[Congressional Record (Bound Edition), Volume 153 (2007), Part 5]
[Senate]
[Pages 7528-7538]
[From the U.S. Government Publishing Office, www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. OBAMA (for himself and Mr. Burr):
  S. 976. A bill to secure the promise of personalized medicine for all 
Americans by expanding and accelerating genomic research and 
initiatives to improve the accuracy of disease diagnosis, increase the 
safety of drugs, and identify novel treatments; to the Committee on 
Health, Education, Labor, and Pensions.
  Mr. OBAMA. Mr. President, I rise today joined by my colleague Senator 
Richard Burr, to reintroduce the Genomics and Personalized Medicine Act 
of 2007. This bill will expand and accelerate scientific advancement in 
the field of genomics, which is already beginning to change the 
paradigm of medical practice as we know it, and has profound 
implications for health and health care in this nation.
  The ``miracles of medicine'' have been demonstrated since early man. 
Many of the traditional medicines used today, such as aspirin and 
morphine, are derivatives of plants ancient people used to treat 
illnesses and injuries centuries ago. Since those ancient times, our 
knowledge of medicine and disease has expanded tremendously. Today, 
modern breakthroughs in the fields of genetics and genomics have 
uncovered another layer of complexity in the way we treat and prevent 
disease.
  Over the past decade, we have unlocked many of the mysteries about 
DNA and RNA, their structure, and how their code is translated into the 
proteins that make up the tissues and organs of the human body. 
Researchers have also made discoveries about the various functions of 
DNA such as replication, genetic recombination and regulation, just to 
name a few, and have developed the necessary technologies to do all of 
this work.
  This knowledge isn't just sitting in books on the shelf nor is it 
confined to the work benches of laboratories. We have used these 
research findings to pinpoint the causes of many diseases, such as 
sickle cell anemia, cystic fibrosis, and chronic myelogenous leukemia. 
Moreover, scientists have translated this genetic knowledge into 
several treatments and therapies prompting a bridge between the 
laboratory bench and the patient's bedside.
  We've made so many achievements and come a long way in our 
understanding and application of genetics knowledge. And yet, we are 
just beginning to realize the full potential of this science to predict 
the onset of disease, diagnose earlier, and develop therapies that can 
treat or cure Americans from so many afflictions.
  Just 4 years ago, scientists at the National Institutes of Health and 
the Department of Energy reached another major landmark, with the 
completion of the sequencing of the entire human genome, our genetic 
blueprint described by many as the Holy Grail of biology and hailed as 
one of the greatest scientific achievements to date.


[[Page 7529]]


  The completion of the Human Genome Project has paved the way for a 
more sophisticated understanding of disease causation. The HGP has 
expanded focus from the science of genetics, which refers to the study 
of single genes, to include genomics, which describes the study of all 
the genes in an individual, as well as the interactions of those genes 
with each other. The role environmental factors play in promoting 
disease and the potential influence they have at the genetic level is 
also an area of interest.
  We know that all human beings are 99.9 percent identical in genetic 
makeup, but differences in the remaining 0.1 percent hold important 
clues about the causes of disease and response to drugs. Simply put, 
the study of genomics will help us learn why some people get sick and 
others do not, and use this information to better prevent and treat 
disease.
  The relatively new field of genomics is key to the practice of 
personalized medicine. Personalized medicine is the use of genomic and 
molecular data to better target the delivery of health care, facilitate 
the discovery and clinical testing of new products, and help determine 
a patient's predisposition to a particular disease or condition. 
Personalized medicine represents a revolutionary and exciting change in 
the fundamental approach and practice of medicine
  Pharmacogenomics, or the study of how genes affect a person's 
response to drugs, is a critical component of personalized medicine. 
Currently, so-called blockbuster drugs are typically effective in only 
40 to 60 percent of patients who take them. Other studies have found 
that up to 15 percent of hospitalized patients experience a serious 
adverse drug reaction, causing an estimated 100,000 deaths each year. 
Pharmacogenomics has the potential to dramatically increase the 
effectiveness and safety of drugs, both of which are major health care 
concerns.
  We have a growing number of examples of how pharmacogenomics research 
has helped to save lives. For example, the chemotherapy Purinethol is a 
lifesaver for kids with leukemia, but in some cases, patients suffer 
severe, sometimes fatal, side effects. In the 1990's, researchers 
identified the gene variant that prevents affected patients from 
properly breaking down Purinethol, allowing doctors to screen patients 
and adjust dosages for safer use of the drug.
  Herceptin, another example, is a breast cancer drug that initially 
failed in clinical trials. However, researchers discovered that 1 in 4 
breast cancers have too many copies of a certain gene, which helps 
cells grow, divide and repair themselves. Extra copies of this gene 
cause uncontrolled and rapid growth resulting in tumor formation. As it 
turns out, Herceptin is an effective drug for patients with this type 
of cancer, with significantly improved survival for affected women. 
Herceptin offers a clear illustration of the power of personalized 
medicine and highlights the importance of incorporating genetic 
analysis in the development and application of new therapies.
  Realizing the promise of personalized medicine will require continued 
Federal leadership and agency collaboration; expansion and acceleration 
of genomics research; a capable genomics workforce; incentives to 
encourage development of genomic tests and therapies; and greater 
attention to the quality of genetic tests, direct-to-consumer 
advertising and use of personal genomic information.
  The Genomics and Personalized Medicine Act of 2007 will address many 
of these issues. The bill requires the Secretary of the Department of 
Health and Human Services to establish the Genomics and Personalized 
Medicine Interagency Working Group to expand and accelerate genomics 
research through enhanced communication, collaboration and integration 
of relevant activities.
  Genetic and genomics research will be expanded, to increase the 
collection of data that will advance both fields, through the support 
of the biobanking initiative aimed at increasing and improving genomic 
screening tools, diagnostics and therapeutics. The Secretary will also 
establish a national distributed database so data finding can be 
shared.
  This bill requests that the Secretary support efforts to improve the 
adequacy of genetics and genomics training through modernized curricula 
and review of relevant certifications, and by identifying alternative 
education options such as distance or on-line learning programs. In 
addition, the Secretary will promote initiatives to increase the 
integration of genetics and genomics into all aspects of medical and 
public health practice, with specific focus on training and guideline 
development for providers without expertise or experience in the field 
of genomics.
  This bill also requests the National Academies of Science to formally 
study the development of companion diagnostic tests and to provide 
expert guidance about the level of incentives and potential approaches 
to really move this area forward.
  Last but not least, the bill focuses on the safety, efficacy and 
availability of information about genetic tests, including 
pharmacogenetic and pharmacogenomics tests. The Secretary will contract 
with the Institute of Medicine to conduct a study and make 
recommendations regarding Federal oversight and regulation of genetic 
tests. After this study is complete, the Secretary will develop a 
decision matrix to help determine which types of tests require review 
and the level of review needed for such tests as well as the 
responsible agency. The Secretary will also establish a specialty area 
for molecular and biochemical genetics tests at CMS and direct a review 
by the CDC of direct-to-consumer marketing practices.
  In conclusion, we stand at this new and expansive frontier of 
personalized medicine we must explore and test the hypotheses and 
innovations in the area of genomics that can protect and promote our 
health. Genomics holds unparalleled promise for public health and for 
medicine, and the Genomics and Personalized Medicine Act of 2007 will 
help us to fulfill this promise. I urge my colleagues to support me in 
passing this critical legislation.
                                 ______
                                 
      By Mr. WYDEN (for himself and Mr. Kerry):
  S. 979. A bill to establish a Vote by Mail grant program; to the 
Committee on Rules and Administration.
  Mr. WYDEN. Mr. President, on Election Day 2006 in Tillamook County, 
OR, 13 inches of rain fell. Roads were closed. Parts of the county 
became unreachable. Governor Kulongoski declared a state of emergency. 
And yet--70 percent of the voters in the county still cast their 
ballots.
  Why? Because Oregonians in Tillamook County and all over the State 
cast their votes by mail.
  Even without weather like this, folks in other States around the 
country had trouble casting their votes.
  In Denver, CO, hundreds of voters were turned away when the database 
of registered voters crashed.
  Nearly a quarter of precincts in Indianapolis, IN, resorted to paper 
ballots when poll workers couldn't figure out how to connect optical 
scan voting machines with the new touch-screen models.
  In Johnson County, KS, poll workers used hand lotion to prevent the 
county's touch-screen voting machines from spitting out cards.
  In Missouri, poll workers were demanding photo identification despite 
a court ruling barring the practice.
  In Shaker Heights, OH, voters were turned from the polls when 
electronic voting machines failed to work.
  Voters in Washington State received phone calls instructing them to 
vote at the wrong precinct.
  A polling location in New Mexico received 150 ballots instead of 
1,500.
  The list goes on and on.
  The point is, vote by mail has worked in Oregon and not just in this 
election, but in every election it has been used.
  It's a pretty simple system. Voters get their ballots in the mail. 
Wherever and whenever they would like, right up to Election Day, voters 
complete their ballots and return them.
  Vote by mail makes polling place problems a thing of the past--no 
more 

