[Congressional Record (Bound Edition), Volume 149 (2003), Part 15]
[Senate]
[Pages 21131-21135]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           TEXT OF AMENDMENTS

                                 ______
                                 
  SA 1556. Mr. INHOFE submitted an amendment intended to be proposed to 
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making 
appropriations for the Departments of Labor, Health and Human Services, 
and Education, and related agencies for the fiscal year ending 
September 30, 2004, and for other purposes; which was ordered to lie on 
the table; as follows:
       On page 19, line 16, strike ``$351,295,000'' and insert 
     ``$301,197,000''.
       On page 63, line 2, strike ``$1,188,226,000, of which 
     $1,025,292,000'' and insert ``$1,238,324,000, of which 
     $1,073,000,000''.

       On page 63, line 7, strike ``$59,610,000'' and insert 
     ``$62,000,000''.
                                 ______
                                 
  SA 1557. Mr. NELSON of Florida proposed an amendment to amendment SA 
1542 proposed by Mr. Specter to the bill H.R. 2660, making 
appropriations for the Departments of Labor, Health and Human Services, 
and Education, and related agencies for the fiscal year ending 
September 30, 2004, and for other purposes; as follows:

       On page 61, between lines 14 and 15, insert the following:

     SEC. __. GAO STUDY AND REPORT ON THE PROPAGATION OF CONCIERGE 
                   CARE.

       (a) Study.--
       (1) In general.--The Comptroller General of the United 
     States shall conduct a study on concierge care (as defined in 
     paragraph (2)) to determine the extent to which such care--
       (A) is used by medicare beneficiaries (as defined in 
     section 1802(b)(5)(A) of the Social Security Act (42 U.S.C. 
     1395a(b)(5)(A))); and
       (B) has impacted upon the access of medicare beneficiaries 
     (as so defined) to items and services for which reimbursement 
     is provided under the medicare program under title XVIII of 
     the Social Security Act (42 U.S.C. 1395 et seq.).
       (2) Concierge care.--In this section, the term ``concierge 
     care'' means an arrangement under which, as a prerequisite 
     for the provision of a health care item or service to an 
     individual, a physician, practitioner (as described in 
     section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 
     1395u(b)(18)(C))), or other individual--
       (A) charges a membership fee or another incidental fee to 
     an individual desiring to receive the health care item or 
     service from such physician, practitioner, or other 
     individual; or
       (B) requires the individual desiring to receive the health 
     care item or service from such physician, practitioner, or 
     other individual to purchase an item or service.
       (b) Report.--Not later than the date that is 18 months 
     after the date of enactment of this Act, the Comptroller 
     General of the United States shall submit to Congress a 
     report on the study conducted under subsection (a)(1) 
     together with such recommendations for legislative or 
     administrative action as the Comptroller General determines 
     to be appropriate.
                                 ______
                                 
  SA 1558. Mr. KOHL proposed an amendment to amendment SA 1542 proposed 
by Mr. Specter to the bill H.R. 2660, making appropriations for the 
Departments of Labor, Health and Human Services, and Education, and 
related agencies for the fiscal year ending September 30, 2004, and for 
other purposes; as follows:

       At the appropriate place insert the following:
       Sec. __. In addition to any amounts otherwise appropriated 
     under this Act under the heading of Administration on Aging, 
     there are appropriated an additional $1,000,000: Provided, 
     That in addition to the amounts already made available to 
     carry out the ombudsman program under chapter 2 of title VII 
     of the Older Americans Act of 1965 (42 U.S.C. 3058 et seq.), 
     there are made available an additional $1,000,000.
                                 ______
                                 
  SA 1559. Mrs. MURRAY (for herself, Mr. Kennedy, Mr. Dodd, Mr. Leahy, 
Mr. Jeffords, Mr. Bingaman, and Mr. Johnson) proposed an amendment to 
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making 
appropriations for the Departments of Labor, Health and Human Services, 
and Education, and related agencies for the fiscal year ending 
September 30, 2004, and for other purposes; as follows:

       In the matter under the heading ``Training and Employment 
     Services'' under the heading ``Employment and Training 
     Administration'' in title I, add at the end the following:
       Subject to the following sentence, for necessary expenses 
     of the Workforce Investment Act of 1998, including the 
     purchase and hire of passenger motor vehicles, the 
     construction, alteration, and repair of buildings and other 
     facilities, and the purchase of real property for training 
     centers as authorized by the Workforce Investment Act of 
     1998, $801,000,000, of which--
       (1) $100,000,000 is available to carry out activities 
     described in section 132(a)(1) of that Act (relating to adult 
     employment and training activities);
       (2) $159,000,000 is available to carry out activities 
     described in subparagraphs (A) and (B) of section 132(a)(2) 
     of that Act (relating to dislocated worker employment and 
     training activities and other activities for dislocated 
     workers);
       (3) $99,000,000 is available to carry out chapter 4 of 
     subtitle B of title I of that Act (relating to youth 
     activities);

