[Congressional Record Volume 155, Number 87 (Thursday, June 11, 2009)]
[Senate]
[Pages S6545-S6568]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mrs. FEINSTEIN (for herself and Mrs. Boxer):
  S. 1236. A bill to amend title XVIII of the Social Security Act to 
transition to the use of metropolitan statistical areas as fee schedule 
areas for the physician fee schedule in California under the Medicare 
program; to the Committee on Finance.
  Mrs. FEINSTEIN. Mr. President, I rise to introduce legislation to 
correct a longstanding flaw in the Medicare Geographic Practice Cost 
Index, GPCI, system that negatively impacts physicians in California 
and several other states.
  This legislation will base California physician payments on 
Metropolitan Statistical Areas, MSAs. Hospital payments are developed 
this way, and it makes sense to pay our doctors in the same manner.
  It holds harmless the counties, predominately rural ones, whose 
locality average would otherwise drop as other counties are 
reclassified.
  Congressman Sam Farr, along with several California colleagues, is 
introducing companion legislation.
  The Medicare Geographic Practice Cost Index measures the cost of 
providing a Medicare covered service in a geographic area. Medicare 
payments are supposed to reflect the varying costs of rent, malpractice 
insurance, and other expenses necessary to operate a medical process. 
Counties are assigned to ``payment localities'' that are supposed to 
accurately capture these costs.
  Here is the problem. Some of these payment localities have not 
changed since 1997. Others have been in place since 1966. Many areas 
that were rural even 10 years ago have experienced significant 
population growth, as metropolitan areas and suburbs have spread. Many 
counties now find themselves in payment localities that do not 
accurately reflect their true practice costs.
  These payment discrepancies have a real and serious impact on 
physicians and the Medicare beneficiaries they are unable to serve. My 
home State of California has been hit particularly hard.
  San Diego County physicians are underpaid by 4 percent. A number of 
physicians have left the county and 60 percent of remaining San Diego 
physicians report that they cannot recruit new doctors to their 
practices.
  Santa Cruz County receives an 8.6 percent underpayment, and as a 
result, no physicians are accepting new Medicare patients. Instead, 
they are moving to neighboring Santa Clara, which has similar practice 
cost expense, but is reimbursed at a much higher rate. This means that 
seniors often need to travel at least 20 miles to see a physician.
  Sacramento County, a major metropolitan area, is underpaid by 2.7 
percent. The county's population has grown by 9.6 percent, while the 
number of physicians has declined by 11 percent.
  Sonoma County physicians are paid at least 6.2 percent less than 
their geographic practice costs. They have experienced at 10 percent 
decline in specialists and a 9 percent decline in primary care 
physicians.
  Health care coverage is not the same as access to health care. 
Seniors' Medicare cards are of no value if physicians in their 
community cannot afford to provide them with health care.
  Physicians deserve to be fairly compensated for the work they 
perform. California doctors simply want to be compensated at the 
correct rate for the practice expenses they face.
  This is not too much to ask.
  The underpayment problem grows more severe every year, and the longer 
we wait to address it, the more drastic the solution will need to be. 
This legislation provides a common sense solution, increasing payment 
for those facing the most drastic underpayments, while protecting other 
counties from cuts in the process.
  This is an issue of equity. It costs more to provide health care in 
expensive areas, and physicians serving our seniors must be fairly 
compensated.
  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. 1236

       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 ``GPCI Justice Act of 2009''.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) From 1966 through 1991, the Medicare program paid 
     physicians based on what they charged for services. The 
     Omnibus Reconciliation Act of 1989 required the establishment 
     of a national Medicare physician fee schedule, which was 
     implemented in 1992, replacing the charge-based system.
       (2) The Medicare physician fee schedule currently includes 
     more than 7000 services together with their corresponding 
     payment rates. In addition, each service on the fee schedule 
     has three relative value units (RVUs) that correspond to the 
     three physician payment components of physician work, 
     practice expense, and malpractice expense.
       (3)(A) Each geographically adjusted RVU measures the 
     relative costliness of providing a particular service in a 
     particular location referred to as a locality. Physician 
     payment localities are primarily consolidations of the 
     carrier-defined localities that were established in 1966.
       (B) When physician payment localities were redesignated in 
     1997, the Administrator of the Centers for Medicare & 
     Medicaid Services acknowledged that the new payment locality 
     configuration had not been established on a consistent 
     geographic basis. Some were based on zip codes or 
     Metropolitan Statistical Areas (MSAs) while others were based 
     on political boundaries, such as cities, counties, or States.
       (C) The Medicare program has not revised the geographic 
     boundaries of the physician payment localities since the 1997 
     revision.
       (4) Medicare's geographic adjustment for a particular 
     physician payment locality is determined using three GPCIs 
     (Geographic Practice Cost Indices) that also correspond to 
     the three Medicare physician payment components of physician 
     work, practice expense, and malpractice expense.
       (5) The major data source used in calculating the GPCIs is 
     the decennial census which provides new data only once every 
     10 years.
       (6) This system of geographic payment designation has 
     resulted in more than half of the current physician payment 
     localities having counties within them with a large payment 
     difference of 5 percent or more. A disproportionate number of 
     these underpaid counties are located in California, Georgia, 
     Minnesota, Ohio, and Virginia.
       (7) For purposes of payment under the Medicare program, 
     hospitals are organized and reimbursed for geographic costs 
     according to MSAs.
       (8) Studies by the Medicare Payment Advisory Commission 
     (MedPAC) in 2007, the Government Accountability Office (GAO) 
     in 2007, the Urban Institute in 2008, and Acumen LLC in 2008 
     have all documented this physician GPCI payment discrepancy--
     specifically that more than half of the current physician 
     payment localities had counties within them with a large 
     payment difference (that is, a payment difference of 5 
     percent or more) between GAO's measure of physicians' costs 
     and Medicare's geographic adjustment for an area. All these 
     objective studies have recommended changes to the locality 
     system to correct the payment discrepancies.
       (9) A common recommendation among the GPCI payment 
     discrepancy studies referred to in paragraph (8) is to 
     eliminate the county-based locality and replace it with one 
     determined by Metropolitan Statistical Area.

[[Page S6546]]

     SEC. 3. REDESIGNATING THE GEOGRAPHICAL PRACTICE COST INDEX 
                   (GPCI) LOCALITIES IN CALIFORNIA.

       (a) In General.--Section 1848(e) of the Social Security Act 
     (42 U.S.C.1395w-4(e)) is amended by adding at the end the 
     following new paragraph:
       ``(6) Transition to use of msas as fee schedule areas in 
     california.--
       ``(A) In general.--
       ``(i) Revision.--Subject to clause (ii) and notwithstanding 
     the previous provisions of this subsection, for services 
     furnished on or after January 1, 2010, the Secretary shall 
     revise the fee schedule areas used for payment under this 
     section applicable to the State of California using the 
     Metropolitan Statistical Area (MSA) iterative Geographic 
     Adjustment Factor methodology as follows:

       ``(I) The Secretary shall configure the physician fee 
     schedule areas using the Core-Based Statistical Areas-
     Metropolitan Statistical Areas (each in this paragraph 
     referred to as an `MSA'), as defined by the Director of the 
     Office of Management and Budget, as the basis for the fee 
     schedule areas. The Secretary shall employ an iterative 
     process to transition fee schedule areas. First, the 
     Secretary shall list all MSAs within the State by Geographic 
     Adjustment Factor described in paragraph (2) (in this 
     paragraph referred to as a `GAF') in descending order. In the 
     first iteration, the Secretary shall compare the GAF of the 
     highest cost MSA in the State to the weighted-average GAF of 
     the group of remaining MSAs in the State. If the ratio of the 
     GAF of the highest cost MSA to the weighted-average GAF of 
     the rest of State is 1.05 or greater then the highest cost 
     MSA becomes a separate fee schedule area.
       ``(II) In the next iteration, the Secretary shall compare 
     the MSA of the second-highest GAF to the weighted-average GAF 
     of the group of remaining MSAs. If the ratio of the second-
     highest MSA's GAF to the weighted-average of the remaining 
     lower cost MSAs is 1.05 or greater, the second-highest MSA 
     becomes a separate fee schedule area. The iterative process 
     continues until the ratio of the GAF of the highest-cost 
     remaining MSA to the weighted-average of the remaining lower-
     cost MSAs is less than 1.05, and the remaining group of lower 
     cost MSAs form a single fee schedule area, If two MSAs have 
     identical GAFs, they shall be combined in the iterative 
     comparison.

       ``(ii) Transition.--For services furnished on or after 
     January 1, 2010, in the State of California, after 
     calculating the work, practice expense, and malpractice 
     geographic indices described in clauses (i), (ii), and (iii) 
     of paragraph (1)(A) that would otherwise apply through 
     application of this paragraph, the Secretary shall increase 
     any such index to the county-based fee schedule area value on 
     December 31, 2009, if such index would otherwise be less than 
     the value on January 1, 2010.
       ``(B) Subsequent revisions.--
       ``(i) Periodic review and adjustments in fee schedule 
     areas.--Subsequent to the process outlined in paragraph 
     (1)(C), not less often than every three years, the Secretary 
     shall review and update the California Rest-of-State fee 
     schedule area using MSAs as defined by the Director of the 
     Office of Management and Budget and the iterative methodology 
     described in subparagraph (A)(i).
       ``(ii) Link with geographic index data revision.--The 
     revision described in clause (i) shall be made effective 
     concurrently with the application of the periodic review of 
     the adjustment factors required under paragraph (1)(C) for 
     California for 2012 and subsequent periods. Upon request, the 
     Secretary shall make available to the public any county-level 
     or MSA derived data used to calculate the geographic practice 
     cost index.
       ``(C) References to fee schedule areas.--Effective for 
     services furnished on or after January 1, 2010, for the State 
     of California, any reference in this section to a fee 
     schedule area shall be deemed a reference to an MSA in the 
     State.''.
       (b) Conforming Amendment to Definition of Fee Schedule 
     Area.--Section 1848(j)(2) of the Social Security Act (42 
     U.S.C. 1395w(j)(2)) is amended by striking ``The term'' and 
     inserting ``Except as provided in subsection (e)(6)(C), the 
     term''.
                                 ______
                                 
      By Mr. BINGAMAN (for himself, Mr. Thune, and Mrs. Gillibrand):
  S. 1239. A bill to amend section 340B of the Public Health Service 
Act to revise and expand the drug discount program under that section 
to improve the provision of discounts on drug purchases for certain 
safety net providers; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. BINGAMAN. Mr. President, I rise today with my colleague from 
South Dakota, Sen. Thune, to introduce the 340B Program Improvement and 
Integrity Act of 2009. This legislation is designed to address the 
growing burden faced by our Nation's health care safety net 
institutions in being able to provide adequate pharmaceutical care to 
the most vulnerable patient populations.
  Communities across the country rely on public and non-profit 
hospitals to serve as the health care ``safety net'' for low-income, 
uninsured, and underinsured patients. With the ever-increasing cost of 
pharmaceuticals, these institutions are struggling more and more to 
provide basic pharmaceutical care to those least able to afford it.
  Fortunately, many safety net hospitals are currently able to 
participate in the federal 340B Drug Discount Program, which enables 
them to purchase outpatient drugs for their patients at discounted 
prices. These hospitals, known as ``covered entities'' under the 340B 
statute, include high-Medicaid disproportionate share hospitals, DSH, 
large and small urban hospitals, and certain rural hospitals.
  I am introducing legislation today, the 340B Program Improvement and 
Integrity Act of 2009, which would extend discounted drug prices 
currently mandated only for outpatient drugs to inpatient drugs 
purchased by covered entities under the 340B program. Although the 
Medicare Modernization Act (MMA) of 2003 permitted pharmaceutical 
manufacturers to offer 340B drug discounts to covered entities, this 
legislation did not include a mandate. Without a mandate we have seen 
very little willingness on the part of manufactures to offer 340B drug 
discounts for inpatient drugs. As the prices of pharmaceutical drugs 
continue to increase sharply, the need for these inpatient discounts 
grows more and more acute.
  My legislation would also allow expanded participation in the program 
to a subset of rural hospitals that, for a variety of reasons, cannot 
currently access 340B discounts. These newly eligible rural hospitals 
include: critical access hospitals, sole community hospitals, and rural 
referral centers. In proposing this modest expansion to the program, we 
have struck an important balance between ensuring a close nexus with 
low-income and indigent care, ensuring that a significant portion of 
savings are passed on to the Medicaid program, and strengthening the 
integrity of the program.
  Specifically, newly eligible rural hospitals would have to meet 
appropriate standards demonstrating their ``safety net'' status, as do 
all hospitals that currently participate in the program. For example, 
sole community hospitals and rural referral centers, all of which are 
paid under the prospective payment system, would be required under this 
legislation to serve a significant percentage of low-income and 
indigent patients, have public or non-profit status, and, if privately 
owned and operated, to have a contract with state or local government 
to provide a significant level of indigent care. All standards are 
designed to reinforce the obligation of these covered entities to 
continue serving low-income and uninsured patients.
  This legislation would also generate savings for the Medicaid program 
by requiring participating hospitals to credit to their State Medicaid 
program a percentage of their savings on inpatient drugs. It would 
address the overall efficiency and integrity of the 340B program 
through improved enforcement and compliance measures with respect to 
manufacturers and covered entities. This is designed to improve program 
administration and to prevent and remedy instances of program abuse.
  The 340B Program Improvement and Integrity Act of 2009 would help 
safety net providers stretch their limited resources through increased 
access to discounted pharmaceuticals, enhance 340B program integrity by 
making sure participants are complying with program rules, and improve 
the care provided to this Nation's most vulnerable populations.
  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. 1239

       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 ``340B Program Improvement and 
     Integrity Act of 2009''.

     SEC. 2. EXPANDED PARTICIPATION IN SECTION 340B PROGRAM.

       (a) Expansion of Covered Entities Receiving Discounted 
     Prices.--Section 340B(a)(4) of the Public Health Service Act 
     (42 U.S.C. 256b(a)(4)) is amended by adding at the end the 
     following:
       ``(M) A children's hospital excluded from the Medicare 
     prospective payment system pursuant to section 
     1886(d)(1)(B)(iii) of the Social Security Act which would 
     meet the

[[Page S6547]]

     requirements of subparagraph (L), including the 
     disproportionate share adjustment percentage requirement 
     under clause (ii) of such subparagraph, if the hospital were 
     a subsection (d) hospital as defined by section 1886(d)(1)(B) 
     of the Social Security Act.
       ``(N) An entity that is a critical access hospital (as 
     determined under section 1820(c)(2) of the Social Security 
     Act), and that meets the requirements of subparagraph (L)(i).
       ``(O) An entity that is a rural referral center, as defined 
     by section 1886(d)(5)(C)(i) of the Social Security Act, or a 
     sole community hospital, as defined by section 
     1886(d)(5)(C)(iii) of such Act, and that both meets the 
     requirements of subparagraph (L)(i) and has a 
     disproportionate share adjustment percentage equal to or 
     greater than 8 percent.''.
       (b) Extension of Discounts to Inpatient Drugs.--Section 
     340B of the Public Health Service Act (42 U.S.C. 256b) is 
     amended--
       (1) in subsection (a), by striking ``outpatient'' each 
     place that such appears in paragraphs (2), (5), (7), and (9); 
     and
       (2) in subsection (b)--
       (A) by striking ``In this section'' and inserting the 
     following:
       ``(A) In general.--In this section''; and
       (B) by adding at the end the following:
       ``(B) Covered drug.--In this section, the term `covered 
     drug'--
       ``(i) means a covered outpatient drug (as defined in 
     section 1927(k)(2) of the Social Security Act); and
       ``(ii) includes, notwithstanding paragraph (3)(A) of such 
     section 1927(k), a drug used in connection with an inpatient 
     or outpatient service provided by a hospital described in 
     subparagraph (L), (M), (N), or (O) of subsection (a)(4) that 
     is enrolled to participate in the drug discount program under 
     this section.
       ``(C) Purchasing arrangements for inpatient drugs.--The 
     Secretary shall ensure that a hospital described in 
     subparagraph (L), (M), (N), or (O) of subsection (a)(4) that 
     is enrolled to participate in the drug discount program under 
     this section shall have multiple options for purchasing 
     covered drugs for inpatients including by utilizing a group 
     purchasing organization or other group purchasing 
     arrangement, establishing and utilizing its own group 
     purchasing program, purchasing directly from a manufacturer, 
     and any other purchasing arrangements that the Secretary may 
     deem appropriate to ensure access to drug discount pricing 
     under this section for inpatient drugs taking into account 
     the particular needs of small and rural hospitals.''.
       (c) Prohibition on Group Purchasing Arrangements.--Section 
     340B(a) of the Public Health Service Act (42 U.S.C. 256b(a)) 
     is amended--
       (1) in paragraph (4)(L)--
       (A) in clause (i), by adding ``and'' at the end;
       (B) in clause (ii), by striking ``; and'' and inserting a 
     period; and
       (C) by striking clause (iii); and
       (2) in paragraph (5)--
       (A) by redesignating subparagraphs (C) and (D) as 
     subparagraphs (D) and (E); respectively; and
       (B) by inserting after subparagraph (B), the following:
       ``(C) Prohibiting the use of group purchasing 
     arrangements.--
       ``(i) In general.--A hospital described in subparagraphs 
     (L), (M), (N), or (O) of paragraph (4) shall not obtain 
     covered outpatient drugs through a group purchasing 
     organization or other group purchasing arrangement, except as 
     permitted or provided for pursuant to clauses (ii) or (iii).
       ``(ii) Inpatient drugs.--Clause (i) shall not apply to 
     drugs purchased for inpatient use.
       ``(iii) Exceptions.--The Secretary shall establish 
     reasonable exceptions to clause (i)--

       ``(I) with respect to a covered outpatient drug that is 
     unavailable to be purchased through the program under this 
     section due to a drug shortage problem, manufacturer 
     noncompliance, or any other circumstance beyond the 
     hospital's control;
       ``(II) to facilitate generic substitution when a generic 
     covered outpatient drug is available at a lower price; or
       ``(III) to reduce in other ways the administrative burdens 
     of managing both inventories of drugs subject to this section 
     and inventories of drugs that are not subject to this 
     section, so long as the exceptions do not create a duplicate 
     discount problem in violation of subparagraph (A) or a 
     diversion problem in violation of subparagraph (B).''.

       (d) Medicaid Credits on Inpatient Drugs.--Section 
     340B(a)(5) of the Public Health Service Act (42 U.S.C. 
     256b(a)(5)) is amended by adding at the end the following:
       ``(E) Medicaid credits.--Not later than 90 days after the 
     date of filing of the hospital's most recently filed Medicare 
     cost report, the hospital shall issue a credit as determined 
     by the Secretary to the State Medicaid program for inpatient 
     covered drugs provided to Medicaid recipients.''.
       (e) Integrity Improvements.--Subsection (c) of section 340B 
     of the Public Health Service Act (42 U.S.C. 256b(c)) is 
     amended to read as follows:
       ``(c) Improvements in Program Integrity.--
       ``(1) Manufacturer compliance.--
       ``(A) In general.--From amounts appropriated under 
     paragraph (4), the Secretary shall provide for improvements 
     in compliance by manufacturers with the requirements of this 
     section in order to prevent overcharges and other violations 
     of the discounted pricing requirements specified in this 
     section.
       ``(B) Improvements.--The improvements described in 
     subparagraph (A) shall include the following:
       ``(i) The development of a system to enable the Secretary 
     to verify the accuracy of ceiling prices calculated by 
     manufacturers under subsection (a)(1) and charged to covered 
     entities, which shall include the following:

       ``(I) Developing and publishing through an appropriate 
     policy or regulatory issuance, precisely defined standards 
     and methodology for the calculation of ceiling prices under 
     such subsection.
       ``(II) Comparing regularly the ceiling prices calculated by 
     the Secretary with the quarterly pricing data that is 
     reported by manufacturers to the Secretary.
       ``(III) Performing spot checks of sales transactions by 
     covered entities.
       ``(IV) Inquiring into the cause of any pricing 
     discrepancies that may be identified and either taking, or 
     requiring manufacturers to take, such corrective action as is 
     appropriate in response to such price discrepancies.

       ``(ii) The establishment of procedures for manufacturers to 
     issue refunds to covered entities in the event that there is 
     an overcharge by the manufacturers, including the following:

       ``(I) Providing the Secretary with an explanation of why 
     and how the overcharge occurred, how the refunds will be 
     calculated, and to whom the refunds will be issued.
       ``(II) Oversight by the Secretary to ensure that the 
     refunds are issued accurately and within a reasonable period 
     of time, both in routine instances of retroactive adjustment 
     to relevant pricing data and exceptional circumstances such 
     as erroneous or intentional overcharging for covered drugs.

       ``(iii) The provision of access through the Internet 
     website of the Department of Health and Human Services to the 
     applicable ceiling prices for covered drugs as calculated and 
     verified by the Secretary in accordance with this section, in 
     a manner (such as through the use of password protection) 
     that limits such access to covered entities and adequately 
     assures security and protection of privileged pricing data 
     from unauthorized re-disclosure.
       ``(iv) The development of a mechanism by which--

       ``(I) rebates and other discounts provided by manufacturers 
     to other purchasers subsequent to the sale of covered drugs 
     to covered entities are reported to the Secretary; and
       ``(II) appropriate credits and refunds are issued to 
     covered entities if such discounts or rebates have the effect 
     of lowering the applicable ceiling price for the relevant 
     quarter for the drugs involved.

       ``(v) Selective auditing of manufacturers and wholesalers 
     to ensure the integrity of the drug discount program under 
     this section.
       ``(vi) The imposition of sanctions in the form of civil 
     monetary penalties, which--

       ``(I) shall be assessed according to standards established 
     in regulations to be promulgated by the Secretary within 180 
     days of the date of enactment of the 340B Program Improvement 
     and Integrity Act of 2009;
       ``(II) shall not exceed $5,000 for each instance of 
     overcharging a covered entity that may have occurred; and
       ``(III) shall apply to any manufacturer with an agreement 
     under this section that knowingly and intentionally charges a 
     covered entity a price for purchase of a drug that exceeds 
     the maximum applicable price under subsection (a)(1).

       ``(2) Covered entity compliance.--
       ``(A) In general.--From amounts appropriated under 
     paragraph (4), the Secretary shall provide for improvements 
     in compliance by covered entities with the requirements of 
     this section in order to prevent diversion and violations of 
     the duplicate discount provision and other requirements 
     specified under subsection (a)(5).
       ``(B) Improvements.--The improvements described in 
     subparagraph (A) shall include the following:
       ``(i) The development of procedures to enable and require 
     covered entities to regularly update (at least annually) the 
     information on the Internet website of the Department of 
     Health and Human Services relating to this section.
       ``(ii) The development of a system for the Secretary to 
     verify the accuracy of information regarding covered entities 
     that is listed on the website described in clause (i).
       ``(iii) The development of more detailed guidance 
     describing methodologies and options available to covered 
     entities for billing covered drugs to State Medicaid agencies 
     in a manner that avoids duplicate discounts pursuant to 
     subsection (a)(5)(A).
       ``(iv) The establishment of a single, universal, and 
     standardized identification system by which each covered 
     entity site can be identified by manufacturers, distributors, 
     covered entities, and the Secretary for purposes of 
     facilitating the ordering, purchasing, and delivery of 
     covered drugs under this section, including the processing of 
     chargebacks for such drugs.
       ``(v) The imposition of sanctions, in appropriate cases as 
     determined by the Secretary, additional to those to which 
     covered entities are subject under subparagraph (a)(5)(E), 
     through one or more of the following actions:

       ``(I) Where a covered entity knowingly and intentionally 
     violates subparagraph (a)(5)(B), the covered entity shall be 
     required to pay a monetary penalty to a manufacturer or 
     manufacturers in the form of interest on sums for which the 
     covered entity is found liable

[[Page S6548]]

     under paragraph (a)(5)(E), such interest to be compounded 
     monthly and equal to the current short term interest rate as 
     determined by the Federal Reserve for the time period for 
     which the covered entity is liable.
       ``(II) Where the Secretary determines a violation of 
     subparagraph (a)(5)(B) was systematic and egregious as well 
     as knowing and intentional, removing the covered entity from 
     the drug discount program under this section and 
     disqualifying the entity from re-entry into such program for 
     a reasonable period of time to be determined by the 
     Secretary.
       ``(III) Referring matters to appropriate Federal 
     authorities within the Food and Drug Administration, the 
     Office of Inspector General of Department of Health and Human 
     Services, or other Federal agencies for consideration of 
     appropriate action under other Federal statutes, such as the 
     Prescription Drug Marketing Act.