[[Page 7530]]

polls opening late and no more long lines.
  There's no more confusion about whether you are on the voter rolls. 
Either you get the ballot in the mail, or you don't and if you don't, 
you have ample time to contact your election officials to sort it out.
  Vote by mail dramatically reduces the chance of voter fraud. Trained 
election officials match the signature on each ballot against the 
signature on each voter's registration card and no ballot is processed 
or counted until officials are satisfied that the two signatures match.
  Vote by mail ensures a paper trail--each voter marks up their ballot 
and sends it in. That ballot is counted and then becomes the paper 
record used in the event of a recount.
  There's less risk of voter intimidation and that's why a 2003 study 
of Oregon voters showed that those groups that would likely be most 
vulnerable to coercion, including the elderly, actually prefer vote by 
mail.
  Vote by mail leads to more educated voters. Because folks get their 
ballots weeks before the election, they have the time they need to get 
educated about the candidates and the issues, and deliberate in a way 
not possible at a polling place.
  And vote by mail generates costs savings that can be spent on other 
priorities like education, law enforcement and roads. Because there is 
no longer any need to transport equipment to polling stations and to 
hire and train poll workers, Oregon has reduced its election-related 
costs by 30 percent since implementing vote by mail.
  I think the Oregon experience can be copied elsewhere and that's why 
I am introducing my Vote by Mail Act of 2007 today, which creates a 
three year, $18 million grant program to help states adopt vote by mail 
election systems like the one that Oregon voters have been successfully 
using for some time now.
  To participate in the grant program, States must demonstrate that the 
vote by mail system they intend to implement includes the same elements 
that have made Oregon's system so successful, including a system for 
recording electronically each voter's registration and signature and a 
process for ensuring that the signature on each VBM ballot is verified 
against that voter's electronically recorded signature. States that 
decide to participate in the program have the option of adopting vote 
by mail State-wide, within a group of selected counties, or even in a 
single county. States transitioning to vote by mail State-wide will 
receive $2 million. States transitioning to VBM less than State-wide 
will receive $1 million.
  I think that vote by mail will improve the elections in every State 
that adopts it. But to be sure, my bill instructs the Government 
Accountability Office to evaluate the benefits of vote by mail and to 
produce a study comparing traditional voting methods and vote by mail.
  I urge my colleagues to lend their support to the Vote by Mail Act of 
2007. I believe it can help ensure hassle-free elections and help 
rebuild confidence in our election system.
  Because right now, some folks feel like they are so powerless to do 
anything to fix things that they throw their hands in the air and walk 
away. And society suffers. For democracies to work there needs to be 
public engagement. But that requires a sense of investedness--unless I 
think of the government as my government, which means it's considering 
my interests and, more importantly, trying to solve them, it's pretty 
hard to stay invested.
  The sense of resignation, of frustration, even dislocation, expressed 
by some folks troubles me. And I consider it my job to foster a greater 
sense of public investment. This means making sure that the government 
works for everyone and that there are tangible results that you can 
show people so that they understand that it's their government and that 
it works for them.
  I think election reform like my vote by mail bill accomplishes this 
goal at the most basic level. Without fair, trouble-free elections, 
you've got serious problems. You don't even get past go. The public 
can't have confidence in its government if it doesn't have confidence 
in the system that elected that government. As we saw in 2000 in 
Florida, it is extremely difficult to untangle problems after Election 
Day so you really have to get it right the first time. Vote by mail 
helps ensures this.
  I am pleased to have my esteemed colleague from Massachusetts, 
Senator Kerry as an original co-sponsor. I am also pleased that 
Congresswoman Susan David of California is introducing the House 
companion bill. I am also happy to announce that the American 
Association of People with Disabilities, the American Postal Workers 
Union, Common Cause, and the National Association of Postal Supervisors 
are publicly supporting this bill.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                 S. 979

       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 ``Vote by Mail Act of 2007''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) The Supreme Court declared in Reynolds v. Sims that 
     ``[i]t has been repeatedly recognized that all qualified 
     voters have a constitutionally protected right to vote . . . 
     and to have their votes counted.''.
       (2) In the 2000 and 2004 presidential elections, voting 
     technology failures and procedural irregularities deprived 
     some Americans of their fundamental right to vote.
       (3) In 2000, faulty punch card ballots and other equipment 
     failures prevented accurate vote counts nationwide. A report 
     by the Caltech/MIT Voting Technology Project estimates that 
     approximately 1,500,000 votes for president were intended to 
     be cast but not counted in the 2000 election because of 
     equipment failures.
       (4) In 2004, software errors, malfunctioning electronic 
     voting systems, and long lines at the polls prevented 
     accurate vote counts and prevented some people from voting. 
     For instance, voters at Kenyon College in Gambier, Ohio 
     waited in line for up to 12 hours because there were only 2 
     machines available for 1,300 voters.
       (5) In 2006, election day problems plagued voters in a 
     number of States as well. For instance, in Denver, Colorado, 
     hundreds of voters were turned away when the database of 
     registered voters crashed. In Allegheny County, Pennsylvania, 
     malfunctioning machines and an inadequate number of 
     provisional ballots generated long lines, causing many voters 
     to leave without casting a vote.
       (6) Under the Oregon Vote by Mail system, election 
     officials mail ballots to all registered voters at least 2 
     weeks before election day. Voters mark their ballots, seal 
     the ballots in both unmarked secrecy envelopes and signed 
     return envelopes, and return the ballots by mail or to secure 
     drop boxes. Once a ballot is received, election officials 
     scan the bar code on the ballot envelope, which brings up the 
     voter's signature on a computer screen. The election official 
     compares the signature on the screen and the signature on the 
     ballot envelope. Only if the signature on the ballot envelope 
     is determined to be authentic is the ballot forwarded on to 
     be counted.
       (7) Oregon's Vote by Mail system has deterred voter fraud 
     because the system includes numerous security measures such 
     as the signature authentication system. Potential misconduct 
     is also discouraged by the power of the State to punish those 
     who engage in voter fraud with up to five years in prison, 
     $100,000 in fines, and the loss of their vote.
       (8) Oregon's Vote by Mail system promotes uniformity and 
     strict compliance with Federal and State voting laws because 
     ballot processing is centralized in county clerk's offices, 
     rather than at numerous polling places.
       (9) Vote by Mail is one factor making voter turnout in 
     Oregon consistently higher than the average national voter 
     turnout. For example, Oregon experienced a record voting-age-
     eligible population turnout of 70.6 percent in the 2004 
     presidential election, compared to 58.4 percent nationally. 
     Oregon's turnout of registered voters for that election was 
     86.48 percent.
       (10) Women, younger voters, and homemakers also report that 
     they vote more often using Vote by Mail.
       (11) Vote by Mail reduces election costs by eliminating the 
     need to transport equipment to polling stations and to hire 
     and train poll workers. Oregon has reduced its election-
     related costs by 30 percent since implementing Vote by Mail.
       (12) Vote by Mail allows voters to educate themselves 
     because they receive ballots well before election day, which 
     provides them with ample time to research issues, study 
     ballots, and deliberate in a way that is not possible at a 
     polling place.
     
 [[Page 7531]]    
     
       (13) Vote by Mail is accurate--at least 2 studies comparing 
     voting technologies show that absentee voting methods, 
     including Vote by Mail systems, result in a more accurate 
     vote count.
       (14) Vote by Mail results in more up-to-date voter rolls, 
     since election officials use forwarding information from the 
     post office to update voter registration.
       (15) Vote by Mail allows voters to visually verify that 
     their votes were cast correctly and produces a paper trail 
     for recounts.
       (16) In a survey taken 5 years after Oregon implemented the 
     Vote by Mail system, more than 8 in 10 Oregon voters said 
     they preferred voting by mail to traditional voting.

     SEC. 3. DEFINITIONS.

