[Congressional Record (Bound Edition), Volume 147 (2001), Part 15]
[Senate]
[Pages 21208-21212]
[From the U.S. Government Publishing Office, www.gpo.gov]



                  STATEMENTS ON SUBMITTED RESOLUTIONS

      By Mr. FEINGOLD (for himself and Mr. Kohl):
  S. 1595. A bill to authorize the Secretary of Agriculture to 
establish a program to control bovine Johne's disease; to the Committee 
on Agriculture, Nutrition, and Forestry.
  Mr. FEINGOLD. Madam President, I rise today to introduce the Johne's 
Disease Elimination Act, which would provide incentives to encourage 
dairy producers to voluntarily begin testing for Johne's disease and to 
remove infected and exposed animals from their dairy herds.
  Johne's disease is a devastating infection that has adversely 
impacted dairy herds across the country for many years.
  Johne's disease was identified more than a century ago, yet remains a 
common and costly infectious disease of dairy cattle.
  Johne's disease starts as an infection in calves, though indications 
do not appear until 2 to 5 years later. Over 20 percent of all dairy 
herds may be infected with an animal pathogen that causes Johne's 
disease, which causes losses in milk production and an eventual wasting 
away of the animal. And if not detected and eliminated, the disease can 
spread throughout the herd.
  This animal disease, for which there is no cure, is projected to cost 
U.S. diary producers in excess of $200 million annually.
  Let me repeat, $200 million. The average cost to producers is about 
$245 per cow. In other words, the cost for a 100 cow dairy with an 
infected herd would be about $24,000.
  One of the biggest challenge to eradicate Johne's disease is the lack 
of a consistent national or industry-wide education or control program. 
One of the more prominent recent efforts involves the Johne's Committee 
of the U.S. Animal Health Association, which formed the National 
Johne's Working Group to begin more cohesive education, research, and 
control efforts to deal with the disease.
  The legislation I am introducing today is based on the work of the 
National Johne's Working Group. My legislation would authorize the 
creation of a program to encourage dairy herd owners to be practically 
free of Johne's disease in 7 years.
  This program would be absolutely voluntary and confidential, as the 
working group recommended.
  This program would provide incentives to encourage dairy producers to 
voluntarily begin testing for Johne's disease and to remove infected 
and exposed animals from their dairy herds.
  The incentives provided will also help farmers to perform herd risk 
assessments and utilize best management practices to develop 
appropriate Johne's Herd Management Plans to prevent further 
introduction and spread of the disease.
  We need to listen to America's dairy industry and follow their common 
sense suggestions to eradicate a disease that hurts dairy farmers 
across the United States. I urge my colleagues to join me in 
cosponsoring this legislation.
                                 ______
                                 
      By Mr. ROCKEFELLER:
  S. 1598. To amend section 1706 of title 38, United States Code, to 
enhance the management of the provision by the Department of Veterans 
Affairs of specialized treatment and rehabilitation for disabled 
veterans, and for other purposes; to the Committee on Veterans' 
Affairs.
  Mr. ROCKEFELLER. Madam President, I am proud today to introduce 
legislation that would improve upon the current requirement that the 
Department of Veterans Affairs maintain specialized health care 
services. It is my hope that the ``Veterans Specialized Treatment Act'' 
will finally settle the issue and that high quality, specialized health 
care services will be readily available to our veterans at each and 
every VA hospital.
  From its inception, the Department of Veterans' Affairs' health care 
system has been challenged to meet the special needs of its veteran 
patients, such as spinal cord injuries, amputations, blindness, post-
traumatic stress disorder, substance abuse, and homelessness. Over the 
years, VA has developed widely recognized expertise in providing 
specialized services to meet these needs. We have all been proud of 
VA's expertise, some of which is unparalleled in the larger health care 
community.
  Unfortunately, in recent years, VA's specialized programs have come 
under stress due to budget constraints, reorganizational changes, and 
the introduction of a new resource allocation system. Budgetary 
pressures, in particular, raised concerns back in 1996 that VA's costly 
specialized programs may be particularly vulnerable and 
disproportionately subject to reductions. As a result, Congress 
recognized the need to include protections for the specialized services 
programs. Public Law 104-262 specifically required the Secretary of 
Veterans Affairs to maintain capacity to provide for the specialized 
treatment needs of disabled veterans at the level in existence at the 
time the bill was passed, October 9, 1996 and to report annually to 
Congress on the status of its efforts.
  While each of the VA's required reports have proclaimed success in 
maintaining capacity, some remain skeptical. The General Accounting 
Office found that ``much more information and analyses are needed to 
support VA's, 1998, conclusion, that capacity was up to par.'' The VA 
Federal Advisory Committee on Prosthetics and Special Disability 
Programs has in the past called VA's data ``flawed'' and has not 
endorsed all of VA's report. In 1999, my own staff on the Committee on 
Veterans' Affairs also examined VA's implementation of the law and 
found that certain key programs, such as Post-Traumatic Stress Disorder 
and substance abuse disorder programs, were not meeting the mandated 
capacity levels.