       ``(3) Administrative dispute resolution process.--
       ``(A) In general.--Not later than 180 days after the date 
     of enactment of the 340B Program Improvement and Integrity 
     Act of 2009, the Secretary shall promulgate regulations to 
     establish and implement an administrative process for the 
     resolution of claims by covered entities that they have been 
     overcharged for drugs purchased under this section, and 
     claims by manufacturers, after the conduct of audits as 
     authorized by subsection (a)(5)(D), of violations of 
     subsections (a)(5)(A) or (a)(5)(B), including appropriate 
     procedures for the provision of remedies and enforcement of 
     determinations made pursuant to such process through 
     mechanisms and sanctions described in paragraphs (1)(B) and 
     (2)(B).
       ``(B) Deadline and procedures.--Regulations promulgated by 
     the Secretary under subparagraph (A) shall--
       ``(i) designate or establish a decision-making official or 
     decision-making body within the Department of Health and 
     Human Services to be responsible for reviewing and finally 
     resolving claims by covered entities that they have been 
     charged prices for covered drugs in excess of the ceiling 
     price described in subsection (a)(1), and claims by 
     manufacturers that violations of subsection (a)(5)(A) or 
     (a)(5)(B) have occurred;
       ``(ii) establish such deadlines and procedures as may be 
     necessary to ensure that claims shall be resolved fairly, 
     efficiently, and expeditiously;
       ``(iii) establish procedures by which a covered entity may 
     discover and obtain such information and documents from 
     manufacturers and third parties as may be relevant to 
     demonstrate the merits of a claim that charges for a 
     manufacturer's product have exceeded the applicable ceiling 
     price under this section, and may submit such documents and 
     information to the administrative official or body 
     responsible for adjudicating such claim;
       ``(iv) require that a manufacturer conduct an audit of a 
     covered entity pursuant to subsection (a)(5)(D) as a 
     prerequisite to initiating administrative dispute resolution 
     proceedings against a covered entity;
       ``(v) permit the official or body designated under clause 
     (i), at the request of a manufacturer or manufacturers, to 
     consolidate claims brought by more than one manufacturer 
     against the same covered entity where, in the judgment of 
     such official or body, consolidation is appropriate and 
     consistent with the goals of fairness and economy of 
     resources; and
       ``(vi) include provisions and procedures to permit multiple 
     covered entities to jointly assert claims of overcharges by 
     the same manufacturer for the same drug or drugs in one 
     administrative proceeding, and permit such claims to be 
     asserted on behalf of covered entities by associations or 
     organizations representing the interests of such covered 
     entities and of which the covered entities are members.
       ``(C) Finality of administrative resolution.--The 
     administrative resolution of a claim or claims under the 
     regulations promulgated under subparagraph (A) shall be a 
     final agency decision and shall be binding upon the parties 
     involved, unless invalidated by an order of a court of 
     competent jurisdiction.
       ``(4) Authorization of appropriations.--There are 
     authorized to be appropriated to carry out this subsection, 
     such sums as may be necessary for fiscal year 2010, and each 
     succeeding fiscal year.''.
       (f) Conforming Amendments.--
       (1) Social security act.--Section 1927 of the Social 
     Security Act (42 U.S.C. 1396r-8), is amended--
       (A) in subsection (a)(5)--
       (i) in subparagraph (A), by striking ``covered outpatient 
     drugs'' and inserting ``covered drugs (as defined in section 
     340B(b)(2) of the Public Health Service Act)'';
       (ii) by striking subparagraph (D); and
       (iii) by redesignating subparagraph (E) as subparagraph 
     (D);
       (B) in subsection (c)(1)(C)(i), by redesignating subclauses 
     (II) through (IV) as subclauses (III) through (V), 
     respectively and by inserting after subclause (I) the 
     following new subclause:

       ``(II) any prices charged for a covered drug (as defined in 
     section 340B(b)(2) of the Public Health Service Act);''; and

       (C) in subsection (k)(1)--
       (i) in subparagraph (A), by striking ``subparagraph (B)'' 
     and inserting ``subparagraphs (B) and (D)''; and
       (ii) by adding at the end the following new subparagraph:
       ``(D) Calculation for covered drugs.--With respect to a 
     covered drug (as defined in section 340B(b)(2) of the Public 
     Health Service Act), the average manufacturer price shall be 
     determined in accordance with subparagraph (A) except that, 
     in the event a covered drug is not distributed to the retail 
     pharmacy class of trade, it shall mean the average price paid 
     to the manufacturer for the drug in the United States by 
     wholesalers for drugs distributed to the acute care class of 
     trade, after deducting customary prompt pay discounts. The 
     Secretary shall establish a mechanism for collecting the 
     necessary data for the acute care class of trade from 
     manufacturers.''.
       (2) Public health service act.--Section 340B(a) of such Act 
     (42 U.S.C. 256b(a)) is amended--
       (A) in subsection (a)(1), by adding at the end the 
     following: ``Each such agreement shall require that the 
     manufacturer furnish the Secretary with reports, on a 
     quarterly basis, of the price for each covered drug subject 
     to the agreement that, according to the manufacturer, 
     represents the maximum price that covered entities may 
     permissibly be required to pay for the drug (referred to in 
     this section as the `ceiling price'), and shall require that 
     the manufacturer offer each covered entity covered drugs for 
     purchase at or below the applicable ceiling price if such 
     drug is made available to any other purchaser at any 
     price.''; and
       (B) in the first sentence of subsection (a)(5)(E), as so 
     redesignated by subsection (c)(2), by inserting ``after an 
     audit as described in subparagraph (D), and'' after 
     ``finds,''.

     SEC. 3. EFFECTIVE DATES.

       (a) In General.--The amendments made by this Act shall take 
     effect on January 1, 2010, and shall apply to drugs purchased 
     on or after January 1, 2010.
       (b) Effectiveness.--The amendments made by this Act shall 
     be effective, and shall be taken into account in determining 
     whether a manufacturer is deemed to meet the requirements of 
     section 340B(a) of the Public Health Service Act (42 U.S.C. 
     256b(a)) and of section 1927(a)(5) of the Social Security Act 
     (42 U.S.C. 1396r-8(a)(5)), notwithstanding any other 
     provision of law.
                                 ______
                                 
      By Mr. INHOFE (for himself and Mr. Tester):
  S. 1241. A bill to amend Public Law 106-206 to direct the Secretary 
of the Interior and the Secretary of Agriculture to require annual 
permits and assess annual fees for commercial filming activities on 
Federal land for film crews of 5 persons or fewer; to the Committee on 
Energy and Natural Resources.
  Mr. INHOFE. Mr. President, I am introducing legislation today with 
Senator Tester to lessen the burdens for small commercial filming on 
public lands. Specifically, this legislation provides special 
permitting to small film crews, defined in the bill as 5 persons or 
fewer, to simply pay a reasonable annual fee to be able to film on 
public lands.
  Our Nation's public lands are an incredible natural resource, and the 
professional outdoor media industry is a valuable way to bring 
awareness to our Nation's resources and bring about awareness of the 
value of conservation of our Nation's land and resources through 
documentaries, sporting programs, and other productions. Small filming 
crews can be negatively affected by the current permitting and fee 
schedule because the business of wildlife filming is done on a 
speculative basis and often relies on unpredictable factors requiring 
much patience and time. Last Congress, Chairman Rahall held a Natural 
Resources Committee hearing on the fees for filming and photography on 
public lands. At that hearing, Steve Scott, an independent television 
producer from Norman, OK, and Chairman of the Professional Outdoor 
Media Association, probably best described the work of small outdoor 
filming operations. He testified, ``By its very nature, wildlife 
photography is extremely time consuming, often done in the harshest 
conditions. . . . While large film and television production crews need 
relatively little time on public lands to complete their project, our 
nation's professional outdoor media may spend weeks or months in the 
field in order to capture a few magic seconds of unstaged Nature in its 
pristine state. And when outdoor media members spend time in the field, 
under the current fee structure, we also spend money, and lots of it.'' 
The small professional outdoor filming industry has enough natural 
barriers; The Federal Government should not impose itself as another 
through daily fees adding to the expense.
  Last Congress, my colleague from Oklahoma, Congressman Dan Boren, and 
Don Young, introduced H.R. 5502 to

[[Page S6549]]

accomplish the same aim of the legislation Senator Tester and I are 
introducing today. That legislation was supported by nearly 30 outdoors 
and sportsmen's organizations.
  Those organizations supporting last Congress' legislation include the 
American Fisheries Society, the American Sportfishing Association, the 
Archery Trade Association, Bass Pro Shops, the Berkley Conservation 
Institute, Boone and Crockett Club, Bowhunting Preservation Alliance, 
Campfire Club of America, Catch-A-Dream Foundation, the Congressional 
Sportsmen's Foundation, Conservation Force, Dallas Safari Club, Mule 
Deer Foundation, the National Assembly of Sportsmen's Caucuses, the 
National Rifle Association, the National Shooting Sports Foundation, 
the National Wild Turkey Federation, the North American Bear 
Foundation, the North American Grouse Partnership, Pheasants Forever, 
Pure Fishing, Quality Deer Management Association, Quail Forever, the 
Ruffed Grouse Society, Safari Club International, the Texas Wildlife 
Association, the Theodore Roosevelt Conservation Partnership, the U.S. 
Sportsmen's Alliance, the Wild Sheep Foundation, and Wildlife Forever.
  This Congress, Congressmen Boren, Ryan, Courtney, Miller, Putnam, and 
Ross introduced H.R. 2031 on April 22, 2009, which is identical 
legislation to the legislation Senator Tester and I are introducing 
today. I am sure it will enjoy the same support from our outdoor and 
sportsmen's organizations, and I look forward to its consideration in 
the Senate.
  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. 1241

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

     SECTION 1. PURPOSE.

       The purpose of this Act is to provide commercial film crews 
     of 5 persons or fewer access to film in areas designated for 
     public use during public hours on Federal lands and 
     waterways.

     SEC. 2. ANNUAL PERMIT AND FEE FOR FILM CREWS OF 5 PERSONS OR 
                   FEWER.

       (a) In General.--Section (1)(a) of Public Law 106-206 (16 
     U.S.C. 460l-6d) is amended by--
       (1) redesignating paragraphs (1), (2), and (3) as 
     subparagraphs (A), (B), and (C), respectively;
       (2) striking ``The Secretary of the Interior'' and 
     inserting ``(1) In general.--Except as provided by paragraph 
     (3), the Secretary of the Interior'';
       (3) inserting ``(2) Other considerations.--'' before ``The 
     Secretary may include other factors''; and
       (4) adding at the end the following new paragraph:
       ``(3) Special rules for film crews of 5 persons or fewer.--
       ``(A) For any film crew of 5 persons or fewer, the 
     Secretary shall require a permit and assess an annual fee of 
     $200 for commercial filming activities or similar projects on 
     Federal lands and waterways administered by the Secretary. 
     The permit shall be valid for commercial filming activities 
     or similar projects that occur in areas designated for public 
     use during public hours on all Federal lands and waterways 
     administered by the Secretary for a 12-month period beginning 
     on the date of issuance of the permit.
       ``(B) For persons holding a permit described in this 
     paragraph, the Secretary shall not assess, during the 
     effective period of the permit, any additional fee for 
     commercial filming activities and similar projects that occur 
     in areas designated for public use during public hours on 
     Federal lands and waterways administered by the Secretary.
       ``(C) In this paragraph, the term `film crew' includes all 
     persons present on Federal land under the Secretary's 
     jurisdiction who are associated with the production of a 
     certain film.
       ``(D) The Secretary shall not prohibit, as a mechanized 
     apparatus or under any other purposes, use of cameras or 
     related equipment used for the purpose of commercial filming 
     activities or similar projects in accordance with this 
     paragraph on Federal lands and waterways administered by the 
     Secretary.''.
       (b) Recovery of Costs.--Section (1)(b) of Public Law 106-
     206 (16 U.S.C. 460l-6d) is amended by--
       (1) striking ``collect any costs'' and inserting ``recover 
     any costs''; and
       (2) striking ``similar project'' and inserting ``similar 
     projects''.
                                 ______
                                 
      By Mr. THUNE (for himself, Mr. Coburn, Mr. Inhofe, Mr. Vitter, 
        Mr. Johanns, Mr. Cornyn, Mr. Kyl, Mr. McConnell, Mr. Barrasso, 
        and Mr. Ensign):
  S. 1242. A bill to prohibit the Federal Government from holding 
ownership interests, and for other purposes; to the Committee on 
Banking, Housing, and Urban Affairs.
  Mr. THUNE. Mr. President, over the past 15 months, the Federal 
Government has taken unprecedented actions to stabilize the U.S. 
economy. Unfortunately, these actions include the Federal Government 
acquiring direct ownership stakes in private companies, which exposes 
the American taxpayer to significant liabilities and creates a 
dangerous conflict of interest between the Federal Government and the 
private sector.
  Thanks to the fact that the government has intervened in all these 
private companies, we now have about 500 banks, we have auto 
manufacturers, financial institutions, and insurance companies that the 
government now has an ownership interest in. President Obama has become 
a de facto CEO managing large segments of our economy, and Congress is 
now acting as a 535-Member board of directors.
  I think it is fair to say when you combine business with politics, it 
inevitably leads to harmful conflicts of interest--which we are already 
beginning to see--because political decisions get substituted for 
business decisions.
  As everyone in this Chamber knows all too well, government control of 
private business hampers investments. It hampers innovation, job 
creation. It diminishes the entrepreneurial spirit on which our economy 
is based.
  Having the Federal Government call the shots for private industry is 
plain bad for business. It is bad for the economy, and it is bad for 
the American taxpayer.
  So today I am introducing a piece of legislation, S. 1242, which 
gives the Federal Government an exit plan, a way of exiting the scene 
from the ownership that the Federal Government now has in all these 
various private companies in our economy. It essentially has four basic 
provisions.
  The first provision is that upon enactment of the legislation, the 
Treasury Department may not purchase any additional ownership stake of 
private entities, such as warrants, preferred stock, or common stock 
purchased through the TARP program.
  The second provision is this: The legislation would require the 
Treasury to sell any ownership stake of a private entity by July 1, 
2010. Any revenue that comes in from the sale of those TARP assets 
would have to be used for debt reduction.
  The third provision of the bill is that if the Treasury Secretary 
determines the assets are undervalued and there is a reasonable 
expectation that the assets will increase to their original purchase 
value, the Secretary may hold the assets for up to 1 additional year.
  Finally, the fourth provision of the bill is that beyond July 1 of 
2011, the Treasury Secretary may not hold any direct ownership of 
private companies unless Congress grants additional authority.
  Essentially, what we are doing is saying that all this ownership 
interest the Federal Government now has acquired in all these private 
companies would have to be wound down, if you will, divested, by that 
July 1 deadline in the year 2010. If the Treasury Department determines 
that, in fact, doing so would impair the ability of the Treasury to 
recover the full value of those assets or if those assets are expected 
to appreciate, there is an additional year, up to a year of 
flexibility--essentially a waiver--from the July 1, 2010, deadline that 
would extend it to July 1, 2011. So it buys an additional year. But it 
does put a time certain out there, a deadline, if you will, by which 
the Federal Government has to dispose of and divest itself of all these 
ownership interests it has in our private economy.
  The other issue I think is important is it prevents the Federal 
Government from acquiring an ownership stake going into the future. As 
I said before, any funds that are returned to the Treasury as a result 
of these assets being sold would have to be used for debt reduction. 
They cannot be recycled; they cannot be reused; they cannot go into 
some fund that is going to be used for additional acquisition of 
private sector assets.
  I think the reason why this is important is if you look at what 
Secretary Geithner has said, he has indicated before that their 
intention is that when

[[Page S6550]]

some of these funds come back into the Treasury--and we saw this 
recently with banks that agreed to pay this money back--they are going 
to reuse it. I don't believe that is what was intended in the first 
place. I don't think this was at any point designed to become a slush 
fund that could be used for the acquisition of other assets; it was 
designed to be used--at least initially, the way it was presented--for 
the purchase of toxic assets, illiquid assets on the balance sheets of 
many of our financial institutions. It quickly evolved into something 
else. It became a fund that was used to acquire an equity stake, equity 
interest in many of these companies. So I don't think that was the 
purpose for which it was intended.
  I think a lot of people who made votes assumed at the time it 
wouldn't be used to buy toxic assets. It ended up being used to buy an 
ownership interest in these companies, and I think, again, the American 
people are uncomfortable with the notion of the Federal Government 
owning a big share of our private economy. I also do not think it was 
intended in the first place to be used to buy the assets of other types 
of industries--essentially, to do industrial policy, as some people 
have referred to it--to acquire assets of auto manufacturers, for 
example; it was designed specifically for the financial services 
industry.
  There is no real exit strategy out there. In fact, Secretary Geithner 
was asked in front of the Senate Banking Committee a couple weeks ago 
about whether there was a plan to dispose of some of these assets, and 
he said there isn't a plan; it is not necessary at this point.
  Well, I think we need to have an exit strategy. Everybody talks about 
an exit strategy. The President needs an exit strategy in Iraq. It 
seems to me we need to have an exit strategy that would allow the 
American taxpayer to recover funds they have been investing through the 
TARP program in all these various companies that would get the Federal 
Government out of the way of these companies and out of the day-to-day 
decisionmaking and management of these companies. My bill would 
prohibit that as well, in addition to some of these other provisions I 
mentioned.
  It would prohibit or bar the Federal Government from dictating to 
these companies with respect to hiring decisions when it comes to 
senior executives, when it comes to boards of directors, when it comes 
to where to relocate or locate or close certain plants. Those are 
decisions that should not be made by politicians in Washington. They 
should not be made by bureaucrats in Washington, DC. They ought to be 
business decisions and not political decisions.
  The bill, as I said, is very straightforward.
  There are a number of folks who have commented on, made observations 
about what is happening in the economy right now, and this sort of 
proliferation of companies in which the Federal Government now has an 
ownership share. I wish to read for my colleagues some of what has been 
said by folks who I think know a lot about the private economy and 
whether it is a good idea to have the Federal Government owning and 
controlling as much as they do currently of some of these companies. If 
you look at the various percentages, they are significant. Of course, 
we know most recently General Motors, a $50 billion investment there 
gets the taxpayer ownership interest to about 60 percent; Chrysler, 
about 12 percent; Citibank, about 36 percent, and you can go down the 
list of all these various private companies in which the government now 
has an ownership interest.
  There was an editorial in the Kansas City Star that said that:

       What's worrisome is that while the administration said it 
     isn't interested in running car companies, it has said little 
     on an exit strategy.

  It went on to say:

       Any government bailout of private industry should be 
     temporary and as brief as possible.

  Anne Mulcahy, chief executive of Xerox--I am sure I just butchered 
the name--said recently:

       I think all of us understand the need for the government to 
     intervene and to take the actions they did, but I also think 
     there's a need for an exit plan.

  Jim Owens, who is the chief executive at Caterpillar, said:

       I think that's fundamentally unhealthy. The Federal 
     Government needs to be in and out.

  Google's Eric Schmidt noted that the U.S. stimulus package was 
designed to cover a 2-year period. He said:

       It's very important that government get out of business and 
     let business do its thing. The most important thing to 
     remember, I think, is that jobs, wealth, are created in the 
     private sector. That's about capitalism.

  In a Wall Street Journal opinion piece, Paul Ingrassia argues:

       . . . must have a clear exit timetable for the government 
     to sell its shares for both Chrysler and GM and get the 
     companies back in the hands of private investors. Mr. Obama 
     has an exit strategy for Iraq; he needs one for Detroit, too.

  So there are a lot of people who have a lot of experience when it 
comes to running companies who have concluded that the government does, 
in fact, need an exit strategy. I think, as I said before, it is fair 
to say that one doesn't exist today, and when Secretary Geithner 
testified in front of the Senate Banking Committee a couple weeks back 
he admitted as much, that there isn't an exit plan.
  What my bill does is it gives us an exit plan. It gives us an exit 
plan with a deadline, with a little flexibility in the deadline, some 
ability to provide a waiver for the Treasury Department that would 
allow for an additional year, if necessary; if those assets the 
government holds are considered to be assets that could appreciate over 
time and, therefore, yield a higher return for the Federal Government 
but, at some point, we have to say enough is enough. We have to put an 
end to this practice we have gotten involved with, this precedent we 
have now created of having the Federal Government own more and more of 
our private economy.
  I would argue, again, that is not good for business, it is not good 
for the economy, it is not good for job creation; it stifles the 
entrepreneurial spirit which has built this country and made it great, 
and I don't think it does anything to create jobs and get our economy 
back on track.
  I hope we will have an opportunity to debate this. It seems to me at 
least that in the days ahead there will be various bills that will be 
debated on the floor of the Senate that would give us a chance to 
debate this issue. I intend to offer this, if I can't get some interest 
in moving it as a freestanding bill, as an amendment to other vehicles 
that might be moving through the Senate in the days and the weeks and 
the months ahead. But I do think it is important. I think it is 
important to the American taxpayer. I think it is important to the 
American economy. I think it is important to American business that the 
Federal Government have an exit strategy. We have a plan whereby we can 
move and get away from this practice we have undertaken now with great 
regularity and great frequency of acquiring even more and more 
interests in American business.
                                 ______
                                 
      By Mr. HATCH (for himself and Mrs. Lincoln):
  S. 1243. A bill to require repayments of obligations and proceeds 
from the sale of assets under the Troubled Asset Relief Program to be 
repaid directly into the Treasury for reduction of the public debt; to 
the Committee on Banking, Housing, and Urban Affairs.
  Mr. HATCH. Mr. President, I rise today to introduce the Stop TARP 
Asset Recycling Act, or the STAR Act, a bill that would require any 
funds returned to the Treasury Department that were originally 
allocated under the Troubled Asset Relief Program, TARP, to be placed 
in the general fund rather than being put back into TARP. I am proud to 
say that this is a bipartisan bill, cosponsored by my friend from 
Arkansas, Senator Lincoln.
  It is apparent that TARP has become a slush fund for the Obama 
administration to acquire banks, insurance companies and auto 
manufacturers. We need to ensure that the original purpose of TARP is 
maintained and Treasury is prevented from unilaterally and arbitrarily 
nationalizing our nation's private sector.
  The Emergency Economic Stabilization Act, which was signed into law 
last October, created TARP. This act authorized TARP to purchase up to 
$700 billion in troubled assets from financial institutions ``to 
restore liquidity and stability to the financial system.'' However, 
since its inception,

[[Page S6551]]

