[Congressional Record (Bound Edition), Volume 153 (2007), Part 5]
[Senate]
[Pages 6540-6564]
[From the U.S. Government Publishing Office, www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. DURBIN (for himself, Mr. Coburn, Mr. Leahy, Mr. Cornyn, 
        and Mr. Feingold):
  S. 888. A bill to amend section 1091 of title 18, United States Code, 
to allow the prosecution of genocide in appropriate circumstances; to 
the Committee on the Judiciary.
  Mr. DURBIN. 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. 888

       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 ``Genocide Accountability Act 
     of 2007''.

     SEC. 2. GENOCIDE.

       Section 1091 of title 18, United States Code, is amended by 
     striking subsection (d) and inserting the following:
       ``(d) Required Circumstance for Offenses.--The circumstance 
     referred to in subsections (a) and (c) is that--
       ``(1) the offense is committed in whole or in part within 
     the United States;
       ``(2) the alleged offender is a national of the United 
     States (as that term is defined in section 101 of the 
     Immigration and Nationality Act (8 U.S.C. 1101));
       ``(3) the alleged offender is an alien lawfully admitted 
     for permanent residence in the United States (as that term is 
     defined in section 101 of the Immigration and Nationality Act 
     (8 U.S.C. 1101));
       ``(4) the alleged offender is a stateless person whose 
     habitual residence is in the United States; or
       ``(5) after the conduct required for the offense occurs, 
     the alleged offender is brought into, or found in, the United 
     States, even if that conduct occurred outside the United 
     States.''.

  Mr. COBURN. Mr. President, I rise today as the lead Republican 
sponsor of the Genocide Accountability Act of 2007. I thank my 
colleague, Senator Durbin, for introducing this important piece of 
legislation.
  Senator Durbin serves as the chairman and I serve as the ranking 
member of the new Subcommittee on Human Rights and the Law in the 
Senate Judiciary Committee. We held our first hearing, entitled 
``Genocide and the Rule of Law,'' on February 5, 2007. There could not 
be a more appropriate way to begin examining the law as it relates to 
human rights than to determine what we can and must do to prevent and 
stop genocide. The United States is a signatory of the Convention on 
the Prevention and Punishment of the Crime of Genocide. This convention 
provides that the contracting parties must ``undertake to prevent and 
to punish'' the crime of genocide. We have also passed a law 
implementing the Genocide Convention.
  However, our hearing demonstrated that there are changes that need to 
be made in law and foreign policy to respond to the ongoing genocide in 
Sudan and to any genocide that may occur elsewhere in the future. 
Fortunately, two of these changes can be accomplished right now.
  The first change can be accomplished through a bill Senators Durbin 
and Cornyn introduced last week, of which I am a cosponsor. That bill, 
the Sudan Divestment Authorization Act of 2007, will allow State and 
local governments to prohibit the investment of State assets in the 
Government of Sudan or companies with certain business relationships 
with Sudan, while the Government of Sudan is subject to sanctions under 
U.S. law. The second change can be accomplished through the bill we are 
introducing today, the Genocide Accountability Act of 2007. This act 
will ensure that our justice system has the authority to prosecute 
someone who has committed genocide if that person is found or brought 
into the United States.
  Under current law, the United States can deny admission to and 
exclude aliens from the United States on human rights grounds. The 
Attorney General can also consider avenues for the prosecution of 
aliens who have committed certain crimes, including genocide. However, 
the Attorney General can only prosecute a perpetrator of genocide if he 
committed his crimes within the United States or is a U.S. national.
  What does this mean? It means that if a person who plans or 
participates in the genocide occurring right now in Darfur travels to 
the United States on vacation, business, or even to live here for an 
extended period of time--as a refugee or student, for instance--a court 
in the United States cannot touch him. The best our justice system can 
do is deport him once his crime is discovered.
  Without question, it may be more appropriate in some cases to 
extradite someone who commits genocide to his home country or turn him 
over to an international tribunal. However, there are also times when a 
person's home country may not be willing to prosecute him and there is 
no viable alternative for prosecution. In these cases, extraditing a 
criminal would be no different than setting him free. This bill will 
not force our justice system to prosecute those who commit genocide 
just because they are found on our soil--it simply gives us the option. 
Nonetheless, in America we are blessed with great resources and the 
most effective and just legal system in the world. With these blessings 
comes great responsibility. It is contrary to our system of justice to 
allow perpetrators of genocide to go free without fear of prosecution.
  It simply makes no sense to withhold from our justice system the 
authority to prosecute someone who is found in the United States and 
who committed a crime as atrocious as genocide just because he is not 
American and did not commit the crime here. We have passed tough laws 
that ensure that we can prosecute anyone found in the United States who 
has committed terrorist acts or supports terrorism. We do not want to 
become a safe haven for terrorists, so I ask: Do we want to be a safe 
haven for those who have committed genocide? The answer should be 
clear.
  Fundamentally, we must decide if genocide is a bad enough crime, no 
matter where it happens, that it warrants the same treatment as 
terrorism-related crimes. I deeply believe that it is, and that is why 
I am proud to cosponsor this bill today.
                                 ______
                                 
      By Mr. INOUYE (for himself, Mr. Stevens, Mr. Roberts, and Mr. 
        Hagel):
  S. 890. A bill to provide for certain administrative and support 
services for the Dwight D. Eisenhower Memorial Commission, and for 
other purposes; to the Committee on Energy and Natural Resources.
  Mr. INOUYE. Mr. President, the Eisenhower Memorial Commission was 
created by the U.S. Congress in 1999 as a bipartisan commission for the 
purpose of considering and formulating plans for the location, design 
and construction of a permanent memorial to President Dwight D. 
Eisenhower to perpetuate his memory and his contributions to the United 
States. Since being fully appointed in 2001, the Commission considered 
twenty-six different sites in the District of Columbia. In 2005, it 
selected a site between the Department of Education and the National 
Air and Space Museum, two institutions resulting from and greatly 
influenced by President Eisenhower's leadership.
  In 2006, Congress approved the memorial's location within Area I, in 
compliance with the Commemorative Works Act. The Commission secured 
full approval for the selected site following extensive review by the 
National Park Service, the National Capital Memorial Advisory 
Commission, the National

[[Page 6541]]

Capital Planning Commission, and the Commission of Fine Arts. Since its 
inception, the Commission has also taken great care to study and 
analyze President Eisenhower's legacy. It produced a report by leading 
scholars and experts on President Eisenhower that provides a definitive 
statement on the transcending elements of President Eisenhower's 
enduring legacy. He ranks as one of the preeminent figures in the 
global history of the 20th century.
  The Eisenhower Memorial Commission now needs to move into the design 
phase. As design begins, the Commission's organization, specifically 
with regard to contracting and staffing, needs to be updated and 
revised to enable efficient management and responsible stewardship. The 
proposed legislation which I introduce today provides for the necessary 
reorganization. I am joined by Senators Stevens, Roberts, and Hagel as 
original cosponsors of the bill.
  The legislation enables the Commission to retain the services of 
full, part-time, and volunteer staff as government employees, without 
the restrictions of the competitive service requirements. It also 
provides the authority for the Commission's Executive Architect to 
manage technical and administrative aspects of design and construction. 
It provides for staff to be released on the completion of the memorial 
and enables the Commission to work in collaboration with federal 
agencies.
  President Eisenhower spent his entire life in public service. His 
extraordinary contributions include serving as Supreme Commander of the 
Allied Expeditionary Forces in World War II and as 34th President of 
the United States, but President Eisenhower also served as the first 
commander of NATO and as President of Columbia University. Dramatic 
changes occurred in America during his lifetime, many of which he 
participated in and influenced through his extraordinary leadership as 
President.
  Although President Eisenhower grew up before automobiles existed, he 
created the Interstate Highway System and took America into space. He 
created the National Aeronautics and Space Administration, the 
Department of Health, Education, and Welfare, and the Federal Aviation 
Administration. He added the State of Hawaii and the State of Alaska to 
the United States and ended the Korean War. President Eisenhower 
desegregated the District of Columbia and sent Federal troops into 
Little Rock, Arkansas, to enforce school integration. He defused 
international crises and inaugurated the national security policies 
that guided the nation for the next three decades, leading to the 
peaceful end of the Cold War.
  A career soldier, President Eisenhower championed peace, freedom, 
justice and security, and, as President, he stressed the 
interdependence of those goals. He spent a lifetime fulfilling his duty 
to his country, always remembering to ask: What is best for America?
  President Eisenhower once said, ``I know that the American people 
share my belief that if a danger exists in the world, it is a danger 
shared by all; and equally, that if hope exists in the mind of one 
nation, that hope should be shared by all.'' President Eisenhower's 
legacy provides hope to all of us--like him, through education and 
public service, we, as a nation and individually, can rise to meet any 
challenge. Accordingly, I urge my colleagues to support this 
legislation.
  I ask unanimous consent that the text of my bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 890

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

     SECTION 1. DWIGHT D. EISENHOWER MEMORIAL COMMISSION.

       Section 8162 of the Department of Defense Appropriations 
     Act, 2000 (Public Law 106-79; 113 Stat. 1274) is amended--
       (1) by striking subsection (j), and inserting the 
     following:
       ``(j) Powers of the Commission.--
       ``(1) In general.--
       ``(A) Powers.--The Commission may--
       ``(i) make such expenditures for services and materials for 
     the purpose of carrying out this section as the Commission 
     considers advisable from funds appropriated or received as 
     gifts for that purpose;
       ``(ii) solicit and accept contributions to be used in 
     carrying out this section or to be used in connection with 
     the construction or other expenses of the memorial;
       ``(iii) hold hearings and enter into contracts;
       ``(iv) enter into contracts for specialized or professional 
     services as necessary to carry out this section; and
       ``(v) take such actions as are necessary to carry out this 
     section.
       ``(B) Specialized or professional services.--Services under 
     subparagraph (A)(iv) may be--
       ``(i) obtained without regard to the provisions of title 5, 
     United States Code, including section 3109 of that title; and
       ``(ii) may be paid without regard to the provisions of 
     title 5, United States Code, including chapter 51 and 
     subchapter III of chapter 53 of that title;
       ``(2) Gifts of property.--The Commission may accept gifts 
     of real or personal property to be used in carrying out this 
     section, including to be used in connection with the 
     construction or other expenses of the memorial.
       ``(3) Federal cooperation.--To ensure the overall success 
     of the efforts of the Commission, the Commission may call 
     upon any Federal department or agency to assist in and give 
     support to the Commission. The head of each Federal 
     department or agency shall furnish such information or 
     assistance requested by the Commission, as appropriate, 
     unless prohibited by law.
       ``(4) Powers of members and agents.--
       ``(A) In general.--If authorized by the Commission, any 
     member or agent of the Commission may take any action that 
     the Commission is authorized to take under this section.
       ``(B) Architect.--The Commission may appoint an architect 
     as an agent of the Commission to--
       ``(i) represent the Commission on various governmental 
     source selection and planning boards on the selection of the 
     firms that will design and construct the memorial; and
       ``(ii) perform other duties as designated by the 
     Chairperson of the Commission.
       ``(C) Treatment.--An authorized member or agent of the 
     Commission (including an individual appointed under 
     subparagraph (B)) providing services to the Commission shall 
     be considered an employee of the Federal Government in the 
     performance of those services for the purposes of chapter 171 
     of title 28, United States Code, relating to tort claims.
       ``(5) Travel.--Each member of the Commission shall be 
     allowed travel expenses, including per diem in lieu of 
     subsistence, at rates authorized for employees of agencies 
     under subchapter I of chapter 57 of title 5, United States 
     Code, while away from their homes or regular places of 
     business in the performance of services for the 
     Commission.'';
       (2) by redesignating subsection (o) as subsection (q); and
       (3) by adding at the end the following:
       ``(o) Staff and Support Services.--
       ``(1) Executive director.--There shall be an Executive 
     Director appointed by the Commission to be paid at a rate not 
     to exceed the maximum rate of basic pay for level IV of the 
     Executive Schedule.
       ``(2) Staff.--
       ``(A) In general.--The staff of the Commission may be 
     appointed and terminated without regard to the provisions of 
     title 5, United States Code, governing appointments in the 
     competitive service, and may be paid without regard to the 
     provisions of chapter 51 and subchapter III of chapter 53 of 
     that title, relating to classification and General Schedule 
     pay rates, except that an individual appointed under this 
     paragraph may not receive pay in excess of the maximum rate 
     of basic pay for GS-15 of the General Schedule.
       ``(B) Senior staff.--Notwithstanding subparagraph (A), not 
     more than 3 staff employees of the Commission (in addition to 
     the Executive Director) may be paid at a rate not to exceed 
     the maximum rate of basic pay for level IV of the Executive 
     Schedule
       ``(3) Staff of federal agencies.--Upon request by the 
     Chairperson of the Commission, the Vice-Chairperson, or the 
     Executive Director, the head of any Federal department or 
     agency may detail, on a nonreimbursable basis, any of the 
     personnel of the department or agency to the Commission to 
     assist the Commission to carry out its duties under this 
     section.
       ``(4) Federal support.--The Commission shall obtain 
     administrative and support services from the General Services 
     Administration on a reimbursable basis. The Commission may 
     use all contracts, schedules, and acquisition vehicles 
     allowed to external clients through the General Services 
     Administration.
       ``(5) Cooperative agreements.--The Commission may enter 
     into cooperative agreements with Federal agencies, State, 
     local, tribal and international governments, and private 
     interests and organizations which will further the goals and 
     purposes of this section.
       ``(6) Temporary, intermittent, and part-time services.--

[[Page 6542]]

       ``(A) In general.--The Commission may obtain temporary, 
     intermittent, and part-time services under section 3109 of 
     title 5, United States Code, at rates not to exceed the 
     maximum annual rate of basic pay payable under section 5376 
     of that title.
       ``(B) Non-applicability to certain services.--This 
     paragraph shall not apply to services under subsection 
     (j)(1)(A)(iv).
       ``(7) Volunteer services.--
       ``(A) In general.--Notwithstanding section 1342 of title 
     31, United States Code, the Commission may accept and utilize 
     the services of volunteers serving without compensation.
       ``(B) Reimbursement.--The Commission may reimburse such 
     volunteers for local travel and office supplies, and for 
     other travel expenses, including per diem in lieu of 
     subsistence, as authorized by section 5703 of title 5, United 
     States Code.
       ``(C) Treatment.--A person providing volunteer services to 
     the Commission shall be considered an employee of the Federal 
     government in the performance of those services for the 
     purposes of--
       ``(i) chapter 81 of title 5, United States Code, relating 
     to compensation for work-related injuries;
       ``(ii) chapter 171 of title 28, United States Code, 
     relating to tort claims; and
       ``(iii) chapter 11 of title 18, United States Code, 
     relating to conflicts of interest.
       ``(p) Authorization of Appropriations.--There are 
     authorized to be appropriated such sums as necessary to carry 
     out this section.''.
                                 ______
                                 
      By Mr. INHOFE (for himself and Mr. Coburn):
  S. 891. A bill to protect children and their parents from being 
coerced into administering a controlled substance in order to attend 
school, and for other purposes; to the Committee on Health, Education, 
Labor, and Pensions.
  Mr. INHOFE. Mr. President, I rise today, along with my colleague, Tom 
Coburn, to proudly reintroduce the Child Medication Safety Act, a bill 
to protect children and their parents from being coerced into 
administering a controlled substance or psychotropic drug in order to 
attend a school.
  Parents today face many challenges when raising their children, one 
of which is ensuring that their children receive the best education 
possible. My views on education come from a somewhat unique perspective 
in that my wife, Kay, was a teacher at Edison High School in Tulsa for 
many years and now both of our daughters are teachers. I can assure you 
that I am one of the strongest supporters of quality education. 
However, it has come to my attention that schools have been acting as 
physicians or psychologists by strongly suggesting that children with 
behavioral problems be put immediately on some form of psychotropic 
drugs. Schools and teachers are not equipped to make this diagnosis and 
should not make it mandatory for the student to continue attending the 
school. This is clearly beyond their area of expertise. Therefore, I am 
introducing this legislation to ensure that parents are not required by 
school personnel to medicate their children.
  The Child Medication Safety Act requires, as a condition of receiving 
funds from the Department of Education, that States develop and 
implement polices and procedures prohibiting school personnel from 
requiring a child to obtain a prescription as a condition of attending 
the school. It should be noted that this bill does not prevent teachers 
or other school personnel from sharing with parents or guardians 
classroom-based observations regarding a student's academic performance 
or regarding the need for evaluation for special education. 
Additionally, this bill calls for a study by the Comptroller General of 
the United States reviewing: (1) the variation among States in the 
definition of psychotropic medication as used in public education, (2) 
the prescription rates of medication used in public schools to treat 
children with attention deficit disorder and other such disorders, 3) 
which medications listed under the Controlled Substances Act are being 
prescribed to such children, and 4) which medications not listed under 
the Controlled Substances Act are being used to treat these children 
and their properties and effects. This GAO report is due no later than 
one year after the enactment of this Act.
  I believe this is an extremely important bill that protects the 
rights of our children against improper intrusion regarding health 
issues by those not qualified. If a parent or guardian believes their 
child is in need of medication, then they have the right to make that 
decision and consult with a licensed medical practitioner who is 
qualified to prescribe an appropriate drug. Please join us in support 
of this legislation that protects the freedoms of our children.
                                 ______
                                 
      By Mr. INHOFE:
  S. 892. A bill to amend the Internal Revenue Code of 1986 to provide 
for the indexing of certain assets for purposes of determining gain or 
loss; to the Committee on Finance.
  Mr. INHOFE. Mr. President, I rise today to introduce the Capital 
Gains Inflation Relief Act of 2007. The taxation of inflation is one of 
the most unjust practices of the tax code. This simple improvement will 
not only enhance the basic fairness and efficiency of the tax code, but 
will also immediately increase the net return on capital investment.
  Under current law, a taxable capital gain occurs whenever a capital 
asset is sold at a price higher than the original purchase price. 
However, the timing of capital gains taxation sets it apart from other 
types of income. While wages are generally taxed on a yearly basis, the 
taxation on capital assets occurs at the time the capital asset holder 
chooses to sell his asset and realize his gains. The gains on capital 
assets accrue over the course of the asset's life, which is usually 
many years. This is generally favorable to the capital asset holder, 
because he can defer taxation on his gains to a future year. This tax 
deferral is often cited as the primary reason for holding assets long 
term.
  However, the value of tax deferral is often times overstated because 
current tax policy taxes the capital asset holder not only on real 
gains, but also on gains due to inflation. This creates a situation 
that is patently unfair to the American taxpayer. For example, an 
American who purchased a share of stock for $10 in 1950 and sold it for 
twice that amount today would be subject to capital gains taxes on the 
nominal gain of $10, though the transaction was a clear loss when one 
accounts for inflation. Why should an American taxpayer, who invested 
in a capital asset in his youth, be forced to pay capital gains taxes, 
on what can only be viewed as a loss, in his later years? In spite of 
all our efforts to curb inflation, it will remain a fact of life. This 
does not mean we should tax hard-working Americans with long-term goals 
on gains that are due to inflation, gains that they will never actually 
realize.
  Without an inflation index, the tax code incentivizes short-term 
speculation and discourages long-term capital investment. The current 
turmoil in the subprime lending market is an example that demonstrates 
the perils of emphasizing short-term speculation over long-term capital 
investment. Though inflation has remained relatively modest recently, 
there is no guarantee of future stability. Inflation indexing would 
instantly increase the net return on capital investment and 
consequently encourage more of it. Inflation indexing would also 
restore core principles of sound tax policy such as ``horizontal 
equity,'' wherein two taxpayers in identical situations are treated 
identically by the tax system. Indexing capital gains would improve the 
basic fairness of the tax code with only a minor increase in 
administrative costs and a single step of simple multiplication for 
taxpayer compliance.
  The need for indexing is clear. It would help average Americans and 
improve tax policy by enhancing both the basic fairness and the pro-
growth incentive of the tax code. The merits of the capital gains tax 
are themselves debatable, but if we are to tax capital gains let us 
make sure they are taxed fairly. Please join with me in supporting this 
legislation to free the American taxpayer from the unfairness of the 
current tax policy.
                                 ______
                                 
      By Mrs. CLINTON:
  S. 895. A bill to amend titles XIX and XXI of the Social Security Act 
to ensure that every child in the United States has access to 
affordable, quality health insurance coverage, and for other purposes; 
to the Committee on Finance.

