[Congressional Record (Bound Edition), Volume 148 (2002), Part 12]
[Senate]
[Pages 17077-17085]
[From the U.S. Government Publishing Office, www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. BAYH (for himself and Mr. Lugar)
  S. 2952. A bill to amend the National Trails System Act to extend the 
Lewis and Clark National Historic Trail; to the Committee on Energy and 
Natural Resources.
  Mr. BAYH. Mr. President, next year America will celebrate the 
bicentennial of the cross-country expedition of Meriwether Lewis and 
William Clark. With what became known as the Corps of Discovery, Lewis 
and Clark embarked on an epic journey to chart an overland route to the 
Pacific Ocean, developing a record of its native people and resources. 
They catalogued varieties of never before seen plant and animal life. 
In fact, their expedition is seen as a critical precursor to America's 
great movement to the West.
  Less known, but of no less significance to the expedition, are the 
historic events that occurred at the outset of the journey. I rise 
today, with my colleague from Indiana, Senator Lugar, to introduce 
legislation that recognizes the importance of these events by adding 
the Falls of the Ohio, in Clarksville, IN and Louisville, KY, to the 
sites honored and preserved by inclusion on the Lewis and Clark 
National Historic Trail.
  Many historians have detailed the fact that it was the Falls of the 
Ohio, in Clarksville, IN, that Meriwether Lewis and William Clark met 
and formed their famous partnership. It was there that they spent 12 
days recruiting and enlisting members for their Western expedition in 
Louisville and southern Indiana for the Corps of Discovery. Ultimately 
they selected nine men from the area. After establishing their crew, 
Lewis and Clark set out for the West on the Ohio River from Clarksville 
on October 26, 1803.
  One of the many accounts of the formation of the Corps of Discovery 
is included in historian Stephen E. Ambrose's work on the expedition, 
Undaunted Courage. Mr. Ambrose writes that: ``At the foot of the 
rapids, on the north bank, was Clarksville, Indiana Territory. . . . On 
October 15, Lewis hired local pilots, who took the boat and pirogues 
into the dangerous but passable passage on the north bank. Safely 
through, Lewis tied up at Clarksville and set off to meet his 
partner.''
  ``When they shook hands, the Lewis and Clark expedition began.''

[[Page 17078]]

  And Ambrose continues: ``Word has spread up and down the Ohio, and 
inland, and young men longing for adventure and ambitious for a piece 
of land of their own set out for Clarksville to sign up . . . Those 
selected were sworn into the army in solemn ceremony, in the presence 
of General Clark, and the Corps of Discovery was born.''
  The National Park Service agreed with Mr. Ambrose and other 
historical sources that the events at the Falls of the Ohio are of 
important historical significance. The National Park Service certified 
the Falls of the Ohio State Park as an official site associated with 
the Lewis and Clark National Historic Trail.
  My legislation would simply reiterate the Park Service's conclusion 
that the events at the Falls of the Ohio are a significant part of the 
history of the Lewis and Clark expedition and would include the Falls 
of the Ohio among the areas designated for recognition on the Lewis and 
Clark National Historic Trail.
  The National Council of the Lewis and Clark Bicentennial designated 
the Falls of the Ohio as the second signature event of the 
bicentennial, which will be held in October 2003.
  The Falls of the Ohio is an integral part of the Lewis and Clark 
story, which will be uniquely celebrated next year. It is my hope that 
we can move quickly to pass this legislation to insure that the 
recognition occurs in time for the much anticipated 200th anniversary 
of the trail. That way the citizens of Clarksville and Louisville can 
honor and preserve their local heritage and all students of history can 
fully follow in the footsteps of Lewis and Clark and experience the 
birth of the Corps of Discovery at the Falls of the Ohio.
                                 ______
                                 
      By Mr. CAMPBELL:
  S. 2953. A bill to redesignate the Colonnade Center in Denver, 
Colorado, as the ``Cesar E. Chavez Memorial Building''; to the 
Committee on Environment and Public Works.
  Mr. CAMPBELL. Mr. President, today I am introducing legislation to 
name the Federal building located at 1244 Speer Boulevard, Denver, CO., 
as the ``Cesar E. Chavez Memorial Building.''
  Cesar E. Chavez was an ordinary American who left behind an 
extraordinary legacy of commitment and accomplishment.
  Born on March 31, 1927 in Yuma Arizona on a farm his grandfather 
homesteaded in the 1880's, he began his life as a migrant farm worker 
at the age of 10 when the family lost the farm during the Great 
Depression. Those were desperate years for the Chavez family as they 
joined the thousands of displaced people who were forced to migrate 
throughout the country to labor in the fields and vineyards.
  Motivated by the poverty and harsh working conditions, he began to 
follow his dream of establishing an organization dedicated to helping 
these farm workers. In 1962 he founded the National Farm Workers 
Association which would eventually evolve into the United Farm Workers 
of America.
  Over the next three decades with an unwavering commitment to 
democratic principals and a philosophy of non-violence he struggled to 
secure a living wage, health benefits and safe working conditions for 
arguably the most exploited work force in our country, that they might 
enjoy the basic protections and workers right to which all Americans 
aspire.
  In 1945, at the age of 18 Cesar Chavez joined the U.S. Navy and 
served his country for two years. He was the recipient of the Martin 
Luther King Jr. Peace Prize as well as the Presidential medal of 
Freedom, the highest award this country can bestow upon a civilian.
  Chavez's efforts brought dignity and respect to this country's farm 
workers and in doing so became a hero, role model and inspiration to 
people engaged in human rights struggles throughout the world.
  The naming of this building will keep alive the memory of his 
sacrifice and commitment for the millions of people whose lives he 
touched.
  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. 2953

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

     SECTION 1. DESIGNATION OF CESAR E. CHAVEZ MEMORIAL BUILDING.

       The building known as the Colonnade Center, located at 1244 
     Speer Boulevard, Denver, Colorado, shall be known and 
     designated as the ``Cesar E. Chavez Memorial Building''.

     SEC. 2. REFERENCES.

