[Congressional Record Volume 156, Number 132 (Tuesday, September 28, 2010)]
[Senate]
[Pages S7650-S7653]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STEM CELL THERAPEUTIC AND RESEARCH REAUTHORIZATION ACT OF 2010
Mr. FRANKEN. Mr. President, I ask unanimous consent that the Senate
proceed to the immediate consideration of Calendar No. 587, S. 3751.
The PRESIDING OFFICER. The clerk will report the bill by title.
The assistant legislative clerk read as follows:
A bill (S. 3751) to amend the Stem Cell Therapeutic and
Research Act of 2005.
There being no objection, the Senate proceeded to consider the bill,
which had been reported from the Committee on Health, Education, Labor,
and Pensions, with an amendment in the nature of a substitute to strike
all after the enacting clause and insert in lieu thereof the following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Stem Cell Therapeutic and
Research Reauthorization Act of 2010''.
SEC. 2. AMENDMENTS TO THE STEM CELL THERAPEUTIC AND RESEARCH
ACT OF 2005.
(a) Cord Blood Inventory.--Section 2 of the Stem Cell
Therapeutic and Research Act of 2005 (42 U.S.C. 274k note) is
amended--
(1) in subsection (a), by inserting ``the inventory goal of
at least'' before ``150,000'';
(2) in subsection (c)--
(A) in paragraph (2), by striking ``or is transferred'' and
all that follows through the period and inserting ``for a
first-degree relative.''; and
(B) in paragraph (3), by striking ``150,000'';
(3) in subsection (d)--
(A) in paragraph (1), by inserting ``beginning on the last
date on which the recipient of a contract under this section
receives Federal funds under this section'' after ``10
years'';
(B) in paragraph (2), by striking ``; and'' and inserting
``;'';
(C) by redesignating paragraph (3) as paragraph (5); and
(D) by inserting after paragraph (2) the following:
``(3) will provide a plan to increase cord blood unit
collections at collection sites that exist at the time of
application, assist with the establishment of new collection
sites, or contract with new collection sites;
``(4) will annually provide to the Secretary a plan for,
and demonstrate, ongoing measurable progress toward achieving
self-sufficiency of cord blood unit collection and banking
operations; and'';
(4) in subsection (e)--
(A) in paragraph (1)--
(i) by striking ``10 years'' and inserting ``a period of at
least 10 years beginning on the last date on which the
recipient of a contract under this section receives Federal
funds under this section''; and
(ii) by striking the second sentence and inserting ``The
Secretary shall ensure that no Federal funds shall be
obligated under any such contract after the date that is 5
years after the date on which the contract is entered into,
except as provided in paragraphs (2) and (3).'';
(B) in paragraph (2)--
(i) in the matter preceding subparagraph (A)--
(I) by striking ``Subject to paragraph (1)(B), the'' and
inserting ``The''; and
(II) by striking ``3'' and inserting ``5'';
(ii) in subparagraph (A) by striking ``150,000'' and all
that follows through ``and'' at the end and inserting ``the
inventory goal described in subsection (a) has not yet been
met;'';
(iii) in subparagraph (B)--
(I) by inserting ``meeting the requirements under
subsection (d)'' after ``receive an application for a
contract under this section''; and
(II) by striking ``or the Secretary'' and all that follows
through the period at the end and inserting ``; or''; and
(iv) by adding at the end the following:
``(C) the Secretary determines that the outstanding
inventory need cannot be met by the qualified cord blood
banks under contract under this section.''; and
(C) by striking paragraph (3) and inserting the following:
``(3) Extension eligibility.--A qualified cord blood bank
shall be eligible for a 5-year extension of a contract
awarded under this section, as described in paragraph (2),
provided that the qualified cord blood bank--
``(A) demonstrates a superior ability to satisfy the
requirements described in subsection (b) and achieves the
overall goals for which the contract was awarded;
``(B) provides a plan for how the qualified cord blood bank
will increase cord blood unit collections at collection sites
that exist at the time of consideration for such extension of
a contract, assist with the establishment of new collection
sites, or contract with new collection sites; and
``(C) annually provides to the Secretary a plan for, and
demonstrates, ongoing measurable progress toward achieving
self-sufficiency of cord blood unit collection and banking
operations.'';
(5) in subsection (g)(4), by striking ``or parent''; and
(6) in subsection (h)--
(A) by striking paragraphs (1) and (2) and inserting the
following:
``(1) Authorization of appropriations.--There are
authorized to be appropriated to the Secretary to carry out
the program under this section $23,000,000 for each of fiscal
years 2011 through 2014 and $20,000,000 for fiscal year
2015.'';
(B) by redesignating paragraph (3) as paragraph (2); and
(C) in paragraph (2), as so redesignated, by striking ``in
each of fiscal years 2007 through 2009'' and inserting ``for
each of fiscal years 2011 through 2015''.
