[Congressional Record Volume 163, Number 151 (Tuesday, September 19, 2017)]
[Senate]
[Pages S5862-S5866]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Ms. COLLINS (for herself and Mr. Nelson):
S. 1835. A bill to provide support to States to establish invisible
high risk pool or reinsurance programs; to the Committee on Finance.
Ms. COLLINS. Mr. President, the cost of health insurance has been a
major problem with the Affordable Care Act and with many of the bills
which have been advanced to repeal and replace this law.
I rise to introduce the Lower Premiums Through Reinsurance Act of
2017. This bill would provide States with the flexibility and support
they need to create State-based reinsurance programs for their
individual health insurance markets in order to lower premiums while
ensuring continued coverage for people with preexisting conditions.
I am very pleased to be joined by my colleague and friend Senator
Bill Nelson in introducing this bill. Senator Nelson is a former
insurance commissioner who comes to this issue with a wealth of
knowledge dating to his experience with Florida's innovative
homeowners' reinsurance program, developed in the 1990s in the wake of
Hurricane Andrew. For my own part, I spent 5 years in State government
overseeing a department which included the Bureau of Insurance.
Over the past 2 weeks, the Senate HELP Committee, on which I am
privileged to serve, completed a round of hearings under the able
leadership of Chairman Lamar Alexander and Ranking Member Patty Murray.
They
[[Page S5863]]
looked at the steps we could take in the near term to stabilize the
individual market and help to bring down rates. Reinsurance was
frequently mentioned as an option Congress should consider and adopt.
Insurance commissioners from Alaska, Pennsylvania, South Carolina,
Tennessee, and Washington State all spoke positively of its benefits,
as did the five Governors who testified before the committee--three
Republicans and two Democrats. Although the witnesses presented
different views on how a reinsurance mechanism might be structured,
they were in broad agreement that reinsurance funding would help
stabilize the markets and lower premiums.
The National Association of Insurance Commissioners has recommended
that Congress provide reinsurance funding of $15 billion annually to
help cover high-cost claims in the individual market. We realize,
however, we are living in very tight budget times, and there is an
understandable reluctance among many Members to provide that level of
Federal funding. We believe the ACA's section 1332's flowthrough
mechanism can effectively leverage that level of funding with a much
smaller contribution of Federal dollars. Our bill, therefore, would
appropriate $2.25 billion per year in 2018 and 2019, which should be
sufficient to leverage $15 billion in total reinsurance funding
annually, based on the ratios in Alaska's recently approved 1332
waiver.
As Alaska's insurance commissioner told the HELP Committee, next year
her State will be able to fund its $55 million reinsurance program with
just $6.6 million of its own money--15 percent of the total. The
remaining $48.4 million will be provided in Federal flowthrough funding
that matches the savings to the Federal Government resulting from the
reinsurance program. Let me explain why there would be savings for the
Federal Government.
If we are able to reduce the cost of premiums, then the Federal
Government will be paying less by way of subsidies to individuals who
qualify for those subsidies because they make 400 percent or less of
the Federal poverty level.
The bill we are introducing today would allow States to quickly stand
up their own reinsurance programs through the Affordable Care Act's
section 1332 waiver process. Broadly speaking, the bill would create a
menu of options States could use to design reinsurance programs, which
in turn would be eligible for Federal seed money grants. States may
also obviously add funds from other sources to the mix.
States that want to set up their own reinsurance pools quickly could
do so under our bill by using one of three options designed for
expedited review: first, by demonstrating that their program is an
``invisible high-risk pool'' along the lines of the Maine and Alaska
models, which I will describe in more detail in a moment; second, by
showing that their program fits within the parameters of ObamaCare's
``transitional insurance program,'' which expired at the end of last
year; and third, by submitting what I would call a ``me too''
application based on another State's program that has already received
approval.
I wish to take a moment to explain why our legislation provides
expedited review for different reinsurance pool designs. First, many of
the witnesses who testified before the HELP Committee made the point
that States would have difficulty quickly coming up with their own
design. We acknowledge that, and that is why we provided expedited
review for a pool based on the transitional ACA reinsurance program
previously in effect and with which States are already familiar.