[[Page 21132]]

       (4) $250,000,000 is available to carry out section 169 of 
     that Act (relating to youth opportunity grants);
       (5) $23,000,000 is available to carry out section 167 of 
     that Act (relating to migrant and seasonal farmworker 
     programs);
       (6) $20,000,000 is available to carry out section 166 of 
     that Act (relating to Native American programs); and
       (7) $150,000,000 is available for the acquisition and 
     improvement of one-stop center infrastructure, including 
     acquisition of real estate, payment of rent or utilities, 
     improvement of technology, and staff development.
       The amount $6,895,199,000 in section 305(a)(1) of this Act 
     shall be deemed to be $7,696,199,000 and the amount 
     $6,783,301,000 in section 305(a)(2) of this Act shall be 
     deemed to be $5,982,301,000: Provided, That of the funds 
     appropriated in this Act for the National Institutes of 
     Health, $370,000,000 shall not be available for obligation 
     until September 30, 2004.
                                 ______
                                 
  SA 1560. Mr. DeWINE (for himself and Mrs. Murray) submitted an 
amendment intended to be proposed to amendment SA 1542 proposed by Mr. 
Specter to the bill H.R. 2660, making appropriations for the 
Departments of Labor, Health and Human Services, and Education, and 
related agencies for the fiscal year ending September 30, 2004, and for 
other purposes; as follows:

       On page 61, between lines 14 and 15, insert the following:
       Sec. __. (a) In General.--To provide funding for poison 
     control centers under the Poison Control Enhancement and 
     Awareness Act (42 U.S.C. 14801 et seq.), there are 
     appropriated a total of $27,600,000, including amounts 
     otherwise made available in this Act for such centers.
       (b) Offset.--Amounts appropriated under title III under the 
     heading ``Program Administration'' for building alterations 
     and related expenses for relocation shall be reduced by 
     $5,300,000.
                                 ______
                                 
  SA 1561. Mr. DeWINE (for himself and Mrs. Clinton) submitted an 
amendment intended to be proposed to amendment SA 1542 proposed by Mr. 
Specter to the bill H.R. 2660, making appropriations for the 
Departments of Labor, Health and Human Services, and Education, and 
related agencies for the fiscal year ending September 30, 2004, and for 
other purposes; as follows:

       On page 61, between lines 14 and 15, insert the following:
       Sec. __. (a) In General.--To carry out programs to support 
     graduate medical education programs in children's hospitals 
     under section 340E of the Public Health Service Act (42 
     U.S.C. 256e et seq.), there are appropriated a total of 
     $305,000,000, including amounts otherwise made available in 
     this Act for such programs.
       (b) Offset.--Amounts appropriated under title III under the 
     heading ``Program Administration'' shall be reduced by 
     $15,000,000.
                                 ______
                                 
  SA 1562. Mr. DODD (for himself, Mr. DeWine, Mr. Kennedy, Mrs. 
Lincoln, and Ms. Landrieu) submitted an amendment intended to be 
proposed to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 
2660, making appropriations for the Departments of Labor, Health and 
Human Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 61, between lines 14 and 15, insert the following:
       Sec. __. In addition to any amounts otherwise appropriated 
     under this Act for the support of the improved newborn and 
     child screening for heritable disorders program authorized 
     under section 1109 of the Public Health Service Act (42 
     U.S.C. 300b-8), there are appropriated an additional 
     $10,000,000 to carry out such program: Provided, That of the 
     funds appropriated under this Act for the National Institutes 
     of Health, $19,000,000 shall not be available for obligation 
     until September 30, 2004: Provided further, That the amount 
     $6,895,199,000 in section 305(a)(1) of this Act shall be 
     deemed to be $6,905,199,000: Provided further, That the 
     amount $6,783,301,000 in section 305(a)(2) of this Act shall 
     be deemed to be $6,773,301,000.
                                 ______
                                 
  SA 1563. Mr. BINGAMAN (for himself, Mr. Reid, and Mrs. Murray) 
submitted an amendment intended to be proposed to amendment SA 1542 
proposed by Mr. Specter to the bill H.R. 2660, making appropriations 
for the Departments of Labor, Health and Human Services, and Education, 
and related agencies for the fiscal year ending September 30, 2004, and 
for other purposes; which was ordered to lie on the table; as follows:

       At the end of title III, insert the following:
       Sec. 306. (a) In addition to any amounts otherwise 
     appropriated under this Act, there are appropriated, out of 
     any money in the Treasury not otherwise appropriated, an 
     additional $20,000,000 to carry out part H of title I of the 
     Elementary and Secondary Education Act of 1965 (school 
     dropout prevention).
       (b) Of the funds appropriated in this Act for the National 
     Institutes of Health, $4,000,000 shall not be available for 
     obligation until September 30, 2004.
       (c) The amount $6,895,199,000 in section 305(a)(1) of this 
     Act shall be deemed to be $6,915,199,000 and the amount 
     $6,783,301,000 in section 305(a)(2) of this Act shall be 
     deemed to be $6,763,301,000.
                                 ______
                                 
  SA 1564. Mr. COLEMAN (for himself and Ms. Collins) submitted an 
amendment intended to be proposed to amendment SA 1542 proposed by Mr. 
Specter to the bill H.R. 2660, making appropriations for the 
Departments of Labor, Health and Human Services, and Education, and 
related agencies for the fiscal year ending September 30, 2004, and for 
other purposes; which was ordered to lie on the table; as follows:

       On page 70, line 12, strike ``$14,174,115,000'' and insert 
     ``$14,712,115,000''.
                                 ______
                                 
  SA 1565. Mrs. CLINTON submitted an amendment intended to be proposed 
to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, 
making appropriations for the Departments of Labor, Health and Human 
Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; as follows:

       On page 36, line 16, strike the period at the end and 
     insert ``: Provided further, That the amount $6,252,256,000 
     under the heading `Health Resources and Services' shall be 
     deemed to be $6,272,256,000 of which the additional 
     $20,000,000 shall be available for carrying out sections 765 
     and 767 of the Public Health Service Act: Provided further, 
     That the amount $4,588,671,000 under the heading `Disease 
     Control, Research, and Training' shall be deemed to be 
     $4,631,871,000: Provided further, That the amount 
     $1,726,846,000 under the heading `Public Health and Social 
     Services Emergency Fund' shall be deemed to be 
     $1,756,846,000: Provided further, That the amount 
     $1,116,156,000 under the heading `Public Health and Social 
     Services Emergency Fund' shall be deemed to be $1,146,156,000 
     Provided further, That the amount $6,895,199,000 in section 
     305(a)(1) of this Act shall be deemed to be $6,988,399,000: 
     Provided further, That the amount $6,783,301,000 in section 
     305(a)(2) of this Act shall be deemed to be $6,690,101,000: 
     Provided further, That of the funds appropriated in this Act 
     for the National Institutes of Health, $93,200,000 shall not 
     be available for obligation until September 30, 2004.
                                 ______
                                 
  SA 1566. Mr. KENNEDY (for himself, Ms. Collins, Mr. Dodd, Mr. Reed, 
Mr. Bingaman, Mrs. Murray, Mr. Kerry, Mr. Lieberman, Mr. Edwards, Mr. 
Pryor, Mr. Corzine, Ms. Stabenow, Mr. Akaka, Mr. Lautenberg, Mr. 
Schumer, Mr. Jeffords, and Mr. Harkin) proposed an amendment to 
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making 
appropriations for the Departments of Labor, Health and Human Services, 
and Education, and related agencies for the fiscal year ending 
September 30, 2004, and for other purposes; as follows:

       On the appropriate page and line, insert before the period 
     the following: ``: Provided further, That of the funds 
     appropriate in this Act for the National Institutes of 
     Health, $1,470,000,000 shall not be available for obligation 
     until September 30, 1994''.
       On page 76, between lines 4 and 5, insert the following:
       Sec. __. (a) Increase in Funding.--In addition to any 
     amounts otherwise appropriated under this Act for Federal 
     Pell Grants under subpart 1 of part A of title IV of the 
     Higher Education Act of 1965, there are appropriated an 
     additional $1,688,000,000 for such grants. In addition to any 
     amounts otherwise appropriated under this Act for Federal 
     Supplemental Education Opportunity Grants under subpart 3 of 
     part A of title IV of the Higher Education Act of 1965, there 
     are appropriated an additional $115,000,000 for such grants. 
     In addition to any amounts otherwise appropriated under this 
     Act for Federal Work-Study Programs under part C of title IV 
     of the Higher Education Act of 1965, there are appropriated 
     an additional $157,000,000 for such programs. In addition to 
     any amounts otherwise appropriated under this Act for the 
     Leveraging Educational Assistance Partnership Program under 
     subpart 4 of part A of title IV of the Higher Education Act 
     of 1965, there are appropriated an additional $33,445,000 for 
     such program. In addition to any amounts otherwise 
     appropriated under this Act for Federal Trio programs under 
     chapter 1 of subpart 2 of part A of title IV of the Higher 
     Education Act of 1965, there are appropriated an additional 
     $160,000,000 for such programs. In addition to any amounts 
     otherwise appropriated under this Act for Gear Up programs 
     under