(b) National Program.--Section 379 of the Public Health
Service Act (42 U.S.C. 274k) is amended--
(1) by striking subsection (a)(6) and inserting the
following:
``(6) The Secretary, acting through the Administrator of
the Health Resources and Services Administration, shall
submit to Congress an annual report on the activities carried
out under this section.'';
(2) in subsection (d)--
(A) in paragraph (2)--
(i) in the matter preceding subparagraph (A), by striking
``With respect to cord blood, the Program shall--'' and
inserting the following:
``(A) In general.--With respect to cord blood, the Program
shall--'';
[[Page S7651]]
(ii) by redesignating subparagraphs (A) through (H) as
clauses (i) through (viii) respectively;
(iii) by striking clause (iv), as so redesignated, and
inserting the following:
``(iv) support and expand new and existing studies and
demonstration and outreach projects for the purpose of
increasing cord blood unit donation and collection from a
genetically diverse population and expanding the number of
cord blood unit collection sites partnering with cord blood
banks receiving a contract under the National Cord Blood
Inventory program under section 2 of the Stem Cell
Therapeutic and Research Act of 2005, including such studies
and projects that focus on--
``(I) remote collection of cord blood units, consistent
with the requirements under the Program and the National Cord
Blood Inventory program goal described in section 2(a) of the
Stem Cell Therapeutic and Research Act of 2005; and
``(II) exploring novel approaches or incentives to
encourage innovative technological advances that could be
used to collect cord blood units, consistent with the
requirements under the Program and such National Cord Blood
Inventory program goal;''; and
(iv) by adding at the end the following:
``(B) Efforts to increase collection of high quality cord
blood units.--In carrying out subparagraph (A)(iv), not later
than 1 year after the date of enactment of the Stem Cell
Therapeutic and Research Reauthorization Act of 2010 and
annually thereafter, the Secretary shall set an annual goal
of increasing collections of high quality cord blood units,
consistent with the inventory goal described in section 2(a)
of the Stem Cell Therapeutic and Research Act of 2005
(referred to in this subparagraph as the `inventory goal'),
and shall identify at least one project under subparagraph
(A)(iv) to replicate and expand nationwide, as appropriate.
If the Secretary cannot identify a project as described in
the preceding sentence, the Secretary shall submit a plan,
not later than 180 days after the date on which the Secretary
was required to identify such a project, to the Committee on
Health, Education, Labor, and Pensions of the Senate and the
Committee on Energy and Commerce of the House of
Representatives for expanding remote collection of high
quality cord blood units, consistent with the requirements
under the National Cord Blood Inventory program under section
2 of the Stem Cell Therapeutic and Research Act of 2005 and
the inventory goal. Each such plan shall be made available to
the public.
``(C) Definition.--In this paragraph, the term `remote
collection' means the collection of cord blood units at
locations that do not have written contracts with cord blood
banks for collection support.''; and
(B) in paragraph (3)(A), by striking ``(2)(A)'' and
inserting ``(2)(A)(i)''; and
(3) by striking subsection (f)(5)(A) and inserting the
following:
``(A) require the establishment of a system of strict
confidentiality to protect the identity and privacy of
patients and donors in accordance with Federal and State law;
and''.
(c) Additional Reports.--
(1) Interim report.--In addition to the annual report
required under section 379(a)(6) of the Public Health Service
Act (42 U.S.C. 274k(a)(6)), the Secretary of Health and Human
Services (referred to in this subsection as the
``Secretary''), in consultation with the Advisory Council
established under such section 379, shall submit to Congress
an interim report not later than 180 days after the date of
enactment of this Act describing--
(A) the methods to distribute Federal funds to cord blood
banks used at the time of submission of the report;
(B) how cord blood banks contract with collection sites for
the collection of cord blood units; and
(C) recommendations for improving the methods to distribute
Federal funds described in subparagraph (A) in order to
encourage the efficient collection of high-quality and
diverse cord blood units.
