[Congressional Record (Bound Edition), Volume 146 (2000), Part 4]
[Senate]
[Pages 5167-5186]
[From the U.S. Government Publishing Office, www.gpo.gov]



          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. GRAHAM:
  S. 2383. A bill to amend the Immigration and Nationality Act to 
provide temporary protected status to certain unaccompanied alien 
children, to provide for the adjustment of status of aliens unlawfully 
present in the United States who are under 18 years of age, and for 
other purposes; to the Committee on the Judiciary.


                 alien children protection act of 2000

  Mr. GRAHAM. Mr. President, for many weeks, we have been dealing with 
the tragedy of Elian Gonzalez. If this tragedy teaches us anything, it 
is that the U.S. immigration laws have not

[[Page 5168]]

been constructed in a manner that accounts for the special needs of our 
Nation's most precious resource--I also say our world's most precious 
resource--our children.
  Yesterday, CNN-USA Today released a Gallup Poll on the Elian Gonzalez 
tragedy. That poll said by a 2-to-1 margin Americans believe Elian 
Gonzalez should live with his father in Cuba rather than with relatives 
in the United States. But that same poll, also by a 2-to-1 margin, 
found that Americans disapprove of the way the Government has handled 
this case. That disapproval of the way in which the Government has 
handled this case could be a disapproval of hundreds of cases if they 
had the same notoriety as Elian.
  I come this afternoon to introduce legislation that will require the 
Federal Government to dramatically improve its treatment of the 
thousands of unaccompanied children who arrive in the United States 
each year.
  Many of us are parents. I personally have been blessed with four 
beautiful daughters and 10 wonderful grandchildren. We all know the 
special joy a child brings to our lives. We know that bond across 
generations that relationship between a parent or a grandparent and a 
child brings. We all want to pour all of the history, all of our 
personal experience into safeguarding and into paving the way in the 
best interests of our children.
  The Bible tells us to take this responsibility seriously. In the book 
of Proverbs, it imparts this wisdom:

       Train up a child in the way he should go, and when he is 
     old he will not depart from it.

  We all have that responsibility to train up a child.
  As that passage from Proverbs suggests, we have a responsibility to 
protect and nurture all of our children. Their future--our planet's 
future--depends on it.
  Unfortunately, U.S. law prevents us from carrying out that 
responsibility with respect to some of this planet's most vulnerable 
children.
  Each year, there are about 5,000 unaccompanied children who are 
detained by the U.S. Immigration and Naturalization Service. Some 
children come to this country seeking asylum, others hope to be 
reunified with families, and others seek nothing but a better life. 
While many of these children ultimately are deported or voluntarily 
returned home, some have legitimate claims which merit our attention.
  Regardless of the outcome of their cases, in most instances, these 
children must endure the rigors of an immigration system that is 
anything but child friendly. Unfortunately, many children in INS 
custody end up spending time in jail-like settings while their cases 
are pending. They have no one to guide them through complex immigration 
law and procedure.
  Moreover, immigration laws are technical and inflexible and do not 
permit compassion or frequently even common wisdom to enter into the 
equation when determining the fate of a child.
  I will give some examples. Six Chinese children were detained by the 
INS last year in Oregon. Though charged with no crime, they were sent 
to a juvenile detention facility for 8 months where they were exposed 
to violent youthful offenders who had committed crimes such as murder 
and drug trafficking. One of the group, a 15-year-old girl, was forced 
to remain at the jail for several weeks after she had been granted 
asylum, even though she had relatives living in New York.
  Such innocent children should not have to endure exposure to hardened 
juveniles and criminals as part of their experience with the U.S. 
immigration process.
  Equally compelling is the story of a Kosovar Albanian boy who was 
suffering from severe depression. He was held in a juvenile 
correctional facility for over 6 months during his immigration 
proceedings. The INS provided psychiatric care but by a professional 
who spoke only English. After a mental episode, the boy was placed in 
the maximum security section of the jail rather than being provided 
with appropriate care. The INS even balked at placing the boy in foster 
care after he was granted asylum, thus further delaying his stay in an 
inappropriate facility.
  The Federal Government's insensitivity to child immigrants is also 
illustrated by a recent case of two children from the Caribbean. Their 
mother is a legal, permanent resident in the United States, but she had 
left her minor children behind with the belief they would soon follow. 
The mother promptly applied for visas for her children. Yet the 
children were required to wait in their home country for months and, in 
some cases, even years before they could even get an interview at the 
local U.S. Embassy to pave the way for reunification with their mother.
  These are just three examples of children who were improperly treated 
as a result of our current immigration laws. Many of these cases are 
the result of INS's inherent conflict of interest: Children are 
detained and frequently deported by the same agency that is responsible 
for caring for them and protecting their legal rights. This system does 
not work well enough, and it needs improvement. Children are entitled 
to receive care from child welfare authorities who will act in their 
best interest and who are trained to protect children's rights.
  Indeed, there is an irony. The Federal Government requires States to 
place children in facilities that are separate and apart from adult 
correctional facilities. The INS should at least abide by the same 
standard with respect to alien children.
  To address these problems, my legislation takes four actions: First, 
it requires that INS place children in its custody in a facility 
appropriate for children; in other words, no jails. These facilities 
are required to provide for the health, welfare, and educational needs 
of children.
  Two, provide children in INS custody with a guardian ad litem to 
champion that child's best interest. Notably, this guardian would not 
be associated with the INS in order to eliminate any conflict of 
interest.
  Three, give the Attorney General the flexibility and the authority in 
extraordinary cases to evaluate a child's case on the basis of what is 
in the best interest of the child.
  Four, to direct the General Accounting Office to conduct a study and 
report back to Congress regarding whether and to what extent U.S. 
diplomatic officials are fulfilling their obligation to reunify on a 
priority basis children in foreign countries whose parents are legally 
present in the United States.
  With these changes in the law, children will no longer be forced to 
struggle through the immigration process alone under the adverse 
conditions to which they are currently exposed. The INS will have the 
flexibility to treat children in its custody with greater compassion 
and common sense.
  I hope the recent attention which has and will continue to surround 
the Elian Gonzalez tragedy will encourage us to shield all our children 
from the vagaries of U.S. immigration law. Our future generations 
deserve to be protected, not persecuted or prosecuted. They deserve to 
be inspired, not incarcerated. They deserve to have decisions about 
their future made consistent with what is in their best interest, not 
confused by conflicts of interest.
  I conclude with hope that this Congress will give attention to an 
issue which affects not one child but thousands of children who are in 
the custody of the United States and whose treatment reflects our 
fundamental American values of justice and concern for their rights.
  Mr. President, I ask unanimous consent that the bill and three 
newspaper articles and editorials on the subject of ``INS Treats 
Children Shamefully'' be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 2383

       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 ``Alien Children Protection 
     Act of 2000''.

     SEC. 2. USE OF APPROPRIATE FACILITIES FOR THE DETENTION OF 
                   ALIEN CHILDREN.

       (a) In General.--Except as provided in subsection (b), in 
     the case of any alien under 18 years of age who is awaiting 
     final adjudication of the alien's immigration status

[[Page 5169]]

     and who does not have a parent, guardian, or relative in the 
     United States into whose custody the alien may be released, 
     the Attorney General shall place such alien in a facility 
     appropriate for children not later than 72 hours after the 
     Attorney General has taken custody of the alien.
       (b) Exception.--The provisions of subsection (a) do not 
     apply to any alien under 18 years of age who the Attorney 
     General finds has engaged in delinquent behavior, is an 
     escape risk, or has a security need greater than that 
     provided in a facility appropriate for children.
       (c) Definition.--In this section, the term ``facility 
     appropriate for children'' means a facility, such as foster 
     care or group homes, operated by a private nonprofit 
     organization, or by a local governmental entity, with 
     experience and expertise in providing for the legal, 
     psychological, educational, physical, social, nutritional, 
     and health requirements of children. The term ``facility 
     appropriate for children'' does not include any facility used 
     primarily to house adults or delinquent minors.

     SEC. 3. ADJUSTMENT TO PERMANENT RESIDENT STATUS.

       Section 245 of the Immigration and Nationality Act (8 
     U.S.C. 1255) is amended by adding at the end the following:
       ``(l)(1) The Attorney General may, in the Attorney 
     General's discretion, adjust the status of an alien under 18 
     years of age who has no lawful immigration status in the 
     United States to that of an alien lawfully admitted for 
     permanent residence if--
       ``(A)(i) the alien (or a parent or legal guardian acting on 
     the alien's behalf) has applied for the status; and
       ``(ii) the alien has resided in the United States for a 
     period of 5 consecutive years; or
       ``(B)(i) no parent or legal guardian requests the alien's 
     return to the country of the parent's or guardian's domicile, 
     or with respect to whom the Attorney General finds that 
     returning the child to his or her country of origin would 
     subject the child to mental or physical abuse; and
       ``(ii) the Attorney General determines that it is in the 
     best interests of the alien to remain in the United States 
     notwithstanding the fact that the alien is not eligible for 
     asylum protection under section 208 or protection under 
     section 101(a)(27)(J).
       ``(2) The Attorney General shall make a determination under 
     paragraph (1)(B)(ii) based on input from a person or entity 
     that is not employed by or a part of the Service and that is 
     qualified to evaluate children and opine as to what is in 
     their best interest in a given situation.
       ``(3) Upon the approval of adjustment of status of an alien 
     under paragraph (1), the Attorney General shall record the 
     alien's lawful admission for permanent residence as of the 
     date of such approval, and the Secretary of State shall 
     reduce by one the number of visas authorized to be issued 
     under sections 201(d) and 203(b)(4) for the fiscal year then 
     current.
       ``(4) Not more than 500 aliens may be granted permanent 
     resident status under this subsection in any fiscal year.''.

     SEC. 4. ASSIGNMENT OF GUARDIANS AD LITEM TO ALIEN CHILDREN.

       (a) Assignment.--Whenever a covered alien is a party to an 
     immigration proceeding, the Attorney General shall assign 
     such covered alien a child welfare professional or other 
     individual who has received training in child welfare matters 
     and who is recognized by the Attorney General as being 
     qualified to serve as a guardian ad litem (in this section 
     referred to as the ``guardian''). The guardian shall not be 
     an employee of the Immigration and Naturalization Service.
       (b) Responsibilities.--The guardian shall ensure that--
       (1) the covered alien's best interests are promoted while 
     the covered alien participates in, or is subject to, the 
     immigration proceeding; and
       (2) the covered alien understands the proceeding.
       (c) Requirements on the Attorney General.--The Attorney 
     General shall serve notice of all matters affecting a covered 
     alien's immigration status (including all papers filed in an 
     immigration proceeding) on the covered alien's guardian.
       (d) Definition.--In this section, the term ``covered 
     alien'' means an alien--
       (1) who is under 18 years of age;
       (2) who has no lawful immigration status in the United 
     States and is not within the physical custody of a parent or 
     legal guardian; and
       (3) whom no parent or legal guardian requests the person's 
     return to the country of the parent's or guardian's domicile 
     or with respect to whom the Attorney General finds that 
     returning the child to his or her country of origin would 
     subject the child to physical or mental abuse.

     SEC. 5. SENSE OF CONGRESS.

       Congress commends the Immigration and Naturalization 
     Service for its issuance of its ``Guidelines for Children's 
     Asylum Claims'', dated December 1998, and encourages and 
     supports the Service's implementation of such guidelines in 
     an effort to facilitate the handling of children's asylum 
     claims.

     SEC. 6 GENERAL ACCOUNTING OFFICE REPORT.

       The General Accounting Office shall prepare a report to 
     Congress regarding whether and to what extent U.S. Embassy 
     and consular officials are fulfilling their obligation to 
     reunify, on a priority basis, children in foreign countries 
     whose parent or parents are legally present in the United 
     States.
                                  ____


             [From the St. Petersburg Times, Mar. 8, 2000]

                     INS Treats Children Shamefully

       Reaching the U.S. mainland usually is no easy feat for 
     illegal immigrants fleeing their homelands. Whether crossing 
     the ocean by boat or trudging miles across desert, immigrants 
     nearly always face a journey that is dangerous and traumatic. 
     For the children of these immigrants, who often have no say 
     in their parents' decision to flee to the United States, that 
     trauma too often is compounded once they arrive--by an 
     American immigration system that treats kids like criminals.
       The Immigration and Naturalization Service says children 
     detained by the agency must be moved to a safe, kid-friendly 
     environment within 72 hours of their initial detention, 
     unless they are suspected criminals or considered a flight 
     risk. Advocates for these children say that rule rarely is 
     enforced. Instead, immigrant children typically are separated 
     from their loved ones and locked in juvenile detention 
     facilities, often before the INS has a chance to determine 
     the family's status.
       Because of a worsening space crunch at INS facilities, 
     nearly 1,000 of the 4,000 children detained by the INS within 
     the past year have been remanded to secure, jail-like 
     facilities where many have remained for months. The children 
     typically wear prison uniforms, and many are forced to mingle 
     with the teenage convicts also housed in the facilities. 
     Unlike the convicts, immigrant children get no legal 
     representation, and no adult guardians are appointed to 
     protect their interests.
       This shameful treatment of children is a symptom of the 
     broader problems plaguing U.S. immigration policy. It is a 
     system that allows legal U.S. residents to be detained 
     indefinitely on the basis of secret evidence. It is a system 
     that no longer gives judges discretion in deportation cases. 
     And it is a system that even the INS's own chief has 
     described as slow, inefficient and poorly managed.
       The INS is expected to issue new rules that will require 
     jails housing non-criminal INS detainees to meet specific 
     standards of care. Immigrant advocates hope the new rules 
     will give detainees the right to make phone calls, meet with 
     lawyers and prevent guards from subjecting them to arbitrary 
     strip searches.
       Even if those rules pass, they should be only the first of 
     many reforms initiated by the INS and Congress to ensure that 
     all detainees--especially children--are treated more humanely 
     by the U.S. government.
                                  ____


          [From the Seattle Post-Intelligencer, Mar. 21, 2000]

                   Immigration Law Busts Up Families

                       (By Llewelyn G. Pritchard)

       Llewelyn G. Pritchard is a Seattle attorney at Helsell 
     Fetterman. He is chairman of the American Bar Association 
     Advisory Committee to the Immigration Pro Bono Development 
     and Bar Activation Project. He is a former member of the 
     boards of the Washington State Bar Association and the 
     American Bar Association.
       Lately we have been bombarded with media stories about 
     immigrant families being ripped apart due to draconian 
     measures undertaken by the U.S. Immigration and 
     Naturalization Service.
       There is the Atlanta story about the German mother of two 
     who, having applied for citizenship, faces deportation 
     instead because years ago she admitted to pulling another 
     girl's hair over the affections of a boy.
       There is the Falls Church, Va., mom who called police after 
     repeatedly being beaten by her husband. She was arrested for 
     biting him after he sat on her. She faces deportation and 
     separation from her children, all of whom were born in the 
     United States.
       But we don't have to look beyond he boundaries of 
     Washington to hear terrible tales.
       There is the case of Emma Hay. This Puyallup mother of 
     four--all U.S. citizens--is being deported. Her crime was to 
     answer the telephone for a visiting relative who said he 
     didn't speak English well enough to talk to the caller.
       By simply saying her relative ``couldn't help the caller 
     today, but could help tomorrow,'' Hay was caught in a drug 
     sting and charged with ``using a communications facility to 
     facilitate the distribution of cocaine.'' Although she 
     claimed she wasn't aware of her cousin's activities, she 
     pleaded guilty and was convicted on federal drug charges. She 
     got no jail time, and was placed on probation for three 
     years, which she successfully completed.
       After living in our state for more than 20 years and 
     running a restaurant, Hay now faces deportation. While the 
     original incident earned her a probationary sentence because 
     she agreed to plead guilty, it has now become a deportable 
     offense.
       Hay was grabbed by the INS upon returning from a vacation, 
     all because the tough 1996 Illegal Immigration Reform and 
     Immigrant Responsibility Act has tipped the legal scales 
     against non-citizens * * *. This draconian law reclassifies 
     past infractions and

[[Page 5170]]

     makes them deportable offenses even in cases where no prison 
     time has been served or where there is evidence of 
     rehabilitation.
       This law also widely expanded the definition of aggravated 
     felony. Non-citizens convicted of ``aggravated felonies'' are 
     now not only deportable, but are also ineligible for a waiver 
     from deportation or even judicial review.
       Woe to the immigrant who applies to become a citizen only 
     to be trapped in the INS web, as in the case of the German 
     mother in Atlanta, or who seeks to re-enter the country as 
     Hay did.
       So now Hay sits in a Louisiana jail, thousands of miles 
     away from her lawyer and her children, awaiting deportation. 
     Her 20-year-old daughter has quit school to support the 
     family.
       What's the benefit of justice to her, her family or our 
     country? There is none under this new act.
       The INS has the fastest growing prison population in the 
     United States. There are more than 17,000 immigrants 
     detained, with predictions of 23,000 by year's end. Most 
     detainees do not have legal representation, even though the 
     INS adopted standards in 1998 allowing lawyer access in 
     federal INS facilities.
       The majority, or 60 percent, are warehoused in state and 
     local jails, at great cost to our overburdened prison budget. 
     Those folks are far away from immigration lawyers and have no 
     guarantee of legal access. Even those in federal INS 
     facilities are in remote areas and access is often difficult.
       We should be outraged. This can't be happening in America. 
     Newcomers live in all our communities, work at our sides, 
     attend our churches and our schools. They are our neighbors 
     and our friends.
       But there is some good news.
       The 60,000 member American Bar Association Section of 
     Litigation, which will meet in Seattle in early April, 
     announced that it will adopt our ABA immigration project as 
     one of its pro bono efforts, pairing up with lawyers with 
     detainees around the country.
       Their efforts will help some of the most defenseless in our 
     country. I applaud and welcome them in this worthy fight.
       We must make certain that the basic premise and promise of 
     our country is not forgotten: ``Justice for all.''
                                  ____


                 [From the Miami Herald, Jan. 9, 2000]

         The Littlest Refugees Merit Better Treatment From INS

       Immigration and Naturalization Service Commissioner Doris 
     Meissner projects uncommon compassion. ``Both U.S. and 
     international law recognize the unique relationship between 
     parent and child,'' she said in announcing her decision to 
     return 6-year-old Elian Gonzalez to his father in Cuba. 
     ``Family reunification has long been a cornerstone of both 
     American Immigration law and INS practice.''
       Unfortunately her agency doesn't always practice what she 
     preaches. Case in point: Two children, ages 8 and 10, were 
     repatriated to Haiti while their mother, desperate with worry 
     not knowing what had happened to them, was brought to Miami 
     for medical care.
       Yvena Rhinvil and her children were among some 400 
     passengers on the boat from Haiti that ran aground off Key 
     Biscayne on New Years Eve. They were trying to enter the 
     United States illegally. Both the Coast Guard and INS now say 
     that they didn't know about the children. Had it known, INS 
     says it would have tried to keep the kids with their mother.
       But Ms. Rhinvil says she spoke of her kids both to an 
     interpreter before being taken off the ship and once again on 
     land. What mother wouldn't?