[[Page 21133]]

     chapter 2 of subpart 2 of part A of title IV of the Higher 
     Education Act of 1965, there are appropriated an additional 
     $57,000,000 for such programs. In addition to any amounts 
     otherwise appropriated under this Act for loan cancellations 
     under the Federal Perkins Loans program under part E of title 
     IV of the Higher Education Act of 1965, there are 
     appropriated an additional $33,000,000 for such loan 
     cancellations. In addition to any amounts otherwise 
     appropriated under this Act for the Graduate Assistance in 
     Areas of National Need program under subpart 2 of part A of 
     title VII of the Higher Education Act of 1965, there are 
     appropriated an additional $13,200,000 for such program. In 
     addition to any amounts otherwise appropriated under this Act 
     for the Thurgood Marshall Legal Educational Opportunity 
     Program under subpart 3 of part A of title VII of the Higher 
     Education Act of 1965, there are appropriated an additional 
     $7,000,000 for such program. The amount $4,050 under the 
     heading `Student Financial Assistance' in this title shall be 
     deemed to be $4,500. The amount $9,935,000 under the heading 
     `Higher Education' in this title shall be deemed to be 
     $15,000,000.
       (b) Budgetary Authority.--The amount $6,895,199,000 in 
     section 305(a)(1) of this Act shall be deemed to be 
     $9,151,909,000. The amount $6,783,301,000 in section 
     305(a)(2) of this Act shall be deemed to be $4,526,591,000.
                                 ______
                                 
  SA 1567. Mr. CONRAD (for himself, Mr. Roberts, and Mr. Crapo) 
submitted an amendment intended to be proposed to amendment SA 1542 
proposed by Mr. Specter to the bill H.R. 2660, making appropriations 
for the Departments of Labor, Health and Human Services, and Education, 
and related agencies for the fiscal year ending September 30, 2004, and 
for other purposes; which was ordered to lie on the table; as follows:

       On page 27, line 2, insert before the period the following: 
     ``: Provided further, That $5,000,000 shall be made available 
     to carry out the rural emergency medical service training and 
     equipment assistance program under section 330J of the Public 
     Health Service Act (42 U.S.C. 254c-15)''.
                                 ______
                                 
  SA 1568. Mr. DASCHLE (for himself, Ms. Collins, Mr. Conrad, Mr. 
Dorgan, Mr. Dodd, Mr. Baucus, Mr. Pryor, Mr. Bingaman, Mrs. Lincoln, 
Mr. Johnson, Mr. Kerry, and Mr. Nelson of Nebraska) proposed an 
amendment to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 
2660, making appropriations for the Departments of Labor, Health and 
Human Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; as follows:

       On page 76, between lines 10 and 11, insert the following:
       Sec.__. In addition to any amounts otherwise appropriated 
     under this Act to carry out part B of title VI of the 
     Elementary and Secondary Education Act of 1965 (20 U.S.C. 
     7341 et seq.), there are appropriated an additional 
     $132,347,000 to carry out such part: Provided, That of the 
     funds appropriated in this Act for the National Institutes of 
     Health, $25,000,000 shall not be available for obligation 
     until September 30, 2004: Provided further, That the amount 
     $6,895,199,000 in section 305(a)(1) of this Act shall be 
     deemed to be $7,027,546,000: Provided further, That the 
     amount $6,783,301,000 in section 305(a)(2) of this Act shall 
     be deemed to be $6,650,954,000.
                                 ______
                                 
  SA 1569. Mrs. BOXER submitted an amendment intended to be proposed to 
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making 
appropriations for the Departments of Labor, Health and Human Services, 
and Education, and related agencies for the fiscal year ending 
September 30, 2004, and for other purposes; which was ordered to lie on 
the table; as follows:

       At the appropriate place, insert the following:
       Sec.   . Not later than May 1, 2004, the Secretary of 
     Health and Human Services shall submit to the appropriate 
     committees of Congress a report concerning the manner in 
     which the Department of Health and Human Services expends 
     Federal funds for research, patient care, and other 
     activities relating to Hansen's Disease. The report shall 
     include--
       (1) the amounts provided for each research project;
       (2) the amounts provided to each of the 12 treatment 
     centers for each of research, patient care, and other 
     activities;
       (3) the per patient expenditure of patient care funds at 
     each of the 12 treatment centers; and
       (4) the mortality rates at each of the 12 treatment 
     centers.
                                 ______
                                 
  SA 1570. Mr. DeWINE submitted an amendment intended to be proposed to 
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making 
appropriations for the Departments of Labor, Health and Human Services, 
and Education, and related agencies for the fiscal year ending 
September 30, 2004, and for other purposes; which was ordered to lie on 
the table; as follows:

       On page 61, between lines 14 and 15, insert the following:
       Sec. __. In addition to any amounts otherwise appropriated 
     under this Act to carry out mother-to-child HIV transmission 
     prevention activities, there are appropriated an additional 
     $60,000,000 to carry out such activities.
                                 ______
                                 