       Any reference in a law, map, regulation, document, paper, 
     or other record of the United States to the building referred 
     to in section 1 shall be deemed to be a reference to the 
     Cesar E. Chavez Memorial Building.
                                 ______
                                 
      By Mr. FEINGOLD (for himself, Mr. Jeffords, Mr. Wellstone, Mr. 
        Leahy, and Mr. Dayton):
  S. 2954. A bill to amend the Elementary and Secondary Education Act 
of 1965 to permit States and local educational agencies to decide the 
frequency of using high quality assessments to measure and increase 
student academic achievement, to permit States and local educational 
agencies to obtain a waiver of certain testing requirements, and for 
other purposes; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. FEINGOLD. Mr. President, as millions of public school students 
and teachers around the country settle into the new school year, I am 
introducing a bill that would help to return a measure of local control 
that was taken from school districts and State educational agencies 
with the enactment of the No Child Left Behind Act earlier this year.
  I am pleased to be joined in this effort by Senators Jeffords, 
Wellstone, Leahy, and Dayton.
  I strongly support maintaining local control over decisions affecting 
our children's day-to-day classroom experiences. I also believe that 
the Federal Government has an important role to play in supporting our 
State educational agencies and local school districts as they carry out 
one of their most important responsibilities, the education of our 
children.
  I voted against the recently-enacted No Child Left Behind Act in 
large part because of the new annual testing mandate for students in 
grades 3-8. While I agree that there should be a strong accountability 
system in place to ensure that public school students are making 
progress, I strongly oppose over-testing students in our public 
schools. I agree that some tests are needed to ensure that our children 
are keeping pace, but taking time to test students has to take a back 
seat to taking the time to teach students in the first place.
  I have heard a lot about these new annual tests from the people of 
Wisconsin, and their response has been almost universally negative. My 
constituents are concerned about this additional layer of testing for 
many reasons, including the cost of developing and implementing these 
tests, the loss of teaching time every year to prepare for and take the 
tests, and the extra pressure that the tests will place on students, 
teachers, schools, and school districts.
  I share my constituents' concerns about this new Federal mandate. I 
find it interesting that proponents of the No Child Left Behind Act say 
that it will return more control to the States and local school 
districts. In my view, however, this massive new Federal testing 
mandate runs counter to the idea of local control.
  Many States and local school districts around the country, including 
Wisconsin, already have comprehensive testing programs in place. The 
Federal Government should leave decisions about the frequency of using 
high quality assessments to measure and increase student academic 
achievement up to the States and local school districts that bear the 
responsibility for educating our children. Every State and every school 
district is different. A uniform testing policy may not be the best 
approach.
  I have heard from many education professionals in my state that this 
new testing requirement is a waste of money and a waste of time. These 
people are dedicated professionals who are

[[Page 17079]]

committed to educating Wisconsin's children, and they don't oppose 
testing. I think we can all agree that testing has its place. What they 
oppose is the magnitude of testing that is required by this law.
  Beginning in the 2005-2006 school year, the No Child Left Behind Act 
will pile more tests on our Nation's public school students. And of 
course, when those tests are piled on students, they burden our 
teachers as well, because teachers must spend more and more time 
preparing students to take these exams.
  This kind of teaching, sometimes called ``teaching to the test,'' is 
becoming more and more prevalent in our schools as testing has become 
increasingly common. The dedicated teachers in our classrooms will now 
be constrained by teaching to yet more tests, instead of being able to 
use their own judgment about what subject areas the class needs to 
spend extra time studying. This additional testing time could also 
reduce the opportunity for teachers to create and implement innovative 
learning experiences for their students.
  Teachers in my State are concerned about the amount of time that they 
will have to spend preparing their students to take the tests and 
administering the tests. They are concerned that these additional tests 
will disrupt the flow of education in their classrooms. One teacher 
said the preparation for the tests Wisconsin already requires in grades 
3, 4, 8, and 10 can take up to a month, and the administration of the 
test takes another week. That is five weeks out of the school year. And 
now the Federal Government is requiring teachers to take a huge chunk 
out of instruction time each year in grades 3-8. In my view, and in the 
view of the people of my State, this time can be better spent on 
regular classroom instruction.
  The legislation that I introduce today, the Student Testing 
Flexibility Act of 2002, would give State educational agencies, SEAs, 
and local educational agencies, LEAs, that have demonstrated academic 
success the flexibility to apply to waive the new annual testing 
requirements in the No Child Left Behind Act. SEAs and LEAs with 
waivers would still be required to administer high quality tests to 
students in, at a minimum, reading or language arts and mathematics at 
least once in grades 3-5, 6-9, and 10-12 as required under the law.
  This bill would allow SEAs and LEAs that meet the same specific 
accountability criteria outlined for school-level excellence under the 
State Academic Achievement Award Program to apply to the Secretary of 
Education for a waiver from the new annual reading or language arts and 
mathematics tests for students in grades 3-8. The waiver would be for a 
period of three years and would be renewable, so long as the SEA or LEA 
met the criteria.
  To qualify for the waiver, the SEA or LEA must have significantly 
closed the achievement gap between a number of subgroups of students as 
required under Title I, or must have exceeded their adequate yearly 
progress, AYP, goals for two or more consecutive years. The bill would 
require the Secretary to grant waivers to SEAs or LEAs that meet these 
criteria and apply for the waiver. LEAs in states that have waivers 
would not be required to apply for a separate waiver.
  The Federal Government should not impose an additional layer of 
testing on states that are succeeding in meeting or exceeding their AYP 
goals or on closing the achievement gap. Instead, we should allow those 
States that have demonstrated academic success to use their share of 
Federal testing money to help those schools that need it the most.
  The bill I introduce today would do just that by allowing States with 
waivers to retain their share of the Federal funding appropriated to 
develop and implement the new annual tests. These important dollars 
would be used for activities that these states deem appropriate for 
improving student achievement at individual public elementary and 
secondary schools that have failed to make AYP.
  I am pleased that this legislation is supported by the National PTA, 
the National Association of Elementary School Principals, the National 
Association of Secondary School Principals, the Wisconsin Department of 
Public Instruction, the Wisconsin Education Association Council, the 
Wisconsin Association of School Boards, the Milwaukee Teachers' 
Education Association, and the Wisconsin School Administrators 
Alliance, which includes the Association of Wisconsin School 
Administrators, the Wisconsin Association of School District 
Administrators, the Wisconsin Association of School Business Officials, 
and the Wisconsin Council for Administrators of Special Services.
  While this bill focuses on the over-testing of students in our public 
schools, I would like to note that my constituents have raised a number 
of other concerns about the No Child Left Behind Act that I hope will 
be addressed by Congress. In particular, many of my constituents are 
concerned about the new adequate yearly progress requirements and about 
finding the funding necessary to implement all of the provisions of 
this new law. I hope that my bill, the Student Testing Flexibility Act, 
will help to focus attention on the perhaps unintended consequences 
that the ongoing implementation of the No Child Left Behind Act will 
have for States, school districts, and individual schools, teachers, 
and students.
  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. 2954

       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 ``Student Testing Flexibility 
     Act of 2002''.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) State and local governments bear the majority of the 
     cost and responsibility of educating public elementary school 
     and secondary school students;
       (2) State and local governments often struggle to find 
     adequate funding to provide basic educational services;
       (3) the Federal Government has not provided its share of 
     funding for numerous federally mandated elementary and 
     secondary education programs;
       (4) underfunded Federal education mandates increase 
     existing financial pressures on States and local educational 
     agencies;
       (5) the cost to States and local educational agencies to 
     implement the annual student academic assessments required 
     under section 1111(b)(3)(C)(vii) of the Elementary and 
     Secondary Education Act of 1965 (20 U.S.C. 
     6311(b)(3)(C)(vii)) remains uncertain;
       (6) public elementary school and secondary school students 
     take numerous tests each year, from classroom quizzes and 
     exams to standardized and other tests required by the Federal 
     Government, State educational agencies, or local educational 
     agencies;
       (7) multiple measures of student academic achievement 
     provide a more accurate picture of a student's strengths and 
     weaknesses than does a single score on a high-stakes test; 
     and
       (8) the frequency of the use of high quality assessments as 
     a tool to measure and increase student achievement should be 
     decided by State educational agencies and local educational 
     agencies.