                         kids don't come first

       If indeed the INS didn't know, it should have known before 
     it sent the children back. Nobody asked, which is 
     inexcusable. Fortunately an aunt watched Ms. Rhinvil's 
     children. But who knows if there were other unaccompanied 
     youths aboard that boat?
       The problem is that the INS is not equipped either by 
     mission or staffing to look out for the welfare of children. 
     First and foremost it is an enforcement agency, charged with 
     protecting our borders. Both policy and practice reflect it.
       Another case: A 15-year-old Chinese girl remained in a 
     Portland, Ore., juvenile jail more than six weeks after being 
     granted asylum and after an uncle in New York had agreed to 
     take her. She and five other teens fled China in April, only 
     to spend eight months in a criminal facility.
       Unfortunately, locking up minors such as these teens is not 
     an exception. That's because INS practices regarding children 
     vary widely by their nationality and INS district. Even 
     though international law and common decency dictate that 
     refugee children be detained only as a last measure and only 
     for a short time, detention in criminal juvenile facilities 
     happens regularly in some districts. Without caretakers and 
     most often without legal advisers, what hope can detained 
     children have of knowing or demanding their legal rights?


                           little protection

       For the most part, the Florida INS District treats minors 
     better than most. Unaccompanied children without U.S. 
     relatives are often placed with Catholic Charities facilities 
     such as Boystown. Children who arrive with parents are 
     typically placed in a hotel until the family is deported or 
     released from detention.
       Ideally all minors could be released to caring relatives, 
     and the INS frequently does this. Yet without the 
     intervention of child-welfare authorities, there is little 
     protection from abuse. The INS mandates such intervention 
     only when the child is from China or India because of the 
     track record of child servant-slaves. Yet Haitian children, 
     too, have been known to be sold into servitude.
       Capricious and inconsistent treatment of children simply is 
     unacceptable when last year alone the INS had some 5,300 
     minors in its custody.
                                 ______
                                 
      By Mrs. FEINSTEIN (for herself, Mrs. Hutchison, Mr. Baucus, Mr. 
        Murkowski, Mr. Cleland, Mr. Durbin, Ms. Landrieu, Mr. Smith of 
        Oregon, Mr. Lautenberg, Mr. Johnson, Mr. Kennedy, Mr. Edwards, 
        Mr. Campbell, Mr. Abraham, Mr. Kerry, Mr. Feingold, Mr. 
        Santorum, Mr. Leahy, Mr. Inhofe, Mr. Wellstone, Mr. Bingaman, 
        Mr. Moynihan, Mr. Hatch, Ms. Snowe, Mr. Hagel, Mr. Biden, Mr. 
        Mack, Mr. Grassley, Mr. Ashcroft, Mr. Bryan, Mrs. Murray, Mrs. 
        Boxer, Ms. Mikulski, Mr. Reid, Mr. Breaux, Mr. Dodd, Mr. 
        Lieberman, Mr. Kerrey, Mr. Daschle, Mr. Jeffords, and Mr. 
        Roth):
  S. 2386. A bill to extend the Stamp out Breast Cancer Act; to the 
Committee on Governmental Affairs.


        breast cancer research stamp reauthorization act of 2000

  Mrs. FEINSTEIN. Mr. President, I rise to introduce the bill entitled 
the Breast Cancer Research Stamps Reauthorization Act of 2000. I am 
pleased that Senator Kay Bailey Hutchison has joined me as the lead 
cosponsor.
  The Breast Cancer Research stamp is the first stamp in our nation's 
history dedicated to raising funds for a special cause. Since the 
stamp's issuance in the summer of 1998, the U.S. Postal Service has 
sold 164 million Breast Cancer Research stamps--raising over $12 
million for breast cancer research. In addition, the stamp has focused 
public awareness on the devastating disease and has stood out as a 
beacon of hope and strength around which breast-cancer survivors can 
rally.
  Unfortunately, without congressional action, the Breast Cancer 
Research stamp will expire on July 28, 2000. The Breast Cancer Research 
Stamp Reauthorization Act of 2000 would permit the sale of the Breast 
Cancer Research stamp for 2 additional years. The stamp would continue 
to cost 40 cents and sell as a first class stamp. The extra money 
collected will be directed to breast cancer research at the National 
Institutes of Health and the Department of Defense.
  A Breast Cancer Research stamp remains just as necessary today as 2 
years ago. Breast cancer is the most commonly diagnosed cancer among 
women in every major ethnic group in the United States. More than 2 
million women are living with breast cancer in America, 1 million of 
whom have yet to be diagnosed.
  Breast cancer continues to be the number one cancer killer of women 
between the ages of 15 and 54. This year alone, 182,800 women will be 
diagnosed with breast cancer, and 40,800 women will die from the 
disease. The disease claims another woman's life every 15 minutes in 
the United States.
  Thanks to breakthroughs in cancer research, more and more people are 
becoming cancer survivors rather than cancer victims. According to the 
American Association for Cancer Research, 8 million people are alive 
today as a result of cancer research. The bottom line is that every 
dollar we continue to raise will save lives.
  I am pleased to report that this reauthorization bill has over 39 
original cosponsors and broad support within the health community.
  Let me just repeat a couple of the glowing comments from the many 
groups in support of this bill. It shows the truly astounding impact of 
this stamp.
  The Susan G. Komen Foundation writes:

       The Breast Cancer Research stamp has not only raised 
     millions of dollars by providing a

[[Page 5171]]

     convenient and innovative mechanism for public participation 
     in the [battle against breast cancer], but it has also 
     focused public awareness on this devastating disease.

  Betsy Mullen of Women's Information Network--Against Breast Cancer 
adds:

       This bill, if passed will provide an innovative, simple and 
     now proven way for individuals to make a substantial 
     contribution to fund federal cancer research and to continue 
     to be a part of what has become an effective public-private 
     partnership.

  The American Association of Health Plan attests:

       We've heard from our physicians about women who have 
     scheduled examinations or mammograms after purchasing the 
     stamp or receiving a card or letter posted with it.

  Oliver Goldsmith, chairman of the Southern California Permanente 
Medical Group, writes:

       The Breast Cancer Research stamp captures the essence of 
     innovation, volunteerism and partnership that are such an 
     integral aspect of our country's history and spirit. This 
     vital legislation will give all of us the opportunity to 
     continue to work together to eradicate breast cancer. The 
     American people can realistically continue to raise millions 
     of dollars a year to fund cutting edge research to end this 
     rampant disease that claims the lives of all too many breast 
     cancer victims in this country and around the world.

  Other supporters of the Breast Cancer Stamp Reauthorization Act of 
2000 include the American Cancer Society, the American Medical 
Association, the Y-Me National Breast Cancer Organization, Leadership 
America, the National Association of Women's Health, the American 
Cancer League, the American College of Surgeons, Friends of Cancer 
Research, the California Nurses Association, the Association of 
Reproductive Health Care Professionals, and many others.
  I urge my colleagues to join me in enacting this important 
legislation.
                                 ______
                                 
      By Mr. LEAHY (for himself, Mr. Jeffords, Mr. Kennedy, Mr. Kerry, 
        Mr. Durbin, and Mr. Wellstone):
  S. 2387. A bill to improve global health by increasing assistance to 
developing nations with high levels of infectious disease and premature 
deaths, by improving children's and women's health and nutrition, by 
reducing unintended pregnancies, and by combating the spread of 
infectious diseases, particularly HIV/AIDS, and for other purposes; to 
the Committee on Foreign Relations.


                       GLOBAL HEALTH ACT OF 2000

  Mr. LEAHY. Mr. President, today the Foreign Operations Subcommittee 
held its third hearing on global health since 1997. Our first hearing 
was the first of its kind in the Congress, when we highlighted how 
disease outbreaks and impoverished public health systems half a world 
away directly threaten Americans. Since then, the interest in these 
issues in the Congress, the Administration, the media and the public 
has skyrocketed.
  Today, there are about a dozen pieces of legislation pending which 
deal with some aspect of global health, the President has proposed 
major increases in funding and policy initiatives to encourage the 
pharmaceutical companies to invest in new vaccines against HIV/AIDS, 
malaria, TB, and other major killers, and the World Health Organization 
is setting the pace for us all to tackle these challenges with new 
energy and new resources.
  This sea change is a reflection of the magnitude of the challenges 
and opportunities, as well as a recognition of the essential role the 
United States must play in global health.
  There is no need to recite at length what has spurred this interest, 
but I do want to cite a couple of illustrative facts:
  In America, each year we spend over $4,000 per person on health care.
  In the countries where 2 billion of the world's people live in 
desperate poverty, only $3 to $5 per person per year is spent on health 
care.
  It would cost just $15 per person per year to address most of the 
urgent health needs of those 2 billion people.
  With that $15 per person, we could prevent or cure the many millions 
of deaths caused by tuberculosis, malaria, pneumonia, diarrheal 
diseases, measles, HIV/AIDS, and pregnancy related diseases.
  That is the challenge we face. The benefits to the world, and to the 
United States, should be obvious. In an increasingly interdependent 
world, reducing the threats posed by infectious diseases and poor 
reproductive health, and the social and economic consequences of 
poverty and disease, is absolutely key to our own future security and 
prosperity.
  The Congress has become increasingly seized with these issues. 
However, while I strongly support most of the bills that have been 
introduced--and I am a cosponsor of Senator Kerry's ``Vaccines for the 
New Millennium Act,'' they have tended to focus narrowly on the 
eradication of specific diseases and the development of new vaccines.
  These are admirable and important goals, but I have always believed 
that global health consists of a broader set of issues that must be 
addressed together. Our primary challenge is to provide the resources 
to enable developing countries to build the capacity--both human and 
infrastructure, to support effective public health systems. That was 
the motivation for my infectious disease initiative three years ago, 
which since then has provided an additional $175 million to support 
programs in surveillance, anti-microbial resistance, TB, and malaria.
  Today, in an effort to build on that initiative, I am introducing new 
legislation to authorize an additional $1 billion to support five key 
components of global health. The ``Global Health Act of 2000,'' targets 
HIV/AIDS; other deadly infectious diseases such as TB, malaria, and 
measles; children's health; women's health; and family planning.
  Together, these five groups of issues account for over 80 percent of 
the disproportionate burden of disease and death borne by the 2 billion 
people living in the world's poorest countries. This legislation, an 
identical version of which Congressman Joseph Crowley has introduced in 
the House, has the strong support of the Global Health Council, the 
world's largest consortium of private and public companies and 
organizations, agencies and governments, involved in public health.
  We have the technology to do this. The key missing ingredient is 
political will, and resources.
  We can, and we must, recognize that we need to think in terms of far 
larger amounts of money if we are serious about global health. Every 
dollar of the additional $1 billion called for in my legislation, which 
is approximately double the amount we currently spend on these 
activities, is justified and urgently needed. And the payoff would be 
enormous, both in terms of lives saved and in future health care cost 
savings.
  Senator McConnell, the chairman of the Foreign Operations 
Subcommittee, has been a strong supporter of global health, and I will 
be working in the Appropriations Committee to obtain the funds we need 
to achieve these goals.
                                 ______
                                 
      By Mr. ROTH;
  S. 2389. A bill to provide additional assistance for fire and 
emergency services, and for other purposes; to the Committee on 
Environment and Public Works.


          21st century fire and emergency services act of 2000

 Mr. ROTH. Mr. President, firefighters and EMS personnel are 
truly our nation's first responders. When the tragic images of natural 
or manmade disasters flash across our TV screens, there is one image 
that stands alone. The American firefighter is always there to rescue 
the family from a burning building, always there in the wake of a 
natural disaster, and is always there should a terrorist strike in our 
nation's heartland. These scenes are played out around our country on a 
daily basis. And while we see these images on TV as just a part of our 
society today, what is not realized is the cost our first responders 
bear.
  The 1.2 million men and women that serve in our nation's 32,000 fire 
departments do so with little fanfare, and often with little or no pay. 
Our nation's first responders ask very little of us, but, thankfully, 
they are always there when we need them.
  That is why I have introduced the 21st Century Fire and Emergency 
Services Act which is a companion to the

[[Page 5172]]

House-passed legislation. This legislation is an important step forward 
for the fire and EMS community.
  Every year I hear from fire departments in Delaware who are looking 
to acquire state-of-the-art equipment to enhance their performance on a 
fire scene, or attempting to secure funding to train personnel in arson 
detection. I also hear from fire personnel seeking funds to create all-
important fire prevention programs at local elementary schools. These 
are just a few examples. The point is that for all too many 
departments, after the general operating expenses are calculated, there 
is no funding for this equipment or special program. Funds raised 
through chicken dinners, bingo and bake sales can only go so far.
  Back home, the Delaware Volunteer Firemen's Association is sending 
out the call for help. My legislation establishes two grant programs at 
the Federal Emergency Management Agency. The first is an $80 million 
competitive grant program for volunteer and paid fire and emergency 
services departments. With these 50/50 matching grants, I believe this 
legislation will give departments throughout our country an opportunity 
to have the thermal imaging camera or the health and wellness program 
needed to help them do their jobs even better.
  Second, this bill establishes a $10 million burn research grant 
program through FEMA. Under this program, safety organizations, 
hospitals, and governmental and nongovernmental entities that are 
responsible for burn research, prevention, or treatment are eligible 
for competitive grants to continue their important work.
  Finally, this bill recognizes the contributions of volunteer 
firefighters by providing $10 million to fully fund the USDA's 
Volunteer Fire Assistance Program. This program allows the nearly 
28,000 rural fire departments nationwide to apply for cost-share grants 
for training, equipping and organizing their personnel. These rural 
fire departments represent the first line of defense for rural areas 
coping with fires and other emergencies.
  Personally, I am excited about the technology that is available to 
first responders today, and I am committed to working to ensure that 
every department in Delaware and throughout the country has the tools 
it needs to make us all safer in our homes and communities. Let's not 
wait for the next disaster to hear the call.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2389

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``21st Century Fire and 
     Emergency Services Act of 2000''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) Agency.--The term ``Agency'' means the Federal 
     Emergency Management Agency.
       (2) Burn program.--The term ``burn program'' means the Burn 
     Services Grant Program established by section 3(a).
       (3) Director.--The term ``Director'' means the Director of 
     the Agency.
       (4) Fire program.--The term ``fire program'' means the 
     ``Fire Services Grant Program'' established under section 
     4(a).

     SEC. 3. BURN SERVICES GRANT PROGRAM.

       (a) Establishment.--There is established within the Agency 
     a grant program to be known as the ``Burn Services Grant 
     Program''.
       (b) Competitive Grants.--The Director may make a grant 
     under the burn program, on a competitive basis, to--
       (1) a safety organization that has experience in conducting 
     burn safety programs, for the purpose of assisting the 
     organization in conducting or augmenting a burn prevention 
     program;
       (2) a hospital that serves as a regional burn center, for 
     the purpose of conducting acute burn care research; or
       (3) a governmental or nongovernmental entity, for the 
     purpose of providing after-burn treatment and counseling to 
     individuals that are burn victims.
       (c) Program Office.--The Director shall establish within 
     the Agency an office to--
       (1) establish criteria for use by the Director in awarding 
     grants under the burn program; and
       (2) administer grants awarded under the burn program.
       (d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $10,000,000, to 
     remain available until expended.

     SEC. 4. FIRE SERVICES GRANT PROGRAM.