[[Page 6543]]


  Mrs. CLINTON. Mr. President, I was proud to help create the State 
Children's Health Insurance Program during the Clinton Administration. 
It has provided health insurance for 6 million children, including more 
than 425,000 in New York. SCHIP was the biggest expansion in providing 
health insurance coverage in more than 30 years--a big first step to 
providing quality health care coverage for all children.
  And now it is time to take the next step. Today, I am introducing new 
legislation with my colleague from the House of Representatives, 
Chairman Dingell: a plan to make quality affordable health care 
available to every child in America.
  The Children's Health First Act will make quality, affordable health 
care available to all children, and will pave the way to cover the more 
than nine million children in our country without health coverage.
  Our bill cuts red tape to allow States to provide affordable 
healthcare options for all families to cover their children. It gives 
States the financial incentives and resources to expand--existing State 
coverage and find and enroll the 6 million children who are currently 
eligible for health coverage but are not enrolled. And it provides 
incentives to expand employer sponsored coverage for children.
  As individuals and as a Nation, an ounce of prevention is truly worth 
a pound of cure. Health care accessible and affordable for all children 
will keep kids healthy, save lives, control costs, and end heartache 
and worry for so many parents. This plan is practical and fiscally 
responsible--it will honor our values and prevent kids from needing 
more costly healthcare in the future.
  Our bill will provide incentives for States to expand SCHIP to more 
children and provide health coverage for children up to 400 percent of 
poverty, about $70,000 for a family of three.
  Parents whose incomes are above their State's SCHIP eligibility 
levels and employers who want to provide coverage to dependents will 
also have the option to buy-in to the SCHIP program. This will ensure 
that all families have access to affordable coverage and aren't forced 
into the private insurance market where affordable options for their 
children are often out of reach.
  And while expanding coverage is critical, enrolling children who are 
already eligible must also be part of our efforts to ensure every child 
has health insurance.
  Currently, there are 6 million uninsured children who are eligible 
for public programs but not enrolled. In order to receive expanded 
Federal funding under our bill, States must undertake strategies 
designed to enhance outreach and enrollment of currently eligible 
children.
  In addition, the Children's Health First Act would prevent funding 
shortfalls like those that 14 States are currently facing. Unlike the 
original SCHIP bill our legislation would determine funding based on 
State spending and indexed to medical inflation and child population 
growth so that states will get the funds they need.
  Every child deserves a healthy start in life. This goes to the heart 
of our values, our responsibility to one another, the promise of our 
country. Far too many children in our Nation--more than 9 million--do 
not have health care. And, for the first time in nearly a decade, 
between 2004 and 2005, the number of uninsured children in New York 
increased by 61,000--part of a trend nationally.
  It's simply wrong that there are working parents who worry about 
their children playing sports because they can't afford a doctor if 
their child gets hurt. I've met parents who when their children get 
sick fret and worry about their children's illness--but have the added 
anxiety of wondering how they are going to pay for the doctor visit. 
That just shouldn't happen.
  No child in America, the greatest, richest Nation on Earth home to so 
much promise, should lack for the care he or she needs to grow up to be 
a healthy, happy adult.
  We can tackle this challenge--and provide access to quality, 
affordable health care for all children in America. It's the right 
thing to do, and it's the smart thing to do.
  I am proud to introduce this legislation. It will help us honor our 
values, protect our children. We can meet this challenge and that's 
what I'll be working with Chairman Dingell and my Senate colleagues to 
achieve this year.
                                 ______
                                 
      By Ms. MURKOWSKI (for herself, Mr. Schumer, Mr. Stevens, and Mr. 
        Sanders):
  S. 896. A bill to amend the Public Health Service Act and the Social 
Security Act to increase the number of primary care physicians and 
medical residents serving health professional shortage areas, and for 
other purposes; to the Committee on Health, Education, Labor, and 
Pensions.
  Ms. MURKOWSKI. Mr. President, I rise again this evening to speak 
about a growing crisis in rural America. This crisis is found in rural 
New England, throughout Appalachia, spans the Great Plains, crosses the 
Western deserts, and reaches the mountains of the great Northwest. It 
impacts the seniors, children, the women, and the men of rural America. 
What I am speaking about today is a lack of access to quality health 
care.
  In rural America, patients have long gone without care. Despite the 
fact that one-fifth of the U.S. population lives in rural America, only 
9 percent of the Nation's physicians are practicing in these areas. 
Over 50 million of these rural Americans live in areas that have a 
shortage of physicians to meet their basic needs.
  Now, physician recruitment to rural America is a big problem. Part of 
this problem comes about through high student debt, which often forces 
many students away from a rural practice and into urban specialty 
medicine where they can probably command higher salaries.
  I recently held a Senate HELP Committee field hearing in Alaska. This 
was during the February recess. I held this field committee hearing on 
the physician shortage crisis in rural America. At that hearing, I had 
a young woman come up and speak. She is a medical student who is 
currently part of the WAMI Program, the Western States medical program. 
This young woman, Melissa Howell, is 26 years old. She stated the 
student debt she has accumulated is a huge concern that hangs over the 
decisions she makes as she decides where she is going to practice. 
Simply put, she said that the $100,000 student debt she faces is ``kind 
of scary.'' I have to admit, that is kind of scary.
  A dozen States already report severe physician shortages. These 
shortages exist in the areas of cardiology, radiology, neurology, to 
name a few. But the greatest shortages persistently have been in 
primary care. In fact, the shortage of primary care physicians in rural 
areas of the United States represents one of the most intractable 
health policy problems of the past century.
  It will only worsen. In 20 years, 20 percent of the U.S. population 
will be 65 or older, and this is a percentage larger than at any other 
time in our Nation's history. Just as this aging population places the 
highest demand on our health care system, we have some experts who 
predict a national shortage of close to 200,000 physicians. If that 
becomes a reality, 84 million patients could be potentially left 
without a doctor's care.
  So the question has to be asked, where are the doctors going? We are 
losing some of our doctors through attrition. One-third of physicians 
are 55 years old and older and are likely to retire as this baby boom 
generation moves into its time of greatest medical need. Additionally, 
for the last quarter of a century, medical schools have kept their 
student enrollments virtually flat.
  We are also losing a lot of our doctors, quite simply, through 
frustration. Low Medicare and Medicaid reimbursement rates, coupled 
with complex regulations and paperwork, leave physicians aggravated, 
leave them disappointed with the practice of medicine.
  In Alaska, we have lived with provider shortages since statehood. I 
grew up in a part of the State down in the southeastern area where you 
did not

[[Page 6544]]

have doctors who were available to deliver babies except on Tuesdays 
and Thursdays. You hoped you could give birth on a Tuesday or a 
Thursday. Still, in many parts of our State, we do not have providers 
who can deliver. If you are out in the Aleutian chain, you are told by 
your physician's attendant to come to Anchorage, some 600 miles away, 
to wait out the remaining month of your pregnancy because they do not 
have the facilities, do not have the doctors available to take care of 
you in the event of an emergency.
  So we have lived with provider shortages for a long time. Because our 
State is larger than Texas and California and Montana combined, 
``rural'' brings on a new meaning and the physician shortage crisis is 
even more amplified, as I have given in my two examples. But we have 
had some recent events in the State that have created a situation far 
worse than Alaska has known in the past. Currently, in the State, we 
have the sixth lowest ratio of physicians to population in the United 
States. That is when you take into account Anchorage, which is our 
largest population center. In rural Alaska, it is the worst physician-
to-population situation in the Nation. Alaska needs nearly 400 more 
doctors to provide the same level of care as elsewhere in the country.
  One of our problems is we do not have a medical school, and we are 
not likely to be getting a medical school in the near future. We also 
have the lowest per capita number of medical school slots in the 
country and the lowest number of residency slots. We have two small but 
very successful programs; this is the University of Washington Medical 
School Partnership and the Alaska Family Residency Program. These two 
programs help train Alaskans as physicians and also help us bring 
doctors to Alaska. But despite the success of these programs, each is 
far too small to meet our population's needs.
  Each week, without fail, I receive faxes, phone calls, letters, and 
e-mails from Alaskan seniors who simply cannot find a doctor to treat 
them. I wish to read a few excerpts from recent e-mails we have 
received. The first one is from a gentleman in Anchorage. Keep in mind, 
Anchorage is our largest population center; about half the population 
of the State is here.
  He writes:

       My mother . . . has had difficulty in the extreme in 
     getting a doctor who will take her on as she is a medicare 
     patient . . . doctors are telling potential patients that 
     they are no longer taking medicaid. My mother has made in 
     excess of 100 calls to physicians in Anchorage.

  Another constituent writes--and this is also from Anchorage:

       During the past year, I've tried to find a doctor that 
     accepts Medicare. I used the Anchorage Yellow pages and 
     called over 100 doctors, only to be told that they won't 
     accept any more Medicare patients.

  She then writes to say:

       I'll tell you ahead of time, we'll be going to the hospital 
     emergency rooms, to receive, even the basic medical care, 
     i.e.: colds, flu, and other basic medical care, that could 
     have been treated through seeing a doctor, at their 
     established practice. This doesn't sound like good fiscal 
     management.

  Another constituent--and this was actually in a letter to the editor 
in the Anchorage Daily News--says:

       My friends telephoned more than 80 doctors recently, and 
     not one was accepting new Medicare patients.

  A third gentleman from Kenai, AK, writes:

       My mom has Medicare and she had to wait 5 months to be seen 
     by a Neurologist because she had been put on a waiting list 
     to be seen due to the fact she was a Medicare patient.

  Another woman from Anchorage says:

       I just got through trying to find a physician for an 
     elderly Medicare-dependent friend. At this time I have found 
     no one who will take her. Most physicians take no Medicare 
     patients or have a quota which is full. The Providence health 
     care provider list has no one who takes Medicare.

  The last e-mail was from Anchorage stating:

       Almost no family practice office in Anchorage is accepting 
     new Medicare patients.

  This is just a sample of what we get from constituents around the 
State of Alaska saying: I don't have anyone who can see my mother. I 
can't get in to see anyone myself.
  I mentioned in my comments this is a crisis that is growing. In 
Alaska, we don't often think of it as being a State where we have a 
large senior population. We think of some of the Southern States as 
being the ones that attract our seniors. But the fact is Alaska has the 
second fastest-growing senior population in the Nation, second only to 
Nevada.
  So again we ask the question: Why aren't Alaska's doctors able to 
provide care to our seniors? Why are they saying: No, we are not 
accepting any new Medicare patients? Well, a lot of it has to do with 
the reimbursement rates. Recent Federal reductions in Alaska Medicare 
reimbursement rates have been so severe that primary care physicians 
report that Medicare pays them only 37 cents--it is actually between 37 
cents to 40 cents--for every dollar that it costs to treat a patient. 
So the doctor is spending a dollar in the care provided but is getting 
reimbursed about 40 cents to every dollar. We had one physician testify 
at the field hearing, and he said that in order for him to basically 
break even with his medical practice, he would have to see one Medicare 
patient every 7 minutes in order for him not to lose money. For those 
of us who go into our doctor's office, if we only had 7 minutes in 
there with our medical provider, I don't think we would feel we were 
getting the care and the attention our medical issues deserve.
  Losing money by seeing Medicare patients has meant that many of our 
physicians have stopped accepting Medicare patients entirely. They are 
making a decision not to accept any new Medicare patients. Or if you 
have been a patient of a particular physician and you turn 65, you may 
have had a good relationship with that physician, but if he tells you: 
I am sorry, I am not accepting any new Medicare patients, that date of 
your birthday comes and all of a sudden you don't have the care that 
you had relied on for some period of time.
  During this committee field hearing, we had testimony that revealed 
that only one neighborhood health clinic in the entire city of 
Anchorage--and again, this is a city that has half the State's 
population--only one neighborhood health clinic is still accepting new 
Medicare patients.
  So if you are lucky enough to find a physician, it often takes weeks 
or months for an appointment. So when you are faced with this kind of a 
delay, you have one of two options. You either go to the emergency room 
if the conditions are severe enough or you go without care entirely, 
putting it off until perhaps it becomes even more complicated down the 
road.
  We had testify at the field hearing one gentleman who is from the 
city of Bethel. Bethel is in the western part of the State. He said he 
was willing to fly the 500-some-odd miles from Bethel to Anchorage if 
only he could find a primary care doctor who would accept him. He kind 
of joked because he said he counted himself lucky because he had a 
heart condition, and he was at least able to get in to see a specialist 
once in awhile.
  The chairman of the Alaska Commission on Aging, Mr. Frank Appel, 
called the lack of access to health care for seniors ``the most 
critical problem facing Alaska's seniors.''
  I know Alaska is not alone. The crisis is not just Alaska. It is 
nationwide. We as a body, as a Congress, should find this situation 
intolerable.
  I haven't been in the Senate for as long as many of my other 
colleagues, but I have been here long enough to know that we fight a 
lot about health care. We debate the solvency issues, the funding 
issues, the insurance, the benefit coverage, universal coverage, health 
savings accounts, the prescription drug benefit. We debate and argue 
about a lot of these issues as they relate to health care, and each and 
every one of these issues is certainly worthy of great debate. But I 
would submit that not one of those very worthy debates matters in the 
least to one of the seniors I have mentioned in these letters who can't 
find a primary care doctor after making 100 phone calls.
  So instead of this body debating how health care is delivered, it is 
time we focus on the fact that it is not delivered in much of America. 
We have a

[[Page 6545]]

crisis that, simply put, cannot wait. We have to do two things. We have 
to help current physicians stay in the practice of medicine, and we 
must vastly increase our health care work force.
  Earlier this year, Senator Stevens and I introduced the Rural 
Physician Relief Act, and this is a bill that provides tax incentives 
for physicians to practice in our most rural and frontier locations in 
the country. Today, along with my colleagues, Senator Schumer, Senator 
Stevens, and Senator Sanders, we are introducing legislation entitled 
the ``Physician Shortage Elimination Act.'' This legislation will 
double the funding for the National Health Service Corps, a program 
that is dedicated to meeting the needs of the underserved. Despite its 
success over the years, it has been vastly underfunded. We understand 
that 85 percent of the applicants to this worthy program have to be 
turned away each year because we don't fund it.
  This legislation will also allow rural and underserved physician 
residency programs to expand by removing barriers that prevent programs 
from developing rural training programs.
  We will also double certain title VII funding to create programs that 
target disadvantaged youth in rural and underserved areas and nurture 
them to create a pipeline to careers in health care. We need to get 
more people interested in the field.
  Finally, we must bolster the cornerstone of rural health care, which 
is the community health center, through additional grants and by 
allowing them to expand their residency programs.
  I would suggest that the prognosis for the quality of health care in 
America is poor. Fifteen million Americans in underserved areas across 
the Nation already do without care. Soon, with even greater physician 
shortages, it could mean that potentially another 84 million patients 
will be left without a physician's care.
  The time for Congress to act is now. In fact, it is past time. I look 
forward to working with my colleagues on this issue that again is not 
just Alaska-specific. I think the facts on the ground up North perhaps 
make the arguments more accentuated, but I think it points to a 
situation in this Nation that we must deal with now before the crisis 
is felt throughout the country.
  I appreciate the attention of the Chair.
                                 ______
                                 
      By Ms. MIKULSKI (for herself, Mr. Grassley, Mr. Bond, Mrs. 
        Clinton, and Ms. Collins):
  S. 897. A bill to amend the Internal Revenue Code of 1986 to provide 
more help to Alzheimer's disease caregivers; to the Committee on 
Finance.
  Mr. GRASSLEY. Mr. President, I am pleased to join in cosponsoring the 
Alzheimer's Family Assistance Act of 2007 introduced by my colleague, 
Senator Mikulski.
  As much as we all would like to think that we will remain healthy and 
strong throughout our lifetimes, many of us will need long-term care. 
The cost of that care, whether provided in a nursing home, assisted 
living facility, or in one's own home with the assistance of health 
aides, can quickly add up. That is why we should do everything we can 
to make people aware of long-term care insurance and to ensure that 
policies are affordable.
  We need to encourage people to include long-term care insurance in 
their planning, especially when people are younger and premiums would 
be lower. The Deficit Reduction Act of 2005, DRA, made good progress in 
that regard by expanding State long-term care partnership programs. In 
addition, the DRA established an information clearinghouse to help 
individuals learn about long-term care insurance options in their 
states.
  We also need to encourage older individuals to purchase long-term 
care insurance. By establishing a deduction for long-term care 
insurance premiums, this legislation will help accomplish that goal. In 
order to qualify for the deduction, the policy must include several 
important consumer protections recommended by the National Association 
of Insurance Commissioners, NAIC. The DRA incorporated the same 
protections plus some additional NAIC consumer protections into the 
State long-term care partnership policies. As this bill moves forward, 
I look forward to working with Senator Mikulski to ensure consistency 
in the application of these consumer protections to long-term care 
policies. Specifically, I hope we can expand the consumer protections 
in this bill so they are in line with those included in the DRA.
  Finally, this legislation recognizes that individuals and their 
caregivers may need assistance in paying for medical supplies, nursing 
care, and other long-term care expenses. The tax credit called for in 
the bill, which increases from $1,000 to $3,000 in 2011 and beyond, 
will help defray these costs.
  Mr. President, I have long supported the policies included in this 
legislation and commend my colleague for her work on this important 
issue.
                                 ______
                                 
      By Mr. DODD (for himself, Ms. Mikulski, Mrs. Murray, Mr. Sanders, 
        Mr. Durbin, Mr. Lieberman, Ms. Cantwell, Mr. Akaka, and Mr. 
        Levin):
  S. 899. A bill to amend section 401(b)(2) of the Higher Education Act 
of 1965 regarding the Federal Pell Grant maximum amount; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. DODD. Mr. President, I rise today, joined by my colleagues 
Senators Mikulski, Murray, Sanders, Durbin, Lieberman, Cantwell, Akaka, 
and Levin, to introduce legislation to amend the Higher Education Act 
to improve access to college for low- and moderate-income students by 
raising the authorized maximum Pell grant to $11,600 within 5 years. 
This bill has the strong support of the American Association of 
Universities, American Jesuit Colleges and Universities, the American 
Association of Community Colleges, the National Association of 
Independent Colleges and Universities, the American Council on 
Education, and The Higher Education Consortium for Special Education.
  Pell grants were first established in the early 1970s by our former 
colleague, Senator Claiborne Pell. Pell grants are the largest source 
of Federal grant aid for college students and make it possible for 
millions of low- and moderate-income students to attend college. The 
benefits of Pell grant aid cannot be overstated. Pell grants are 
beneficial to individual students as well as our society as a whole. 
Often, our Nation's great innovators and creative minds sharpen their 
skills on college campuses. By increasing the Pell grant, we make a 
college education more affordable, and thus, make it more likely that 
qualified and hard working low- and moderate-income students will 
attend. It would be a significant loss to this great Nation if a 
generation of individuals were not able to earn a college degree simply 
because they could not afford to pay for it.
  In 1975, the maximum appropriated Pell grant covered 80 percent of 
the average student's tuition, fees, room, and board at 4-year public 
universities. In 2005-2006, the average Pell grant covered 33 percent 
of the total charges at 4-year public universities. That's not just a 
drop in aid, it's a free-fall. For low- and moderate-income families, 
the cost of college has also increased as a percentage of income. In 
1999 it took 43 percent of a low-income family's income to pay for a 
college education. In 1972, it only took 27 percent. The cornerstone of 
American democracy is providing all citizens with access and 
opportunities so that through hard work they can achieve the ``American 
dream.'' We must keep that dream alive by providing students the 
financial opportunity to attend college.
  In order to meet the cost of attending college, many low- and 
moderate-income students are forced to take out an exorbitant amount in 
student loans. Upon graduation these students are often faced with an 
unmanageable debt load. Surveys tell us that students with a 
significant amount of debt are postponing marriage and having children. 
Others are choosing their jobs based on where they think they can 
afford to work. Clearly, we do not want student loan debt to solely 
drive our young people's goals and aspirations.
  Over the past several years, the administration has not raised the 
maximum Pell grant. On top of leaving

[[Page 6546]]

millions of children behind by underfunding K-12 education, they are 
also leaving students behind who have done well in school and want the 
chance to go on to college. If we are serious about leaving no student 
behind--if we are serious about having a society where equal 
opportunity for all is more than just rhetoric--then we must increase 
the Pell grant.
  It has been said that investing in a student's future is investing in 
our Nation's future. We can start investing in our Nation's future by 
supporting this bill to increase the maximum appropriated Pell grant to 
$11,600. This bill won't bring the Pell grant's purchasing power back 
to where it was in 1975, but it is a critical first step. I hope that 
my colleagues will join me in taking this important step toward 
ensuring all that have the ability to excel in college are given that 
opportunity.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 899

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

     SECTION 1. FEDERAL PELL GRANT MAXIMUM AMOUNT.

       Section 401(b)(2) of the Higher Education Act of 1965 (20 
     U.S.C. 1070a(b)(2)) is amended--
       (1) by redesignating subparagraph (B) as subparagraph (C);
       (2) by striking subparagraph (A) and inserting the 
     following:
       ``(A) Except as provided in subparagraph (B), the amount of 
     the Federal Pell Grant for a student eligible under this part 
     shall be--
       ``(i) $7,600 for academic year 2007-2008;
       ``(ii) $8,600 for academic year 2008-2009;
       ``(iii) $9,600 for academic year 2009-2010;
       ``(iv) $10,600 for academic year 2010-2011; and
       ``(v) $11,600 for academic year 2011-2012,
     less an amount equal to the amount determined to be the 
     expected family contribution with respect to that student for 
     that year.''; and
       (3) by inserting after subparagraph (A) (as amended by 
     paragraph (2)) the following:
       ``(B) If the Secretary determines that the increase from 
     one academic year to the next in the amount of the maximum 
     Federal Pell Grant authorized under subparagraph (A) does not 
     increase students' purchasing power (relative to the cost of 
     attendance at an institution of higher education) by not less 
     than 5 percentage points, then the amount of the maximum 
     Federal Pell Grant authorized under subparagraph (A) for the 
     academic year for which the determination is made shall be 
     increased by an amount sufficient to achieve such a 5 
     percentage point increase.''.
                                 ______
                                 
      By Mr. HATCH (for himself and Mr. Bennett):
  S. 900. A bill to authorize the Boy Scouts of America to exchange 
certain land in the State of Utah acquired under the Recreation and 
Public Purposes Act; to the Committee on Energy and Natural Resources.
  Mr. .HATCH. Mr. President, I rise today to introduce the Boy Scouts 
of America Land Transfer Act of 2007. This important legislation will 
allow the exchange of two small parcels of land between the Utah Parks 
Council of the Boy Scouts of America and Brian Head Ski Resort.
  In 1983, the Bureau of Land Management granted the Boy Scouts of 
America roughly 1,300 acres in Parowan, Utah. The land patent was 
granted with the stipulation that it be used exclusively for purposes 
of a Boy Scout camp. The Scout camp, known as Camp Thunder Ridge, is 
situated in the mountains adjacent to Brian Head Ski Resort and near 
Cedar Breaks National Monument.
  When the land was given to the Scout Camp, a local rancher owned a 
parcel of land adjacent to the camp and another parcel in the middle of 
the camp. Upon his retirement, the rancher turned over his parcels, 
totaling 120 acres, to Brian Head Ski Resort. Thus, the ski resort now 
owns land in the middle of a Boy Scout Camp.
  The Boy Scouts and the Resort agree that the land previously owned by 
the rancher would best be used as part of Camp Thunder Ridge, while 
certain parcels of the Scout Camp would be of more use to the Ski 
Resort.
  The Boy Scouts of America Land Transfer Act would allow the Boy 
Scouts to exchange 120 acres of their land on the south end of the camp 
with Brian Head for 120 acres on the eastern side of the camp, 
including the 40 acres located in the middle of the camp. Because of 
the stipulations of the original BLM patent given to the Scout Camp, 
legislation is required to authorize this exchange.
  While Camp Thunder Ridge is located in a steep, rough, mountainous 
area, much of the land the Boy Scouts seek is flat, making it 
particularly important for the camp. Obtaining the land would make it 
possible for the Scouts to make the camp shooting area and archery 
range safer and would allow them to improve and expand their camping 
facilities. It would also allow for the installation of much-needed 
septic tanks.
  I am a strong supporter of the Boy Scouts of America. Scout camps, 
such as Camp Thunder Ridge, give young men the opportunity to learn 
vital skills, fulfill merit badge requirements, and otherwise improve 
themselves. This small land exchange will allow Camp Thunder Ridge to 
do a better job in helping these young men learn and grow.
  For its part, Brian Head Ski Resort is seeking to expand their 
operations and have received preliminary approval from local officials. 
The local Planning Commission, however, has required them to build an 
emergency exit for their property. The only place to build such a road 
is through land owned by the Boy Scouts. The exchange will allow Brian 
Head to construct the access road and comply with county fire safety 
regulations.
  The Boy Scouts have been working for more than 20 years to secure the 
lands in question, and Brian Head needs to build on lands currently 
owned by the Scouts. Therefore, it would be in the best interest of 
both parties to authorize this land exchange. In fact, the exchange is 
desperately needed by both parties, and I urge my colleagues to support 
this important legislation.
                                 ______
                                 