     SEC. 3. WAIVER AUTHORITY.

       Section 1111(b)(3) of the Elementary and Secondary 
     Education Act of 1965 (20 U.S.C. 6311(b)(3)) is amended by 
     adding at the end the following:
       ``(E) Waiver authority.--
       ``(i) States.--Upon application by a State educational 
     agency, the Secretary shall waive the requirements of 
     subparagraph (C)(vii) for a State if the State educational 
     agency demonstrates that the State--

       ``(I) significantly closed the achievement gap between the 
     groups of students described in paragraph (2); or
       ``(II) exceeded the State's adequate yearly progress, 
     consistent with paragraph (2), for 2 or more consecutive 
     years.

       ``(ii) Local educational agencies.--Upon application of a 
     local educational agency located in a State that does not 
     receive a waiver under clause (i), the Secretary shall waive 
     the application of the requirements of subparagraph (C)(vii) 
     for the local educational agency if the local educational 
     agency demonstrates that the local educational agency--

       ``(I) significantly closed the achievement gap between the 
     groups of students described in paragraph (2); or
       ``(II) exceeded the local educational agency's adequate 
     yearly progress, consistent with paragraph (2), for 2 or more 
     consecutive years.

       ``(iii) Period of waiver.--A waiver under clause (i) or 
     (ii) shall be for a period of 3 years and may be renewed for 
     subsequent 3-year periods.

[[Page 17080]]

       ``(iv) Utilization of certain federal funds.--

       ``(I) Permissive uses.--Subject to subclause (II), a State 
     or local educational agency granted a waiver under clause (i) 
     or (ii) shall use funds, that are awarded to the State or 
     local educational agency, respectively, under this Act for 
     the development and implementation of annual assessments 
     under subparagraph (C)(vii), to carry out educational 
     activities that the State educational agency or local 
     educational agency, respectively, determines will improve the 
     academic achievement of students attending public elementary 
     schools and secondary schools in the State or local 
     educational agency, respectively, that fail to make adequate 
     yearly progress (as defined in paragraph (2)(C)).
       ``(II) Nonpermissive use of funds.--A State or local 
     educational agency granted a waiver under clause (i) or (ii) 
     shall not use funds, that are awarded to the State or local 
     educational agency, respectively, under this Act for the 
     development and implementation of annual assessments under 
     subparagraph (C)(vii), to pay a student's cost of tuition, 
     room, board, or fees at a private school.''.

                                 ______
                                 
      By Mr. BROWNBACK (for himself and Mr. Gregg):
  S. 2955. A bill to improve data collection and dissemination, 
treatment, and research relating to cancer, and for other purposes; to 
the Committee on Health, Education, Labor, and Pensions.
  Mr. BROWNBACK. Mr. President, today, I am proud to join with the 
ranking member of the Senate HELP Committee in introducing and the 
National Cancer Act of 2002. We believe that this is the proverbial 
first step of the thousand mile journey toward the goal of making 
cancer death rare by the year 2015.
  First, I would be remiss if I failed to point out that we are not the 
first in the Senate to drop a cancer bill. Indeed, fired the first 
salvo in our Nation's conflict with cancer with the passage of the 
National Cancer Institute Act back in 1937. This law, established the 
National Cancer Institute, (NCI), within the public health service and 
directed the Surgeon General to promote cancer research.
  In 1971, responding to the call of President Nixon, Congress 
officially declared war on cancer with the passage of the National 
Cancer Act of 1971. This law established the Director of the National 
Cancer Institute as one of two Presidentially appointment posts within 
all of the National Institutes of Health. In addition, the '71 Act gave 
the Director the ability to bypass the normal budget process and submit 
the NCI budget directly to the President, a privilege that is entirely 
unique throughout the Executive Branch. With our declaration of war our 
Nation saw the establishment of the President's Cancer Panel, the 
National Cancer Advisory Board, the International Cancer Research Data 
Bank and the first cancer center. The stated goal of the country that 
had just landed a man on the moon was to cure cancer within a decade.
  Since 1971, we have seen 31 years pass, six Presidents sworn in, 15 
sessions of Congress, and ten different bills signed into law with the 
goal of ending the prolonged war on cancer. This year over half a 
million Americans will die from cancer. It is for them, and for the 1.2 
million Americans who will be diagnosed with cancer, and for the 
millions of cancer survivors who are living beyond this disease that we 
introduce this bill today.
  Ours is the time in history when we must reinvigorate the battle. 
Thanks to advances in treatment and increased screening and early 
detection, between 1990 and 1997, for the first time in history, the 
number of cancer deaths and diagnoses have declined. However, to whom 
much is given, much is expected. The National Cancer Act of 2002, 
answers the call and lays out a battle plan for the next, and hopefully 
final attack in the war on cancer.
  Mr. GREGG. Mr. President, I am very pleased this morning to introduce 
this bill with my good friend Senator Brownback. Our bill, the National 
Cancer Act of 2002, is an important step forward in making survivorship 
of cancer the rule in this Nation and cancer mortality the rare 
exception. I want to thank our good friends in the cancer and pain care 
communities who have provided critical feedback during the development 
of the Act. Our bill will: Enhance coordination between State 
registries and between those registries and Federal cancer control and 
research efforts, with a focus on developing interoperability and 
compatible hardware/software infrastructure. Reauthorize the successful 
CDC Breast and Cervical Cancer screening program, with expansion 
encouraged for colorectal cancer screening. Improve NIH efforts in the 
area of pain and palliative care research and dissemination of 
information to patients and providers. Expand access for patients to 
experimental therapies, both in NIH-funded clinical trials, privately-
funded manufacturer trials and access for terminal patients to 
therapies that have not yet been approved by FBA. Encourage Congress 
and the Administration to address several of the most significant 
cancer-related problems in the Medicare system.
  I look forward to working with my colleagues on the HELP Committee to 
move this important piece of legislation this year. I know that we all 
share the agenda of combating this public health problem facing so many 
Americans.
                                 ______
                                 