       (a) Establishment.--The Director shall establish within the 
     Agency a grant program known as the ``Fire Services Grant 
     Program'' to award grants to volunteer, paid, and combined 
     volunteer-paid departments that provide fire and emergency 
     medical services.
       (b) Use of Funds.--A grant awarded under the fire program 
     may be used to--
       (1) acquire--
       (A) personal protective equipment required for firefighting 
     personnel by the Occupational Safety and Health 
     Administration; and
       (B) other personal protective equipment for firefighting 
     personnel;
       (2) acquire additional firefighting equipment, including 
     equipment for communication and monitoring;
       (3) establish wellness and fitness programs for 
     firefighting personnel to reduce the number of injuries and 
     deaths related to health and conditioning problems;
       (4) promote professional development of fire code 
     enforcement personnel;
       (5) integrate computer technology to improve records 
     management and training capabilities;
       (6) train firefighting personnel in--
       (A) firefighting;
       (B) emergency response; and
       (C) arson prevention and detection;
       (7) enforce fire codes;
       (8) fund fire prevention programs and public education 
     programs on--
       (A) arson prevention and detection; and
       (B) juvenile fire setter intervention; and
       (9) modify fire stations, fire training facilities, and 
     other facilities to protect the health and safety of 
     firefighting personnel.
       (c) Applications.--An applicant for a grant awarded under 
     the fire program shall submit to the Director an application 
     that includes--
       (1) a demonstration of the financial need of the applicant;
       (2) evidence of a commitment by the applicant to provide 
     matching funds from non-Federal sources for the project that 
     is the subject of the application in an amount that is at 
     least equal to the amount of funds requested in the 
     application;
       (3) a cost-benefit analysis linking the funds requested to 
     improvements in public safety; and
       (4) a commitment by the applicant to provide information to 
     the National Fire Incident Reporting System for the period 
     for which the grant is received.
       (d) Audits.--The Director shall conduct audits of grant 
     recipients to ensure that grant funds are used for the 
     purposes for which the grant is awarded.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $80,000,000, to 
     remain available until expended.

     SEC. 5. COOPERATIVE FORESTRY ASSISTANCE.

       The Secretary of Agriculture shall use the funds, 
     facilities, and authorities of the Commodity Credit 
     Corporation to carry out paragraphs (1) through (3) of 
     section 10(b) of the Cooperative Forestry Assistance Act of 
     1978 (16 U.S.C. 2106(b)), not to exceed $10,000,000, to 
     remain available until expended.
                                 ______
                                 
      By Mr. DeWINE (for himself, Mr. Warner, Mr. Hutchinson, Mr. 
        Sessions, Mr. Helms, and Mr. Abraham):
  S. 2390. A bill to establish a grant program that provides incentives 
for States to enact mandatory minimum sentences for certain firearms 
offenses, and for other purposes; to the Committee on the Judiciary.


     project exile: the safe streets and neighborhoods act of 2000

 Mr. DeWINE. Mr. President, I come to the floor today because I 
am troubled. Guns are falling into the wrong hands. It's killing our 
children. It's killing our friends and our neighbors. It's creating 
mayhem in communities across America. That's why I'm introducing 
Project Exile: The Safe Streets and Neighborhoods Act of 2000.
  It's no secret that gun control measures are very controversial and 
are subject to a great deal of debate--as they should be. But, in the 
heat of that debate, we must not lose sight of the real issue--gun 
violence. There is nothing controversial about protecting our children, 
our families and our communities by keeping guns out of the wrong 
hands--the hands of armed criminals--not law-abiding citizens, Mr. 
President, but criminals.
  The Safe Streets and Neighborhoods Act offers a simple, commonsense 
approach to fighting gun violence. My bill would provide $100 million 
in grants over 5 years to those states agreeing to impose mandatory 
minimum 5-year jail sentences on criminals who use or possess an 
illegal gun.

[[Page 5173]]

As an alternative, a state can also qualify for the grants by turning 
armed criminals over for federal prosecution under existing firearms 
laws. Therefore, a state has the option of having armed felons 
prosecuted in state or federal courts. Qualifying states can use their 
grants for any purpose that would strengthen the ability of their 
criminal or juvenile justice systems to deal with violent criminals.
  Back in 1991, the Federal Government implemented a program to aim 
antigun violence efforts at the root of the problem--at criminals. This 
program--known as project Triggerlock--directed every U.S. attorney to 
coordinate with federal, state, and local investigators to bring 
federal weapons charges against armed criminals. Sentences for these 
prosecutions were generally more severe than they would have been under 
state laws. The program was hugely successful. In fact, simply by 
making gun prosecutions a federal priority, starting in 1991, Project 
Triggerlock took away over 2,000 guns from violent felons in just 18 
months.
  Tragically, Mr. President, despite the success of Project 
Triggerlock, the current administration has not aggressively prosecuted 
all armed criminals. Between 1992 and 1998, for example, the number of 
gun cases filed for prosecution dropped from 7,048 to about 3,807--
that's a 46-percent decrease. As a result, the number of federal 
criminal convictions for firearms offenses have fallen dramatically.
  Even worse, some federal firearms laws are almost never enforced by 
this administration. While Brady law background checks have stopped 
nearly 300,000 prohibited purchasers of firearms from buying guns, less 
than one-tenth of one percent have been prosecuted. Similarly, federal 
criminal prosecutions for possession of a firearm on school grounds 
numbered just eight in 1998, despite the fact that 6,000 individuals 
were caught carrying guns to school. There's something wrong with this 
picture, Mr. President, something terribly wrong.
  I believe most Americans would agree that we should take guns out of 
the hands of armed criminals. I believe that most Americans would agree 
that criminals who possess a firearm or use a firearm during the 
commission of a violent crime or a serious drug trafficking offense 
should face severe penalties. And, Mr. President, I also believe that 
most Americans would favor legislation that offers a single, 
noncontroversial, commensense approach to fighting gun violence.
  So, today, I, along with my colleagues, introduce Project Exile: The 
Safe Streets and Neighborhoods Act, which builds on the previous 
success of programs like Project Triggerlock and offers the kind of 
practical solution we need to thwart gun crimes.
  This approach works, Mr. President. For example, in 1997, Virginia 
revived Project Triggerlock under the name ``Project Exile.'' 
Specifically, the city of Richmond and the U.S. attorney implemented a 
program based on one simple principle: any criminal caught with a gun 
serves a minimum mandatory sentence of 5 years in federal prison. 
Period. End of story. As a result, gun-toting criminals are being 
prosecuted six times faster, and serving sentences up to four times 
longer than they otherwise would under state law. Moreover, the 
homicide rate in Richmond already has dropped 40 percent.
  It is clear that programs like Project Triggerlock and Virginia's 
Project Exile work, while at the same time being very simple. But 
still, federal gun prosecutions have declined considerably during this 
administration because it has not emphasized these programs. Why? I 
have repeatedly questioned Attorney General Reno and her deputies about 
this decline, and their standard response is that the Department of 
Justice is focusing on so-called ``high-level'' offenders, instead of 
``low-level'' offenders who commit a crime with a gun. With all due 
respect, I consider that response to be bureaucratic nonsense. One 
thing I learned as Greene County Prosecutor in my home state of Ohio is 
that any criminal who commits a crime with a gun is a high-level 
offender. And, I'm willing to bet that any citizen who has ever been a 
victim of a gun-crime would agree.
  Furthermore, the idea that there are a lot of so-called ``low-level'' 
offenders, who commit only one crime with a gun, is just plain wrong. 
The average armed criminal commits 160 crimes a year; that is an 
average of three crimes per week. These people are, by themselves, 
walking crime waves.
  Along the same lines, Attorney General Reno recently said that she 
would aggressively prosecute armed criminals, but only if they commit a 
violent crime. Again, that type of law enforcement policy just does not 
make sense. Current law prohibits felons from possessing guns--we 
should enforce the law. We should aggressively prosecute armed 
criminals before they use those guns to injure and kill people.
  We need to take all of these armed criminals off the streets. That is 
how we will prevent crime and save lives. Why wait for armed criminals 
to commit more heinous crimes before we prosecute them to the full 
extent of the law? Why wait when we can do something that will make a 
difference now, before another Ohioan--or any American--becomes a 
victim of gun violence.
  Every state should have the opportunity to implement Project Exile in 
their high-crime communities. The bill that we are introducing today 
will make this proven, commonsense approach to reducing gun violence 
available to every state. Programs like Project Triggerlock and Project 
Exile will take guns out of the hands of violent criminals. They will 
make our neighborhoods safer. They will save lives.
  We can take concrete steps toward making our streets and 
neighborhoods safer from armed criminals by passing the ``Safe Streets 
and Neighborhoods Act.'' I urge my colleagues on both sides of the 
aisle to support and pass this legislation. It's time to protect our 
children and our families. It's time to get guns out of the wrong 
hands. It's time we take back our neighborhoods and our communities 
from the criminals and take action to stop gun crimes.
                                 ______
                                 
      By Mr. ROTH:
  S. 2391. A bill to suspend temporarily the duty on (S)-6-chloro-3,4-
dihydrol - 4 - cyclopropyethynyl-4-trifluoromethyl-2(1H)-quinazolinone; 
to the Committee on Finance.
  S. 2392. A bill to suspend temporarily the duty on (S)-6-chloro-3,4-
dihydro-
4E-cyclopropyethynyl - 4 - trifluoro-methyl-2(1H)-quinazolinone; to the 
Committee on Finance.


    legislation to temporarily reduce tariffs on hiv-combating drugs

  Mr. ROTH. Mr. President, I rise today to introduce two bills, each of 
which would temporarily suspend the tariff collected on imports of two 
HIV-combating drugs, thus lowering their price for HIV-infected 
consumers in the United States.
  The two drugs are DPC 961 and DPC 083. They have been selected from 
hundreds of candidates to have superior attributes relative to 
currently marketed similar drugs. As such, their combined potency, 
excellent resistance profile, lower protein binding, and longer plasma 
half life increases the probability that these drugs will successfully 
treat both HIV patients who have not previously had a similar treatment 
as well as those HIV patients who have already developed resistance to 
currently available agents. According to publicly available 
information, there is no other HIV treatment in clinical trials that is 
expected to be able to treat most patients with resistance to currently 
available agents. DPC 961 and DPC 083 are also expected to have the 
advantage of once daily therapy.
  In addition, it is my expectation that the revenue impact of these 
measures will be determined by the Congressional Budget Office to be de 
minimus. There is no manufacturer of these drugs in the United States. 
It is my hope that these measures will win the unanimous support of my 
colleagues.
                                 ______
                                 
      By Mr. DURBIN (for himself and Mr. Feingold):
  S. 2393. A bill to prohibit the use of racial and other 
discriminatory profiling in connection with searches

[[Page 5174]]

and detentions of individuals by the United States Customs Service 
personnel, and for other purposes; to the Committee on Finance.


                  the reasonable search standards act

 Mr. DURBIN. Mr. President, I rise today to introduce the 
Reasonable Search Standards Act. This act prohibits racial or other 
discriminatory profiling by Customs Service personnel. Representative 
John Lewis from Georgia has introduced similar legislation in the 
House.
  Two years ago, I requested a GAO study of the U.S. Customs Service's 
procedures for conducting inspections of airport passengers. The need 
for this study grew out of an investigation report by Renee Ferguson of 
WMAQ-TV in Chicago and several complaints from African-American women 
in my home state of Illinois who were strip-searched at O'Hare Airport 
for suspicion of carrying drugs. No drugs were found and the women felt 
that they had been singled out for these highly intrusive searches 
because of their race. These women, approximately 100 of them, have 
filed a class action suit in Chicago.
  The purpose of the GAO study was to review Customs' policies and 
procedures for conducting personal searches of airport passengers and 
to determine the internal controls in place to ensure that airline 
passengers are not inappropriately targeted or subjected to personal 
searches.
  Approximately 140 million passengers entered the United States on 
international flights during fiscal years 1997 and 1998. Because there 
is no data available on the gender, race and citizenship of this 
traveling population, GAO was not able to determine whether specific 
groups of passengers are disproportionately selected to be searched.
  However, once passengers are selected for searches, GAO was able to 
evaluate the likelihood that people with various race and gender 
characteristics would be subjected to searches that are more personally 
intrusive, such as strip-searches and x-rays, rather than simply being 
frisked or patted down.
  The GAO study revealed some very troubling patterns in the searches 
conducted by U.S. Customs Service inspectors.
  GAO found disturbing disparities in the likelihood that passengers 
from certain populations groups, having been selected for some form of 
search, would be subjected to the more intrusive searches including 
strip-searches or x-ray searches. Moreover, that increased likelihood 
of being intrusively searched did not always correspond to an increased 
likelihood of actual carrying contraband.
  Because of the intrusive nature of strip-searches and x-ray searches, 
it is important that the Customs Service avoid any discriminatory bias 
in forcing passengers to undergo these searches.
  GAO found that African-American women were much more likely to be 
strip-searched than most other passengers. This disproportionate 
treatment was not justified by the rate at which these women were found 
to be carrying contraband. Certain other groups also experienced a 
greater likelihood of being strip-searched relative to their likelihood 
of being found carrying contraband.
  Specifically, African-American women were nearly 3 times as likely as 
African-American men to be strip-searched, even though they were only 
half as likely to be found carrying contraband. Hispanic-American and 
Asian-American women were also nearly 3 times as likely as Hispanic-
American and Asian-American men to be strip-searched, even though they 
were 20 percent less likely to be found carrying contraband.
  In addition, African-American women were 73 percent more likely than 
White-American women to be strip-searched in 1998 and nearly 3 times as 
likely to be strip-searched in 1997, despite only a 42 percent higher 
likelihood of being found carrying contraband. Moreover, among non-
citizens, White men and women were more likely to be strip-searched 
than Black and Hispanic men and women, despite lower rates of being 
found carrying contraband.
  As with strip-searches, x-rays are personally intrusive and it is of 
particular concern that the Customs Service avoid any discriminatory 
bias in requiring x-ray searches of passengers suspected of carrying 
contraband.
  GAO found that African-Americans and Hispanic-Americans were much 
more likely to be x-rayed than other passengers. This disproportionate 
treatment was not justified by the rate at which these passengers were 
found to be carrying contraband.
  Specifically, GAO found that African-American women were nearly 9 
times as likely as White-American women to be x-rayed even though they 
were half as likely to be carrying contraband. African-American men 
were nearly 9 times as likely as White-American men to be x-rayed, even 
though they were no more likely than White-American men to be carrying 
contraband. Moreover, Hispanic-American women and men were nearly 4 
times as likely as White-American women and men to be x-rayed, even 
though they were only a little more than half as likely to be carrying 
contraband. And among non-citizens, Black women and men were more than 
4 times as likely as White women and men to be x-rayed, even though 
Black women were only half as likely and Black men were no more likely 
to be found carrying contraband.
  For these reasons, I am introducing the Reasonable Search Standards 
Act. This bill is a direct response to the concerns raised by the GAO 
report. The bill prohibits Customs Service personnel from selecting 
passengers for searches based in whole or in part on the passenger's 
actual or perceived race, religion, gender, national origin, or sexual 
orientation.
  To ensure that a sound reason exists for selecting someone to be 
searched, the bill requires Customs Service personnel to document the 
reasons for searching a passenger before the passenger is searched. The 
only exception to this requirement is when the Customs official 
suspects that the passenger is carrying a weapon.
  The bill also requires all Customs Service personnel to undergo 
periodic training on the procedures for searching passengers, with a 
particular emphasis on the prohibition on profiling. The training shall 
include a review of the reasons given for searches, the results of the 
searches and the effectiveness of the criteria used by Customs to 
select passengers for searches.
  Finally, the bill calls for an annual study and report on detentions 
and searches of individuals by Customs Service personnel. The report 
shall include the number of searches conducted by Customs Service 
personnel, the race and gender of travelers subjected to the searches, 
the type of searches conducted--including pat down searches and 
intrusive non-routine searches--and the results of these searches.
  With this proposed legislation, I call on the Congress of the United 
States to act, to make a commitment giving all persons entering and 
leaving our borders, regardless of gender, race, color, religion, or 
ethnic background, the right to be treated fairly.
  Lyndon B. Johnson once said, ``I am a free man, an American, a United 
States Senator, and a Democrat, in that order.'' I am also all of 
these, in that order.
  As a man, I am saddened that, in this new millennium, women and 
minorities are disproportionately selected for intrusive searches at 
our nation's borders.
  As an American, I am deeply troubled by the thought that any citizen, 
or non-citizen, might be detained and stripped or x-rayed because of 
their gender or the color of their skin.
  As a United States Senator, I am proposing legislation to prohibit 
racial or other inappropriate profiling and establish statutory 
procedures to track and prevent disproportionate search rates. This 
approval reflects our nation's basic posture of common sense and common 
justice.
  I implore my colleagues to examine this issue from the viewpoint of 
the nation and its entire people. In the immortal words of John F. 
Kennedy, ``The rights of every man are diminished when the rights of 
one man are threatened.''