Second, we know from the experience of the States of Maine and Alaska
how effective invisible reinsurance pools can be. Alaska's invisible
pool reduced a projected 40-percent rate increase to just 7 percent
this year and is expected to contribute to a 20-percent decline in
premiums next year. Maine saw similar results in its program, the Maine
Guaranteed Access Reinsurance Association.
The Maine program, which was in operation from 2012 until the end of
2013, covered approximately 3,600 insured individuals, at a cost of
approximately $12,500 per person, per year, and reduced rates in the
individual market by about 20 percent on average.
It is important for us to keep in mind that the individual market is
where people who do not have employer-sponsored insurance have to go to
buy their insurance. If they make 400 percent or less of the Federal
poverty level, they get premium tax credits--subsidies, in other
words--from the Federal Government to assist them with the cost. But if
they make a dollar over 400 percent of the Federal poverty level, they
lose that assistance altogether.
Another problem that is in the ACA is those cliffs, which make no
sense whatsoever and really penalize individuals who may work in the
trades, such as electricians and plumbers, who don't know for certain
what their income is going to be and can face an unexpected bill where
they have to pay back the entire subsidy. But there are others who make
above 400 percent who knew it and didn't qualify for the subsidy, but
they still have to purchase in the individual market. I think that
should be revisited, but that is a speech for another day.
My point is that they would benefit greatly from a 20-percent
reduction in the premiums they pay. That was our experience in Maine.
On average there was a 20-percent reduction in premiums when the
reinsurance pool was in effect. The reinsurance pool even generated a
surplus of $5 billion during its 18 months of operation.
The Maine pool was successful for several reasons. First, risks were
ceded up front so insurers could not wait until a policyholder
developed an unexpected serious health condition to decide who was
going to be in the high-risk pool and who was not. The rules also
required policies for individuals who suffered from certain high-risk
conditions to be automatically ceded to the pool on enrollment.
I note that when an insurer made the decision to cede to the pool the
risk for a particular policyholder, or if it was an automatic ceding,
90 percent of the premiums from that policyholder went to the
reinsurance pool to help finance it.
Second--and this is important--the program was invisible to both
individuals who were insured through it and to healthcare providers.
Individuals were covered seamlessly and enjoyed the same benefits as
nonpool enrollees. Likewise, healthcare providers did not know whose
policy had been ceded to the pool.
Third--and also very important--Maine's program operated with the
full set of consumer protection guardrails set by the ACA, including
guaranteed issue, guaranteed renewability, and prohibitions against
taking preexisting conditions or health status into account in issuing
policies or setting rates.
Fourth, the Maine program was designed to provide true reinsurance.
Insurers paid the first $7,500 in costs, plus 10 percent of the next
$25,000. After that threshold, the pool picked up the rest of the
costs.
Finally, Maine's program was backed by a stable funding source. In
addition to receiving 90 percent of the premiums for ceded policies, it
also received funding that was assessed at a rate of $4 per person, per
month, on all healthcare policies.
While Alaska's reinsurance program differs from Maine's in some
respects, the success of both models shows the promise and proves the
promise of invisible reinsurance pools, and that is why our bill
includes invisible reinsurance pools as an option for expedited review
and approval.
Open enrollment in the ACA exchanges begins November 1, just about 6
weeks from now. In just days, CMS is expected to finalize the premiums
insurers will charge in the ACA exchanges next year. While I personally
remain ever hopeful that a bipartisan agreement on a targeted,
consensus approach to stabilizing the markets and reducing premiums can
still be reached, clearly, we have very little time. Beyond providing
cost-sharing reduction funding, there is no step that would be more
powerful in stabilizing markets and reducing premiums than providing
reinsurance.
This Chamber is deeply divided on what to do on healthcare policy,
but surely we ought to be able to come together and build on the good
work that the leaders of the HELP Committee have done--work that more
than 60
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Senators have witnessed and participated in by attending coffees that
Senator Lamar Alexander and Senator Patty Murray have sponsored with
our witnesses and by participating in the HELP Committee hearings. They
have worked hard to produce a bill that would really make a difference.