[[Page 21209]]

  The most recent report shows, again, that there is concern about 
whether VA is adhering to the law. The VA Federal Committee on Care of 
Severely Chronically Mentally Ill Veterans stated in an official 
response that the 2000 report on capacity ``once again, documents the 
Department's decline in maintaining specialized services for . . . high 
priority patients, without explicitly acknowledging it.'' Committee 
members also emphasized that based on the results of the report, it did 
not appear that high-quality, system-wide access to specialized 
services is being provided by VA.
  I am disappointed that VA has still been unable to properly 
demonstrate that adequate levels of care for those veterans with 
specialized health care needs are being maintained. The legislation I 
introduce today seeks to remedy this problem by closing loopholes in 
the original law to ensure VA's compliance. Congress has spoken quite 
clearly in the past: VA does not have the discretion about whether or 
not to maintain capacity for specialized services.
  My proposed legislation would modify the existing report and require 
that VA submit information on the number of full-time staff providing 
treatment and the number of dedicated staffed beds; the number of 
veterans served by each such distinct program and facility; the number 
of units of service provided to veterans by such program, including the 
number of inpatient and residential days of care as well as the number 
of outpatient visits; and the amount of money spent for the care of 
veterans using these specialized services. Having this information for 
each of the distinct specialized services will allow Congress to fully 
understand how the specialized services are fairing. While I applaud 
VA's use of outcome measures, I believe it is imperative that the 
report contain hard data on the number of staffed beds and other 
information.
  VA would also be required to maintain capacity of the Department at 
each and every medical center. Current law only requires that 
``overall'' capacity be maintained.
  Another key element of the legislation is that the Inspector General 
of VA would conduct an annual audit to ensure that the requirements of 
the capacity law are carried out every year. The IG would also be 
required to review the VA's yearly report and provide their assessment, 
on that report, to Congress. Finally, in an effort to encourage VA 
managers to comply with the legislation, VA would be required to look 
at the status of the specialized services programs whenever job 
performance is reviewed.
  My colleagues, I ask for your support of this bill, as it would help 
ensure that specialized services, a crucial segment of the health care 
VA provides to veterans, are maintained at the necessary level.
                                 ______
                                 