TARP has taken on a different role in our free enterprise system. It 
seems to have become the go-to solution for all of our problems. It has 
been used to bail out banks, insurance companies and automobile 
manufacturers. What is next, Mr. President?
  Some of our healthier banks are now returning this money because, I 
believe, of the unreasonable regulations that have been and could be 
placed on firms with TARP funds. While it is clear that proceeds from 
TARP sales must be placed in the general fund to pay down our 
increasing debt, it is unclear under the law whether or not the 
original investment from TARP must be placed in the general fund or can 
be recycled back into TARP. The latter option would result in an ever-
revolving slush fund for TARP and could provide this administration 
with the means to pick and choose which company it would next like to 
nationalize.
  For example, the Treasury Department recently used $30 billion to 
purchase up to 60 percent of General Motors' shares. If, in the future, 
Treasury sells these shares at a gain, let us say $32 billion, the $2 
billion profit must be put back into the general fund, but it is 
unclear whether the original $30 billion investment recovered from the 
sale can be put back into TARP.
  I do not believe any of my colleagues intended TARP to get this out 
of control. It is time that we reestablish the purpose of TARP by 
requiring Treasury to put the original investment back into the general 
fund. Congress must no longer stand by and watch Treasury amass an 
everlasting fund it can use to bail out any industry it deems ``too big 
to fail'' without congressional approval.
  Ten large banks have recently received Treasury approval to repay $68 
billion received under TARP. I believe now is the time to start 
restricting Treasury's access to these funds. My bill would force 
Treasury to put this money back into the general fund once it is used. 
It would not prevent Treasury from using up to $700 billion already 
authorized under TARP, but it would force Treasury to make sure that 
the taxpayers' investment is spent wisely.
  The American taxpayer has been told to foot the bill for rescuing the 
financial sector, but now they are being forced to bail out any company 
at the discretion of the Department of Treasury. Many Utahns are saying 
it is time to be fiscally conservative, and I agree. So do millions 
elsewhere across the Nation.
  I hope my colleagues would agree as well and support this 
legislation; otherwise, we have not only written a blank check to 
Treasury, but we have delegated an enormous amount of power over our 
free enterprise system. This money belongs to the people, not the Obama 
administration. I think it is time Congress acts to ensure that TARP is 
being used for its intended purpose.
                                 ______
                                 
      By Mr. MERKLEY:
  S. 1244. A bill to amend the Civil Rights Act of 1964 to protect 
breastfeeding by new mothers, to provide for a performance standard for 
breast pumps, and to provide tax incentives to encourage breastfeeding; 
to the Committee on Finance.
  Mr. MERKLEY. Mr. President, I rise today to discuss a bill to help 
promote and protect breastfeeding in the workplace.
  The science is undisputable--babies who are breastfed the first 6 
months of life have a greatly reduced risk for acute and chronic 
disease--yet only ten percent of all infants receive this nourishment 
that they need to remain healthy. One of the primary reasons for this 
is that working moms face real and serious challenges to expressing 
milk when they return to work.
  Well, today is a day to change that. In Oregon, we have enacted 
strong legislation to make sure that working moms are afforded the time 
and space they need at work to express milk. In fact, my first event as 
a candidate for U.S. Senate was at a luncheon celebrating the success 
of Oregon's breastfeeding promotion law. I said that day that I would 
work to expand Oregon's efforts nationwide, and today we take the 
important first step towards enacting legislation to protect working 
moms across the country.
  First, I want to thank Representative Carolyn Maloney of New York for 
her strong leadership on this issue. For years, she has been a champion 
for working moms everywhere, and I applaud her determination to make it 
easier for women.
  We know that 72 percent of moms work full time, and that number is 
growing. In fact, according to the Center on Work and Family at Boston 
College, the fastest-growing segment of the U.S. workforce is women 
with children under three years of age.
  Women who decide to breastfeed often face unique challenges and at 
times, social stigmas, for trying to give their baby the healthiest 
start in life.
  In an environment where mothers return to work as early as 3 to 6 
weeks post-partum, often driven by economic necessity, it is simply an 
act of human decency to protect their right to continue breastfeeding 
after they return to work to help meet their basic needs with regard to 
the care and nourishment of their children. But for most, it is an 
unachievable goal.
  If we are to have any hope of increasing the number of babies being 
breastfed, we need to implement a strategy that addresses workplace 
conditions.
  The Breastfeeding Promotion Act that Representative Maloney and I are 
introducing today is a measured step in this direction.
  It protects breastfeeding women from discrimination in the workplace, 
provides tax credits to employers who make accommodations for 
breastfeeding moms, and most importantly, it affords working moms with 
the time, space, and privacy they need to express milk.
  Many of these changes have been successfully implemented in my home 
State of Oregon where we have seen a tremendous difference in the 
experiences of mothers, as well as positive impacts for employers, as a 
result of this type of legislation.
  Tonya Hirte, a senior customer service representative in Portland, 
said that before the law took effect, she had to express breast milk in 
a bathroom on a separate floor from her worksite, but that after 
implementation of the law, her company converted a storage closet into 
a private, simply-furnished room, bringing dignity to her experience as 
a mother, and helping her feel valued as an employee.
  A Lane County employee said that having a breastfeeding-friendly 
workplace allowed her to focus better on her work, knowing her 
daughter's needs were being met emotionally and physically because the 
work breaks to express breast milk facilitated their breastfeeding 
relationship when they were together.
  But it's not just the employees who are seeing positive changes as a 
result of the Oregon law. Jim Rochs, General Manager of Carinos Italian 
Restaurant in Bend, Oregon, says that they create a better team overall 
if they take care of one another. The time and space his employee 
needed to express breast milk was not difficult to provide.
  Gretchen Peterson, Human Resources Manager for Hanna Andersson 
clothing design, manufacturer and retail store, said that ``legislation 
to encourage longer-term breastfeeding by eliminating potential 
workplace barriers has been successfully passed and implemented in 
Oregon with no negative impact to business.'' She goes on to say, 
``Without this opportunity, our employees may have made the choice to 
stay at home or choose to work for another company which would have 
caused a significant disruption to our business.''
  Research from the Maternal Child Health Bureau demonstrates a 
significant return on investment when businesses support worksite 
lactation programs.
  The Mutual of Omaha insurance company conducted a study that found 
health care costs for newborns to be three times lower for babies whose 
mothers participate in their company's maternity and lactation program. 
Per person health care costs were $2,146 more for employees who did not 
participate in the program, with a yearly savings of $115,881 in health 
care claims for the breastfeeding mothers and babies.
  This is truly a public health issue. Encouraging breastfeeding for 
working mothers will help alleviate the negative effects of low 
breastfeeding rates, including a 21 percent greater infant mortality 
rate for babies not exclusively breastfed for 6 months, and

[[Page S6552]]

greater risk over a lifetime for many illnesses including asthma, 
diabetes, obesity, and certain cancers.
  Finally, the timing could not be better as we ramp up our efforts to 
reform our health care system and work to contain costs. A 2001 USDA 
study found that if half of the babies in the U.S. were exclusively 
breastfed for 6 months, we would realize a savings of $3.6 billion in 
health care costs for the three leading childhood illnesses alone. 
According to the U.S. Breastfeeding Committee, if we replicate that 
study based on current breastfeeding statistics, the savings could 
reach nearly $14 billion in health care costs for all childhood 
illnesses.
  Colleagues, I look forward to passing the Breastfeeding Promotion Act 
to help make it easier for moms to breastfeed, which will lead to 
healthier babies, stronger families, and happier workers.
                                 ______
                                 
      Mr. WHITEHOUSE (for himself and Ms. Snowe):
  S. 1245. A bill to amend the Internal Revenue Code of 1986 to provide 
a tax credit for property owners who remove lead-based paint hazards; 
to the Committee on Finance.
  Ms. SNOWE. Mr. President, I rise today along with my friend Senator 
Whitehouse to introduce the Home Lead Safety Tax Credit Act. 
Unfortunately, lead paint remains a serious risk to families across the 
country and poses an especially dangerous hazard for children. 
According to the Department of Housing and Urban Development, HUD, 23 
million homes in the United States currently have a significant amount 
of lead-based paint, and exposure has caused 240,000 children under the 
age of six to have blood-lead levels high enough to cause irreversible 
neurological damage and learning disabilities.
  The current Federal abatement programs are simply inadequate to 
address the home repair requirements of millions of families who remain 
exposed to lead. In fiscal year 2008, HUD's Lead Hazard Control Program 
provided for lead abatement of only 12,600 homes. It doesn't take an 
advanced degree in mathematics to know that 12,600 is an insufficient 
abatement number when 240,000 children have already been exposed to 
harmful levels of lead-based paint.
  The tax credit in the Whitehouse-Snowe bill would be worth up to 
$3,000 per eligible housing unit for abatement costs or up to $1,000 
for each unit for interim control costs--which reduce but do not 
eliminate the hazard. These incentives will encourage property owners 
to make their homes and properties lead-safe. According to the Maine 
Indoor Air Quality Council, almost 80 percent of homes and apartments 
in Maine built before 1978 could have lead paint. That being said, the 
tax credit in our legislation will help greatly reduce that number and 
in turn reduce the number of children who require medical treatment as 
a result of lead exposure.
  The Whitehouse-Snowe bill will provide a powerful tax incentive to 
landlords and make a much greater impact in reducing household lead 
exposure. It is no surprise that many of our poorest residents are the 
most affected by lead-based paint illnesses. Whatever their economic 
situation, no family should be forced to choose between affordability 
and the safety of their children. Our citizens are facing a multitude 
of difficult financial decisions in the midst of the current recession, 
and many people are unable to bear the costs of lead abatement.
  It is not news that health care costs are spiraling out of control, 
and Congress is working hard to find a solution to this complicated 
problem. Lead-based paint does not require such a complicated solution, 
and the Home Lead Safety Tax Credit Act takes a proactive role in 
preventing an illness that doesn't have to exist at all. Children 
exposed to lead-based paint will pay thousands of dollars in health 
care costs. Our legislation will not only save the lives of children 
across our country, but help mitigate the unnecessary burden of lead-
based paint poisoning on our health care system. We must do everything 
in our power to encourage landlords an property owners to rid homes of 
harmful lead-based paint and I hope my colleagues will join us in 
supporting this legislation.
                                 ______
                                 
      By Mr. SANDERS:
  S. 1246. A bill to establish a home energy retrofit finance program; 
to the Committee on Energy and Natural Resources.
  Mr. SANDERS. Mr. President, I am pleased to introduce legislation to 
establish a Home Energy Retrofit Finance Program. My office has worked 
closely with a number of stakeholders and experts in developing this 
Program. It is supported by the Vermont Energy Investment Corporation, 
the National Trust for Historic Preservation, Green for All, the Apollo 
Alliance, and the Union of Concerned Scientists, because they know that 
improving residential sector energy use is a strategy to address global 
warming, save families on their utility bills, and create jobs.
  Households across the Nation will be able to lower their energy bills 
and generate their own renewable energy through the Program. It would 
provide initial capital to States, according to the established State 
energy program formula, to set up state revolving finance funds. These 
State funds would in turn provide financial support for local 
government programs, such as clean energy district financing, and 
energy utility programs, such as on-bill financing.
  There are already a number of innovative programs to help finance 
residential energy efficiency and renewable energy across the country. 
For example, States such as Vermont, New Mexico, California, Virginia, 
Texas, and Maryland have authorized local governments to provide 
financing to homeowners for energy improvements. Homeowners then can 
pay back the cost of the improvements over time on their property tax 
bills.
  The Home Energy Retrofit Finance Program would give these efforts a 
boost by supporting local government and utility programs that provide 
households with cost-effective financing for energy efficiency measures 
and renewable energy. This Program offers a win-win situation where we 
can achieve our economic and environmental goals. I ask that my 
colleagues consider the merits of the Home Energy Retrofit Finance 
Program as we move forward with comprehensive energy and climate change 
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 
printed in the Record, as follows:

                                S. 1246

       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 ``Home Energy Retrofit Finance 
     Program Act''.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) many families lack access to upfront capital to make 
     cost-effective energy improvements to homes and apartments;
       (2) a number of States, local governments, and energy 
     utilities are considering enacting, or have already enacted, 
     innovative energy efficiency and renewable energy finance 
     programs;
       (3) home retrofits create and support jobs in the United 
     States in a number of fields, including jobs for 
     electricians, heating and air conditioning installers, 
     carpenters, construction, roofers, industrial truck drivers, 
     energy auditors and inspectors, construction managers, 
     insulation workers, renewable energy installers, and others;
       (4) cost-effective energy improvements pay for themselves 
     over time and also save consumers energy, reduce energy 
     demand and peak electricity demand, move the United States 
     towards energy independence, reduce greenhouse gas emissions, 
     and improve the value of residential properties;
       (5) modeling has shown that--
       (A) energy efficiency and renewable energy upgrades in just 
     15 percent of residential buildings in the United States 
     would require $280,000,000,000 in financing; and
       (B) the upgrades described in subparagraph (A) could reduce 
     carbon dioxide emissions by more than a gigaton; and
       (6) home retrofits--
       (A) are a key strategy to reducing global warming 
     pollution; and
       (B) create and support green jobs.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Eligible participant.--The term ``eligible 
     participant'' means a homeowner, apartment complex owner, 
     residential cooperative association, or condominium 
     association that finances energy efficiency measures and 
     renewable energy improvements to homes and residential 
     buildings under this Act.
       (2) Energy efficiency measure and renewable energy 
     improvement.--The term

[[Page S6553]]

     ``energy efficiency measure and renewable energy 
     improvement'' means any installed measure (including 
     products, equipment, systems, services, and practices) that 
     would result in a reduction in--
       (A) end-use demand for externally supplied energy or fuel 
     by a consumer, facility, or user; and
       (B) carbon dioxide emissions, as determined by the 
     Secretary.
       (3) Program.--The term ``program'' means the Home Energy 
     Retrofit Finance Program established under section 4(a).
       (4) Qualified program delivery entity.--The term 
     ``qualified program delivery entity'' means a local 
     government, energy utility, or any other entity designated by 
     the Secretary that administers the program for a State under 
     this Act.
       (5) Secretary.--The term ``Secretary'' means the Secretary 
     of Energy.

     SEC. 4. HOME ENERGY RETROFIT FINANCE PROGRAM.

       (a) Establishment.--The Secretary shall provide Home Energy 
     Retrofit Finance Program grants to States for the purpose of 
     establishing or expanding a State revolving finance fund to 
     support financing offered by qualified program delivery 
     entities for energy efficiency measures and renewable energy 
     improvements to existing homes and residential buildings 
     (including apartment complexes, residential cooperative 
     associations, and condominium buildings under 5 stories).
       (b) Funding Mechanism.--In carrying out the program, the 
     Secretary shall provide funds to States, for use by qualified 
     program delivery entities that administer finance programs 
     directly or under agreements with collaborating third party 
     entities, to capitalize revolving finance funds and increase 
     participation in associated financing programs.
       (c) Eligibility of Qualified Program Delivery Entities.--
       (1) In general.--The Secretary shall provide guidance to 
     the States on application requirements for a local government 
     or energy utility that seeks to participate in the program, 
     including criteria that require, at a minimum--
       (A) a description of a method for determining eligible 
     energy professionals who can be contracted with under the 
     program for energy audits and energy improvements, including 
     a plan to provide preference for entities that--
       (i) hire locally;
       (ii) partner with State Workforce Investment Boards, labor 
     organizations, community-based organizations, and other job 
     training entities; or
       (iii) are committed to ensuring that at least 15 percent of 
     all work hours are performed by participants from State-
     approved apprenticeship programs; and
       (B) a certification that all of the work described in 
     subparagraph (A) will be carried out in accordance with 
     subchapter IV of chapter 31 of title 40, United States Code.
       (2) Repayment over time.--To be eligible to participate in 
     the program, a qualified program delivery entity shall 
     establish a method by which eligible participants may pay 
     over time for the financed cost of allowable energy 
     efficiency measures and renewable energy improvements.
       (d) Allocation.--In making funds available to States for 
     each fiscal year under this Act, the Secretary shall use the 
     allocation formula used to allocate funds to States to carry 
     out State energy conservation plans under part D of title III 
     of the Energy Policy and Conservation Act (42 U.S.C. 6321 et 
     seq.).
       (e) Use of Funds.--Of the amounts in a State revolving 
     finance fund--
       (1) not more than 20 percent may be used by qualified 
     program delivery entities for interest rate reductions for 
     eligible participants; and
       (2) the remainder shall be available to provide direct 
     funding or other financial support to qualified program 
     delivery entities.
       (f) State Revolving Finance Funds.--On repayment of any 
     funds made available by qualified program delivery entities 
     under the program, the funds shall be deposited in the 
     applicable State revolving finance fund to support additional 
     financing to qualified program delivery entities for energy 
     efficiency measures and renewable energy improvements.
       (g) Coordination With State Energy Efficiency Retrofit 
     Programs.--Home energy retrofit programs that receive 
     financing through the program shall be carried out in 
     accordance with all authorized measures, performance 
     criteria, and other requirements of any applicable Federal 
     home energy efficiency retrofit programs.
       (h) Program Evaluation.--
       (1) In general.--The Secretary shall conduct a program 
     evaluation to determine--
       (A) how the program is being used by eligible participants, 
     including what improvements have been most typical and what 
     regional distinctions exist, if any;
       (B) what improvements could be made to increase the 
     effectiveness of the program; and
       (C) the quantity of verifiable energy savings and renewable 
     energy deployment achieved through the program.
       (2) Reports.--
       (A) In general.--Not later than 3 years after the date of 
     enactment of this Act, the Secretary shall submit to the 
     Committee on Energy and Natural Resources of the Senate and 
     the Committee on Energy and Commerce of the House of 
     Representatives a report that describes the results of the 
     program evaluation required under this subsection, including 
     any recommendations.
       (B) State reports.--Not less than once every 2 years, 
     States participating in the program shall submit to the 
     Secretary reports on the use of funds through the program 
     that include any information that the Secretary may require.

     SEC. 5. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There are authorized to be appropriated 
     such sums as are necessary to carry out this Act for each of 
     fiscal years 2010 through 2015.
       (b) Administrative Expenses.--An amount not exceeding 5 
     percent of the amounts made available under subsection (a) 
     shall be available for each fiscal year to pay the 
     administrative expenses necessary to carry out this Act.
                                 ______
                                 
      By Mr. CASEY:
  S. 1248. A bill to establish a program in the Department of Energy to 
encourage consumers to trade in older vehicles for more fuel-efficient 
vehicles and motorcycles, and for other purposes; to the Committee on 
Finance.
  Mr. CASEY. Mr. President, I rise today to introduce the Green 
Transportation Efficiency Act of 2009. This bill would establish a 
voucher program in the Department of Energy to encourage American 
consumers to trade in their older, less fuel-efficient vehicles for 
new, more fuel-efficient vehicles, including motorcycles.
  This act is very similar to other ``cash for clunkers'' bills offered 
in the House and Senate in that it will help stimulate the economy by 
providing a much needed boost to our struggling automobile industry, 
but will go a step further by bolstering the U.S. motorcycle industry 
as well. After 14 straight years of growth, sales of motorcycles in the 
U.S. declined eight percent in 2007, and, 10 percent in 2008. Due in 
large part to the downturn in our economy, motorcycle sales have 
dropped 30 percent in the first quarter of 2009, according to the 
Motorcycle Industry Council. In my home State of Pennsylvania, Harley-
Davidson has had to cut production and reduce its work force as a 
result of these declines in motorcycle sales. Established in 1973, the 
Harley-Davidson assembly plant in York, PA, is the company's largest 
manufacturing facility and is the third largest employer in York 
County, PA, employing over 2,200 people. It has been reported that it 
is probably the leanest time that Harley has faced since the company 
went public in 1986. Harley-Davidson, like the auto makers and other 
manufacturing sectors, is fighting hard to maintain its workforce and 
to continue to produce a high quality, American-made product during 
these tough economic times. However, the specter of further reductions 
in motorcycle sales could lead to further job losses in my State, a 
State already hard hit by the current economic crisis.
  Indeed, the economic impact of the American motorcycle industry also 
extends far beyond the direct employment at facilities such as the 
Harley-Davidson manufacturing plants in Pennsylvania, Missouri, or 
Wisconsin. Many of the same parts suppliers that provide the critical 
supply chain for our American auto manufacturers, in States such as 
Michigan, Indiana, Ohio, and many others, also rely upon motorcycle 
manufacturers as critical customers. These parts manufacturers and 
suppliers will also be aided by increased motorcycle sales. The effect 
of increased motorcycle sales will be immediate and meaningful. For 
example, Harley-Davidson utilizes ``Just In Time'' manufacturing 
principles, meaning they do not hold parts inventories. So, every new 
bike ordered triggers new orders for parts--there is very little 
elasticity in the supply chain, so the economic benefit down the line 
is immediate.
  Finally, in terms of economic activity, this act recognizes the 
challenges faced by our auto dealerships and the best way to help those 
dealerships is to encourage the purchasing of new, more fuel-efficient 
vehicles. The same principle applies to our motorcycle dealers.
  In addition to helping to spur economic recovery and protect 
manufacturing jobs in Pennsylvania and other parts of the country where 
motorcycles and motorcycle parts are manufactured and assembled, the 
inclusion of motorcycles in this act will help America move away from 
its dependence on foreign sources of oil. Motorcycles are inherently 
fuel efficient. Average miles-per-gallon for motorcycles ranges from 
40-50 MPG, even higher for smaller bikes.