(2) Recommendations.--Not later than 1 year after the date
of enactment of this Act, the Advisory Council shall submit
recommendations to the Secretary with respect to--
(A) whether models for remote collection of cord blood
units should be allowed only with limited, scientifically-
justified safety protections; and
(B) whether the Secretary should allow for cord blood unit
collection from routine deliveries without temperature or
humidity monitoring of delivery rooms in hospitals approved
by the Joint Commission.
(d) Authorization of Appropriations.--Section 379B of the
Public Health Service Act (42 U.S.C. 274m) is amended by
striking ``$34,000,000'' and all that follows through the
period at the end, and inserting ``$30,000,000 for each of
fiscal years 2011 through 2014 and $33,000,000 for fiscal
year 2015.''.
(e) Report on Cord Blood Unit Donation and Collection.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, the Comptroller General of the United
States shall submit to the Committee on Health, Education,
Labor, and Pensions and the Committee on Appropriations of
the Senate, the Committee on Energy and Commerce and the
Committee on Appropriations of the House of Representatives,
and the Secretary of Health and Human Services a report
reviewing studies, demonstration programs, and outreach
efforts for the purpose of increasing cord blood unit
donation and collection for the National Cord Blood Inventory
to ensure a high-quality and genetically diverse inventory of
cord blood units.
(2) Contents.--The report described in paragraph (1) shall
include a review of such studies, demonstration programs, and
outreach efforts under section 2 of the Stem Cell Therapeutic
and Research Act of 2005 (42 U.S.C. 274k note) (as amended by
this Act) and section 379 of the Public Health Service Act
(42 U.S.C. 274k) (as amended by this Act), including--
(A) a description of the challenges and barriers to
expanding the number of cord blood unit collection sites,
including cost, the cash flow requirements and operations of
awarding contracts, the methods by which funds are
distributed through contracts, the impact of regulatory and
administrative requirements, and the capacity of cord blood
banks to maintain high-quality units;
(B) remote collection or other innovative technological
advances that could be used to collect cord blood units;
(C) appropriate methods for improving provider education
about collecting cord blood units for the national inventory
and participation in such collection activities;
(D) estimates of the number of cord blood unit collection
sites necessary to meet the outstanding national inventory
need and the characteristics of such collection sites that
would help increase the genetic diversity and enhance the
quality of cord blood units collected;
(E) best practices for establishing and sustaining
partnerships for cord blood unit collection at medical
facilities with a high number of minority births;
(F) potential and proven incentives to encourage hospitals
to become cord blood unit collection sites and partner with
cord blood banks participating in the National Cord Blood
Inventory under section 2 of the Stem Cell Therapeutic and
Research Act of 2005 and to assist cord blood banks in
expanding the number of cord blood unit collection sites with
which such cord blood banks partner;
(G) recommendations about methods cord blood banks and
collection sites could use to lower costs and improve
efficiency of cord blood unit collection without decreasing
the quality of the cord blood units collected; and
(H) a description of the methods used prior to the date of
enactment of this Act to distribute funds to cord blood banks
and recommendations for how to improve such methods to
encourage the efficient collection of high-quality and
diverse cord blood units, consistent with the requirements of
the C.W. Bill Young Cell Transplantation Program and the
National Cord Blood Inventory program under section 2 of the
Stem Cell Therapeutic and Research Act of 2005.
(f) Definition.--In this Act, the term ``remote
collection'' has the meaning given such term in section
379(d)(2)(C) of the Public Health Service Act.
Mr. REED. Mr. President, today the Senate passed the Stem Cell
Therapeutic and Research Reauthorization Act of 2010. I was pleased to
have been involved in the crafting of this bill, which is the product
of months of bipartisan discussions, collaboration, and negotiation. I
also want to recognize the hard work and dedication of Senators Dodd,
Hatch, Burr, and Ensign in getting this bill across the finish line in
the Senate.
This bill offers promise to the tens of thousands of individuals
diagnosed with leukemia and lymphomas, sickle cell anemia, and rare
genetic blood disorders.