       In this Act:
       (1) Election.--The term ``election'' means any general, 
     special, primary, or runoff election.
       (2) Participating state.--The term ``participating State'' 
     means a State receiving a grant under the Vote by Mail grant 
     program under section 4.
       (3) Residual vote rate.--The term ``residual vote rate'' 
     means the sum of all votes that cannot be counted in an 
     election (overvotes, undervotes, and otherwise spoiled 
     ballots) divided by the total number of votes cast.
       (4) State.--The term ``State'' means a State of the United 
     States, the District of Columbia, the Commonwealth of Puerto 
     Rico, or a territory or possession of the United States.
       (5) Voting system.--The term ``voting system'' has the 
     meaning given such term under section 301(b) of the Help 
     America Vote Act of 2002 (42 U.S.C. 15481(b)).

     SEC. 4. VOTE BY MAIL GRANT PROGRAM.

       (a) Establishment.--Not later than 270 days after the date 
     of enactment of this Act, the Election Assistance Commission 
     shall establish a Vote by Mail grant program (in this section 
     referred to as the ``program'').
       (b) Purpose.--The purpose of the program is to make 
     implementation grants to participating States solely for the 
     implementation of procedures for the conduct of all elections 
     by mail at the State or local government level.
       (c) Limitation on Use of Funds.--In no case may grants made 
     under this section be used to reimburse a State for costs 
     incurred in implementing mail-in voting for elections at the 
     State or local government level if such costs were incurred 
     prior to the date of enactment of this Act.
       (d) Application.--A State seeking to participate in the 
     program under this section shall submit an application to the 
     Election Assistance Commission containing such information, 
     and at such time, as the Election Assistance Commission may 
     specify.
       (e) Amount and Awarding of Implementation Grants; Duration 
     of Program.--
       (1) Amount of implementation grants.--
       (A) In general.--Subject to subparagraph (B), the amount of 
     an implementation grant made to a participating State shall 
     be, in the case of a State that certifies that it will 
     implement all elections by mail in accordance with the 
     requirements of subsection (f), with respect to--
       (i) the entire State, $2,000,000; or
       (ii) any single unit or multiple units of local government 
     within the State, $1,000,000.
       (B) Excess funds.--
       (i) In general.--To the extent that there are excess funds 
     in either of the first 2 years of the program, such funds may 
     be used to award implementation grants to participating 
     States in subsequent years.
       (ii) Excess funds defined.--For purposes of clause (i), the 
     term ``excess funds'' means any amounts appropriated pursuant 
     to the authorization under subsection (h)(1) with respect to 
     a fiscal year that are not awarded to a participating State 
     under an implementation grant during such fiscal year.
       (C) Continuing availability of funds after appropriation.--
     An implementation grant made to a participating State under 
     this section shall be available to the State without fiscal 
     year limitation.
       (2) Awarding of implementation grants.--
       (A) In general.--The Election Assistance Commission shall 
     award implementation grants during each year in which the 
     program is conducted.
       (B) One grant per state.--The Election Assistance 
     Commission shall not award more than 1 implementation grant 
     to any participating State under this section over the 
     duration of the program.
       (3) Duration.--The program shall be conducted for a period 
     of 3 years.
       (f) Requirements.--
       (1) Required procedures.--A participating State shall 
     establish and implement procedures for conducting all 
     elections by mail in the area with respect to which it 
     receives an implementation grant to conduct such elections, 
     including the following:
       (A) A process for recording electronically each voter's 
     registration information and signature.
       (B) A process for mailing ballots to all eligible voters.
       (C) The designation of places for the deposit of ballots 
     cast in an election.
       (D) A process for ensuring the secrecy and integrity of 
     ballots cast in the election.
       (E) Procedures and penalties for preventing election fraud 
     and ballot tampering, including procedures for the 
     verification of the signature of the voter accompanying the 
     ballot through comparison of such signature with the 
     signature of the voter maintained by the State in accordance 
     with subparagraph (A).
       (F) Procedures for verifying that a ballot has been 
     received by the appropriate authority.
       (G) Procedures for obtaining a replacement ballot in the 
     case of a ballot which is destroyed, spoiled, lost, or not 
     received by the voter.
       (H) A plan for training election workers in signature 
     verification techniques.
       (I) Plans and procedures to ensure that voters who are 
     blind, visually-impaired, or otherwise disabled have the 
     opportunity to participate in elections conducted by mail and 
     to ensure compliance with the Help America Vote Act of 2002. 
     Such plans and procedures shall be developed in consultation 
     with disabled and other civil rights organizations, voting 
     rights groups, State election officials, voter protection 
     groups, and other interested community organizations.
       (J) Plans and procedures to ensure the translation of 
     ballots and voting materials in accordance with section 203 
     of the Voting Rights Act of 1965 (42 U.S.C. 1973aa-1a)).
       (g) Best Practices, Technical Assistance, and Reports.--
       (1) In general.--The Election Assistance Commission shall--
       (A) develop, periodically issue, and, as appropriate, 
     update best practices for conducting elections by mail;
       (B) provide technical assistance to participating States 
     for the purpose of implementing procedures for conducting 
     elections by mail; and
       (C) submit to the appropriate committees of Congress--
       (i) annual reports on the implementation of such procedures 
     by participating States during each year in which the program 
     is conducted; and
       (ii) upon completion of the program conducted under this 
     section, a final report on the program, together with 
     recommendations for such legislation or administrative action 
     as the Election Assistance Commission determines to be 
     appropriate.
       (2) Consultation.--In developing, issuing, and updating 
     best practices, developing materials to provide technical 
     assistance to participating States, and developing the annual 
     and final reports under paragraph (1), the Election 
     Assistance Commission shall consult with interested parties, 
     including--
       (A) State and local election officials;
       (B) the United States Postal Service;
       (C) the Postal Regulatory Commission established under 
     section 501 of title 39, United States Code; and
       (D) voting rights groups, voter protection groups, groups 
     representing the disabled, and other civil rights or 
     community organizations.
       (h) Authorization of Appropriations.--
       (1) Grants.--There are authorized to be appropriated to 
     award grants under this section, for each of fiscal years 
     2007 through 2009, $6,000,000, to remain available without 
     fiscal year limitation until expended.
       (2) Administration.--There are authorized to be 
     appropriated to administer the program under this section, 
     $200,000 for the period of fiscal years 2007 through 2009, to 
     remain available without fiscal year limitation until 
     expended.
       (i) Rule of Construction.--Nothing in this Act may be 
     construed to authorize or require conduct prohibited under 
     any of the following laws, or to supersede, restrict, or 
     limit the application of such laws:
       (1) The Help America Vote Act of 2002 (42 U.S.C. 15301 et 
     seq.).
       (2) The Voting Rights Act of 1965 (42 U.S.C. 1973 et seq.).
       (3) The Voting Accessibility for the Elderly and 
     Handicapped Act (42 U.S.C. 1973ee et seq.).
       (4) The Uniformed and Overseas Citizens Absentee Voting 
     Act(42 U.S.C. 1973ff et seq.).
       (5) The National Voter Registration Act of 1993 (42 U.S.C. 
     1973gg et seq.).
       (6) The Americans with Disabilities Act of 1990 (42 U.S.C. 
     12101 et seq.).
       (7) The Rehabilitation Act of 1973 (29 U.S.C. 701 et seq.).

     SEC. 5. STUDY ON IMPLEMENTATION OF MAIL-IN VOTING FOR 
                   ELECTIONS.

       (a) Study.--
       (1) In general.--The Comptroller General of the United 
     States (in this section referred to as the ``Comptroller 
     General'') shall conduct a study evaluating the benefits of 
     broader implementation of mail-in voting in elections, taking 
     into consideration the annual reports submitted by the 
     Election Assistance Commission under section 4(g)(1)(C)(i) 
     before November 1, 2009.
       (2) Specific issues studied.--The study conducted under 
     paragraph (1) shall include a comparison of traditional 
     voting methods and mail-in voting with respect to--
       (A) the likelihood of voter fraud and misconduct;
       (B) the accuracy of voter rolls;
       (C) the accuracy of election results;
       (D) voter participation in urban and rural communities and 
     by minorities, language minorities (as defined in section 203 
     of the Voting Rights Act of 1965 (42 U.S.C. 1973aa-1a)), and 
     individuals with disabilities and by individuals who are 
     homeless or who frequently change their official residences;
     
[[Page 7532]]    
     