  SA 1571. Mr. DeWINE submitted an amendment intended to be proposed to 
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making 
appropriations for the Departments of Labor, Health and Human Services, 
and Education, and related agencies for the fiscal year ending 
September 30, 2004, and for other purposes; which was ordered to lie on 
the table; as follows:

       On page 61, between lines 14 and 15, insert the following:
       Sec. __. In addition to any amounts otherwise appropriated 
     under this Act to carry out mother-to-child HIV transmission 
     prevention activities, there are appropriated an additional 
     $60,000,000 to carry out such activities. Amounts 
     appropriated under this section shall be designated as 
     emergency spending pursuant to section 502(c) of House 
     Concurrent Resolution 95 (108th Congress).
                                 ______
                                 
  SA 1572. Mr. DODD (for himself, Mr. Hagel, Mr. Jeffords, Ms. Collins, 
Mrs. Murray, Mr. Dorgan, Mr. Bingaman, Mr. Kerry, Ms. Mikulski, Mr. 
Pryor, Mr. Coleman, and Ms. Stabenow) proposed an amendment to 
amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, making 
appropriations for the Departments of Labor, Health and Human Services, 
and Education, and related agencies for the fiscal year ending 
September 30, 2004, and for other purposes; as follows:

       On page 76, between lines 10 and 11, insert the following:
       Sec.__. In addition to any amounts otherwise appropriated 
     under this Act for grants to States under part B of the 
     Individuals with Disabilities Education Act (20 U.S.C. 1411 
     et seq.), there are appropriated an additional $1,200,000,000 
     for such grants: Provided, That of the funds appropriated in 
     this Act for the National Institutes of Health, $84,000,000 
     shall not be available for obligation until September 30, 
     2004: Provided further, That the amount $6,895,199,000 in 
     section 305(a)(1) of this Act shall be deemed to be 
     $8,095,199,000: Provided further, That the amount 
     $6,783,301,000 in section 305(a)(2) of this Act shall be 
     deemed to be $5,583,301,000.
                                 ______
                                 
  SA 1573. Ms. MIKULSKI submitted an amendment intended to be proposed 
to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, 
making appropriations for the Departments of Labor, Health and Human 
Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 61, between lines 14 and 15, insert the following:

     SEC. __. STUDIES CONCERNING MAMMOGRAPHY STANDARDS.

       (a) Study by GAO.--
       (1) In general.--The Comptroller General of the United 
     States shall conduct a study of the program established under 
     the Mammography Quality Standards Act of 1992 (section 354 of 
     the Public Health Service Act (42 U.S.C. 263b)) (referred to 
     in this section as the ``MQSA'') to--
       (A) evaluate the demonstration program regarding frequency 
     of inspections authorized under section 354(g) of the Public 
     Health Service Act (42 U.S.C. 263b(g)), including the effect 
     of the program on compliance with the MQSA;
       (B) evaluate the factors that contributed to the closing of 
     the approximately 700 mammography facilities nationwide since 
     2001, whether those closings were due to consolidation or 
     were a true reduction in mammography availability, explore 
     the relationship between certified units and facility 
     capacity, and evaluate capacity issues, and determine the 
     effect these and other closings have had on the accessibility 
     of mammography services, including for underserved 
     populations, since the April 2002 General Accounting Office 
     report on access to mammography; and
       (C) evaluate the role of States in acting as accreditation 
     bodies or certification bodies, or both, in addition to 
     inspection agents under the MQSA, and in acting as 
     accreditation bodies for facilities in other States and 
     determine whether and how these roles affect the system of 
     checks and balances within the MQSA.
       (2) Report.--Not later than 16 months after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall submit to the Committee on Health, Education, 
     Labor, and Pensions and the Committee on Appropriations of 
     the Senate

[[Page 21134]]