[[Page S6554]]

  Allowing consumers the option of trading in their older, inefficient 
vehicles for newer, more fuel efficient cars, trucks, and motorcycles 
will help the Nation achieve the dual goals of reducing our demand for 
imported oil and reducing our emissions of greenhouse gases--both 
critical components of our energy future. Just as importantly, the act 
will provide a much needed jump start to the auto and motorcycle 
industries at a time when their sales are at historic lows, plants are 
closing, and jobs are being lost.
  I urge all of my colleagues to join me in support of this Act so that 
consumers are given a strong signal from Washington to trade in their 
older, inefficient vehicles and purchase new, high-fuel-efficient cars, 
trucks, or motorcycles.
  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. 1248

       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 ``Green Transportation 
     Efficiency Act of 2009''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) Automobile.--The term ``automobile'' has the meaning 
     given the term in section 32901(a) of title 49, United States 
     Code.
       (2) Category 1 truck.--
       (A) In general.--The term ``category 1 truck'' means a non-
     passenger automobile that has a combined fuel economy value 
     of at least 18 miles per gallon.
       (B) Exclusion.--The term ``category 1 truck'' does not 
     include a category 2 truck.
       (3) Category 2 truck.--The term ``category 2 truck'' means 
     a non-passenger automobile that is a large van or a large 
     pickup, as categorized by the Secretary using the method used 
     by the Environmental Protection Agency and described in the 
     report entitled ``Light-Duty Automotive Technology and Fuel 
     Economy Trends: 1975 through 2008''.
       (4) Category 3 truck.--The term ``category 3 truck'' means 
     a work truck.
       (5) Combined fuel economy value.--The term ``combined fuel 
     economy value'' means--
       (A) in the case of a qualifying vehicle, the number, 
     expressed in miles per gallon, centered below the term 
     ``Combined Fuel Economy'' on the label required to be affixed 
     or caused to be affixed on a qualifying vehicle pursuant to 
     part 600 of title 40, Code of Federal Regulations (or 
     comparable regulations);
       (B) in the case of an eligible trade-in vehicle, the 
     equivalent of the number described in subparagraph (A) that 
     is posted--
       (i) under the term ``Estimated New EPA MPG'' and above the 
     term ``Combined'' for vehicles of model years 1984 through 
     2007; or
       (ii) under the term ``New EPA MPG'' and above the term 
     ``Combined'' for vehicles of model year 2008 or later on the 
     fuel economy website of the Environmental Protection Agency 
     for the make, model, and year of the vehicle; or
       (C) in the case an eligible trade-in vehicle manufactured 
     during model years 1978 through 1984, the equivalent of the 
     number described in subparagraph (A), as determined by the 
     Secretary (and posted on the website of the National Highway 
     Traffic Safety Administration) using data maintained by the 
     Environmental Protection Agency for the make, model, and year 
     of the eligible trade-in vehicle.
       (6) Dealer.--The term ``dealer'' means a person licensed by 
     a State who engages in the sale of new automobiles to 
     ultimate purchasers.
       (7) Eligible trade-in vehicle.--The term ``eligible trade-
     in vehicle'' means an automobile, work truck, or motorcycle 
     that, at the time the automobile, work truck, or motorcycle 
     is presented for trade-in under this Act--
       (A) is in drivable condition;
       (B) has been continuously insured consistent with the 
     applicable State law and registered to the same owner for a 
     period of not less than 1 year immediately prior to the 
     trade-in;
       (C) was manufactured less than 25 years before the date of 
     the trade-in; and
       (D) in the case of an automobile, has a combined fuel 
     economy value of 18 miles per gallon or less.
       (8) Motorcycle.--The term ``motorcycle'' means a motor 
     vehicle with motive power having a seat or saddle for the use 
     of the rider and designed to travel on not more than 3 wheels 
     in contact with the ground.
       (9) New fuel-efficient automobile.--The term ``new fuel-
     efficient automobile'' means a passenger automobile, category 
     1 truck, category 2 truck, or category 3 truck--
       (A) the equitable or legal title of which has not been 
     transferred to any person other than the ultimate purchaser;
       (B) that carries a manufacturer's suggested retail price of 
     $45,000 or less;
       (C) that--
       (i) in the case of a passenger automobile, category 1 
     truck, or category 2 truck, is certified to applicable 
     standards established under section 86.1811-04 of title 40, 
     Code of Federal Regulations (or a successor regulation); or
       (ii) in the case of a category 3 truck, is certified to the 
     applicable vehicle or engine standards established under 
     section 86.1816-08, 86.007-11, or 86.008-10 of title 40, Code 
     of Federal Regulations (or successor regulations); and
       (D) that has the combined fuel economy value of--
       (i) in the case of a passenger automobile, 22 miles per 
     gallon;
       (ii) in the case of a category 1 truck, 18 miles per 
     gallon; and
       (iii) in the case of a category 2 truck or a category 3 
     truck, 15 miles per gallon.
       (10) New fuel-efficient motorcycle.--The term ``new fuel-
     efficient motorcycle'' means a motorcycle--
       (A) the equitable or legal title of which has not been 
     transferred to any person other than the ultimate purchaser;
       (B) that carries a manufacturer's suggested retail price of 
     not less than $7,000 and not more than $20,000; and
       (C) that has a manufacturer's estimated combined fuel 
     economy of at least 40 miles per gallon.
       (11) Non-passenger automobile.--The term ``non-passenger 
     automobile'' has the meaning given the term in section 
     32901(a) of title 49, United States Code.
       (12) Passenger automobile.--The term ``passenger 
     automobile'' means a passenger automobile (as defined in 
     section 32901(a) of title 49, United States Code) that has a 
     combined fuel economy value of at least 22 miles per gallon.
       (13) Program.--The term ``Program'' means the Green 
     Transportation Efficiency Program established by section 3.
       (14) Qualifying lease.--The term ``qualifying lease'' means 
     a lease of an automobile for a period of not less than 5 
     years.
       (15) Qualifying vehicle.--The term ``qualifying vehicle'' 
     means--
       (A) a new fuel-efficient automobile; or
       (B) a new fuel-efficient motorcycle.
       (16) Scrappage value.--The term ``scrappage value'' means 
     the amount received by the dealer for a vehicle on 
     transferring title of the vehicle to the person responsible 
     for ensuring the dismantling and destroying of the vehicle.
       (17) Secretary.--The term ``Secretary'' means the Secretary 
     of Energy.
       (18) Ultimate purchaser.--The term ``ultimate purchaser'' 
     means, in the case of any qualifying vehicle, the first 
     person who in good faith purchases the qualifying vehicle for 
     purposes other than resale.
       (19) Vehicle identification number.--The term ``vehicle 
     identification number'' means the 17-character number used by 
     the automobile industry to identify individual automobiles.
       (20) Work truck.--The term ``work truck'' has the meaning 
     given the term in section 32901(a) of title 49, United States 
     Code.

     SEC. 3. GREEN TRANSPORTATION EFFICIENCY PROGRAM.

       (a) Establishment.--There is established in the Department 
     of Energy a voluntary program to be known as the ``Green 
     Transportation Efficiency Program'' under which the 
     Secretary, in accordance with this section and regulations 
     issued under subsection (h), shall--
       (1) authorize the issuance of an electronic voucher in 
     accordance with subsection (c) to offset the purchase price, 
     or lease price for a qualifying lease, of a qualifying 
     vehicle on the surrender of an eligible trade-in vehicle to a 
     dealer participating in the Program;
       (2) certify dealers for participation in the Program--
       (A) to accept vouchers in accordance with this section as 
     partial payment or down payment for the purchase or 
     qualifying lease of any qualifying vehicle offered for sale 
     or lease by the dealer; and
       (B) in accordance with subsection (c)(2), to transfer each 
     eligible trade-in vehicle surrendered to the dealer to an 
     entity for disposal;
       (3) in consultation with the Secretary of the Treasury, 
     make electronic payments to dealers for vouchers accepted by 
     the dealers, in accordance with the regulations issued under 
     subsection (h);
       (4) in consultation with the Secretary of the Treasury, 
     provide for the payment of rebates to persons who qualify for 
     a rebate under subsection (c)(3); and
       (5) in consultation with the Secretary of the Treasury and 
     the Inspector General of the Department of Energy, establish 
     and provide for the enforcement of measures to prevent and 
     penalize fraud under the Program.
       (b) Qualifications for and Value of Vouchers.--
       (1) In general.--A voucher issued under the Program shall 
     have a value that may be applied to offset the purchase 
     price, or lease price for a qualifying lease, of a qualifying 
     vehicle in accordance with this subsection.
       (2) New fuel-efficient automobiles.--
       (A) $3,500 value.--A voucher may be used to offset the 
     purchase price or lease price of a new fuel-efficient 
     automobile by $3,500 if the new fuel-efficient automobile is 
     --
       (i) a passenger automobile and the combined fuel economy 
     value of the passenger automobile is at least 4 miles per 
     gallon higher than the combined fuel economy value of the 
     eligible trade-in vehicle;
       (ii) a category 1 truck and the combined fuel economy value 
     of the category 1 truck is at least 2 miles per gallon higher 
     than the

[[Page S6555]]

     combined fuel economy value of the eligible trade-in vehicle;
       (iii) a category 2 truck that has a combined fuel economy 
     value of at least 15 miles per gallon and--

       (I) the eligible trade-in vehicle is a category 2 truck and 
     the combined fuel economy value of the new fuel-efficient 
     automobile is at least 1 mile per gallon higher than the 
     combined fuel economy value of the eligible trade-in vehicle; 
     or
       (II) the eligible trade-in vehicle is a category 3 truck of 
     model year 2001 or earlier; or

       (iv) a category 3 truck and the eligible trade-in vehicle 
     is a category 3 truck of model year of 2001 or earlier and is 
     of similar size or larger than the new fuel-efficient 
     automobile, as determined in a manner prescribed by the 
     Secretary.
       (B) $4,500 value.--A voucher may be used to offset the 
     purchase price or lease price of the new fuel-efficient 
     automobile by $4,500 if the new fuel-efficient automobile 
     is--
       (i) a passenger automobile and the combined fuel economy 
     value of the passenger automobile is at least 10 miles per 
     gallon higher than the combined fuel economy value of the 
     eligible trade-in vehicle;
       (ii) a category 1 truck and the combined fuel economy value 
     of the category 1 truck is at least 5 miles per gallon higher 
     than the combined fuel economy value of the eligible trade-in 
     vehicle; or
       (iii) a category 2 truck that has a combined fuel economy 
     value of at least 15 miles per gallon and the combined fuel 
     economy value of the category 2 truck is 2 miles per gallon 
     higher than the combined fuel economy value of the eligible 
     trade-in vehicle and the eligible trade-in vehicle is a 
     category 2 truck.
       (3) New fuel-efficient motorcycles.--A voucher may be used 
     to offset the purchase price of the new fuel-efficient 
     motorcycle by $2,500 if--
       (A) the new fuel-efficient motorcycle is street-use 
     approved; and
       (B) the manufacturer's estimated combined fuel economy is 
     at least 15 miles higher than the combined fuel economy value 
     of the eligible trade-in vehicle.
       (c) Program Specifications.--
       (1) Limitations.--
       (A) General period of eligibility.--A voucher issued under 
     the Program shall be used only for the purchase or qualifying 
     lease of a qualifying vehicle that occurs during the period--
       (i) beginning on January 1, 2009; and
       (ii) ending on the date that is 3 years after the date on 
     which the regulations issued under subsection (h) are issued.
       (B) Number of vouchers per person and per trade-in 
     vehicle.--
       (i) Single person.--Not more than 1 voucher may be issued 
     for a single person.
       (ii) Joint registered owners.--Not more than 1 voucher may 
     be issued for the joint registered owners of a single 
     eligible trade-in vehicle.
       (C) No combination of vouchers.--Only 1 voucher issued 
     under the Program may be applied toward the purchase or 
     qualifying lease of a qualifying vehicle.
       (D) Limitation on funds for category 3 trucks and 
     motorcycles.--Not more than 7.5 percent and 15 percent of the 
     total funds made available for the Program shall be used for 
     vouchers for the purchase or qualifying lease of category 3 
     trucks and motorcycles, respectively.
       (E) Combination with other incentives permitted.--The 
     availability or use of a Federal, State, or local incentive 
     or a State-issued voucher for the purchase or lease of a 
     qualifying vehicle shall not limit the value or issuance of a 
     voucher under the Program to any person otherwise eligible to 
     receive the voucher.
       (F) No additional fees.--A dealer participating in the 
     Program may not charge a person purchasing or leasing a 
     qualifying vehicle any additional fees associated with the 
     use of a voucher under the Program.
       (G) Number and amount.--The total number and value of 
     vouchers issued under the Program may not exceed the amounts 
     made available for vouchers under subsection (i).
       (2) Disposition of eligible trade-in vehicles.--
       (A) In general.--Subject to subparagraph (B), for each 
     eligible trade-in vehicle surrendered to a dealer under the 
     Program, the dealer shall certify to the Secretary, in such 
     manner as the Secretary shall prescribe by regulation, that 
     the dealer--
       (i) has not and will not sell, lease, exchange, or 
     otherwise dispose of the eligible trade-in vehicle for use as 
     an automobile in the United States or in any other country; 
     and
       (ii) will transfer the eligible trade-in vehicle (including 
     the engine and drive train), in such manner as the Secretary 
     prescribes, to an entity that will ensure that the eligible 
     trade-in vehicle--

       (I) will be crushed or shredded within such period and in 
     such manner as the Secretary prescribes; and
       (II) has not been, and will not be, sold, leased, 
     exchanged, or otherwise disposed of for use as an automobile 
     in the United States or in any other country.

       (B) Sale of parts.--Nothing in subparagraph (A) prevents a 
     person who dismantles or disposes of an eligible trade-in 
     vehicle from--
       (i) selling any parts of the disposed eligible trade-in 
     vehicle other than the engine block and drive train (unless 
     the engine or drive train has been crushed or shredded); or
       (ii) retaining the proceeds from the sale.
       (C) Coordination.--
       (i) In general.--The Secretary shall coordinate with the 
     Attorney General and the Secretary of Transportation to 
     ensure that the National Motor Vehicle Title Information 
     System and other publicly accessible systems are 
     appropriately updated on a timely basis to reflect the 
     crushing or shredding of eligible trade-in vehicles under 
     this section and appropriate reclassification of the titles 
     of the eligible trade-in vehicles.
       (ii) Access to vins.--The commercial market shall have 
     electronic and commercial access to the vehicle 
     identification numbers of eligible trade-in vehicles that 
     have been disposed of on a timely basis.
       (3) Eligible purchases or leases prior to date of 
     enactment.--A person who purchased or leased a qualifying 
     vehicle after January 1, 2009, and before the date of the 
     enactment of this Act, shall be eligible for a cash rebate 
     equivalent to the amount described in subsection (b)(2)(A) if 
     the person proves to the satisfaction of the Secretary that--
       (A)(i) the person was the registered owner of an eligible 
     trade-in vehicle; or
       (ii) if the person leased the qualifying vehicle, the lease 
     was a qualifying lease; and
       (B) the eligible trade-in vehicle has been disposed of in 
     accordance with paragraph (2)(A).
       (d) Anti-Fraud Provisions.--
       (1) Violation.--It shall be unlawful for any person to 
     knowingly violate this section (including a regulation issued 
     pursuant to subsection (h)).
       (2) Penalties.--Any person who commits a violation 
     described in paragraph (1) shall be liable to the United 
     States Government for a civil penalty of not more than 
     $15,000 for each violation.
       (e) Information to Consumers and Dealers.--
       (1) In general.--Not later than 60 days after the date of 
     the enactment of this Act and promptly on the updating of any 
     applicable information, the Secretary shall make available on 
     an Internet website and through other means determined by the 
     Secretary information about the Program, including--
       (A) how to determine if a vehicle is an eligible trade-in 
     vehicle;
       (B) how to participate in the Program, including how to 
     determine participating dealers; and
       (C) a comprehensive list, by make and model, of qualifying 
     vehicles meeting the requirements of the Program.
       (2) Public awareness campaign.--Once information described 
     in paragraph (1) is available, the Secretary shall conduct a 
     public awareness campaign to inform consumers about the 
     Program and where to obtain additional information.
       (f) Recordkeeping and Report.--
       (1) Database.--The Secretary, in coordination with the 
     Secretary of Transportation, shall maintain a database of the 
     vehicle identification numbers of all qualifying vehicles 
     purchased or leased and all eligible trade-in vehicles 
     disposed of under the Program.
       (2) Report.--Not later than 60 days after the termination 
     date described in subsection (c)(1)(A)(ii), the Secretary 
     shall submit to the Committee on Energy and Commerce of the 
     House of Representatives and the Committee on Commerce, 
     Science, and Transportation of the Senate a report that 
     describes the efficacy of the Program, including--
       (A) a description of Program results, including--
       (i) the total number and amount of vouchers issued for 
     purchase or lease of qualifying vehicles by manufacturer 
     (including aggregate information concerning the make, model, 
     model year, and category of automobile and motorcycle);
       (ii) aggregate information regarding the make, model, model 
     year, and manufacturing location of eligible trade-in 
     vehicles traded in under the Program; and
       (iii) the location of sale or lease;
       (B) an estimate of the overall increase in fuel efficiency 
     in terms of miles per gallon, total annual oil savings, and 
     total annual greenhouse gas reductions, as a result of the 
     Program; and
       (C) an estimate of the overall economic and employment 
     effects of the Program.
       (g) Exclusion of Vouchers and Rebates From Income.--
       (1) For purposes of all federal programs.--A voucher issued 
     under the Program or a cash rebate issued under subsection 
     (c)(3) shall not be regarded as income and shall not be 
     regarded as a resource for the month of receipt of the 
     voucher or rebate and the following 12 months, for purposes 
     of determining the eligibility of the recipient of the 
     voucher or rebate (or the spouse or other family or household 
     member of the recipient) for benefits or assistance, or the 
     amount or extent of benefits or assistance, under any Federal 
     program.
       (2) For purposes of taxation.--A voucher issued under the 
     Program or a cash rebate issued under subsection (c)(3) shall 
     not be considered as gross income for purposes of the 
     Internal Revenue Code of 1986.
       (h) Regulations.--Notwithstanding section 553 of title 5, 
     United States Code, not later than 30 days after the date of 
     the enactment of this Act, the Secretary shall issue final 
     regulations to implement the Program, including regulations 
     that--
       (1) provide for a means of certifying dealers for 
     participation in the Program;

[[Page S6556]]

       (2) establish procedures for the reimbursement of dealers 
     participating in the Program to be made through electronic 
     transfer of funds for both the amount of the vouchers and any 
     reasonable administrative costs incurred by the dealer as 
     soon as practicable but not later than 10 days after the 
     submission to the Secretary of a voucher for a qualifying 
     vehicle;
       (3) allow the dealer to use the voucher in addition to any 
     other rebate or discount offered by the dealer or the 
     manufacturer for a qualifying vehicle and prohibit the dealer 
     from using the voucher to offset any such other rebate or 
     discount;
       (4) require dealers to disclose to the person trading in an 
     eligible trade-in vehicle the best estimate of the scrappage 
     value of the vehicle and to permit the dealer to retain $50 
     of any amounts paid to the dealer for scrappage of the 
     eligible trade-in vehicle as payment for any administrative 
     costs to the dealer associated with participation in the 
     Program;
       (5) establish a process by which persons who qualify for a 
     rebate under subsection (c)(3) may apply for the rebate;
       (6) consistent with subsection (c)(2), establish 
     requirements and procedures for the disposal of eligible 
     trade-in vehicles and provide such information as may be 
     necessary to entities engaged in the disposal to ensure that 
     the eligible trade-in vehicles are disposed of in accordance 
     with the requirements and procedures, including--
       (A) requirements for the removal and appropriate 
     disposition of refrigerants, antifreeze, lead products, 
     mercury switches, and such other toxic or hazardous vehicle 
     components prior to the crushing or shredding of an eligible 
     trade-in vehicle, in accordance with procedures established 
     by the Secretary in consultation with the Administrator of 
     the Environmental Protection Agency, and in accordance with 
     other applicable Federal and State requirements;
       (B) a mechanism for dealers to certify to the Secretary 
     that each eligible trade-in vehicle will be transferred to an 
     entity that will ensure that the eligible trade-in vehicle is 
     disposed of, in accordance with the requirements and 
     procedures, and to submit the vehicle identification numbers 
     of the vehicles disposed of and the qualifying vehicle 
     purchased with each voucher; and
       (C) a list of entities to which dealers may transfer 
     eligible trade-in vehicles for disposal;
       (7) consistent with subsection (c)(2), establish 
     requirements and procedures for the disposal of eligible 
     trade-in vehicles and provide such information as may be 
     necessary to entities engaged in the disposal to ensure that 
     the eligible trade-in vehicles are disposed of in accordance 
     with the requirements and procedures; and
       (8) provide for the enforcement of the penalties described 
     in subsection (d).
       (i) Funding.--From the amounts made available under the 
     American Recovery and Reinvestment Act of 2009 (Public Law 
     111-5), the Director of the Office of Management and Budget 
     may allocate such sums as the Director determines are 
     necessary to carry out this Act.
                                 ______
                                 
      By Mr. NELSON, of Florida (for himself, Mr. Crapo, Mr. Bingaman, 
        Mr. Bennet, Mr. Martinez, Mr. Cardin, and Mr. Brownback):
  S. 1250. A bill to amend the Internal Revenue code of 1986 to expand 
the definition of cellulosic biofuel to include algae-based biofuel for 
purposes of the cellulosic biofuel producer credit and the special 
allowance for cellulosic biofuel plant property; to the Committee on 
Finance.
  Mr. NELSON of Florida. Mr. President, I rise today to introduce, with 
several of my colleagues, the Algae-based Renewable Fuel Promotion Act.
  The energy, environmental, and food supply challenges confronting our 
nation are immense. The United States imports roughly 60 percent of the 
crude oil consumed domestically, much of it from unstable parts of the 
world. As global demand continues to rise, price shocks in oil markets 
are increasingly common, causing economic pain and hardship for 
American consumers. Our overwhelming reliance on traditional fossil 
fuels contributes to unsustainable greenhouse gas emissions levels and 
the damaging effects of global warming. Ethanol made from corn or 
soybean--also called first generation biofuels--serve an important 
function in diversifying our energy base, but their benefits are 
largely offset by their adverse effects on food prices and the 
environment.
  Addressing these challenges requires a multi-faceted strategy that 
invests in renewable and alternative energy sources, green technology, 
and conservation measures. If we succeed, the payoff will be a cleaner, 
healthier, and more economically prosperous future.
  I was pleased that the economic stimulus legislation enacted earlier 
this year included important investments in renewable energy and green 
technology programs. It also included a number of expanded tax 
incentives, including tax credits for renewable energy sources, such as 
wind, geothermal, hydropower, and biomass; energy-efficient home 
improvements; and plug-in electric vehicles, to name just a few.
  The legislation I am introducing today with six of my colleagues in 
the Senate--three on each side of the aisle--builds on these 
investments and incentives by recognizing the powerful potential of a 
new and emerging energy source, algae.
  After years of basic research at the academic and governmental level, 
new algae-based fuels are poised to move from the experimentation stage 
to commercial development. These fuels have the potential to make a 
significant contribution to our energy future. Algae are one of 
nature's most prolific and efficient photosynthetic organisms. They 
have a short growing cycle, high oil content, and can require little 
land or potable water. An algae-based fuel needs only sunlight, 
CO2, and in some cases, other nutrient inputs to produce 
biomass that can be converted into readily usable liquid transportation 
fuels--gasoline, jet fuel, and diesel. Unlike some of the other energy 
sources currently under development, algae-based fuels are ``drop-in'' 
fuels, that is to say, they can be incorporated into our existing 
energy infrastructure, including our pipelines, terminals, and our 
fleet of trucks, cars and jets.
  For example, over the past several months, commercial airlines have 
flown four successful test flights using a variety of biofuel jet fuel 
blends, including a Continental Airlines flight using a blend of algae- 
and jatropha-derived biofuel and a Japan Airlines flight using a 
similar blend that also included camelina.
  Moreover, some algae-based fuel production processes even sequester 
and consume CO2. Algae production facilities can use 
CO2 emitted by a coal-fired electric utility as a feedstock 
for the production of the fuel. As a result, algae-based fuels can help 
transform the energy landscape by shifting our energy consumption to a 
renewable, home-grown fuel that is carbon neutral or better.
  Unfortunately, current Federal tax policy inhibits the production of 
algae-based fuels by failing to provide a level playing--field relative 
to other alternative and renewable fuels. Tax incentives currently 
apply to the production of liquefied petroleum gas, compressed or 
liquefied natural gas, ethanol, liquefied hydrogen, biodiesel, liquid 
fuels derived from coal, and other alternative fuels. Many of these 
incentives were added to the tax code well before recent technological 
developments demonstrated the extraordinary promise of algae as a 
renewable fuel source. In order to ensure that Federal tax incentives 
stimulate the most promising and environmentally beneficial energy 
sources available, the tax code should be updated to incorporate and 
promote algae-based fuel production.
  The Algae-based Renewable Fuel Promotion Act would make two modest 
changes to the tax code to promote the development and 
commercialization of algae-based fuels in the U.S. First, the bill 
would expand the $1.01 per gallon income tax credit for cellulosic 
biofuels to cover algae-based biofuels. The bill retains the current 
law December 31, 2012, expiration date for the cellulosic biofuel 
producer credit. Second, the bill would extend the capital investment 
tax incentives for cellulosic biofuels to cover equipment used to 
produce algae-based fuels. Specifically, the bill would modify the 50 
percent bonus depreciation provision for property used to produce 
cellulosic biofuel by extending the provision to qualified algae-based 
biofuel plant property. The bill retains the current law requirement 
that qualified property must be placed in service before January 1, 
2013. By ensuring that algae-based fuels fully benefit under Federal 
tax policies that promote renewable and alternative fuels, the 
legislation will encourage investment in this sustainable energy source 
and make an important contribution to our energy landscape for years to 
come.
  Algae-based fuels are just one of the many renewable and alternative 
energy sources under development by aggressive and entrepreneurial 
start-up firms. These firms seek to capitalize on the commercial 
opportunities presented by the transition away from reliance on fossil 
fuels. It is critical that we regularly review the tax code to ensure

[[Page S6557]]

that it encourages and promotes the most promising renewable energy 
sources available. The Algae-based Renewable Fuel Promotion Act is one 
step in this direction. I encourage my colleagues to support it.
  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. 1250

       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 ``Algae-based Renewable Fuel 
     Promotion Act of 2009''.

     SEC. 2. INCLUSION OF ALGAE-BASED BIOFUEL IN DEFINITION OF 
                   CELLULOSIC BIOFUEL.