[[Page 5175]]


                                 ______
                                 
      (By Mr. MOYNIHAN (for himself, Mr. Kennedy, Mr. Schumer, Mr. 
        Helms, Mr. Kerrey, Mrs. Boxer, Mr. Inouye, Mr. Santorum, Mr. 
        Torricelli, Mr. Johnson, Mrs. Feinstein, Mr. Smith of Oregon, 
        Mr. Kerry, Mr. DeWine, Mr. Edwards, Mr. Cleland, Mr. Lieberman, 
        Mr. Levin, Mr. Sarbanes, Mr. Wellstone, Mr. Reed, Mrs. Murray, 
        Ms. Mikulski, and Mr. Specter):
  S. 2394. A bill to amend title XVIII of the Social Security Act to 
stabilize indirect graduate medical education payments; to the 
Committee on Finance.


             THE TEACHING HOSPITAL PRESERVATION ACT OF 2000

 Mr. MOYNIHAN. Mr. President, today I am introducing a bill--
The Teaching Hospital Preservation Act of 2000--that would provide much 
needed financial support for America's 144 accredited medical and 
osteopathic schools and 1,250 graduate medical education (GME) teaching 
institutions. Teaching hospitals are national treasures; these 
institutions are the very best in the world. Yet, today they find 
themselves in a precarious financial situation as market forces reshape 
the health care delivery system in the United States.
  Markets do not provide for public goods such as teaching hospitals. 
Everyone benefits from public goods but no one has any incentive to 
pay. It follows, therefore that for the most part teaching hospitals 
have to be paid for by the public either indirectly through tax 
exemption or directly through expenditure.
  The legislation I am introducing is similar to S. 1023--The Graduate 
Medical Education Payment Restoration Act of 1999--a bill I introduced 
during the first session. Congressman Rangel is introducing an 
identical bill in the House today.
  My particular interest in this subject began in 1994, when the 
Finance Committee took up the President's Health Security Act. I was 
Chairman of the Committee at the time. In January of that year, I asked 
Dr. Paul Marks, M.D., President of Memorial Sloan-Kettering Cancer 
Center in New York City, if he would arrange a ``seminar'' for me on 
health care issues. He agreed, and gathered a number of medical school 
deans together one morning in New York.
  Early on in the meeting, one of the seminarians remarked that the 
University of Minnesota might have to close its medical school. In an 
instant I realized I had heard something new. Minnesota is a place 
where they open medical schools, not close them. How, then, could this 
be? The answer was that Minnesota, being Minnesota, was a leading state 
in the growth of competitive health care markets, in which managed care 
organizations try to deliver services at lower costs. In this 
environment, HMOs and the like do not send patients to teaching 
hospitals, absent which you cannot have a medical school.
  We are, my friends, in the midst of a great era of discovery in 
medical science--an era which might end prematurely if we are not 
careful with our finances. It is certainly not a time to close medical 
schools. This great era of medical discovery is occurring right here in 
the United States, not in Europe like past ages of scientific 
discovery. And it is centered in New York City. Progress over the past 
60 years has been remarkable: images of the inside of the human body 
based on the magnetic resonance of bodily tissues; laser surgery; micro 
surgery for reattaching limbs; and organ transplantation, among other 
wonders. Physicians are now working on a gene therapy that might 
eventually replace bypass surgery. I can hardly imagine what might be 
next.
  The growth of managed for-profit care, which does not fund public 
goods, combined with reductions in Medicare support for GME, is having 
a deleterious effect on the financial position of teaching hospitals. 
The Medicare program is the nation's largest explicit financier of GME, 
with annual payments of about $5.4 billion in 1999. However, because of 
payment reductions set forth by the Balanced Budget Act (BBA) of 1997, 
Medicare support is eroding as well--down from $6.3 billion in 1997. 
According to the Medicare Payment Advisory Commission, between 1997 and 
1998, the margins for major teaching hospital have been slashed by more 
than half, and are at their lowest point of the century. And this is an 
average; individual hospitals have fared far worse.
  With declining margins and many hospitals operating in the red, the 
mission of these fine institutions is in jeopardy. The teaching 
hospitals that we know and depend on today--including those in my state 
of New York-- may not be able to continue their work, or even to 
survive. If this is to happen, we could face what Walter Reich has 
called ``the dumbing down of American medicine.''
  Last year, we forestalled some cuts enacted in the BBA by passing the 
Balanced Budget Refinement Act (BBRA) of 1999, however, this 
legislation provided only short-term relief and does not go for enough. 
To ensure that this precious public resource is maintained and the 
United States continues to lead the world in quality health care, my 
bill, the Teaching Hospital Preservation Act of 2000 would maintain 
critically required funding.
  The Teaching Hospital Preservation Act of 2000, with a total of 23 
cosponsors, would freeze the scheduled reductions to the indirect 
portion of GME funding. Under the BBA, the indirect payment adjustor 
was scheduled to be reduced from 7.7 percent to 5.5 percent by FY 2001. 
Last year, the BBRA slowed the cuts by holding the indirect payment 
adjuster at 6.5 percent in FY 2000, 6.25 percent in FY 2001 and 5.5 
percent in FY 2002 and thereafter. BBRA restored about $500 million--
over 5 years--in funding for teaching hospitals. The bill I introduce 
today would maintain the indirect payment adjuster at 6.5 percent. In 
total, this bill restores about another $2 billion over 5 years in GME 
funding for teaching hospitals.
  This bill would protect our nation's teaching hospitals and ensure 
that the United States will continue to be in the forefront of 
developing new cures, new medical technology, and training of the 
worlds finest medical professionals. Without this bill, the state of 
our nation's teaching hospitals and the delivery of health care will 
remain in jeopardy.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2394

       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 ``Teaching Hospital 
     Preservation Act of 2000''.

     SEC. 2. REVISION OF REDUCTION OF INDIRECT GRADUATE MEDICAL 
                   EDUCATION PAYMENTS.

       Section 1886(d)(5)(B)(ii) of the Social Security Act (42 
     U.S.C. 1395ww(d)(5)(B)(ii)) (as amended by section 111(a) of 
     the Medicare, Medicaid, and SCHIP Balanced Budget Refinement 
     Act of 1999 (113 Stat. 1501A-329), as enacted into law by 
     section 1000(a)(6) of Public Law 106-113) is amended--
       (1) in subclause (IV), by adding ``and'' at the end; and
       (2) by striking subclauses (V) and (VI) and inserting the 
     following:
       ``(V) on or after October 1, 2000, `c' is equal to 
     1.6.''.

 Mr. KENNEDY. Mr. President, the Teaching Hospital Preservation 
Act that we are introducing today will restore much-needed support for 
the nation's teaching hospitals by freezing the Medicare Indirect 
Medical Education adjustment at 6.5 percent. The so-called IME payments 
under Medicare go to teaching hospitals to help defray their added 
costs of caring for the sickest patients, training physicians, and 
providing an environment in which clinical research can flourish. Under 
current law, the IME payments will be reduced from their current level 
of 6.5 percent to 6.25 percent for fiscal year 2001 and 5.5 percent for 
fiscal year 2002 and future years. If these reductions take place, they 
will have a devastating impact on the nation's teaching hospitals.
  Enactment of this relief is essential to complete the task we began 
last

[[Page 5176]]

year in the Balanced Budget Restoration Act of 1999. Across the 
country, teaching hospitals continue to suffer severe financial losses. 
According to the Association of American Medical Colleges, even with 
enactment of last year's measure, the typical teaching hospital will 
still lose more that $40 million in Medicare payments between 1998 and 
2002. At the most recent meeting of the Medicare Payment Advisory 
Committee, it was reported that the margins of major teaching hospitals 
dropped from 5.1 percent in 1997 to 2.3 percent in 1998. 
Notwithstanding major efforts by the leadership of this institutions to 
reduce their costs, there is every reason to believe this ominous trend 
is continuing.
  In Boston, teaching hospitals lost $22 million just in the first 
quarter of the current fiscal year, and Boston is far from alone. The 
financial problems of the nation's pre-eminent teaching hospitals 
around the country are well-known. Cutbacks in care for patients, 
research, and teaching have already been implemented by many of these 
respected institutions, and are being considered by many others. These 
teaching hospitals are the backbone of our health care system, and 
Congress should not stand silent in the face of these distressing 
developments.
  Teaching hospitals are facing substantially higher costs for drugs, 
labor, medical devices and new technologies. The tight labor market is 
pushing wages higher and higher. Despite these heavy financial 
pressures. Medicare is scheduled to impose serious cutbacks in its 
reimbursements to teaching hospitals. The result of this shortfall may 
well be disastrous for these indispensable institutions.
  A significant part of the problem was caused by the excessive and 
unintended Medicare reductions required by the Balanced Budget Act of 
1997. Last year's Balanced Budget Restoration Act delayed reductions in 
the IME adjustment. That relief was an important first step, but it was 
only a first step. The legislation we are introducing today will ensure 
that Medicare support for teaching hospitals remains at its current 
level.
  The pre-eminence of American academic medicine is at stake. The 
nation's teaching hospitals provide the highest quality health care to 
the sickest patients. They ensure the highest quality physicians 
training, and an unparalleled research capability. In addition, 
teaching hospitals are the safety net for 44 percent of the uninsured, 
despite comprising only 6 percent of all hospitals. They perform a vast 
array of services to their communities, from neighborhood health 
programs to drug treatment programs to well baby clinics. All of these 
programs are in jeopardy if the currently scheduled cutbacks take 
place. We cannot afford to let teaching hospitals fail. I urge my 
colleagues to join us in enacting this important bill this 
year.
                                 ______
                                 
      By Mr. BENNETT:
  S. 2396. A bill to authorize the Secretary of the Interior to enter 
into contracts with the Weber Basin Water Conservancy District, Utah, 
to use Weber Basin Project facilities for the impounding, storage, and 
carriage of nonproject water for domestic, municipal, industrial, and 
other beneficial purposes; to the Committee on Energy and Natural 
Resources.


    legislation regarding the weber basin water conservancy district

  Mr. BENNETT. Mr. President, I am pleased to take a step in addressing 
the long-term water needs of Summit County, Utah. The bill I am 
introducing today, to make a necessary technical correction, authorizes 
the Secretary of the Interior to enter into contracts with the Weber 
Basin Water Conservancy District. This legislation would permit non-
federal water intended for domestic, municipal, industrial, and other 
uses to utilize federal facilities of the original Weber Basin Project 
for various purposes such as storage and transportation.
  In this case, the Smith Morehouse Dam and Reservoir was constructed 
by the Weber Basin Water Conservancy District in the early 1980's using 
local funding resources in order to create a supply of non-federal 
project water. However, it has been determined that there is currently 
a need to deliver approximately 5,000 acre feet of this non-federal 
Smith Morehouse water in conjunction with approximately 5,000 acre feet 
of federal Weber Basin project water to the Snyderville Basin area of 
Summit County, Utah and to Park City, Utah.
  In 1996, the Weber Basin Water Conservancy District entered into 
aMemorandum of Understanding and Agreement to deliver this water 
approximately 14 miles from Weber Basin Weber River sources within a 
certain time frame and dependent upon the execution of an Interlocal 
Agreement with Park City and Summit County. The Warren Act requires 
that legislation be enacted to enable the District to move ahead with 
this agreement with Summit County and Park City to deliver the water 
utilizing Weber Basin Project facilities built by the Bureau of 
Reclamation.
  There is an immediate need for the delivery of water to this area. 
The Utah State Engineer halted the approval of new groundwater 
developments in the area last year. At the same time, Summit County is 
experiencing tremendous growth; in fact it is one of the highest growth 
areas in the state. Within the areas to be served, taxed by the Weber 
Basin District, there is a definite public need for an adequate, 
reliable, and cost effective water delivery project in order to meet 
the future demands of this area.
  Since there is precedent allowing the wheeling of non-federal water 
through federal facilities, my colleagues should realize that this is a 
non-controversial piece of legislation. Therefore, I hope that Congress 
will move quickly to pass this legislation next session and I look 
forward to working closely with my colleagues on the Committee on 
Energy and Natural Resources to move it quickly.
                                 ______
                                 
      By Mr. FITZGERALD (for himself, Mr. Schumer, Mr. Durbin, Mr. 
        Santorum, Mr. Specter, Ms. Mikulski, Mr. Sarbanes, and Mr. 
        Kerrey):
  S. 2398. A bill to amend the Public Health Service Act to revise and 
extend the programs relating to organ procurement and transplantation; 
to the Committee on Health, Education, Labor, and Pensions.


               organ transplantation fairness act of 2000

  Mr. FITZGERALD. Thank you, Mr. President.
  Mr. President, I rise today to introduce the Organ Transplantation 
Fairness Act of 2000.
  I thank my original cosponsors on this bill: Senators Schumer, 
Durbin, Santorum, Specter, Mikulski, Sarbanes, and Kerrey.
  Our Nation's organ procurement and transplant system is in serious 
need of change.
  We could be saving more lives through organ transplants in this 
country than we are at the present time.
  The purpose of our bill and the goals of our bill are threefold.
  First, we want to increase the amount of organs that are being 
donated all across the country.
  There are many more people who need to receive organs to remain 
alive. They need organ transplants, and there are not a sufficient 
number of people donating those organs. This bill attempts to address 
that issue.
  Second, we want to bring greater fairness to how we allocate scarce 
organs after they are donated.
  Right now those organs are not allocated in the best possible way. 
And because of problems in our allocation system, people are dying 
unnecessarily. We could be saving more lives.
  The third goal of the bill is to seek to implement many of the 
recommendations of the Institute of Medicine in their 1999 report 
entitled ``Organ Procurement and Transplantation.''
  In attempting to improve the system of organ procurement transplants 
in this country, we have picked out many of the Institute of Medicine's 
recommendations, and we tried to enact them into law. Our system is 
saving many more lives than it used to.
  Organ transplantation is fairly new to this country. If you go back 
20 years or so, there were very few organs being transplanted. But now 
many more people are benefiting and going on to live

[[Page 5177]]

healthy lives thanks to people who have donated organs, and thanks to 
successful transplants. But as many lives as our system has saved, we 
are not saving as many lives as we could.
  I have a chart to demonstrate this. As of today, there are over 
68,000 American patients waiting for a life-saving organ transplant.
  In 1998, the most recent statistics available, over 4,800 people died 
while on that organ transplant waiting list.
  That means about 13 people a day are dying in this country while 
waiting to get an organ that can be transplanted into their bodies.
  I said earlier that we are not saving as many lives as we could save.
  Let me demonstrate why that is the case, and why we know we are not 
saving enough lives.
  According to the Department of Health and Human Services, in 1998, 
some 71 percent of livers were transplanted to patients in the least 
urgent medical status categories. But at the same time that we were 
transplanting those livers into patients in the least urgent medical 
status categories, in the same year, 1,300 patients died while waiting 
for a liver.
  How can it be that we are transplanting livers into patients who 
aren't in the most critically ill categories, while at the same time 
people in the most critical condition were dying for lack of a liver 
transplant?
  The reason for that is we have a system in our country that is based 
on where you live. Whether you live or die because of an organ 
transplant may depend not on how sick you are but on where you live in 
this country.
  Let's examine this a little bit more closely.
  There is a private not-for-profit corporation in this country that 
has been given the authority to be in charge of our Nation's organ 
transplant and procurement network. They have set up a series of 
regions. They divided the whole country into regions. There are organs 
that are available within those regions. But if you live outside one of 
the regions where an organ is available, you are not liable to get one 
of the organs when it comes up.
  As a Senator from Illinois, I think the simplest thing for me to do 
in illustrating this problem is to use Illinois as an example. Most of 
Illinois is in organ procurement organization district 29. You can have 
a patient who lives in northern Illinois, just a few miles from the 
border of Wisconsin, and this patient could need a liver transplant. He 
or she could be in status 1 medical condition, which means he or she is 
in the most critical category and in need of a liver transplant 
immediately. A liver may become available just over the border in 
region 37, the Wisconsin network. But that liver can't be sent to the 
person in Illinois because that person in Illinois is in region 29--not 
37.
  If a liver becomes available from a donor in Wisconsin, they will 
first look to see if they have a very critically ill person who needs a 
liver transplant in region 37. If they don't find such a person, then 
they will go to somebody who is in a less urgent situation who doesn't 
need the liver as quickly as that other person in Illinois. Thus, 
somebody who may be in status 2, or even what they call status 3 
medical condition, which isn't as critical as status 1, could get the 
liver transplant up in Wisconsin. But that person a few miles south of 
the border who needs the liver immediately, because he or she happens 
to live in Illinois, cannot get it. If an organ doesn't become 
available in that region in which he or she lives, that person may not 
survive.
  There is a saying in the real estate industry by the real estate 
brokers and agents. When you go to them, they always tell you that 
everything and the value of your home depends on ``location, location, 
location.'' I bet not many Americans realize that in some cases if you 
are in need of a liver transplant or a heart transplant, your chances 
of survival are going to depend on your location, your location, your 
location.
  The purpose of our bill is to try to open this system up, and instead 
of directing the organs to the people depending on where they live, 
instead of determining whether people are going to live or die simply 
based on accidents of geography, we try to bring sense to this whole 
system. We try to get organs to people in the most critical need of 
those organs as soon as possible. We would hope to get those to the 
sickest people as soon as possible--the sickest people who have the 
chance of going on and having a successful transplant.
  There comes a point when your organs are so damaged and you are so 
sick that it could be that a transplant would no longer help you. 
Certainly, we have to be careful to make sure that we get the organs to 
those who are the sickest but who still have a good chance of surviving 
an organ transplant.
  In addition, attempting to get the organs to the sickest patients 
first, making that our Nation's public policy, we would like to 
encourage a broader sharing of organs.
  The Institute of Medicine's report suggested that each of these areas 
should contain at least 9 million people. That is the minimum level for 
optimal sharing to get the organs out and save the most lives. We want 
to make sure we broaden these networks.
  It isn't possible in all cases for all organs to be shared 
nationally. With the heart, for example, a heart cannot last much more 
than 4 hours after it has been given by a donor. It has to be 
transplanted quickly. Other organs, such as kidneys, my understanding 
is we can preserve them for over 24 hours, or even longer, and in that 
circumstance it would be possible to have more nationwide sharing to 
get those organs allocated to the people who need them the most.
  Another important provision of our legislation is to take a strong 
stand for the proposition that the private not-for-profit corporation 
that now runs the whole Nation's organ procurement and transplant 
network should have some public accountability. Members may have heard 
that a bill passed by the House of Representatives provides no public 
accountability for this private corporation that has life or death 
control over at least 68,000 Americans. There is no accountability in 
that bill. They wouldn't be accountable to elected officials. They 
could not be regulated by the Department of Health and Human Services. 
If people had a complaint with how that organization was being run, 
there would be little or no recourse. I guess you could knock on their 
doors at their corporate headquarters in Richmond, VA, and ask them to 
listen to you, but they wouldn't have to. They are private not-for-
profit corporations with no responsibility to make sure the best public 
policy goals of this country are achieved.
  I don't think that is right. I think we want this corporation to be 
publicly accountable to make sure that it is meeting the objectives of 
the laws that are on the books and serving the public interest.
  In addition, the Organ Transplantation Fairness Act of 2000 would 
create a national organ transplant advisory board. It implements the 
recommendations of the Institute of Medicine in this regard by creating 
an advisory board that reviews the organ procurement and 
transplantation network policies and advises the Secretary of our 
Department of Health and Human Services.
  We also put in place a process, based on sound medical criteria, for 
the certification and recertification of what they call OPOs--organ 
procurement organizations. It requires the OPOs that fail to meet 
performance criteria to file a corrected plan, and they will have 3 
years to implement such a plan. We have to have a way of making sure 
the organ procurement organizations in this country are doing a good, 
professional job. There has to be some accountability of those 
organizations.
  One of the most important issues, of course, is encouraging more 
organ donations. Earlier this morning I had the opportunity to meet in 
my office with several individuals who had actually been the recipients 
of donated organs. Those transplants they had had saved their lives. 
One of them was a constituent of mine. His name was Kent Schlink from 
Peoria, IL. When Kent was in his late twenties, he had to have a heart 
transplant to correct a defect