      By Mr. DAYTON:
  S. 1600. A bill to amend the Internal Revenue Code of 1986 to allow 
Medicare beneficiaries a refundable credit against income tax for the 
purchase of outpatient prescription drugs; to the Committee on Finance.
  Mr. DAYTON. Madam President, one of the groups consistently left out 
of most current economic stimulus proposals are America's senior 
citizens. Prescription drug prices continue to escalate, putting 
enormous financial strains on seniors in Minnesota and throughout the 
Nation. That is why I am introducing today The Rx Relief for Seniors 
Act. It would give America's hard-pressed senior citizens a one-time, 
refundable tax credit of up to $500 per individual and up to $1,000 per 
married couple, to offset their payments for prescription drugs during 
the year 2001.
  Millions of senior citizens in my home state of Minnesota and 
throughout this country have had their limited personal incomes ravaged 
by the rising costs of prescription medicines. These escalating prices 
force the elderly to reduce their expenditures for other essential 
needs such as food, clothing, and utilities. They also prevent seniors 
from spending money on additional discretionary items such as 
recreation, travel, and other needed goods and services.
  The assurance of this $500 refundable tax credit, either as a credit 
on Federal taxes due next April 15, or as a cash refund from the 
Internal Revenue Service shortly thereafter, would permit budget-
conscious senior citizens to increase immediately their purchases of 
additional consumer goods and services. Seniors, especially the 
majority who live on limited and fixed incomes, would be among the 
people most likely to spend quickly any new tax relief and thus help 
stimulate the economy. For this reason, the bill directs the Secretary 
of Health and Human Services to notify all Medicare beneficiaries that 
they are eligible for this refundable tax credit for their 2001 
prescription drug purchases.
  Since my election to the Senate a year ago, I have been urging my 
colleagues to adopt some form of prescription drug coverage for 
America's senior citizens. Regrettably, such permanent, comprehensive 
coverage has been once again delayed by differences over the design of 
such a program. Yet, for millions of elderly citizens, the financial 
strains caused by escalating drug costs are urgent and acute. The Rx 
Relief for Seniors Act would provide them with a one-time dose of 
immediate relief. Hopefully, it would also provide a transition to 
permanent, comprehensive prescription drug coverage legislation next 
year.
                                 ______
                                 
      By Mr. CORZINE (for himself, Mr. Jeffords, Mrs. Boxer, and Mrs. 
        Clinton):
  S. 1602. A bill to help protect the public against the threat of 
chemical attack; to the Committee on Environment and Public Works.
  Mr. CORZINE. Madam President, today I am introducing a bill, the 
Chemical Security Act of 2001, that will reduce the vulnerability of 
our communities to releases of hazardous chemicals.
  In the past, concern about chemical facilities has largely focused on 
accidental releases. Unfortunately, recent events have shown that the 
potential for catastrophic accidents is still with us. As recently as 
September 21, an accident at a chemical plant in France caused 300 tons 
of nitrates to explode, killing 29, injuring thousands, and damaging 
10,000 houses.
  We need to ensure that we are taking all appropriate measures to 
prevent such catastrophes from occurring accidentally. But today, in 
the world of post 9/11, perhaps more importantly, we need to ensure 
that we do what we can to prevent such catastrophes from being caused 
intentionally by terrorists.
  In the wake of the attacks in New York and Washington, it is clear 
that wee need to look at all of our nation's assets and people as 
potential terrorist targets. We need to get ahead of the curve as 
quickly as we can. I believe that one of the places that we need to 
look first is at our nation's chemical production, processing, 
transportation and disposal infrastructure. Vulnerability of these 
sectors to either terrorist attack or the theft of dangerous chemicals 
can pose a serious threat to public health, safety and the environment.
  This is not just my opinion, Madam President. The Department of 
Justice studied this matter last year and concluded that there is a 
``real and credible threat'' that terrorists would try to cause an 
industrial chemical release in the foreseeable future. The Department 
noted that attacking an existing chemical facility, for example, 
presents an easier and more attractive alternative for terrorists than 
constructing a weapon of mass destruction. In addition, the Department 
concluded that many plants that contain hazardous chemicals would be 
attractive targets for terrorists because of the plants' proximity to 
densely populated areas. This is certainly the case in my home state of 
New Jersey--the most densely populated State in the Nation.
  Other studies also have shown that our nation's chemical facilities 
are indeed vulnerable. For example, the Agency for Toxic Substances and 
Disease Registry studied over 60 chemical plants in West Virginia, 
Georgia, and Nevada. The Agency found that security at those plants 
ranged from fair to very poor.