       (a) Cellulosic Biofuel Producer Credit.--
       (1) General rule.--Paragraph (4) of section 40(a) of the 
     Internal Revenue Code of 1986 is amended by inserting ``and 
     algae-based'' after ``cellulosic''.
       (2) Definitions.--Paragraph (6) of section 40(b) of such 
     Code is amended--
       (A) by inserting ``and algae-based'' after ``Cellulosic'' 
     in the heading,
       (B) by striking subparagraph (A) and inserting the 
     following:
       ``(A) In general.--The cellulosic and algae-based biofuel 
     producer credit of any taxpayer is an amount equal to the 
     applicable amount for each gallon of--
       ``(i) qualified cellulosic biofuel production, and
       ``(ii) qualified algae-based biofuel production.'',
       (C) by redesignating subparagraphs (F), (G), and (H) as 
     subparagraphs (I), (J), and (K), respectively,
       (D) by inserting ``and algae-based'' after ``cellulosic'' 
     in the heading of subparagraph (I), as so redesignated,
       (E) by inserting ``or algae-based biofuel, whichever is 
     appropriate,'' after ``cellulosic biofuel'' in subparagraph 
     (J), as so redesignated,
       (F) by inserting ``and qualified algae-based biofuel 
     production'' after ``qualified cellulosic biofuel 
     production'' in subparagraph (K), as so redesignated, and
       (G) by inserting after subparagraph (E) the following new 
     subparagraphs:
       ``(F) Qualified algae-based biofuel production.--For 
     purposes of this section, the term `qualified algae-based 
     biofuel production' means any algae-based biofuel which is 
     produced by the taxpayer, and which during the taxable year--
       ``(i) is sold by the taxpayer to another person--

       ``(I) for use by such other person in the production of a 
     qualified algae-based biofuel mixture in such other person's 
     trade or business (other than casual off-farm production),
       ``(II) for use by such other person as a fuel in a trade or 
     business, or
       ``(III) who sells such algae-based biofuel at retail to 
     another person and places such algae-based biofuel in the 
     fuel tank of such other person, or

       ``(ii) is used or sold by the taxpayer for any purpose 
     described in clause (i).

     The qualified algae-based biofuel production of any taxpayer 
     for any taxable year shall not include any alcohol which is 
     purchased by the taxpayer and with respect to which such 
     producer increases the proof of the alcohol by additional 
     distillation.
       ``(G) Qualified algae-based biofuel mixture.--For purposes 
     of this paragraph, the term `qualified algae-based biofuel 
     mixture' means a mixture of algae-based biofuel and gasoline 
     or of algae-based biofuel and a special fuel which--
       ``(i) is sold by the person producing such mixture to any 
     person for use as a fuel, or
       ``(ii) is used as a fuel by the person producing such 
     mixture.
       ``(H) Algae-based biofuel.--For purposes of this 
     paragraph--
       ``(i) In general.--The term `algae-based biofuel' means any 
     liquid fuel, including gasoline, diesel, aviation fuel, and 
     ethanol, which--

       ``(I) is produced from the biomass of algal organisms, and
       ``(II) meets the registration requirements for fuels and 
     fuel additives established by the Environmental Protection 
     Agency under section 211 of the Clean Air Act (42 U.S.C. 
     7545).

       ``(ii) Algal organism.--The term `algal organism' means a 
     single- or multi-cellular organism which is primarily aquatic 
     and classified as a non-vascular plant, including microalgae, 
     blue-green algae (cyanobacteria), and macroalgae (seaweeds).
       ``(iii) Exclusion of low-proof alcohol.--Such term shall 
     not include any alcohol with a proof of less than 150. The 
     determination of the proof of any alcohol shall be made 
     without regard to any added denaturants.''.
       (3) Conforming amendments.--
       (A) Subparagraph (D) of section 40(d)(3) of such Code is 
     amended--
       (i) by inserting ``and algae-based'' after ``cellulosic'' 
     in the heading,
       (ii) by inserting ``or (b)(6)(F)'' after ``(b)(6)(C)'' in 
     clause (ii), and
       (iii) by inserting ``or algae-based'' after ``such 
     cellulosic''.
       (B) Paragraph (6) of section 40(d) of such Code is 
     amended--
       (i) by inserting ``and algae-based'' after ``cellulosic'' 
     in the heading, and
       (ii) by striking the first sentence and inserting ``No 
     cellulosic and algae-based biofuel producer credit shall be 
     determined under subsection (a) with respect to any 
     cellulosic or algae-based biofuel unless such cellulosic or 
     algae-based biofuel is produced in the United States and used 
     as a fuel in the United States.''
       (C) Paragraph (3) of section 40(e) of such Code is amended 
     by inserting ``and algae-based'' after ``cellulosic'' in the 
     heading.
       (D) Paragraph (1) of section 4101(a) of such Code is 
     amended--
       (i) by inserting ``or algae-based'' after ``cellulosic'', 
     and
       (ii) by inserting ``and 40(b)(6)(H), respectively'' after 
     ``section 40(b)(6)(E)''.
       (b) Special Allowance for Cellulosic Biofuel Plant 
     Property.--Subsection (l) of section 168 of the Internal 
     Revenue Code of 1986 is amended--
       (1) by inserting ``and Algae-Based'' after ``Cellulosic'' 
     in the heading,
       (2) by inserting ``and any qualified algae-based biofuel 
     plant property'' after ``qualified cellulosic biofuel plant 
     property'' in paragraph (1),
       (3) by redesignating paragraphs (4) through (8) as 
     paragraphs (6) through (10), respectively,
       (4) by inserting ``or qualified algae-based biofuel plant 
     property'' after ``cellulosic biofuel plant property'' in 
     paragraph (7)(C), as so redesignated,
       (5) by striking ``with respect to'' and all that follows in 
     paragraph (9), as so redesignated, and inserting ``with 
     respect to any qualified cellulosic biofuel plant property 
     and any qualified algae-based biofuel plant property which 
     ceases to be such qualified property.'',
       (6) by inserting ``or qualified algae-based biofuel plant 
     property'' after ``cellulosic biofuel plant property'' in 
     paragraph (10), as so redesignated, and
       (7) by inserting after paragraph (3) the following new 
     paragraphs:
       ``(4) Qualified algae-based biofuel plant property.--The 
     term `qualified algae-based biofuel plant property' means 
     property of a character subject to the allowance for 
     depreciation--
       ``(A) which is used in the United States solely to produce 
     algae-based biofuel,
       ``(B) the original use of which commences with the taxpayer 
     after December 31, 2008,
       ``(C) which is acquired by the taxpayer by purchase (as 
     defined in section 179(d)) after December 31, 2008, but only 
     if no written binding contract for the acquisition was in 
     effect on or before such date, and
       ``(D) which is placed in service by the taxpayer before 
     January 1, 2013.
       ``(5) Algae-based biofuel.--
       ``(A) In general.--The term `algae-based biofuel' means any 
     liquid fuel which is produced from the biomass of algal 
     organisms.
       ``(B) Algal organism.--The term `algal organism' means a 
     single- or multi-cellular organism which is primarily aquatic 
     and classified as a non-vascular plant, including microalgae, 
     blue-green algae (cyanobacteria), and macroalgae 
     (seaweeds).''.
       (c) Effective Dates.--
       (1) Cellulosic biofuel producer credit.--The amendments 
     made by subsection (a) shall apply to fuel produced after 
     December 31, 2008.
       (2) Special allowance for cellulosic biofuel plant 
     property.--The amendments made by subsection (b) shall apply 
     to property purchased and placed in service after December 
     31, 2008.

  Mr. CRAPO. Mr. President, I rise today to speak in support of the 
Algae-based Renewable Fuel Promotion Act.
  I would first like to thank Senator Bill Nelson for his leadership on 
this extraordinary piece of legislation, which gives algae-based 
biofuels the same tax incentives that cellulosic biofuels currently 
enjoy. Specifically, the bill would provide a $1.01 per gallon tax 
credit and offer 50 percent bonus depreciation for property used in the 
production of algae-based biofuels. In short, this legislation will 
level the playing field for algae, resulting in enhanced development 
and commercialization.
  Recent technological advances have showcased the tremendous potential 
of algae as a renewable fuel source. Algae-based biofuels can be 
refined into gasoline, jet fuel and diesel. These fuels are renewable, 
have a low-carbon footprint, and can fit seamlessly into our existing 
energy infrastructure. Additionally, algae does not compete for arable 
land or potable water. Algae grows best in very sunny climates, making 
the desert an ideal place for production, and it utilizes saltwater, 
not freshwater, to grow. It also has a short-life cycle and high oil 
content.
  Algae-based renewable fuels will play an important role in America's 
clean energy portfolio, and provide an answer to the question of how we 
will decrease our dependence on foreign oil and increase our domestic 
security. Again, I thank my colleague, Senator Bill Nelson, and I look 
forward to working with my colleagues in the Senate on this important 
piece of legislation.

[[Page S6558]]

                                 ______
                                 
      By Mr. WARNER:
  S. 1251. A bill to amend title XVIII of the Social Security Act to 
provide for advanced illness care management services for Medicare 
beneficiaries, and for other purposes; to the Committee on Finance.
  Mr. WARNER. Mr. President, I rise today to introduce legislation to 
help seniors navigate through a complicated and often overwhelming 
health care delivery system. Because of the fragmented nature of our 
healthcare system, we often fail to provide patients, their families, 
and caregivers with the necessary tools, information, and support to 
age well and with dignity in the setting of their preference. I believe 
that if we provide patients with better information about advance care 
planning in non-crisis situations, they will make decisions for 
themselves and their families that result in better care and better 
quality of life.
  Our health care system is in need of sweeping reforms that will not 
only provide broader coverage but will also increase value and 
efficient access to quality care. As we provide meaningful reforms for 
the healthcare system, we should take the opportunity to refine and 
enhance those parts of the Medicare system that work well for seniors.
  Currently, Medicare beneficiaries with advanced illnesses have a good 
option in the Medicare hospice benefit to receive care, family support, 
and counseling during the last six months of life. For those who are 
ill or in need of advanced illness care, but are not eligible for the 
hospice benefit, there are very few options for counseling and services 
that would help them make informed choices about their care options. 
Often, they are left in the dark about their treatment alternatives and 
without the support they and their family members need to prepare and 
plan for the care they want and need. Frankly, it is unconscionable to 
leave it to families to resolve these extraordinarily difficult 
decisions, often in moments of crisis, without appropriate information, 
materials and supportive services. The Senior Navigation and Planning 
Act of 2009 will help seniors and their families navigate through an 
extremely complex system and will help them make informed medical 
decisions.
  My legislation would provide access to an advanced illness care 
management benefit, increase the awareness of advance care planning 
through a national education campaign and clearinghouse, reduce legal 
hurdles to the enforcement of advance directives, create incentives for 
hospitals and physicians to get accredited and certified in palliative 
care, increase compliance with medical orders and discharge 
instructions, educate entities including faith-based organizations on 
advance care planning issues, and increase integration and coordination 
between the Medicare and Medicaid programs. Collectively, these 
initiatives will create a more accessible environment for seniors to 
receive the care they need, when they need it, in the setting they 
prefer.
  Specifically, the advanced illness care management benefit would 
allow Medicare beneficiaries who have been diagnosed with a life 
expectancy of 18 months or less to have access to the guidance and 
expertise of a hospice team and receive services such as consultations 
on palliative care, advance care planning that is patient-centered, and 
counseling, respite, and care giving training for their family members. 
This new advanced illness care management benefit will provide seniors 
with the support they need to make informed decisions.
  This initiative builds upon the efforts of the hospice community and 
the private sector. For example, United Health Group has created an 
Advanced Illness model in their benefit design and offers this program 
to the seniors they serve in Medicare Advantage and Special Needs 
Plans. They have found by providing access to the hospice and 
palliative care teams earlier, patients experience an increase in the 
quality of their life and duplicative or futile care is reduced. Aetna 
and Kaiser Permanente have also implemented these types of programs 
with similar results.
  In addition to the impact a lack of advance care planning and access 
to supportive services has on a patient's quality of life, inadequate 
access to advance care planning services contributes to 27 percent of 
Medicare costs spent in the last year of life. Advanced illness, 
palliative, and hospice care have been shown to improve quality of care 
at a reduced cost. Specifically, studies demonstrate that if an 
additional 2 percent of hospitalized Medicare beneficiaries received 
palliative care, direct cost savings to the Medicare program would be 
$1.57 billion. Given health care costs are growing at an alarming rate 
and that seniors may not be getting the necessary information they need 
to make appropriate treatment decisions, we need to act now to provide 
them with access to advanced illness and advance care planning 
services.
  I believe that rather than deny or withhold healthcare services, 
overall health reform should include a thoughtful process that informs 
patients, their families, and caregivers on how to navigate and think 
through decisions about when and how long to pursue treatments at the 
end-of-life. By doing this, we will provide a culture in which all of 
us will have the ability to age well, with dignity, in the setting of 
our choosing.
  It is my hope that this legislation will be incorporated into the 
broader health care reform effort that is underway in the Finance and 
Health, Education, Labor, and Pensions Committees. I look forward to 
working with Chairmen Baucus and Kennedy to implement these meaningful 
reforms so seniors have access to the information and services they 
need to receive the care they deserve.
                                 ______
                                 
      By Mr. ROCKEFELLER (for himself, Mr. Inouye, and Ms. Cantwell):
  S. 1252. A bill to promote ocean and human health and for other 
purposes; to the Committee on Commerce, Science, and Transportation.
  Mr. ROCKEFELLER. Mr. President, oceans affect human health both 
directly and indirectly from the water quality at our beaches to the 
safety of seafood at U.S. markets; therefore, it is important to 
understand the relationship between environmental stressors, coastal 
conditions, climate change, and human health. Over the last several 
decades ocean and coastal waters have become channels for environmental 
threats to human health including infectious disease, harmful toxins 
from algae, and chemical pollutants from contact with contaminated 
seafood, polluted drinking water, and dirty beaches. Since the 1960s, 
scientists have realized that marine plants, animals, and microbes can 
also produce substances that benefit human health, such as anticancer, 
anti-inflammatory, and antibiotic medicines.
  Through well designed research and monitoring programs, we can 
maximize the health benefits derived from the oceans, improve the 
safety of American seafood, reduce beach closures, and detect emerging 
threats to human health in a proactive rather than reactive manner.
  In 2004, Congress enacted the Oceans and Human Health Act which 
authorized the National Oceanic and Atmospheric Administration, the 
National Science Foundation, and the National Institutes of Health to 
conduct research to improve understanding of the connection between the 
oceans and public health. Today, Senator Inouye, Senator Cantwell, and 
I are introducing the Oceans and Human Health Reauthorization Act of 
2009.
  This legislation would direct the President, working through the 
National Science and Technology Council, to coordinate a national 
research program to improve understanding of the role of the oceans, 
coasts and Great Lakes in human health and deliver information, 
products, and services to assist the nation in reducing public health 
risks, including those related to climate change, and enhancing health 
benefits from the ocean. It would establish the Oceans and Human Health 
Task Force that will include a number of federal agencies, such as the 
National Oceanic and Atmospheric Administration, the National 
Institutes of Health, the National Science Foundation, the National 
Institute for Environmental Health Science, and the Center for Disease 
Control. It would direct the Interagency Oceans and Human Health Task 
Force to develop an implementation plan that: establishes the goals and 
priorities for federal research that advance scientific

[[Page S6559]]

understanding of the connections between oceans and human health; 
provides information for the prediction, surveillance, and forecasting 
of marine-related public health problems, including those related to 
climate change; and uses the biological and chemical potentials of the 
oceans to develop new products for the prevention and treatment of 
diseases and to increase our understanding of the biological properties 
of ocean resources. The legislation would also reauthorize the National 
Oceanic and Atmospheric Administration's Oceans and Human Health 
Initiative and establish a Distinguished Scholars program for 
scientists to work with the National Oceanic and Atmospheric 
Administration on the oceans and human health initiative.
  Importantly, this bill would recognize the effects of climate change 
on oceans and human health. The effects of climate change do not stop 
with sea level rise and increased water temperatures. Without physical 
and ecological boundaries, climate change causes a cascade of effects 
throughout ocean environments that can result in surprising impacts on 
ocean and human health. This reauthorization bill would include climate 
change and oceans and human health as a new research area.
  Our oceans impact every American and they are a foundation of 
America's economy. The research and monitoring supported by this bill 
will help make sure we have healthy oceans where people can swim, fish, 
play, and eat seafood. It will also help us develop new blue jobs in 
marine natural products and lead to new discoveries in medicines to 
cure deadly diseases.
  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. 1252

       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 ``Oceans and Human Health 
     Reauthorization Act of 2009''.

     SEC. 2. INTERAGENCY OCEANS AND HUMAN HEALTH RESEARCH PROGRAM.

       (a) Coordination.--Subsection (a) of section 902 of the 
     Oceans and Human Health Act (33 U.S.C. 3101) is amended by 
     striking ``in human health.'' and inserting ``, coasts, and 
     Great Lakes in human health and deliver information, 
     products, and services to assist the nation in reducing 
     public health risks, including those related to climate 
     change, and enhancing health benefits from the ocean.''.
       (b) Implementation Plan.--Subsection (b) of section 902 of 
     the Oceans and Human Health Act (33 U.S.C. 3101) is amended--
       (1) by amending the matter preceding paragraph (1) to read 
     as follows:
       ``(b) Implementation Plan.--Not later than 5 years after 
     the date of the enactment of the Oceans and Human Health 
     Reauthorization Act of 2009, an Interagency Oceans and Human 
     Health Task Force or working group established by the 
     National Science and Technology Council, through the Director 
     of the Office of Science and Technology Policy, shall revise 
     and update the 2007 `Interagency Oceans and Human Health 
     Research Implementation Plan' and submit to the Congress the 
     updated Plan. Nothing in this subsection is intended to 
     duplicate or supersede the activities of the Inter-Agency 
     Task Force on Harmful Algal Blooms and Hypoxia established 
     under section 603 of the Harmful Algal Bloom and Hypoxia 
     Research and Control Act of 1998 (Public Law 105-383; 16 
     U.S.C. 1451 note). The updated plan shall--'';
       (2) in paragraph (1)--
       (A) by inserting ``, surveillance, and forecasting'' after 
     ``prediction'';
       (B) by inserting ``, including problems related to climate 
     change,'' after ``health problems'';
       (C) by inserting ``and chemical'' after ``biological''; and
       (D) by inserting ``products for the prevention and'' after 
     ``new'';
       (3) in paragraph (2), by striking ``and participation;'' 
     and all that follows through the end and inserting 
     ``participation in national and international research and 
     outreach efforts, and outreach to the medical community and 
     the public;'';
       (4) in paragraph (3), by inserting ``, including joint 
     efforts,'' after ``departments'';
       (5) in paragraph (4), by striking ``preventive'' and 
     inserting ``preventing'';
       (6) in paragraph (5), by inserting ``Resources'' after 
     ``the Ocean'';
       (7) in paragraph (6), by striking ``and'' at the end;
       (8) by amending paragraph (7) to read as follows:
       ``(7) estimate funding needed for research, surveillance, 
     education, and outreach activities to be conducted within or 
     supported by Federal agencies and departments under the 
     program.''; and
       (9) by at the end the following:
       ``(8) build on, and complement, the research, surveillance, 
     and outreach activities of the National Oceanic and 
     Atmospheric Administration, the National Science Foundation, 
     the National Institutes of Health, the Centers for Disease 
     Control and Prevention, the National Institute of 
     Environmental Health Sciences, and other departments and 
     agencies.''.
       (c) Program Scope.--Subsection (c) of section 902 of the 
     Oceans and Human Health Act (33 U.S.C. 3101) is amended--
       (1) by amending paragraph (1) to read as follows:
       ``(1) Interdisciplinary research among the ocean, 
     atmospheric, and medical sciences, and coordinated research 
     and activities to improve understanding of processes within 
     the ocean that may affect human and marine animal health and 
     to explore the potential contribution of marine organisms to 
     medicine and research, including--
       ``(A) vector-, water-, and food-borne diseases of humans 
     and marine organisms, including marine mammals, corals, and 
     fish;
       ``(B) health effects for both humans and marine animals 
     associated with harmful algal blooms and hypoxia (in 
     collaboration with the Inter-Agency Task Force on Harmful 
     Algal Blooms and Hypoxia);
       ``(C) health effects for humans and marine organisms 
     associated with climate change impacts in ocean, coastal, and 
     Great Lakes waters;
       ``(D) marine-derived pharmaceuticals and other natural 
     products;
       ``(E) marine organisms and habitats as models for 
     biomedical research and as indicators of human health and 
     well being and marine environmental health;
       ``(F) marine environmental microbiology;
       ``(G) legacy and emerging chemicals of concern, including 
     bioaccumulative and endocrine-disrupting chemical 
     contaminants;
       ``(H) predictive models based on indicators of marine 
     environmental health or public health threats; and
       ``(I) social, economic, and behavioral studies of 
     relationships between the condition of oceans, coasts, and 
     Great Lakes and human health and well-being.'';
       (2) by amending paragraph (2) to read as follows:
       ``(2) Coordination with any appropriate interagency working 
     group of the Joint Subcommittee on Ocean Science and 
     Technology, or its successor body, through the National 
     Science and Technology Council, to ensure that any integrated 
     ocean and coastal observing system provides information 
     necessary to monitor and reduce marine public health 
     problems, including climate change information, health-
     related data on biological populations, and detection of 
     toxins and contaminants in marine waters and seafood.''; and
       (3) in paragraph (3)--
       (A) in subparagraph (A), by striking ``genomics and 
     proteomics'' and inserting ``genomics, proteomics, 
     metabolomics, and other related sciences'';
       (B) by amending subparagraph (C) to read as follows:
       ``(C) in situ, laboratory, and remote sensors--
       ``(i) to detect, quantify, and predict the presence, 
     distribution, concentration, toxicity, or virulence of 
     infectious microbes, harmful algae, toxins, and chemical 
     contaminants in ocean, coastal, and Great Lakes waters, 
     sediments, organisms, and seafood; and
       ``(ii) to identify new genetic resources for biomedical 
     purposes;''; and
       (C) in subparagraph (E), by striking ``equipment and 
     technologies'' and inserting ``equipment, technologies, and 
     methodologies''.
       (d) Biennial Report.--Subsection (d) of section 902 of the 
     Oceans and Human Health Act (33 U.S.C. 3101) is amended--
       (1) in the heading, by striking ``Annual'' and inserting 
     ``Biennial'';
       (2) in the material preceding paragraph (1)--
       (A) by striking ``24 months after the date of enactment of 
     this Act'' and inserting ``12 months after the date of the 
     enactment of the Oceans and Human Health Reauthorization Act 
     of 2009'';
       (B) by striking ``each year an annual'' and inserting 
     ``alternate years a biennial''; and
       (C) by striking ``year,'' and inserting ``years,'';
       (3) in paragraph (1), by striking ``year;'' and inserting 
     ``years;'';
       (4) in paragraph (4), by striking ``that preceding fiscal 
     year;'' and inserting ``the preceding two fiscal years;'' and
       (5) in paragraph (5), by inserting ``, funding needs,'' 
     after ``action''.

     SEC. 3. NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION 
                   OCEANS AND HUMAN HEALTH INITIATIVE.