      By Mr. KENNEDY (for himself, Mr. Hatch, Mr. Dodd, Mr. Roberts, 
        Mr. Harkin, Mr. Bond, Ms. Mikulski, Ms. Snowe, Mr. Bingaman, 
        Mr. Domenici, Mr. Reed, Ms. Murkowski, Mrs. Clinton, Mr. 
        Bennett, Mr. Obama, Mr. Grassley, Mr. Brown, and Mr. Burr):
  S. 901. A bill to amend the Public Health Service Act to provide 
additional authorizations of appropriations for the health centers 
program under section 330 of such Act, tot he Committee on Health, 
Education, Labor, and Pensions.
  Mr. KENNEDY. Mr. President, it's an honor to join Senator Hatch and 
my HELP Committee colleagues today in introducing this bill to 
reauthorize the community health centers program. The Health Centers 
Renewal Act extends the program through 2012, it authorizes the funds 
needed to stabilize existing centers and enable them to increase their 
capacity and funds for new centers in underserved areas that have no 
existing center.
  The community health centers program has been a success story by any 
measure over the past 40 years. It began as a two-site demonstration 
project for ``neighborhood health centers'' in 1965, with funds for 
Columbia Point in Massachusetts and Mound Bayou in Mississippi. The 
health center model was the brainchild of two young physicians and 
civil rights activists, Dr. H. Jack Geiger and Dr. Count Gibson. Their 
model was intended to address both health care and the roots of 
poverty, by giving communities a voice in their health care through a 
patient-majority community board, by creating jobs and investments in 
local communities, and by focusing on primary care and reducing health 
disparities among income groups.
  Today, more than 1,000 health centers provide good health care to 16 
million patients each year. They provide safety nets in their 
communities for the most vulnerable Americans, and bring care to 1 of 
every 4 Americans living in poverty. Nearly 70 percent of health center 
patients have incomes below the poverty line, and two-thirds are 
members of racial and ethnic minorities. Health centers give those who

[[Page 6547]]

are so often disenfranchised in our society a voice in their own health 
care and in the care available in their community. Health centers are 
also an incentive for economic growth, providing 50,000 jobs across the 
country for residents in their communities.
  As the number of uninsured and underinsured persons grows each year, 
the need for health center services increases. More than 40 percent of 
health center patients have no health insurance and their number is 
increasing. Another 36 percent of patients have coverage through 
Medicaid or CHIP, and cuts in these programs affect health centers as 
well. As the number of patients who rely on health centers continues to 
grow, we must provide the funds needed to open new centers in areas 
that are underserved and to provide additional funds to enable existing 
centers to meet the growing demand for care.
  The funding authorized in this bill will provide stability and 
expanded services in existing centers, and enable new centers to open 
in areas that have no centers today. The legislation will keep health 
centers on track to serve 20 million patients by 2010 and more than 23 
million patients by 2012. It also provides the funds needed to expand 
existing health centers to reach more uninsured and underinsured 
patients, open new centers in underserved areas with no current 
centers, expand coverage of mental health, dental, and pharmacy 
services to all centers, invest in information technology, and take 
other steps to improve health outcomes. Our goal in the bill is to make 
sure that health centers can provide high-quality care to their 
patients for years to come, and I look forward to its enactment into 
law.
  I ask unanimous request that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 901

       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 ``Health Centers Renewal Act 
     of 2007''.

     SEC. 2. FINDINGS.

       Congress finds as follows:
       (1) Community, migrant, public housing, and homeless health 
     centers are vital to thousands of communities across the 
     United States.
       (2) There are more than 1,000 such health centers serving 
     more than 16,000,000 people at more than 5,000 health 
     delivery sites, located in all 50 States of the United 
     States, the District of Columbia, and Puerto Rico, Guam, the 
     Virgin Islands, and other territories of the United States.
       (3) Health centers provide cost-effective, quality health 
     care to poor and medically underserved people in the States, 
     the District of Columbia, and the territories, including the 
     working poor, the uninsured, and many high-risk and 
     vulnerable populations, and have done so for over 40 years.
       (4) Health centers provide care to 1 of every 8 uninsured 
     Americans, 1 of every 4 Americans in poverty, and 1 of every 
     9 rural Americans.
       (5) Health centers provide primary and preventive care 
     services to more than 700,000 homeless persons and more than 
     725,000 farm workers in the United States.
       (6) Health centers are community-oriented and patient-
     focused and tailor their services to fit the special needs 
     and priorities of local communities, working together with 
     schools, businesses, churches, community organizations, 
     foundations, and State and local governments.
       (7) Health centers are built through community initiative.
       (8) Health centers encourage citizen participation and 
     provide jobs for 50,000 community residents.
       (9) Congress established the program as a unique public-
     private partnership, and has continued to provide direct 
     funding to community organizations for the development and 
     operation of health centers systems that address pressing 
     local health needs and meet national performance standards.
       (10) Federal grants assist participating communities in 
     finding partners and recruiting doctors and other health 
     professionals.
       (11) Federal grants constitute, on average, 24 percent of 
     the annual budget of such health centers, with the remainder 
     provided by State and local governments, Medicare, Medicaid, 
     private contributions, private insurance, and patient fees.
       (12) Health centers make health care responsive and cost-
     effective through aggressive outreach, patient education, 
     translation, and other enabling support services.
       (13) Health centers help reduce health disparities, meet 
     escalating health care needs, and provide a vital safety net 
     in the health care delivery system of the United States.
       (14) Health centers increase the use of preventive health 
     services, including immunizations, pap smears, mammograms, 
     and HBa1c tests for diabetes screenings.
       (15) Expert studies have demonstrated the impact that these 
     community-owned and patient-controlled primary care delivery 
     systems have achieved both in the reduction of traditional 
     access barriers and the elimination of health disparities 
     among their patients.

     SEC. 3. ADDITIONAL AUTHORIZATIONS OF APPROPRIATIONS FOR 
                   HEALTH CENTERS PROGRAM OF PUBLIC HEALTH SERVICE 
                   ACT.

       Section 330(r) of the Public Health Service Act (42 U.S.C. 
     254b(r)) is amended by amending paragraph (1) to read as 
     follows:
       ``(1) In general.--For the purpose of carrying out this 
     section, in addition to the amounts authorized to be 
     appropriated under subsection (d), there are authorized to be 
     appropriated--
       ``(A) $2,188,745,000 for fiscal year 2008;
       ``(B) $2,451,394,400 for fiscal year 2009;
       ``(C) $2,757,818,700 for fiscal year 2010;
       ``(D) $3,116,335,131 for fiscal year 2011; and
       ``(E) $3,537,040,374 for fiscal year 2012.''.

  Mr. HATCH. Mr. President, today I am introducing the Health Centers 
Renewal Act with my colleagues, Senators Kennedy, Roberts, Dodd, Bond, 
Harkin, Snowe, Mikulski, Domenici, Bingaman, Murkowski, Reed, Bennett, 
Clinton, Grassley, Obama, Burr and Brown.
  The Health Centers program, created over 40 years ago, has an 
outstanding record of providing quality health care services to many 
Americans who do not have adequate health insurance. This ranges from 
children to parents and grandparents, in virtually every comer of the 
United States. In fact, Health Centers are a necessary component of our 
nation's health care safety net--they supply health services to over 15 
million people in our country.
  Health Centers include community health centers, which are local, 
not-for-profit 50l(c)(3) corporations that give community-oriented 
health care and are governed by Boards of Directors that are made up of 
at least 51 percent health centers patients, to ensure that the 
patients and their communities are well represented.
  From my work in Utah, I know how important Health Centers are. They 
have made a tremendous difference for Utah's citizens with insufficient 
health coverage--Utah community health centers serve close to 85,000 
patients. Whenever I come home to Utah, I always hear wonderful things 
about the work of Community Health Centers.
  Since 2001, Congress has consistently increased funding for Community 
Health Centers to meet President Bush's goal of having 1,200 new or 
expanded centers. The new dollars have provided services to four 
million new patients and have added facilities in over 750 communities 
across the country. By reauthorizing this program, Health Centers will 
give low-cost health care to many more deserving individuals.
  S. 901 I will reauthorize the Health Centers program for 5 more 
years; it includes funding levels of: $2,188,745,000 in fiscal year 
2008; $2,451,394,400 in fiscal year 2009; $2,757,818,700 in fiscal year 
2010; $3,116,335,131 in fiscal year 2011; and $3,537,040,374 in fiscal 
year 2012. These numbers are based on the National Association of 
Community Health Centers; NACHC, growth plan--NACHC's goal is for 
Community Health Centers to serve 20 million patients a year by 2010 
and 30 million patients a year by 2015.
  I believe that Community Health Centers are worth every dime that our 
government invests in them.
  Utah Health Centers have made a tremendous difference in the lives of 
many Utahns--66 percent of patients come from Utah's urban areas and 27 
percent are from the rural parts of the state. Ninety-six percent of 
Utah Health Center patients' incomes are below 200 percent of the 
Federal Poverty Level. Utah Health Centers have literally changed these 
patients' lives, serving as a link to the health care safety net system 
for the medically underserved and uninsured. In rural areas, Health 
Centers are often the only health care provider.
  Community Health Centers have made a huge impact on people's lives. I 
am pleased and proud to support them by introducing this legislation 
today.

[[Page 6548]]

  I urge my colleagues to cosponsor this important bill, which not only 
provides people with essential health care services, but also ensures 
that the Health Centers will continue to have the funding necessary to 
provide these services.
                                 ______
                                 
      By Mr. HARKIN (for himself, Mr. Leahy, Mr. Kerry, Mr. Lautenberg, 
        Mr. Rockefeller, Ms. Landrieu, and Ms. Cantwell):
  S. 902. A bill to provide support and assistance for families of 
members of the National Guard and Reserve who are undergoing 
deployment, and for other purposes; to the Committee on Armed Services.
  Mr. HARKIN. Mr President, Americans are divided over the Iraq war, 
but we are 100 percent united in our determination to support the 
troops in the field and their families back home.
  But just as we have seen shortcomings in the treatment of wounded 
warriors at Walter Reed, it is clear to me that we are falling short in 
supporting the families of Guard and Reserve personnel who serve in 
Iraq and Afghanistan. These families are especially vulnerable because 
of their isolation, their distance from military bases, and their lack 
of access to the services that active-duty military families can draw 
upon.
  This is a new era for our National Guard and for the Reserves. They 
are shouldering a huge share of the combat burden in Iraq and 
Afghanistan, plus a stepped-up role in homeland security. More than 
four times as many Guard members have been killed in Iraq as during the 
entire Vietnam war.
  With many Guard and Reserve members on their third or even fourth 
deployment, and with some deployments being stretched out to 16 months, 
the stresses on their families are acute. Their children are at greater 
risk for depression, behavioral disorders, or academic problems. And 
long family separations often result in financial difficulties and 
troubled marriages.
  To address this quiet crisis, today I am introducing legislation 
titled the Coming Together for Guard and Reserve Families Act. This 
bill does several things.
  First, it expands and strengthens the existing family assistance 
program. We need to ensure that there is adequate professional staff to 
work with Guard and Reserve families and meet their special needs at 
every point of the deployment cycle--as they prepare for deployment, 
during the long absence, and during reunification and readjustment.
  I am especially concerned that there are few resources for the 
families of Guard and Reserve members who are wounded or experience 
mental illness. My bill expands the VA's Disabled Transition Assistance 
program to ensure that family members have access to family counseling 
and mental health services during this critical time.
  Children of deployed service members often react to parental 
separation with acting-out behaviors, anxiety, or depression. My bill 
calls for outreach to professionals who serve children--including 
school administrators and teachers--to alert them to the special needs 
of kids in military families, especially those with a parent deployed 
in a war zone.
  Forty-one percent of Guard members and Reservists report symptoms of 
mental illness--including post-traumatic stress disorder--within 6 
months of returning home from deployment. Currently, mental health 
information is distributed to service members when they return from 
deployment--and often that's it. But symptoms of PTSD may not appear 
for months after return. My bill will ensure that families receive 
mental health information 6 months post-deployment.
  Finally, my bill creates a family-to-family mentoring program to 
enable military spouses to serve as peer counselors to other spouses 
and family members. It can be extremely valuable for a military spouse 
to consult with someone who has gone through a similar experience.
  The role of our Guard and Reserve members in defending our national 
security abroad has significantly increased. In turn, we have an 
expanded obligation to care for their spouses and children, who are 
facing tremendous stresses, often alone and with no one to turn to.
  The aim of my bill is to address the unmet needs of Guard and Reserve 
families before this becomes the kind of full-fledged crisis we 
witnessed at Walter Reed. I urge my colleagues to support this urgent 
and important legislation.
                                 ______
                                 
      By Mr. DURBIN (for himself, Mr. Bennett, Mrs. Clinton, Mr. Kerry, 
        and Mr. Harkin):
  S. 903. A bill to award a Congressional Gold Medal to Dr. Muhammad 
Yunus, in recognition of his contributions to the fight against global 
poverty; to the Committee on Banking, Housing, and Urban Affairs.
  Mr. DURBIN. Mr. President, I rise today to honor Dr. Muhammad Yunus 
for his contributions to the fight against global poverty.
  Today, joined by my colleague Senator Bennett of Utah as well as 
Senators Clinton, Kerry and Harkin, I introduced the Muhammad Yunus 
Congressional Gold Medal Act.
  This bipartisan bill would award Dr. Yunus a Congressional Gold Medal 
in recognition of his efforts to fight poverty and promote economic and 
social opportunity.
  Along with the Grameen Bank, which he founded, Dr. Yunus was awarded 
the Nobel Peace Prize in 2006 for developing the concept of 
microcredit. Through the Grameen system, Dr. Yunus created an 
economically sound model of extending very small loans, at competitive 
interest rates, to the very poor. Through this system, he has been 
transforming lives, one loan at a time.
  He began in 1976 with a loan of just $27, out of his own pocket, to 
42 village craftspeople in Bangladesh. Over the past 30 years, his 
model has been emulated around the world.
  I met Dr. Yunus on my first trip to Bangladesh, and there I saw 
firsthand the economic miracle that microcredit can help create.
  Nearly half the world's population lives on less than $2 a day. We 
can not hope to achieve lasting global peace and stability until we 
find a means by which the world's poorest can begin to lift themselves 
out of poverty.
  The microcredit movement that Dr. Yunus pioneered has made enormous 
strides towards that goal. Over 125 million households have already 
been transformed by microcredit loans, and more are joining them every 
day.
  Dr. Yunus' work has had a particularly strong impact on improving the 
economic prospects of women. Women disproportionately shoulder the 
burden of poverty. They also make up over 95 percent of microcredit 
borrowers.
  I have long believed that if you want to predict the economic 
prospects of a country, ask how it treats its women. If a country sends 
its daughters to school, if its wives and mothers have economic and 
political rights and opportunities, then it is likely to prosper. But 
if it treats its women as second-class citizens, its chances for 
development diminish dramatically. Microcredit opens doors for women 
and in so doing it creates new opportunities for their sons and 
daughters alike.
  Muhammad Yunus's work has also affected the lives of millions of 
Americans. Although Dr. Yunus launched his movement in 1976 in 
Bangladesh--a long time ago and a long way away--it has come home to us 
here in America and is still relevant today.
  There are now an estimated 21 million microentrepreneurs in the U.S., 
accounting for approximately 16 percent of private employment in the 
country. Over $318 million worth of microloans have been made to 
American entrepreneurs in the past 15 years.
  Culminating with his Nobel Peace Prize, Dr. Yunus has been recognized 
around the world as a leading figure in the effort to fight poverty and 
promote economic and social opportunity.
  It is time that we properly recognize him here in Congress with our 
most distinguished honor.
  Dr. Yunus would join a long and illustrious line of Congressional 
Gold Medal recipients that stretches back to 1776, when the award was 
created. Although most of the recipients have been American, many have 
not: Prime Minister Tony Blair, Pope John Paul II, and His Holiness, 
the Fourteenth

[[Page 6549]]

Dalai Lama, are just a few. We hope that Dr. Yunus will join them.
  I want to thank Senator Bennett and my other colleagues for joining 
me today in honoring Dr. Yunus. Dr. Muhammad Yunus is a great man who 
deserves our admiration and our thanks.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 903

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

     SECTION 1. FINDINGS.

       Congress finds that--
       (1) Dr. Muhammad Yunus is recognized in the United States 
     and throughout the world as a leading figure in the fight 
     against poverty and the effort to promote economic and social 
     change;
       (2) Muhammad Yunus is the recognized developer of the 
     concept of microcredit, and Grameen Bank, which he founded, 
     has created a model of lending that has been emulated across 
     the globe;
       (3) Muhammad Yunus launched this global movement to create 
     economic and social development from below, beginning in 
     1976, with a loan of $27 from his own pocket to 42 crafts 
     persons in a small village in Bangladesh;
       (4) Muhammad Yunus has demonstrated the life-changing 
     potential of extending very small loans (at competitive 
     interest rates) to the very poor and the economic feasibility 
     of microcredit and other microfinance and microenterprise 
     practices and services;
       (5) Dr. Yunus's work has had a particularly strong impact 
     on improving the economic prospects of women, and on their 
     families, as over 95 percent of microcredit borrowers are 
     women;
       (6) Dr. Yunus has pioneered a movement with the potential 
     to assist a significant number of the more than 1,000,000,000 
     people, mostly women and children, who live on less than $1 a 
     day, and the nearly 3,000,000,000 people who live on less 
     than $2 a day, and which has already reached 125,000,000 
     households, by one estimate;
       (7) there are now an estimated 21,000,000 
     microentrepreneurs in the United States (accounting for 
     approximately 16 percent of private (nonfarm) employment in 
     the United States), and the Small Business Administration has 
     made over $318,000,000 in microloans to entrepreneurs since 
     1992;
       (8) Dr. Yunus, along with the Grameen Bank, was awarded the 
     Nobel Peace Prize in 2006 for his efforts to promote economic 
     and social opportunity and out of recognition that lasting 
     peace cannot be achieved unless large population groups find 
     the means, such as microcredit, to break out of poverty; and
       (9) the microcredit ideas developed and put into practice 
     by Muhammad Yunus, along with other bold initiatives, can 
     make a historical breakthrough in the fight against poverty.

     SEC. 2. CONGRESSIONAL GOLD MEDAL.

       (a) Presentation Authorized.--The Speaker of the House of 
     Representatives and the President pro tempore of the Senate 
     shall make appropriate arrangements for the presentation, on 
     behalf of Congress, of a gold medal of appropriate design, to 
     Dr. Muhammad Yunus, in recognition of his many enduring 
     contributions to the fight against global poverty.
       (b) Design and Striking.--For purposes of the presentation 
     referred to in subsection (a), the Secretary of the Treasury 
     (referred to in this Act as the ``Secretary'') shall strike a 
     gold medal with suitable emblems, devices, and inscriptions, 
     to be determined by the Secretary.

     SEC. 3. DUPLICATE MEDALS.

       The Secretary may strike and sell duplicates in bronze of 
     the gold medal struck pursuant to section 3, under such 
     regulations as the Secretary may prescribe, at a price 
     sufficient to cover the cost thereof, including labor, 
     materials, dies, use of machinery, and overhead expenses, and 
     the cost of the gold medal.

     SEC. 4. STATUS OF MEDALS.

       (a) National Medals.--The medals struck pursuant to this 
     Act are national medals for purposes of chapter 51 of title 
     31, United States Code.
       (b) Numismatic Items.--For purposes of sections 5134 and 
     5136 of title 31, United States Code, all medals struck under 
     this Act shall be considered to be numismatic items.

     SEC. 5. AUTHORITY TO USE FUND AMOUNTS; PROCEEDS OF SALE.

       (a) Authority To Use Fund Amounts.--There are authorized to 
     be charged against the United States Mint Public Enterprise 
     Fund, such amounts as may be necessary to pay for the costs 
     of the medals struck pursuant to this Act.
       (b) Proceeds of Sale.--Amounts received from the sale of 
     duplicate bronze medals authorized under section 4 shall be 
     deposited into the United States Mint Public Enterprise Fund.

  Mr. KERRY. Mr. President, I rise today to recognize Dr. Muhammad 
Yunus. For those who don't already know, Dr. Yunus is a modest man of 
great ideas, now revered around the world, as the father of microcredit 
and the founder of the Grameen Bank. His concept of microcredit has 
helped thousands of people work their way out of poverty. For his work 
to beat global poverty, I am very proud to join my colleagues, Senators 
Durbin and Bennett, in introducing a bill to honor Dr. Yunus with a 
Congressional Gold Medal.
  When I look at the success of Dr. Yunus's idea and the 
microenterprise programs it has inspired over the past 30 years, one 
thing that amazes me the most is that it all began with a loan of 27 
U.S. dollars. The beauty of microcredit is that such a small amount of 
money can have such tremendous and lasting effects to foster 
entrepreneurship among those who would not qualify for typical bank 
loans. By offering loans at competitive interest rates, or no interest, 
Dr. Yunus's Grameen Bank has been able to give individuals suffering 
from poverty the power to determine their own futures.
  Last year, Dr. Yunus and his Grameen Bank were honored with a Nobel 
Peace Prize for his economic imagination. Dr. Yunus's innovation and 
entrepreneurship are certainly commendable and worthy of such an honor, 
as well as the distinction of a Congressional Gold Medal. In accepting 
his Nobel Peace Prize, Dr. Yunus challenged the world to think of an 
entrepreneur as not only being motivated by profit, but also by ``doing 
good to people and the world.''
  The effectiveness of microcredit programs is evident by the success 
stories they have inspired all around the world. As chairman of the 
Small Business and Entrepreneurship Committee, I have seen first hand 
the power of microcredit in this country, through the SBA's--Small 
Business Administration's--microloan programs. In my home State of 
Massachusetts, Thondup and Dolma Tsering, two Tibetan refugees in the 
United States, were able to start their own restaurant in 2005, with 
assistance from the Massachusetts Small Business Development Center and 
financing from the Western Massachusetts Enterprise Fund. Through 
financing and support, otherwise not available to them from the banking 
community, they are now the successful owners of Lhasa Cafe in 
Northampton. As small business owners, the Tserings are socially 
responsible and support local farmers and their community.
  From Dr. Yunus's first microloans to 42 entrepreneurs in Bangladesh 
in 1976, the concept of microcredit has come a long way. Here in the 
United States, where SBA has had a similar program since 1992, more 
than $328 million in microloans have been made to deserving 
entrepreneurs.
  I have long been a supporter of funding microloan programs, which 
offer current and potential small business owners the opportunity to 
achieve financial independence, financial security, and dignity through 
work. Sometimes they use it to work their way out of poverty, but 
sometimes they use it to patch together income when they need more 
money, lose a job, want to buy a house or car, or maybe pay for college 
or send a child to college. These entrepreneurs create jobs, provide 
services and products to our communities, and generate tax revenue to 
benefit the economy. Funding microloan programs not only makes economic 
sense; it makes social sense as well.
  In spite of growing support for microloan programs, and in spite of 
the return on investment to our economy, microenterprise does not get 
the support in this country that it does in other countries. In 2005, 
the administration provided approximately $211 million for the 
development of foreign microenterprise programs through the Agency for 
International Development, USAID. In fiscal year 2006, we are told that 
the administration provided more than $54 million for microloans in 
Iraq:

        The efforts of the U.S. government in its assistance to 
     Iraq have been broad based . . . For example, over $54 
     million in micro-loans have been disbursed, resulting in 
     26,700 loans in twelve cities, and the program is set to 
     expand to even more areas. Also, a Loan Guarantee Corporation 
     is currently being established to encourage private banks to 
     make

[[Page 6550]]

     loans to small businesses.--Ambassador Zalmay Khalilzad, U.S. 
     Ambassador to Iraq, May 9, 2006.