The bill Senator Nelson and I are introducing today helps to fill out
the reinsurance provisions that I know from attending each of those
hearings have been widely supported by virtually every witness who
testified before us. It would enable States to stand up their own
reinsurance program simply and quickly, and it would reduce the costs
of the Federal Government if we used the section 1332 flow-through
mechanism far below what would otherwise be required. Most important of
all, it is something that we could do right off, along with the cost-
saving reductions, which help low-income people with their copays and
their deductibles--their out-of-pocket costs. Those two steps are
actions that we could take right now to help moderate premium increases
that would otherwise occur and that would be of real benefit to anyone
who is in the individual market.
______
By Mr. DURBIN (for himself, Mr. Brown, Mr. Reed, Mr. Blumenthal,
Mr. Markey, and Mr. Franken):
S. 1837. A bill to amend the Internal Revenue Code of 1986 to provide
tax rate parity among all tobacco products, and for other purposes; to
the Committee on Finance.
Mr. DURBIN. Mr. President, I ask unanimous consent that the text of
the bill be printed in the Record.
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:
S. 1837
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 ``Tobacco Tax Equity Act of
2017''.
SEC. 2. ESTABLISHING EXCISE TAX EQUITY AMONG ALL TOBACCO
PRODUCT TAX RATES.
(a) Tax Parity for Pipe Tobacco and Roll-Your-Own
Tobacco.--Section 5701(f) of the Internal Revenue Code of
1986 is amended by striking ``$2.8311 cents'' and inserting
``$24.78''.
(b) Tax Parity for Smokeless Tobacco.--
(1) Section 5701(e) of the Internal Revenue Code of 1986 is
amended--
(A) in paragraph (1), by striking ``$1.51'' and inserting
``$13.42'';
(B) in paragraph (2), by striking ``50.33 cents'' and
inserting ``$5.37''; and
(C) by adding at the end the following:
``(3) Smokeless tobacco sold in discrete single-use
units.--On discrete single-use units, $50.33 per thousand.''.
(2) Section 5702(m) of such Code is amended--
(A) in paragraph (1), by striking ``or chewing tobacco''
and inserting ``, chewing tobacco, or discrete single-use
unit'';
(B) in paragraphs (2) and (3), by inserting ``that is not a
discrete single-use unit'' before the period in each such
paragraph; and
(C) by adding at the end the following:
``(4) Discrete single-use unit.--The term `discrete single-
use unit' means any product containing tobacco that--
``(A) is not intended to be smoked; and
``(B) is in the form of a lozenge, tablet, pill, pouch,
dissolvable strip, or other discrete single-use or single-
dose unit.''.
(c) Tax Parity for Large Cigars.--
(1) In general.--Paragraph (2) of section 5701(a) of the
Internal Revenue Code of 1986 is amended by striking ``52.75
percent'' and all that follows through the period and
inserting the following: ``$24.78 per pound and a
proportionate tax at the like rate on all fractional parts of
a pound but not less than 5.033 cents per cigar.''.
(2) Guidance.--The Secretary of the Treasury, or the
Secretary's delegate, may issue guidance regarding the
appropriate method for determining the weight of large cigars
for purposes of calculating the applicable tax under section
5701(a)(2) of the Internal Revenue Code of 1986.
(d) Tax Parity for Roll-Your-Own Tobacco and Certain
Processed Tobacco.--Subsection (o) of section 5702 of the
Internal Revenue Code of 1986 is amended by inserting ``, and
includes processed tobacco that is removed for delivery or
delivered to a person other than a person with a permit
provided under section 5713, but does not include removals of
processed tobacco for exportation'' after ``wrappers
thereof''.
(e) Clarifying Tax Rate for Other Tobacco Products.--
(1) In general.--Section 5701 of the Internal Revenue Code
of 1986 is amended by adding at the end the following new
subsection:
``(i) Other Tobacco Products.--Any product not otherwise
described under this section that has been determined to be a
tobacco product by the Food and Drug Administration through
its authorities under the Family Smoking Prevention and
Tobacco Control Act shall be taxed at a level of tax
equivalent to the tax rate for cigarettes on an estimated per
use basis as determined by the Secretary.''.