It will reauthorize the C.W. Bill Young National Marrow Donor
Program, which has been helping to connect individuals in need of a
bone marrow transplant with donors since 1986, and the National Cord
Blood Inventory, which has been helping to connect individuals in need
of an umbilical cord blood transplant with donors since 1999.
I am particularly pleased that the bill will remove a cap on the
number of cord blood units that could be stored by qualified cord blood
banks in the National Cord Blood Inventory. The original law limited
the number to 150,000 units. As the science has evolved, we know that
150,000 is nowhere near the amount necessary to meet the demands of
those in need of a cord blood transplant. And, in eliminating this cap,
I am pleased that we have included provisions to encourage greater cord
blood donation and collection as well as provisions to help shed light
onto the obstacles to greater donation and collection.
I am proud that the Rhode Island Blood Center has contributed to the
success of the National Marrow Donor Program with over 61,000
registered marrow donors. In addition, last year a new partnership
formed between the Rhode Island Blood Bank and Women and Infants
Hospital in Providence, RI, to begin collecting umbilical cord blood
units as part of a pilot project. Over 1,000 units have already been
collected, and I look forward to the time when Rhode Island will be
contributing to the National Cord Blood Inventory.
The public registries made up of Rhode Island donors and those from
all over the country have been a true lifeline for the Americans who
have found an unrelated match. By strengthening and enhancing the
important programs operating these registries, many more
[[Page S7652]]
Americans will be afforded the opportunity to find a match if they are
ever in need.
I look forward to swift passage of this legislation in the House of
Representatives and the President signing this bill into law shortly
thereafter.
Mr. HATCH. Mr. President, I am pleased that the Senate is considering
S. 3751, the Stem Cell Therapeutic and Research Reauthorization Act of
2010 which reauthorizes the Stem Cell Therapeutic and Research Act of
2005--P.L. 109-129--through the end of 2015. I am also grateful that
Senators Dodd, Burr, Reed, Ensign, Franken and Coburn have joined me as
sponsors of this bipartisan bill, which was unanimously approved by the
Senate Committee on Health, Education, Labor and Pensions and the House
Energy and Commerce Committee last week.
S. 3751, the Stem Cell Therapeutic and Research Reauthorization Act,
reauthorizes the C.W. Bill Young Cell Transplantation Program--the
Program--and the National Cord Blood Inventory program--NCBI. These
programs maintain donor registries for individuals in need of bone
marrow and umbilical cord blood transplants. Today, more than eight
million Americans are registered bone marrow donors, and in the 5 years
since NCBI was established, more than 28,600 cord blood units have been
collected. Cord blood transplantation accounts for over 40 percent of
all transplants in the country.
I believe it is important for Senators to understand the specifics of
S. 3751. Our bill reauthorizes the program through the end of Fiscal
Year 2015. The authorization levels for the Program are $30 million
from FY11 through FY14 and $33 million in FY15. The NCBI authorization
levels are $23 million from FY11 through FY14 and $20 million in FY15.
The total authorization level for both programs combined is $53 million
annually, which is the same authorization level included in the Stem
Cell Therapeutic and Research Act of 2005.
Our bill calls for the collection and maintenance of at least 150,000
high-quality cord blood units. In order to collect high-quality and
diverse units, the Health Resources and Services Administration--HRSA--
contracts with cord blood banks to collect and maintain umbilical cord
blood units for the national inventory. To achieve the goal of
collecting at least 150,000 units, S. 3751 requires cord blood banks to
provide a strategic plan to increase collection, assist with the
creation of new collection sites, or contract with new collection sites
when first applying for a contract or extending an existing contract.
S. 3751 also requires cord blood banks to submit an annual plan for
achieving self-sufficiency and demonstrates on-going measurable
progress toward achieving self-sufficiency of cord blood collection and
banking operations. The bill also extends the duration of a contract
from 3 to 5 years and allows cord blood units to remain part of the
national inventory for at least 10 years.
Additionally, S. 3751 redefines the term ``first-degree relative'' as
a sibling of an individual requiring a transplant. Children are not a
match for parents in need of a cord blood transplant, as the original
law suggested. The bill also aligns the privacy protections provided to
bone marrow donors and patients with umbilical cord blood donors and
transplant patients.
The legislation encourages the Program to support studies and
demonstration projects to increase cord blood donation and collection.
