.
       (C) Termination if adverse determination.--If the Secretary 
     determines that the alien does not meet such requirements, 
     the Secretary shall notify the alien of such determination 
     and terminate the conditional permanent resident status of 
     the alien as of the date of the determination.
       (3) Time to file petition.--An alien may petition to remove 
     the conditional basis to lawful resident status during the 
     period beginning 180 days before and ending 2 years after 
     either the date that is 6 years after the date of the 
     granting of conditional permanent resident status or any 
     other expiration date of the conditional permanent resident 
     status as extended by the Secretary of Homeland Security in 
     accordance with this Act. The alien shall be deemed in 
     conditional permanent resident status in the United States 
     during the period in which the petition is pending.
       (d) Details of Petition.--
       (1) Contents of petition.--Each petition for an alien under 
     subsection (c)(1) shall contain information to permit the 
     Secretary of Homeland Security to determine whether each of 
     the following requirements is met:
       (A) The alien has demonstrated good moral character during 
     the entire period the alien has been a conditional permanent 
     resident.
       (B) The alien is in compliance with section 4(a)(1)(C).
       (C) The alien has not abandoned the alien's residence in 
     the United States. The Secretary shall presume that the alien 
     has abandoned such residence if the alien is absent from the 
     United States for more than 365 days, in the aggregate, 
     during the period of conditional residence, unless the alien 
     demonstrates that alien has not abandoned the alien's 
     residence. An alien who is absent from the United States due 
     to active service in the uniformed services has not abandoned 
     the alien's residence in the United States during the period 
     of such service.
       (D) The alien has completed at least 1 of the following:
       (i) The alien has acquired a degree from an institution of 
     higher education in the United States or has completed at 
     least 2 years, in good standing, in a program for a 
     bachelor's degree or higher degree in the United States.
       (ii) The alien has served in the uniformed services for at 
     least 2 years and, if discharged, has received an honorable 
     discharge.
       (E) The alien has provided a list of each secondary school 
     (as that term is defined in section 9101 of the Elementary 
     and Secondary Education Act of 1965 (20 U.S.C. 7801)) that 
     the alien attended in the United States.
       (2) Hardship exception.--
       (A) In general.--The Secretary of Homeland Security may, in 
     the Secretary's discretion, remove the conditional status of 
     an alien if the alien--
       (i) satisfies the requirements of subparagraphs (A), (B), 
     and (C) of paragraph (1);
       (ii) demonstrates compelling circumstances for the 
     inability to complete the requirements described in paragraph 
     (1)(D); and
       (iii) demonstrates that the alien's removal from the United 
     States would result in exceptional and extremely unusual 
     hardship to the alien or the alien's spouse, parent, or child 
     who is a citizen or a lawful permanent resident of the United 
     States.
       (B) Extension.--Upon a showing of good cause, the Secretary 
     of Homeland Security may extend the period of conditional 
     resident status for the purpose of completing the 
     requirements described in paragraph (1)(D).
       (e) Treatment of Period for Purposes of Naturalization.--
     For purposes of title III of the Immigration and Nationality 
     Act (8 U.S.C. 1401 et seq.), in the case of an alien who is 
     in the United States as a lawful permanent resident on a 
     conditional basis under this section, the alien shall be 
     considered to have been admitted as an alien lawfully 
     admitted for permanent residence and to be in the United 
     States as an alien lawfully admitted to the United States for 
     permanent residence. However, the conditional basis must be 
     removed before the alien may apply for naturalization.

     SEC. 6. RETROACTIVE BENEFITS UNDER THIS ACT.

       If, on the date of enactment of this Act, an alien has 
     satisfied all the requirements of subparagraphs (A) through 
     (E) of section 4(a)(1) and section 5(d)(1)(D), the Secretary 
     of Homeland Security may adjust the status of the alien to 
     that of a conditional resident in accordance with section 4. 
     The alien may petition for removal of such condition at the 
     end of the conditional residence period in accordance with 
     section 5(c) if the alien has met the requirements of 
     subparagraphs (A), (B), and (C) of section 5(d)(1) during the 
     entire period of conditional residence.

     SEC. 7. EXCLUSIVE JURISDICTION.