  And for fiscal year 2007, we are told that the administration is 
requesting supplemental funding for Iraq that includes at least $160 
million for microloans.

       We will help local leaders improve their capacity to govern 
     and deliver public services. Our economic efforts will be 
     more targeted on specific local needs with proven records of 
     success, like micro-credit programs. And we will engage with 
     leading private sector enterprises and other local 
     businesses, including the more promising state-owned firms, 
     to break the obstacles to growth.--Secretary of State 
     Condoleezza Rice, Foreign Relations Committee hearing on the 
     administration's plan for Iraq, January 11, 2007.

  At the same time, the President has proposed for fiscal years 2005, 
2006, 2007, and 2008 eliminating all funding for the SBA's microloan 
programs.
  Today I not only honor and recognize the genius of Dr. Yunus, but 
also call attention to President Bush's lack of support for U.S. 
microloans and call on the administration to reverse its policy. If we 
can support microloans in Baghdad, we should support microloans in 
Boston, and every other city that's home to a would-be entrepreneur.
  I am honored to add my name in support of Dr. Muhammad Yunus, and I 
am gratified to see the support he has received among my colleagues. 
But I also implore my colleagues to pay tribute to American 
entrepreneurs and to fund the SBA's microloan program. We must honor 
Dr. Yunus's ingenuity with more than words; we must honor him with our 
actions.
                                 ______
                                 
      By Ms. SNOWE (for herself, Mr. Pryor, and Mr. Craig):
  S. 904. A bill to provide additional relief for small business owners 
ordered to active duty as members of reserve components of the Armed 
Forces, and for other purposes; to the Committee on Small Business and 
Entrepreneurship.
  Ms. SNOWE. Mr. President, I rise today to introduce the Veterans 
Small Business Opportunity Act of 2007. Senators Pryor, Craig, and I 
are introducing this legislation to assist veterans and small 
businesses that employ Guard and reservists. Our bill improves the 
Small Business Administration's, SBA's, Military Reservist Economic 
Injury Disaster Loan, MREIDL, program. Additionally, this bill 
increases procurement opportunities, capital access, and other types of 
business development assistance for veterans and service-disabled 
veterans.
  We all know today's small business men and women play a vital role in 
the economic stability and prosperity of our Nation. Quite often, these 
same entrepreneurs are the veterans who have protected our Nation in 
years past, or who serve in the Armed Forces today. When our Nation's 
patriotic men and women are called to duty, they often leave behind 
thriving small businesses, and as a result, many of these businesses 
experience production slowdowns and lost sales, or incur additional 
expenses to compensate for an employee's absence.
  In recent years, the Department of Defense has placed a greater 
reliance on our country's Guard and Reserve Forces. In fact, since 
September 2001, nearly 600,000 Guard and Reserve members have been 
called up in support of current operations, comprising nearly one-third 
of deployed service members in Iraq and Afghanistan. Furthermore, Guard 
and Reserve members were charged with assisting recovery efforts in the 
gulf coast region in the aftermath of Hurricanes Katrina and Rita.
  In my 4 years as chair of the Senate Committee on Small Business and 
Entrepreneurship, and now as ranking member, I have fought to support 
our patriotic small businesses affected by the Guard and Reserve call-
ups. My home State of Maine has one of the highest Guard and Reserve 
deployment levels in the country--over 50 percent have been deployed to 
Iraq and Afghanistan. In response to this I commissioned a 
Congressional Budget Office, CBO, study which found that 35 percent of 
Guard and reservists work for small busineses or are self-employed. In 
addition, the small businesses that employ them may be ``paying'' a 
disproportionate and unfair share of the burden of increased Guard and 
Reserve member call-ups. The burden is further magnified when it is the 
small business owner or a key employee who is deployed.
  Our legislation will raise the maximum MREIDL amount from $1,500,000 
to $2,000,000. A maximum military reservist loan amount of $2,000,000 
is the same level as many of the SBA's other loan programs, including: 
7(a) loans, international trade loans, and 504 Certified Development 
Corporation loans that serve a public policy goal.
  Currently, some of the SBA's contracting and business development 
programs have defined time limits for participation. If the firm's time 
for participation expires prematurely, then competitive opportunities, 
investments, and jobs become lost. Today, small business owners who get 
called-up to active duty in the National Guard or Reserve are 
effectively penalized because their active duty time is counted against 
the time limitation participation in the SBA's programs. The Veterans 
Small Business Opportunity Act amends the Small Business Act by 
allowing small businesses owned by veterans and service-disabled 
veterans to extend their SBA program participation time limitations by 
the duration of their owners' active duty service after September 11, 
2001.
  Additionally, this bill will allow the SBA Administrator, either 
directly or through banks, to offer loans up to $25,000 without 
requiring collateral from a loan applicant. Currently, the SBA offers 
military reservist loans up to $5,000 without collateral. This 
provision would increase that level to eligible small businesses.
  The bill will also require the Administrator to give military 
reservist loan applications priority for processing and ensure that 
Guard and Reserve members are adequately assisted with their loan 
application by incorporating the support and expertise of SBA 
entrepreneurial development partners, such as Small Business 
Development Centers and Veterans Business Outreach Centers.
  This legislation increases the authorization of appropriations for 
the SBA's Office of Veteran Business Development to $2 million for 
fiscal year 2008, $2.1 million for fiscal year 2009 and $2.2 million 
for fiscal year 2010. Increased funding for SBA's Office of Veterans 
Business Development help them better assist our Nation's veterans and 
provide the business services they need.
  This legislation will also strengthen the access of veterans and 
service-disabled veterans to Federal contracts and subcontracts. Under 
the Small Business Act and the President's Executive Order 13360, 
Providing Opportunities for Service-Disabled Veteran Businesses To 
Increase Their Federal Contracting and Subcontracting, Federal agencies 
must award at least 3 percent of prime contracts and subcontracts to 
small businesses owned by service-disabled veterans. The order states 
that, to achieve these goals, Federal agencies ``shall more 
effectively'' use the authorities in the Small Business Act to reserve 
and award contracts to service-disabled veterans. During the Senate 
Small Business and Entrepreneurship Committee hearing held in January, 
it became very clear that Federal agencies have been short-changing 
service-disabled veteran-owned small businesses to the tune of over 
$7.5 billion a year in government contracts during fiscal year 2003 
through fiscal year 2005. To remedy this unacceptable situation, our 
legislation puts the force of a congressional statute behind the 
requirements of the President's Executive order.
  In addition, our legislation ensures that veterans and service-
disabled veterans do not face confusing and duplicative red tape before 
they can be eligible to access the Federal procurement market. 
Currently, the Department of Veterans Affairs and the SBA both operate 
registration databases for small businesses owned by veterans and 
service-disabled veterans. A veteran must often register in both 
databases to be properly considered for bidding. Surely, in this 
information age, we can have a better process. Registration data can 
easily be made to migrate from one

[[Page 6551]]

database to the other. Our legislation requires that a single 
registration point for both of these databases be established within a 
year. Such one-stop registration must be reliable and compliant with 
statutory provisions concerning veteran and service-disabled veteran 
status certifications for small businesses.
  To increase the capacity of service-disabled veteran-owned firms, my 
legislation permits the SBA, in cooperation with the Department of 
Veterans Affairs, to develop a business development assistance program, 
including mentor-Protege assistance, to be administered by the SBA. Our 
legislation contains a strict fairness requirement that any such 
program must be developed in such a way as to ensure success of other 
small business contracting programs. Within a year, the SBA is required 
to submit a report to Congress on its proposals for this program. In 
2004, I succeeded in amending the Department of Defense Mentor-Protege 
Program statute by expanding it to service-disabled veterans. Since 
then, over $204 million in contracts and subcontracts have been awarded 
to service-disabled veteran-owned small businesses as a result of the 
$17 million in mentor-Protege assistance. This represents a stunning 
$12 return for every $1 in assistance investment. I believe the success 
of this initiative should be replicated. The SBA is already 
administering a Mentor-Protege Program as part of the 8(a) business 
development program for small disadvantaged businesses, and both the 
SBA and the DOD programs would provide useful examples for helping our 
disabled veterans succeed.
  Finally, our legislation creates an interagency task force among 
Federal agencies charged with improving procurement opportunities for 
service-disabled veterans. The scope of this task force will, in 
addition to procurement, include franchising, capital access, and other 
types of business development assistance. In examining the 
implementation of Executive Order 13360 and other veterans business 
development initiatives, our committee found that the responsible 
agencies were not talking to each other on a regular basis, and that no 
overall ``game plan'' was in place to coordinate various Federal 
efforts.
  I would like to thank Senators Pryor and Craig for working with me on 
this critical issue and I urge my colleagues to support this bill.
  Mr. CRAIG. Mr. President, I rise to comment on a bill that is being 
introduced by Senator Snowe today, the Veterans Small Business 
Opportunity Act of 2007. I am proud to join with Senator Snowe and 
Senator Pryor as an original cosponsor of this important bill.
  This legislation will benefit patriot ``citizen-soldiers'' who are 
called from their employment at America's small businesses to serve our 
country in uniform. In States across the Nation, small businesses are 
being affected by the mobilization of our Guard and Reserve personnel. 
In my home State, the Idaho National Guard's 116th Brigade Combat Team 
returned in 2005 from an 18-month deployment to Iraq. I visited members 
of the 116th while they were in Iraq and discovered that a good number 
had left jobs at small businesses across Idaho. I also held a hearing 
in Idaho during the 109th Congress to examine the reemployment rights 
of returning Guard and Reserve members.
  At that hearing, it was emphasized that, although legal rights to 
reemployment are critical, they do little for those who have no 
employer, or no small business, to return to. To me, it was clear that 
we should do more to help small businesses in coping with the financial 
hardships of frequent and lengthy mobilizations of its employees or 
owners during the war on terrorism. I believe we can provide some of 
that needed assistance with this legislation, which includes key 
provisions from The Patriot Loan Act of 2006, a bill that Senator Snowe 
and I introduced last year.
  This bill would enhance the U.S. Small Business Administration's 
Military Reservist Economic Injury Disaster Loan, or MREIDL, Program. 
That program provides loan assistance to small businesses to help them 
meet ordinary and necessary operating expenses after essential 
employees are called to active duty in their roles as citizen-soldiers.
  This bill would raise the maximum military reservist loan amount from 
$1.5 million to $2 million. It would also allow the Small Business 
Administration, by direct loan or through banks, to offer unsecured 
loans of up to $25,000, an increase from the current $5,000 limit. In 
addition, this bill would ensure proactive outreach to Guard and 
Reserve members about the MREIDL Program and other small business 
programs by requiring SBA and the Department of Defense to develop a 
joint Web site and printed materials with information about those 
programs.
  For the brave men and women who serve our Nation in the Guard and 
Reserve, we must do what we can to ensure that their sacrifices do not 
place them in financial harm's way when they return home. I urge my 
colleagues to support these measures, and I thank Senator Snowe for her 
leadership in introducing this bill.
                                 ______
                                 
      By Mr. INHOFE:
  S. 905. A bill to amend the Internal Revenue Code of 1986 to 
eliminate the taxable income limit on percentage depletion for oil and 
natural gas produced from marginal properties; to the Committee on 
Finance.
  Mr. INHOFE. Mr. President, the independent producers of oil and gas 
are the backbone of our domestic supply of energy. They have played and 
continue to play a critical role in meeting our domestic needs, 
especially as the big oil companies' focus mainly offshore. In fact, 
independents develop 90 percent of our Nation's wells. According to the 
Department of Energy, independent producers supply 68 percent of 
American oil production and 82 percent of overall American natural gas.
  Therefore, I rise today to introduce legislation that eliminates the 
taxable income limit on percentage depletion for oil and natural gas 
produced from marginal wells; wells producing 15 barrels of day and 
less than 90 thousand cubic feet of natural gas.
  Under current law, the percentage depletion method is limited to only 
independent producers and royalty owners. It is a form of cost recovery 
for capital initially invested toward production of oil and gas wells. 
Generally, the percentage depletion rate is 15 percent of the 
taxpayer's gross income from an oil and gas producing property and is 
limited to a daily average of 1,000 barrels of oil or 6,000 thousand 
cubic feet of natural gas. However, under the net income limitation, 
percentage depletion is limited to 100 percent of the net income from 
an individual property. In the case of marginal wells, where total 
deductions often do exceed this net-income, this limitation discourages 
producers from investing in the continued production from marginal 
wells.
  As a result Congress has suspended the net-income limitation for 1998 
through 2005; and again for 2006 and 2007, with the passage of the Tax 
Relief and Health Care Act of 2006, H.R. 6111.
  My bill would simply clarify the policy by doing away with the 
taxable net income limitation altogether.
  In my own State of Oklahoma, it is the small independents, basically 
mom-and-pop operations, producing the majority of oil and natural gas, 
with 85 percent of Oklahoma's oil coming from marginal wells.
  Because marginal wells supply such a significant amount of our oil 
and gas, it is vital we keep them in operation. According to the Energy 
Department, between 1994 and 2003, we lost 110 million barrels of crude 
oil due to plugged marginal wells. Thus, when we lose marginal wells, 
we become more dependent upon foreign sources of energy, at a time when 
virtually all agree that U.S. policies should encourage reliance upon 
domestic sources. Furthermore, we lose domestic jobs to foreign 
nations.
  My bill would allow independents the necessary capital to continue to 
produce from these existing marginal wells--which is critical to the 
Nation's overall energy security. I ask unanimous consent that the text 
of the bill be printed in the Record.

[[Page 6552]]

  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 905

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

     SECTION 1. ELIMINATION OF TAXABLE INCOME LIMIT ON PERCENTAGE 
                   DEPLETION FOR OIL AND NATURAL GAS PRODUCED FROM 
                   MARGINAL PROPERTIES.

       (a) In General.--Subparagraph (H) of section 613A(c)(6) of 
     the Internal Revenue Code of 1986 (relating to oil and 
     natural gas produced from marginal properties) is amended to 
     read as follows:
       ``(H) Nonapplication of taxable income limit with respect 
     to marginal production.--The second sentence of subsection 
     (a) of section 613 shall not apply to so much of the 
     allowance for depletion as is determined under subparagraph 
     (A).''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after December 31, 
     2006.
                                 ______
                                 
      By Mr. OBAMA (for himself and Ms. Murkowski):
  S. 906. A bill to prohibit the sale, distribution, transfer, and 
export of elemental mercury, and for other purposes; to the Committee 
on Environment and Public Works.
  Mr. OBAMA. Mr. President, I am pleased to be joined today by my 
esteemed colleague from Alaska, Ms. Murkowski, in introducing the 
Mercury Market Minimization Act of 2007.
  As most of us in this Chamber know, elemental mercury is a poisonous 
neurotoxin that can cause serious disability or death if ingested. 
Unfortunately, many people in the United States, and many millions more 
worldwide, do indeed ingest mercury--unintentionally, however, as a 
result of industrial emissions or practices, or poor waste management 
and storage techniques. When mercury enters into the environment, it 
often shows up in plants and animals, and that means a major source of 
mercury ingestion for humans comes as a result of eating certain types 
of fish. That, in turn, causes serious developmental problems in half a 
million children in our country, and similar health problems in adults, 
especially women at childbearing age.
  Last year, an investigative report published in the Chicago Tribune 
outlined the extent of mercury contamination in fish. After concluding 
that the fish sampling efforts conducted by the Federal Government were 
limited and outdated, the Tribune conducted its own sampling, and the 
results showed surprisingly high levels of mercury concentrations in 
freshwater and saltwater fish purchased by consumers in the Chicago 
region--higher levels than had been documented by the Federal 
Government. Mercury was found in both freshwater and saltwater 
species--tuna, swordfish, orange roughy, and walleye, to name a few 
examples. The Tribune also reported on how existing programs at the 
Food and Drug Administration and the Environmental Protection Agency 
have failed to adequately test and evaluate mercury levels in fish.
  For those of us who like fish, it causes us to pause when we first 
learn of the range of species with high mercury levels. For pregnant 
women and other at-risk groups, however, this doesn't just cause pause, 
it creates serious concerns about health consequences. Meanwhile, 
experts tell us that fish is an excellent source of critical nutrients 
and other compounds indispensable for good health. More of us should 
eat more fish.
  So the real long-term solution is not to eat less fish, or to 
criticize those who commercially provide us with fish as food. It's not 
about issuing advisories, or printing labels on tuna cans, or posting 
placards at the supermarket, or creating inspection bureaucracies, or 
collecting statistics. If we're serious about eliminating mercury from 
fish, we need to reduce mercury in the environment.
  Half of mercury settles where it is emitted, and the other half gets 
transported around the globe where we lose track of it, and it winds up 
in oceans, lakes, and rivers nowhere near mercury sources. From there, 
up it goes, through the food chain. If mercury is both local, and 
global, then the solution is not up to one state, or one nation, but up 
to all states and nations. The bill we introduce today was crafted 
based on that premise.
  The Mercury Market Minimization Act, or M3 Act, establishes a ban on 
U.S. exports of mercury by the year 2010. Such a ban, when coupled with 
goal of the European Union to ban mercury exports by 2011, and the 
insufficient capacity in the world's mercury mines to respond, will 
result in a tightening of the global supply of commercially available 
elemental mercury in sufficient quantities that developing nations that 
still use mercury will be compelled to switch to the affordable 
alternatives that are already widespread in industrialized nations.
  The M3 Act also requires those Federal agencies that now hold mercury 
in stockpiles to keep that mercury. Right now, the Department of 
Energy, and the Department of Defense, possess tons of mercury left 
over from various operations over the years. While it is the policy of 
these agencies to keep this mercury--not to sell it, not to transfer 
it, not to release it from their possession--it is not the law. The M3 
act codifies these policies. In December of 2006, it was widely 
understood that the Department of Energy was considering the sale of 
its mercury stockpiles. After various inquiries into the matter, the 
Department of Energy ultimately announced that it would not sell its 
stockpiles. That underscores why a prohibition of stockpile sales must 
be enacted into law by the M3 act if we are to be assured that mercury 
remains safely stored, away from the environment, and not sold overseas 
to places where tracking and emissions and waste disposal laws may be 
inadequate.
  Finally, the M3 Act calls for the creation of a committee to explore 
and make recommendations on the issues associated with the development 
of a permanent repository of mercury collected as a result of an export 
prohibition. Mercury is not like spent nuclear fuel, or other 
substances that may create community concerns, in that when mercury is 
stored in stainless steel containers in refrigeration, it remains 
benign. Every community must be provided the opportunity to evaluate 
for themselves if and when mercury is stored nearby in secure and 
stable storage. I do believe, however, that when mercury is safely and 
permanently stored, it means less microscopic mercury on one's dinner 
plate, less mercury in our kids' tuna fish sandwiches, and less mercury 
in the air we breathe.
  Last month, a United States delegation, led by the State Department, 
participated in an international meeting in Kenya, sponsored by the 
United Nations Environmental Programme, where world representative 
discussed how to reduce mercury pollution. Two years ago, the U.S. 
Government could have taken a bolder stance, and did not. This time, 
with the decision of the E.U. to ban mercury exports, the United States 
had an opportunity to partner with its allies to eliminate a major part 
of worldwide elemental mercury contamination. Again, the State 
Department did not.
  It is not often that policy options, such as this, might be 
considered ``low-hanging fruit''--in that a small act of international 
leadership by the United States government could have far reaching 
benefits for the health of our kids, as well as millions of low-income 
hardworking artisanal gold miners whom we will never meet. But the 
United States, so far, has not acted. This bill, the M3 bill, is 
designed to change that course and the mark the beginning of the end of 
a global market of an outdated and obsolete poison. I hope my 
colleagues will support this bill, and I ask unanimous consent that the 
text of this legislation be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 906

       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 ``Mercury Market Minimization 
     Act of 2007''.

     SEC. 2. FINDINGS.

       Congress finds that--
       (1) mercury and mercury compounds are highly toxic to 
     humans, ecosystems, and wildlife;

[[Page 6553]]

       (2) as many as 10 percent of women in the United States of 
     childbearing age have mercury in the blood at a level that 
     could put a baby at risk;
       (3) as many as 630,000 children born annually in the United 
     States are at risk of neurological problems related to 
     mercury;
       (4) the most significant source of mercury exposure to 
     people in the United States is ingestion of mercury-
     contaminated fish;
       (5) the Environmental Protection Agency reports that, as of 
     2004--
       (A) 44 States have fish advisories covering over 13,000,000 
     lake acres and over 750,000 river miles;
       (B) in 21 States the freshwater advisories are statewide; 
     and
       (C) in 12 States the coastal advisories are statewide;
       (6) the long-term solution to mercury pollution is to 
     minimize global mercury use and releases to eventually 
     achieve reduced contamination levels in the environment, 
     rather than reducing fish consumption since uncontaminated 
     fish represents a critical and healthy source of nutrition 
     worldwide;
       (7) mercury pollution is a transboundary pollutant, 
     depositing locally, regionally, and globally, and affecting 
     water bodies near industrial sources (including the Great 
     Lakes) and remote areas (including the Arctic Circle);
       (8) the free trade of mercury and mercury compounds on the 
     world market, at relatively low prices and in ready supply, 
     encourages the continued use of mercury outside of the United 
     States, often involving highly dispersive activities such as 
     artisinal gold mining;
       (9) the intentional use of mercury is declining in the 
     United States as a consequence of process changes to 
     manufactured products (including batteries, paints, switches, 
     and measuring devices), but those uses remain substantial in 
     the developing world where releases from the products are 
     extremely likely due to the limited pollution control and 
     waste management infrastructures in those countries;
       (10) the member countries of the European Union 
     collectively are the largest source of mercury exports 
     globally;
       (11) the European Union is in the process of enacting 
     legislation that will prohibit mercury exports by not later 
     than 2011;
       (12) the United States is a net exporter of mercury and, 
     according to the United States Geologic Survey, exported 506 
     metric tons of mercury more than the United States imported 
     during the period of 2000 through 2004; and
       (13) banning exports of mercury from the United States will 
     have a notable affect on the market availability of mercury 
     and switching to affordable mercury alternatives in the 
     developing world.