       (a) Establishment.--Subsection (a) of section 903 of the 
     Oceans and Human Health Act (33 U.S.C. 3102) is amended--
       (1) in the matter preceding paragraph (1), by striking the 
     second sentence, and inserting ``In carrying out this 
     section, the Secretary shall consult with other Federal 
     agencies and departments conducting integrated oceans and 
     human health research and disease surveillance activities and 
     research in related areas, including the National Science 
     Foundation, the National Institutes of Health, the Centers 
     for Disease Control and

[[Page S6560]]

     Prevention, the National Institute of Environmental Health 
     Sciences, and other agencies and departments.''; and
       (2) in paragraph (2), by inserting ``external'' after 
     ``an''.
       (b) Advisory Panel.--Subsection (b) of section 903 of the 
     Oceans and Human Health Act (33 U.S.C. 3102) is amended--
       (1) by striking ``is authorized to'' and inserting 
     ``shall''; and
       (2) by striking ``sciences.'' and inserting ``sciences, 
     including public health practitioners.''.
       (c) National Centers.--Subsection (c) of section 903 of the 
     Oceans and Human Health Act (33 U.S.C. 3102) is amended--
       (1) in paragraph (1), by striking ``for''; and
       (2) by amending paragraph (2) to read as follows:
       ``(2) The centers shall focus on--
       ``(A) areas related to agency missions, including use of 
     marine organisms and habitats as indicators for marine 
     environmental health, impacts of climate change on ocean 
     health threats, ocean pollutants, marine toxins and 
     pathogens, harmful algal blooms, hypoxia, seafood safety and 
     quality, identification of potential marine products, and 
     biology and pathobiology of marine mammals, corals, and other 
     marine organisms; and
       ``(B) supporting disciplines including marine genomics, 
     marine environmental microbiology, ecological chemistry, and 
     conservation medicine.''.
       (d) Extramural Research Grants.--Subsection (d) of section 
     903 of the Oceans and Human Health Act (33 U.S.C. 3102) is 
     amended by adding at the end the following:
       ``(3) Grants under this subsection shall support research 
     to improve understanding of processes within the ocean that 
     may affect human and marine animal health and to explore the 
     potential contribution of marine organisms to medicine and 
     research, including--
       ``(A) vector-, water-, and food-borne diseases of humans 
     and marine organisms, including marine mammals, corals, and 
     fish;
       ``(B) health effects for humans and marine organisms 
     associated with climate change impacts in ocean, coastal, and 
     Great Lakes waters;
       ``(C) marine-derived pharmaceuticals and other natural 
     products;
       ``(D) marine organisms and habitats as models for 
     biomedical research and as indicators of human health and 
     well being and marine environmental health;
       ``(E) marine environmental microbiology;
       ``(F) legacy and emerging chemicals of concern, including 
     bioaccumulative and endocrine-disrupting chemical 
     contaminants;
       ``(G) predictive models based on indicators of marine 
     environmental health or public health threats;
       ``(H) cataloging and interpreting microbes and 
     understanding microbial functions in ecosystems and impacts 
     on human and marine health; and
       ``(I) social, economic, and behavioral studies of 
     relationships between the condition of oceans, coasts, and 
     Great Lakes, and human health and well-being.''.
       (e) Distinguished Scholars; Cooperative Agreements.--
     Section 903 of the Oceans and Human Health Act (33 U.S.C. 
     3102) is amended by adding at the end the following:
       ``(f) Distinguished Scholars.--The Secretary of Commerce is 
     authorized to establish a competitive program to recognize 
     highly distinguished external scientists in any area of 
     oceans and human health research and to involve those 
     scientists in collaborative work with the Oceans and Human 
     Health Initiative of the National Oceanic and Atmospheric 
     Administration.
       ``(g) Cooperative Agreements.--The Secretary of Commerce 
     may execute and perform such contracts, leases, grants, or 
     cooperative agreements as may be necessary to carry out this 
     section.''.

     SEC. 4. PUBLIC INFORMATION AND OUTREACH.

       (a) In General.--Subsection (a) of section 904 of the 
     Oceans and Human Health Act (33 U.S.C. 3103) is amended by 
     striking ``program,'' and inserting ``and institutions of 
     higher education,''.
       (b) Report.--Subsection (b) of section 904 of the Oceans 
     and Human Health Act (33 U.S.C. 3103) is amended to read as 
     follows:
       ``(b) Report.--
       ``(1) Requirement.--The Secretary of Commerce shall submit 
     to Congress a biennial report reviewing the results of the 
     research, assessments, and findings developed under the 
     Oceans and Human Health Initiative of the National Oceanic 
     and Atmospheric Administration. Each such report shall--
       ``(A) describe the projects, products, and programs funded 
     under the Initiative;
       ``(B) describe the work of the Advisory Committee and the 
     manner in which the program is meeting development and 
     implementation recommendations for the program; and
       ``(C) include recommendations for improving or expanding 
     the program.
       ``(2) Combined reports.--Each report required by paragraph 
     (1) may be combined with the National Ocean and Atmospheric 
     Administration's input to the biennial interagency report 
     required by section 902(d).''.

     SEC. 5. AUTHORIZATION OF APPROPRIATIONS.

       Subsection (a) of section 905 of the Oceans and Human 
     Health Act (33 U.S.C. 3104) is amended--
       (1) by striking ``2005 through 2008'' and inserting ``2010 
     through 2014''; and
       (2) by inserting ``, distinguished scholar,'' after 
     ``grant''.
                                 ______
                                 
      By Mr. CORKER (for himself, Mr. Nelson of Florida, Mrs. Shaheen, 
        Ms. Snowe, Mr. Isakson, and Mr. Wicker):
  S. 1253. A bill to address reimbursement of certain costs to 
automobile dealers; to the Committee on the Judiciary.
  Mr. CORKER. 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. 1253

       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 ``Automobile Dealers 
     Assistance Act of 2009''.

     SEC. 2. REIMBURSEMENT OF AUTOMOBILE DISTRIBUTORS.

       (a) In General.--Notwithstanding any other provision of 
     law, any funds provided by the United States Government, or 
     any agency, department, or subdivision thereof, to an 
     automobile manufacturer or a distributor thereof as credit, 
     loans, financing, advances, or by any other agreement in 
     connection with such automobile manufacturer's or 
     distributor's proceeding as a debtor under title 11, United 
     States Code, shall be conditioned upon use of such funds to 
     fully reimburse all dealers of such automobile manufacturer 
     or manufacturer's distributor for--
       (1) the cost incurred by such dealers during the 9-month 
     period preceding the date on which the proceeding under title 
     11, United States Code, by or against the automobile 
     manufacturer or manufacturer's distributor is commenced, in 
     acquisition of all parts and inventory in the dealer's 
     possession on on the same basis as if the dealers were 
     terminating pursuant to existing franchise agreements or 
     dealer agreements; and
       (2) all other obligations owed by such automobile 
     manufacturer or manufacturer's distributor under any other 
     agreement between the dealers and the automobile manufacturer 
     or manufacturer's distributor arising during that 9-month 
     period, including, without limitation, franchise agreement or 
     dealer agreements.
       (b) Inclusion in Terms.--Any note, security agreement, loan 
     agreement, or other agreement between an automobile 
     manufacturer or manufacturer's distributor and the Government 
     (or any agency, department, or subdivision thereof) shall 
     expressly provide for the use of such funds as required by 
     this section. A bankruptcy court may not authorize the 
     automobile manufacturer or manufacturer's distributor to 
     obtain credit under section 364 of title 11, United States 
     Code, unless the credit agreement or agreements expressly 
     provided for the use of funds as required by this section.
       (c) Effectiveness of Rejection.--Notwithstanding any other 
     provision of law, any rejection by an automobile manufacturer 
     or manufacturer's distributor that is a debtor in a 
     proceeding under title 11, United States Code, of a franchise 
     agreement or dealer agreement pursuant to section 365 of that 
     title, shall not be effective until at least 180 days after 
     the date on which such rejection is otherwise approved by a 
     bankruptcy court.
                                 ______
                                 
      By Ms. CANTWELL (for herself and Mr. Kohl):
  S. 1256. A bill to amend title XIX of the Social Security Act to 
establish financial incentives for States to expand the provision of 
long-term services and supports to Medicaid beneficiaries who do not 
reside in an institution, and for other purposes; to the Committee on 
Finance.
  Ms. CANTWELL. Mr. President, I rise today to introduce the Home and 
Community Balanced Incentives Act of 2009, together with my colleague 
from Wisconsin, Senator Kohl. As we in the Senate embark on reforming 
America's health care system, we cannot forget those who are dependent 
on daily care in order to survive: those in long-term care. Long-term 
care provides health care and daily living services to the elderly and 
disabled population, providing them with the ability to live happy, 
productive lives that age, illness and disability would otherwise 
prevent.
  In 2007, the U.S. spent close to $109 billion on long term 
institutional care services under the Medicaid program; in my state of 
Washington it was approximately $2 billion. This amount represents more 
than 30 percent of all Medicaid payments, and is a number we can easily 
reduce. This legislation seeks to rebalance how states handle long term 
care by providing the tools they need to shift people out of expensive 
institutional care facilities and into home and community based care, 
where they can remain vibrant, active members of their community.
  As Dorothy from the Wizard of Oz once said: There is no place like 
home. I could not agree more, which is why I believe in providing 
individuals and

[[Page S6561]]

families with the option to remain in their home, where studies have 
shown the overall quality of life is far superior to that in an 
institutional facility. Additionally, home and community based care is 
far more cost efficient than institutional care; by diverting just 5 
percent of the long term care community away from institutional care 
and into home and community based services, we would see a net savings 
of more than $10 billion dollars over five years. In a time when rising 
health care spending plays such a pivotal role in the health of the 
overall economy, these savings represent a giant step towards reining 
in unnecessary health care spending.
  The Home and Community Balanced Incentives Act would achieve the goal 
of transitioning to home and community based services by offering 
states modest increases to their federal medical assistance payment, 
FMAP, for home and community based services. States would have to use 
these increases to develop the programs needed to provide effective 
home and community based services. These services will reduce barriers 
that currently prohibit people from accessing home and community based 
services.
  This bill succeeds in not only saving the Medicaid program a 
significant amount of money, but it will empower families to make 
informed decisions about their long term care needs.
  Specifically, this bill would: improve case management to help people 
remain in their homes and communities and out of nursing homes; provide 
consumer empowerment helping to put individuals in charge of their 
care; provide a coordinated transition structure for those wishing to 
leave institutional care and return to their homes and communities; 
create a clear and well coordinated system for providing long term care 
information and support; improve methodology for determining 
eligibility and tracking provider data on services and quality 
outcomes.
  Senator Kohl and I are excited to introduce this important 
legislation and to begin working with our colleagues on improving the 
long term care system in America.
  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. 1256

       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 ``Home and 
     Community Balanced Incentives Act of 2009''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.

                     TITLE I--BALANCING INCENTIVES

Sec. 101. Enhanced FMAP for expanding the provision of non-
              institutionally-based long-term services and supports.

  TITLE II--STRENGTHENING THE MEDICAID HOME AND COMMUNITY-BASED STATE 
                         PLAN AMENDMENT OPTION

Sec. 201. Removal of barriers to providing home and community-based 
              services under State plan amendment option for 
              individuals in need.
Sec. 202. Mandatory application of spousal impoverishment protections 
              to recipients of home and community-based services.
Sec. 203. State authority to elect to exclude up to 6 months of average 
              cost of nursing facility services from assets or 
              resources for purposes of eligibility for home and 
              community-based services.

      TITLE III--COORDINATION OF HOME AND COMMUNITY-BASED WAIVERS

Sec. 301. Streamlined process for combined waivers under subsections 
              (b) and (c) of section 1915.

                     TITLE I--BALANCING INCENTIVES

     SEC. 101. ENHANCED FMAP FOR EXPANDING THE PROVISION OF NON-
                   INSTITUTIONALLY-BASED LONG-TERM SERVICES AND 
                   SUPPORTS.

       (a) Enhanced Fmap to Encourage Expansion.--Section 1905 of 
     the Social Security Act (42 U.S.C. 1396d) is amended--
       (1) in the first sentence of subsection (b)--
       (A) by striking ``, and (4)'' and inserting ``, (4)''; and
       (B) by inserting before the period the following: ``, and 
     (5) in the case of a balancing incentive payment State, as 
     defined in subsection (y)(1), that meets the conditions 
     described in subsection (y)(2), the Federal medical 
     assistance percentage shall be increased by the applicable 
     number of percentage points determined under subsection 
     (y)(3) for the State with respect to medical assistance 
     described in subsection (y)(4)''; and
       (2) by adding at the end the following new subsection:
       ``(y) State Balancing Incentive Payments Program.--For 
     purposes of clause (5) of the first sentence of subsection 
     (b):
       ``(1) Balancing incentive payment state.--A balancing 
     incentive payment State is a State--
       ``(A) in which less than 50 percent of the total 
     expenditures for medical assistance for fiscal year 2009 for 
     long-term services and supports (as defined by the Secretary, 
     subject to paragraph (5)) are for non-institutionally-based 
     long-term services and supports described in paragraph 
     (5)(B);
       ``(B) that submits an application and meets the conditions 
     described in paragraph (2); and
       ``(C) that is selected by the Secretary to participate in 
     the State balancing incentive payment program established 
     under this subsection.
       ``(2) Conditions.--The conditions described in this 
     paragraph are the following:
       ``(A) Application.--The State submits an application to the 
     Secretary that includes the following:
       ``(i) A description of the availability of non-
     institutionally-based long-term services and supports 
     described in paragraph (5)(B) available (for fiscal years 
     beginning with fiscal year 2009).
       ``(ii) A description of eligibility requirements for 
     receipt of such services.
       ``(iii) A projection of the number of additional 
     individuals that the State expects to provide with such 
     services to during the 5-fiscal year period that begins with 
     fiscal year 2011.
       ``(iv) An assurance of the State's commitment to a 
     consumer-directed long-term services and supports system that 
     values quality of life in addition to quality of care and in 
     which beneficiaries are empowered to choose providers and 
     direct their own care as much as possible.
       ``(v) A proposed budget that details the State's plan to 
     expand and diversify medical assistance for non-
     institutionally-based long-term services and supports 
     described in paragraph (5)(B) during such 5-fiscal year 
     period, and that includes--

       ``(I) a description of the new or expanded offerings of 
     such services that the State will provide; and
       ``(II) the projected costs of the services identified in 
     subclause (I).

       ``(vi) A description of how the State intends to achieve 
     the target spending percentage applicable to the State under 
     subparagraph (B).
       ``(vii) An assurance that the State will not use Federal 
     funds, revenues described in section 1903(w)(1), or revenues 
     obtained through the imposition of beneficiary cost-sharing 
     for medical assistance for non-institutionally-based long-
     term services and supports described in paragraph (5)(B) for 
     the non-federal share of expenditures for medical assistance 
     described in paragraph (4).
       ``(B) Target spending percentages.--
       ``(i) In the case of a balancing incentive payment State in 
     which less than 25 percent of the total expenditures for home 
     and community-based services under the State plan and the 
     various waiver authorities for fiscal year 2009 are for such 
     services, the target spending percentage for the State to 
     achieve by not later than October 1, 2015, is that 25 percent 
     of the total expenditures for home and community-based 
     services under the State plan and the various waiver 
     authorities are for such services.
       ``(ii) In the case of any other balancing incentive payment 
     State, the target spending percentage for the State to 
     achieve by not later than October 1, 2015, is that 50 percent 
     of the total expenditures for home and community-based 
     services under the State plan and the various waiver 
     authorities are for such services.
       ``(C) Maintenance of eligibility requirements.--The State 
     does not apply eligibility standards, methodologies, or 
     procedures for determining eligibility for medical assistance 
     for non-institutionally-based long-term services and supports 
     described in paragraph (5)(B)) that are more restrictive than 
     the eligibility standards, methodologies, or procedures in 
     effect for such purposes on December 31, 2010.
       ``(D) Use of additional funds.--The State agrees to use the 
     additional Federal funds paid to the State as a result of 
     this subsection only for purposes of providing new or 
     expanded offerings of non-institutionally-based long-term 
     services and supports described in paragraph (5)(B) 
     (including expansion through offering such services to 
     increased numbers of beneficiaries of medical assistance 
     under this title).
       ``(E) Structural changes.--The State agrees to make, not 
     later than the end of the 6-month period that begins on the 
     date the State submits and application under this paragraph, 
     such changes to the administration of the State plan (and, if 
     applicable, to waivers approved for the State that involve 
     the provision of long-term care services and supports) as the 
     Secretary determines, by regulation or otherwise, are 
     essential to achieving an improved balance between the 
     provision of non-institutionally-based long-term services and 
     supports described in paragraph (5)(B) and other long-term 
     services and supports, and which shall include the following:
       ``(i) `No wrong door'--single entry point system.--
     Development of a statewide system to enable consumers to 
     access all long-term

[[Page S6562]]

     services and supports through an agency, organization, 
     coordinated network, or portal, in accordance with such 
     standards as the State shall establish and that--

       ``(I) shall require such agency, organization, network, or 
     portal to provide--

       ``(aa) consumers with information regarding the 
     availability of such services, how to apply for such 
     services, and other referral services; and
       ``(bb) information regarding, and make recommendations for, 
     providers of such services; and

       ``(II) may, at State option, permit such agency, 
     organization, network, or portal to--

       ``(aa) determine financial and functional eligibility for 
     such services and supports; and
       ``(bb) provide or refer eligible individuals to services 
     and supports otherwise available in the community (under 
     programs other than the State program under this title), such 
     as housing, job training, and transportation.
       ``(ii) Presumptive eligibility.--At the option of the 
     State, provision of a 60-day period of presumptive 
     eligibility for medical assistance for non-institutionally-
     based long-term services and supports described in paragraph 
     (5)(B) for any individual whom the State has reason to 
     believe will qualify for such medical assistance (provided 
     that any expenditures for such medical assistance during such 
     period are disregarded for purposes of determining the rate 
     of erroneous excess payments for medical assistance under 
     section 1903(u)(1)(D)).
       ``(iii) Case management.--Development, in accordance with 
     guidance from the Secretary, of conflict-free case management 
     services to--

       ``(I) address transitioning from receipt of 
     institutionally-based long-term services and supports 
     described in paragraph (5)(A) to receipt of non-
     institutionally-based long-term services and supports 
     described in paragraph (5)(B); and
       ``(II) in conjunction with the beneficiary, assess the 
     beneficiary's needs and , if appropriate, the needs of family 
     caregivers for the beneficiary, and develop a service plan, 
     arrange for services and supports, support the beneficiary 
     (and, if appropriate, the caregivers) in directing the 
     provision of services and supports, for the beneficiary, and 
     conduct ongoing monitoring to assure that services and 
     supports are delivered to meet the beneficiary's needs and 
     achieve intended outcomes.

       ``(iv) Core standardized assessment instruments.--
     Development of core standardized assessment instruments for 
     determining eligibility for non-institutionally-based long-
     term services and supports described in paragraph (5)(B), 
     which shall be used in a uniform manner throughout the State, 
     to--

       ``(I) assess a beneficiary's eligibility and functional 
     level in terms of relevant areas that may include medical, 
     cognitive, and behavioral status, as well as daily living 
     skills, and vocational and communication skills;
       ``(II) based on the assessment conducted under subclause 
     (I), determine a beneficiary's needs for training, support 
     services, medical care, transportation, and other services, 
     and develop an individual service plan to address such needs;
       ``(III) conduct ongoing monitoring based on the service 
     plan; and
       ``(IV) require reporting of collect data for purposes of 
     comparison among different service models.

       ``(F) Data collection.--Collecting from providers of 
     services and through such other means as the State determines 
     appropriate the following data:
       ``(i) Services data.--Services data from providers of non-
     institutionally-based long-term services and supports 
     described in paragraph (5)(B) on a per-beneficiary basis and 
     in accordance with such standardized coding procedures as the 
     State shall establish in consultation with the Secretary.
       ``(ii) Quality data.--Quality data on a selected set of 
     core quality measures agreed upon by the Secretary and the 
     State that are linked to population-specific outcomes 
     measures and accessible to providers.
       ``(iii) Outcomes measures.--Outcomes measures data on a 
     selected set of core population-specific outcomes measures 
     agreed upon by the Secretary and the State that are 
     accessible to providers and include--

       ``(I) measures of beneficiary and family caregiver 
     experience with providers;
       ``(II) measures of beneficiary and family caregiver 
     satisfaction with services; and
       ``(III) measures for achieving desired outcomes appropriate 
     to a specific beneficiary, including employment, 
     participation in community life, health stability, and 
     prevention of loss in function.

       ``(3) Applicable number of percentage points increase in 
     fmap.--The applicable number of percentage points are--
       ``(A) in the case of a balancing incentive payment State 
     subject to the target spending percentage described in 
     paragraph (2)(B)(i), 5 percentage points; and
       ``(B) in the case of any other balancing incentive payment 
     State, 2 percentage points.
       ``(4) Eligible medical assistance expenditures.--
       ``(A) In general.--Subject to subparagraph (B), medical 
     assistance described in this paragraph is medical assistance 
     for non-institutionally-based long-term services and supports 
     described in paragraph (5)(B) that is provided during the 
     period that begins on October 1, 2011, and ends on September 
     30, 2015.
       ``(B) Limitation on payments.--In no case may the aggregate 
     amount of payments made by the Secretary to balancing 
     incentive payment States under this subsection during the 
     period described in subparagraph (A), or to a State to which 
     paragraph (6) of the first sentence of subsection (b) 
     applies, exceed $3,000,000,000.
       ``(5) Long-term services and supports defined.--In this 
     subsection, the term `long-term services and supports' has 
     the meaning given that term by Secretary and shall include 
     the following:
       ``(A) Institutionally-based long-term services and 
     supports.--Services provided in an institution, including the 
     following:
       ``(i) Nursing facility services.
       ``(ii) Services in an intermediate care facility for the 
     mentally retarded described in subsection (a)(15).
       ``(B) Non-institutionally-based long-term services and 
     supports.--Services not provided in an institution, including 
     the following:
       ``(i) Home and community-based services provided under 
     subsection (c), (d), or (i), of section 1915 or under a 
     waiver under section 1115.
       ``(ii) Home health care services.
       ``(iii) Personal care services.
       ``(iv) Services described in subsection (a)(26) (relating 
     to PACE program services).
       ``(v) Self-directed personal assistance services described 
     in section 1915(j)''.
       (b) Enhanced Fmap for Certain States to Maintain the 
     Provision of Home and Community-Based Services.--The first 
     sentence of section 1905(b) of such Act (42 U.S.C. 1396d 
     (b)), as amended by subsection (a), is amended--
       (1) by striking ``, and (5)'' and inserting ``, (5)''; and
       (2) by inserting before the period the following: ``, and 
     (6) in the case of a State in which at least 50 percent of 
     the total expenditures for medical assistance for fiscal year 
     2009 for long-term services and supports (as defined by the 
     Secretary for purposes of subsection (y)) are for non-
     institutionally-based long-term services and supports 
     described in subsection (y)(5)(B), and which satisfies the 
     requirements of subparagraphs (A) (other than clauses (iii), 
     (v), and (vi)), (C), and (F) of subsection (y)(2), and has 
     implemented the structural changes described in each clause 
     of subparagraph (E) of that subsection, the Federal medical 
     assistance percentage shall be increased by 1 percentage 
     point with respect to medical assistance described in 
     subparagraph (A) of subsection (y)(4) (but subject to the 
     limitation described in subparagraph (B) of that 
     subsection)''.
       (c) Grants to Support Structural Changes.--
       (1) In general.--The Secretary of Health and Human Services 
     shall award grants to States for the following purposes:
       (A) To support the development of common national set of 
     coding methodologies and databases related to the provision 
     of non-institutionally-based long-term services and supports 
     described in paragraph (5)(B) of section 1905(y) of the 
     Social Security Act (as added by subsection (a)).
       (B) To make structural changes described in paragraph 
     (2)(E) of section 1905(y) to the State Medicaid program.
       (2) Priority.--In awarding grants for the purpose described 
     in paragraph (1)(A), the Secretary of Health and Human 
     Services shall give priority to States in which at least 50 
     percent of the total expenditures for medical assistance 
     under the State Medicaid program for fiscal year 2009 for 
     long-term services and supports, as defined by the Secretary 
     for purposes of section 1905(y) of the Social Security Act, 
     are for non-institutionally-based long-term services and 
     supports described in paragraph (5)(B) of such section.
       (3) Collaboration.--States awarded a grant for the purpose 
     described in paragraph (1)(A) shall collaborate with other 
     States, the National Governor's Association, the National 
     Conference of State Legislatures, the National Association of 
     State Medicaid Directors, the National Association of State 
     Directors of Developmental Disabilities, and other 
     appropriate organizations in developing specifications for a 
     common national set of coding methodologies and databases.
       (4) Authorization of appropriations.--There are authorized 
     to be appropriated to carry out this subsection, such sums as 
     may be necessary for each of fiscal years 2010 through 2012.
       (d) Authority for Individualized Budgets Under Waivers to 
     Provide Home and Community-Based Services.--In the case of 
     any waiver to provide home and community-based services under 
     subsection (c) or (d) of section 1915 of the Social Security 
     Act (42 U.S.C. 1396n) or section 1115 of such Act (42 U.S.C. 
     1315), that is approved or renewed after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall permit a State to establish individualized 
     budgets that identify the dollar value of the services and 
     supports to be provided to an individual under the waiver.
       (e) Oversight and Assessment.--
       (1) Development of standardized reporting requirements.--
       (A) Standardization of data and outcome measures.--The 
     Secretary of Health and Human Services shall consult with 
     States and the National Governor's Association, the National 
     Conference of State Legislatures, the National Association of 
     State Medicaid Directors, the National Association of State 
     Directors of Developmental Disabilities, and other 
     appropriate organizations to develop specifications for 
     standardization of--
       (i) reporting of assessment data for long-term services and 
     supports (as defined by the

[[Page S6563]]

     Secretary for purposes of section 1905(y)(5) of the Social 
     Security Act) for each population served, including 
     information standardized for purposes of certified EHR 
     technology (as defined in section 1903(t)(3)(A) of the Social 
     Security Act (42 U.S.C. 1396b(t)(3)(A)) and under other 
     electronic medical records initiatives; and
       (ii) outcomes measures that track assessment processes for 
     long-term services and supports (as so defined) for each such 
     population that maintain and enhance individual function, 
     independence, and stability.
       (2) Administration of home and community services.--The 
     Secretary of Health and Human Services shall promulgate 
     regulations to ensure that all States develop service systems 
     that are designed to--
       (A) allocate resources for services in a manner that is 
     responsive to the changing needs and choices of beneficiaries 
     receiving non-institutionally-based long-term services and 
     supports described in paragraph (5)(B) of section 1905(y) of 
     the Social Security Act (as added by subsection (a)) 
     (including such services and supports that are provided under 
     programs other the State Medicaid program), and that provides 
     strategies for beneficiaries receiving such services to 
     maximize their independence;
       (B) provide the support and coordination needed for a 
     beneficiary in need of such services (and their family 
     caregivers or representative, if applicable) to design an 
     individualized, self-directed, community-supported life; and
       (C) improve coordination among all providers of such 
     services under federally and State-funded programs in order 
     to--
       (i) achieve a more consistent administration of policies 
     and procedures across programs in relation to the provision 
     of such services; and
       (ii) oversee and monitor all service system functions to 
     assure--

       (I) coordination of, and effectiveness of, eligibility 
     determinations and individual assessments; and
       (II) development and service monitoring of a complaint 
     system, a management system, a system to qualify and monitor 
     providers, and systems for role-setting and individual budget 
     determinations.