     
       (E) public confidence in the election system;
       (F) the residual vote rate, including such rate based on 
     voter age, education, income, race, or ethnicity or whether a 
     voter lives in an urban or rural community, is disabled, or 
     is a language minority (as so defined); and
       (G) cost savings.
       (3) Consultation.--In conducting the study under paragraph 
     (1), the Comptroller General shall consult with interested 
     parties, including--
       (A) State and local election officials;
       (B) the United States Postal Service;
       (C) the Postal Regulatory Commission established under 
     section 501 of title 39, United States Code; and
       (D) voting rights groups, voter protection groups, groups 
     representing the disabled, and other civil rights or 
     community organizations.
       (b) Report.--Not later than November 1, 2009, the 
     Comptroller General shall prepare and submit to the 
     appropriate committees of Congress a report on the study 
     conducted under subsection (a), together with such 
     recommendations for legislation or administrative action as 
     the Comptroller General determines to be appropriate.
                                 ______
                                 
      By Mrs. FEINSTEIN (for herself and Mr. Sessions):
  S. 980. A bill to amend the Controlled Substances Act to address 
online pharmacies; to the Committee on the Judiciary.
  Mrs. FEINSTEIN. Mr. President, I am pleased to join with Senator 
Sessions to re-introduce the Online Pharmacy Consumer Protection Act. 
Our legislation protects the safety of consumers who wish to fill 
legitimate prescriptions over the Internet, while holding accountable 
those who operate unregistered pharmacies.
  This legislation imposes basic, commonsense requirements on an 
industry that presents both promise and peril.
  First, this bill establishes disclosure standards for Internet 
pharmacies.
  Second, this bill prohibits an Internet pharmacy from dispensing or 
selling a controlled substance without an in-person examination by a 
physician.
  Third, it allows a State Attorney General to bring a civil action in 
a federal district court to enjoin a pharmacy operating in violation of 
the law, and to enforce compliance with the provisions of this law.
  The disclosure requirements contained in this bill will allow 
patients to differentiate between shady off-shore pharmacies and 
legitimate licensed ones. Under this legislation, pharmacies must 
clearly disclose: the name and address of the pharmacy. Contact 
information for the pharmacist-in-charge. A list of States in which the 
pharmacy is licensed to operate.
  They must also clearly post a statement that they comply with the 
requirements in this legislation.
  The bill states that pharmacies can dispense to patients only if they 
have a valid prescription from a practitioner who has performed an in-
person examination. This requirement will ensure that doctors can 
verify the health status of a patient and ensure that the drug he or 
she will receive from the pharmacy is medically appropriate.
  This legislation recognizes that in the case of an emergency, a 
patient may not always be able to see his or her typical physician. For 
that reason, it allows a doctor to designate a covering practitioner to 
write a valid prescription if he or she is not available.
  Finally, this bill contains real penalties to hold accountable those 
who continue to operate pharmacies in violation of these requirements.
  First, for Internet sales of controlled substances, the bill makes 
clear that such activities are subject to the current Federal laws 
against illegal distributions and the same penalties applicable to 
hand-to-hand sales.
  Second, the bill increases the penalties for illegal distributions of 
controlled substances categorized by the DEA as Schedule III, IV and V 
substances, with new penalties if death or serious bodily injury 
results, and longer periods of supervised release available after 
convictions.
  The bill also allows a State's Attorney General to file a Federal 
motion to stop these pharmacies from operating illegally, no matter 
where the entity is headquartered. Previously, this type of enforcement 
would require a filing in every state.
  Prescription drug abuse is a growing front on the War on Drugs, with 
15.1 million adults admitting to abuse of prescription drugs in a 2003 
study. That's a 94 percent increase in the last decade.
  Last month, the Centers for Disease Control and Prevention reported 
that deaths from accidental drug overdoses nearly doubled from 1999 to 
2004, increasing from 11,155 in 1999 to 19,838 in 2004. Accidental drug 
overdoses are now the Nation's second-leading cause of accidental 
death, behind automobile crashes.
  The CDC attributed the rise in drug overdose deaths to a higher use 
of prescription painkillers and increasing numbers of overdoses of 
cocaine and prescription sedatives. These increases did not occur in 
our inner cities; instead, the increase was described as being fueled 
by prescription drug abuse in middle-class, rural America--with 
overdose death rates doubling in 23 States, mostly in the South and 
Midwest.
  Ready access to controlled substances over the Internet is helping to 
fuel these addictions. A study conducted by the National Center on 
Addiction and Substance Abuse at Columbia University found at least 344 
websites offering controlled substances.
  89 percent of these pharmacies do not require a prescription from a 
physician, accepting either an online consultation or no prescription 
at all.
  38 percent of these pharmacies claim their drugs are shipping within 
the United States, putting them within the reach of U.S. law 
enforcement.
  We also know that internet pharmacies fill a disproportionate number 
of prescriptions for controlled substances. According to data from the 
National Community Pharmacy Association (NCPA)-Pfizer Digest, 
controlled substances account for only 11 percent of the business at 
community ``brick and mortar'' pharmacies. 89 percent of their business 
consists of non-controlled prescription drugs. In contrast, 
approximately 95 percent of the business done by internet pharmacies is 
controlled substances.
  To understand how many of these Internet pharmacy websites exist, 
just visit any Internet search engine. Type in the name of any 
controlled substance, like Vicodin, Oxycontin, codeine, or even 
anabolic steroids. Several websites will appear, offering to sell you 
these drugs without a prescription and without a medical examination. 
Some of these websites simply ask patients to send copies of medical 
records, with no verification of their validity. Patients use these 
pharmacies to obtain addictive drugs like Vicodin and Oxycontin. They 
can receive these dangerous drugs without a doctor performing a 
physical exam to ensure that an underlying health condition will not 
cause a dangerous side effect. Often, a credit card is all that is 
required.
  Law enforcement officials are well aware of this growing problem but 
face many challenges in trying to find and prosecute rogue pharmacy 
operators. Last year, Attorney General Alberto Gonzales appeared before 
the Senate Judiciary Committee and warned at that time how ``the 
purchase of . . . controlled pharmaceuticals on the Internet is of 
great concern.'' He said that the Internet's wide accessibility and 
anonymity ``give drug abusers the ability to circumvent the law, as 
well as sound medical practice, a[s] they dispense potentially 
dangerous controlled pharmaceuticals,'' and said that, with ``no 
identifying . . . information on these websites, it is very difficult 
for law enforcement to track any of the individuals behind them.''
  In January of this year, Attorney General Alberto Gonzales again 
appeared before the Senate Judiciary Committee. The problem had only 
grown worse. He described the non-medicinal use of controlled substance 
prescription drugs as ``the fastest rising category of drug abuse in 
recent years.'' He noted how ``[r]ogue pharmacies operating illicitly 
through the Internet increasingly have become a source for the illegal 
supply of controlled substances,'' and offered to work with Congress to 
try to adopt additional enforcement tools that may be appropriate.
  I believe that the bill I introduce today will address many of these 
problems that the Attorney General has identified.


[[Page 7533]]


  At the same time, receiving medications from a legitimate, licensed 
Internet pharmacy is one of the new conveniences ushered in by the 
Internet age. This bill preserves the ability of well run pharmacies 
and well intentioned patients to access controlled substances by means 
of the Internet.
  In closing, I want to share with you the story of Ryan T. Haight of 
La Mesa, CA. Ryan was an 18-year-old honor student from La Mesa, CA, 
when he died in his home on February 12, 2001.
  His parents found a bottle of Vicodin in his room with a label from 
an out-of-state pharmacy.
  It turns out that Ryan had been ordering addictive drugs online and 
paying with a debit card his parents gave him to buy baseball cards on 
eBay.
  Without a physical exam or his parents' consent, Ryan had been 
obtaining controlled substances, some from an Internet site in 
Oklahoma. It only took a few months before Ryan's life was ended by an 
overdose on a cocktail of painkillers.
  Ryan's story is just one of many. Internet pharmacies are making it 
increasingly easy for teens like Ryan to access deadly prescription 
drugs. That is why I support this legislation. It creates sensible 
requirements for Internet pharmacy websites that will not impact access 
to convenient, oftentimes cost-saving drugs.
  I urge my colleagues to join me in supporting this legislation and I 
ask unanimous consent that the text of the legislation be printed in 
the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                 S. 980

       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 ``Online Pharmacy Consumer 
     Protection Act of 2007''.

     SEC. 2. AMENDMENTS TO THE CONTROLLED SUBSTANCES ACT RELATING 
                   TO THE DELIVERY OF CONTROLLED SUBSTANCES BY 
                   MEANS OF THE INTERNET.