      By Mr. FEINGOLD:
  S. 2956. A bill to require the Secretary of Homeland Security to 
submit a semi-annual report to Congress regarding the effectiveness 
with which information is exchanged between the Department of Homeland 
Security, the Federal Bureau of Investigation, and State and local law 
enforcement authorities; to the Committee on the Judiciary.
  Mr. FEINGOLD. Mr. President, first let me commend the Chairman and 
Ranking Member of the Governmental Affairs Committee for all of their 
efforts in crafting the Homeland Security measure before the Senate 
today.
  As I have listened to the various proposals to create a Department of 
Homeland Security one of my primary concerns is what are we going to do 
to improve the role of the FBI as an intelligence gathering agency. I 
rise today to introduce legislation on this matter, and I send a copy 
of this legislation to the desk.
  I also rise to offer the same legislation as an amendment to the 
Homeland Security bill, and I send a copy of the amendment to the desk.
  The need for this amendment is clear. We have heard, over and over 
again, that one of the chief purposes of the new Department is to 
enable one agency to serve as a central clearinghouse for all terrorism 
related information, regardless of the source. For the consumers of 
intelligence information, like the Department of Homeland Security, it 
should not matter whether the information comes from a CIA agent in the 
Middle East, an FBI agent listening to a wire-tap from overseas or a 
cop on a street corner in New York City.
  I am concerned that we have not done enough to insure that the 
relevant information gathered by the FBI is passed on to those who can 
analyze it and evaluate a potential threat against our Nation's safety. 
Simply put, I wonder about what type of information the FBI will be 
providing to the new Department and what the new Department will do 
with the information. I am concerned about the lack of policies and 
procedures in place for the new Department to request follow-up 
investigation from the FBI and local law enforcement.
  I have offered this amendment, entitled the Intelligence Analysis 
Reporting Act of 2002, to assist Congress in determining if the 
division of investigative responsibilities between the Department of 
Homeland Security and the FBI is working effectively. This amendment 
will provide Congress with the information necessary to determine if 
the FBI is taking competent steps to provide information to the new 
Department and to respond to intelligence requests in a useful manner.
  Presently, the FBI does not have the technological nor personnel 
capacity to provide information to the Department of Homeland Security 
or to any other intelligence agency in a highly useful form. This is 
because criminal investigations, which involve grand jury testimony, 
witness interviews and

[[Page 17081]]

wire-taps, are not conducive to the standards of intelligence gathering 
which require some sifting of the material before it is disseminated to 
consumers like a Department of Homeland Security.
  This amendment would require the new Department to report to Congress 
on policies and procedures implemented to insure that it can adequately 
request information and investigation from the FBI and local law 
enforcement. In addition, it requires the Department of Homeland 
Security to report on what types of intelligence information have been 
turned over such as summary interviews, transcripts and warrants from 
the FBI and other law enforcement agencies.
  I firmly believe that no matter how many agencies are moved into a 
Department of Homeland Security or how much money we spend on putting 
up a new building, the only test of our success will be how effective 
we are in protecting ourselves against future threats. This amendment 
will allow us to determine if the critical intelligence information we 
need to prevent a possible attack is being provided to people at the 
Department of Homeland Security who can act on it promptly and 
effectively.
  I urge my colleagues to support this measure.
                                 ______
                                 
      By Mr. JOHNSON:
  S. 2963: A bill to reform the United States Army Corps of Engineers; 
to the Committee on Environment and Public Works.
  Mr. JOHNSON. 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. 2963

       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 ``Corps of Engineers Reform 
     Act of 2002''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) Corps.--The term ``Corps'' means the Corps of 
     Engineers.
       (2) Secretary.--The term ``Secretary'' means the Secretary 
     of the Army.

     SEC. 3. INLAND WATERWAY REFORM.

       (a) Construction.--Section 102(a) of the Water Resources 
     Development Act of 1986 (33 U.S.C. 2212(a)) is amended--
       (1) in the first sentence, by striking ``One-half of the 
     costs of construction'' and inserting ``Forty-five percent of 
     the costs of construction''; and
       (2) by striking the second sentence and inserting ``Fifty-
     five percent of those costs shall be paid only from amounts 
     appropriated from the Inland Waterways Trust Fund.''.
       (b) Operation and Maintenance.--Section 102 of the Water 
     Resources Development Act of 1986 (33 U.S.C. 2212) is amended 
     by striking subsections (b) and (c) and inserting the 
     following:
       ``(b) Operation and Maintenance.--
       ``(1) Federal share.--The Federal share of the cost of 
     operation and maintenance shall be 100 percent in the case 
     of--
       ``(A) a project described in paragraph (1) or (2) of 
     subsection (a); or
       ``(B) the portion of the project authorized by section 844 
     that is allocated to inland navigation.
       ``(2) Source of federal share.--
       ``(A) General fund.--In the case of a project described in 
     paragraph (1) or (2) of subsection (a) with respect to which 
     the cost of operation and maintenance is less than or equal 
     to 1 cent per ton mile, or in the case of the portion of the 
     project authorized by section 844 that is allocated to inland 
     navigation, the Federal share under paragraph (1) shall be 
     paid only from amounts appropriated from the general fund of 
     the Treasury.
       ``(B) General fund and inland waterways trust fund.--In the 
     case of a project described in paragraph (1) or (2) of 
     subsection (a) with respect to which the cost of operation 
     and maintenance is greater than 1 but less than or equal to 
     10 cents per ton mile--
       ``(i) 45 percent of the Federal share under paragraph (1) 
     shall be paid only from amounts appropriated from the general 
     fund of the Treasury; and
       ``(ii) 55 percent of the Federal share under paragraph (1) 
     shall be paid only from amounts appropriated from the Inland 
     Waterways Trust Fund.
       ``(C) Inland waterways trust fund.--In the case of a 
     project described in paragraph (1) or (2) of subsection (a) 
     with respect to which the cost of operation and maintenance 
     is greater than 10 cents per ton mile, 100 percent of the 
     Federal share under paragraph (1) shall be paid only from 
     amounts appropriated from the Inland Waterways Trust Fund.''.

     SEC. 4. INDEPENDENT REVIEW.