     and the Committee on Energy and Commerce and the Committee on 
     Appropriations of the House of Representatives a report on 
     the study described in paragraph (1).
       (b) Study by the Institute of Medicine.--
       (1) In general.--Not later than 30 days after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall enter into an agreement with the Institute of 
     Medicine of the National Academy of Sciences for the conduct 
     of a study and the making of recommendations regarding the 
     following:
       (A) Ways to improve physicians' interpretations of 
     mammograms, including approaches that could be taken under 
     the MQSA without negatively impacting access to quality 
     mammography.
       (B) What changes could be made in the MQSA to improve 
     mammography quality, including additional regulatory 
     requirements that would improve quality, as well as the 
     reduction or modification of regulatory requirements that do 
     not contribute to quality mammography, or are no longer 
     necessary to ensure quality mammography. Such reduction or 
     modification of regulatory requirements and improvements in 
     the efficiency of the program are important to help eliminate 
     disincentives to enter or remain in the field of mammography.
       (C) Ways, including incentives, to ensure that sufficient 
     numbers of adequately trained personnel at all levels are 
     recruited and retained to provide quality mammography 
     services.
       (D)(i) How data currently collected under the MQSA could be 
     used to improve the quality, interpretation of, and access to 
     mammography.
       (ii) Identification of new data points that could be 
     collected to aid in the monitoring and assessment of 
     mammography quality and access.
       (E) Other approaches that would improve the quality of and 
     access to mammography services, including approaches to 
     improving provisions under the MQSA.
       (F) Steps that should be taken to help make available safe 
     and effective new screening and diagnostic devices and tests 
     for breast cancer.
       (2) Report.--Not later than 15 months after the date on 
     which the agreement is entered into under paragraph (1), the 
     Institute of Medicine shall complete the study described 
     under such subsection and submit a report to the Secretary of 
     Health and Human Services, the Committee on Health, 
     Education, Labor, and Pensions and the Committee on 
     Appropriations of the Senate, and the Committee on Energy and 
     Commerce and the Committee on Appropriations of the House of 
     Representatives.
       (3) Funding.--Of the amounts appropriated under this title 
     to the Office of the Secretary of Health and Human Services 
     for general departmental management, $500,000 shall be made 
     available to carry out the study under this subsection.
                                 ______
                                 
  SA 1574. Ms. CANTWELL submitted an amendment intended to be proposed 
to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, 
making appropriations for the Departments of Labor, Health and Human 
Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; which was ordered to 
lie on the table; as follows:

       In the matter under the heading ``Training and Employment 
     Services'' under the heading ``Employment and Training 
     Administration'' in title I, add at the end the following:
       For necessary expenses of the Workforce Investment Act of 
     1998, including the purchase and hire of passenger motor 
     vehicles, the construction, alteration, and repair of 
     buildings and other facilities, and the purchase of real 
     property for training centers as authorized by the Workforce 
     Investment Act of 1998, $50,000,000 to carry out activities 
     described in section 132(a)(2)(B) of that Act (relating to 
     dislocated worker employment and training activities and 
     other activities for dislocated workers). There shall be 
     transferred from the account relating to the Department of 
     Labor's Working Capital Fund, $5,000,000 to the account 
     relating to carrying out activities described in section 
     132(a)(2)(B) of the Workforce Investment Act of 1998 
     (relating to dislocated worker employment and training 
     activities and other activities for dislocated workers). 
     There shall be transferred from the account relating to the 
     Department of Labor's management cross cut activities, 
     $5,000,000 to the account relating to carrying out activities 
     described in section 132(a)(2)(B) of the Workforce Investment 
     Act of 1998 (relating to dislocated worker employment and 
     training activities and other activities for dislocated 
     workers).
       On page 2, line 23, strike ``$276,608,000 shall be for 
     activities'' and insert ``$226,608,000 shall be used with 
     priority given to carry out the amendments made by section 
     203 of the Trade Adjustment Assistance Reform Act of 2002 and 
     shall be for activities''.
                                 ______
                                 
  SA 1575. Mr. HARKIN (for himself, Mrs. Clinton, Mr. Corzine, Mr. 
Kerry, Mr. Bingaman, Mrs. Murray, and Ms. Stabenow) proposed an 
amendment to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 
2660, making appropriations for the Departments of Labor, Health and 
Human Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; as follows:

       On page 76, between lines 10 and 11, insert the following:
       Sec.__. (a) Additional Funds.--
       (1) In general.--In addition to any amounts otherwise 
     appropriated under this Act for the Fund for the Improvement 
     of Education under part D of title V of the Elementary and 
     Secondary Education Act of 1965 (20 U.S.C. 7241 et seq.), 
     there are appropriated an additional $1,000,000,000 for such 
     fund that shall be used by the Secretary of Education to 
     award formula grants to State educational agencies to enable 
     such State educational agencies--
       (A) to expand existing structures to alleviate overcrowding 
     in public schools;
       (B) to make renovations or modifications to existing 
     structures necessary to support alignment of curriculum with 
     State standards in mathematics, reading or language arts, or 
     science in public schools served by such agencies;
       (C) to make emergency repairs or renovations necessary to 
     ensure the safety of students and staff and to bring public 
     schools into compliance with fire and safety codes;
       (D) to make modifications necessary to render public 
     schools in compliance with the Americans with Disabilities 
     Act of 1990 (42 U.S.C. 12101 et seq.) and section 504 of the 
     Rehabilitation Act of 1973 (29 U.S.C. 794);
       (E) to abate or remove asbestos, lead, mold, and other 
     environmental factors in public schools that are associated 
     with poor cognitive outcomes in children; and
       (F) to renovate, repair, and acquire needs related to 
     infrastructure of charter schools.
       (2) Amount of grants.--The Secretary shall allocate amounts 
     available for grants under this subsection to States in 
     proportion to the funds received by the States, respectively, 
     for the previous fiscal year under part A of title I of the 
     Elementary and Secondary Education Act of 1965 (20 U.S.C. 
     6311 et seq).
       (b) Offset.--Of the funds appropriated in this Act for the 
     National Institutes of Health, $352,000,000 shall not be 
     available for obligation until September 30, 2004: Provided, 
     That the amount $6,895,199,000 in section 305(a)(1) of this 
     Act shall be deemed to be $7,895,199,000, and the amount 
     $6,783,301,000 in section 305(a)(2) of this Act shall be 
     deemed to be $5,783,301,000.
                                 ______
                                 