[[Page 5178]]

he had in his heart dating from his early childhood. He was very sick. 
He was on the waiting list for quite some time. He ultimately had a 
heart transplant at St. Francis Hospital in Peoria, IL, that saved his 
life. His life was saved at a time when he had a 6-month-old child. He 
has gone on to have another child. To see him talk about the joy to be 
with his young kids drives home what a gift people who donate organs 
make--a gift of life.
  We also had the opportunity to meet in my office with Britney Green, 
a young girl whom I believe is 13 years old. She had a liver transplant 
when she was 3 years old. She is currently on a waiting list for a new 
heart. She has had a very tough road to hoe, but she is a bright and 
cheerful young lady. She is very supportive and hopes we can improve 
the system in this country.
  Finally, I wish to mention one other young man who impressed me. His 
name is Danny Canal. Danny is 14 years old, and he is an incredibly 
bright, wonderful young man. He is a transplant recipient who actually 
had a four-organ transplant, if you can believe that. Not only did he 
have four organs transplanted, he actually had two sets of those organs 
before the third set began functioning properly. This wonderful young 
kid who has been saved by these organ transplants probably wouldn't 
have had to have so many organs transplanted into him, because he 
originally only needed a transplant of a small intestine. 
Unfortunately, it took so long, he was on the waiting list for the 
transplant of that intestine so long that his other organs started to 
fail, to the point where he had to have his pancreas and other organs 
replaced. Then there were problems and it took three times before they 
got that right. He is a wonderful young man. It was a very moving 
experience to hear his story.
  We need to encourage more people to donate organs so there can be 
more Danny Covals and Kent Schlinks and Britney Greens whose lives can 
be saved in this country. Our bill does a lot to address that. We seek 
to establish a grant program to assist organ procurement organizations 
and other not-for-profit organizations in developing and expanding 
programs aimed at increasing organ donation rates.
  We create a congressional donor medal to honor living organ donors 
and organ donor families, and give credit to the tremendous gift they 
are giving by giving an organ. We establish a system of support for 
State programs to increase organ donation, and we provide some 
financial support to pay for nonmedical travel expenses of living 
donors.
  We have long had a transplant policy in this country that it was 
against public policy, against the law to pay people for donating 
organs. That creates many medical and ethical issues. I agree with that 
prohibition against paying people for donating organs. Everybody who 
does it is doing it just for the internal reward of helping somebody 
else. They are not doing it for any financial gain. However, I think it 
is appropriate that we could at least help defray some of the 
nonmedical travel expenses of the living donors. Most health insurance 
policies do, in fact, now in this country cover the medical expenses 
associated with donating the organ.
  The bill also bans lobbying by the organ procurement and transplant 
network administrator. That is the private not-for-profit corporation 
in Richmond, VA. We prohibit that firm which administers the program 
under contract with the Department of Health and Human Services from 
using fees that it collects from transplant patients to lobby Members 
of Congress. That firm is collecting, I believe, $375 from every person 
who is on an organ donor waiting list in the country. We want to make 
sure those fees are helping to match organs with patients so that more 
people can be saved. We do not think they need to be using those funds 
to lobby Members of Congress.
  Finally, one of the things the bill does is it actually comes in and 
abolishes State laws that are on the books in several States that are 
referred to as organ hoarding laws. Several States now, I regret to 
say, have enacted laws saying organs donated within their State borders 
cannot be given to people outside of their States. One of those States 
is the State of Wisconsin, that borders on my State of Illinois.
  I love Wisconsin. I think it is one of the most beautiful States in 
our country. Every summer my family and I go up and we vacation in 
northern Wisconsin. We enjoy their fishing and beautiful forests and 
the wildlife there. But I disagree with the law they have on the books 
that says if somebody in Wisconsin donates an organ, it cannot save a 
life in Illinois. I know Walter Payton, if he could have had an organ 
donated from a Green Bay Packer fan, would have gladly accepted it.
  We do not need to be engaging in the Balkanization of our country. We 
do not need to have these kinds of barriers erected between States. We 
are, in the end, one nation, one giant State. This Balkanization has no 
place in our country. A report from the Institute of Medicine and other 
reports have indicated the statutes on the books in these several 
States greatly diminish the effectiveness and equity of a national 
organ transplant policy. We need to make sure that is no longer 
allowed.
  The other thing I point out is many of the people from Wisconsin may 
come down and get listed on a transplant list at a hospital in Chicago. 
Then the effect of that law, passed by the Wisconsin legislature, would 
be to deny their own resident of the State of Wisconsin the ability to 
get the transplant at maybe a very renowned hospital in Chicago, or 
even one they go to in New York or another big State. That is 
inappropriate. It is not good public policy. Our bill would very firmly 
say that those laws would no longer be allowed in the States, and I 
think we would be on our way toward developing a much better national 
policy.
  With that, Mr. President, I ask unanimous consent that the text of my 
bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2398

       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 ``Organ Transplantation 
     Fairness Act of 2000''.

     SEC. 2. FINDINGS.

       (a) In General.--Congress makes the following findings:
       (1) It is in the public interest to maintain and 
     continually improve a national network to ensure the fair and 
     effective distribution of organs among patients on the 
     national waiting list irrespective of their place of 
     residence or the location of the transplant program with 
     which they are listed, and to ensure quality and facilitate 
     collaboration among network members and individual medical 
     practitioners participating in the network activities.
       (2) The Organ Procurement and Transplantation Network 
     (referred to in this section as the ``Network'') was created 
     in 1984 by the National Organ Transplant Act (Public Law 98-
     507) in order to facilitate an equitable allocation of organs 
     among all patients on a national basis.
       (3) The Federal Government should continue to provide 
     Federal oversight of the Network and is responsible for 
     protecting the public's health care interest and ensuring 
     that the policies of the Network meet the goals established 
     by this Act.
       (4) The responsibility for developing, establishing, and 
     maintaining medical criteria and standards for organ 
     procurement and transplantation should be a function of the 
     Network, and the Secretary of Health and Human Services 
     should provide oversight to ensure compliance with this Act 
     and other applicable laws.
       (5) The network should be operated by a private 
     organization under contract with the Department of Health and 
     Human Services.
       (6) The Federal Government is responsible for ensuring that 
     the efforts of the Network serve patients and donor families 
     in the procurement and distribution of organs.
       (7) The Federal Government should take immediate action to 
     improve organ donation rates and increase the number of 
     organs available for transplantation.
       (8) There is a significant disparity between the number of 
     organ donors and the number of individuals waiting for organ 
     transplants, and it is in the public's best interest to have 
     a system of organ allocation that ensures that transplant 
     candidates with similar severity of illness have similar 
     likelihood of transplantation irrespective of their place of 
     residence or the location of the transplant program with 
     which they are listed.
       (b) Sense of Congress Regarding Organ Donation.--It is the 
     sense of Congress that--

[[Page 5179]]

       (1) the factors that impact organ donation rates are 
     complex and require a multifaceted approach to increase organ 
     donation rates;
       (2) the Federal Government should lead the national effort 
     to increase organ donation and develop programs with the 
     transplant community to research and implement a best 
     practices approach to increasing organ donation; and
       (3) a generous contribution has been made by each 
     individual who has donated an organ to save a life.

     SEC. 3. ORGAN PROCUREMENT ORGANIZATIONS.

       Section 371 of the Public Health Service Act (42 U.S.C. 
     273) is amended to read as follows:

     ``SEC. 371. ORGAN PROCUREMENT ORGANIZATIONS.

       ``(a) Authority of the Secretary.--The Secretary may make 
     grants to, and enter into contracts with, qualified organ 
     procurement organizations described in subsection (b), and 
     other nonprofit private entities, for the purpose of carrying 
     out special projects designed to increase the number of organ 
     donors.
       ``(b) Qualified Organizations.--
       ``(1) Requirements.--A qualified organ procurement 
     organization for which grants may be made under subsection 
     (a) is an organization that, as determined by the Secretary, 
     will carry out the functions described in paragraph (2), and 
     that--
       ``(A) is a nonprofit entity;
       ``(B) has accounting and other fiscal procedures (as 
     specified by the Secretary) necessary to ensure the fiscal 
     stability of the organization;
       ``(C) has an agreement with the Secretary to be reimbursed 
     under title XVIII of the Social Security Act for the 
     procurement of kidneys;
       ``(D) notwithstanding any other provision of law, has met 
     the other requirements of this subsection and has been 
     certified or recertified by the Secretary as meeting the 
     performance standards to be a qualified organ procurement 
     organization through a process that--
       ``(i) granted certification or recertification within the 
     previous 4 years with such certification in effect as of 
     October 1, 2000, and remaining in effect through the earlier 
     of--

       ``(I) January 1, 2002; or
       ``(II) the completion of recertification under the 
     requirements of clause (ii); or

       ``(ii) is set forth in regulations prescribed by the 
     Secretary not later than January 1, 2002, that--

       ``(I) require recertifications of qualified organ 
     procurement organizations not more frequently than once every 
     4 years;
       ``(II) rely on outcome and process performance measures 
     that are based on available, practical empirical evidence of 
     organ donor potential or other related factors in each 
     service area of qualified organ procurement organizations;
       ``(III) use multiple outcome measures as part of the 
     certification process;
       ``(IV) provide for the filing and approval of a corrective 
     action plan by a qualified organ procurement organization if 
     the Secretary notifies the organ procurement organization 
     that it has failed to meet the performance measures after the 
     first 2 years of the 4 year certification period, which 
     corrective action plan shall apply for the 3 years following 
     approval of such plan;
       ``(V) provide for a qualified organ procurement 
     organization to appeal a decertification to the Secretary on 
     substantive and procedural grounds;

       ``(E) has procedures to obtain payment for nonrenal organs 
     provided to transplant centers;
       ``(F) has a defined service area that is of sufficient size 
     to assure maximum effectiveness in the procurement of organs;
       ``(G) has a director and other such staff, including the 
     organ donation coordinators and organ procurement specialists 
     necessary to effectively obtain organs from donors in its 
     service area; and
       ``(H) has a board of directors or an advisory board that--
       ``(i) is composed of--

       ``(I) members who represent hospital administrators, 
     intensive care or emergency room personnel, tissue banks, and 
     voluntary health organizations in its service area;
       ``(II) members who represent the public residing in such 
     area;
       ``(III) a physician with knowledge, experience, or skill in 
     the field of histocompatibility or an individual with a 
     doctorate degree in biological science with knowledge, 
     experience, or skill in the field of histocompatibility;
       ``(IV) a physician with knowledge or skill in the field of 
     neurology; and
       ``(V) from each transplant center in its service area, a 
     member who is a surgeon who has practicing privileges in such 
     center and who performs organ transplant surgery;

       ``(ii) has the authority to recommend policies for the 
     procurement of organs and the other functions described in 
     paragraph (2); and
       ``(iii) has no authority over any other activity of the 
     organization.
       ``(2) Functions.--An organ procurement organization shall--
       ``(A) have effective agreements, to identify potential 
     organ donors, with all of the hospitals and other health care 
     entities in its service area that have facilities for organ 
     donation;
       ``(B) conduct and participate in systematic efforts, 
     including professional education, to acquire all usable 
     organs from potential donors;
       ``(C) arrange for the acquisition and preservation of 
     donated organs and provide quality standards for the 
     acquisition of organs which are consistent with the standards 
     adopted by the Organ Procurement and Transplantation Network 
     under section 372(b)(2)(F), including arranging for testing 
     with respect to preventing the acquisition of organs that are 
     infected with the etiologic agent for acquired immune 
     deficiency syndrome;
       ``(D) arrange for the appropriate tissue typing of donated 
     organs;
       ``(E) assist the Organ Procurement and Transplantation 
     Network in the equitable distribution of organs among 
     patients on a national basis;
       ``(F) provide or arrange for the transportation of donated 
     organs to transplant centers;
       ``(G) have arrangements to coordinate its activities with 
     transplant centers in its service area;
       ``(H) participate in the Organ Procurement and 
     Transplantation Network established under section 372;
       ``(I) have arrangements to cooperate with tissue banks for 
     the retrieval, processing, preservation, storage, and 
     distribution of tissues as may be appropriate to assure that 
     all usable tissues are obtained from potential donors;
       ``(J) evaluate annually the effectiveness of the 
     organization in acquiring potentially available organs; and
       ``(K) assist hospitals in establishing and implementing 
     protocols for assuring that all deaths and imminent deaths 
     are reported to the appropriate organ procurement 
     organization.''.

     SEC. 4. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK.

       Section 372 of the Public Health Service Act (42 U.S.C. 
     274) is amended to read as follows:

     ``SEC. 372. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK.