       (a) In General.--Section 102 of the Controlled Substances 
     Act (21 U.S.C. 802) is amended by adding at the end the 
     following:
       ``(47) The term `Internet' means collectively the myriad of 
     computer and telecommunications facilities, including 
     equipment and operating software, which comprise the 
     interconnected worldwide network of networks that employ the 
     Transmission Control Protocol/Internet Protocol, or any 
     predecessor or successor protocol to such protocol, to 
     communicate information of all kinds by wire or radio.
       ``(48) The term `deliver, distribute, or dispense by means 
     of the Internet' refers, respectively, to any delivery, 
     distribution, or dispensing of a controlled substance that is 
     caused or facilitated by means of the Internet.
       ``(49) The term `online pharmacy'--
       ``(A) means a person, entity, or Internet site, whether in 
     the United States or abroad, that delivers, distributes, or 
     dispenses, or offers to deliver, distribute, or dispense, a 
     controlled substance by means of the Internet; and
       ``(B) does not include--
       ``(i) manufacturers or distributors registered under 
     subsection (a), (b), (c), or (d) of section 303 who do not 
     dispense controlled substances;
       ``(ii) nonpharmacy practitioners who are registered under 
     section 303(f);
       ``(iii) mere advertisements that do not attempt to 
     facilitate an actual transaction involving a controlled 
     substance; or
       ``(iv) a person, entity, or Internet site which is not in 
     the United States and does not facilitate the delivery, 
     distribution, or dispensing of a controlled substance by 
     means of the Internet to any person in the United States.
       ``(50) The term `homepage' means the first page of the 
     website of an online pharmacy that is viewable on the 
     Internet.''.
       (b) Registration Requirements.--Section 303 of the 
     Controlled Substances Act (21 U.S.C. 823) is amended by 
     adding at the end the following new subsection:
       ``(i) Dispenser of Controlled Substances by Means of the 
     Internet.--(1) A pharmacy that seeks to deliver, distribute, 
     or dispense by means of the Internet a controlled substance 
     shall obtain a registration specifically authorizing such 
     activity, in accordance with regulations promulgated by the 
     Attorney General. In determining whether to grant an 
     application for such registration, the Attorney General shall 
     apply the factors set forth in subsection (f).
       ``(2) Registration under this subsection shall be in 
     addition to, and not in lieu of, registration under 
     subsection (f).
       ``(3) This subsection does not apply to pharmacies that 
     merely advertise by means of the Internet but do not attempt 
     to facilitate an actual transaction involving a controlled 
     substance by means of the Internet.''.
       (c) Reporting Requirements.--Section 307(d) of the 
     Controlled Substances Act (21 U.S.C. 827(d)) is amended by--
       (1) designating the text as paragraph (1); and
       (2) inserting after paragraph (1), as so designated by this 
     Act, the following new paragraph:
       ``(2) A pharmacy registered under section 303(i) shall 
     report to the Attorney General the controlled substances 
     dispensed under such registration, in such manner and 
     accompanied by such information as the Attorney General by 
     regulation shall require.''.
       (d) Online Prescription Requirement.--Section 309 of the 
     Controlled Substances Act (21 U.S.C. 829) is amended by 
     adding at the end the following new subsection:
       ``(e) Controlled Substances Dispensed by Means of the 
     Internet.--(1) As used in this subsection--
       ``(A) the term `valid prescription' means a prescription 
     that is issued for a legitimate medical purpose in the usual 
     course of professional practice that is based upon a 
     qualifying medical relationship by a practitioner registered 
     by the Attorney General under this part;
       ``(B) the term `qualifying medical relationship'--
       ``(i) means a medical relationship that exists when the 
     practitioner--
       ``(I) has conducted at least one medical evaluation with 
     the user in the physical presence of the practitioner, 
     without regard to whether portions of the evaluation are 
     conducted by other health professionals; or
       ``(II) conducts a medical evaluation of the patient as a 
     covering practitioner and is not prescribing a controlled 
     substance in schedule II, III, or IV; and
       ``(ii) shall not be construed to imply that one medical 
     evaluation described in clause (i) demonstrates that a 
     prescription has been issued for a legitimate medical purpose 
     within the usual course of professional practice; and
       ``(C) the term `covering practitioner' means, with respect 
     to a patient, a practitioner who conducts a medical 
     evaluation, without regard to whether the medical evaluation 
     of the patient involved is an in-person evaluation, at the 
     request of a practitioner who has conducted at least one in-
     person medical evaluation of the patient and is temporarily 
     unavailable to conduct the evaluation of the patient.
       ``(2) In addition to the requirements of subsections (a) 
     through (c), no controlled substance may be delivered, 
     distributed, or dispensed by means of the Internet without a 
     valid prescription.
       ``(3) Nothing in this subsection shall apply to--
       ``(A) the dispensing of a controlled substance pursuant to 
     telemedicine practices sponsored by--
       ``(i) a hospital that has in effect a provider agreement 
     under title XVIII of the Social Security Act; or
       ``(ii) a group practice that has not fewer than 100 
     physicians who have in effect provider agreements under such 
     title; or
       ``(B) the dispensing or selling of a controlled substance 
     pursuant to practices as determined by the Attorney General 
     by regulation.''.
       (e) Online Prescription Requirements.--The Controlled 
     Substances Act is amended by adding after section 310 (21 
     U.S.C. 830) the following:


        ``ONLINE PHARMACY LICENSING AND DISCLOSURE REQUIREMENTS

       ``Sec. 311.  (a) In General.--An online pharmacy shall 
     display in a visible and clear manner on its homepage a 
     statement that it complies with the requirements of this 
     section with respect to the delivery or sale or offer for 
     sale of controlled substances and shall at all times display 
     on the homepage of its Internet site a declaration of 
     compliance in accordance with this section.
       ``(b) Licensure.--Each online pharmacy shall comply with 
     the requirements of State law concerning the licensure of 
     pharmacies in each State from which it, and in each State to 
     which it, delivers, distributes, or dispenses or offers to 
     deliver, distribute, or dispense controlled substances by 
     means of the Internet.
       ``(c) Compliance.--No online pharmacy or practitioner shall 
     deliver, distribute, or dispense by means of the Internet a 
     controlled substance without a valid prescription (as defined 
     in section 309(e)) and each online pharmacy shall comply with 
     all applicable requirements of Federal and State law.
       ``(d) Internet Site Disclosure Information.--Each online 
     pharmacy site shall post in a visible and clear manner on the 
     homepage of its Internet site or on a page directly linked 
     from its homepage the following:
       ``(1) The name of the owner, street address of the online 
     pharmacy's principal place of business, telephone number, and 
     email address.
       ``(2) A list of the States in which the online pharmacy, 
     and any pharmacy which dispenses, delivers, or distributes a 
     controlled substance on behalf of the online pharmacy, is 
     licensed to dispense controlled substances or prescription 
     drugs and any applicable license number.
     
     
     
[[Page 7534]]     
     