       (3) Monitoring.--The Secretary of Health and Human Services 
     shall assess on an ongoing basis and based on measures 
     specified by the Agency for Healthcare Research and Quality, 
     the safety and quality of non-institutionally-based long-term 
     services and supports described in paragraph (5)(B) of 
     section 1905(y) of that Act provided to beneficiaries of such 
     services and supports and the outcomes with regard to such 
     beneficiaries' experiences with such services. Such oversight 
     shall include examination of--
       (A) the consistency, or lack thereof, of such services in 
     care plans as compared to those services that were actually 
     delivered; and
       (B) the length of time between when a beneficiary was 
     assessed for such services, when the care plan was completed, 
     and when the beneficiary started receiving such services.
       (4) GAO study and report.--The Comptroller General of the 
     United States shall study the longitudinal costs of Medicaid 
     beneficiaries receiving long-term services and supports (as 
     defined by the Secretary for purposes of section 1905(y)(5) 
     of the Social Security Act) over 5-year periods across 
     various programs, including the non-institutionally-based 
     long-term services and supports described in paragraph (5)(B) 
     of such section, PACE program services under section 1894 of 
     the Social Security Act (42 U.S.C. 1395eee, 1396u-4), and 
     services provided under specialized MA plans for special 
     needs individuals under part C of title XVIII of the Social 
     Security Act.

  TITLE II--STRENGTHENING THE MEDICAID HOME AND COMMUNITY-BASED STATE 
                         PLAN AMENDMENT OPTION

     SEC. 201. REMOVAL OF BARRIERS TO PROVIDING HOME AND 
                   COMMUNITY-BASED SERVICES UNDER STATE PLAN 
                   AMENDMENT OPTION FOR INDIVIDUALS IN NEED.

       (a) Parity With Income Eligibility Standard for 
     Institutionalized Individuals.--Paragraph (1) of section 
     1915(i) of the Social Security Act (42 U.S.C. 1396n(i)) is 
     amended by striking ``150 percent of the poverty line (as 
     defined in section 2110(c)(5))'' and inserting ``300 percent 
     of the supplemental security income benefit rate established 
     by section 1611(b)(1)''.
       (b) Additional State Options.--Section 1915(i) of the 
     Social Security Act (42 U.S.C. 1396n(i)) is amended by adding 
     at the end the following new paragraphs:
       ``(6) State option to provide home and community-based 
     services to individuals eligible for services under a 
     waiver.--
       ``(A) In general.--A State that provides home and 
     community-based services in accordance with this subsection 
     to individuals who satisfy the needs-based criteria for the 
     receipt of such services established under paragraph (1)(A) 
     may, in addition to continuing to provide such services to 
     such individuals, elect to provide home and community-based 
     services in accordance with the requirements of this 
     paragraph to individuals who are eligible for home and 
     community-based services under a waiver approved for the 
     State under subsection (c), (d), or (e) or under section 1115 
     to provide such services, but only for those individuals 
     whose income does not exceed 300 percent of the supplemental 
     security income benefit rate established by section 
     1611(b)(1).
       ``(B) Application of same requirements for individuals 
     satisfying needs-based criteria.--Subject to subparagraph 
     (C), a State shall provide home and community-based services 
     to individuals under this paragraph in the same manner and 
     subject to the same requirements as apply under the other 
     paragraphs of this subsection to the provision of home and 
     community-based services to individuals who satisfy the 
     needs-based criteria established under paragraph (1)(A).
       ``(C) Authority to offer different type, amount, duration, 
     or scope of home and community-based services.--A State may 
     offer home and community-based services to individuals under 
     this paragraph that differ in type, amount, duration, or 
     scope from the home and community-based services offered for 
     individuals who satisfy the needs-based criteria established 
     under paragraph (1)(A), so long as such services are within 
     the scope of services described in paragraph (4)(B) of 
     subsection (c) for which the Secretary has the authority to 
     approve a waiver and do not include room or board.
       ``(7) State option to offer home and community-based 
     services to specific, targeted populations.--
       ``(A) In general.--A State may elect in a State plan 
     amendment under this subsection to target the provision of 
     home and community-based services under this subsection to 
     specific populations and to differ the type, amount, 
     duration, or scope of such services to such specific 
     populations.
       ``(B) 5-year term.--
       ``(i) In general.--An election by a State under this 
     paragraph shall be for a period of 5 years.
       ``(ii) Phase-in of services and eligibility permitted 
     during initial 5-year period.--A State making an election 
     under this paragraph may, during the first 5-year period for 
     which the election is made, phase-in the enrollment of 
     eligible individuals, or the provision of services to such 
     individuals, or both, so long as all eligible individuals in 
     the State for such services are enrolled, and all such 
     services are provided, before the end of the initial 5-year 
     period.
       ``(C) Renewal.--An election by a State under this paragraph 
     may be renewed for additional 5-year terms if the Secretary 
     determines, prior to beginning of each such renewal period, 
     that the State has--
       ``(i) adhered to the requirements of this subsection and 
     paragraph in providing services under such an election; and
       ``(ii) met the State's objectives with respect to quality 
     improvement and beneficiary outcomes.''.
       (c) Removal of Limitation on Scope of Services.--Paragraph 
     (1) of section 1915(i) of the Social Security Act (42 U.S.C. 
     1396n(i)), as amended by subsection (a), is amended by 
     striking ``or such other services requested by the State as 
     the Secretary may approve''.
       (d) Optional Eligibility Category To Provide Full Medicaid 
     Benefits to Individuals Receiving Home and Community-Based 
     Services Under a State Plan Amendment.--
       (1) In general.--Section 1902(a)(10)(A)(ii) of the Social 
     Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
       (A) in subclause (XVIII), by striking ``or'' at the end;
       (B) in subclause (XIX), by adding ``or'' at the end; and
       (C) by inserting after subclause (XIX), the following new 
     subclause:

       ``(XX) who are eligible for home and community-based 
     services under needs-based criteria established under 
     paragraph (1)(A) of section 1915(i), or who are eligible for 
     home and community-based services under paragraph (6) of such 
     section, and who will receive home and community-based 
     services pursuant to a State plan amendment under such 
     subsection;''.

       (2) Conforming amendments.--
       (A) Section 1903(f)(4) of the Social Security Act (42 
     U.S.C. 1396b(f)(4)) is amended in the matter preceding 
     subparagraph (A), by inserting ``1902(a)(10)(A)(ii)(XX),'' 
     after ``1902(a)(10)(A)(ii)(XIX),''.
       (B) 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 new 
     clause:
       ``(xiv) individuals who are eligible for home and 
     community-based services under needs-based criteria 
     established under paragraph (1)(A) of section 1915(i), or who 
     are eligible for home and community-based services under 
     paragraph (6) of such section, and who will receive home and 
     community-based services pursuant to a State plan amendment 
     under such subsection,''.
       (e) Elimination of Option To Limit Number of Eligible 
     Individuals or Length of Period for Grandfathered Individuals 
     if Eligibility Criteria Is Modified.--Paragraph (1) of 
     section 1915(i) of such Act (42 U.S.C. 1396n(i)) is amended--
       (1) by striking subparagraph (C) and inserting the 
     following:
       ``(C) Projection of number of individuals to be provided 
     home and community-based services.--The State submits to the 
     Secretary, in such form and manner, and upon such frequency 
     as the Secretary shall specify, the projected number of 
     individuals to be provided home and community-based 
     services.''; and
       (2) in subclause (II) of subparagraph (D)(ii), by striking 
     ``to be eligible for such services

[[Page S6564]]

     for a period of at least 12 months beginning on the date the 
     individual first received medical assistance for such 
     services'' and inserting ``to continue to be eligible for 
     such services after the effective date of the modification 
     and until such time as the individual no longer meets the 
     standard for receipt of such services under such pre-modified 
     criteria''.
       (f) Elimination of Option To Waive Statewideness; Addition 
     of Option to Waive Comparability.--Paragraph (3) of section 
     1915(i) of such Act (42 U.S.C. 1396n(3)) is amended by 
     striking ``1902(a)(1) (relating to statewideness)'' and 
     inserting ``1902(a)(10)(B) (relating to comparability''.
       (g) Effective Date.--The amendments made by this section 
     take effect on the first day of the first fiscal year quarter 
     that begins after the date of enactment of this Act.

     SEC. 202. MANDATORY APPLICATION OF SPOUSAL IMPOVERISHMENT 
                   PROTECTIONS TO RECIPIENTS OF HOME AND 
                   COMMUNITY-BASED SERVICES.

       (a) In General.--Section 1924(h)(1)(A) of the Social 
     Security Act (42 U.S.C. 1396r-5(h)(1)(A)) is amended by 
     striking ``(at the option of the State) is described in 
     section 1902(a)(10)(A)(ii)(VI)'' and inserting ``is eligible 
     for medical assistance for home and community-based services 
     under subsection (c), (d), (e), or (i) of section 1915''.
       (b) Effective Date.--The amendment made by subsection (a) 
     takes effect on October 1, 2009.

     SEC. 203. STATE AUTHORITY TO ELECT TO EXCLUDE UP TO 6 MONTHS 
                   OF AVERAGE COST OF NURSING FACILITY SERVICES 
                   FROM ASSETS OR RESOURCES FOR PURPOSES OF 
                   ELIGIBILITY FOR HOME AND COMMUNITY-BASED 
                   SERVICES.

       (a) In General.--Section 1917 of the Social Security Act 
     (42 U.S.C. 1396p) is amended by adding at the end the 
     following new subsection:
       ``(i) State Authority To Exclude up to 6 Months of Average 
     Cost of Nursing Facility Services From Home and Community-
     Based Services Eligibility Determinations.--Nothing in this 
     section or any other provision of this title, shall be 
     construed as prohibiting a State from excluding from any 
     determination of an individual's assets or resources for 
     purposes of determining the eligibility of the individual for 
     medical assistance for home and community-based services 
     under subsection (c), (d), (e), or (i) of section 1915 (if a 
     State imposes an limitation on assets or resources for 
     purposes of eligibility for such services), an amount equal 
     to the product of the amount applicable under subsection 
     (c)(1)(E)(ii)(II) (at the time such determination is made) 
     and such number, not to exceed 6, as the State may elect.''.
       (b) Rule of Construction.--Nothing in the amendment made by 
     subsection (a) shall be construed as affecting a State's 
     option to apply less restrictive methodologies under section 
     1902(r)(2) for purposes of determining income and resource 
     eligibility for individuals specified in that section.

      TITLE III--COORDINATION OF HOME AND COMMUNITY-BASED WAIVERS

     SEC. 301. STREAMLINED PROCESS FOR COMBINED WAIVERS UNDER 
                   SUBSECTIONS (B) AND (C) OF SECTION 1915.

       Not later than 90 days after the date of enactment of this 
     Act, the Secretary of Health and Human Services shall create 
     a template to streamline the process of approving, 
     monitoring, evaluating, and renewing State proposals to 
     conduct a program that combines the waiver authority provided 
     under subsections (b) and (c) of section 1915 of the Social 
     Security Act (42 U.S.C. 1396n) into a single program under 
     which the State provides home and community-based services to 
     individuals based on individualized assessments and care 
     plans (in this section referred to as the ``combined waivers 
     program''). The template required under this section shall 
     provide for the following:
       (1) A standard 5-year term for conducting a combined 
     waivers program.
       (2) Harmonization of any requirements under subsections (b) 
     and (c) of such section that overlap.
       (3) An option for States to elect, during the first 5-year 
     term for which the combined waivers program is approved to 
     phase-in the enrollment of eligible individuals, or the 
     provision of services to such individuals, or both, so long 
     as all eligible individuals in the State for such services 
     are enrolled, and all such services are provided, before the 
     end of the initial 5-year period.
       (4) Examination by the Secretary, prior to each renewal of 
     a combined waivers program, of how well the State has--
       (A) adhered to the combined waivers program requirements; 
     and
       (B) performed in meeting the State's objectives for the 
     combined waivers program, including with respect to quality 
     improvement and beneficiary outcomes.
                                 ______
                                 
      By Ms. CANTWELL (for herself and Ms. Stabenow):
  S. 1257. A bill to amend the Social Security Act to build on the 
aging network to establish long-term services and supports through 
single-entry point systems, evidence based disease prevention and 
health promotion programs, and enhanced nursing home diversion 
programs; to the Committee on Finance.
  Ms. CANTWELL. Mr. President, I rise today to introduce Project 2020: 
Building on the Promise of Home and Community-Based Services Act with 
my colleague from Michigan, Senator Stabenow. By the year 2020, almost 
1 in 6 Americans will be over the age of 65 and the population of 
people over the age of 85, the fastest growing segment of the 
population, will double. Our current long term care financing structure 
is unsustainable as the population in need of such services rapidly 
increases. As such, we must turn our focus to reforming the long term 
care system to provide the best care available to this vulnerable 
population.
  The average cost of a nursing home in this country is $70,000 a year, 
making this an unrealistic option for most Americans. In fact, most 
people who end up in a nursing home last just six months before they 
have spent so much they become poor enough to qualify for Medicaid. 
This situation is expensive for consumers, for states, and for the 
federal government. Fortunately, there is a clear answer. It costs 
Medicaid one third as much to provide someone with home and community 
based care as it would cost to care for them in a nursing home. In 
addition, most people want to stay in their own home or community 
whenever possible. An independent analysis conducted by the Lewin Group 
shows that Project 2020 would reach over 40 million Americans, while 
simultaneously reducing Medicare and Medicaid costs by more than $2.8 
billion over 5 years.
  Project 2020 addresses the urgent need to shift away from 
institutional care and towards home and community based services in 
three distinct ways: through enhanced nursing home diversion; by 
increasing the use of person-centered access to information; and by 
utilizing evidence-based disease and injury prevention. As I previously 
mentioned, increased nursing home diversion will not only provide 
significant savings to the Medicaid program, it will also allow 
families to stay together and let people be active members of their 
communities. Through the creation of a person-center access point to 
information, consumers, family members, and caregivers will be given 
the tools necessary to make well informed decisions about long term 
care. Finally, this bill will provide for programs that help consumers 
get proven education about avoiding preventable diseased and injuries, 
such as falls and malnutrition, which result in thousands of 
unnecessary hospitalizations every year.
  As you can see, these three programs constitute a common-sense, 
multifaceted approach to improving the quality of life of individuals 
and their families, while providing a substantial amount of savings to 
the health care system.
  I am pleased to introduce this important legislation along with my 
colleague Senator Stabenow and I look forward to working with the rest 
of my Senate colleagues to provide families with the long term care 
services and support they need.
  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. 1257

       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 ``Project 2020: Building on 
     the Promise of Home and Community-Based Services Act of 
     2009''.

     SEC. 2. LONG-TERM SERVICES AND SUPPORTS.

       The Social Security Act (42 U.S.C. 301 et seq.) is amended 
     by adding at the end the following:

             ``TITLE XXII--LONG-TERM SERVICES AND SUPPORTS

     ``SEC. 2201. DEFINITIONS.

       ``Except as otherwise provided, the terms used in this 
     title have the meanings given the terms in section 102 of the 
     Older Americans Act of 1965 (42 U.S.C. 3002).

            ``Subtitle A--Single-Entry Point System Program

     ``SEC. 2211. STATE SINGLE-ENTRY POINT SYSTEMS.

       ``(a) Definitions.--In this title:
       ``(1) Long-term services and supports.--The term `long-term 
     services and supports' means any service (including a disease 
     prevention and health promotion service, an in-home service, 
     or a case management service), care, or item (including an 
     assistive device) that is--
       ``(A) intended to assist individuals in coping with, and, 
     to the extent practicable, compensating for, functional 
     impairment in carrying out activities of daily living;

[[Page S6565]]

       ``(B) furnished at home, in a community care setting, 
     including a small community care setting (as defined in 
     section 1929(g)(1)) and a large community care setting (as 
     defined in section 1929(h)(1)), or in a long-term care 
     facility; and
       ``(C) not furnished to diagnose, treat, or cure a medical 
     disease or condition.
       ``(2) Single-entry point system.--The term `single-entry 
     point system' means any coordinated system for providing--
       ``(A) comprehensive information to consumers and caregivers 
     on the full range of available public and private long-term 
     services and supports, options, service providers, and 
     resources, including information on the availability of 
     integrated long-term care, including consumer directed care 
     options;
       ``(B) personal counseling to assist individuals in 
     assessing their existing or anticipated long-term care needs, 
     and developing and implementing a plan for long-term care 
     designed to meet their specific needs and circumstances; and
       ``(C) consumers and caregivers access to the range of 
     publicly supported and privately supported long-term services 
     and supports that are available.
       ``(b) Program.--The Secretary shall establish and carry out 
     a single-entry point system program. In carrying out the 
     program, the Secretary shall make grants to States, from 
     allotments described in subsection (c), to pay for the 
     Federal share of the cost of establishing State single-entry 
     point systems.
       ``(c) Allotments.--
       ``(1) Allotments to indian tribes and territories.--
       ``(A) Reservation.--The Secretary shall reserve from the 
     funds made available under subsection (g)--
       ``(i) for fiscal year 2010, $1,962,456; and
       ``(ii) for each subsequent fiscal year, $1,962,456, 
     increased by the percentage increase in the Consumer Price 
     Index for All Urban Consumers, between October of the fiscal 
     year preceding the subsequent fiscal year and October, 2007.
       ``(B) Allotments.--The Secretary shall use the funds 
     reserved under subparagraph (A) to make allotments to--
       ``(i) Indian tribes; and
       ``(ii) Guam, American Samoa, the Commonwealth of the 
     Northern Mariana Islands, the Commonwealth of Puerto Rico, 
     and the United States Virgin Islands.
       ``(2) Allotments to states.--
       ``(A) In general.--
       ``(i) Amount.--The Secretary shall allot to each eligible 
     State for a fiscal year the sum of the fixed amount 
     determined under subparagraph (B), and the allocation 
     determined under subparagraph (C), for the State.
       ``(ii) Subgrants to area agencies on aging.--

       ``(I) In general.--Each State agency receiving an allotment 
     under clause (i) shall use such allotment to make subgrants 
     to area agencies on aging that can demonstrate performance 
     capacity to carry out activities described in this section 
     whether such area agency on aging carries out the activities 
     directly or through contract with an aging network or 
     disability entity. An area agency on agency desiring a 
     subgrant shall establish or designate a collaborative board 
     to ensure meaningful involvement of stakeholders in the 
     development, planning, implementation, and evaluation of a 
     single-entry point system consistent with the following:

       ``(aa) The collaborative board shall be composed of--
       ``(AA) individuals representing all populations served by 
     the agency's single-entry point system, including older 
     adults and individuals from diverse backgrounds who have a 
     disability or a chronic condition requiring long-term 
     support;
       ``(BB) a representative from the local center for 
     independent living (as defined in section 702 of the 
     Rehabilitation Act of 1973 (29 U.S.C. 796a)), and 
     representatives from other organizations that provide 
     services to the individuals served by the system and those 
     who advocate on behalf of such individuals; and
       ``(CC) representatives of the government and non-
     governmental agencies that are affected by the system.
       ``(bb) The agency shall work in conjunction with the 
     collaborative board on--
       ``(AA) the design and operations of the single-entry point 
     system;
       ``(BB) stakeholder input; and
       ``(CC) other program and policy development issues related 
     to the single-entry point system.
       ``(cc) An advisory board established under the Real Choice 
     Systems Change Program or for an existing single-entry point 
     system may be used to carry out the activities of a 
     collaborative board under this subclause if such advisory 
     board meets the requirements under item (aa).

       ``(II) Subgrants to other entities.--A State agency may 
     make subgrants described in subclause (I) to other qualified 
     aging network or disability entities only if the area agency 
     on aging chooses not to apply for a subgrant or is not able 
     to demonstrate performance capacity to carry out the 
     activities described in this section.
       ``(III) Subgrantee recipient subgrants.--An administrator 
     of a single-entry point system established by a State 
     receiving an allotment under clause (i) shall make any 
     necessary subgrants to key partners involved in developing, 
     planning, or implementing the single-entry point system. Such 
     partners may include centers for independent living (as 
     defined in section 702 of the Rehabilitation Act of 1973 (29 
     U.S.C. 796a)).

       ``(B) Fixed amounts for states.--
       ``(i) Reservation.--The Secretary shall reserve from the 
     funds made available under subsection (g)--

       ``(I) for fiscal year 2010, $15,759,000; and
       ``(II) for each subsequent fiscal year, $15,759,000, 
     increased by the percentage increase in the Consumer Price 
     Index for All Urban Consumers, between October of the fiscal 
     year preceding the subsequent fiscal year and October, 2007.