     SEC. 3. PROHIBITION ON SALE, DISTRIBUTION, OR TRANSFER OF 
                   MERCURY BY DEPARTMENT OF DEFENSE OR DEPARTMENT 
                   OF ENERGY.

       Section 6 of the Toxic Substances Control Act (15 U.S.C. 
     2605) is amended by adding at the end the following:
       ``(f) Mercury.--
       ``(1) Prohibition on sale, distribution, or transfer of 
     mercury by federal agencies.--Except as provided in paragraph 
     (2), effective beginning on the date of enactment of this 
     subsection, no Federal agency shall convey, sell, or 
     distribute to any other Federal agency, any State or local 
     government agency, or any private individual or entity any 
     elemental mercury under the control or jurisdiction of the 
     Federal agency.
       ``(2) Exception.--Paragraph (1) shall not apply to a 
     transfer between Federal agencies of elemental mercury for 
     the sole purpose of facilitating storage of mercury to carry 
     out this Act.''.

     SEC. 4. PROHIBITION ON EXPORT OF MERCURY.

       Section 12 of the Toxic Substances Control Act (15 U.S.C. 
     2611) is amended--
       (1) in subsection (a) by striking ``subsection (b)'' and 
     inserting ``subsections (b) and (c)''; and
       (2) by adding at the end the following:
       ``(c) Prohibition on Export of Mercury.--
       ``(1) Elemental mercury.--Effective January 1, 2010, the 
     export of elemental mercury from the United States is 
     prohibited.
       ``(2) Report to congress on mercury compounds.--
       ``(A) Report.--
       ``(i) In general.--Not later than 1 year after the date of 
     enactment of the Mercury Market Minimization Act of 2007, the 
     Administrator shall publish and submit to Congress a report 
     on mercuric chloride, mercurous chloride or calomel, mercuric 
     oxide, and other mercury compounds, if any, that may 
     currently be used in significant quantities in products or 
     processes.
       ``(ii) Inclusions.--The report shall include an analysis 
     of--

       ``(I) the sources and amounts of each mercury compound 
     produced annually in, or imported into, the United States;
       ``(II)(aa) the purposes for which each of the compounds are 
     used domestically;
       ``(bb) the quantity of the compounds currently consumed 
     annually for each purpose; and
       ``(cc) the estimated quantity of the compounds to be 
     consumed for each purpose during calendar year 2010 and 
     thereafter;
       ``(III) the sources and quantities of each mercury compound 
     exported from the United States during each of the preceding 
     3 calendar years;
       ``(IV) the potential for the compounds to be processed into 
     elemental mercury after export from the United States; and
       ``(V) other information that Congress should consider in 
     determining whether to extend the export prohibition to 
     include 1 or more of those mercury compounds.

       ``(B) Procedure.--
       ``(i) In general.--Except as provided in clause (ii), for 
     the purpose of preparing the report under this paragraph, the 
     Administrator may use the information gathering authorities 
     of this title, including sections 10 and 11.
       ``(ii) Exception.--Subsection (b)(2) of section 11 shall 
     not apply to activities under this subparagraph.
       ``(3) Excess mercury storage advisory committee.--
       ``(A) Establishment.--There is established an advisory 
     committee, to be known as the `Excess Mercury Storage 
     Advisory Committee' (referred to in this paragraph as the 
     `Committee').
       ``(B) Membership.--
       ``(i) In general.--The Committee shall be composed of 9 
     members, of whom--

       ``(I) 2 members shall be jointly appointed by the Speaker 
     of the House of Representatives and the Majority Leader of 
     the Senate--

       ``(aa) 1 of whom shall be designated to serve as 
     Chairperson of the Committee; and
       ``(bb) 1 of whom shall be designated to serve as Vice-
     Chairperson of the Committee;

       ``(II) 1 member shall be the Administrator;
       ``(III) 1 member shall be the Secretary of Defense;
       ``(IV) 1 member shall be a representative of State 
     environmental agencies;
       ``(V) 1 member shall be a representative of State attorneys 
     general;
       ``(VI) 1 member shall be a representative of the chlorine 
     industry;
       ``(VII) 1 member shall be a representative of the mercury 
     waste treatment industry; and
       ``(VIII) 1 member shall be a representative of a nonprofit 
     environmental organization.

       ``(ii) Appointments.--Not later than 45 days after the date 
     of enactment of this subsection, the Administrator, in 
     consultation with the appropriate congressional committees, 
     shall appoint the members of the Committee described in 
     subclauses (IV) through (VIII) of clause (i).
       ``(C) Initial meeting.--Not later than 30 days after the 
     date on which all members of the Committee have been 
     appointed, the Committee shall hold the initial meeting of 
     the Committee.
       ``(D) Meetings.--The Committee shall meet at the call of 
     the Chairperson.
       ``(E) Quorum.--A majority of the members of the Committee 
     shall constitute a quorum.
       ``(F) Report.--Not later than 1 year after the date of 
     enactment of this subsection, the Committee shall submit to 
     Congress a report describing the findings and recommendations 
     of the Committee, if any, relating to--
       ``(i) the environmental, health, and safety requirements 
     necessary to prevent--

       ``(I) the release of elemental mercury into the 
     environment; and
       ``(II) worker exposure from the storage of elemental 
     mercury;

       ``(ii) the estimated annual cost of storing elemental 
     mercury on a per-pound or per-ton basis;
       ``(iii) for the 40-year period beginning on the date of 
     submission of the report, the optimal size, number, and other 
     characteristics of Federal facilities required to store 
     elemental mercury under current and anticipated jurisdictions 
     of each Federal agency;
       ``(iv) the estimated quantity of--

       ``(I) elemental mercury that will result from the 
     decommissioning of mercury cell chlor-alkali facilities in 
     the United States; and
       ``(II) any other supplies that may require storage to carry 
     out this Act;

       ``(v) for the 40-year period beginning on the date of 
     submission of the report, the estimated quantity of elemental 
     mercury generated from the recycling of unwanted products and 
     other wastes that will require storage to comply with the 
     export prohibitions under this Act;
       ``(vi) any legal, technical, economic, or other barrier 
     that may prevent the private sector from storing elemental 
     mercury produced by the private sector during the 40-year 
     period beginning on the date of submission of the report, 
     including a description of measures to address the barriers;
       ``(vii) the advantages and disadvantages of consolidating 
     the storage of mercury produced by public and private sources 
     under the management of the public or private sector;
       ``(viii) the optimal plan of the Committee for storing 
     excess mercury produced by public and private sources; and
       ``(ix) additional research, if any, required to determine a 
     long-term disposal option for the storage of excess mercury.
       ``(G) Compensation of members.--
       ``(i) In general.--

       ``(I) Non-federal employees.--A member of the Committee who 
     is not an officer or employee of the Federal Government shall 
     be compensated at a rate equal to the daily equivalent of the 
     annual rate of basic pay

[[Page 6554]]

     prescribed for level V of the Executive Schedule under 
     section 5316 of title 5, United States Code, for each day 
     (including travel time) during which the member is engaged in 
     the performance of the duties of the Committee.
       ``(II) Federal employees.--A member of the Committee who is 
     an officer or employee of the Federal Government shall serve 
     without compensation in addition to the compensation received 
     for the services of the member as an officer or employee of 
     the Federal Government.

       ``(ii) Travel expenses.--A member of the Committee 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 
     Committee.
       ``(H) Staff and funding.--The Administrator shall provide 
     to the Committee such funding and additional personnel as are 
     necessary to enable the Committee to perform the duties of 
     the Committee.
       ``(I) Termination.--The Committee shall terminate 180 days 
     after the date on which the Committee submits the report of 
     the Committee under subparagraph (F).
       ``(4) Inapplicability of unreasonable risk requirement.--
     Subsection (a) shall not apply to this subsection.''.
                                 ______
                                 
      By Mrs. CLINTON:
  S. 907. A bill to establish an Advisory Committee on Gestational 
Diabetes, to provide grants to better understand and reduce gestational 
diabetes, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mrs. CLINTON. Mr. President, I am pleased to introduce the 
Gestational Diabetes Act of 2007 with my colleague Senator Collins, to 
bring attention to an important health issue facing women and children.
  I don't need to tell anyone that we have an obesity epidemic in the 
United States. Many of us realize that as parents, it is our 
responsibility to pass on good nutritional habits to our children. But 
many women may not realize that watching what you eat, exercising 
regularly, and having control of your blood sugar levels are serious 
health considerations during pregnancy. In fact, these factors are 
serious enough that they can affect both the health of the mother and 
the life of the child into adulthood.
  More women than ever are entering their pregnancies overweight but 
without an understanding of how their own weight and nutritional habits 
can trigger gestational diabetes--a type of diabetes that only occurs 
during pregnancy. Women who are overweight before pregnancy are not 
only at greater risk of having gestational diabetes but are also more 
likely to have a c-section and are at an increased risk for other 
serious pregnancy complications.
  In New York, gestational diabetes is on the rise. In New York City 
alone, gestational diabetes has risen by nearly 50 percent in about 10 
years. This means that gestational diabetes affects 1 in 25 women, 
about 400 women per month. But across the Nation, between 4 and 8 
percent of pregnant women in the United States are affected by 
gestational diabetes. Infants of women who have gestational diabetes 
are at increased risk for obesity and developing type 2 diabetes as 
adolescents or adults.
  As women, we need to pay attention to our health. We are always 
worrying about the health of our children, our husbands, and our 
parents, but we often forget to take care of ourselves.
  Today, I am introducing the Gestational Diabetes Act, also known as 
the GEDI Act. This legislation will increase our understanding of 
gestational diabetes by determining the factors that contribute to this 
condition and help mothers who had gestational diabetes reduce their 
risk of developing type 2 diabetes post-pregnancy.
  The GEDI Act will provide funding for projects to assist health care 
providers, as well as for communities to find ways to reach out to 
women so that they understand how their own good health during 
pregnancy can decrease serious health risks for their children.
  The GEDI Act would expand research to determine and develop 
interventions to lower the incidence of gestational diabetes. We need 
to alert women to the risk before this condition becomes an epidemic 
and, as we have seen so many times before, education is critical.
  We should be doing everything we can to address the impact of obesity 
during pregnancy and to reduce the prevalence of gestational diabetes 
in pregnant women. The GEDI Act is an important step in assuring that 
women understand this critical issue and that we fully understand how 
to equip pregnant women to make the best choices for their health.
  The GEDI Act is supported by the American Diabetes Association, 
American College of Obstetricians and Gynecologists, National Research 
Center for Women & Families, International Community Health Services, 
American Association of Diabetes Educators, and the American 
Association of Colleges of Pharmacy.
                                 ______
                                 
      By Mr. BINGAMAN (for himself, Mr. Akaka, Mr. Kerry, and Mrs. 
        Clinton):
  S. 909. A bill to amend title XIX of the Social Security Act to 
permit States, at their option, to require certain individuals to 
present satisfactory documentary evidence of proof of citizenship or 
nationality for purposes of eligibility for Medicaid, and for other 
purposes; to the Committee on Finance.
  Mr. BINGAMAN. Mr. President, the legislation I am introducing today 
is designed to make several very important changes to current law to 
ensure that U.S. citizens receive the Medicaid to which they are 
entitled.
  Since July 1, 2006, most U.S. citizens and nationals applying for or 
renewing their Medicaid coverage face a new Federal requirement to 
provide documentation of their citizenship status. Recent reports 
indicate that tens-of-thousands of U.S. citizens, and in particular 
children, inappropriately are being denied Medicaid benefits simply 
because they don't have access to newly required documentation. The 
articles below and report by the Center on Budget and Policy Priorities 
highlight this very serious problem. Hospitals, physicians, and 
pharmacies may not be willing to treat these individuals until they 
have a source of payment, but they cannot qualify for Medicaid until 
they produce a birth certificate and ID.
  This new Federal requirement was added to Medicaid by the Deficit 
Reduction Act of 2005, DRA, enacted February 8, 2006. The Tax Relief 
and Health Care Act of 2006, TRHCA, signed into law December 20, 2006, 
included some amendments to the DRA citizenship documentation 
requirement, primarily to exempt certain groups. Prior to enactment of 
the DRA, States were permitted to use their discretion in requiring 
such citizenship documentation.
  Under Section 6036 of the DRA, citizens applying for or renewing 
their Medicaid coverage must provide ``satisfactory documentary 
evidence of citizenship or nationality.'' The DRA specifies documents 
that are acceptable for this purpose and authorizes the HHS Secretary 
to designate additional acceptable documents. No Federal matching funds 
are available for services provided to individuals who declare they are 
citizens or nationals unless the State obtains satisfactory evidence of 
their citizenship or determines that they are subject to a statutory 
exemption.
  It is important to note that citizenship documentation requirements 
do not affect Medicaid rules relating to immigrants--they apply to 
individuals claiming to be citizens. Most new legal immigrants are 
excluded from Medicaid during their first 5 years in the U.S. and 
undocumented immigrants remain eligible for Medicaid emergency services 
only.
  The legislation I am introducing would make several very important 
changes to current law to ensure that U.S. citizens receive the 
Medicaid to which they are entitled.
  First, the legislation would restore citizenship verification to a 
State option. Specifically, States would be permitted to determine when 
and to what extent citizenship verification is required of U.S. 
Citizens. States would also be permitted to utilize the standards most 
appropriate to the their population as long as such standards were

[[Page 6555]]

no more stringent than those currently used by the Social Security 
Administration and includes native American tribal documents when 
appropriate.
  Second, the legislation would ensure that individuals are afforded a 
reasonable time period to provide citizenship documentation utilizing 
the same reasonable time period standard that is available to legal 
immigrants to provide satisfactory evidence of their immigration 
status.
  Third the legislation protects children who are U.S. citizens by 
virtue of being born in the United States from being denied coverage 
after birth because of citizenship verification requirements.
  Fourth, the legislation also clarifies ambiguities in federal law to 
ensure that these citizen children, regardless of the immigration 
status of their parents, are treated like all other low-income children 
born in the United States and are deemed eligible to receive Medicaid 
services for one year.
  Finally, the legislation also ensures that the thousands of citizen 
children and adults, who were erroneously denied Medicaid coverage, may 
receive retroactive Medicaid eligibility for coverage they were 
inappropriately denied because of citizenship verification 
requirements.
  I urge my colleagues in the Senate to support this critical 
legislation, which protects low-income U.S. citizens from being 
inappropriately denied Medicaid coverage because of lack of 
documentation.
  I ask unanimous consent that the text of the bill and supporting 
documentation be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                 S. 909

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

     SECTION 1. STATE OPTION TO REQUIRE CERTAIN INDIVIDUALS TO 
                   PRESENT SATISFACTORY DOCUMENTARY EVIDENCE OF 
                   PROOF OF CITIZENSHIP OR NATIONALITY FOR 
                   PURPOSES OF ELIGIBILITY FOR MEDICAID.

       (a) In General.--Section 1902(a)(46) of the Social Security 
     Act (42 U.S.C. 1396a(a)(46)) is amended--
       (1) by inserting ``(A)'' after ``(46)'';
       (2) by adding ``and'' after the semicolon; and
       (3) by adding at the end the following new subparagraph:
       ``(B) at the option of the State and subject to section 
     1903(x), require that, with respect to an individual (other 
     than an individual described in section 1903(x)(1)) who 
     declares to be a citizen or national of the United States for 
     purposes of establishing initial eligibility for medical 
     assistance under this title (or, at State option, for 
     purposes of renewing or redetermining such eligibility to the 
     extent that such satisfactory documentary evidence of 
     citizenship or nationality has not yet been presented), there 
     is presented satisfactory documentary evidence of citizenship 
     or nationality of the individual (using criteria determined 
     by the State, which shall be no more restrictive than the 
     criteria used by the Social Security Administration to 
     determine citizenship, and which shall accept as such 
     evidence a document issued by a federally-recognized Indian 
     tribe evidencing membership or enrollment in, or affiliation 
     with, such tribe (such as a tribal enrollment card or 
     certificate of degree of Indian blood, and, with respect to 
     those federally-recognized Indian tribes located within 
     States having an international border whose membership 
     includes individuals who are not citizens of the United 
     States, such other forms of documentation (including tribal 
     documentation, if appropriate) that the Secretary, after 
     consulting with such tribes, determines to be satisfactory 
     documentary evidence of citizenship or nationality for 
     purposes of satisfying the requirement of this 
     subparagraph));''.
       (b) Limitation on Waiver Authority.--Notwithstanding any 
     provision of section 1115 of the Social Security Act (42 
     U.S.C. 1315), or any other provision of law, the Secretary of 
     Health and Human Services may not waive the requirements of 
     section 1902(a)(46)(B) of such Act (42 U.S.C. 
     1396a(a)(46)(B)) with respect to a State.
       (c) Conforming Amendments.--Section 1903 of such Act (42 
     U.S.C. 1396b) is amended--
       (1) in subsection (i)--
       (A) in paragraph (20), by adding ``or'' after the 
     semicolon;
       (B) in paragraph (21), by striking ``; or'' and inserting a 
     period; and
       (C) by striking paragraph (22); and
       (2) in subsection (x) (as amended by section 405(c)(1)(A) 
     of division B of the Tax Relief and Health Care Act of 2006 
     (Public Law 109-432))--
       (A) by striking paragraphs (1) and (3);
       (B) by redesignating paragraph (2) as paragraph (1);
       (C) in paragraph (1), as so redesignated, by striking 
     ``paragraph (1)'' and inserting ``section 1902(a)(46)(B)''; 
     and
       (D) by adding at the end the following new paragraph:
       ``(2) In the case of an individual declaring to be a 
     citizen or national of the United States with respect to whom 
     a State requires the presentation of satisfactory documentary 
     evidence of citizenship or nationality under section 
     1902(a)(46)(B), the individual shall be provided at least the 
     reasonable opportunity to present satisfactory documentary 
     evidence of citizenship or nationality under this subsection 
     as is provided under clauses (i) and (ii) of section 
     1137(d)(4)(A) to an individual for the submittal to the State 
     of evidence indicating a satisfactory immigration status.''.

     SEC. 2. CLARIFICATION OF RULES FOR CHILDREN BORN IN THE 
                   UNITED STATES TO MOTHERS ELIGIBLE FOR MEDICAID.

       Section 1903(x) of such Act (42 U.S.C. 1396b(x)), as 
     amended by section 1(c)(2), is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (C), by striking ``or'' at the end;
       (B) by redesignating subparagraph (D) as subparagraph (E); 
     and
       (C) by inserting after subparagraph (C) the following new 
     subparagraph:
       ``(D) pursuant to the application of section 1902(e)(4) 
     (and, in the case of an individual who is eligible for 
     medical assistance on such basis, the individual shall be 
     deemed to have provided satisfactory documentary evidence of 
     citizenship or nationality and shall not be required to 
     provide further documentary evidence on any date that occurs 
     during or after the period in which the individual is 
     eligible for medical assistance on such basis); or''; and
       (2) by adding at the end the following new paragraph:
       ``(3) Nothing in subparagraph (A) or (B) of section 
     1902(a)(46), the preceding paragraphs of this subsection, or 
     the Deficit Reduction Act of 2005, including section 6036 of 
     such Act, shall be construed as changing the requirement of 
     section 1902(e)(4) that a child born in the United States to 
     an alien mother for whom medical assistance for the delivery 
     of such child is available as treatment of an emergency 
     medical condition pursuant to subsection (v) shall be deemed 
     eligible for medical assistance during the first year of such 
     child's life.''.

     SEC. 3. EFFECTIVE DATE.

       (a) Retroactive Application.--The amendments made by this 
     Act shall take effect as if included in the enactment of the 
     Deficit Reduction Act of 2005 (Public Law 109-171; 120 Stat. 
     4).
       (b) Restoration of Eligibility.--In the case of an 
     individual who, during the period that began on July 1, 2006, 
     and ends on the date of enactment of this Act, was determined 
     to be ineligible for medical assistance under a State 
     Medicaid program solely as a result of the application of 
     subsections (i)(22) and (x) of section 1903 of the Social 
     Security Act (as in effect during such period), but who would 
     have been determined eligible for such assistance if such 
     subsections, as amended by sections 1 and 2, had applied to 
     the individual, a State may deem the individual to be 
     eligible for such assistance as of the date that the 
     individual was determined to be ineligible for such medical 
     assistance on such basis.
                                  ____


               [From the Associated Press, Nov. 29, 2006]

       KS: Sebelius: New Medicaid Rules Could Cost State Millions

                            (By John Hanna)

       The state could face millions of dollars in additional 
     costs because of federal rules requiring Medicaid recipients 
     to verify their citizenship, Gov. Kathleen Sebelius said 
     Wednesday.
       Sebelius said she's worried the state will have to pick up 
     the full cost of caring for some poor, frail and elderly 
     Kansans who are living in nursing homes, instead of sharing 
     the cost with the federal government. Also, she said, she 
     will propose adding state employees to verify the citizenship 
     status of Medicaid recipients and applicants.
       The governor told reporters she hopes Congress reviews the 
     issue and other attempts to prevent illegal immigrants from 
     obtaining social services or using driver's licenses as 
     identification.
       ``There was no input from the states on how realistic these 
     were or what the cost was,'' Sebelius said during a brief 
     news conference following an unrelated meeting.
       Under Medicaid requirements that took effect July 1, 
     recipients must provide either a passport or two other 
     documents, such as a birth certificate and a driver's 
     license, to verify citizenship.
       While the measure is targeted at illegal immigrants, some 
     advocates for the needy have worried that citizens will 
     either lose or be denied services because they have trouble 
     finding the necessary documents.
       State officials say the number of Kansans covered by 
     Medicaid dropped almost 7 percent since July 1, down to 
     253,000 from 271,000. They believe much of the decline can be 
     attributed to the new requirements.