       (a) In General.--The Secretary of Homeland Security shall 
     have exclusive jurisdiction to determine eligibility for 
     relief under this Act, except where the alien has been placed 
     into deportation, exclusion, or removal proceedings either 
     prior to or after filing an application for relief under this 
     Act, in which case the Attorney General shall have exclusive 
     jurisdiction and shall assume

[[Page S3932]]

     all the powers and duties of the Secretary until proceedings 
     are terminated, or if a final order of deportation, 
     exclusion, or removal is entered the Secretary shall resume 
     all powers and duties delegated to the Secretary under this 
     Act.
       (b) Stay of Removal of Certain Aliens Enrolled in Primary 
     or Secondary School.--The Attorney General shall stay the 
     removal proceedings of any alien who--
       (1) meets all the requirements of subparagraphs (A), (B), 
     (C), and (E) of section 4(a)(1);
       (2) is at least 12 years of age; and
       (3) is enrolled full time in a primary or secondary school.
       (c) Employment.--An alien whose removal is stayed pursuant 
     to subsection (b) may be engaged in employment in the United 
     States consistent with the Fair Labor Standards Act (29 
     U.S.C. 201 et seq.) and State and local laws governing 
     minimum age for employment.
       (d) Lift of Stay.--The Attorney General shall lift the stay 
     granted pursuant to subsection (b) if the alien--
       (1) is no longer enrolled in a primary or secondary school; 
     or
       (2) ceases to meet the requirements of subsection (b)(1).

     SEC. 8. PENALTIES FOR FALSE STATEMENTS IN APPLICATION.

       Whoever files an application for relief under this Act and 
     willfully and knowingly falsifies, misrepresents, or conceals 
     a material fact or makes any false or fraudulent statement or 
     representation, or makes or uses any false writing or 
     document knowing the same to contain any false or fraudulent 
     statement or entry, shall be fined in accordance with title 
     18, United States Code, or imprisoned not more than 5 years, 
     or both.

     SEC. 9. CONFIDENTIALITY OF INFORMATION.

       (a) Prohibition.--Except as provided in subsection (b), no 
     officer or employee of the United States may--
       (1) use the information furnished by the applicant pursuant 
     to an application filed under this Act to initiate removal 
     proceedings against any persons identified in the 
     application;
       (2) make any publication whereby the information furnished 
     by any particular individual pursuant to an application under 
     this Act can be identified; or
       (3) permit anyone other than an officer or employee of the 
     United States Government or, in the case of applications 
     filed under this Act with a designated entity, that 
     designated entity, to examine applications filed under this 
     Act.
       (b) Required Disclosure.--The Attorney General or the 
     Secretary of Homeland Security shall provide the information 
     furnished under this section, and any other information 
     derived from such furnished information, to--
       (1) a duly recognized law enforcement entity in connection 
     with an investigation or prosecution of an offense described 
     in paragraph (2) or (3) of section 212(a) of the Immigration 
     and Nationality Act (8 U.S.C. 1182(a)), when such information 
     is requested in writing by such entity; or
       (2) an official coroner for purposes of affirmatively 
     identifying a deceased individual (whether or not such 
     individual is deceased as a result of a crime).
       (c) Penalty.--Whoever knowingly uses, publishes, or permits 
     information to be examined in violation of this section shall 
     be fined not more than $10,000.

     SEC. 10. EXPEDITED PROCESSING OF APPLICATIONS; PROHIBITION ON 
                   FEES.

       Regulations promulgated under this Act shall provide that 
     applications under this Act will be considered on an 
     expedited basis and without a requirement for the payment by 
     the applicant of any additional fee for such expedited 
     processing.

     SEC. 11. HIGHER EDUCATION ASSISTANCE.

       Notwithstanding any provision of the Higher Education Act 
     of 1965 (20 U.S.C. 1001 et seq.), with respect to assistance 
     provided under title IV of the Higher Education Act of 1965 
     (20 U.S.C. 1070 et seq.), an alien who adjusts status to that 
     of a lawful permanent resident under this Act shall be 
     eligible only for the following assistance under such title:
       (1) Student loans under parts B, D, and E of such title IV 
     (20 U.S.C. 1071 et seq., 1087a et seq., 1087aa et seq.), 
     subject to the requirements of such parts.
       (2) Federal work-study programs under part C of such title 
     IV (42 U.S.C. 2751 et seq.), subject to the requirements of 
     such part.
       (3) Services under such title IV (20 U.S.C. 1070 et seq.), 
     subject to the requirements for such services.