       ``(a) In General.--The Secretary shall by regulation 
     provide for the establishment and operation of an Organ 
     Procurement and Transplantation Network that meets the 
     requirements of subsection (b).
       ``(b) Requirements.--
       ``(1) In general.--The Organ Procurement and 
     Transplantation Network shall carry out the functions 
     described in paragraph (2) and shall--
       ``(A) be operated by a private entity under contract with 
     the Department of Health and Human Services; and
       ``(B) have a board of directors--
       ``(i) not more than 50 percent of which members are 
     transplant surgeons or transplant physicians;
       ``(ii) at least 25 percent of which members are transplant 
     candidates, transplant recipients, organ donors, and family 
     members; and
       ``(iii) that includes representatives of organ procurement 
     organizations, voluntary health associations, and the general 
     public; and
       ``(iv) that shall establish an executive committee and 
     other committees, whose chairpersons shall be selected to 
     ensure continuity of the board.
       ``(2) Functions.--The Organ Procurement and Transplantation 
     Network shall--
       ``(A) establish and maintain one or more lists derived from 
     a national list of individuals who need organ transplants;
       ``(B) establish a national system, through the use of 
     computers and in accordance with established medical 
     criteria, to match organs and individuals included on such 
     lists;
       ``(C) establish membership criteria for hospitals, for 
     performing organ transplants, and for individual members;
       ``(D) maintain a 24-hour telephone service to facilitate 
     matching organs with individuals included in such lists;
       ``(E) allocate organs so that transplant candidates with 
     similar severity of illness have similar likelihood of 
     receiving a transplant irrespective of their place of 
     residence or the location of the transplant program with 
     which they are listed;
       ``(F) adopt and use standards of quality for the 
     acquisition and transportation of donated organs, including 
     standards for preventing the acquisition of organs that are 
     infected with the etiologic agent for acquired immune 
     deficiency syndrome;
       ``(G) prepare and distribute, on a national basis, samples 
     of blood sera from individuals who are included on such lists 
     in order to facilitate matching the compatibility of such 
     individuals with organ donors;
       ``(H) coordinate, as appropriate, the transportation of 
     organs from organ procurement organizations to transplant 
     centers;
       ``(I) provide information to physicians and other health 
     professionals and the general public regarding organ 
     donation;
       ``(J) collect, analyze, and publish data concerning organ 
     donation and transplants;
       ``(K) provide data to the Secretary in order to permit the 
     Secretary to carry out the Secretary's responsibilities under 
     this part, and to the Scientific Registry maintained pursuant 
     to section 373;

[[Page 5180]]

       ``(L) respond in a timely fashion and to the extent 
     permitted, to requests for data from researchers and 
     investigators;
       ``(M) carry out studies and demonstration projects for the 
     purpose of improving procedures for organ procurement and 
     allocation;
       ``(N) work actively to increase the supply of donated 
     organs;
       ``(O) submit to the Secretary an annual report containing 
     information on the comparative costs and patient outcomes at 
     each transplant center affiliated with the Organ Procurement 
     and Transplantation Network; and
       ``(P) submit to the Secretary an annual report containing 
     such financial information, as determined by the Secretary, 
     to be necessary to evaluate the cost of operating the Organ 
     Procurement and Transplantation Network.
       ``(3) Availability of patient listing fees and 
     participation fees.--
       ``(A) In general.--Any fees described in subparagraph (B) 
     that are collected by the Organ Procurement and 
     Transplantation Network--
       ``(i) shall be available to the Organ Procurement and 
     Transplantation Network, without fiscal year limitation, for 
     use in carrying out the functions of the Organ Procurement 
     Transplantation Network under this section; and
       ``(ii) shall not be used for any activity (including 
     lobbying or other political activity) that is not authorized 
     under this section.
       ``(B) Covered fees.--Subparagraph (A) applies with respect 
     to the following:
       ``(i) Listing fees.
       ``(ii) Fees imposed as a condition of being a participant 
     in the Organ Procurement and Transplantation Network.
       ``(C) Construction.--No provision of this paragraph may be 
     construed to prohibit the Organ Procurement and 
     Transplantation Network from--
       ``(i) collecting fees other than the fees described in 
     subparagraph (B); or
       ``(ii) using fees covered by clause (i) for an activity 
     covered by subparagraph (A)(ii) or other activity.
       ``(c) Organ Allocation.--
       ``(1) Development of policies.--The Organ Procurement and 
     Transplantation Network shall develop organ-specific policies 
     (including combinations of organs, such as for kidney-
     pancreas transplants), subject to the review of and approval 
     by the Secretary, for the equitable allocation of cadaveric 
     organs to individuals on the national waiting list.
       ``(2) Listing criteria.--Standardized minimum listing 
     criteria for including individuals on the national list shall 
     be established and, to the extent possible, shall--
       ``(A) contain explicit thresholds for the listing of a 
     patient;
       ``(B) avoid futile transplants or the wasting of organs;
       ``(C) be expressed through objective and measurable medical 
     criteria; and
       ``(D) be reviewed periodically and revised as appropriate.
       ``(3) Requirements relating to transplant candidates.--
     Where appropriate for the specific organ, transplant 
     candidates shall--
       ``(A) be grouped by status categories from most to least 
     medically urgent with--
       ``(i) sufficient categories to avoid grouping together 
     individuals with substantially different medical urgency;
       ``(ii) explicit thresholds for differentiating among 
     patients; and
       ``(iii) explicit standards for the movement of individuals 
     among the status categories;
       ``(B) be expressed through objective and measurable medical 
     criteria; and
       ``(C) be reviewed periodically and revised as appropriate.
       ``(4) Requirements for allocation policies and 
     procedures.--Organ allocation policies and procedures shall 
     be established in accordance with sound medical judgment and 
     shall--
       ``(A) be designed and implemented to allocate organs among 
     transplant candidates--
       ``(i) in order of decreasing medical urgency status;
       ``(ii) over the largest geographic area practicable in a 
     manner consistent with organ viability so that neither place 
     of residence nor place of listing shall be a major 
     determinant; and
       ``(iii) so as to maintain organ viability and avoid organ 
     wastage; and
       ``(B) be reviewed periodically and revised as appropriate.
       ``(5) Policies where medical urgency is not an appropriate 
     measurement.--Where medical urgency is not an appropriate 
     measurement for organ allocation, policies and procedures 
     shall be established in accordance with sound medical 
     judgment.
       ``(d) Authority of the Secretary.--The policies and rules 
     established by the Organ Procurement and Transplantation 
     Network that are to be enforceable shall be subject to review 
     and approval by the Secretary. The Secretary shall--
       ``(1) in consultation with the Organ Procurement and 
     Transplantation Network, develop mechanisms to promote and 
     review compliance with the requirements of this section;
       ``(2) establish and approve all fees, dues, or similar 
     costs charged to support the operation of the Organ 
     Procurement and Transplantation Network;
       ``(3) establish procedures for receiving from interested 
     persons critical comments relating to the manner in which the 
     Organ Procurement and Transplantation Network is carrying out 
     the duties of the Network under subsection (b); and
       ``(4) take such action, as determined by the Secretary, to 
     enforce the requirements of this section as well as the 
     requirements under title XVIII of the Social Security Act.
       ``(5) if the Organ Procurement and Transplantation Network 
     fails to submit a policy on a matter which the Secretary 
     determines should be enforced under this section or section 
     1138 of the Social Security Act, or the Organ Procurement and 
     Transplantation Network submits a policy that the Secretary 
     determines is inconsistent with the goals of this Act, submit 
     to the board of directors or advisory board of the Organ 
     Procurement and Transplantation Network the Secretary's 
     version of such policy.
       ``(e) National Transplant Advisory Board.--
       ``(1) Establishment.--The Secretary shall, by regulation, 
     provide for the establishment of a National Organ Transplant 
     Advisory Board (referred to in this subsection as the 
     `Board').
       ``(2) Membership.--The Board shall carry out the functions 
     described in paragraph (3) and shall be comprised of 
     individuals that--
       ``(A) include a broad spectrum of representatives of the 
     medical and scientific community, including transplant 
     surgeons, transplant physicians, epidemiologists, and health 
     service researchers, as well as representatives from organ 
     procurement organizations and the community of transplant 
     patients, family members and donor families;
       ``(B) are selected by the Secretary;
       ``(C) serve terms of not less than 3 years.
       ``(3) Functions.--The Board shall assist the Secretary in 
     ensuring that the Organ Procurement and Transplantation 
     Network is grounded on the best available medical science and 
     is effective and equitable as possible and shall--
       ``(A) at the request of the Secretary, review the policies 
     and rules of the Organ Procurement and Transplantation 
     Network;
       ``(B) advise and propose to the Secretary policies, rules, 
     and regulations affecting organ procurement and 
     transplantation;
       ``(C) at the request of the Secretary, review and consider 
     policies and regulations affecting organ transplantation 
     developed by the Secretary;
       ``(D) advise the Secretary with respect to comments 
     received by the Secretary under subsection (d)(3);
       ``(E) meet at the request of the Secretary, but not less 
     than 2 times each year; and
       ``(F) elect a Chairperson and Vice-chairperson as well as 
     any other officers as determined appropriate by the Board.
       ``(4) Authorization of appropriations.--For the purpose of 
     carrying out this subsection, there are authorized to be 
     appropriated $1,000,000 for each of the fiscal years 2000 
     through 2005.''.

     SEC. 5. SCIENTIFIC REGISTRY.

       Section 373 of the Public Health Service Act (42 U.S.C. 
     274a) is amended to read as follows:

     ``SEC. 373. SCIENTIFIC REGISTRY.

       ``The Secretary shall, by grant or contract, develop and 
     maintain a scientific registry of the recipients of organ 
     transplants. The registry shall include such information 
     concerning patients and transplant procedures as the 
     Secretary determines to be necessary to an ongoing evaluation 
     to the scientific and clinical status of organ 
     transplantation. The registry shall also include such 
     information concerning both donors and patients in 
     transplants involving living donors. The Secretary shall 
     prepare for inclusion in the report under section 376 an 
     analysis of information derived from the registry.''.

     SEC. 6. ADMINISTRATION.

       Section 375 of the Public Health Service Act (42 U.S.C. 
     274c) is amended to read as follows:

     ``SEC. 375. ADMINISTRATION.

       ``The Secretary shall designate and maintain an 
     identifiable administrative unit in the Public Health Service 
     to--
       ``(1) administer this part and coordinate with organ 
     procurement activities under title XVIII of the Social 
     Security Act;
       ``(2) administer and coordinate programs, as determined by 
     the Secretary, to increase organ donation rates;
       ``(3) provide technical assistance to organ procurement 
     organizations, the Organ Procurement and Transplantation 
     Network established under section 372, and other entities in 
     the health care system involved in organ donations, 
     procurements, and transplants; and
       ``(4) provide information--
       ``(A) to patients, their families, and their physicians 
     about transplantation; and
       ``(B) to patients and their families about resources 
     available nationally and in each State, and the comparative 
     costs and patient outcomes at each transplant center 
     affiliated with the Organ Procurement and Transplantation 
     Network, in order to assist the patients and families with 
     the costs associated with transplantation.''.

[[Page 5181]]



     SEC. 7. ADDITIONAL AMENDMENTS.

       Part H of title III of the Public Health Service Act (42 
     U.S.C. 273 et seq.) is amended--
       (1) in section 374 (42 U.S.C. 274b)--
       (A) in subsection (b)(1), by striking ``and may not exceed 
     $100,000'' and inserting ``and other organizations for the 
     purpose of increasing the supply of transplantable organs''; 
     and
       (B) in subsection (b)(2), by striking the second sentence;
       (2) in section 376 (42 U.S.C. 274d), by striking 
     ``Committee on Energy and Commerce'' and inserting 
     ``Committee on Commerce''; and
       (3) by striking section 377 (42 U.S.C. 274f).

     SEC. 8. PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES INCURRED 
                   TOWARD LIVING ORGAN DONATION.

       Part H of title III of the Public Health Service Act (42 
     U.S.C. 273 et seq.) is amended by inserting after section 376 
     the following section:

     ``SEC. 376A. TRAVEL AND SUBSISTENCE PAYMENTS FOR LIVING ORGAN 
                   DONATION.

       ``(a) In General.--The Secretary may make awards of grants 
     or contracts to States, transplant centers, qualified organ 
     procurement organizations under section 371, or other public 
     or private entities for the purpose of--
       ``(1) providing for the payment of travel and subsistence 
     expenses incurred by individuals toward making living 
     donations of their organs (referred to in this section as 
     `donating individuals'); and
       ``(2) in addition, providing for the payment of such 
     incidental nonmedical expenses that are so incurred as the 
     Secretary determines by regulation to be appropriate.
       ``(b) Eligibility.--
       ``(1) In general.--Payments under subsection (a) may be 
     made for the qualifying expenses of a donating individual 
     only if--
       ``(A) the State in which the donating individual resides is 
     a different State than the State in which the intended 
     recipient of the organ resides; and
       ``(B) the annual income of the intended recipient of the 
     organ does not exceed $35,000 (as adjusted for fiscal year 
     2002 and subsequent fiscal years to offset the effects of 
     inflation occurring after the beginning fiscal year 2001).
       ``(2) Certain circumstances.--Subject to paragraph (1), the 
     Secretary may in carrying out subsection (a) provide as 
     follows:
       ``(A) The Secretary may consider the term `donating 
     individuals' as including individuals who in good faith incur 
     qualifying expenses toward the intended donation of an organ 
     but with respect to whom, for such reason as the Secretary 
     determines to be appropriate, no donation of the organ 
     occurs.
       (B) The Secretary may consider the term `qualifying 
     expenses' as including the expenses of having one or more 
     family members of donating individuals accompany the donating 
     individuals for purposes of subsection (a) (subject to making 
     payment for only such types of expenses as are paid for 
     donating individuals).
       ``(c) Limitation on Amount of Payment.--
       ``(1) In general.--With respect to the geographic area to 
     which a donating individual travels for purposes of section 
     (a), if such area is other than the covered vicinity for the 
     intended recipient of the organ, the amount of qualifying 
     expenses for which payments under such subsection are made 
     may not exceed the amount of such expenses for which payment 
     would have been made if such area had been the covered 
     vicinity for the intended recipient, taking into account the 
     costs of travel and regional differences in the cost of 
     living.
       ``(2) Covered vicinity.--For purposes of this section, the 
     term `covered vicinity' with respect to an intended recipient 
     of an organ from a donating individual, means the vicinity of 
     the nearest transplant center to the residence of the 
     intended recipient that regularly performs transplants of 
     that type of organ.
       ``(d) Relationship to Payments Under Other Programs.--An 
     award may be made under subsection (a) only if the applicant 
     agrees that the award will not be expended to pay the 
     qualifying expenses of a donating individual to the extent 
     that payment has been made, or can reasonably be expected to 
     be made, with respect to such expenses--
       ``(1) under any State compensation program, under an 
     insurance policy, or under any Federal or State health 
     benefits program; or
       ``(2) by an entity that provides health services on a 
     prepaid basis.
       ``(e) Definitions.--In this section:
       ``(1) Covered vicinity.--The term `covered vicinity' has 
     the meaning given such term in subsection (c)(2).
       ``(2) Donating individual.--The term `donating individual' 
     has the meaning indicated for such term in subsection (a)(1), 
     subject to subsection (b)(2)(A).
       ``(3) Qualifying expenses.--The term `qualifying expenses' 
     means the expenses authorized for purposes of subsection (a), 
     subject to subsection (b)(2)(B).
       ``(f) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there is authorized to be 
     appropriated $5,000,000 for each of fiscal years 2000 through 
     2005.''.

     SEC. 9. PROGRAMS AND DEMONSTRATION PROJECTS TO INCREASE ORGAN 
                   DONATION.

       Part H of title III of the Public Health Service Act (42 
     U.S.C. 273 et seq.) is amended by inserting after section 377 
     the following:

     ``SEC. 377A. INITIATIVES TO INCREASE ORGAN DONATION.

       ``(a) Public Awareness.--The Secretary shall (directly or 
     through grants or contracts) carry out a program to educate 
     the public with respect to organ donation.
       ``(b) Studies and Demonstrations.--The Secretary may make 
     grants to public and nonprofit entities for the purpose of 
     carrying out studies and demonstration projects with respect 
     to increasing rates of organ donation. The Secretary shall--
       ``(1) give priority to those studies and demonstration 
     projects that are founded upon a best practices approach to 
     increasing organ donation consent rates;
       ``(2) give priority to those geographic areas with lower 
     organ donation consent rates, especially among minorities;
       ``(3) provide assistance to qualified organ procurement 
     organizations described under section 371 to implement 
     programs and projects, that as determined by Secretary 
     through studies and demonstration projects, have proven to be 
     effective in increasing organ donation rates; and
       ``(4) provide assistance to the study and consideration of 
     presumed consent as an opportunity to increase organ donation 
     rates.
       ``(c) Grants to States.--The Secretary may make grants to 
     States for the purpose of carrying out public education and 
     outreach programs designed to increase the number of organ 
     donors within the State. To be eligible, each State shall--
       ``(1) submit an application to the Secretary, in such form 
     as prescribed by the Secretary; and
       ``(2) establish yearly benchmarks for improvement in organ 
     donation rates in the State.
       ``(d) Congressional Medal.--
       ``(1) Design.--The Secretary shall design a bronze medal 
     with suitable emblems, devices, and inscriptions, to be 
     determined by the Secretary, to commemorate organ donors and 
     their families.
       ``(2) Eligibility.--Any organ donor, or the family of any 
     organ donor, shall be eligible for a medal under this 
     subsection.
       ``(3) Requirements.--The Secretary shall direct the Organ 
     Procurement and Transplantation Network, established under 
     section 372, to--
       ``(A) establish an application procedure requiring the 
     relevant organ procurement organizations, described in 
     section 371, through which an individual or their family made 
     an organ donation, to submit documentation supporting the 
     eligibility of that individual or their family to receive a 
     medal; and
       ``(B) determine through the documentation provided, and, if 
     necessary, independent investigation, whether the individual 
     or family is eligible to receive a medal.
       ``(4) Delivery.--The Secretary shall make suitable 
     arrangements as necessary with the Secretary of the Treasury 
     to strike and deliver the medals described in paragraph (3).
       ``(5) Presentation.--The Secretary shall provide for the 
     presentation to the relevant organ procurement organizations 
     all medals struck pursuant to this section to individuals or 
     families that, in accordance with paragraph (3), the Organ 
     Procurement and Transplantation Network has determined 
     eligible to receive medals.
       ``(6) Limitation.--
       ``(A) in general.--Except as provided in subparagraph (B), 
     only 1 medal may be presented to a family under paragraph 
     (5). Such medal shall be presented to the donating family 
     member, or in the case of a deceased donor, the family member 
     who signed the consent form authorizing, or who otherwise 
     authorized, the donation of the organ involved.
       ``(B) Additional medals.--In the case of a family in which 
     more than 1 member is an organ donor, an additional medal may 
     be presented to each such organ donor or their family.
       ``(7) Duplicates.--The Secretary or the Organ Procurement 
     and Transplantation Network may provide duplicates of a 
     medal--
       ``(A) to any recipient of a medal under paragraph (4) under 
     such regulation as the Secretary may issue; and
       ``(B) the cost of which shall be sufficient to cover the 
     costs of such duplicates.
       ``(8) National medals.--The medals struck pursuant to this 
     subsection are national medals for purposes of section 5111 
     of title 31, United States Code.
       ``(9) Applicability of provisions.--No provision of law 
     governing procurement or public contracts shall be applicable 
     to the procurement of goods or services necessary for 
     carrying out the provisions of this subsection.
       ``(10) Funding.--
       ``(A) Agreements.--The Secretary of the Treasury may enter 
     into an agreement with the Organ Procurement and 
     Transplantation Network to collect funds to offset 
     expenditures relating to the issuance of medals authorized 
     under this subsection.
       ``(B) Payment and limitation.--
       ``(i) Payment.--Except as provided in clause (ii), all 
     funds received by the Organ