More specifically, S. 3751 directs the Secretary of Health and Human
Services--HHS, acting though the HRSA Administrator, to submit to
Congress an annual report on the National Program's activities
including novel approaches for increasing cord blood unit donation and
collection. The HHS Secretary also is directed to set an annual goal of
increasing collections of high-quality and diverse cord blood units
through remote collection or other approaches. In addition, S. 3751
directs the HHS Secretary to identify at least one of these approaches
to replicate and expand across the country. If a project is not
identified, the HHS Secretary shall submit a plan for expanding remote
collection of high-quality and diverse cord blood units.
S. 3751 requires the HHS Secretary, in consultation with the Advisory
Council, to submit to Congress an interim report within 6 months after
enactment, describing existing methods used to distribute Federal funds
to cord blood banks. The report also would explain how cord blood banks
contract with cord blood unit collection sites and recommend how these
methods may be improved in order to encourage efficient collection of
high-quality and diverse cord blood units.
Our legislation also requires the Advisory Council to submit
recommendations to the HHS Secretary 1 year after enactment on whether
remote models for cord blood unit collection should be allowed with
only limited, scientifically justified safety protections. The Advisory
Council would also make recommendations on whether HHS should allow for
cord blood unit collection from routine deliveries without temperature
or humidity monitoring of delivery rooms in hospitals approved by the
Joint Commission.
Finally, S. 3751 requires the Government Accountability Office--GAO--
to study existing cord blood donation and collection methods and the
barriers responsible for limiting donation and collection. GAO also
would analyze the methods used to distribute funds to cord blood banks
and novel approaches to grow the NCBI.
S. 3751 proves that contrary to popular belief, bipartisanship still
exists in the United States Congress. The original Stem Cell
Therapeutic and Research Act passed Congress unanimously and became
law--P.L 109-129--on December 20, 2005. This law offered a unique
opportunity to assist those suffering from a serious illness requiring
cord blood or bone marrow transplants. In 2005, our goal was to
increase the number of bone marrow and cord blood donors to meet our
goal of 150,000 high-quality and diverse cord blood units. Today, our
goal remains the same except we are encouraging the collection of at
least 150,000 units. The sponsors of this legislation want to do
everything in our power to provide patients with the best transplant
options and signing this legislation into law is how we achieve this
second goal. Transplant patients and their families deserve nothing
less.
S. 3751 is supported by the following organizations: American Society
of Bone Marrow Transplant, Aplastic Anemia and MDS Society, Center for
International Blood and Marrow Transplantation, Colorado Cord Blood
Bank, Duke University Cord Blood Bank, Intermountain Primary Children's
Hospital, Jeff Gordon Foundation, Leukemia and Lymphoma Foundation,
LifeCord Cord Blood Bank, National Marrow Donor Program, Nevada Cancer
Institute, New Jersey Cord Blood Bank, New York Blood Center Cord Blood
Bank, Rhode Island Blood Center, St. Louis Cord Blood Bank, StemCyte
International Cord Blood Bank, University of Utah's Cell Therapy
Facility, Villanova football head coach Andy Talley, and Yale
University Hospital.
Finally, I ask unanimous consent to have printed in the Record the
section by section analysis of S. 3751.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Sec. 1. Short title
Stem Cell Therapeutic and Research Reauthorization Act of
2010.
Sec. 2. Amendments to the Stem Cell Therapeutic and Research Act of
2005
(a) Instructs the Secretary of Health and Human Services
(HHS) to enter into contracts with qualified cord blood banks
in order to create and maintain a national inventory of at
least 150,000 new high quality cord blood units suitable for
transplantation into unrelated recipients. The 2005 law
authorized a 3-year demonstration project to collect
umbilical cord blood units specifically for use in a first-
degree relative. The law instructed these units to be
combined with the national inventory at the end of the 3-year
demo. Since the FDA follows different collection and storage
requirements for cord blood units intended for use in a
first-degree relative and a stranger, the substitute
amendment eliminates this instruction and requires the units
collected for the demonstration program only be stored for
use in a first-degree relative.