[[Page 21210]]

  As I noted earlier, beyond the new threat of terrorism is the 
existing problem of chemical accidents. According to the National 
Response Center of the United States Coast Guard, which is the sole 
point of registry for reporting oil and chemical spills, there were 
28,822 accidental industrial chemical releases in 1998. Those releases 
caused 2,193 injuries and 170 deaths.
  Remarkably, Madam President, despite this risk, the federal 
government lacks mandatory security standards for any chemical 
facilities. Even those in densely populated areas. Even those with 
extremely hazardous chemicals. Now we do require owners and operators 
of such facilities to prepare risk management plans that analyze the 
potential off-site consequences of a release of regulated substances. 
These reports must include plans to prevent an unintended release and 
to mitigate the effects of such a release, should it occur. However, no 
federal requirements are in place that require specific steps to 
prevent releases caused by criminal or terrorist activity.
  Madam President, the Chemical Security Act of 2001 would fill this 
gap in current law by requiring common sense steps to address the 
highest priority threats from accidents and attacks involving hazardous 
chemicals.
  To enable the federal government to take immediate action upon 
enactment to address the most serious risks on a case-by-case basis, 
the bill provides EPA and the Attorney General the authority to issue 
administrative orders and secure relief through the courts to abate an 
imminent and substantial endangerment from a potential accidental or 
criminal release.
  The bill directs the EPA Administrator to consult with the Attorney 
General, states and localities to identify ``high priority'' categories 
within our chemical production, processing, transportation and disposal 
infrastructure. In designating these ``high priority'' categories, the 
Administrator is to consider a set of factors, including the severity 
of potential harm from a release, proximity to population centers, 
threats to critical infrastructure and national security, and other 
factors the Administrator considers appropriate.
  The bill also directs the Administrator to consider threshold 
quantities of chemicals in establishing high priority categories. This 
is to ensure that small businesses like gas stations and photo shops 
are not swept up in the regulations.
  Those businesses that are designated as high priorities are subject 
to two other provisions of the bill designed to reduce the threat of 
chemical attacks.
  First, a general duty is placed on any owner or operator of a 
facility that falls within a high priority category to identify 
hazards, take measures to prevent a criminal release, and minimize the 
consequences of any criminal release that occurs.
  Second, the EPA is directed to develop regulations for the high 
priority categories that will require them to take adequate actions to 
prevent, control, and minimize the potential consequences of an 
accident or attack.
  The bill includes other provisions to enable the EPA and the Attorney 
General to carry out and enforce the act, such as the authority to 
obtain information that may be needed, while providing for protection 
of trades secrets and national security information.
  Madam President, the legislation is not overly prescriptive, and this 
is intentional. I believe that in the wake of September 11, it is self-
evident that we need to do a better job safeguarding our communities 
from terrorism. And I believe that the possibility of chemical attacks 
is something we need to look at. So the heart of the bill is a 
requirement that EPA and DOJ work with state and local agencies to 
ensure that the highest priority threats from chemical facilities are 
being addressed. But I don't want to tie the hands of the executive 
branch. I think that they should have wide latitude in determining what 
types of chemicals and facilities need to implement better security 
measures. But this latitude should not be misconstrued as a mandate to 
regulate gas stations, photo shops, and everyone under the sun who uses 
hazardous chemicals. Rather, the latitude is there to give EPA and DOJ 
broad enough authority so that they are able to address the most 
pressing threats, wherever they may be.
  Madam President, strengthening security at high priority chemical 
sources is an immediate and necessary step to safeguard our 
communities. Over the longer, term, however, I believe that our desire 
to protect our communities and our environment will be best served by 
reducing the use of hazardous chemicals. That's why this bill includes 
provisions to require high priority chemical sources to reduce risks 
where practicable by using inherently safer technology, well-maintained 
secondary control equipment, robust security measures, and buffer 
zones.
  We have seen this type of approach work in New Jersey, where the 
legislature enacted a law requiring facilities to implement alternate 
processes that would reduce the risk of a release of extremely 
hazardous substances. After the enactment of this law, the number of 
water treatment plants using levels of chlorine at a level considered 
extremely hazardous decreased from 575 in 1988 to 22 in September of 
2001. Chlorine, which can cause a number of problems include burning of 
the skin and eyes, nosebleeds, chest pain, and death, was replaced by 
sodium hypochlorite or other much less hazardous chemicals or 
processes. Although I believe this New Jersey law has afforded my 
constituents a high level of safety with regard to accidents, the 
current federal and state security requirements in New Jersey do not 
address the threat of terrorist attacks. I suspect that this is most if 
not all of our states, Madam President. That's why it's critical for 
Congress to act.
  I am glad to note, Madam President, that the chemical industry has 
indicated a willingness to engage the federal government on the issue 
of security. On October 4, 2001, the American Chemistry Council sent a 
letter to President Bush, requesting that the federal government 
immediately begin a comprehensive assessment of security at chemical 
plants. On October 10, a representative of the American Chemistry 
Council who testified before the House Transportation and 
Infrastructure Subcommittee on Water and the Environment reiterated 
this message, stating that ``Our industry believes it will benefit from 
a comprehensive assessment conducted by appropriate federal law 
enforcement, national security and safety experts. While we are taking 
aggressive steps to make our operations more secure, we recognize that 
we cannot achieve this objective by ourselves.'' Madam President, I 
agree with the American Chemistry Council's on this point, and I look 
forward to working with industry to ensure that the federal government 
has the tools that it needs to play its proper role.
  In conclusion, Madam President, reducing the threat of a terrorist 
attack against a chemical facility, or an accidental release of 
hazardous substances, is critically important to ensure the safety of 
all Americans. We should not wait any longer before beginning to 
address this problem, and I urge my colleagues to support this 
legislation.
                                 ______
                                 