[[Page 5182]]

     Procurement and Transplantation Network under this paragraph 
     shall be promptly paid to the Secretary of the Treasury.
       ``(ii) Limitation.--Not more than 5 percent of any funds 
     received under this paragraph may be used to pay 
     administrative costs incurred by the Organ Procurement and 
     Transplantation Network as a result of an agreement 
     established under this subsection.
       ``(C) Deposits and expenditures.--Notwithstanding any other 
     provision of law--
       ``(i) all amounts received by the Secretary of the Treasury 
     under paragraph (10)(A)(i) shall be deposited in the 
     Numismatic Public Enterprise Fund, as described in section 
     5134 of title 31, United States Code; and
       ``(ii) the Secretary of the Treasury shall charge such fund 
     with all expenditures relating to the issuance of medals 
     authorized under this subsection.
       ``(D) Start-up costs.--A one-time amount of not to exceed 
     $55,000 shall be provided by the Secretary to the Organ 
     Procurement and Transplantation Network to cover initial 
     start-up costs to be paid back in full within 3 years of the 
     date of enactment of this section from funds received under 
     this subsection.
       ``(11) Definition.--For the purposes of this section, the 
     term `organ' means the human kidney, liver, heart, lung, 
     pancreas, and any other human organ (other than corneas and 
     eyes) specified by regulation by the Secretary.
       ``(12) Effective date.--This subsection shall be effective 
     for the 5-year period beginning on the date of the enactment 
     of this section.
       ``(e) Annual Report to Congress.--The Secretary shall 
     submit to the Congress an annual report on the activities 
     carried out under this section, including provisions 
     describing the extent to which the activities have affected 
     the rate of organ donation.
       ``(f) Authorization of Appropriations.--
       ``(1) In general.--For the purpose of carrying out this 
     section, there are authorized to be appropriated $10,000,000 
     for fiscal year 2000, and such sums as may be necessary for 
     each of the fiscal years 2001 through 2005. Such 
     authorization of appropriations is in addition to any other 
     authorizations of appropriations that are available for such 
     purpose.
       ``(2) Public awareness.--Of the amounts appropriated under 
     paragraph (1) for a fiscal year, the Secretary may not 
     obligate more than $2,000,000 for carrying out subsection 
     (a).''.

     SEC. 10. AUTHORIZATION OF APPROPRIATIONS.

       Section 378 of the Public Health Service Act (42 U.S.C. 
     274g) is amended to read as follows:

     ``SEC. 378. AUTHORIZATION OF APPROPRIATIONS FOR ORGAN 
                   PROCUREMENT AND TRANSPLANTATION NETWORK.

       ``For the purpose of providing for the Organ Procurement 
     and Transplantation Network under section 372, and for the 
     Scientific Registry under section 373, there are authorized 
     to be appropriated $4,000,000 for fiscal year 2000, and such 
     sums as may be necessary for each of fiscal years 2001 
     through 2005.''.

     SEC. 11. PREEMPTION.

       Part H of title III of the Public Health Service Act (42 
     U.S.C. 273 et seq.) is amended by inserting after section 378 
     the following:

     ``SEC. 378A. PREEMPTION.

       ``No State or political subdivision of a State shall 
     establish or continue in effect any law, rule, regulation, or 
     other requirement that would restrict in any way the ability 
     of any transplant hospital, organ procurement organization, 
     or other entity to comply with the organ allocation policies 
     of the Network under this part.''.

     SEC. 12. EFFECTIVE DATE.

       The amendments made by this Act shall take effect on 
     October 1, 2000, or upon the date of enactment of this Act, 
     whichever occurs later.
                                 ______
                                 
      By Mr. DURBIN (for himself and Mr. Levin):
  S. 2399. A bill to amend title XVIII of the Social Security Act to 
revise the coverage of immunosuppressive drugs under the Medicare 
program; to the Committee on Finance.


 comprehensive immunosuppressive drug coverage for transplant patients 
                              act of 2000

 Mr. DURBIN. Mr. President, I rise to make a few remarks 
concerning this bill I am introducing today, which will help many 
Medicare beneficiaries who have had organ transplants.
  Every year, over 4,000 people die waiting for an organ transplant. 
Currently, over 62,000 Americans are waiting for a donor organ. It is 
this scarcity that has fueled the current controversy over organ 
allocation.
  Given that organs are extremely scarce, Federal law should not 
compromise the success of organ transplantation. Yet that is exactly 
what current Medicare policy does, because Medicare denies certain 
transplant patients coverage for the drugs needed to prevent rejection.
  Medicare does this in three different ways. Firstly, Medicare has 
time limits on coverage of immunosuppressive drugs. Permanent Medicare 
law only provides immunosuppressive drug coverage for 3 years with 
expanded coverage totaling 3 years and 8 months between 2000 and 2004. 
However, 61 percent of patients receiving a kidney transplant after 
someone has died still have the graft intact 5 years after 
transplantation. 76.6 percent of patients receiving a kidney from a 
live donor still have their transplant intact after 5 years post 
transplantation. For livers, the graft survival rate after 5 years is 
62 percent. For hearts, the 5 year graft survival rate is 67.7 percent. 
So many Medicare beneficiaries lose coverage of the essential drugs 
that are needed to maintain their transplant.
  Secondly, Medicare does not pay for anti-rejection drugs for Medicare 
beneficiaries, who received their transplants prior to becoming a 
Medicare beneficiary. So for instance, if a person received a 
transplant at age 64 through their health insurance plan, when they 
retire and rely on Medicare for their health care they will no longer 
have immunosuppressive drug coverage.
  Thirdly, Medicare only pays for anti-rejection drugs for transplants 
performed in a Medicare approved transplant facility. However, many 
beneficiaries are completely unaware of this fact and how it can 
jeopardize their future coverage of immunosuppressive drugs. To receive 
an organ transplant, a person must be very ill and many are far too ill 
at the time of transplantation to be researching the intricate nuances 
of Medicare coverage policy.
  The bill that I am introducing today, the ``Comprehensive 
Immunosuppressive Drug Coverage for Transplant Patients of 2000 Act'' 
would remove these short-sighted limitations. The bill sets up a new, 
easy to follow policy: All Medicare beneficiaries who have had a 
transplant and need immunosuppressive drugs to prevent rejection of 
their transplant, would be covered as long as such anti-rejection drugs 
were needed.
  I am introducing this bill on behalf of some of the constituents that 
I have met who are unfortunately very adversely affected by the current 
gaps in Medicare coverage.
  Richard Hevrdejs was a Chicago attorney in private practice until 
1993. Unfortunately, he suffered a debilitating heart attack that year, 
which left him unable to work and on disability. In 1997, suffering 
from congestive heart failure, he was placed on a Heart-Mate machine at 
the University of Illinois Medical Center (UIC). In April of 1998, he 
received a heart transplant at UIC but because UIC was not at the time 
a Medicare approved facility for heart transplants, Medicare will not 
cover his immunosuppressive drugs. Richard was near death when he had 
his transplant and was in no condition to research the intricacies of 
Medicare coverage policies. His drug costs are now around $25,000 per 
year. He gets some assistance from the drug company medical assistance 
plans and he has a Medigap policy that provides a little assistance. 
But for the most part, he is forced to watch all his savings dwindle 
because of Medicare's coverage gaps.
  Anita Milton is from Morris, Illinois. In 1995, she became so 
disabled that she was no longer able to work and was forced onto 
disability. The following year, her lungs gave up and she had to have a 
bilateral lung transplant. Because Medicare is not available for 2 
years after a person becomes eligible for disability, Anita was not on 
Medicare when she had the transplant. Today, the huge bills for the 
transplant remain at collection agencies. Because Anita was not on 
Medicare when she received her transplant, she does not receive 
Medicare coverage for the antirejection drugs that she needs. She 
receives $940 in disability payments per month. She is now on Medicaid 
but due to the spend down requirements in Illinois, she must spend $689 
on drug costs to get Medicaid coverage for her drugs. In effect, she 
gets coverage every month. Anita cannot afford her anti-rejection drugs 
and she tried to scale back on them. This caused her to nearly reject 
the transplant. Consequently,

[[Page 5183]]

she has lost a third of her lung capacity permanently. As Anita said at 
a Town Hall meeting in Chicago in January ``these Medicare and Medicaid 
rules make no sense.''
  I am introducing this bill on the same day that another bill the 
``Organ Transplant Act of 2000'', which I am an original cosponsor is 
also being introduced. The ``Organ Transplant Fairness Act'' also seeks 
to change another aspect of Federal law to improve the Nation's organ 
allocation system. The two bills are good companions. It makes little 
sense to improve the organ allocation system to maximize the success of 
organ transplantation and increase the number of lives saved, if we do 
not at the same time reduce the ways that Medicare jeopardizes 
transplants by denying transplant patients the anti-rejection drugs 
they need to maintain their transplant.
  Mr. President, I ask unanimous consent that a copy of the bill the 
``Comprehensive Immunosuppresive Drug Coverage for Transplant Patients 
of 2000'' be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2399

       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 ``Comprehensive 
     Immunosuppressive Drug Coverage for Transplant Patients Act 
     of 2000''.

     SEC. 2. REVISION OF COVERAGE OF IMMUNOSUPPRESSIVE DRUGS UNDER 
                   THE MEDICARE PROGRAM.

       (a) Revision.--
       (1) In general.--Section 1861(s)(2)(J) of the Social 
     Security Act (42 U.S.C. 1395x(s)(2)(J)) (as amended by 
     section 227(a) of the Medicare, Medicaid, and SCHIP Balanced 
     Budget Refinement Act of 1999 (113 Stat. 1501A-354), as 
     enacted into law by section 1000(a)(6) of Public Law 106-113) 
     is amended by striking ``, to an individual who receives'' 
     and all that follows before the semicolon at the end and 
     inserting ``to an individual who has received an organ 
     transplant''.
       (2) Conforming amendments.--
       (A) Section 1832 of the Social Security Act (42 U.S.C. 
     1395k) (as amended by section 227(b) of the Medicare, 
     Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 
     (113 Stat. 1501A-354), as enacted into law by section 
     1000(a)(6) of Public Law 106-113) is amended--
       (i) by striking subsection (b); and
       (ii) by redesignating subsection (c) as subsection (b).
       (B) Subsections (c) and (d) of section 227 of the Medicare, 
     Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 
     (113 Stat. 1501A-355), as enacted into law by section 
     1000(a)(6) of Public Law 106-113, are repealed.
       (3) Effective date.--The amendments made by this subsection 
     shall apply to drugs furnished on or after the date of 
     enactment of this Act.
       (b) Extension of Certain Secondary Payer Requirements.--
     Section 1862(b)(1)(C) of the Social Security Act (42 U.S.C. 
     1395y(b)(1)(C)) is amended by adding at the end the 
     following: ``With regard to immunosuppressive drugs furnished 
     on or after the date of enactment of the Comprehensive 
     Immunosuppressive Drug Coverage for Transplant Patients Act 
     of 2000, this subparagraph shall be applied without regard to 
     any time limitation.''.
                                 ______
                                 
      By Mr. GREGG (for himself and Mr. Kohl):
  S. 2401. A bill to provide jurisdictional standards for imposition of 
State and local business activity, sales, and use tax obligations on 
interstate commerce, and for other purposes; to the Committee on 
Finance.


                 the new economy tax simplification act

 Mr. GREGG. Mr. President, I rise today with Senator Kohl to 
introduce the New Economy Tax Simplification Act or NETSA. Electronic 
commerce is reshaping our society. In many ways, the strong economic 
conditions we currently enjoy are a result of the convenience, lower 
costs, and global connections provided by the internet. The question 
for us as a nation is how to manage this new enterprise so that it 
continues to benefit our nation's economy, particularly in regard to 
the taxation of e-commerce.
  So far, the government's hands-off approach is working. Our nation's 
unemployment and inflation rates are at record lows and higher paying 
jobs are being created at a tremendous rate. Many financial experts 
attribute the record low inflation rates to the Internet. A University 
of Texas study found that the Internet economy grew an astounding 68% 
rate in the past 12 months.
  Another sign of the good times is the surplus revenue flowing into 
federal and state treasuries all over the nation. The federal 
government's budget is balanced for the first time in a generation and 
the 50 states ended 1998 with a collective surplus of $11 billion. 
States are seeing revenue increases of more than 5 percent a year 
through the 1990's. This hardly seems like a compelling rationale for 
levying taxes on the Internet. Yet a heated debate is raging between 
those who want to keep the internet free of taxes and state and local 
governments who seek to impose widespread taxes on internet sales.
  The Advisory Commission on Electronic Commerce (ACEC), set up by 
Congress last year to develop recommendations on Internet taxes, 
recently concluded its final meeting but failed to reach the required 
supermajority to make any formal recommendations. Notably, it did agree 
by a simple majority vote to extend the current moratorium on Internet 
taxes for five years.
  The Commission is set to deliver it's report to Congress tomorrow. It 
will recommend that we extend the internet tax moratorium for another 
five years and I fully support this. The Commission will also ask 
Congress to establish nexus safeguards--to make clear when a State or 
municipality has the power to levy taxes. Our legislation establishes 
these important nexus safeguards.
  Currently, online sales are governed by the very same tax rules that 
govern mail order sales. The existing rules of the road are based upon 
two prior Supreme Court decisions--National Bellas Hess case in 1967, 
and the Quill case in 1992. Both decisions established the power of 
state tax authority to be limited by nexus--or the scope of a company's 
connection to the taxing state.
  Local sales taxes are incredibly complex. There are 7,600 different 
tax jurisdictions across the country--within these systems about 600-
700 rate changes occur per year. There are 46 different sets of rules 
(45 states and the District of Columbia have state sales tax). If 
forced to comply with these rules, companies would be filing 425 tax 
returns each month or 5,100 a year.
  The Gregg/Kohl bill, the New Economy Tax Simplification Act (NETSA), 
codifies these mail order tax rules as outlined in the Quill decision, 
updating this decision for the 21st century.
  Sales/use tax nexus rules are court-based, and income tax nexus rules 
are based upon a 1950s federal statute that applies only to tangible 
goods. The Gregg/Kohl plan would codify nexus standards across the 
board. This legislation would update and strengthen the nexus standards 
for the 21st Century economy--ensuring that intangible sales, web pages 
and servers do not cause nexus. It maintains current constitutional 
principles and keeps state powers within their jurisdictions, and does 
not try to pre-empt a state's tax authority within its own borders.
  I ask unanimous consent that the full text of the bill be printed in 
the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2401

       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 ``The New Economy Tax 
     Simplification Act (NETSA)''.

     SEC. 2. JURISDICTIONAL STANDARDS FOR THE IMPOSITION OF STATE 
                   AND LOCAL BUSINESS ACTIVITY, SALES, AND USE TAX 
                   OBLIGATIONS ON INTERSTATE COMMERCE.

       Title I of the Act entitled ``An Act relating to the power 
     of the States to impose net income taxes on income derived 
     from interstate commerce, and authorizing studies by 
     congressional committees of matters pertaining thereto'', 
     approved on September 14, 1959 (15 U.S.C. 381 et seq.), is 
     amended to read as follows:
                  ``TITLE I--JURISDICTIONAL STANDARDS

     ``SEC. 101. IMPOSITION OF STATE AND LOCAL BUSINESS ACTIVITY, 
                   SALES, AND USE TAX OBLIGATIONS ON INTERSTATE 
                   COMMERCE.