       ``(ii) Fixed amounts.--The Secretary shall use the funds 
     reserved under clause (i) to provide equal fixed amounts to 
     the States.
       ``(C) Allocation for states.--The Secretary shall allocate 
     to each eligible State for a fiscal year an amount that bears 
     the same relationship to the funds made available under 
     subsection (g) (and not reserved under paragraph (1) or 
     subparagraph (B)) for that fiscal year as the number of 
     persons who are either older individuals or individuals with 
     disabilities in that State bears to the number of such 
     persons or individuals in all the States.
       ``(D) Determination of number of persons.--
       ``(i) Older individuals.--The number of older individuals 
     in any State and in all States shall be determined by the 
     Secretary on the basis of the most recent data available from 
     the Bureau of the Census, and other reliable demographic data 
     satisfactory to the Secretary.
       ``(ii) Individuals with disabilities.--The number of 
     individuals with disabilities in any State and in all States 
     shall be determined by the Secretary on the basis of the most 
     recent data available from the American Community Survey, and 
     other reliable demographic data satisfactory to the 
     Secretary, on individuals who have a sensory disability, 
     physical disability, mental disability, self-care disability, 
     go-outside-home disability, or employment disability.
       ``(3) Eligibility.--In addition to the States determined by 
     the Secretary to be eligible for a grant under this section, 
     a State that receives a Federal grant for an aging and 
     disability resource center is eligible for a grant under this 
     section.
       ``(4) Definition.--In this subsection, the term `State' 
     shall not include any jurisdiction described in paragraph 
     (1)(B)(ii).
       ``(d) Applications.--
       ``(1) In general.--To be eligible to receive an initial 
     grant under this section, a State agency shall, after 
     consulting and coordinating with consumers, other 
     stakeholders, centers for independent living in the State, if 
     any, and area agencies on aging in the State, if any, submit 
     an application to the Secretary at such time, in such manner, 
     and containing the following information:
       ``(A) Evidence of substantial involvement of stakeholders 
     and agencies in the State that are administering programs 
     that will be the subject of referrals.
       ``(B) The applicant's plan for providing--
       ``(i) comprehensive information on the full range of 
     available public and private long-term services and supports 
     options, providers, and resources, including building 
     awareness of the single-entry point system as a resource;
       ``(ii) objective, neutral, and personal information, 
     counseling, and assistance to individuals and their 
     caregivers in assessing their existing or anticipated long-
     term care needs, and developing and implementing a plan for 
     long-term care to meet their needs;
       ``(iii) for eligibility screening and referral for 
     services;
       ``(iv) for stakeholder input;
       ``(v) for a management information system; and
       ``(vi) for an evaluation of the effectiveness of the 
     single-entry point system.
       ``(C) A specification of the period of the grant request, 
     which shall include not less than 3 consecutive fiscal years 
     in the 5-fiscal-year-period beginning with fiscal year 2010.
       ``(D) Such other information as the Secretary determines 
     appropriate.
       ``(2) Application for continuation.--
       ``(A) In general.--A State that receives an initial grant 
     under this section shall apply, after consulting and 
     coordinating with the area agencies on aging, for a 
     continuation of the initial grant, which includes a 
     description of any significant changes to the information 
     provided in the initial application and such data concerning 
     performance measures related to the requirements in the 
     initial application as the Secretary shall require.
       ``(B) Effect.--The requirement under subparagraph (A) shall 
     be in effect through fiscal year 2020.
       ``(e) Use of Funds.--
       ``(1) In general.--A State that receives a grant under this 
     section shall use the funds made available through the grant 
     to--
       ``(A) establish a State single-entry point system, to 
     enable older individuals and individuals with disabilities 
     and their caregivers to obtain resources concerning long-term 
     services and supports options; and
       ``(B) provide information on, access to, and assistance 
     regarding long-term services and supports.
       ``(2) Services.--In particular, the State single-entry 
     point system shall be the referral source to--
       ``(A) provide information about long-term care planning and 
     available long-term services and supports through a variety 
     of media (such as websites, seminars, and pamphlets);
       ``(B) provide assistance with making decisions about long-
     term services and supports

[[Page S6566]]

     and determining the most appropriate services through options 
     counseling, future financial planning, and case management;
       ``(C) provide streamlined access to and assistance with 
     applying for federally funded long-term care benefits 
     (including medical assistance under title XIX, Medicare 
     skilled nursing facility services, services under title III 
     of the Older Americans Act of 1965 (42 U.S.C. 3021 et seq.), 
     the services of Aging and Disability Resource Centers), and 
     State-funded and privately funded long-term care benefits, 
     through efforts to shorten and simplify the eligibility 
     processes for older individuals and individuals with 
     disabilities;
       ``(D) provide referrals to the State evidence-based disease 
     prevention and health promotion programs under subtitle B;
       ``(E) allocate the State funds available under subtitle C 
     and carry out the State enhanced nursing home diversion 
     program under subtitle C; and
       ``(F) and provide information about, other services 
     available in the State that may assist an individual to 
     remain in the community, including the Medicare and Medicaid 
     programs, the State health insurance assistance program, the 
     supplemental nutrition assistance program established under 
     the Food and Nutrition Act of 2008 (7 U.S.C. 2011 et seq.), 
     and the Low-Income Home Energy Assistance Program under the 
     Low-Income Home Energy Assistance Act of 1981 (42 U.S.C. 8621 
     et seq.), and such other services, as the State shall 
     include.
       ``(3) Collaborative arrangements.--
       ``(A) Center for independent living.--Each entity receiving 
     an allotment under subsection (c) shall involve in the 
     planning and implementation of the single-entry point system 
     the local center for independent living (as defined in 
     section 702 of the Rehabilitation Act of 1973 (29 U.S.C. 
     796a)), which provides information, referral, assistance, or 
     services to individuals with disabilities.
       ``(B) Other entities.--To the extent practicable, the State 
     single-entry point system shall enter into collaborative 
     arrangements with aging and disability programs, service 
     providers, agencies, the direct care work force, and other 
     entities in order to ensure that information about such 
     services may be made available to individuals accessing the 
     State single-entry point system.
       ``(f) Federal Share.--
       ``(1) In general.--The Federal share of the cost described 
     in subsection (b) shall be 75 percent.
       ``(2) Non-federal share.--The State may provide the non-
     Federal share of the cost in cash or in-kind, fairly 
     evaluated, including plant, equipment, or services. The State 
     may provide the non-Federal share from State, local, or 
     private sources.
       ``(g) Funding.--
       ``(1) In general.--The Secretary shall use amounts made 
     available under paragraph (2) to make the grants described in 
     subsection (b).
       ``(2) Funding.--There are authorized to be appropriated to 
     carry out this section--
       ``(A) $30,900,000 for fiscal year 2010;
       ``(B) $38,264,000 for fiscal year 2011;
       ``(C) $48,410,000 for fiscal year 2012;
       ``(D) $53,560,000 for fiscal year 2013;
       ``(E) $63,860,000 for fiscal year 2014;
       ``(F) $69,010,000 for fiscal year 2015;
       ``(G) $74,160,000 for fiscal year 2016;
       ``(H) $79,310,000 for fiscal year 2017;
       ``(I) $84,460,000 for fiscal year 2018;
       ``(J) $89,610,000 for fiscal year 2019; and
       ``(K) $95,790,000 for fiscal year 2020.
       ``(3) Availability.--Funds appropriated under paragraph (2) 
     shall remain available until expended.

                  ``Subtitle B--Healthy Living Program

     ``SEC. 2221. EVIDENCE-BASED DISEASE PREVENTION AND HEALTH 
                   PROMOTION PROGRAMS.

       ``(a) Program.--The Secretary shall establish and carry out 
     a healthy living program. In carrying out the program, the 
     Secretary shall make grants to State agencies, from 
     allotments described in subsection (b), to pay for the 
     Federal share of the cost of carrying out evidence-based 
     disease prevention and health promotion programs.
       ``(b) Allotments.--
       ``(1) Allotments to indian tribes and territories.--
       ``(A) Reservation.--The Secretary shall reserve from the 
     funds made available under subsection (g)--
       ``(i) for fiscal year 2010, $1,500,952; and
       ``(ii) for each subsequent fiscal year, $1,500,952, 
     increased by the percentage increase in the Consumer Price 
     Index for All Urban Consumers, between October of the fiscal 
     year preceding the subsequent fiscal year and October, 2007.
       ``(B) Allotments.--The Secretary shall use the reserved 
     funds under subparagraph (A) to make allotments to--
       ``(i) Indian tribes; and
       ``(ii) Guam, American Samoa, the Commonwealth of the 
     Northern Mariana Islands, the Commonwealth of Puerto Rico, 
     and the United States Virgin Islands.
       ``(2) In general.--
       ``(A) Amounts.--
       ``(i) In general.--Except as provided in paragraph (3), the 
     Secretary shall allot to each eligible State for a fiscal 
     year an amount that bears the same relationship to the funds 
     made available under this section and not reserved under 
     paragraph (1) for that fiscal year as the number of older 
     individuals in the State bears to the number of older 
     individuals in all the States.
       ``(ii) Older individuals.--The number of older individuals 
     in any State and in all States shall be determined by the 
     Secretary on the basis of the most recent data available from 
     the Bureau of the Census, and other reliable demographic data 
     satisfactory to the Secretary.
       ``(B) Subgrants.--
       ``(i) In general.--Each State agency that receives an 
     amount under subparagraph (A) shall award subgrants to area 
     agencies on aging that can demonstrate performance capacity 
     to carry out activities under this section whether such area 
     agency on aging carries out the activities directly or 
     through contract with an aging network entity.
       ``(ii) Subgrants to other entities.--A State agency may 
     make subgrants described in clause (i) to other qualified 
     aging network entities only if the area agency on aging 
     chooses not to apply for a subgrant or is not able to 
     demonstrate performance capacity to carry out the activities 
     described in this section.
       ``(3) Minimum allotment.--No State shall receive an 
     allotment under this section for a fiscal year that is less 
     than 0.5 percent of the funds made available to carry out 
     this section for that fiscal year and not reserved under 
     paragraph (1).
       ``(4) Eligibility.--In addition to the States determined by 
     the Secretary to be eligible for a grant under this section, 
     a State that receives a Federal grant for evidence-based 
     disease prevention is eligible for a grant under this 
     section.
       ``(c) Applications.--To be eligible to receive a grant 
     under this section, a State agency shall, after consulting 
     and coordinating with consumers, other stakeholders, and area 
     agencies on aging in the State, if any, submit an application 
     to the Secretary at such time, in such manner, and containing 
     the following information:
       ``(1) A description of the evidence-based disease 
     prevention and health promotion program.
       ``(2) Sufficient information to demonstrate that the 
     infrastructure exists to support the program.
       ``(3) A specification of the period of the grant request, 
     which shall include not less than 3 consecutive fiscal years 
     in the 5 fiscal year period beginning with fiscal year 2010.
       ``(4) Such other information as the Secretary determines 
     appropriate.
       ``(d) Application for Continuation.--
       ``(1) In general.--A State that receives an initial grant 
     under this section shall apply, after consulting and 
     coordinating with the area agencies on aging, for a 
     continuation of the initial grant, which application shall 
     include--
       ``(A) a description of any significant changes to the 
     information provided in the initial application; and
       ``(B) such data concerning performance measures related to 
     the requirements in the initial application as the Secretary 
     shall require.
       ``(2) Effect.--The requirement under paragraph (1) shall be 
     in effect through fiscal year 2020.
       ``(e) Use of Funds.--A State that receives a grant under 
     this section shall use the funds made available through the 
     grant to carry out--
       ``(1) an evidence-based chronic disease self-management 
     program;
       ``(2) an evidence-based falls prevention program; or
       ``(3) another evidence-based disease prevention and health 
     promotion program.
       ``(f) Federal Share.--
       ``(1) In general.--The Federal share of the cost described 
     in subsection (a) shall be 85 percent.
       ``(2) Non-federal share.--The State may provide the non-
     Federal share of the cost in cash or in-kind, fairly 
     evaluated, including plant, equipment, or services. The State 
     may provide the non-Federal share from State, local, or 
     private sources.
       ``(g) Funding.--
       ``(1) In general.--The Secretary shall use amounts made 
     available under paragraph (2) to make the grants described in 
     subsection (a).
       ``(2) Funding.--There are authorized to be appropriated to 
     carry out this section--
       ``(A) $36,050,000 for fiscal year 2010;
       ``(B) $41,200,000 for fiscal year 2011;
       ``(C) $56,650,000 for fiscal year 2012;
       ``(D) $77,250,000 for fiscal year 2013;
       ``(E) $92,700,000 for fiscal year 2014;
       ``(F) $103,000,000 for fiscal year 2015;
       ``(G) $118,450,000 for fiscal year 2016;
       ``(H) $133,900,000 for fiscal year 2017;
       ``(I) $149,350,000 for fiscal year 2018;
       ``(J) $157,590,000 for fiscal year 2019; and
       ``(K) $173,040,000 for fiscal year 2020.
       ``(3) Availability.--Funds appropriated under paragraph (2) 
     shall remain available until expended.

                    ``Subtitle C--Diversion Programs

     ``SEC. 2231. ENHANCED NURSING HOME DIVERSION PROGRAMS.

       ``(a) Definition.--In this section:
       ``(1) Low-income senior.--The term `low-income senior' 
     means an individual who--
       ``(A) is age 75 or older; and
       ``(B) is from a household with a household income that is 
     not less than 150 percent, and not more than 300 percent, of 
     the poverty line.
       ``(2) Nursing home.--The term `nursing home' means--
       ``(A) a skilled nursing facility, as defined in section 
     1819(a); or
       ``(B) a nursing facility, as defined in section 1919(a).

[[Page S6567]]

       ``(b) Program.--
       ``(1) In general.--The Secretary shall establish and carry 
     out a diversion program. In carrying out the program, the 
     Secretary shall make grants to States, from allotments 
     described in subsection (c), to pay for the Federal share of 
     the cost of carrying out enhanced nursing home diversion 
     programs.
       ``(2) Cohorts.--The Secretary shall make the grants to--
       ``(A) a first year cohort consisting of one third of the 
     States, for fiscal year 2010;
       ``(B) a second year cohort consisting of the cohort 
     described in subparagraph (A) and an additional one third of 
     the States, for fiscal year 2011; and
       ``(C) a third year cohort consisting of all the eligible 
     States, for fiscal year 2012 and each subsequent fiscal year.
       ``(3) Readiness.--In determining whether to include an 
     eligible State in the first year, second year, or third year 
     and subsequent year cohort, the Secretary shall consider the 
     readiness of the State to carry out an enhanced nursing home 
     diversion program under this section. Readiness shall be 
     determined based on a consideration of the following factors:
       ``(A) Availability of a comprehensive array of home- and 
     community-based services.
       ``(B) Sufficient home- and community-based services 
     provider capacity.
       ``(C) Availability of housing.
       ``(D) Availability of supports for consumer-directed 
     services, including whether a fiscal intermediary is in 
     place.
       ``(E) Ability to perform timely eligibility determinations 
     and assessment for services.
       ``(F) Existence of a quality assessment and improvement 
     program for home and community-based services.
       ``(G) Such other factors as the Secretary determines 
     appropriate.
       ``(c) Allotments.--
       ``(1) In general.--
       ``(A) Amount.--The Secretary shall allot to an eligible 
     State (within the applicable cohort) for a fiscal year an 
     amount that bears the same relationship to the funds made 
     available under subsection (i) for that fiscal year as the 
     number of low-income seniors in the State bears to the number 
     of low-income seniors within States in the applicable cohort 
     for that fiscal year.
       ``(B) Low-income seniors.--The number of low-income seniors 
     in any State and in all States shall be determined by the 
     Secretary on the basis of the most recent data available from 
     the American Community Survey, and other reliable demographic 
     data satisfactory to the Secretary.
       ``(2) Eligibility.--In addition to the States determined by 
     the Secretary to be eligible for a grant under this section, 
     a State that receives a Federal grant for a nursing home 
     diversion is eligible for a grant under this section.
       ``(d) Applications.--To be eligible to receive a grant 
     under this section, a State agency shall, after consulting 
     and coordinating with consumers, other stakeholders, and area 
     agencies on aging in the State, if any, submit an application 
     to the Secretary at such time, in such manner, and containing 
     such information as the Secretary may require, including a 
     specification of the period of the grant request, which shall 
     include not less than 3 consecutive fiscal years in the 5 
     fiscal year period beginning with the fiscal year prior to 
     the year of application.
       ``(e) Application for Continuation.--
       ``(1) In general.--A State that receives an initial grant 
     under this section shall apply, after consulting and 
     coordinating with the area agencies on aging, for a 
     continuation of the initial grant, which application shall 
     include--
       ``(A) a description of any significant changes to the 
     information provided in the initial application; and
       ``(B) such data concerning performance measures related to 
     the requirements in the initial application as the Secretary 
     shall require.
       ``(2) Effect.--The requirement under paragraph (1) shall be 
     in effect through fiscal year 2020.
       ``(f) Use of Funds.--
       ``(1) In general.--A State that receives a grant under this 
     section shall carry out the following:
       ``(A) Use the funds made available through the grant to 
     carry out an enhanced nursing home diversion program that 
     enables eligible individuals to avoid admission into nursing 
     homes by enabling the individuals to obtain alternative long-
     term services and supports and remain in their communities.
       ``(B) Award subgrants to area agencies on aging that can 
     demonstrate performance capacity to carry out activities 
     under this section whether such area agency on aging carries 
     out the activities directly or through contract with an aging 
     network entity. A State may make subgrants to other qualified 
     aging network entities only if the area agency on aging 
     chooses not to apply for a subgrant or is not able to 
     demonstrate performance capacity to carry out the activities 
     described in this section.
       ``(2) Case management.--
       ``(A) In general.--The State, through the State single-
     entry point system established under subtitle A, shall 
     provide for case management services to the eligible 
     individuals.
       ``(B) Use of existing services.--In carrying out 
     subparagraph (A), the State agency or area agency on aging 
     may utilize existing case management services delivery 
     networks if--
       ``(i) the networks have adequate safeguards against 
     potential conflicts of interest; and
       ``(ii) the State agency or area agency on aging includes a 
     description of such safeguards in the grant application.
       ``(C) Care plan.--The State shall provide for development 
     of a care plan for each eligible individual served, in 
     consultation with the eligible individual and their 
     caregiver, as appropriate. In developing the care plan, the 
     State shall explain the option of consumer directed care and 
     assist an individual, who so requests, with developing a 
     consumer-directed care plan that shall include arranging for 
     support services and funding. Such assistance shall include 
     providing information and outreach to individuals in the 
     hospital, in a nursing home for post-acute care, or 
     undergoing changes in their health status or caregiver 
     situation.
       ``(g) Eligible Individuals.--In this section, the term 
     `eligible individual' means an individual--
       ``(1) who has been determined by the State to be at high 
     functional risk of nursing home placement, as defined by the 
     State agency in the State agency's grant application;
       ``(2) who is not eligible for medical assistance under 
     title XIX; and
       ``(3) who meets the income and asset eligibility 
     requirements established by the State and included in such 
     State's grant application for approval by the Secretary.
       ``(h) Federal Share.--
       ``(1) In general.--The Federal share of the cost described 
     in subsection (b) shall be, for a State and for a fiscal 
     year, the sum of--
       ``(A) the Federal medical assistance percentage applicable 
     to the State for the year under section 1905(b); and
       ``(B) 5 percentage points.
       ``(2) Non-federal share.--The State may provide the non-
     Federal share of the cost in cash or in-kind, fairly 
     evaluated, including plant, equipment, or services. The State 
     may provide the non-Federal share from State, local, or 
     private sources.
       ``(i) Funding.--
       ``(1) In general.--The Secretary shall use amounts made 
     available under paragraph (2) to make the grants described in 
     subsection (b).
       ``(2) Funding.--There are authorized to be appropriated to 
     carry out this section--
       ``(A) $111,825,137 for fiscal year 2010;
       ``(B) $337,525,753 for fiscal year 2011;
       ``(C) $650,098,349 for fiscal year 2012;
       ``(D) $865,801,631 for fiscal year 2013;
       ``(E) $988,504,887 for fiscal year 2014;
       ``(F) $1,124,547,250 for fiscal year 2015;
       ``(G) $1,276,750,865 for fiscal year 2016;
       ``(H) $1,364,488,901 for fiscal year 2017;
       ``(I) $1,466,769,052 for fiscal year 2018;
       ``(J) $1,712,755,702 for fiscal year 2019; and
       ``(K) $1,712,755,702 for fiscal year 2020.
       ``(3) Availability.--Funds appropriated under paragraph (2) 
     shall remain available until expended.

   ``Subtitle D--Administration, Evaluation, and Technical Assistance

     ``SEC. 2241. ADMINISTRATION, EVALUATION, AND TECHNICAL 
                   ASSISTANCE.

       ``(a) Administration and Expenses.--For purposes of 
     carrying out this title, there are authorized to be 
     appropriated for administration and expenses--
       ``(1) of the area agencies on aging--
       ``(A) $16,825,895 for fiscal year 2010;
       ``(B) $39,246,141 for fiscal year 2011;
       ``(C) $50,766,948 for fiscal year 2012;
       ``(D) $66,999,101 for fiscal year 2013;
       ``(E) $76,979,152 for fiscal year 2014;
       ``(F) $87,163,513 for fiscal year 2015;
       ``(G) $98,780,562 for fiscal year 2016;
       ``(H) $106,063,792 for fiscal year 2017;
       ``(I) $114,324,642 for fiscal year 2018;
       ``(J) $123,312,948 for fiscal year 2019; and
       ``(K) $133,215,845 for fiscal year 2020;
       ``(2) of the State agencies--
       ``(A) $8,412,948 for fiscal year 2010;
       ``(B) $19,623,071 for fiscal year 2011;
       ``(C) $25,383,474 for fiscal year 2012;
       ``(D) $33,499,551 for fiscal year 2013;
       ``(E) $38,489,576 for fiscal year 2014;
       ``(F) $43,581,756 for fiscal year 2015;
       ``(G) $49,390,281 for fiscal year 2016;
       ``(H) $53,031,896 for fiscal year 2017;
       ``(I) $57,162,321 for fiscal year 2018;
       ``(J) $61,656,474 for fiscal year 2019; and
       ``(K) $66,607,923 for fiscal year 2020; and
       ``(3) of the Administration--
       ``(A) $2,103,237 for fiscal year 2010;
       ``(B) $4,905,768 for fiscal year 2011;
       ``(C) $6,345,868 for fiscal year 2012;
       ``(D) $8,374,888 for fiscal year 2013;
       ``(E) $9,622,394 for fiscal year 2014;
       ``(F) $10,895,439 for fiscal year 2015;
       ``(G) $12,347,570 for fiscal year 2016;
       ``(H) $13,257,974 for fiscal year 2017;
       ``(I) $14,290,580 for fiscal year 2018;
       ``(J) $15,414,118 for fiscal year 2019; and
       ``(K) $16,651,981 for fiscal year 2020.
       ``(b) Evaluation and Technical Assistance.--
       ``(1) Conditions to receipt of grant.--In awarding grants 
     under this title, the Secretary shall condition receipt of 
     the grant for the second and subsequent grant years on a 
     satisfactory determination that the State agency is meeting 
     benchmarks specified in the grant agreement for each grant 
     awarded under this title.
       ``(2) Evaluations.--The Secretary shall measure and 
     evaluate, either directly or through grants or contracts, the 
     impact of the programs authorized under this title. Not later 
     than June 1 of the year that is 6 years after the year of the 
     date of enactment of the Project 2020: Building on the 
     Promise of Home and Community-Based Services Act of 2009 and 
     every 2 years thereafter, the Secretary shall--

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       ``(A) compile the reports of the measures and evaluations 
     of the grantees;
       ``(B) establish benchmarks to show progress toward savings; 
     and
       ``(C) present a compilation of the information under this 
     paragraph to Congress.
       ``(3) Technical assistance grants.--The Secretary shall 
     award technical assistance grants, including State specific 
     grants whenever practicable, to carry out the programs 
     authorized under this title.
       ``(4) Transfer.--There are authorized to be appropriated 
     for such evaluation and technical assistance under this 
     subsection--
       ``(A) $4,206,474 for fiscal year 2010;
       ``(B) $9,811,535 for fiscal year 2011;
       ``(C) $8,461,158 for fiscal year 2012;
       ``(D) $11,166,517 for fiscal year 2013;
       ``(E) $12,829,859 for fiscal year 2014;
       ``(F) $14,527,252 for fiscal year 2015;
       ``(G) $16,463,427 for fiscal year 2016;
       ``(H) $17,677,299 for fiscal year 2017;
       ``(I) $19,054,107 for fiscal year 2018;
       ``(J) $20,552,158 for fiscal year 2019; and
       ``(K) $22,202,641 for fiscal year 2020.
       ``(c) Availability.--Funds appropriated under this section 
     shall remain available until expended.''.

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