      By Mr. JEFFORDS:
  S. 1604. A bill to establish a national historic barn preservation 
program; to the Committee on Agriculture, Nutrition, and Forestry.
  Mr. JEFFORDS. Madam President, I rise today to introduce the National 
Historic Barn Preservation Act of 2001.
  As I am sure my colleagues agree, historic barns are some of 
America's greatest national treasures symbolizing the agriculture 
foundations upon which our Nation was founded. Unfortunately, many are 
in danger of falling beyond repair. These symbols of the American 
spirit are a vital component of our cultural heritage and must be 
preserved.
  From our agricultural beginnings in Colonial times to the 
frontiersmen' expansion to the West, barns have been a fixture of the 
rural American landscape. Unfortunately, Agriculture and farm 
production has weathered many painful changes over the past decades. 
These changes have been particularly

[[Page 21211]]

difficult for small and medium sized farms where most of our nation's 
historic barns reside. According to a survey conducted by Successful 
Farming, 65 percent of the farmers surveyed had barns over 50 years old 
on their property.
  Our legislation allows these farmers to receive funds administered 
through States and non-profit organizations to bring their barns into 
productive use. Preserving these barns will not only ensure their 
survival for generations to come, it will also provide many practical 
benefits to the communities and economies that surround them.
  Specifically, this bill will allow small and medium-sized farms to 
make necessary investments in their production facilities to keep their 
farms working by providing direct grants. In hard times, small and 
medium-sized farms have had to choose between making improvements on a 
historic structure on their property or investing in machinery to keep 
their existing operations running. Between 1982 and 1997, our nation 
saw a 15 percent decline in the number of farms in use, averaging a 
loss of 22,000 farms per year. This bill will ensure the economic 
viability of these farms by helping farmers preserve their historic 
structures and maintain essential investments. Given our current 
economic outlook, this bill will be particularly beneficial.
  Also, preserving historic barns helps ensure that farmers keep their 
land in agricultural use. This has a tremendous effect in preventing 
sprawl from encroaching on rural communities. It is estimated that 3.6 
million acres of farmland is removed from agricultural use each year.
  This is a sensible bill that ensures the preservation of historic 
barns in ways individual farmers want. The National Trust for Historic 
Preservation recently conducted a survey asking farmers how they could 
preserve historic barns on their property. The number one response from 
these farmers was to create a national grant program, exactly what this 
legislation does.
  This bill enjoys wide support and has been endorsed by the National 
Trust for Historic Preservation. I invite my colleagues to join me in 
my efforts to preserve our Nation's historic barns for the prosperity 
of future generations and the well-being of our rural communities. I 
ask that a summary of the legislation be printed in the Record.
  There being no objection, the summary was ordered to be printed in 
the Record, as follows:

                              Bill Summary

       The bill would instruct the Secretary of Agriculture to act 
     through the Undersecretary of Rural Development to: Assist 
     states in developing a listing of historic barns; collect and 
     disseminate information concerning historic barns; foster 
     educational programs relating to historic barns and their 
     preservation; sponsor and conduct research on the history of 
     barns; and sponsor or conduct research, and study techniques, 
     on protecting historic barns.
       The bill would authorize the Office of Rural Development of 
     USDA to award $25 million in grants over FY 2002 through 2006 
     for barn preservation projects to the following agencies: 
     State Departments of Agriculture, National or State Non-
     profits that have been determined by the Secretary of 
     Agriculture to have experience in historic barn preservation, 
     and a State Historic Preservation Office.
       While most of the $25 million authorized would be awarded 
     for grants used to rehabilitate or repair historic barns, the 
     bill would allow some of the funds to be used to: Install 
     fire detection systems and/or sprinklers; install systems to 
     prevent vandalism; and identify, document and conduct 
     research on historic barns to develop and evaluate 
     appropriate techniques or best practices for protecting 
     historic barns.
                                 ______
                                 
      By Mr. ROCKEFELLER (for himself, and Ms. Snowe):
  S. 1607. A bill to amend title XVIII of the Social Security Act to 
provide coverage of remote monitoring services under the Medicare 
Program; to the Committee on Finance.
  Mr. ROCKEFELLER. Madam President, I rise today to introduce a small 
bill, but one with important consequences. My measure, the ``Medicare 
Remote Monitoring Services Act of 2001,'' seeks to increase access to 
remote management technologies by providing equal payment for these 
services under Medicare. I am pleased to be joined by Senator Snowe in 
introducing this measure.
  As my colleagues know, many new technologies that collect, analyze, 
and transmit clinical health information are in development or have 
recently been introduced to the market. These remote management 
technologies hold clear promise: Better information on the patient's 
condition, collected and stored electronically, analyzed for clinical 
value, and transmitted to the physician or the patient, should improve 
patient care and access. Instead of a time-consuming 20-mile trips to 
the doctor's office, it takes the patient 10 minutes to transmit the 
data by computer. This is not going to replace hands-on medicine, but 
when it's not possible for the physician to be there, this can be a 
tool. It's a more aggressive way to be with the patient and help avoid 
a crisis.
  Despite these innovations, many new clinical information and remote 
management technologies have failed to diffuse rapidly. A significant 
barrier to wider adoption and evolution of the technologies is the 
relative lack of payment mechanisms under Medicare for services 
provided by a physician related to these technologies.
  The June 2001 ``MedPAC report to Congress on Medicare in Rural 
America'' raises concerns about access to health care in rural areas. 
The report states that if policymakers are interested in expanding the 
use of telemedicine approaches to improve access to care, one avenue 
that could be explored is the coverage of technology that enables a 
diagnostic test to be performed on a patient remotely and then be sent 
electronically to the consulting physician for review at a later time.
  In addition, in its March 2001 report, ``Crossing the Quality 
Chasm,'' the Institute of Medicine stated that the automation of 
clinical and other health transactions was an essential factor for 
improving quality, preventing errors, enhancing consumer confidence, 
and improving efficiency, yet ``health care delivery has been 
relatively untouched by the revolution in information technology that 
has been transforming nearly every other aspect of society.''
  Under this legislation remote monitoring services that are found to 
be comparable to face to face, encounter-based, monitoring services 
will be given the same coverage and level of Medicare payment as the 
comparable encounter-based physician service. The provision will be 
implemented in a budget-neutral manner. I urge my colleagues to 
cosponsor this legislation that will improve patient access, care, and 
management, as well as spur the development of new technologies that 
will improve services further.
  Ms. SNOWE. Madam President, today I am joining with Senator 
Rockefeller in introducing the Medicare Remote Monitoring Service 
Coverage Act of 2001. This bill is designed to place Medicare on the 
cutting edge of technology and ensure that our Nation's seniors have 
access to the best treatment options available.
  Ever since the first stethoscope was developed in Paris in 1816, 
medical technology has had a dramatic impact on health care. Over the 
past twenty-five years, the technology of medical devices has improved 
dramatically. The resulting changes in the practice of medicine and the 
improvements in the quality of patient care of have been dramatic and 
this trend will continue as we move into the future.
  Once such important improvement is in the ability of new cutting-edge 
medical devices to electronically monitor a patient's response to 
treatment. The new devices will collect, analyze and transmit clinical 
health information to the patient's physician. As a result, the 
physician will have access to better information on the patient's 
condition, which will improve patient care. These innovative devices 
will also monitor their own internal performance and transmit this 
information in real-time to the physician's office. Physicians can use 
this data to assess a patient's response to treatment and determine if 
new interventions are required.
  One such device that is under development is an advanced version of 
the internal cardiac defibrillator or ICD similar to the one used by 
Vice President Cheney. These devices monitor