(2) Establishing per use basis.--For purposes of section
5701(i) of the Internal Revenue Code of 1986, not later than
12 months after the later of the date of the enactment o this
Act or the date that a product has been determined to be a
tobacco product by the Food and Drug Administration, the
Secretary of the Treasury (or the Secretary of the Treasury's
delegate) shall issue final regulations establishing the
level of tax for such product that is equivalent to the tax
rate for cigarettes on an estimated per use basis.
(f) Clarifying Definition of Tobacco Products.--
(1) In general.--Subsection (c) of section 5702 of the
Internal Revenue Code of 1986 is amended to read as follows:
``(c) Tobacco Products.--The term `tobacco products'
means--
``(1) cigars, cigarettes, smokeless tobacco, pipe tobacco,
and roll-your-own tobacco, and
``(2) any other product subject to tax pursuant to section
5701(i).''.
(2) Conforming amendments.--Subsection (d) of section 5702
of such Code is amended by striking ``cigars, cigarettes,
smokeless tobacco, pipe tobacco, or roll-your-own tobacco''
each place it appears and inserting ``tobacco products''.
(g) Tax Rates Adjusted for Inflation.--Section 5701 of such
Code, as amended by subsection (e), is amended by adding at
the end the following new subsection:
``(j) Inflation Adjustment.--
``(1) In general.--In the case of any calendar year
beginning after 2017, the dollar amounts provided under this
chapter shall each be increased by an amount equal to--
``(A) such dollar amount, multiplied by
``(B) the cost-of-living adjustment determined under
section 1(f)(3) for the calendar year, determined by
substituting `calendar year 2016' for `calendar year 1992' in
subparagraph (B) thereof.
``(2) Rounding.--If any amount as adjusted under paragraph
(1) is not a multiple of $0.01, such amount shall be rounded
to the next highest multiple of $0.01.''.
(h) Effective Dates.--
(1) In general.--Except as provided in paragraphs (2)
through (4), the amendments made by this section shall apply
to articles removed (as defined in section 5702(j) of the
Internal Revenue Code of 1986) after the last day of the
month which includes the date of the enactment of this Act.
(2) Discrete single-use units and processed tobacco.--The
amendments made by subsections (b)(1)(C), (b)(2), and (d)
shall apply to articles removed (as defined in section
5702(j) of the Internal Revenue Code of 1986) after the date
that is 6 months after the date of the enactment of this Act.
(3) Large cigars.--The amendments made by subsection (c)
shall apply to articles removed after December 31, 2017.
(4) Other tobacco products.--The amendments made by
subsection (e)(1) shall apply to products removed after the
last day of the month which includes the date that the
Secretary of the Treasury (or the Secretary of the Treasury's
delegate) issues final regulations establishing the level of
tax for such product.
______
By Mr. DURBIN (for himself, Mr. Scott, Mr. Menendez, Mr. Young,
Mr. Donnelly, and Ms. Duckworth):
S. 1845. A bill to amend the Lead-Based Paint Poisoning Prevention
Act to provide for additional procedures for families with children
under the age of 6, and for other purposes; to the Committee on
Banking, Housing, and Urban Affairs.
Mr. DURBIN. Mr. President, I ask unanimous consent that the text of
the bill be printed in the Record.
There being no objection, the text of the bill was ordered to be
printed in the Record, as follows:
S. 1845
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 ``Lead-Safe Housing for Kids
Act of 2017''.
SEC. 2. AMENDMENTS TO THE LEAD-BASED PAINT POISONING
PREVENTION ACT.
Section 302(a) of the Lead-Based Paint Poisoning Prevention
Act (42 U.S.C. 4822(a)) is amended--
(1) by redesignating paragraph (4) as paragraph (5); and
(2) by inserting after paragraph (3) the following:
``(4) Additional procedures for families with children
under the age of 6.--
``(A) Risk assessment.--
``(i) Definition.--In this subparagraph, the term `covered
housing'--
``(I) means housing receiving Federal assistance described
in paragraph (1) that was constructed prior to 1978; and
``(II) does not include--
``(aa) single-family housing covered by an application for
mortgage insurance under the National Housing Act (12 U.S.C.
1701 et seq.); or
``(bb) multi-family housing that--
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``(AA) is covered by an application for mortgage insurance
under the National Housing Act (12 U.S.C. 1701 et seq.); and
``(BB) does not receive any other Federal housing
assistance.