     
       ``(3) For each pharmacy identified on its license in each 
     State in which it is licensed to engage in the practice of 
     pharmacy and for each pharmacy which dispenses or ships 
     controlled substances on behalf of the online pharmacy:
       ``(A) The name of the pharmacy.
       ``(B) The street address of the pharmacy.
       ``(C) The name, professional degree, and licensure of the 
     pharmacist-in-charge.
       ``(D) The telephone number at which the pharmacist-in-
     charge can be contacted.
       ``(E) A certification that each pharmacy which dispenses or 
     ships controlled substances on behalf of the online pharmacy 
     is registered under this part to deliver, distribute, or 
     dispense by means of the Internet controlled substances.
       ``(4) The name, address, professional degree, and licensure 
     of practitioners who provide medical consultations through 
     the website for the purpose of providing prescriptions.
       ``(5) A telephone number or numbers at which the 
     practitioners described in paragraph (4) may be contacted.
       ``(6) The following statement, unless revised by the 
     Attorney General by regulation: `This online pharmacy will 
     only dispense a controlled substance to a person who has a 
     valid prescription issued for a legitimate medical purpose 
     based upon a medical relationship with a prescribing 
     practitioner, which includes at least one prior in-person 
     medical evaluation. This online pharmacy complies with 
     section 309(e) of the Controlled Substances Act (21 U.S.C. 
     829(e)).'.
       ``(e) Notification.--(1) Thirty days prior to offering a 
     controlled substance for sale, delivery, distribution, or 
     dispensing, the online pharmacy shall notify the Attorney 
     General, in the form and manner as the Attorney General shall 
     determine, and the State boards of pharmacy in any States in 
     which the online pharmacy offers to sell, deliver, 
     distribute, or dispense controlled substances.
       ``(2) The notification required under paragraph (1) shall 
     include--
       ``(A) the information required to be posted on the online 
     pharmacy's Internet site under subsection (d) and shall 
     notify the Attorney General and the applicable State boards 
     of pharmacy, under penalty of perjury, that the information 
     disclosed on its Internet site under to subsection (d) is 
     true and accurate;
       ``(B) the online pharmacy's Internet site address and a 
     certification that the online pharmacy shall notify the 
     Attorney General of any change in the address at least 30 
     days in advance; and
       ``(C) the Drug Enforcement Administration registration 
     numbers of any pharmacies and practitioners referred to in 
     subsection (d), as applicable.
       ``(3) An online pharmacy that is already operational as of 
     the effective date of this section, shall notify the Attorney 
     General and applicable State boards of pharmacy in accordance 
     with this subsection not later than 30 days after the 
     effective date of this section.
       ``(f) Declaration of Compliance.--On and after the date on 
     which it makes the notification under subsection (e), each 
     online pharmacy shall display on the homepage of its Internet 
     site, in such form as the Attorney General shall by 
     regulation require, a declaration that it has made such 
     notification to the Attorney General.
       ``(g) Reports.--Any statement, declaration, notification, 
     or disclosure required under this section shall be considered 
     a report required to be kept under this part.''.
       (f) Offenses Involving Controlled Substances in Schedules 
     III, IV, and V.--Section 401(b) of the Controlled Substances 
     Act (21 U.S.C. 841(b)) is amended--
       (1) in paragraph (1)--
       (A) in subparagraph (C), by striking ``1 gram of'' before 
     ``flunitrazepam'';
       (B) in subparagraph (D), by striking ``or in the case of 
     any controlled substance in schedule III (other than gamma 
     hydroxybutyric acid), or 30 milligrams of flunitrazepam''; 
     and
       (C) by inserting at the end the following:
       ``(E)(i) In the case of any controlled substance in 
     schedule III, such person shall be sentenced to a term of 
     imprisonment of not more than 10 years and if death or 
     serious bodily injury results from the use of such substance 
     shall be sentenced to a term of imprisonment of not more than 
     20 years, a fine not to exceed the greater of that authorized 
     in accordance with the provisions of title 18, or $500,000 if 
     the defendant is an individual or $2,500,000 if the defendant 
     is other than an individual, or both.
       ``(ii) If any person commits such a violation after a prior 
     conviction for a felony drug offense has become final, such 
     person shall be sentenced to a term of imprisonment of not 
     more than 20 years and if death or serious bodily injury 
     results from the use of such substance shall be sentenced to 
     a term of imprisonment of not more than 30 years, a fine not 
     to exceed the greater of twice that authorized in accordance 
     with the provisions of title 18, or $1,000,000 if the 
     defendant is an individual or $5,000,000 if the defendant is 
     other than an individual, or both.
       ``(iii) Any sentence imposing a term of imprisonment under 
     this subparagraph shall, in the absence of such a prior 
     conviction, impose a term of supervised release of at least 2 
     years in addition to such term of imprisonment and shall, if 
     there was such a prior conviction, impose a term of 
     supervised release of at least 4 years in addition to such 
     term of imprisonment'';
       (2) in paragraph (2) by--
       (A) striking ``3 years'' and inserting ``5 years'';
       (B) striking ``6 years'' and inserting ``10 years'';
       (C) striking ``after one or more prior convictions'' and 
     all that follows through ``have become final,'' and inserting 
     ``after a prior conviction for a felony drug offense has 
     become final,''; and
       (3) in paragraph (3) by--
       (A) striking ``2 years'' and inserting ``6 years'';
       (B) striking ``after one or more convictions'' and all that 
     follows through ``have become final,'' and inserting ``after 
     a prior conviction for a felony drug offense has become 
     final,''; and
       (C) adding at the end the following ``Any sentence imposing 
     a term of imprisonment under this paragraph may, if there was 
     a prior conviction, impose a term of supervised release of 
     not more than 1 year, in addition to such term of 
     imprisonment.''
       (g) Offenses Involving Dispensing of Controlled Substances 
     by Means of the Internet.--Section 401 of the Controlled 
     Substances Act (21 U.S.C. 841) is amended by adding at the 
     end the following:
       ``(g) Offenses Involving Dispensing of Controlled 
     Substances by Means of the Internet.--(1) Except as 
     authorized by this title, it shall be unlawful for any person 
     to knowingly or intentionally cause or facilitate the 
     delivery, distribution, or dispensing by means of the 
     Internet of a controlled substance.
       ``(2) Violations of this subsection include--
       ``(A) delivering, distributing, or dispensing a controlled 
     substance by means of the Internet by a pharmacy not 
     registered under section 303(i);
       ``(B) writing a prescription for a controlled substance for 
     the purpose of delivery, distribution, or dispensation by 
     means of the Internet in violation of subsection 309(e);
       ``(C) serving as an agent, intermediary, or other entity 
     that causes the Internet to be used to bring together a buyer 
     and seller to engage in the dispensing of a controlled 
     substance in a manner not authorized by sections 303(i) or 
     309(e); and
       ``(D) making a material false, fictitious, or fraudulent 
     statement or representation in the submission to the Attorney 
     General under section 311.
       ``(3) This subsection does not apply to--
       ``(A) the delivery, distribution, or dispensation of 
     controlled substances by nonpractitioners to the extent 
     authorized by their registration under this title;
       ``(B) the placement on the Internet of material that merely 
     advocates the use of a controlled substance or includes 
     pricing information without attempting to propose or 
     facilitate an actual transaction involving a controlled 
     substance; or
       ``(C) any activity that is limited to--
       ``(i) the provision of a telecommunications service, or of 
     an Internet access service or Internet information location 
     tool (as those terms are defined in section 231 of the 
     Communications Act of 1934 (47 U.S.C. 231)); or
       ``(ii) the transmission, storage, retrieval, hosting, 
     formatting, or translation (or any combination thereof) of a 
     communication, without selection or alteration of the content 
     of the communication, except that deletion of a particular 
     communication or material made by another person in a manner 
     consistent with section 230(c) of the Communications Act of 
     1934 (47 U.S.C. 230(c)) shall not constitute such selection 
     or alteration of the content of the communication.
       ``(4) Any person who knowingly or intentionally violates 
     this subsection shall be sentenced in accordance with 
     subsection (b) of this section.''.
       (h) Publication.--Section 403(c) of the Controlled 
     Substances Act (21 U.S.C. 843(c)) is amended by--
       (1) designating the text as paragraph (1); and
       (2) adding at the end the following:
       ``(2)(A) It shall be unlawful for any person to use the 
     Internet, or cause the Internet to be used, to advertise the 
     sale of, or to offer to sell, distribute, or dispense, a 
     controlled substance except as authorized by this title.
       ``(B) Violations of this paragraph include causing the 
     placement on the Internet of an advertisement that refers to 
     or directs prospective buyers to Internet sellers of 
     controlled substances who are not registered under section 
     303(i).
       ``(C) This paragraph does not apply to material that 
     either--
       ``(i) advertises the distribution of controlled substances 
     by nonpractitioners to the extent authorized by their 
     registration under this title; or
       ``(ii) merely advocates the use of a controlled substance 
     or includes pricing information without attempting to 
     facilitate an actual transaction involving a controlled 
     substance.''.
       (i) Injunctive Relief.--Section 512 of the Controlled 
     Substances Act (21 U.S.C. 882) is amended by adding to the 
     end of the section the following new subsection:
       ``(c) State Cause of Action Pertaining to Online 
     Pharmacies.--(1) In any case in which the State has reason to 
     believe that an interest of the residents of that State has 
     
     
     