[[Page 21212]]

the heart and respond automatically when indicated. When the heart's 
rhythm triggers certain interventions, the patient is required to 
immediately contact their physician and must travel to the emergency 
room to determine if a more serious problem has developed. It is also 
crucial at these times to determine that the device is working 
properly. Access to care in these circumstances is imperative.
  With these new devices, this important information can be transmitted 
electronically to the physician. The physician can then analyze this 
clinical data and determine if further intervention is required. As a 
result of this innovation, costly emergency room visits are avoided and 
patients can receive their physician's assessment more quickly. This 
reduces the cost of the health care intervention by avoiding the 
emergency room visit and provides piece of mind to the patient that the 
life-saving device is working properly. One can easily see that this is 
of greatest value to patients in rural areas who would otherwise have 
to travel great distances to the emergency room for evaluation, many 
times in the middle of the night.
  While these new technologies hold great promise, Medicare 
reimbursement policies are an unfortunate barrier to their use. Under 
current Medicare payment policy, most physician billing codes are 
limited to face-to-face interactions between physician and patient. The 
physician payment system does not provide reimbursement for time spent 
on a clinical evaluation when a face-to-face encounter is not needed. 
As a result, Medicare payment rules will inhibit the adoption of this 
promising technology. This is unfortunate when one considers that, in 
many cases, costly emergency room visits can be avoided while the 
identical clinical analysis and interpretation takes place using data 
that is transmitted electronically to the physician.
  This legislation, which we are introducing today, would create 
reimbursement parity between physician visits on a face-to-face basis 
and equivalent interventions resulting from remote patient management 
made possible by these devices. The legislation would provide the same 
Medicare coverage and level of reimbursement for remote monitoring 
services that are found to be comparable to face-to-face, encounter-
based, services specifically for data collection and analysis. This new 
reimbursement policy will be implemented in a budget-neutral manner and 
simply designed to pay for remote monitoring when a face-to-face 
physician encounter would be reimbursed for the same services under the 
same set of circumstances.
  This proposal will improve patient care and promote the adoption of 
this innovative new technology. Moreover, it will provide better access 
and improved quality of care for patients who rely on these devices, 
particularly in rural areas. This is especially true in cases when an 
immediate evaluation is required. We believe this is a sensible 
proposal that will reduce costs in the long-run and will ensure that 
seniors have access to cutting edge, life-saving technologies. We are 
hopeful that this legislation can be adopted quickly to assure that 
Medicare beneficiaries are not prevented from accessing this 
technology.
                                 ______
                                 
      By Mr. SMITH of New Hampshire (for himself, Mr. Jeffords, Mr. 
        Graham, and Mr. Crapo):
  S. 1608. A bill to establish a program to provide grants to drinking 
water and wastewater facilities to meet immediate security needs; to 
the Committee on Environment and Public Works.
  Mr. SMITH of New Hampshire. Madam 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. 1608

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

     SECTION 1. WATER SECURITY GRANTS.