``(ii) Regulations.--Not later than 180 days after the date
of enactment of the Lead-Safe Housing for Kids Act of 2017,
the Secretary shall promulgate regulations that--
``(I) require the owner of covered housing in which a
family with a child of less than 6 years of age will reside
or is expected to reside to conduct an initial risk
assessment for lead-based paint hazards--
``(aa) in the case of covered housing receiving tenant-
based rental assistance under section 8 of the United States
Housing Act of 1937 (42 U.S.C. 1437f), not later than 15 days
after the date on which the family and the owner submit a
request for approval of a tenancy;
``(bb) in the case of covered housing receiving public
housing assistance under the United States Housing Act of
1937 (42 U.S.C. 1437 et seq.) or project-based rental
assistance under section 8 of the United States Housing Act
of 1937 (42 U.S.C. 1437f), not later than 15 days after the
date on which a physical condition inspection occurs; and
``(cc) in the case of covered housing not described in item
(aa) or (bb), not later than a date established by the
Secretary;
``(II) provide that a visual assessment alone is not
sufficient for purposes of complying with subclause (I);
``(III) require that, if lead-based paint hazards are
identified by an initial risk assessment conducted under
subclause (I), the owner of the covered housing shall--
``(aa) not later than 30 days after the date on which the
initial risk assessment is conducted, control the lead-based
paint hazards, including achieving clearance in accordance
with regulations promulgated under section 402 or 404 of the
Toxic Substances Control Act (15 U.S.C. 2682, 2684), as
applicable; and
``(bb) provide notice to all residents in the covered
housing affected by the initial risk assessment, and provide
notice in the common areas of the covered housing, that lead-
based paint hazards were identified and will be controlled
within the 30-day period described in item (aa); and
``(IV) provide that there shall be no extension of the 30-
day period described in subclause (III)(aa).
``(iii) Exceptions.--The regulations promulgated under
clause (ii) shall provide an exception to the requirement
under subclause (I) of such clause for covered housing--
``(I) if the owner of the covered housing submits to the
Secretary documentation--
``(aa) that the owner conducted a risk assessment of the
covered housing for lead-based paint hazards during the 12-
month period preceding the date on which the family is
expected to reside in the covered housing; and
``(bb) of any clearance examinations of lead-based paint
hazard control work resulting from the risk assessment
described in item (aa);
``(II) from which all lead-based paint has been identified
and removed and clearance has been achieved in accordance
with regulations promulgated under section 402 or 404 of the
Toxic Substances Control Act (15 U.S.C. 2682, 2684), as
applicable;
``(III)(aa) if lead-based paint hazards are identified in
the dwelling unit in the covered housing in which the family
will reside or is expected to reside;
``(bb) the dwelling unit is unoccupied;
``(cc) the owner of the covered housing, without any
further delay in occupancy or increase in rent, provides the
family with another dwelling unit in the covered housing that
has no lead-based paint hazards; and
``(dd) the common areas servicing the new dwelling unit
have no lead-based paint hazards; and
``(IV) in accordance with any other standard or exception
the Secretary deems appropriate based on health-based
standards.
``(B) Relocation.--Not later than 180 days after the date
of enactment of the Lead-Safe Housing for Kids Act of 2017,
the Secretary shall promulgate regulations to provide that a
family with a child of less than 6 years of age that occupies
a dwelling unit in covered housing in which lead-based paint
hazards were identified, but not controlled in accordance
with regulations required under clause (ii), may relocate on
an emergency basis and without placement on any waitlist,
penalty (including rent payments to be made for that dwelling
unit), or lapse in assistance to--
``(i) a dwelling unit that was constructed in 1978 or
later; or
``(ii) another dwelling unit in covered housing that has no
lead-based paint hazards.''.
SEC. 3. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to carry out the
amendments made by section 2 such sums as may be necessary
for each of fiscal years 2018 through 2022.
______
By Mr. DAINES (for himself and Ms. Hassan):
S. 1847. A bill to amend the Homeland Security Act of 2002 to ensure
that the needs of children are considered in homeland security,
trafficking, and disaster recovery planning, and for other purposes; to
the Committee on Homeland Security and Governmental Affairs.