     
[[Page 7535]]


     been or is being threatened or adversely affected by the 
     action of a person, entity, or Internet site that violates 
     the provisions of section 303(i), 309(e), or 311, the State 
     may bring a civil action on behalf of such residents in a 
     district court of the United States with appropriate 
     jurisdiction--
       ``(A) to enjoin the conduct which violates this section;
       ``(B) to enforce compliance with this section;
       ``(C) to obtain damages, restitution, or other 
     compensation, including civil penalties under section 402(b); 
     and
       ``(D) to obtain such other legal or equitable relief as the 
     court may find appropriate.
       ``(2)(A) Prior to filing a complaint under paragraph (1), 
     the State shall serve a copy of the complaint upon the 
     Attorney General and upon the United States Attorney for the 
     judicial district in which the complaint is to be filed. In 
     any case where such prior service is not feasible, the State 
     shall serve the complaint on the Attorney General and the 
     appropriate United States Attorney on the same day that the 
     State's complaint is filed in Federal district court of the 
     United States. Such proceedings shall be independent of, and 
     not in lieu of, criminal prosecutions or any other 
     proceedings under this title or any other laws of the United 
     States.
       ``(B)(i) Not later than 120 days after the later of the 
     date on which a State's complaint is served on the Attorney 
     General and the appropriate United States Attorney, or the 
     date on which the complaint is filed, the United States shall 
     have the right to intervene as a party in any action filed by 
     a State under paragraph (1).
       ``(ii) After the 120-day period described in clause (i) has 
     elapsed, the United States may, for good cause shown, 
     intervene as a party in an action filed by a State under 
     paragraph (1).
       ``(iii) Notice and an opportunity to be heard with respect 
     to intervention shall be afforded the State that filed the 
     original complaint in any action in which the United States 
     files a complaint in intervention under clause (i) or a 
     motion to intervene under clause (ii).
       ``(iv) The United States may file a petition for appeal of 
     a judicial determination in any action filed by a State under 
     this section.
       ``(C) Service of a State's complaint on the United States 
     as required in this paragraph shall be made in accord with 
     the requirements of Federal Rule of Civil Procedure 4(i)(1).
       ``(3) For purposes of bringing any civil action under 
     paragraph (1), nothing in this Act shall prevent an attorney 
     general of a State from exercising the powers conferred on 
     the attorney general of a State by the laws of such State to 
     conduct investigations or to administer oaths or affirmations 
     or to compel the attendance of witnesses of or the production 
     of documentary or other evidence.
       ``(4) Any civil action brought under paragraph (1) in a 
     district court of the United States may be brought in the 
     district in which the defendant is found, is an inhabitant, 
     or transacts business or wherever venue is proper under 
     section 1391 of title 28, United States Code. Process in such 
     action may be served in any district in which the defendant 
     is an inhabitant or in which the defendant may be found.
       ``(5) No private right of action is created under this 
     subsection.''.
       (j) Forfeiture of Facilitating Property in Drug Cases.--
     Section 511(a)(4) of the Controlled Substances Act (21 U.S.C. 
     881(a)(4)) is amended to read as follows:
       ``(4) Any property, real or personal, tangible or 
     intangible, used or intended to be used to commit, or to 
     facilitate the commission, of a violation of this title or 
     title III, and any property traceable thereto.''.
       (k) Import and Export Act.--Section 1010(b) of the 
     Controlled Substances Import and Export Act (21 U.S.C. 
     960(b)) is amended--
       (1) in paragraph (4) by--
       (A) striking ``or any quantity of a controlled substance in 
     schedule III, IV, or V, (except a violation involving 
     flunitrazepam and except a violation involving gamma 
     hydroxybutyric acid)'';
       (B) inserting ``, or'' before ``less than one kilogram of 
     hashish oil''; and
       (C) striking ``imprisoned'' and all that follows through 
     the end of the paragraph and inserting ``sentenced in 
     accordance with section 401(b)(1)(D) of this title (21 U.S.C. 
     841(b)(1)(E)).'';
       (2) by adding at the end the following:
       ``(5) In the case of a violation of subsection (a) of this 
     section involving a controlled substance in schedule III, 
     such person shall be sentenced in accordance with section 
     401(b)(1)(E).
       ``(6) In the case of a violation of subsection (a) of this 
     section involving a controlled substance in schedule IV 
     (except a violation involving flunitrazepam), such person 
     shall be sentenced in accordance with section 401(b)(2).
       ``(7) In the case of a violation of subsection (a) of this 
     section involving a controlled substance in schedule V, such 
     person shall be sentenced in accordance with section 
     401(b)(3).''; and
       (3) in paragraph (3), by striking ``, nor shall a person so 
     sentenced be eligible for parole during the term of such a 
     sentence'' in the final sentence.
       (l) Effective Date.--The amendments made by this Act shall 
     become effective 60 days after the date of enactment of this 
     Act.
       (m) Guidelines and Regulations.--
       (1) In general.--The Attorney General may promulgate and 
     enforce any rules, regulations, and procedures which may be 
     necessary and appropriate for the efficient execution of 
     functions under this subtitle, including any interim rules 
     necessary for the immediate implementation of this Act, on 
     its effective date.
       (2) Sentencing guidelines.--The United States Sentencing 
     Commission, in determining whether to amend, or establish 
     new, guidelines or policy statements, to conform the 
     guidelines and policy statements to this Act and the 
     amendments made by this Act, may not construe any change in 
     the maximum penalty for a violation involving a controlled 
     substance in a particular schedule as requiring an amendment 
     to, or establishing a new, guideline or policy statement.

  Mr. SESSIONS. Mr. President, after working together with Senator 
Feinstein, I am pleased to help introduce the Online Pharmacy Consumer 
Protection Act of 2007. I have worked to take the lead in protecting 
consumers specifically as it relates to the sale and distribution of 
controlled substances over the internet and holding liable those who do 
so via unregistered online pharmacies. I commend Senator Feinstein for 
her leadership on this issue and look forward to working with her to 
pass this important piece of legislation.
  This bill would prohibit the distribution of controlled substances by 
means of the Internet without a valid prescription and provides for the 
legitimate online distribution of those drugs in certain circumstances. 
This past January, Attorney General Gonzalez testified to the Judiciary 
Committee that abuse of controlled substances is being fed by ``the 
proliferation of illicit Web sites that offer controlled substances for 
sale, requiring little more than a cursory online questionnaire and 
charging double the normal price.'' Gonzales further testified that 
``[w]e must preserve legitimate access to medications over the Internet 
while preventing online drug dealers from using cyberspace as a haven 
for drug trafficking. I look forward to working with the Congress to 
ensure that controlled substances are dispensed over the Internet only 
for legitimate medical purposes.'' The sale and distribution of 
controlled pharmaceuticals on the Internet of great concern because is 
gives those who abuse drugs the ability to circumvent the law, and 
sound medical practice. This bill would go a long way in addressing the 
concerns expressed by Attorney General Gonzalez by reigning in a 
practice that has gone unregulated for far too long.
  Recently, there has been an explosion in the number of online 
pharmacies that provide controlled substances to users without valid 
prescriptions. Most illegal drug abuse involving prescription drugs is 
associated with Internet purchases, where users are given a 
prescription without ever seeing a doctor. The most prominent abuse 
occurs with regard to controlled substances such as Hydrocodone, 
Valium, Xanax, OxyContin, and Vicodin.
  A 2006 study reported that ``a staggering 89 percent of sites selling 
controlled prescription drugs have no prescription requirements.'' 
According to the study, 15.1 million adults admitted to abusing 
prescription drugs, including 2.3 million abusers between the ages of 
12 and 17. Currently, there is no way to police this illegal activity.
  The ease with which consumers may purchase controlled substances from 
online pharmacies without a prescription is shocking. Often consumers 
can obtain a prescription from physicians employed by the online 
pharmacy by simply filling out a brief questionnaire on the pharmacy's 
website. Most online pharmacies have no way to verify that the consumer 
ordering the prescription is actually who they claim to be, or that the 
medical condition the consumer describes actually exists. Thus, drug 
addicts and minor children can easily order controlled substances and 
prescription drugs over the internet simply by providing false 
identities or describing non-existent medical conditions.
  In 2001, Ryan Haight, a California high school honors student and 
athlete, died from an overdose of the painkiller hydrocodone that he 
purchased from an 


[[Page 7536]]


online pharmacy. The doctor prescribing hydrocodone 
had never met or personally examined Ryan. Ryan simply filled out the 
pharmacy's online questionnaire, and described himself as a 25-year-old 
male suffering from chronic back pain. Ryan's death could have been 
avoided. I believe that Congress is in the best position to help 
prevent teenagers from purchasing controlled substances and 
prescription drugs from online rouge pharmacies.
  I also believe that Congress has the ability to help prevent adult 
prescription drug abuse by making it harder to purchase these drugs 
online without a valid prescription. The Online Pharmacy Consumer 
Protection Act would: (1) provide criminal penalties for those who 
knowingly or intentionally (unlawfully) dispense controlled substances 
over the Internet, (2) give state attorneys general a civil cause of 
action against anyone who violates the Act if they have reason to 
believe that the violation affects the interests of their state's 
residents, and (3) allow the Federal Government to take possession of 
any tangible or intangible property used illegally by online 
pharmacies.
  The Online Pharmacy Consumer Protection Act would also require online 
pharmacies to: (1) file a registration statement with the Attorney
  General and meet additional registration requirements promulgated by 
him/her, (2) report to the Attorney General any controlled substances 
dispensed over the Internet, and (3) comply with licensing and 
disclosure requirements.
  The Online Pharmacy Consumer Protection Act of 2007 takes a 
substantial step towards plugging a loophole in our drug laws by 
regulating the practice of distributing controlled substances via the 
internet.
  By holding unregistered online pharmacies accountable for their 
activity, we are ensuring that those who seek to purchase prescription 
drugs by using the internet are protected from those engaged in 
reprehensible business practices.
  Once again I thank Senator Feinstein for her leadership in addressing 
this serious issue. I commend this bill to my colleagues for study and 
I urge them to support this important legislation.
                                 ______
                                 