       (a) Definitions.--In this section:
       (1) Affected state.--The term ``affected State'', with 
     respect to a water resources project, means a State or 
     portion of a State that--
       (A) is located, at least partially, within the drainage 
     basin in which the project is carried out; and
       (B) would be economically or environmentally affected as a 
     result of the project.
       (2) Director.--The term ``Director'' means the Director of 
     Independent Review appointed under subsection (c)(1).
       (b) Projects Subject to Independent Review.--
       (1) In general.--The Secretary shall ensure that each draft 
     feasibility report, draft general reevaluation report, and 
     draft environmental impact statement for each water resources 
     project described in paragraph (2) is subject to review by an 
     independent panel of experts established under this section.
       (2) Projects subject to review.--A water resources project 
     shall be subject to review under paragraph (1) if--
       (A) the project has an estimated total cost of more than 
     $30,000,000, including mitigation costs;
       (B) the Governor of an affected State, or the Director of a 
     Federal agency with jurisdiction over resources affected by 
     the proposed project requests the establishment of a panel of 
     independent experts to review the project; and
       (C) the Secretary determines under paragraph (3) that the 
     proposed project is controversial.
       (3) Written requests.--Not later than 30 days after the 
     date on which the Secretary receives a written request of an 
     interested party, or on the initiative of the Secretary, the 
     Director shall determine whether a water resources project is 
     controversial.
       (c) Director of Independent Review.--
       (1) Appointment.--The Secretary of the Army shall appoint 
     in the Office of the Inspector General of the Department of 
     the Army a Director of Independent Review.
       (2) Qualifications.--The Secretary of the Army shall select 
     the Director from among individuals who are distinguished 
     experts in biology, hydrology, engineering, economics, or 
     another discipline relating to water resources management.
       (3) Limitation on appointments.--The Army Inspector General 
     shall not appoint an individual to serve as the Director if 
     the individual has a financial interest in or close 
     professional association with any entity with a strong 
     financial interest in a water resources project that, on the 
     date of appointment of the Director, is--
       (A) under construction;
       (B) in the preconstruction engineering and design phase; or
       (C) under feasibility or reconnaissance study by the Corps.
       (4) Terms.--
       (A) In general.--The term of a Director appointed under 
     this subsection shall be 6 years.
       (B) Term limit.--An individual may serve as the Director 
     for not more than 2 nonconsecutive terms.
       (5) Duties.--The Director shall establish a panel of 
     experts to review each water resources project that is 
     subject to review under subsection (b).
       (d) Establishment of Panels.--
       (1) In general.--After the date on which the Secretary 
     issues a draft feasibility report, draft general reevaluation 
     report, or draft environmental impact statement relating to a 
     water resources project that is subject to review under 
     subsection (b)(2), the Director shall establish a panel of 
     experts to review the project.
       (2) Membership.--A panel of experts established by the 
     Director for a water resources project shall be composed of 
     not less than 5 nor more than 9 independent experts 
     (including 1 or more biologists, engineers, and economists) 
     who represent a range of areas of expertise.
       (3) Limitation on appointments.--The Director shall not 
     appoint an individual to serve on a panel of experts for a 
     project if the individual has a financial interest in or 
     close professional association with any entity with a strong 
     financial interest in the project.
       (4) Consultation.--The Director may consult with the 
     Academy in developing lists of individuals to serve on panels 
     of experts under this section.
       (5) Compensation.--An individual serving on a panel of 
     experts under this section shall be compensated at a rate of 
     pay to be determined by the Inspector General.
       (6) Travel expenses.--A member of a panel of experts under 
     this section shall be allowed travel expenses, including per 
     diem in lieu of subsistence, at rates authorized for an 
     employee of an agency under subchapter I of chapter 57 of 
     title 5, United States Code, while away from the home or 
     regular place of business of the member in the performance of 
     the duties of the panel.
       (e) Duties of Panels.--A panel of experts established for a 
     water resources project under this section shall--
       (1) review each draft feasibility report, draft general 
     reevaluation report, and draft

[[Page 17082]]

     environmental impact statement prepared for the project to 
     identify--
       (A) technical errors;
       (B) outdated and inaccurate data; and
       (C) flawed economic and environmental methodologies and 
     models;
       (2) receive from the public written and oral comments 
     concerning the project; and
       (3) not later than the deadline established under 
     subsection (f), submit to the Secretary a report concerning 
     the economic, engineering, and environmental analysis of the 
     project, including the conclusions and recommendations of the 
     panel.
       (f) Duration of Project Reviews.--Not later than 180 days 
     after the date of establishment of a panel of experts for a 
     water resources project under this section, the panel shall 
     complete each required review of the project and all other 
     duties of the panel relating to the project.
       (g) Final Issuance of Reports and Statements.--Before 
     issuing a final feasibility report, final general 
     reevaluation report, or final environmental impact statement 
     for a water resources project, the Secretary shall--
       (1) take into consideration any recommendations contained 
     in the report described in subsection (e)(3) for the water 
     resources project; and
       (2) prepare and include in the final feasibility report, 
     final general reevaluation report, or final environmental 
     impact statement--
       (A) the report of the panel; and
       (B) for any recommendations of the panel not adopted by the 
     Secretary, a written explanation of the reasons why the 
     recommendations were not adopted.
       (h) Costs.--The cost of conducting a review of a water 
     resources project under this section--
       (1) shall not exceed $250,000;
       (2) shall be considered to be part of the total cost of the 
     project; and
       (3) shall be a Federal expense.
       (i) Applicability of Federal Advisory Committee Act.--The 
     Federal Advisory Committee Act (5 U.S.C. App.) shall apply to 
     a panel of experts established under this section.

     SEC. 5. MITIGATION.

       (a) Concurrent Mitigation.--Section 906(a) of the Water 
     Resources Development Act of 1986 (33 U.S.C. 2283(a)) is 
     amended--
       (1) by striking ``(a)(1) In the case'' and inserting the 
     following:
       ``(a) Mitigation.--
       ``(1) In general.--In the case'';
       (2) in paragraph (1), by indenting subparagraphs (A) and 
     (B) appropriately;
       (3) in paragraph (2), by striking ``(2) For the purposes'' 
     and inserting the following:
       ``(3) Commencement of construction.--For the purposes''; 
     and
       (4) by inserting after paragraph (1) the following:
       ``(2) Implementation of mitigation.--
       ``(A) In general.--To ensure concurrent mitigation, the 
     Secretary shall implement required mitigation under paragraph 
     (1) as expeditiously as practicable, but not later than--
       ``(i) the last day of construction of the project or 
     separable element of the project; or
       ``(ii) in a case in which completion of mitigation by the 
     date described in clause (i) is physically impracticable 
     because 1 or more sites for the remaining mitigation are or 
     will be disturbed by project construction (as determined by 
     the Secretary), not later than the end of the next fiscal 
     year immediately following the last day of construction.
       ``(B) Availability of funds.--Funds made available for 
     preliminary engineering and design, construction, or 
     operations and maintenance may be used to carry out this 
     subsection.''.
       (b) Full Mitigation.--Section 906(d) of the Water Resources 
     Development Act of 1986 (33 U.S.C. 2283(d)) is amended--
       (1) by striking paragraph (1) and inserting the following:
       ``(1) Plans and proposals.--
       ``(A) In general.--After November 17, 1986, the Secretary 
     shall not submit any proposal for the authorization of any 
     water resources project to Congress, and shall not choose a 
     project alternative in any final record of decision, 
     environmental impact statement, or environmental assessment, 
     unless the proposal contains--
       ``(i) a specific plan to fully mitigate fish and wildlife 
     losses created by the project; or
       ``(ii) a determination by the Secretary that the project 
     will have negligible adverse impact on fish and wildlife.
       ``(B) Forests.--A specific mitigation plan described in 
     subparagraph (A)(i) shall ensure, to the maximum extent 
     practicable, that impacts to bottomland hardwood forests are 
     mitigated in kind.
       ``(C) Consultation.--In carrying out this subsection, the 
     Secretary shall consult with appropriate Federal and non-
     Federal agencies.''; and
       (2) by adding at the end the following:
       ``(3) Standards for mitigation.--
       ``(A) In general.--The Secretary shall not recommend a 
     water resources project alternative or select a project 
     alternative in any final record of decision, environmental 
     impact statement, or environmental assessment completed after 
     the date of enactment of this paragraph unless the Secretary 
     determines that the mitigation plan has a high probability of 
     successfully mitigating the adverse impacts of the project on 
     aquatic and other resources, hydrologic functions, and fish 
     and wildlife.
       ``(B) Requirements.--A mitigation plan described in 
     subparagraph (A) shall--
       ``(i) provide for the acquisition and restoration of at 
     least 1 acre of superior or equivalent habitat of the same 
     type to replace each acre of habitat negatively affected by 
     the project;
       ``(ii) ensure that mitigation will result in replacement of 
     all functions of the habitat negatively affected by the 
     project, including--