Mr. DAINES. Mr. President, the Department of Homeland Security, DHS,
is tasked with keeping the American public safe in the homeland. Its
mission ranges from thwarting terrorist attacks to responding to
natural and manmade disasters, from interdicting the movement of
illicit drugs at the border to combating human trafficking and
protecting its victims. Nearly one-quarter of the population within our
borders are children They have unique needs, and we must ensure those
needs are met in the face of threat and in recovery.
For example, when children are stranded at school because of a
terrorist attack or a natural disaster, they need a planned route and
means to get home safely. A child is caught up in a drug cartel and
used as a trafficking mule--the child is a victim, not a criminal. He
needs help breaking the addiction. An adolescent, promised a better
life, has her passport stolen and forced to sell herself. She needs
help escaping her captors and healing.
The recent tragedies of wildfires in Montana and across the Northwest
and Hurricanes Harvey and Irma are all too recent reminders that we
need to plan for the needs of children in both building resiliency and
responding to disasters. That is why I am introducing the-Homeland
Security for Children Act. This legislation would simply ensure DHS's
Under Secretary for Strategy, Policy, and Plans includes input from
organizations representing the needs of children when soliciting
stakeholder feedback and developing policies. Further, a technical
expert at the Federal Emergency Management Agency would be authorized
to lead its external collaboration and policy developments to integrate
the needs of children into its activities to prepare for and respond
to, disasters.
I thank Senator Hassan for being an original cosponsor of this bill,
as well as Representative Donald Payne of New Jersey for leading in the
House of Representatives. I ask my Senate colleagues to join us in
support of this important legislation.
Mr. DAINES Mr. President, I ask unanimous consent that the text of
the legislation be printed in the Record.
S. 1847
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 ``Homeland Security for
Children Act''.
SEC. 2. RESPONSIBILITIES OF THE UNDER SECRETARY FOR STRATEGY,
POLICY, AND PLANS.
Section 709(c)(6) of the Homeland Security Act of 2002 (6
U.S.C. 349(c)(6)) is amended by inserting ``, including
feedback from organizations representing the needs of
children,'' after ``stakeholder feedback''.
SEC. 3. TECHNICAL EXPERT AUTHORIZED.
Section 503(b)(2) of the Homeland Security Act of 2002 (6
U.S.C. 313(b)(2)) is amended--
(1) in subparagraph (G), by striking ``and'' at the end;
(2) in subparagraph (H), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(I) identify and integrate the needs of children into
activities to prepare for, protect against, respond to,
recover from, and mitigate against the risk of natural
disasters, acts of terrorism, and other manmade disasters,
including catastrophic incidents, including by appointing a
technical expert, who may consult with relevant outside
organizations and experts, as necessary, to coordinate such
integration, as necessary.''.
SEC. 4. REPORT.
Not later than 1 year after the date of enactment of this
Act and annually thereafter for 4 years, the Under Secretary
for Strategy, Policy, and Plans of the Department of Homeland
Security shall submit to the Committee on Homeland Security
and Governmental Affairs of the Senate and the Committee on
Homeland Security of the House of Representatives a report
describing the efforts the Department has undertaken to
review and incorporate feedback from organizations
representing the needs of children into Department policy in
accordance with paragraph (6) of section 709(c) of the
Homeland Security Act of 2002 (6 U.S.C. 349(c)) (as added by
section 2 of this Act), and the effect of that review and
incorporation on the efforts of the Department to combat
human trafficking and drug trafficking and respond to natural
and manmade disasters, including information on the
following:
(1) The designation of any individual responsible for
carrying out the duties under such paragraph (6).
(2) Any review, formal or informal, of Department policies,
programs, or activities to assess the suitability of the
policies, programs, or activities for children and where
feedback from organizations representing the needs of
children should be reviewed and incorporated.
[[Page S5866]]
(3) Any review, change, modification, or promulgation of
Department policies, programs, or activities to ensure that
the policies, programs, or activities are appropriate for
children.
(4) Coordination with organizations or experts outside the
Department, under such paragraph (6), conducted to inform any
review, change, modification, or promulgation of policies,
programs, or activities described in paragraph (2) or (3) of
this subsection.
____________________