Includes additional requirements for entities applying to
be qualified cord blood banks. First, the entity must provide
a plan to increase cord blood unit collections at collection
sites that exist at the time of application, assist with the
establishment of new collection sites or contract with new
collection sites. Second, contract recipients must annually
provide to the HHS Secretary
[[Page S7653]]
a plan for and demonstrate ongoing, measurable progress
toward achieving self-sufficiency of cord blood collection
and banking operations.
Extends the length of a cord blood bank contract from three
years to five years. A five year extension of cord blood
contracts will be permitted if such entities: (1) demonstrate
a superior ability to satisfy the requirements included in
the original statute to be federal cord blood banks; (2)
provide a plan for increasing cord blood unit collections at
collection sites that exist at the time of consideration of
such extension, assist with the establishment of new
collection sites, or contract with new collection sites; and
(3) annually provide to the HHS Secretary a plan for and
demonstrate ongoing, measurable progress toward achieving
self-sufficiency of cord blood collection and banking
operations.
Redefines the term, ``first-degree relative'' as a sibling
of the individual requiring a transplant. Authorizes
appropriations for the National Cord Blood Inventory Program
(NCBI) at $23 million in fiscal years 2011-2014 and $20
million in fiscal year 2015. The substitute amendment
eliminates language in the law which allows funds to remain
available until expended since this is overridden by long-
standing policy in appropriations bills. The statutory
language was originally necessary because the 2005
authorization law passed after funds had been appropriated.
(b) Clarifies that the C.W. Bill Young Cell Transplantation
Program, known as the Program, shall support studies and
outreach projects to increase cord collection donation and
collection from a genetically diverse population, including
exploring novel approaches or incentives, such as remote or
other innovative technological advances that could be used to
collect cord blood units, to expand the number of cord blood
collection sites partnering with cord blood banks that
receive a contract under the NCBI program.
Directs the Secretary, acting though the Administrator of
the Health Resources and Services Administration, to submit
to Congress an annual report on activities conducted through
the National Program including novel approaches for the
purpose of increasing cord blood unit donation and
collection. Directs the Secretary to set an annual goal of
increasing collections of high quality cord blood units
through remote collection or other novel approaches. The
Secretary shall identify at least one of these approaches to
replicate and expand nationwide as appropriate. If such a
project cannot be identified by the Secretary, then the
Secretary shall submit a plan for expanding remote collection
of high quality cord blood units. Remote collection is
defined as cord blood unit collections occurring at locations
that do not hold written contracts with existing cord blood
banks for collection support.
Requires the Secretary, in consultation with the Advisory
Council, to submit to Congress an interim report not later
than 6 months after date of enactment, describing the
existing methods used to distribute federal funds to cord
blood banks; how cord blood banks contract with collection
sites for the collection of cord blood units; and
recommendations to improve these methods to encourage the
efficient collection of high quality and diverse cord blood
units.
Requires the Advisory Council shall submit recommendations
to the Secretary one year after enactment about whether:
1. remote models for cord blood unit collection should be
allowed with only limited, scientifically justified safety
protections; and
2. HHS should allow for cord blood unit collection from
routine deliveries without temperature or humidity monitoring
of delivery rooms in hospitals approved by the Joint
Commission.
Authorizes appropriations for the C.W. Bill Young Cell
Transplantation Program (the Program) at $30 million in
fiscal years 2011-2014 and $33 million in fiscal year 2015.
The substitute amendment eliminates language in the law which
allows funds to remain available until expended since this is
overridden by long-standing policy in appropriations bills.
The statutory language was originally necessary because the
2005 authorization law passed after funds had been
appropriated.
Directs the Government Accountability Office (GAO) to
submit a report on cord blood unit donation and collection as
well as methods used to distribute funds to cord blood banks
no later than one year after enactment. The report shall be
submitted to the Senate Committee on Health, Education, Labor
and Pensions, the Senate Committee on Appropriations, the
House Energy and Commerce Committee and the House Committee
on Appropriations.
Mr. FRANKEN. Mr. President, I ask unanimous consent that the
committee-reported substitute amendment be agreed to, the bill, as
amended, be read three times, passed, the motion to reconsider be laid
upon the table, and that any statements relating thereto be printed in
the Record.
The PRESIDING OFFICER. Without objection, it is so ordered.
The committee amendment in the nature of a substitute was agreed to.
The bill (S. 3751), as amended, was ordered to be engrossed for a
third reading, was read the third time, and passed.
____________________