       ``(a) In General.--No State shall have power to impose, for 
     any taxable year ending after the date of enactment of this 
     title, a business activity tax or a duty to collect and remit 
     a sales or use tax on the income derived within such State by 
     any person from

[[Page 5184]]

     interstate commerce, unless such person has a substantial 
     physical presence in such State. A substantial physical 
     presence is not established if the only business activities 
     within such State by or on behalf of such person during such 
     taxable year are any or all of the following:
       ``(1) The solicitation of orders or contracts by such 
     person or such person's representative in such State for 
     sales of tangible or intangible personal property or 
     services, which orders or contracts are approved or rejected 
     outside the State, and, if approved, are fulfilled by 
     shipment or delivery of such property from a point outside 
     the State or the performance of such services outside the 
     State.
       ``(2) The solicitation of orders or contracts by such 
     person or such person's representative in such State in the 
     name of or for the benefit of a prospective customer of such 
     person, if orders or contracts by such customer to such 
     person to enable such customer to fill orders or contracts 
     resulting from such solicitation are orders or contracts 
     described in paragraph (1).
       ``(3) The presence or use of intangible personal property 
     in such State, including patents, copyrights, trademarks, 
     logos, securities, contracts, money, deposits, loans, 
     electronic or digital signals, and web pages, whether or not 
     subject to licenses, franchises, or other agreements.
       ``(4) The use of the Internet to create or maintain a World 
     Wide Web site accessible by persons in such State.
       ``(5) The use of an Internet service provider, on-line 
     service provider, internetwork communication service 
     provider, or other Internet access service provider, or World 
     Wide Web hosting services to maintain or take and process 
     orders via a web page or site on a computer that is 
     physically located in such State.
       ``(6) The use of any service provider for transmission of 
     communications, whether by cable, satellite, radio, 
     telecommunications, or other similar system.
       ``(7) The affiliation with a person located in the State, 
     unless--
       ``(A) the person located in the State is the person's agent 
     under the terms and conditions of subsection (d); and
       ``(B) the activity of the agent in the State constitutes 
     substantial physical presence under this subsection.
       ``(8) The use of an unaffiliated representative or 
     independent contractor in such State for the purpose of 
     performing warranty or repair services with respect to 
     tangible or intangible personal property sold by a person 
     located outside the State.
       ``(b) Domestic Corporations; Persons Domiciled in or 
     Residents of a State.--The provisions of subsection (a) shall 
     not apply to the imposition of a business activity tax or a 
     duty to collect and remit a sales or use tax by any State 
     with respect to--
       ``(1) any corporation which is incorporated under the laws 
     of such State; or
       ``(2) any individual who, under the laws of such State, is 
     domiciled in, or a resident of, such State.
       ``(c) Sales or Solicitation of Orders or Contracts for 
     Sales by Independent Contractors.--For purposes of subsection 
     (a), a person shall not be considered to have engaged in 
     business activities within a State during any taxable year 
     merely by reason of sales of tangible or intangible personal 
     property or services in such State, or the solicitation of 
     orders or contracts for such sales in such State, on behalf 
     of such person by one or more independent contractors, or by 
     reason of the maintenance of an office in such State by one 
     or more independent contractors whose activities on behalf of 
     such person in such State consist solely of making such 
     sales, or soliciting orders or contracts for such sales.
       ``(d) Attribution of Activities and Presence.--For purposes 
     of this section, the substantial physical presence of any 
     person shall not be attributed to any other person absent the 
     establishment of an agency relationship between such persons 
     that--
       ``(1) results from the consent by both persons that one 
     person act on behalf and subject to the control of the other; 
     and
       ``(2) relates to the activities of the person within the 
     State.
       ``(e) Definitions.--For purposes of this title--
       ``(1) Business activity tax.--The term `business activity 
     tax' means a tax imposed on, or measured by, net income, a 
     business license tax, a business and occupation tax, a 
     franchise tax, a single business tax or a capital stock tax, 
     or any similar tax or fee imposed by a State.
       ``(2) Independent contractor.--The term `independent 
     contractor' means a commission agent, broker, or other 
     independent contractor who is engaged in selling, or 
     soliciting orders or contracts for the sale of, tangible or 
     intangible personal property or services for more than one 
     principal and who holds himself or herself out as such in the 
     regular course of his or her business activities.
       ``(3) Internet.--The term `Internet' means collectively the 
     myriad of computer and telecommunications facilities, 
     including equipment and operating software, which comprise 
     the interconnected world-wide network of networks that employ 
     the Transmission Control Protocol/Internet Protocol, or any 
     predecessor or successor protocols to such Protocol.
       ``(4) Internet access.--The term `Internet access' means a 
     service that enables users to access content, information, 
     electronic mail, or other services offered over the Internet, 
     and may also include access to proprietary content, 
     information, and other services as a part of a package of 
     services offered to users.
       ``(5) Representative.--The term `representative' does not 
     include an independent contractor.
       ``(6) Sales tax.--The term `sales tax' means a tax that 
     is--
       ``(A) imposed on or incident to the sale of tangible or 
     intangible personal property or services as may be defined or 
     specified under the laws imposing such tax; and
       ``(B) measured by the amount of the sales price, cost, 
     charge, or other value of or for such property or services.
       ``(7) Solicitation of orders or contracts.--The term 
     `solicitation of orders or contracts' includes activities 
     normally ancillary to such solicitation.
       ``(8) State.--The term `State' means any of the several 
     States, the District of Columbia, or any territory or 
     possession of the United States, or any political subdivision 
     thereof.
       ``(9) Use tax.--The term `use tax' means a tax that is--
       ``(A) imposed on the purchase, storage, consumption, 
     distribution, or other use of tangible or intangible personal 
     property or services as may be defined or specified under the 
     laws imposing such tax; and
       ``(B) measured by the purchase price of such property or 
     services.
       ``(10) World wide web.--The term `World Wide Web' means a 
     computer server-based file archive accessible, over the 
     Internet, using a hypertext transfer protocol, file transfer 
     protocol, or other similar protocols.
       ``(f) Application of Section.--This section shall not be 
     construed to limit, in any way, constitutional restrictions 
     otherwise existing on State taxing authority.

     ``SEC. 102. ASSESSMENT OF BUSINESS ACTIVITY TAXES.

       ``(a) Limitations.--No State shall have power to assess 
     after the date of enactment of this title any business 
     activity tax which was imposed by such State or political 
     subdivision for any taxable year ending on or before such 
     date, on the income derived for activities within such State 
     that affect interstate commerce, if the imposition of such 
     tax for a taxable year ending after such date is prohibited 
     by section 101.
       ``(b) Collections.--The provisions of subsection (a) shall 
     not be construed--
       ``(1) to invalidate the collection on or before the date of 
     enactment of this title of any business activity tax imposed 
     for a taxable year ending on or before such date; or
       ``(2) to prohibit the collection after such date of any 
     business activity tax which was assessed on or before such 
     date for a taxable year ending on or before such date.

     ``SEC. 103. TERMINATION OF SUBSTANTIAL PHYSICAL PRESENCE.

       ``If a State has imposed a business activity tax or a duty 
     to collect and remit a sales or use tax on a person as 
     described in section 101, and the person so obligated no 
     longer has a substantial physical presence in that State, the 
     obligation to pay a business activity tax or to collect and 
     remit a sales or use tax on behalf of that State applies only 
     for the period in which the person has a substantial physical 
     presence.

     ``SEC. 104. SEPARABILITY.

       ``If any provision of this title or the application of such 
     provision to any person or circumstance is held invalid, the 
     remainder of this title or the application of such provision 
     to persons or circumstances other than those to which it is 
     held invalid, shall not be affected thereby.''.
  Mr. KOHL. Mr. President, today Senator Gregg and I are introducing 
legislation, the New Economy Tax Simplification Act, to ask government 
to step out of the way of the growing Internet economy and take a 
middle ground approach to taxation of Internet commerce. Our 
legislation does not stop any one State from forcing Internet companies 
within its borders to collect the sales taxes collected by any other 
business within its borders. But it does stop every one of the over 
7,000 local taxing jurisdictions from imposing every one of their 
unique rules, regulations, and rates on every business that sells over 
the Internet or through the mail.
  We are not here today to ask for special treatment for companies that 
sell on the Internet. We simply want to make sure that businesses that 
are tackling the market with 21st century technology are not bled to 
death by the Byzantine local tax system.
  All companies--regardless of whether they now sell over the Internet 
or not--benefit from the economic boom and consumer convenience 
provided by computer commerce. If you don't sell over the Internet now; 
you probably buy there. If you don't work for a company whose economic 
fortune is tied to

[[Page 5185]]

Internet sales or information, your spouse, child, or neighbor probably 
does. If you haven't invested in one of these successful Internet 
businesses, they have probably invested in you: in the charities in 
your community, in the jobs that are growing our economy everywhere; in 
the State programs financed by the taxes these companies rightly pay to 
the States in which they have a physical presence.
  Our bill provides a clear set of standards for businesses operating 
across state lines through mail-order sales or the Internet. And--very 
significantly--it also protects the rights of state and local officials 
to determine tax policy within their own jurisdictions.
  Some have called for a complete ban on sales taxes on Internet goods. 
Still others have claimed that companies should collect sales taxes on 
all of their products without regard to the point of sale or the state 
or residence of the consumer.
  We strike a balance between these two extremes. Just as my Wisconsin 
constituents should not have to pay local sales taxes for schools and 
sewers in Texas, Nebraska, or New York; it also makes sense that a 
Wisconsin business should not be forced to collect taxes to support 
fire and police protection in the other states. Businesses should 
collect the sales taxes that support the government services they 
receive.
  But the main reason I am here today is to protect against a Federal 
red tape nightmare that would prevent the very growth that we all wish 
to promote. There are over 7,000 tax jurisdictions in this country, all 
with their own tax rates, exemptions, audit requirements and appeals 
procedures. Requiring compliance with all those jurisdictions would 
mean learning and complying with 46 sets of rules. Under this scenario, 
companies would have to file more than 425 tax returns every month. 
That amounts to approximately 5,100 tax returns every year.
  Internet and mail order companies, as well as traditional main street 
stores who are developing or using Internet services, serve consumers 
who like the convenience of phone or Internet shopping or who are 
unable to leave their homes to shop. They offer greater convenience and 
greater choice. And they offer small specialty businesses the chance to 
grow into successful big businesses.
  Our bill will allow these vital markets to continue to flourish--free 
from a tangle of tax red tape. It will also allow state and local 
officials to continue to collect taxes as they see fit within their own 
jurisdictions. We believe it strikes the proper balance, and we look 
forward to convincing our colleagues that it is worthy of their 
support.
                                 ______
                                 
      By Mr. CLELAND:
  S. 2402. A bill to amend title 38, United States Code, to enhance and 
improve educational assistance under the Montgomery GI bill in order to 
enhance recruitment and retention of members of the Armed Forces, and 
for other purposes; to the Committee on Veterans' Affairs.


       helping our professionals educationally (hope) act of 2000

  Mr. CLELAND. Mr. President, I come before you today to introduce 
legislation that addresses the educational needs of our men and women 
in uniform and their families. I call this measure the HOPE Act of 
2000: HOPE, Helping Our Professionals Educationally--that is, our 
military professionals.
  The great Stephen Ambrose, the marvelous historian of World War II, 
the author of ``D-Day'' and other books, has said the GI bill is the 
single best piece of legislation ever passed by the Federal Government.
  Last year, Time magazine named the American GI as the Person of the 
Century--how appropriate. That alone is a powerful statement about the 
high value of our military personnel. They are recognized around the 
world for their dedication and commitment to fight for our country and 
for peace in the world. This past century has been the most violent one 
in modern memory. The American GI has fought in the trenches during the 
first World War, the beaches at Normandy, in the hills of Korea, in the 
jungles of Vietnam, in the deserts of the Persian Gulf, and most 
recently in the valleys of the Balkans.
  During that period, the face of our military and the people who fight 
our wars has changed dramatically. The traditional image of the single, 
mostly male, drafted, and ``disposable'' soldier is now gone. Today we 
are fielding the force for the 21st century. This new force is a 
volunteer force, filled with men and women who are highly skilled, 
married, and definitely not disposable. Gone are the days when quality 
of life for a GI meant a beer in the barracks and a 3-day pass. Now, we 
know we have to recruit a soldier but retain a family.
  We have won the cold war. This victory has further changed the world 
and our military. The new world order has given way to a new world 
disorder. United States is responding to crises around the globe--
whether it be strategic bombing or humanitarian assistance--and our 
military is often seen as our most effective response and our best 
ambassadors. In order to meet these challenges, we are retooling our 
forces to be lighter, leaner, and meaner. This is a positive move. 
Along with this lighter force, our military professionals must be 
highly educated and highly trained.
  Our Nation is currently experiencing the longest continuous peacetime 
economic growth in our history. This economic expansion has been a boon 
for our country. However, there has been a downside to this growing 
economy insofar as our Armed Forces are concerned. With the enticement 
of quick prosperity in the civilian sector it is more difficult than 
ever to recruit and retain our highly skilled forces.
  In fiscal year 1999, the Army missed it recruiting goals by 6291 
recruits, while the Air Force missed its goal by 1,732 recruits. Pilot 
retention problems persist for all services; for fiscal year 1999 the 
Air Force ended up 1,200 pilots short and the Navy ended 500 pilots 
short. We have other problems. The Army is having problems retaining 
captains, while the Navy faces manning challenges for surface warfare 
officers and special warfare officers. It is estimated that $6 million 
is spent to train a pilot. We as a nation cannot afford to continually 
train our people, only to lose them to the private sector. It is 
unarguably far better to retain than retrain.
  There is hope that we are now beginning to address these challenges. 
Last year was a momentous one for our military personnel. The Senate 
passed legislation that significantly enhances the quality of life for 
our military personnel. I am the Ranking Democrat on the Armed Services 
Committee. The Senate, with my vote and support, passed legislation 
that significantly enhances the quality of life for our military 
personnel from retirement reform to pay raises. This Congress is on 
record supporting our men and women in uniform. However, more must be 
done.
  In talking with our military personnel on my visits to the military 
bases in Georgia and around the world, we know that money alone is not 
enough. One of the things I would like to do is focus on education as a 
wonderful addition to the positive incentives we offer people to come 
into the military and stay in the military. Education, as a matter of 
fact, is the No. 1 reason service members come into the military. 
Unfortunately it is also the No. 1 reason why its members are leaving. 
We have to restructure our educational program in the military. We have 
to have a new GI bill. We have to provide hope to our military people, 
hope that the military can become the greatest university they will 
ever encounter.
  Last year the Senate began to address this issue by supporting 
improved education benefits for military members and their families but 
we encountered some concerns in the House. Since last year, we have 
gone back and studied this issue further. In reviewing the current 
Montgomery GI bill--named after the wonderful Representative from 
Mississippi, Congressman Sonny Montgomery--we found several 
disincentives and conflicts among the

[[Page 5186]]

education benefits offered by the services. These conflicts make the GI 
bill, which is actually an earned benefit, less attractive than it 
could be.
  My legislation will improve and enhance the current educational 
benefits and create the GI bill for the 21st century.
  One of the most important provisions of my legislation would give the 
Service Secretaries the ability to authorize a service member to 
transfer his or her basic MGIB benefits, educationally, to family 
members. Many service members tell us that they really want to stay in 
the service, but do not feel that they can stay and provide an 
education for their families. This proposed change will give them an 
opportunity to stay in the service and still provide an education for 
their spouses and children. It will give the Service Secretaries a very 
powerful retention tool by allowing them to authorize transfer of basic 
GI bill benefits, that are earned through the service of the service 
man or woman, anytime after 6 years of service.
  To encourage members to stay longer, the transferred benefits could 
not be used until completion of at least 10 years of service. I believe 
that the services can use this much like a reenlistment bonus to retain 
valuable service members. It can be creatively combined with 
reenlistment bonuses to create a very powerful and cost effective 
incentive for highly skilled military personnel to stay in the Service. 
In talking with service members upon their departure from the military, 
we have found that family considerations play a crucial role in the 
decision of a member to continue their military career.
  I found in discussions with military families and service members 
that at the 8- to 10- to 12-year mark when young service members are 
beginning to make a choice about whether to stay in the military, that 
choice is driven not so much by their own choice to serve the country--
obviously they want to serve the country and stay in the military--that 
choice is more and more driven by family needs, whether their spouse is 
employed or whether their spouse would like to gain an extra degree or 
whether they need to create a college fund for their kids.
  Reality dictates that we must address the needs of the family in 
order to retain our soldiers, sailors, airmen, and marines.
  My legislation would also give the Secretaries the authority to 
authorize the Veterans' Educational Assistance Program, known as VEAP. 
Those VEAP participants and those active duty personnel who did not 
enroll in Montgomery GI bill to participate in the current GI bill 
program. The VEAP participants would contribute $1,200, and those who 
did not enroll in the Montgomery GI bill would contribute $1,500. The 
services would pay any additional costs of the benefits of this 
measure.
  Another enhancement made by my proposal to the current GI bill 
extends the period in which the members of Reserve Components can 
utilize the program. I was shocked to find out that currently, Reserve 
members lose their education benefits when they leave the service or 
after 10 years of service. Amazing, they have no benefits when they 
leave service. My legislation will permit them to use the benefits up 
to 5 years after their separation from the military. This will 
encourage them to stay in the Reserves for a full career.
  It is obvious we are calling upon our reservists and our guards men 
and women more and more to fulfill our commitments around the globe. 
This will, I think, fulfill this Nation's commitment, certainly to our 
reservists, for an improvement in their educational opportunities.
  Other provisions of this legislation would allow the Service 
Secretaries to pay 100 percent tuition assistance or enable service 
members to use the GI bill to cover any unpaid tuition and expenses 
when the services do not pay 100 percent of tuition.
  This will allow a service member an additional incentive to use the 
GI bill in service. Education begets education.
  I believe this is a necessary next step for improving education 
benefits for our military members and their families. We have to offer 
them credible choices. If we offer them such options and treat the 
members and their families properly, we will show them our respect for 
their service and dedication, which they expect. Maybe then we can turn 
around our current sad retention statistics. This GI bill is an 
important retention tool for the services.
  We must continue to focus our resources on retaining our personnel 
based on their actual life needs, particularly their need for an 
educational opportunity. This bill gives them hope.

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