[[Page 6556]]

       Typically, every $1 the state spends on Medicaid is matched 
     by about $1.50 from the federal government. If someone loses 
     their coverage, then the state faces paying the entire bill 
     for their services, Sebelius said.
       ``You're at 100 percent state dollars or push them out the 
     door,'' she said.
       Also, Sebelius said, the state needs to ``ramp up'' its 
     staffing to handle the additional verification work. The 
     governor is working on the budget proposal she'll submit to 
     the 2007 Legislature, which convenes Jan. 8.
       ``We're certainly going to put some of them in place,'' she 
     said. ``We're trying to make a careful analysis of how many 
     we need.''
       She said that if the state refuses to comply with the law, 
     it could face the loss of all federal health care dollars.
       ``We don't have a lot of latitude to say we're not going to 
     do this,'' she said. ``There are literally hundreds of 
     millions of dollars at stake.''
       Meanwhile, Sebelius expressed concern about a federal law 
     on driver's licenses passed last year.
       Starting in 2008, federal agencies won't treat a state's 
     licenses as valid ID unless a state requires license 
     applicants to document that they're living in the United 
     States legally. Lack of ID could prevent someone from 
     entering a federal building or boarding a plane.
       Sebelius said the law will require local driver's licenses 
     offices to certify that someone has the proper documentation 
     and to store the information.
       ``Exactly how that's going to happen, we're not quite 
     sure,'' Sebelius said. ``We don't basically have any of the 
     equipment that's required to do that in any of the rural 
     areas.''
                                  ____


               [From the Associated Press, Nov. 29, 2006]

    KS: Thousands In Kansas Off Medicaid Following Citizenship Rules

       Thousands of low-income Kansans have lost or been denied 
     state health care coverage because of new rules requiring 
     them to prove they are American citizens, state officials 
     say.
       Since the federally mandated rules took effect July 1, the 
     number of Medicaid recipients in Kansas has decreased by 
     about 18,000, to 253,000. While officials can't determine 
     exactly how much of the 7 percent drop can be attributed to 
     the new rules, they believe much of it can.
       ``The impact to the consumer has been severe,'' said John 
     Anzivino, a vice president for MAXIMUS, a Reston, Va., 
     company that helps administer the joint federal-state 
     Medicaid program in Kansas. ``From our perspective, this has 
     possibly been the most dramatic change and challenge to the 
     Medicaid program since its inception.''
       The new rules were included in last year's federal deficit 
     reduction law and were designed to prevent illegal immigrants 
     from enrolling in the state programs providing health 
     coverage.
       But consumer advocates said many vulnerable people who 
     legitimately were eligible for assistance would lose coverage 
     because they couldn't produce the necessary documentation.
       ``We expect that many of these that have lost coverage will 
     regain coverage once they have gathered and provided the 
     necessary documentation,'' Marcia Nielsen, executive director 
     of the Kansas Health Policy Authority, told the Lawrence 
     Journal-World. ``They will, however, experience a gap in 
     coverage that could prove to be significant for some.''
       Medicaid applicants can prove their citizenship by 
     providing a passport. Or they can provide other documents 
     that verify both their citizenship, such as a birth 
     certificate, and their identities, such as a driver's 
     license.
       Anzivino said most people seeking benefits don't have a 
     passport and are left scrambling to find birth certificates 
     and other documents.
       The number of calls each month to a Kansas Medicaid 
     clearinghouse has more than doubled to 49,000 from 23,000, 
     official said.
       Meanwhile, Rep. Dennis Moore, a Democrat whose district is 
     centered on the state's portion of the Kansas City area, said 
     federal officials were aware of states' problems with the new 
     rules and probably would work on it when the new Congress 
     takes office in January.
                                  ____


                [From the Baltimore Sun, Jan. 22, 2007]

  MD: Medicaid Called Harder for Poor; Health Advocates Fear Document 
                   Rules Cause Many To Lose Coverage

                         (By Kelly Brewington)

       Public health advocates fear that a new federal regulation 
     requiring Medicaid applicants to supply proof of identity and 
     citizenship has resulted in thousands of poor Marylanders 
     losing their health insurance.
       The requirement, part of the federal Deficit Reduction Act 
     that went into effect in Maryland in September, was designed 
     to prevent illegal immigrants from fraudulently receiving 
     Medicaid, the nation's premier health insurance program for 
     the poor.
       But advocates and health officers in some Maryland counties 
     insist the rule has burdened citizens who need health care 
     the most and is likely responsible for thousands of 
     Marylanders being kicked off the Medicaid rolls.
       ``It's a completely unnecessary law and Congress made a big 
     mistake in passing it,'' said Laurie Norris, an attorney with 
     the Public Justice Center. ``The people who are on Medicaid 
     in Maryland are supposed to be on Medicaid.``
       The announcement of the regulations last June sparked an 
     uproar among advocates and state health officials, who were 
     given a July 1 deadline to enforce the mandate or risk losing 
     federal funding. The officials complained they were not given 
     enough time to train staff and inform Maryland's 
     approximately 650,000 affected Medicaid recipients that they 
     must furnish such identification as birth certificates, 
     driver's licenses and passports.
       Nationwide, advocates feared huge enrollment declines, 
     saying many of Medicaid's neediest recipients don't possess 
     the necessary documents and would have to struggle to come up 
     with the money to obtain them. Maryland, for instance, does 
     not automatically issue birth certificates, which may be 
     ordered for $12.
       Last summer, the federal government exempted from the 
     requirement elderly and disabled Medicaid recipients who 
     receive Supplemental Security Income from Social Security, 
     and last month it extended the exemption to foster children. 
     Still, states such as Virginia, Iowa, Wisconsin and New 
     Hampshire noted plunging Medicaid enrollment figures and 
     backlogs related to the regulation, according to a report 
     released earlier this month by the Kaiser Family Foundation's 
     Commission on Medicaid and the Uninsured. In Virginia, 12,000 
     children have been dropped from Medicaid rolls in the 
     requirement's first four months of implementation, the report 
     stated.
       In Maryland, Medicaid enrollment numbers are down overall, 
     but state health officials say they are unsure whether the 
     drop is due to the new rule, a point that has frustrated 
     county health officers eager for evidence of the regulation's 
     impact that they could use to push for change.
       From August through December 2006, the state Department of 
     Health and Mental Hygiene recorded about 6,000 fewer Medicaid 
     enrollees statewide compared with the same period in 2005. 
     Maryland officials say the enrollment computer system is not 
     configured to determine the exact cause of the decline.
       ``It is imperative that the state disclose data to 
     demonstrate the impact of this law,'' said Dr. Joshua 
     Sharfstein, Baltimore health commissioner. ``There are 
     warning signs that a major erosion in health coverage could 
     be happening as a result of this new law. This is really 
     concerning. . . .''
       Charles Lehman, who oversees eligibility issues in the 
     state's Medicaid office, said the agency has concentrated its 
     limited resources on ``keeping people on Medicaid rather than 
     tracking the people going off.''
       ``It may not sound like we are doing everything we can, but 
     really, we are, with the resources we have,'' he said. ``It's 
     not just the clients, not just the caseworkers, everyone has 
     been impacted by this.''
       Officials said while applicants are typically allowed a 30-
     day grace period, caseworkers will not discontinue the 
     insurance if applicants are ``making a good-faith effort'' to 
     obtain the documents.
       ``I think we have done a good job applying the law 
     appropriately but not in a way that arbitrarily cuts people 
     off,'' said Lehman. ``We have made our best effort to keep 
     people on.''
       The department has spent $1 million for a toll-free number 
     to help applicants, 866-676-5880.
       The state health department has also partnered with other 
     state databases to verify the citizenship and identity of 
     beneficiaries, without requiring recipients to hand over 
     documents. In July, the agency searched birth certificate 
     records for about 600,000 Medicaid enrollees at the cost of 
     $12 per search, said Lehman.
       But the effort has not gone as smoothly as hoped, said 
     Norris, with the Public Justice Center. For instance, the 
     databases are not automatically synched--staff must print out 
     the information and check it by hand.
       ``The state has been severely hampered in information 
     technology,'' she said.
       Norris alerted state lawmakers to the problem at a briefing 
     in Annapolis last week. The problems come during a push by 
     advocates and some lawmakers and business groups to expand 
     Medicaid and help about 780,000 uninsured Marylanders.
       Officials with local agencies have increased outreach and 
     said they have allowed people extra time to provide the 
     documents they need.
       Nevertheless, in Anne Arundel County, for example, denial 
     rates for the state's Medicaid program for pregnant women and 
     children have jumped from an average of 18 percent from June 
     through December 2005 to 42 percent for the same period in 
     2006.
       ``It's really shocking,'' said Frances Phillips, the 
     county's health officer. ``This is so serious because the 
     people we are talking about are either children with no 
     insurance and no way to access health care, or pregnant 
     women.''
       Many applicants eventually produce the documents and get 
     back on Medicaid, Phillips noted. But for vulnerable 
     populations,

[[Page 6557]]

     any discontinuation in coverage can be harmful, she said.
       A health department program in which nurses make home 
     visits to women with at-risk pregnancies has focused on 
     educating women on the documentation. ``We just feel that 
     this is so critical,'' said Phillips. `` . . . We touch base 
     with the women, find out what is going on with them and make 
     sure they get insurance.''
       In Baltimore, outreach workers with Baltimore HealthCare 
     Access Inc., which assists some of the city's estimated 
     200,000 Medicaid enrollees, are making home visits and 
     contacting state agencies on applicants' behalf.
       The agency received $5,000 from the Abell Foundation to 
     help applicants cover the cost of documents.
       ``We are plowing away that money pretty quickly,'' said 
     Kathleen Westcoat, the organization's president.
       The funding helped Brenda Kent, 36, pay for her birth 
     certificate last month. She lost her wallet two months before 
     she was due to apply for Medicaid benefits for herself, her 
     twin sons and a daughter.
       ``I didn't know how I was supposed to get it,'' said Kent, 
     who does not work. ``If they didn't help me with the cost, it 
     would have taken me longer to do it.''
                                  ____


               [From the Associated Press, Sept. 1, 2006]

        NC: U.S. Citizenship Proof Required for Medicaid in N.C.

       A requirement that Medicaid recipients in North Carolina 
     prove they hold U.S. citizenship probably won't uncover a 
     large amount of fraud, a state official says.
       Starting Sept. 1, new Medicaid applicants and nearly every 
     current beneficiary must provide documentation of their 
     citizenship as part of a new federal law designed to prevent 
     illegal immigrants from receiving the health care coverage.
       ``I would be very surprised if we had a problem in our 
     state with any large number of people receiving benefits who 
     were not entitled to receive them,'' said Mark Benton, senior 
     deputy director for the state Division of Medical Assistance.
       The law was to have taken effect nationwide July 1, but 
     North Carolina delayed its start while it prepared for the 
     changes.
       Under the old rules, social services workers were supposed 
     to ask applicants about their citizenship status. They were 
     permitted to accept an applicant's word unless there was 
     reasonable doubt.
       Now, the person seeking Medicaid will have to provide a 
     U.S. passport, or an original birth certificate with a 
     driver's license, or other combinations of eligible 
     documents.
       Regardless of citizenship, people who need emergency care 
     will continue to receive it through Medicaid, although this 
     type of care is for a limited time period.
       Officials say there is no way to know how many illegal 
     immigrants are on Medicaid. Some argue illegal immigrants 
     aren't enrolling in large numbers in a government program 
     like this for fear of being deported.
       Illegal immigrants received emergency care of nearly $53 
     million in 2005, more than double the amount from 2000, 
     according to the division.
       The changes nationwide will save Medicaid, the government-
     run health care program for the poor and disabled, about $735 
     million by 2015, according to Congressional Budget Office 
     estimates.
                                  ____


                  Children Dropping Off Medicaid Rolls

       (AP) For several years, there has been a steady increase in 
     the number of children enrolling in Virginia's health 
     insurance program for the poor. Beginning July 1, state 
     officials say, an unprecedented slide began.
       Over the following five months, about 12,000 children 
     dropped off the state's Medicaid rolls.
       ``An entire year's growth has been wiped out,'' said 
     Cynthia Jones, chief deputy director for the state's 
     Department of Medical Assistance Services.
       The drop-off, Jones points out, began about the time a new 
     federal law took effect. The law states that U.S. citizens 
     applying for Medicaid or renewing their participation must 
     present proof of their citizenship and identity. The law 
     emerged out of concern that illegal immigrants were obtaining 
     access to health insurance coverage sponsored by the 
     government.
       But some officials say that's not who is losing coverage.
       Besides Virginia, some other states are also reporting 
     declines in children enrolled in Medicaid or a decline in 
     applications. They include Iowa, Louisiana, New Hampshire and 
     Wisconsin. Health researchers say they don't know if the 
     states are representative of a nationwide pattern.
       The states singled out as experiencing enrollment declines 
     were included in a report issued Tuesday by the Kaiser Family 
     Foundation, which conducts health research, and by the Center 
     on Budget and Policy Priorities, a liberal think tank.
       The states experiencing declines are adamant that U.S. 
     citizens and certain legal immigrants are dropping off the 
     Medicaid rolls, not illegal immigrants.
       ``There is no evidence that the decline is due to 
     undocumented aliens leaving the program,'' said Anita Smith 
     of the Iowa Department of Human Services. ``Rather, we 
     believe that these new requirements are keeping otherwise 
     eligible citizens from receiving Medicaid because they cannot 
     provide the documents required to prove their citizenship or 
     identity.''
       Medicaid is a health insurance program serving about 55 
     million people that is financed by the federal government and 
     the states. The declines cited would indicate that just a 
     fraction of the people enrolled in the program have dropped 
     out as a result of the documentation requirements, but they 
     do represent vulnerable populations, such as pregnant women 
     and children.
       ``We've delayed coverage for those children, and if those 
     children need medical care, there's going to be ramifications 
     for them,'' said Donna Cohen Ross, outreach director for the 
     Center on Budget and Policy Priorities.
       But the agency that oversees Medicaid questioned claims 
     that would link enrollment declines to the new documentation 
     requirements.
       ``We believe we've given the states tools they need to both 
     implement the law and provide sufficient flexibility to 
     assist individuals in establishing their citizenship,'' said 
     Jeff Nelligan, spokesman for the Centers for Medicare and 
     Medicaid Services. ``We continue to monitor state 
     implementation and are not aware of any data that shows there 
     are significant barriers to enrollment.
       ``If states are experiencing difficulties, they should 
     bring them to our attention as we certainly want to 
     understand why they are not using the flexibilities we have 
     provided.''
       After Congress passed the documentation requirements, 
     Medicaid officials released rules that established which 
     documents would suffice in meeting the law.
       Primary evidence, namely a U.S. passport or a certificate 
     of U.S. citizenship, is considered the ideal. Secondary 
     evidence or lower-tier evidence must be accompanied by a 
     document showing identity. Such evidence includes birth 
     certificates, insurance records, and as a last resort, 
     written affidavits.
       Original documents or copies certified by the issuing 
     agency are required by the regulation. Copies are not 
     acceptable. The federal government excluded millions of 
     seniors and disabled people from the new documentation 
     requirements. In December, Congress also approved an 
     exception for foster children.
                                  ____


 New Medicaid Citizenship Documentation Requirement Is Taking a Toll: 
    States Report Enrollment Is Down and Administrative Costs Are Up

                         (By Donna Cohen Ross)


                              Introduction

       A new federal law that states were required to implement 
     July 1 is creating a barrier to health-care coverage for U.S. 
     citizens--especially children--who are eligible for health 
     insurance through Medicaid. The new law, a provision of the 
     Deficit Reduction Act of 2005, requires U.S. citizens to 
     present proof of their citizenship and identity when they 
     apply for, or seek to renew, their Medicaid coverage. Prior 
     to enactment of the law, U.S. citizens applying for Medicaid 
     were permitted to attest to their citizenship, under penalty 
     of perjury.
       In the six months following implementation of the new 
     requirement, states are beginning to report marked declines 
     in Medicaid enrollment, particularly among low-income 
     children. States also are reporting significant increases in 
     administrative costs as a consequence of the requirement.
       This analysis presents the data available so far on this 
     matter. The available evidence strongly suggests that those 
     being adversely affected are primarily U.S. citizens 
     otherwise eligible for Medicaid who are encountering 
     difficulty in promptly securing documents such as birth 
     certificates and who are remaining uninsured for longer 
     periods of time as a result.
       The new requirement also appears to be reversing part of 
     the progress that states made over the past decade in 
     streamlining access to Medicaid for individuals who qualify, 
     and especially for children. For example, to improve access 
     to Medicaid and reduce administrative costs, most states 
     implemented mail-in application procedures, and many states 
     reduced burdensome documentation requirements. The new 
     Medicaid citizenship documentation requirement now appears to 
     be pushing states in the opposite direction, by impeding 
     access to Medicaid. Families must furnish more documentation 
     and may be required to visit a Medicaid office in person to 
     apply or renew their coverage, bypassing simpler mail-in and 
     on-line enrollment opportunities, because they must present 
     original documents such as birth certificates that can take 
     time and money to obtain. This is likely to cause the most 
     difficulty for working-poor families that cannot afford to 
     take time off from work to visit the Medicaid office and for 
     low-income families residing in rural areas.
       The new citizenship documentation requirement--which the 
     Bush Administration did not request and the Senate initially 
     did not adopt, but which the House of Representatives 
     insisted upon in conference--was presented by its proponents 
     as being necessary to stem a problem of undocumented 
     immigrants securing Medicaid by falsely declaring themselves 
     to be U.S. citizens. The new

[[Page 6558]]

     requirement was adopted despite the lack of evidence that 
     such a problem existed. In response to a report in 2005 by 
     the Inspector General of the Department of Health and Human 
     Services, Mark McClellan, then the Administrator of the 
     Centers for Medicare and Medicaid Services at HHS, noted: 
     ``The [Inspector General's] report does not find particular 
     problems regarding false allegations of citizenship, nor are 
     we aware of any.


Impact of the Citizen Documentation Requirement on Medicaid Applicants 
                 and Beneficiaries: The Early Evidence

       Medicaid enrollment figures for all states for the period 
     since the new requirement was implemented on July 1 are not 
     yet available. By contacting several individual states that 
     do have such data, however, we were able to secure enrollment 
     information from Wisconsin, Kansas, Iowa, Louisiana, Virginia 
     and New Hampshire. The data show the following:
       All six states report a significant drop in enrollment 
     since implementation of the requirement began.
       Medicaid officials in these states attribute the downward 
     trend primarily or entirely to the citizenship documentation 
     requirement.
       Two types of problems are surfacing:
       Medicaid is being denied or terminated because some 
     beneficiaries and applicants cannot produce the specified 
     documents despite, from all appearances, being U.S. citizens; 
     and
       Medicaid eligibility determinations are being delayed, 
     resulting in large backlogs of applications, either because 
     it is taking time for applicants to obtain the required 
     documents or because eligibility workers are overloaded with 
     the new tasks and paperwork associated with administering the 
     new requirement.
       Some states have designed mechanisms specifically to track 
     enrollment changes resulting from the new procedures. 
     Wisconsin, for example, has established computer codes to 
     distinguish when Medicaid eligibility is denied or 
     discontinued due to a lack of citizenship or identity 
     documents. In other states, a comparison of current and past 
     enrollment trends strongly suggests that the new requirement 
     is largely responsible for the enrollment decline. For 
     example, in many states aggressive ``back to school'' 
     outreach activities conducted in August and September usually 
     result in increased child enrollment in September and 
     October. In 2006, however, states such as Virginia and 
     Louisiana reported that child enrollment declined despite 
     vigorous promotional campaigns, indicating that the new 
     requirement undermined the value of the outreach efforts.
       The Medicaid enrollment declines identified in this memo do 
     not appear to be driven by broader economic trends or a 
     change in the employment of low-income families. If that were 
     the case, parallel enrollment decline trends would appear in 
     the Food Stamp Program, which is the means-tested program 
     whose enrollment levels are most responsive to such 
     developments. Instead, Food Stamp caseloads have been 
     increasing slightly in recent months. Moreover, each of the 
     states identified in this memo as having sustained a drop in 
     Medicaid enrollment saw its food stamp caseload rise during a 
     similar period.
       Both Medicaid and the Food Stamp Program serve similar 
     populations of low-income families and are often administered 
     by the same agencies and caseworkers. A key difference is 
     that the citizenship documentation rules were applied to 
     Medicaid but there were no such changes in the Food Stamp 
     Program. It thus appears that the changes in Medicaid 
     enrollment are a result of changes in Medicaid policies--
     particularly citizenship documentation--that do not affect 
     eligibility for food stamps.
       The following states have documented declines in Medicaid 
     enrollment since the implementation of the Medicaid 
     citizenship documentation requirement:
       Wisconsin: In five months--between August and December 
     2006--a total of 14,034 Medicaid-eligible individuals were 
     either denied Medicaid or lost coverage as a result of the 
     documentation requirement. The loss of Medicaid coverage 
     occurred despite Wisconsin's efforts to minimize the impact 
     of the requirement by obtaining birth records electronically 
     from the state's Vital Records agency. Obtaining proof of 
     identify, rather than proof of citizenship, was the major 
     problem for people in Wisconsin who were otherwise eligible 
     during this period: 69 percent of those who were denied 
     Medicaid or who lost Medicaid coverage due to the new 
     requirement did not have a required identity document, as 
     compared to 17 percent who did not provide the required 
     citizenship documents and 14 percent who were missing both a 
     citizenship and identity document. This indicates that most 
     of those who were denied were, in fact, U.S. citizens.
       Kansas: The Kansas Health Policy Authority (KHPA) reports 
     that between 18,000 and 20,000 applicants and previous 
     beneficiaries, mostly children and parents, have been left 
     without health insurance since the citizenship documentation 
     requirement was implemented. About 16,000 of these 
     individuals are ``waiting to enroll'' or ``waiting to be re-
     enrolled;'' the state says these eligibility determinations 
     are being delayed because of a large backlog of applications 
     related to the difficulties confronting individuals and 
     eligibility workers alike who are attempting to comply with 
     the new rule. Documents on the KHPA website state that the 
     ``majority of families with pending applications will qualify 
     for coverage under the new requirements when we are able to 
     complete processing.'' In the meantime, these children and 
     parents are barred from getting the health coverage for which 
     they qualify and are, in most cases, uninsured.
       Iowa: Iowa has identified an unprecedented decline in 
     Medicaid enrollment that state officials attribute to the 
     Medicaid citizenship documentation requirement. Prior to July 
     1, 2006, overall Medicaid enrollment had steadily increased 
     for the past several years. While sporadic declines occurred 
     in rural counties, no county in the state's larger population 
     centers experienced a decline in the months leading up to the 
     implementation of the new requirement. However, between July 
     and September 2006, Medicaid enrollment sustained the largest 
     decrease in the past five years; this also was the first time 
     in five years that the state has experienced an enrollment 
     decline for three consecutive months.
       Although other factors may contribute to the recent 
     decrease in enrollment, state officials point out the state 
     is now experiencing a more severe effect on enrollment than 
     it has following any of the Medicaid changes that have 
     occurred over the past several years. The state's conclusion 
     that the citizenship documentation requirement is driving the 
     decline is supported by the fact that enrollment has dropped 
     among the populations subject to the requirement (children 
     and families) but has remained steady among groups not 
     affected by the requirement (individuals receiving Medicare 
     and SSI).
       Louisiana: In two months--September and October of 2006--
     Louisiana experienced a net loss of more than 7,500 children 
     in its Medicaid program despite a vigorous back-to-school 
     outreach effort and a significant increase in applications 
     during the month of September.
       According to state officials, the enrollment decline is not 
     driven by population loss from Hurricane Katrina and 
     contrasts dramatically with enrollment spikes that usually 
     occur in September and have reached up to 13,000 in the past. 
     The reason for the drop-off is two-fold, according to the 
     state: for some people, Medicaid is being denied or 
     terminated because they have not presented the required 
     citizenship or identity documents. In addition, the 
     additional workload generated by the new requirement is 
     diverting the time and effort eligibility workers normally 
     would spend on activities to ensure that Medicaid 
     beneficiaries do not lose coverage at renewal.
       Virginia: Since July, enrollment of children in the state's 
     Medicaid program has declined steadily each month. By the end 
     of November, the total net decline stood at close to 12,000 
     children. During the same period, enrollment of children in 
     the state's separate SCHIP program, not subject to the new 
     requirement, increased. Virginia also reported a substantial 
     backlog in application processing at its central processing 
     site, with 2,600 cases pending approval for Medicaid in 
     September, when normally no more than 50 such cases are 
     pending at the end of a month.
       After the plunge in children's Medicaid enrollment over 
     several months, a small increase occurred in December 2006 
     (although Medicaid enrollment for children then began 
     dropping again in January). State officials say the December 
     ``up-tick'' suggests that some families are finally ``getting 
     over the hurdles'' imposed by the new law and children (who 
     were eligible at the time they applied but lacked the 
     required documentation) are getting health coverage after a 
     significant delay during which they were without coverage.
       New Hampshire: Data from the New Hampshire Healthy Kids 
     Program, a private organization that processes mail-in 
     applications for the state's Medicaid and SCHIP programs, 
     indicate that the percentage of applications submitted with 
     all necessary documents in September of this year dropped by 
     almost half compared to the percentage of complete 
     applications submitted in September 2005. If applicants do 
     not supply missing documentation within 28 days, New 
     Hampshire closes the application. The percentage of 
     applications closed due to missing documents has also 
     increased significantly: from around 10 percent of 
     applications before the new requirement to 20 percent in 
     August 2006. In addition, New Hampshire Healthy Kids reports 
     that between June 2006 and September 2006, enrollment of 
     children in Medicaid dropped by 1,275.