       (a) Definitions.--In this Act:
       (1) Administrator.--The term ``Administrator'' means the 
     Administrator of the Environmental Protection Agency.
       (2) Eligible entity.--The term ``eligible entity'' means a 
     publicly- or privately-owned drinking water or wastewater 
     facility.
       (3) Eligible project or activity.--
       (A) In general.--The term ``eligible project or activity'' 
     means a project or activity carried out by an eligible entity 
     to address an immediate physical security need.
       (B) Inclusions.--The term ``eligible project or activity'' 
     includes a project or activity relating to--
       (i) security staffing;
       (ii) detection of intruders;
       (iii) installation and maintenance of fencing, gating, or 
     lighting;
       (iv) installation of and monitoring on closed-circuit 
     television;
       (v) rekeying of doors and locks;
       (vi) site maintenance, such as maintenance to increase 
     visibility around facilities, windows, and doorways;
       (vii) development, acquisition, or use of guidance manuals, 
     educational videos, or training programs; and
       (viii) a program established by a State to provide 
     technical assistance or training to water and wastewater 
     facility managers, especially such a program that emphasizes 
     small or rural eligible entities.
       (C) Exclusions.--The term ``eligible project or activity'' 
     does not include any large-scale or system-wide project that 
     includes a large capital improvement or vulnerability 
     assessment.
       (b) Establishment of Program.--
       (1) In general.--The Administrator shall establish a 
     program to allocate to States, in accordance with paragraph 
     (2), funds for use in awarding grants to eligible entities 
     under subsection (c).
       (2) Allocation to states.--Not later than 30 days after the 
     date on which funds are made available to carry out this 
     section, the Administrator shall allocate the funds to States 
     in accordance with the formula for the distribution of funds 
     described in section 1452(a)(1)(D) of the Safe Drinking Water 
     Act (42 U.S.C. 300j-12(a)(1)(D)).
       (3) Notice.--Not later than 30 days after the date 
     described in paragraph (2), each State shall provide to each 
     eligible entity in the State a notice that funds are 
     available to assist the eligible entity in addressing 
     immediate physical security needs.
       (c) Award of Grants.--
       (1) Application.--An eligible entity that seeks to receive 
     a grant under this section shall submit to the State in which 
     the eligible entity is located an application for the grant 
     in such form and containing such information as the State may 
     prescribe.
       (2) Condition for receipt of grant.--An eligible entity 
     that receives a grant under this section shall agree to 
     expend all funds provided by the grant not later than 
     September 30, 2002.
       (3) Disadvantaged, small, and rural eligible entities.--A 
     State that awards a grant under this section shall ensure, to 
     the maximum extent practicable in accordance with the income 
     and population distribution of the State, that a sufficient 
     percentage of the funds allocated to the State under 
     subsection (b)(2) are available for disadvantaged, small, and 
     rural eligible entities in the State.
       (d) Eligible Projects and Activities.--
       (1) In general.--A grant awarded by a State under 
     subsection (c) shall be used by an eligible entity to carry 
     out 1 or more eligible projects or activities.
       (2) Coordination with existing training programs.--In 
     awarding a grant for an eligible project or activity 
     described in subsection (a)(3)(B)(vii), a State shall, to the 
     maximum extent practicable, coordinate with training programs 
     of rural water associations of the State that are in effect 
     as of the date on which the grant is awarded.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $25,000,000 for 
     fiscal year 2002.

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