       ``(I) spatial distribution; and
       ``(II) natural hydrologic and ecological characteristics;

       ``(iii) contain sufficient detail regarding the mitigation 
     sites and restoration activities selected to permit a 
     thorough evaluation of--

       ``(I) the likelihood of the ecological success of the plan; 
     and
       ``(II) resulting aquatic and other resource functions and 
     habitat values;

       ``(iv) include a detailed and specific plan to monitor 
     mitigation implementation and success; and
       ``(v) include specific ecological success criteria by which 
     the success of the mitigation will be evaluated.''.
       (c) Mitigation Tracking System.--Section 906 of the Water 
     Resources Development Act of 1986 (33 U.S.C. 2283) is amended 
     by adding at the end the following:
       ``(h) Mitigation Tracking System.--
       ``(1) In general.--Not later than 180 days after the date 
     of enactment of this subsection, the Secretary shall 
     establish a recordkeeping system to track for each water 
     resources project constructed, operated, or maintained by the 
     Secretary, and for each permit issued under section 404 of 
     the Federal Water Pollution Control Act (33 U.S.C. 1344)--
       ``(A) the quantity and type of wetland and other types of 
     habitat affected by the project or permitted activity;
       ``(B) the quantity and type of mitigation required for the 
     project or permitted activity;
       ``(C) the quantity and type of mitigation that has been 
     completed for the project or permitted activity; and
       ``(D) the status of monitoring for the mitigation carried 
     out for the project or permitted activity.
       ``(2) Required information and organization.--The 
     recordkeeping system shall--
       ``(A) include information on impacts and mitigation 
     described in subsection (a) that occur after December 31, 
     1969; and
       ``(B) be organized by watershed, project, permit 
     application, and zip code.
       ``(3) Availability of information.--The Secretary shall 
     make information contained in the recordkeeping system 
     available to the public (including through the Internet).''.

     SEC. 6. MODERN ECONOMIC AND ENVIRONMENTAL STANDARDS.

       Section 209 of the Flood Control Act of 1970 (42 U.S.C. 
     1962-2) is amended to read as follows:

     ``SEC. 209. CONGRESSIONAL STATEMENT OF OBJECTIVES.

       ``(a) In General.--It is the intent of Congress that 
     economic development and environmental protection and 
     restoration be coequal goals of water resources planning and 
     development.
       ``(b) Revision of Principles and Guidelines.--Not later 
     than 1 year after the date of enactment of the Army Corps 
     Reform Act of 2002, the Secretary of the Army, in 
     consultation with the National Academy of Sciences, shall 
     revise the principles and guidelines of the Corps of 
     Engineers for water resources projects (consisting of 
     Engineer Regulation 1105-2-100 and Engineer Pamphlet 1165-2-
     1) to reflect modern methods of measuring benefits and costs 
     of water resources projects.
       ``(c) Revision of Guidance.--The Secretary of the Army 
     shall revise the Guidance for Conducting Civil Works Planning 
     Studies (ER 1105-2-100) to comply with this section.''.
                                 ______
                                 
      By Mr. LEVIN (for himself, Ms. Collins, Ms. Stabenow, Mr. DeWine, 
        Mr. Reed, Mr. Warner, Mr. Durbin, Mr. Fitzgerald, Mr. Akaka, 
        Mr. Voinovich, Mr. Inouye, Ms. Cantwell, Mr. Kennedy, and Mr. 
        Bayh):
  S. 2964. A bill to amend the Nonindigenous Aquatic Nuisance 
Prevention and Control Act of 1990 to reauthorize and improve that Act; 
to the Committee on Environment and Public Works.
  Ms. STABENOW. Mr. President, I would like to express my strong 
support for the National Acquatic Invasive Species Act of 2002 (NAISA)
  Last year, I introduced S. 1034, the Great Lakes Ecology Protection 
Act which sought to curb the influx of invasive species into the Great 
Lakes. This is an immense task, as more than

[[Page 17083]]

87 nonindigenous aquatic species have been accidentally introduced into 
the Great Lakes in the past century. I am proud to say that this bill 
had strong bipartisan support with 12 Great Lakes Senators as original 
cosponsors.
  Today, I am proud to join Senator Levin as an original cosponsor of 
NAISA which will provide a national strategy for preventing invasive 
species from being introduced in the Great Lakes and our Nation's 
waters. I am also pleased that NAISA incorporates many of the ideas 
from the Great Lakes Ecology Protection Act in formulating a national 
standard.
  Invasive species have had a devastating economic and ecological 
impact on the U.S. They have already damaged the Great Lakes in a 
number of ways. They have destroyed thousands of fish and threatened 
our clean drinking water.
  For example, Lake Michigan once housed the largest self-reproducing 
lake trout fishery in the entire world. The invasive sea lamprey, which 
was introduced from ballast water almost 80 years ago, has contributed 
greatly to the decline of trout and whitefish in the Great Lakes by 
feeding on and killing native trout species.
  Today, lake trout must be stocked because they cannot naturally 
reproduce in the lake. Many Great Lakes States have had to place severe 
restrictions on catching yellow perch because invasive species such as 
the zebra mussel disrupt the Great Lakes' ecosystem and compete with 
yellow perch for food. The zebra mussel's filtration also increase 
water clarity, which may be making it easier for predators to prey upon 
the yellow perch. Moreover, tiny organisms like zooplankton that help 
from the base of the Great Lakes food chain, have declined due to 
consumption by exploding populations of zebra mussels.
  We have made progress on preventing the spread of invasive species, 
but we have not yet solved this problem. NAISA will create a mandatory 
national ballast water management program to prevent the introduction 
of invasive species into our waters, as well as, encourage the 
development of new ballast treatment technology to eliminate invasive 
species. NAISA also will greatly increase research funding for these 
treatment and prevention technologies, and provide necessary funding 
and resources for invasive species rapid response plans. In addition, 
the bill will increase outreach and education to recreational boaters 
and the general public on how to prevent the spread of invasive 
species.
  As Members of the U.S. Congress, we have a responsibility to share in 
the stewardship of our Nation's natural resources. As a Great Lakes 
Senator, I feel a particularly strong responsibility to protect a 
resource that is not only a source of clean drinking water for more 
than 30 million people in the Great Lakes, but is vital to Michigan's 
economy and environment. I am proud to support a bill that will provide 
innovative solutions and necessary resources to this long-standing 
environmental problem, and will also protect water resources for the 
enjoyment and benefit of future generations of Americans.
                                 ______
                                 