     SEC. 12. GAO REPORT.

       Not later than seven years after the date of enactment of 
     this Act, the Comptroller General of the United States shall 
     submit a report to the Committee on the Judiciary of the 
     Senate and the Committee on the Judiciary of the House of 
     Representatives setting forth--
       (1) the number of aliens who were eligible for cancellation 
     of removal and adjustment of status under section 4(a);
       (2) the number of aliens who applied for adjustment of 
     status under section 4(a);
       (3) the number of aliens who were granted adjustment of 
     status under section 4(a); and
       (4) the number of aliens whose conditional permanent 
     resident status was removed under section 5.

  Mr. LEAHY. Mr. President, I am pleased to join Senator Durbin once 
again to introduce the Development, Relief, and Education for Alien 
Minors Act, DREAM. This legislation has the potential to change the 
lives of many young people in an extraordinary and positive way and is 
an investment in America's future.
  The Senate has attempted several times to pass the DREAM Act, but the 
bitter politics of immigration have stalled our best efforts in the 
past. I appreciate Senator Durbin's persistence, and I share his 
commitment to the young people whose lives this bill would profoundly 
improve. Those who came to the U.S. as minors under the care of their 
parents are not guilty of their parents' transgressions. For many, the 
U.S. is the only home they know. We will further the Federal policy 
that supports educational opportunity and military service if we 
exercise the forbearance to defer rigid application of our laws upon 
those who have the potential to be citizens that will move our country 
forward. We all recognize the value of higher education and service to 
our country. To serve these Federal policy interests by giving legal 
stability and opportunity to young people caught in the limbo of our 
laws through no fault of their own is the right thing to do.
  As Congress and the administration work through the immediate 
challenges that lie ahead, and begin to restore the faith of Americans 
in our economy and our government, I hope Congress will not shy away 
from other important issues such as immigration reform. When our 
Federal Government confronts the issue of immigration, I hope we will 
see not only the opportunity to correct what is wrong, but also to 
improve and build upon what is good and just about the traditions of 
welcoming and refuge that define our immigration system. The promise 
this bill holds for so many young people will reinforce the spirit that 
underlies the history of American immigration and the diversity that 
has moved us so far.
  I thank Senator Durbin and hope all Senators will join us in support 
of this legislation.
                                 ______
                                 
      By Mr. AKAKA (for himself, Mr. Specter, Mr. Cardin, Mr. Schumer, 
        Mr. Voinovich, Mr. Brown, and Mr. Casey):
  S. 732. A bill to amend the National Dam Safety Program Act to 
establish a program to provide grant assistance to States for the 
rehabilitation and repair of deficient dams; to the Committee on 
Environment and Public Works.
  Mr. SPECTER. Mr. President, I seek recognition to comment on my 
cosponsorship of the Dam Rehabilitation and Repair Act of 2009 and 
clarify my intent with respect to Davis-Bacon prevailing wage 
requirements under this bill.
  This bill would establish a grant program within the Federal 
Emergency Management Agency to provide assistance to states for the 
rehabilitation of publicly-owned dams that fail to meet minimum safety 
standards. I am cosponsoring this bill because it is my understanding 
that there are at least 3,040 deficient dams in the United States, 
including 369 in Pennsylvania. These dams pose an unacceptable level of 
risk to the public and should be rehabilitated expeditiously.
  I cosponsored similar legislation in the 110th Congress, however, I 
am advised that it was not considered by the Committee on Environment 
and Public Works due to concerns over language in the bill which would 
have required that dam repair work funded under the act adhere to 
Davis-Bacon locally prevailing wage requirements. As a result, this 
year's version of the bill, as introduced, does not contain Davis-Bacon 
prevailing wage requirements out of deference to the Ranking Member of 
the Committee. However, I am a strong supporter of Davis-Bacon, having 
voted in favor of preserving it 23 separate times on the Senate floor 
since 1982. Accordingly, it is my intention to work to reinsert Davis-
Bacon requirements into the bill either in committee or on the Senate 
floor.

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