                  Impact on State Administrative Costs

       Data on state Medicaid administrative costs for the months 
     since July 1 are not available from CMS or any other national 
     source. Several states, however, have examined the impact of 
     the new Medicaid citizenship documentation requirement on 
     their administrative expenditures. Their findings are as 
     follows:
       Illinois: Illinois is projecting $16 million to $19 million 
     in increased staffing costs in the first year of 
     implementation of the requirement.

[[Page 6559]]

       Arizona: The Arizona legislature has allocated $10 million 
     to implement the citizenship documentation requirement. This 
     included the costs associated with staffing, training and 
     payments for obtaining birth records.
       Colorado: The FY07-08 budget request for the Colorado 
     Department of Health Care Policy and Financing includes a 
     request for an additional $2.8 million for county 
     administration costs. This request is based on an assumption 
     by the Centers for Medicare and Medicaid Services (CMS) that 
     it will take an additional 5 minutes per application for a 
     caseworker to process citizenship and identity documents. The 
     Department stated in a Joint Budget Committee Hearing that 
     this amount ``may not be sufficient for Colorado counties and 
     special record storage needs.
       Washington: Washington State is projecting additional costs 
     associated with hiring 19 additional FTEs in FY07 due to the 
     new requirement, and retaining seven of them in FY08 and 
     FY09. The state estimates that the costs will be $2.7 million 
     on FY07 and $450,000 in each of the succeeding two years.
       Wisconsin: Wisconsin is expecting increased costs of $1.8 
     million to cover the increased workload associated with 
     administering the requirement in FY07 and $600,000 to 
     $700,000 per year for the two years after that.
       Minnesota: Minnesota is estimating that it will spend $1.3 
     million in FY07 for new staff, birth record fees and other 
     administrative expenses.


                               Conclusion

       Based on these findings and reports, and strong anecdotal 
     evidence, it seems increasingly clear that the new Medicaid 
     citizenship documentation requirement is having a negative 
     impact on Medicaid enrollment, especially among children. 
     Insufficient information is available to determine the 
     precise extent to which individuals whose Medicaid 
     eligibility has been delayed, denied or terminated are U.S. 
     citizens, eligible legal immigrants, or ineligible 
     immigrants. However, the fact that significant numbers of 
     individuals are being approved for Medicaid after delays of 
     many months, during which they were uninsured, demonstrates 
     that the requirement is adversely affecting substantial 
     numbers of U.S. citizens, especially children who are 
     citizens. Moreover, a large body of research conducted over a 
     number of years has conclusively shown that increasing 
     documentation and other administrative burdens generally 
     results in eligible individuals failing to obtain coverage as 
     a result of the enrollment and renewal processes having 
     become more complicated to understand and more difficult to 
     navigate. Regarding the Medicaid enrollment declines, Anita 
     Smith, Chief of the Bureau of Medical Supports for the Iowa 
     Department of Human Services, has stated: ``There is no 
     evidence that the [enrollment] decline is due to undocumented 
     aliens leaving the program. Rather, we believe that these new 
     requirements are keeping otherwise eligible citizens from 
     receiving Medicaid because they cannot provide the documents 
     required to prove their citizenship or identity.''
       A number of governors across the nation are announcing 
     their intentions to push new initiatives to cover the 
     uninsured, particularly children. These proposals are being 
     designed to build upon existing public coverage programs, of 
     which Medicaid is the largest, and invariably these proposals 
     call for the enrollment of individuals who are currently 
     eligible for existing programs but remain uninsured. Success 
     will depend, in large measure, on policies and procedures 
     that facilitate rather than frustrate such efforts so that 
     eligible individuals can obtain the benefits for which they 
     qualify. The Medicaid citizenship documentation requirement, 
     which appears to be an extremely blunt instrument, stands to 
     undercut such efforts by placing a daunting administrative 
     obstacle in the way of many low-income U.S. citizens who 
     otherwise have shown that they qualify or by discouraging 
     potentially eligible citizens from applying because the 
     process appears too complex or intimidating. The requirement 
     also appears to be deflecting state human and financial 
     resources away from activities designed to reach eligible 
     children and families and to enroll them in the most 
     efficient and effective manner.
                                 ______
                                 
      By Mr. KENNEDY (for himself, Mr. Dodd, Mr. Harkin, Ms. Mikulski, 
        Mrs. Murray, Mrs. Clinton, Mr. Obama, Mr. Sanders, Mr. Brown, 
        Mr. Durbin, Mr. Inouye, Mr. Biden, Mr. Levin, Mr. Kerry, Mr. 
        Rockefeller, Mr. Lieberman, Mr. Akaka, Mrs. Boxer, Mr. 
        Feingold, Mr. Schumer, Mr. Lautenberg, Mr. Menendez, and Mr. 
        Casey):
  S. 910. A bill to provide for paid sick leave to ensure that 
Americans can address their own health needs and the health needs of 
their families; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. KENNEDY. Mr. President day in and day out across America, 
millions of men and women go to work in jobs that are the backbone of 
our economy. They make our country great and prosperous. They work hard 
to provide for their families and care for them.
  Often, however, they have to miss days of work because of illness. 
Every parent knows what it's like to care for a sick child, and every 
child knows the importance of a parent taking care of them when they 
are ill. Yet, every day, countless Americans find their paychecks or 
even their jobs at risk when illness strikes.
  As Members of Congress, we don't lose our pay or risk our jobs if we 
stay home because of illness. But millions of our fellow citizens are 
not so fortunate.
  Mr. President, 57 million Americans--nearly half of all private-
sector workers in the United States--do not have paid sick days. 
Seventy percent don't have paid sick days they can use to care for 
family members. They can't take a day off to recover from the flu. They 
can't leave work to care for a child who is running a fever.
  Among workers in the lowest income quarter, the numbers are even 
worse--percent do not have the right to take time off for illness 
without losing their payor even their jobs.
  This lack of protection is especially difficult for working women 
with children. Women have moved into the workforce in record numbers, 
but they continue to have primary responsibility for their children's 
health. Nearly 80 percent of mothers say they are solely responsible 
for their children's medical care. Yet they can't take a day off to 
care for a sick child.
  If we truly care about families, we have to change those facts. 
Americans want to be responsible employees and responsible parents. We 
need workplace laws that allow workers the time needed to care for 
themselves or family members when they are sick without losing payor 
risking their jobs.
  That is why today I am introducing the Healthy Families Act, to give 
American workers up to seven paid days of sick leave a year. Now 
Congresswoman Rosa DeLauro is introducing the legislation in the House 
of Representatives.
  Earlier this week, she and I met with hundreds of workers and parents 
from around the country, representing tens of thousands of parents 
asking Congress to take action.
  I am talking about hard-working people such as Bertha Brown, who 
spoke to hundreds of us in front of the Capitol. Bertha is a home 
healthcare aide. She has spent her life caring for America's sick and 
elderly, yet she herself has no paid sick days to care for herself or 
her children. She told us how she had to leave her sick daughter at 
home when she went to work.
  Paid sick days aren't just a family issue--they are also a public 
health issue. When sick people go to work, they are likely to infect 
their coworkers and the public. Every day, we hear reports of stomach 
illnesses breaking out in restaurants or on cruise ships. We learn of 
flu outbreaks leading to hospitalization of the elderly. Such illnesses 
are contagious, but their spread can be minimized if sick people stay 
at home.
  However, a high proportion of workers who have constant contact with 
the public have no paid sick days--85 percent of food service workers 
and 55 percent of workers in the retail industry are denied that 
benefit; 30 percent of health care workers can't take paid time off 
when they are ill.
  That is why nurses and doctors support paid sick days. When our 
Health Committee held a hearing on this issue last month, we heard from 
pediatricians at Boston Children's Hospital and a public health expert 
in San Francisco about the significant health benefits and reduction of 
medical costs that result from paid sick days. We all know that 
preventive care helps reduce medical costs. Giving people the 
opportunity to obtain medical treatment for illnesses or chronic 
medical conditions before their conditions worsen is common sense.
  Paid sick days also are important to help children stay healthy and 
in school so that they can learn. When sick children go to school, they 
don't

[[Page 6560]]

learn well, and they are likely to infect their fellow students.
  We also heard this week from Carolyn Duff, a nurse in an elementary 
school in South Carolina. She treated a fifth grader she suspected had 
strep throat. His parents did not have paid sick days and could not 
take him to the doctor. After 4 days, his condition worsened. He 
developed scarlet fever and a rash covered his entire body--all because 
his parents, for fear of losing their jobs, weren't able to take time 
off to care for him. As Carolyn Duff said, the child not only suffered 
without the care of his parents, he also lost 10 precious days of his 
studies at school.
  Paid sick days will result in significant savings to our economy and 
our health care system. That is why employers support paid sick days 
too. Dancing Deer Bakery--a small business Boston--sent me a letter 
making this important point:

       A national paid sick days law creates a level playing field 
     for all businesses. . . . We hope that a bill will move 
     through both Chambers and be on the President's desk. Paid 
     sick days should be a non-partisan issue. A healthy nation is 
     a productive nation.

  Paid sick days are good for families, good for our public health, and 
good for our economy. Our people have waited long enough for this need 
to be met. It is time to pass the Healthy Families Act.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 910

       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 ``Healthy Families Act''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Working Americans need time to meet their own health 
     care needs and to care for family members, including their 
     children, spouse, parents, and parents-in-law, and other 
     children and adults for whom they are caretakers.
       (2) Health care needs include preventive health care, 
     diagnostic procedures, medical treatment, and recovery in 
     response to short- and long-term illnesses and injuries.
       (3) Providing employees time off to meet health care needs 
     ensures that they will be healthier in the long run. 
     Preventive care helps avoid illnesses and injuries and 
     routine medical care helps detect illnesses early and shorten 
     their duration.
       (4) When parents are available to care for their children 
     who become sick, children recover faster, more serious 
     illnesses are prevented, and children's overall mental and 
     physical health improve. Parents who cannot afford to miss 
     work and must send children with a contagious illness to 
     child care or school contribute to the high rate of 
     infections in child care centers and schools.
       (5) Providing paid sick leave improves public health by 
     reducing infectious disease. Policies that make it easier for 
     sick adults and children to be isolated at home reduce the 
     spread of infectious disease.
       (6) Routine medical care reduces medical costs by detecting 
     and treating illness and injury early, decreasing the need 
     for emergency care. These savings benefit public and private 
     payers of health insurance, including private businesses.
       (7) The provision of individual and family sick leave by 
     large and small businesses, both here in the United States 
     and elsewhere, demonstrates that policy solutions are both 
     feasible and affordable in a competitive economy. Measures 
     that ensure that employees are in good health and do not need 
     to worry about unmet family health problems help businesses 
     by promoting productivity and reducing employee turnover.
       (8) The American Productivity Audit found that 
     presenteeism--the practice of employees coming to work 
     despite illness--costs $180,000,000,000 annually in lost 
     productivity. Studies in the Journal of Occupational and 
     Environmental Medicine, the Employee Benefit News, and the 
     Harvard Business Review show that presenteeism is a larger 
     productivity drain than either absenteeism or short-term 
     disability.
       (9) The absence of paid sick leave has forced Americans to 
     make untenable choices between needed income and jobs on the 
     one hand and caring for their own and their family's health 
     on the other.
       (10) Nearly half of Americans lack paid leave for self-care 
     or to care for a family member. For families in the lowest 
     quartile of earners, 79 percent lack paid sick leave. For 
     families in the next 2 quartiles, 46 and 38 percent, 
     respectively, lack paid sick leave. Even for families in the 
     highest income quartile, 28 percent lack paid sick leave. In 
     addition, millions of workers cannot use paid sick leave to 
     care for ill family members.
       (11) Due to the roles of men and women in society, the 
     primary responsibility for family caretaking often falls on 
     women, and such responsibility affects the working lives of 
     women more than it affects the working lives of men.
       (12) An increasing number of men are also taking on 
     caretaking obligations, and men who request leave time for 
     caretaking purposes are often denied accommodation or 
     penalized because of stereotypes that caretaking is only 
     ``women's work''.
       (13) Employers' reliance on persistent stereotypes about 
     the ``proper'' roles of both men and women in the workplace 
     and in the home continues a cycle of discrimination and 
     fosters stereotypical views about women's commitment to work 
     and their value as employees.
       (14) Employment standards that apply to only one gender 
     have serious potential for encouraging employers to 
     discriminate against employees and applicants for employment 
     who are of that gender.
       (15) It is in the national interest to ensure that all 
     Americans can care for their own health and the health of 
     their families while prospering at work.

     SEC. 3. PURPOSES.

       The purposes of this Act are--
       (1) to ensure that all working Americans can address their 
     own health needs and the health needs of their families by 
     requiring employers to provide a minimum level of paid sick 
     leave including leave for family care;
       (2) to diminish public and private health care costs by 
     enabling workers to seek early and routine medical care for 
     themselves and their family members;
       (3) to accomplish the purposes described in paragraphs (1) 
     and (2) in a manner that is feasible for employers; and
       (4) consistent with the provision of the 14th amendment to 
     the Constitution relating to equal protection of the laws, 
     and pursuant to Congress' power to enforce that provision 
     under section 5 of that amendment--
       (A) to accomplish the purposes described in paragraphs (1) 
     and (2) in a manner that minimizes the potential for 
     employment discrimination on the basis of sex by ensuring 
     generally that leave is available for eligible medical 
     reasons on a gender-neutral basis; and
       (B) to promote the goal of equal employment opportunity for 
     women and men.

     SEC. 4. DEFINITIONS.

       In this Act:
       (1) Child.--The term ``child'' means a biological, foster, 
     or adopted child, a stepchild, a legal ward, or a child of a 
     person standing in loco parentis, who is--
       (A) under 18 years of age; or
       (B) 18 years of age or older and incapable of self-care 
     because of a mental or physical disability.
       (2) Employee.--The term ``employee'' means an individual--
       (A) who is--
       (i)(I) an employee, as defined in section 3(e) of the Fair 
     Labor Standards Act of 1938 (29 U.S.C. 203(e)), who is not 
     covered under clause (v), including such an employee of the 
     Library of Congress, except that a reference in such section 
     to an employer shall be considered to be a reference to an 
     employer described in clauses (i)(I) and (ii) of paragraph 
     (3)(A); or
       (II) an employee of the Government Accountability Office;
       (ii) a State employee described in section 304(a) of the 
     Government Employee Rights Act of 1991 (42 U.S.C. 2000e-
     16c(a));
       (iii) a covered employee, as defined in section 101 of the 
     Congressional Accountability Act of 1995 (2 U.S.C. 1301), 
     other than an applicant for employment;
       (iv) a covered employee, as defined in section 411(c) of 
     title 3, United States Code; or
       (v) a Federal officer or employee covered under subchapter 
     V of chapter 63 of title 5, United States Code; and
       (B) who works an average of at least 20 hours per week or, 
     in the alternative, at least 1,000 hours per year.
       (3) Employer.--
       (A) In general.--The term ``employer'' means a person who 
     is--
       (i)(I) a covered employer, as defined in subparagraph (B), 
     who is not covered under subclause (V);
       (II) an entity employing a State employee described in 
     section 304(a) of the Government Employee Rights Act of 1991;
       (III) an employing office, as defined in section 101 of the 
     Congressional Accountability Act of 1995;
       (IV) an employing office, as defined in section 411(c) of 
     title 3, United States Code; or
       (V) an employing agency covered under subchapter V of 
     chapter 63 of title 5, United States Code; and
       (ii) is engaged in commerce (including government), in the 
     production of goods for commerce, or in an enterprise engaged 
     in commerce (including government) or in the production of 
     goods for commerce.
       (B) Covered employer.--
       (i) In general.--In subparagraph (A)(i)(I), the term 
     ``covered employer''--

       (I) means any person engaged in commerce or in any industry 
     or activity affecting commerce who employs 15 or more 
     employees for

[[Page 6561]]

     each working day during each of 20 or more calendar workweeks 
     in the current or preceding calendar year;
       (II) includes--

       (aa) any person who acts, directly or indirectly, in the 
     interest of an employer to any of the employees of such 
     employer; and
       (bb) any successor in interest of an employer;

       (III) includes any ``public agency'', as defined in section 
     3(x) of the Fair Labor Standards Act of 1938 (29 U.S.C. 
     203(x)); and
       (IV) includes the Government Accountability Office and the 
     Library of Congress.

       (ii) Public agency.--For purposes of clause (i)(III), a 
     public agency shall be considered to be a person engaged in 
     commerce or in an industry or activity affecting commerce.
       (iii) Definitions.--For purposes of this subparagraph:

       (I) Commerce.--The terms ``commerce'' and ``industry or 
     activity affecting commerce'' mean any activity, business, or 
     industry in commerce or in which a labor dispute would hinder 
     or obstruct commerce or the free flow of commerce, and 
     include ``commerce'' and any ``industry affecting commerce'', 
     as defined in paragraphs (1) and (3) of section 501 of the 
     Labor Management Relations Act, 1947 (29 U.S.C. 142 (1) and 
     (3)).
       (II) Employee.--The term ``employee'' has the same meaning 
     given such term in section 3(e) of the Fair Labor Standards 
     Act of 1938 (29 U.S.C. 203(e)).
       (III) Person.--The term ``person'' has the same meaning 
     given such term in section 3(a) of the Fair Labor Standards 
     Act of 1938 (29 U.S.C. 203(a)).

       (C) Predecessors.--Any reference in this paragraph to an 
     employer shall include a reference to any predecessor of such 
     employer.
       (4) Employment benefits.--The term ``employment benefits'' 
     means all benefits provided or made available to employees by 
     an employer, including group life insurance, health 
     insurance, disability insurance, sick leave, annual leave, 
     educational benefits, and pensions, regardless of whether 
     such benefits are provided by a practice or written policy of 
     an employer or through an ``employee benefit plan'', as 
     defined in section 3(3) of the Employee Retirement Income 
     Security Act of 1974 (29 U.S.C. 1002(3)).
       (5) Health care provider.--The term ``health care 
     provider'' means a provider who--
       (A)(i) is a doctor of medicine or osteopathy who is 
     authorized to practice medicine or surgery (as appropriate) 
     by the State in which the doctor practices; or
       (ii) is any other person determined by the Secretary to be 
     capable of providing health care services; and
       (B) is not employed by an employer for whom the provider 
     issues certification under this Act.
       (6) Parent.--The term ``parent'' means a biological, 
     foster, or adoptive parent of an employee, a stepparent of an 
     employee, or a legal guardian or other person who stood in 
     loco parentis to an employee when the employee was a child.
       (7) Pro rata.--The term ``pro rata'', with respect to 
     benefits offered to part-time employees, means the proportion 
     of each of the benefits offered to full-time employees that 
     are offered to part-time employees that, for each benefit, is 
     equal to the ratio of part-time hours worked to full-time 
     hours worked.
       (8) Secretary.--The term ``Secretary'' means the Secretary 
     of Labor.
       (9) Sick leave.--The term ``sick leave'' means an increment 
     of compensated leave provided by an employer to an employee 
     as a benefit of employment for use by the employee during an 
     absence from employment for any of the reasons described in 
     paragraphs (1) through (3) of section 5(d).
       (10) Spouse.--The term ``spouse'', with respect to an 
     employee, has the meaning given such term by the marriage 
     laws of the State in which the employee resides.

     SEC. 5. PROVISION OF PAID SICK LEAVE.