  SA 1576. Mr. EDWARDS submitted an amendment intended to be proposed 
to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 2660, 
making appropriations for the Departments of Labor, Health and Human 
Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 61, between lines 14 and 15, insert the following:
       Sec. __. In addition to any amounts otherwise appropriated 
     in this Act for programs and activities under the Health Care 
     Safety Net Amendments (Public Law 107-251) and the amendments 
     made by such Act, and for other telehealth programs under 
     section 330 of the Public Health Service Act (42 U.S.C. 254b 
     et seq), there are appropriated an additional $10,000,000 for 
     such programs and activities, including $2,500,000 for a 
     minimum of 10 telehealth resource centers which provide 
     assistance with respect to technical, legal and regulatory, 
     service delivery or other related barriers to the deployment 
     of telehealth technologies, $5,000,000 for network grants, 
     and $2,500,000 for grants to State professional licensing 
     boards to carry out programs under which such licensing 
     boards of various States cooperate to develop and implement 
     State policies that will reduce statutory and regulatory 
     barriers to telemedicine: Provided, That $30,000,000 of the 
     amount appropriated under this Act for the National 
     Institutes of Health shall not be available for obligation 
     until September 30, 2004: Provided further, That the amount 
     $6,895,199,000 in section 305(a)(1) of this Act shall be 
     deemed to be $6,905,199,000: Provided further, That the 
     amount $6,783,301,000 in section 305(a)(2) of this Act shall 
     be deemed to be $6,773,301,000.
                                 ______
                                 
  SA 1577. Mrs. FEINSTEIN submitted an amendment intended to be 
proposed to amendment SA 1542 proposed by Mr. Specter to the bill H.R. 
2660, making appropriations for the Departments of Labor, Health and 
Human Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 76, between lines 10 and 11, insert the following:
       Sec. __. In addition to any amounts otherwise appropriated 
     under this Act for the Federal Trio programs under chapter 1 
     of subpart 2 of part A of title IV of the Higher Education 
     Act of 1965 (20 U.S.C. 1070a-11 et seq.), there are 
     appropriated not more than

[[Page 21135]]

     $16,000,000 that shall be used by the Secretary of Education 
     to award grants to Upward Bound, Upbound Math/Science, and 
     McNair grant applicants that submitted applications for 
     grants under chapter 1 of subpart 2 of part A of title IV of 
     the Higher Education Act of 1965 (20 U.S.C. 1070a-11 et seq.) 
     for fiscal year 2003 that were eligible to receive grants but 
     did not receive grants because the applications were received 
     after the closing date or exceeded the 100 page limit. If the 
     amount appropriated under this section is insufficient to pay 
     the full amounts that all applicants are eligible to receive 
     under this section, the Secretary shall ratably reduce such 
     amounts: Provided, That of the funds appropriated in this Act 
     for the National Institutes of Health, $1,500,000,000 shall 
     not be available for obligation until September 30, 2004: 
     Provided further, That the amount $6,895,199,000 in section 
     305(a)(1) of this Act shall be deemed to be $6,911,199,000: 
     Provided further, That the amount $6,783,301,000 in section 
     305(a)(2) of this Act shall be deemed to be $6,767,301,000.
                                 ______
                                 
  SA 1578. Mr. DeWINE (for himself, Mr. Alexander, Ms. Stabenow, Mr. 
Grassley, and Mr. Voinovich) proposed an amendment to amendment SA 1542 
proposed by Mr. Specter to the bill H.R. 2660, making appropriations 
for the Departments of Labor, Health and Human Services, and Education, 
and related agencies for the fiscal year ending September 30, 2004, and 
for other purposes; as follows:

       On page 74, line 1, strike ``$409,863,000, of which 
     $13,644,000'' and insert ``$406,863,000, of which 
     $10,644,000''.
       On page 76, between lines 11 and 12, insert the following:
       Sec. __. For necessary expenses for the Underground 
     Railroad Education and Cultural Program, there are 
     appropriated $3,000,000.
                                 ______
                                 
  SA 1579. Mrs. FEINSTEIN submitted an amendment intended to be 
proposed to SA 1542 proposed by Mr. Specter to the bill H.R. 2660, 
making appropriations for the Departments of Labor, Health and Human 
Services, and Education, and related agencies for the fiscal year 
ending September 30, 2004, and for other purposes; which was ordered to 
lie on the table; as follows:

       At the end of title II, insert the following:
       Sec. __. (a) State Election.--
       (1) In general.--In lieu of the Federal medical assistance 
     percentage otherwise determined for the State under section 
     1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) 
     (without regard to the application of section 401 of the Jobs 
     and Growth Tax Relief Reconciliation Act of 2003 (42 U.S.C. 
     1396d note)), a State may elect to have the alternative 
     Federal medical assistance percentage determined under 
     subsection (b) apply to the State for purposes of 
     expenditures under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.) for fiscal years beginning on or after 
     the date of such an election, but only with respect to 
     expenditures under title XIX of such Act that exceed the 
     total amount of expenditures incurred under that title with 
     respect to the State for fiscal year 2003.
       (2) Irreversible election.--A State election under 
     paragraph (1) shall be irreversible.
       (3) Limitation.--A State may not make an election under 
     paragraph (1) before October 1, 2003.
       (b) Alternative Federal Medical Assistance Percentage.--
       (1) In general.--Subject to paragraph (4), the alternative 
     Federal medical assistance percentage determined under this 
     subsection is, with respect to a State and a fiscal year, 100 
     percent reduced by the product of 0.40 and the ratio of--
       (A) the State's economic resources per person in poverty, 
     as defined in paragraph (2); to
       (B) the economic resources per person in poverty for all 
     States, as defined in paragraph (3).
       (2) State's economic resources per person in poverty.--For 
     purposes of paragraph (1)(A), except as provided in paragraph 
     (4)(C)(i), with respect to a State, the State's economic 
     resources per person in poverty is the ratio of--
       (A) the most recent 3-year average of the total taxable 
     resources of the State, as determined by the Secretary of the 
     Treasury; to
       (B) the most recent 3-year average of the number of 
     individuals residing in the State whose income is below the 
     official poverty income threshold (as determined by the 
     Secretary of Commerce).
       (3) Economic resources per person in poverty for all 
     States.--For purposes of paragraph (1)(B), the economic 
     resources per person in poverty for all States is the ratio 
     of--
       (A) the sum of the most recent 3-year averages determined 
     under paragraph (2)(A) for all States; to
       (B) the sum of the most recent 3-year averages determined 
     under paragraph (2)(B) for the 50 States and the District of 
     Columbia.
       (4) Special rules.--
       (A) Hold harmless; cap on increases.--Subject to 
     subparagraph (B), with respect to a State making an election 
     under this section, the alternative Federal medical 
     assistance percentage determined for the State for a fiscal 
     year under this subsection--
       (i) shall not be less than the Federal medical assistance 
     percentage determined for the State under section 1905(b) of 
     the Social Security Act (42 U.S.C. 1396d(b)) for the fiscal 
     year; and
       (ii) only with respect to each of fiscal years 2004 through 
     2013, shall not exceed--

       (I) the Federal medical assistance percentage determined 
     for the State under section 1905(b) of the Social Security 
     Act (42 U.S.C. 1396d(b)) for the preceding fiscal year by 
     more than 1 percent; and
       (II) the alternative Federal medical assistance percentage 
     determined for the State under this subsection for the 
     preceding fiscal year by more than 1 percent.

       (B) Overall cap.--In no event may the alternative Federal 
     medical assistance percentage determined for a State for a 
     fiscal year exceed 83 percent.
       (C) Alaska; district of columbia.--
       (i) Alaska.--In the case of Alaska, the State's economic 
     resources per person in poverty is the ratio of--

       (I) the most recent 3-year average of the total taxable 
     resources of the State, as determined by the Secretary of the 
     Treasury; to
       (II) the most recent 3-year average of the number of 
     individuals residing in the State whose income is below the 
     official poverty income threshold (as determined by the 
     Secretary of Commerce), multiplied by 1.05.

       (ii) District of columbia.--The alternative Federal medical 
     assistance percentage for the District of Columbia for any 
     fiscal year is 70 percent.
       (c) Scope of Application.--An election under this section 
     shall apply only for purposes of title XIX of the Social 
     Security Act (42 U.S.C. 1396 et seq.) and shall not apply 
     with respect to--
       (1) disproportionate share hospital payments described in 
     section 1923 of such Act (42 U.S.C. 1396r-4);
       (2) payments under title IV or XXI of such Act (42 U.S.C. 
     601 et seq., 1397aa et seq.); or
       (3) any payments under XIX of such Act that are based on 
     the enhanced FMAP described in section 2105(b) of such Act 
     (42 U.S.C. 1397ee(b)).
       (d) Definition of State.--In this section, the term 
     ``State'' has the meaning given such term for purposes of 
     title XIX of the Social Security Act (42 U.S.C. 1396 et 
     seq.).

                          ____________________