      By Mr. KENNEDY (for himself, Mr. Frist, Mrs. Feinstein, Mrs. 
        Hutchison, Mr. Harkin, Ms. Collins, Mr. Biden, Mr. Bond, Ms. 
        Landrieu, Mr. Reid, Mr. Bingaman, Mr. Dodd, Mrs. Clinton, Mr. 
        Hollings, and Mr. Edwards):
  S. 2965. A bill to amend the Public Health Service Act to improve the 
quality of care for cancer, and for other purposes; to the Committee on 
Health, Education, Labor, and Pensions.
  Mr. KENNEDY. Mr. President, it is an honor to join my distinguished 
colleagues, Senators Frist, Harkin, Hutchison, Biden, Landrieu, Reid, 
Bingaman, Dodd, Clinton, Hollings, and Edwards in introducing the 
``Quality of Care for Individuals with Cancer Act.''
  The goal of this important bipartisan legislation is to help close 
the gap between what modern medicine can do today to reduce cancer 
deaths, and the actual medical care that cancer patients receive.
  In the past two decades, the nation has made extraordinary progress 
in treating and curing cancer. In fact, we have made so much progress 
that our greatest challenges in health care today is taking the 
scientific breakthroughs in the laboratory and bringing them to the 
bedside of the patient.
  Too often, we cannot say that American cancer patients are receiving 
the best possible care. Our goal is to match the nation's excellence in 
cancer research with state-of-the-art excellence in cancer care.
  The reward will be seeing a young mother with breast cancer live to 
be a grandmother, enable a toddler with leukemia grow up to be 
President, or a father win the Tour de France for a fourth time.
  Many examples of inadequate care could be cited. For example, only a 
third of all Americans over age fifty have had proper colorectal cancer 
screenings in the last two years. Clearly, there are far too many 
needless and correctable failures in our current system of cancer care.
  By creating uniform ways to measure the quality of cancer care, and 
establishing new, improved and better coordinated ways to monitor care, 
we can do more to see that cancer patients receive state-of-the-art 
care, no matter where they live.
  In response to the needs of cancer survivors, and with the help of 
the Lance Armstrong Foundation, this bipartisan bill will also 
establish new survivorship programs to facilitate the delivery of 
services to cancer patients and their families.
  Just as importantly, we want to make the best cancer care easier for 
patients to obtain. Our bill will improve the networking of the doctors 
and other providers to whom patients go for their care.
  Many of us know family members and friends suffering from cancer. We 
are all to familiar with the feelings of shock, denial, hope, fear, and 
vulnerability that comes when a loved one, especially a child, is found 
to have cancer.
  Dealing with the challenges is never an easy task for any family. But 
the continuing breakthoughs in medical research make clear that much 
more can be done to save and enhance the lives of cancer patients. We 
need to do all we can to make this care available and affordable to all 
patients.
  Make no mistake about it, we have come a long way. But much more must 
be done to improve the lives of cancer patients.
  Mr. FRIST. Mr. President, I am pleased to join Senators Kennedy, 
Hutchison, and others in introducing the ``Quality of Care for 
Individuals with Cancer Act''. This bill represents our next step in 
the battle against cancer. It is critical to increasing access to 
timely, quality health care.
  Cancer is the second leading cause of death among Americans, claiming 
one life each minute. Most of us know someone who has cancer, or who 
has died from cancer. One out of every 4 Americans will die from this 
terrible disease. We have done a tremendous job investing in cancer 
research in this country. We must now make sure the knowledge gained 
from those investments is being applied, and that research advancements 
are translated into improved patient care.
  If you have cancer, the quality of care you receive should not be 
affected by where you live, where you get your care, or whether you 
have health insurance coverage. You should have access to quality care 
whether you have just been diagnosed with cancer, are a cancer 
survivor, or are dying from this disease. The care given should take 
the patient's values and concerns into account and should be provided 
in a culturally competent manner.
  Based on a recent Institute of Medicine's report, ``Ensuring Quality 
Cancer Care'', this bill would coordinate the development and 
collection of information on quality cancer care using quality measures 
that examine care from diagnosis through the end-of-life. Clearly, a 
better system is needed to rapidly identify the results of ongoing 
research with quality implications and ensure that this is transferred 
into daily medical practice.

[[Page 17084]]

  Individuals with cancer receive care from a number of specialists 
during the course of their cancer, and the responsibility for 
navigating through the system often rests on the individual. 
Comprehensible and ongoing communication among providers, patients and 
caregivers is essential to coordinated care. There are two 
demonstration projects authorized by this legislation to help improve 
the coordination of care. One demonstration project provides individual 
case managers to better coordinate care within the health care system 
or to help get patients into the system. The second attempts to improve 
coordination between providers and hospitals so that individuals with 
cancer receive seamless care throughout their course of treatment.
  While receiving care, some individuals with cancer do not receive 
care known to be effective for their condition, such as the delivery of 
palliative care. Much of the suffering from symptoms associated with 
cancer and its treatment could be alleviated if currently available 
symptom control measures and other aspects of palliative care were more 
widely used. This bill authorizes demonstration projects which will 
provide palliative care at any stage of cancer care and train health 
care providers in symptom management. The legislation also seeks to 
help provide better pain and other symptom relief so that individuals 
with cancer do not suffer the consequences of their disease or 
treatment.
  For the nine million Americans living with cancer, this bill provide 
hope in improving the quality of life for individuals with cancer by 
translating what is already known to be effective care to all 
individuals with cancer. For those areas in which we need to 
investigate, demonstration projects will further our knowledge.
  I am pleased to introduce this important legislation, and I look 
forward to its ultimate enactment into law. I want to thank my 
colleagues, Senators Kennedy, Hutchison, and others, for their work on 
this bill. I ask that the summary, section-by-section, and list of 
supporting organizations be printed in the Record.
  There being no objection, the additional material was ordered to be 
printed in the Record, as follows:

     Quality of Care for Individuals With Cancer Act--Kennedy-Frist

       Cancer is a dreaded disease and the second leading cause of 
     death. Over the preceding decades much progress has been made 
     on how to detect, treat and cure individuals who have cancer 
     and those who are affected. But too often, the typical 
     standards of care fall short of the best standards of care.
       Unfortunately, many cancer patients are getting 
     inappropriate care--too little care, too much care in the 
     form of unnecessary procedures, or the wrong care. Simple 
     screening procedures are underutilized and radical 
     interventions are often needlessly performed. Receiving 
     quality care should not be determined by where a patient 
     lives, where they get their care, or whether or not they have 
     health insurance. Unfortunately this is not the case, and 
     variations in quality of care can have dire outcomes. A 
     recent study found that women on Medicaid are likely to be 
     diagnosed with cancer at a later stage and are three times 
     more likely to die of breast cancer than women not on 
     Medicaid.
       The problem: Even with tremendous advancements in treatment 
     and diagnosis, individuals with cancer are still not 
     receiving quality care. Due to lack of data, the magnitude of 
     the problem of inadequate care is not known. Comprehensive 
     data systems do not currently exist with which to measure 
     quality and there is no national cancer care program or 
     system of care within the United States.
       Our solution: Collect better information to discover where 
     problems exist and create statewide plans to address the 
     problems. The bill will draw together Federal agencies and 
     private entities to coordinate the development and collection 
     of information on quality of care. States will receive funds 
     to expand state cancer registries to collect information on 
     quality of care and develop and improve state-wide cancer 
     control programs that address particular needs for each 
     state.
       The Problem: Individuals with cancer often have 
     difficulties negotiating through a complex system of care. 
     Like other chronic illnesses, efforts to diagnose and treat 
     cancer are centered on a variety of individual physicians and 
     can be in multiple settings. Coordination between these 
     entities is often lacking, and the responsibility for 
     navigating through the system often rests on the individual 
     with cancer. Improving coordination can save lives. Research 
     has shown that cooperation among pediatric oncologists has 
     resulted in cure rate increases of 30 percent even in the 
     absence of new therapeutics to treat disease.
       Our Solution: Provide case-managers to guide patients 
     during treatment and improve the coordination of care. Two 
     programs will be developed to help individuals with cancer 
     receive coordinated cancer care. The first provides 
     individual case-managers to help get patients into the system 
     or to act as contacts throughout their care and assist with 
     information, referrals, and care coordination within the 
     system. The second improves coordination between doctors, 
     hospitals, and other health care professionals so that 
     individuals with cancer receive seamless care throughout 
     their treatment.
       The Problem: While research has produced new insights into 
     the causes and cures of cancer, efforts to manage the 
     symptoms of the disease and its treatments have not kept 
     pace. Palliative care, which includes pain and symptom 
     management and psychosocial care, is an area where 
     individuals with cancer have traditionally received 
     relatively poor quality care. For example, less than half of 
     individuals with cancer who suffer from pain receive adequate 
     relief of their pain, and only a very small percentage of 
     cancer patients are offered referrals for palliative care.
       Our Solution: Improve palliative care. The bill will 
     develop programs to provide palliative care and train 
     professionals to provide better palliative care for both 
     adults and children with cancer.
       The Problem: Cancer survivors continue to need quality care 
     while living with, through, and beyond cancer. Although 1,500 
     people die each day from cancer, increasingly, individuals 
     with cancer survive their disease. The more than nine million 
     cancer survivors in the United States face unique care needs, 
     including post-treatment programs and support, which are 
     often inadequately addressed by a system focused on diagnosis 
     and disease treatment.
       Our Solution: Initiate programs to address the unique needs 
     of survivors. The bill develops post-treatment programs 
     including follow-up care and monitoring to improve the long-
     term quality of life for cancer survivors, including 
     children.
       The Problem: Insufficient attention is being paid to 
     individuals with cancer in the final stages of their disease. 
     One-half of those diagnosed with cancer die of the disease. 
     Unfortunately, appropriate end-of-life medical and social 
     support, which would help maximize the quality of life for 
     these individuals and their families, is often unavailable. 
     This is particularly true for children. Most physicians do 
     not receive adequate training on the provision of appropriate 
     end-of-life care. A 1998 study found that 100 percent of 
     residents and 90 percent of attending physicians wanted more 
     support in dealing with issues surrounding the death of a 
     patient.
       Our Solution: Avoid needless pain and suffering by 
     improving end-of-life care. The bill provides grants to 
     coordinate end-of-life cancer care and train health care 
     providers in end-of-life care. Pilot programs will also be 
     developed to address the special needs of children.
                                  ____


    Quality of Care for Individuals With Cancer Act--Kennedy-Frist, 
                       Section-By-Section Summary


             title i--measuring the quality of cancer care

       Seeks to facilitate a contract to a national consensus 
     organization to investigate the validity of existing quality 
     measures and to then establish recommendations for core sets 
     of quality cancer measures. These recommendations would be 
     published within AHRQ's annual report and, after four years, 
     the General Accounting Office will evaluate the extent to 
     which Federal and private sector health care delivery 
     programs have incorporated these quality measures.


                  title ii--enhancing data collection

       Serves to reauthorize the CDC's National Program of Cancer 
     Registries, including new provisions to monitor and evaluate 
     quality cancer care and to increase linkages with various 
     entities to examine disparities in quality cancer care. It 
     also authorizes the CDC's National Program of Cancer 
     Registries--Cancer Surveillance System to advance the 
     development, expansion, and evaluation of State registries 
     and encourages CDC to work with states to meet North American 
     Association of Cancer Registries certification.


  title iii--monitoring and evaluating the quality of cancer care and 
                                outcomes

       Supports research to measure, evaluate, and improve the 
     quality of cancer care, and funds private/public partnerships 
     to enhance the usefulness of such information, including 
     fostering the development or adoption of model systems of 
     care or speeding the pace of improvement in quality of cancer 
     care.


          title iv--strengthening comprehensive cancer control

       Authorizes the CDC's Comprehensive Cancer Control Program 
     to develop an integrated and coordinated approach to cancer. 
     The Program will establish guidelines regarding the design 
     and implementation of

[[Page 17085]]

     state comprehensive cancer control plans, and awards grants 
     to develop, update, implement, and evaluate such plans.


         title v--improving navigation and system coordination

       Provides grants to develop, implement, and evaluate case 
     management programs to enhance the quality of cancer through 
     improved access and navigation. Grants are also awarded to 
     develop coordinated systems of health care providers. 
     Finally, this title defines ``palliative care'' and ``quality 
     of cancer care.''


           title vi--establishing programs in palliative care

       Provides grants to improve palliative care for adults and 
     children with cancer by: integrating programs, conducting 
     outreach and educational activities, providing education and 
     training to health care providers; designing model programs; 
     creating pilot programs for children; and for other 
     activities.


             title vii--establishing survivorship programs

       Establishes demonstration programs to develop post-
     treatment public health programs and services including 
     follow-up care and monitoring to support and improve the 
     long-term quality of life for cancer survivors, including 
     children. A focus on cancer survivorship is also added to 
     cancer control programs.


               title viii--programs for end-of-life care

       Provides grants to develop, implement, and evaluate 
     evidence-based programs for the delivery of quality cancer 
     care during the end-of-life to individuals with cancer (with 
     a special emphasis on children) and their families.


                title ix--developing training curricula

       Provides grants for the development of curricula for health 
     care provider training regarding the assessment, monitoring, 
     improvement, and delivery of quality of cancer care.


                      title x--conducting reports

       Requires IOM reports to: evaluate Federal and State 
     Comprehensive Cancer Control programs; evaluate the quality 
     of cancer care medicare and medicaid beneficiaries receive 
     and the extent to which coverage and reimbursement policies 
     affect access to quality of cancer care; evaluate access to 
     clinical trials; and analyze gaps in and impediments for 
     quality of cancer care. An additional long-range IOM report 
     will provide a follow-up assessment of the bill's success in 
     achieving its initiatives.
                                  ____


    Organizations Supporting the Kennedy-Frist, Quality of Care for 
                      Individuals with Cancer Act

       Alive Hospice;
       American Cancer Society;
       American Pain Foundation;
       American Society of Breast Disease;
       The Children's Hospital at the Cleveland Clinic;
       Colorectal Cancer Network;
       Intercultural Cancer Council;
       Lance Armstrong Foundation;
       Oncology Nursing Society;
       Pain Care Coalition;
       Research Triangle Institute International;
       Stanford University Center for Biomedical Ethics; and
       Vitas Healthcare Corp.

                          ____________________