       (a) In General.--An employer shall provide for each 
     employee employed by the employer not less than--
       (1) 7 days of sick leave with pay and employment benefits 
     annually for employees working 30 or more hours per week; or
       (2) a pro rata number of days or hours of sick leave with 
     pay and employment benefits annually for employees working 
     less than--
       (A) 30 hours per week on a year-round basis; or
       (B) 1,500 hours throughout the year involved.
       (b) Accrual.--
       (1) Period of accrual.--Sick leave provided for under this 
     section shall accrue as determined appropriate by the 
     employer, but not on less than a quarterly basis.
       (2) Accumulation.--Accrued sick leave provided for under 
     this section shall carry over from year to year, but this Act 
     shall not be construed to require an employer to permit an 
     employee to accumulate more than 7 days of the sick leave.
       (3) Use.--The sick leave may be used as accrued. The 
     employer, at the discretion of the employer, may loan the 
     sick leave to the employee in advance of accrual by such 
     employee.
       (c) Calculation.--
       (1) Less than a full workday.--Unless the employer and 
     employee agree to designate otherwise, for periods of sick 
     leave that are less than a normal workday, that leave shall 
     be counted--
       (A) on an hourly basis; or
       (B) in the smallest increment that the employer's payroll 
     system uses to account for absences or use of leave.
       (2) Variable schedule.--If the schedule of an employee 
     varies from week to week, a weekly average of the hours 
     worked over the 12-week period prior to the beginning of a 
     sick leave period shall be used to calculate the employee's 
     normal workweek for the purpose of determining the amount of 
     sick leave to which the employee is entitled.
       (d) Uses.--Sick leave accrued under this section may be 
     used by an employee for any of the following:
       (1) An absence resulting from a physical or mental illness, 
     injury, or medical condition of the employee.
       (2) An absence resulting from obtaining professional 
     medical diagnosis or care, or preventive medical care, for 
     the employee subject to the requirement of subsection (e).
       (3) An absence for the purpose of caring for a child, a 
     parent, a spouse, or any other individual related by blood or 
     affinity whose close association with the employee is the 
     equivalent of a family relationship, who--
       (A) has any of the conditions or needs for diagnosis or 
     care described in paragraph (1) or (2); and
       (B) in the case of someone who is not a child, is otherwise 
     in need of care.
       (e) Scheduling.--An employee shall make a reasonable effort 
     to schedule leave under paragraphs (2) and (3) of subsection 
     (d) in a manner that does not unduly disrupt the operations 
     of the employer.
       (f) Procedures.--
       (1) In general.--Paid sick leave shall be provided upon the 
     oral or written request of an employee. Such request shall--
       (A) include a reason for the absence involved and the 
     expected duration of the leave;
       (B) in a case in which the need for leave is foreseeable at 
     least 7 days in advance of such leave, be provided at least 7 
     days in advance of such leave; and
       (C) otherwise, be provided as soon as practicable after the 
     employee is aware of the need for such leave.
       (2) Certification.--
       (A) Provision.--
       (i) In general.--Subject to subparagraph (C), an employer 
     may require that a request for leave be supported by a 
     certification issued by the health care professional of the 
     eligible employee or of an individual described in subsection 
     (d)(3), as appropriate, if the leave period covers more than 
     3 consecutive workdays.
       (ii) Timeliness.--The employee shall provide a copy of such 
     certification to the employer in a timely manner, not later 
     than 30 days after the first day of the leave. The employer 
     shall not delay the commencement of the leave on the basis 
     that the employer has not yet received the certification.
       (B) Sufficient certification.--
       (i) In general.--A certification provided under 
     subparagraph (A) shall be sufficient if it states--

       (I) the date on which the leave will be needed;
       (II) the probable duration of the leave;
       (III) the appropriate medical facts within the knowledge of 
     the health care provider regarding the condition involved, 
     subject to clause (ii); and
       (IV)(aa) for purposes of leave under subsection (d)(1), a 
     statement that leave from work is medically necessary;
       (bb) for purposes of leave under subsection (d)(2), the 
     dates on which testing for a medical diagnosis or care is 
     expected to be given and the duration of such testing or 
     care; and
       (cc) for purposes of leave under subsection (d)(3), in the 
     case of leave to care for someone who is not a child, a 
     statement that care is needed for an individual described in 
     such subsection, and an estimate of the amount of time that 
     such care is needed for such individual.

       (ii) Limitation.--In issuing a certification under 
     subparagraph (A), a health care provider shall make 
     reasonable efforts to limit the medical facts described in 
     clause (i)(III) that are disclosed in the certification to 
     the minimum necessary to establish a need for the employee to 
     utilize paid sick leave.
       (C) Regulations.--Regulations prescribed under section 13 
     shall specify the manner in which an employee who does not 
     have health insurance shall provide a certification for 
     purposes of this paragraph.
       (D) Confidentiality and nondisclosure.--
       (i) Protected health information.--Nothing in this Act 
     shall be construed to require a health care provider to 
     disclose information in violation of section 1177 of the 
     Social Security Act (42 U.S.C. 1320d-6) or the regulations 
     promulgated pursuant to section 264(c) of the Health 
     Insurance Portability and Accountability Act (42 U.S.C. 
     1320d-2 note).
       (ii) Health information records.--If an employer possesses 
     health information about an employee or an employee's child, 
     parent, spouse or other individual described in subsection 
     (d)(3), such information shall--

       (I) be maintained on a separate form and in a separate file 
     from other personnel information;

[[Page 6562]]

       (II) be treated as a confidential medical record; and
       (III) not be disclosed except to the affected employee or 
     with the permission of the affected employee.

       (g) Current Leave Policies.--
       (1) Equivalency requirement.--An employer with a leave 
     policy providing paid leave options shall not be required to 
     modify such policy, if such policy includes provisions for 
     the provision, use, and administration of paid sick leave 
     that meet the requirements of subsections (a) through (f).
       (2) No elimination, reduction, or redesignation of existing 
     leave.--An employer may not eliminate, reduce, or redesignate 
     any leave in existence on the date of enactment of this Act 
     in order to comply with the provisions of this Act.

     SEC. 6. POSTING REQUIREMENT.

       (a) In General.--Each employer shall post and keep posted a 
     notice, to be prepared or approved in accordance with 
     procedures specified in regulations prescribed under section 
     13, setting forth excerpts from, or summaries of, the 
     pertinent provisions of this Act including--
       (1) information describing leave available to employees 
     under this Act;
       (2) information pertaining to the filing of an action under 
     this Act;
       (3) the details of the notice requirement for foreseeable 
     leave under section 5(f)(1)(B); and
       (4) information that describes--
       (A) the protections that an employee has in exercising 
     rights under this Act; and
       (B) how the employee can contact the Secretary (or other 
     appropriate authority as described in section 8) if any of 
     the rights are violated.
       (b) Location.--The notice described under subsection (a) 
     shall be posted--
       (1) in conspicuous places on the premises of the employer, 
     where notices to employees (including applicants) are 
     customarily posted; or
       (2) in employee handbooks.
       (c) Violation; Penalty.--Any employer who willfully 
     violates the posting requirements of this section shall be 
     subject to a civil fine in an amount not to exceed $100 for 
     each separate offense.

     SEC. 7. PROHIBITED ACTS.

       (a) Interference With Rights.--
       (1) Exercise of rights.--It shall be unlawful for any 
     employer to interfere with, restrain, or deny the exercise 
     of, or the attempt to exercise, any right provided under this 
     Act, including--
       (A) discharging or discriminating against (including 
     retaliating against) any individual, including a job 
     applicant, for exercising, or attempting to exercise, any 
     right provided under this Act;
       (B) using the taking of sick leave under this Act as a 
     negative factor in an employment action, such as hiring, 
     promotion, or a disciplinary action; or
       (C) counting the sick leave under a no-fault attendance 
     policy.
       (2) Discrimination.--It shall be unlawful for any employer 
     to discharge or in any other manner discriminate against 
     (including retaliating against) any individual, including a 
     job applicant, for opposing any practice made unlawful by 
     this Act.
       (b) Interference With Proceedings or Inquiries.--It shall 
     be unlawful for any person to discharge or in any other 
     manner discriminate against (including retaliating against) 
     any individual, including a job applicant, because such 
     individual--
       (1) has filed an action, or has instituted or caused to be 
     instituted any proceeding, under or related to this Act;
       (2) has given, or is about to give, any information in 
     connection with any inquiry or proceeding relating to any 
     right provided under this Act; or
       (3) has testified, or is about to testify, in any inquiry 
     or proceeding relating to any right provided under this Act.
       (c) Construction.--Nothing in this section shall be 
     construed to state or imply that the scope of the activities 
     prohibited by section 105 of the Family and Medical Leave Act 
     of 1993 (29 U.S.C. 2615) is less than the scope of the 
     activities prohibited by this section.

     SEC. 8. ENFORCEMENT AUTHORITY.

       (a) In General.--
       (1) Definition.--In this subsection:
       (A) the term ``employee'' means an employee described in 
     clause (i) or (ii) of section 4(2)(A); and
       (B) the term ``employer'' means an employer described in 
     subclause (I) or (II) of section 4(3)(A)(i).
       (2) Investigative authority.--
       (A) In general.--To ensure compliance with the provisions 
     of this Act, or any regulation or order issued under this 
     Act, the Secretary shall have, subject to subparagraph (C), 
     the investigative authority provided under section 11(a) of 
     the Fair Labor Standards Act of 1938 (29 U.S.C. 211(a)), with 
     respect to employers, employees, and other individuals 
     affected.
       (B) Obligation to keep and preserve records.--An employer 
     shall make, keep, and preserve records pertaining to 
     compliance with this Act in accordance with section 11(c) of 
     the Fair Labor Standards Act of 1938 (29 U.S.C. 211(c)) and 
     in accordance with regulations prescribed by the Secretary.
       (C) Required submissions generally limited to an annual 
     basis.--The Secretary shall not require, under the authority 
     of this paragraph, an employer to submit to the Secretary any 
     books or records more than once during any 12-month period, 
     unless the Secretary has reasonable cause to believe there 
     may exist a violation of this Act or any regulation or order 
     issued pursuant to this Act, or is investigating a charge 
     pursuant to paragraph (4).
       (D) Subpoena authority.--For the purposes of any 
     investigation provided for in this paragraph, the Secretary 
     shall have the subpoena authority provided for under section 
     9 of the Fair Labor Standards Act of 1938 (29 U.S.C. 209).
       (3) Civil action by employees or individuals.--
       (A) Right of action.--An action to recover the damages or 
     equitable relief prescribed in subparagraph (B) may be 
     maintained against any employer in any Federal or State court 
     of competent jurisdiction by one or more employees or 
     individuals or their representative for and on behalf of--
       (i) the employees or individuals; or
       (ii) the employees or individuals and others similarly 
     situated.
       (B) Liability.--Any employer who violates section 7 
     (including a violation relating to rights provided under 
     section 5) shall be liable to any employee or individual 
     affected--
       (i) for damages equal to--

       (I) the amount of--

       (aa) any wages, salary, employment benefits, or other 
     compensation denied or lost by reason of the violation; or
       (bb) in a case in which wages, salary, employment benefits, 
     or other compensation have not been denied or lost, any 
     actual monetary losses sustained as a direct result of the 
     violation up to a sum equal to 7 days of wages or salary for 
     the employee or individual;

       (II) the interest on the amount described in subclause (I) 
     calculated at the prevailing rate; and
       (III) an additional amount as liquidated damages; and

       (ii) for such equitable relief as may be appropriate, 
     including employment, reinstatement, and promotion.
       (C) Fees and costs.--The court in an action under this 
     paragraph shall, in addition to any judgment awarded to the 
     plaintiff, allow a reasonable attorney's fee, reasonable 
     expert witness fees, and other costs of the action to be paid 
     by the defendant.
       (4) Action by the secretary.--
       (A) Administrative action.--The Secretary shall receive, 
     investigate, and attempt to resolve complaints of violations 
     of section 7 (including a violation relating to rights 
     provided under section 5) in the same manner that the 
     Secretary receives, investigates, and attempts to resolve 
     complaints of violations of sections 6 and 7 of the Fair 
     Labor Standards Act of 1938 (29 U.S.C. 206 and 207).
       (B) Civil action.--The Secretary may bring an action in any 
     court of competent jurisdiction to recover the damages 
     described in paragraph (3)(B)(i).
       (C) Sums recovered.--Any sums recovered by the Secretary 
     pursuant to subparagraph (B) shall be held in a special 
     deposit account and shall be paid, on order of the Secretary, 
     directly to each employee or individual affected. Any such 
     sums not paid to an employee or individual affected because 
     of inability to do so within a period of 3 years shall be 
     deposited into the Treasury of the United States as 
     miscellaneous receipts.
       (5) Limitation.--
       (A) In general.--Except as provided in subparagraph (B), an 
     action may be brought under paragraph (3), (4), or (6) not 
     later than 2 years after the date of the last event 
     constituting the alleged violation for which the action is 
     brought.
       (B) Willful violation.--In the case of an action brought 
     for a willful violation of section 7 (including a willful 
     violation relating to rights provided under section 5), such 
     action may be brought within 3 years of the date of the last 
     event constituting the alleged violation for which such 
     action is brought.
       (C) Commencement.--In determining when an action is 
     commenced under paragraph (3), (4), or (6) for the purposes 
     of this paragraph, it shall be considered to be commenced on 
     the date when the complaint is filed.
       (6) Action for injunction by secretary.--The district 
     courts of the United States shall have jurisdiction, for 
     cause shown, in an action brought by the Secretary--
       (A) to restrain violations of section 7 (including a 
     violation relating to rights provided under section 5), 
     including the restraint of any withholding of payment of 
     wages, salary, employment benefits, or other compensation, 
     plus interest, found by the court to be due to employees or 
     individuals eligible under this Act; or
       (B) to award such other equitable relief as may be 
     appropriate, including employment, reinstatement, and 
     promotion.
       (7) Solicitor of labor.--The Solicitor of Labor may appear 
     for and represent the Secretary on any litigation brought 
     under paragraph (4) or (6).
       (8) Government accountability office and library of 
     congress.--Notwithstanding any other provision of this 
     subsection, in the case of the Government Accountability 
     Office and the Library of Congress, the authority of the 
     Secretary of Labor under this subsection shall be exercised 
     respectively by the

[[Page 6563]]

     Comptroller General of the United States and the Librarian of 
     Congress.
       (b) Employees Covered by Congressional Accountability Act 
     of 1995.--The powers, remedies, and procedures provided in 
     the Congressional Accountability Act of 1995 (2 U.S.C. 1301 
     et seq.) to the Board (as defined in section 101 of that Act 
     (2 U.S.C. 1301)), or any person, alleging a violation of 
     section 202(a)(1) of that Act (2 U.S.C. 1312(a)(1)) shall be 
     the powers, remedies, and procedures this Act provides to 
     that Board, or any person, alleging an unlawful employment 
     practice in violation of this Act against an employee 
     described in section 4(2)(A)(iii).
       (c) Employees Covered by Chapter 5 of Title 3, United 
     States Code.--The powers, remedies, and procedures provided 
     in chapter 5 of title 3, United States Code, to the 
     President, the Merit Systems Protection Board, or any person, 
     alleging a violation of section 412(a)(1) of that title, 
     shall be the powers, remedies, and procedures this Act 
     provides to the President, that Board, or any person, 
     respectively, alleging an unlawful employment practice in 
     violation of this Act against an employee described in 
     section 4(2)(A)(iv).
       (d) Employees Covered by Chapter 63 of Title 5, United 
     States Code.--The powers, remedies, and procedures provided 
     in title 5, United States Code, to an employing agency, 
     provided in chapter 12 of that title to the Merit Systems 
     Protection Board, or provided in that title to any person, 
     alleging a violation of chapter 63 of that title, shall be 
     the powers, remedies, and procedures this Act provides to 
     that agency, that Board, or any person, respectively, 
     alleging an unlawful employment practice in violation of this 
     Act against an employee described in section 4(2)(A)(v).

     SEC. 9. COLLECTION OF DATA ON PAID SICK DAYS AND FURTHER 
                   STUDY.

       (a) Compilation of Information.--Effective 90 days after 
     the date of enactment of this Act, the Commissioner of Labor 
     Statistics shall annually compile information on the 
     following:
       (1) The number of employees who used paid sick leave.
       (2) The number of hours of the paid sick leave used.
       (3) The demographic characteristics of employees who were 
     eligible for and who used the paid sick leave.
       (b) GAO Study.--
       (1) In general.--The Comptroller General of the United 
     States shall annually conduct a study to determine the 
     following:
       (A)(i) The number of days employees used paid sick leave 
     and the reasons for the use.
       (ii) The number of employees who used the paid sick leave 
     for leave periods covering more than 3 consecutive workdays.
       (B) Whether employees used the paid sick leave to care for 
     illnesses or conditions caused by domestic violence against 
     the employees or their family members.
       (C) The cost and benefits to employers of implementing the 
     paid sick leave policies.
       (D) The cost to employees of providing certification issued 
     by a health care provider to obtain the paid sick leave.
       (E) The benefits of the paid sick leave to employees and 
     their family members, including effects on employees' ability 
     to care for their family members or to provide for their own 
     health needs.
       (F) Whether the paid sick leave affected employees' ability 
     to sustain an adequate income while meeting health needs of 
     the employees and their family members.
       (G) Whether employers who administered paid sick leave 
     policies prior to the date of enactment of this Act were 
     affected by the provisions of this Act.
       (H) Whether other types of leave were affected by this Act.
       (I) Whether paid sick leave affected retention and turnover 
     and costs of presenteeism.
       (J) Whether the paid sick leave increased the use of less 
     costly preventive medical care and lowered the use of 
     emergency room care.
       (K) Whether the paid sick leave reduced the number of 
     children sent to school when the children were sick.
       (2) Aggregating data.--The data collected under 
     subparagraphs (A), (B), and (E) of paragraph (1) shall be 
     aggregated by gender, race, disability, earnings level, age, 
     marital status, and family type, including parental status.
       (3) Reports.--
       (A) In general.--Not later than 18 months after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall prepare and submit a report to the appropriate 
     committees of Congress concerning the results of the study 
     conducted pursuant to paragraph (1) and the data aggregated 
     under paragraph (2).
       (B) Followup report.--Not later that 5 years after the date 
     of enactment of this Act the Comptroller General of the 
     United States shall prepare and submit a followup report to 
     the appropriate committees of Congress concerning the results 
     of the study conducted pursuant to paragraph (1) and the data 
     aggregated under paragraph (2).

     SEC. 10. EFFECT ON OTHER LAWS.

       (a) Federal and State Antidiscrimination Laws.--Nothing in 
     this Act shall be construed to modify or affect any Federal 
     or State law prohibiting discrimination on the basis of race, 
     religion, color, national origin, sex, age, or disability.
       (b) State and Local Laws.--Nothing in this Act shall be 
     construed to supersede any provision of any State or local 
     law that provides greater paid sick leave or other leave 
     rights than the rights established under this Act.

     SEC. 11. EFFECT ON EXISTING EMPLOYMENT BENEFITS.

       (a) More Protective.--Nothing in this Act shall be 
     construed to diminish the obligation of an employer to comply 
     with any contract, collective bargaining agreement, or any 
     employment benefit program or plan that provides greater paid 
     sick leave rights to employees or individuals than the rights 
     established under this Act.
       (b) Less Protective.--The rights established for employees 
     under this Act shall not be diminished by any contract, 
     collective bargaining agreement, or any employment benefit 
     program or plan.

     SEC. 12. ENCOURAGEMENT OF MORE GENEROUS LEAVE POLICIES.

       Nothing in this Act shall be construed to discourage 
     employers from adopting or retaining leave policies more 
     generous than policies that comply with the requirements of 
     this Act.

     SEC. 13. REGULATIONS.

       (a) In General.--
       (1) Authority.--Except as provided in paragraph (2), not 
     later than 120 days after the date of enactment of this Act, 
     the Secretary shall prescribe such regulations as are 
     necessary to carry out this Act with respect to employees 
     described in clause (i) or (ii) of section 4(2)(A) and other 
     individuals affected by employers described in subclause (I) 
     or (II) of section 4(3)(A)(i).
       (2) Government accountability office; library of 
     congress.--The Comptroller General of the United States and 
     the Librarian of Congress shall prescribe the regulations 
     with respect to employees of the Government Accountability 
     Office and the Library of Congress, respectively and other 
     individuals affected by the Comptroller General of the United 
     States and the Librarian of Congress, respectively.
       (b) Employees Covered by Congressional Accountability Act 
     of 1995.--
       (1) Authority.--Not later than 120 days after the date of 
     enactment of this Act, the Board of Directors of the Office 
     of Compliance shall prescribe (in accordance with section 304 
     of the Congressional Accountability Act of 1995 (2 U.S.C. 
     1384)) such regulations as are necessary to carry out this 
     Act with respect to employees described in section 
     4(2)(A)(iii) and other individuals affected by employers 
     described in section 4(3)(A)(i)(III).
       (2) Agency regulations.--The regulations prescribed under 
     paragraph (1) shall be the same as substantive regulations 
     promulgated by the Secretary to carry out this Act except 
     insofar as the Board may determine, for good cause shown and 
     stated together with the regulations prescribed under 
     paragraph (1), that a modification of such regulations would 
     be more effective for the implementation of the rights and 
     protections involved under this section.
       (c) Employees Covered by Chapter 5 of Title 3, United 
     States Code.--
       (1) Authority.--Not later than 120 days after the date of 
     enactment of this Act, the President (or the designee of the 
     President) shall prescribe such regulations as are necessary 
     to carry out this Act with respect to employees described in 
     section 4(2)(A)(iv) and other individuals affected by 
     employers described in section 4(3)(A)(i)(IV).
       (2) Agency regulations.--The regulations prescribed under 
     paragraph (1) shall be the same as substantive regulations 
     promulgated by the Secretary to carry out this Act except 
     insofar as the President (or designee) may determine, for 
     good cause shown and stated together with the regulations 
     prescribed under paragraph (1), that a modification of such 
     regulations would be more effective for the implementation of 
     the rights and protections involved under this section.
       (d) Employees Covered by Chapter 63 of Title 5, United 
     States Code.--
       (1) Authority.--Not later than 120 days after the date of 
     enactment of this Act, the Director of the Office of 
     Personnel Management shall prescribe such regulations as are 
     necessary to carry out this Act with respect to employees 
     described in section 4(2)(A)(v) and other individuals 
     affected by employers described in section 4(3)(A)(i)(V).
       (2) Agency regulations.--The regulations prescribed under 
     paragraph (1) shall be the same as substantive regulations 
     promulgated by the Secretary to carry out this Act except 
     insofar as the Director may determine, for good cause shown 
     and stated together with the regulations prescribed under 
     paragraph (1), that a modification of such regulations would 
     be more effective for the implementation of the rights and 
     protections involved under this section.

     SEC. 14. EFFECTIVE DATES.

       (a) In General.--This Act shall take effect 1 year after 
     the date of issuance of regulations under section 13(a)(1).
       (b) Collective Bargaining Agreements.--In the case of a 
     collective bargaining agreement in effect on the effective 
     date prescribed by subsection (a), this Act shall take effect 
     on the earlier of--
       (1) the date of the termination of such agreement; or

[[Page 6564]]

       (2) the date that occurs 18 months after the date of 
     issuance of regulations under section 13(a)(1).

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