      By Mrs. CLINTON (for herself, Ms. Collins, Mr. Bingaman, and Ms. 
        Mikulski):
  S. 982. A bill to amend the Public Health Service Act to provide for 
integration of mental health services and mental health treatment 
outreach teams, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mrs. CLINTON. Mr. President, today, Senator Collins and I are 
reintroducing the Positive Aging Act, to improve the accessibility and 
quality of mental health services for our rapidly growing population of 
older Americans. I want to thank Senator Collins for her leadership on 
aging issues, and for partnering with me on numerous pieces of 
legislation and initiatives related to these and other important health 
issues.
  We are pleased to be reintroducing this important legislation in 
anticipation of reauthorization of the Substance Abuse and Mental 
Health Services Administration (SAMHSA).
  I want to acknowledge and thank our partners from the mental health 
and aging community who have collaborated with us and have been working 
diligently on these issues for many years, including the American 
Psychological Association, the American Association for Geriatric 
Psychiatry, the National Association of Social Workers, the Alzheimer's 
Association, the New York City Chapter of the Alzheimer's Association, 
the American Association of Homes and Services for the Aging, the 
American Academy of Child and Adolescent Psychiatry, the American 
Mental Health Counselors Association, the American Society on Aging, 
the Depression and Bipolar Support Alliance, the Geriatric Mental 
Health Alliance of New York, the Gerontological Society of America, 
Mental Health America, the National Association of State Mental Health 
Program Directors, the National Council on Aging, Psychologists in Long 
Term Care, the Older Women's League, the Society of Clinical 
Geropsychology, the Suicide Prevention Action Network USA, and all the 
other groups who have lent their support.
  American society today has benefited tremendously from advances in 
medical science that are helping us to live longer than ever before. In 
New York State alone, there are an estimated two and a half million 
citizens aged 65 or older. And this population will only continue to 
grow as the first wave of Baby Boomers turns 65 in less than ten years.
  According to a December 2006 report from the U.S. Census Bureau, the 
number of older Americans aged 65 and over is expected to double over 
the next 25 years, and nearly 20 percent of citizens will be 65 years 
or older by the year 2030. Further, the fastest growing segment of the 
U.S. population is the age group of Americans who are 85 and older.
  Although it is encouraging that our Nation's citizens are living 
longer than ever before, mental and behavioral health challenges 
accompany this increased longevity. So as we look forward to leading 
longer lives, we must also acknowledge the challenges that we face 
related to the quality of life as we age.
  Although most older adults enjoy good mental health, it is estimated 
that nearly 20 percent of Americans age 55 or older experience a mental 
disorder. In New York State alone, there are an estimated 366,000 
adults aged 55 or older with mental health or substance abuse 
disorders. Nationally, it is anticipated that the number of seniors 
with mental and behavioral health problems will almost quadruple, from 
4 million in 1970 to 15 million in 2030.
  Among the most prevalent mental health concerns older adults 
encounter are anxiety, depression, cognitive impairment, and substance 
abuse. When left untreated, these problems can have severe physical and 
psychological implications. In fact, men age 85 and older have the 
highest rates of suicide in our country and depression is the foremost 
risk factor.
  The physical consequences of mental health disorders can be both 
expensive and debilitating. Depression has a powerful negative impact 
on ability to function, resulting in high rates of disability. The 
World Health Organization projects that by the year 2020, depression 
will remain a leading cause of disability, second only to 
cardiovascular disease. Even mild depression lowers immunity and may 
compromise a person's ability to fight infections and cancers. Research 
indicates that 50-70 percent of all primary care medical visits are 
related to psychological factors such as anxiety, depression, and 
stress. Further, evidence suggests that an estimated 75 percent of 
seniors who commit suicide have visited a primary care professional 
within a month of their death.
  Mental disorders do not have to be a part of the aging process 
because we have effective treatments for these conditions. But despite 
these effective treatments, too many American seniors go without the 
services they need and deserve because of poor integration of physical 
and mental health care. As of 2006, only 37 percent of New Yorkers who 
suffer from depression had obtained mental health treatment.
  The current divide in our country between health care and mental 
health care manifests itself in many ways. Too often physicians and 
other health professionals fail to recognize the signs and symptoms of 
mental health problems. Even more troubling, knowledge about treatment 
is simply not accessible to many primary care practitioners. As a 
whole, we have failed to fully integrate mental health screening and 
treatment into our health service systems.
  These missed opportunities to diagnose and treat mental health 
disorders are taking a tremendous toll on seniors and increasing the 
burden on their families and our health care system.
  It is within our power and our responsibility to bridge the gap 
between physical and mental health care and help promote the well-being 
of older Americans.
  In last year's reauthorization of the Older Americans Act, Senator 
Collins 


[[Page 7537]]


and I successfully enacted Title I of the Positive Aging Act of 
2005, which authorized grants for the delivery of mental health 
screening and treatment services for older adults and grants to promote 
awareness and reduce stigma regarding mental disorders in later life.
  While this took an important step toward improving mental health 
services for older adults, significant efforts are necessary to ensure 
comprehensive geriatric mental health care.
  That is why I am reintroducing the Title II provisions of the 
Positive Aging Act of 2005 as the Positive Aging Act of 2007 with my 
cosponsor Senator Collins. This legislation would amend the Public 
Health Service Act to improve access to mental health services for our 
nation's seniors by integrating mental health services into primary 
care and community settings.
  Specifically, the Positive Aging Act of 2007 would fund demonstration 
projects to support integration of mental health services in primary 
care settings.
  It would fund grants for community-based mental health treatment 
outreach teams to improve older Americans' access to mental health 
services.
  This legislation would also ensure that these geriatric mental health 
programs have proper attention and oversight by: mandating the 
designation of a Deputy Director for Older Adult Mental Health Services 
in the Center for Mental Health Services; including representatives of 
older Americans or their families and geriatric mental health 
professionals on the Advisory Council for the Center for Mental Health 
Services; and requiring state plans under Community Mental Health 
Services Block Grants to include descriptions of the states' outreach 
to and services for older individuals.
  And because substance-related disorders require the same attention as 
mental health conditions, the Positive Aging Act of 2007 will target 
substance abuse in older adults in projects of national significance.
  Today, we are fortunate to have a variety of effective treatments to 
address the mental health needs of American seniors. I believe that we 
owe it to older adults in this country to do all that we can to ensure 
that they have access to high quality mental health care, so they can 
enjoy their golden years.
  The Positive Aging Act of 2007 takes a critical step in this 
direction, and I look forward to working with my colleagues to enact 
this legislation during the upcoming SAMHSA reauthorization.
  Mr. President, I ask unanimous consent that letters of support be 
printed in the Record.
  There being no objection, the letters were ordered to be printed in 
the Record, as follows:

                                              National Association


                                            of Social Workers,

                                   Washington, DC, March 23, 2007.
     Senator Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
     Senator Susan M. Collins,
     Dirkson Senate Office Building,
     Washington, DC.
       Dear Senators Clinton and Collins: The National Association 
     of Social Workers (NASW) is the largest professional social 
     work organization, with 150,000 members nationwide. NASW 
     promotes, develops, and protects the practice of social work 
     and social workers, while enhancing the well-being of 
     individuals, families, and communities through its work, 
     service, and advocacy.
       NASW fully supports the Positive Aging Act of 2007, which 
     you are introducing today, along with Representatives Patrick 
     Kennedy (D-MA) and Ileana Ros-Lehtinen (R-FL). Many older 
     adults are currently unable to obtain much-needed mental 
     health services for a variety of reasons, including lack of 
     access and the stigma attached to mental illness. The 
     Positive Aging Act of 2007 will help integrate primary care 
     with mental health care for older adults, particularly those 
     with low incomes, living in community settings.
       Social workers are aware of the problems older people 
     encounter in obtaining necessary mental health care. 
     Frequently, they are called upon to address older adults' 
     mental health needs only after crises arise, when the 
     emotional toll on clients and their families is much higher, 
     and the costs to Medicare are much more significant.
       Clinical social workers assess and treat many older 
     Americans with mental health needs. In fact, more than 39,000 
     social workers now participate in Medicare, delivering mental 
     health services and enabling many thousands of older 
     beneficiaries to lead more fulfilling and healthier lives.
       NASW is particularly supportive of the multidisciplinary 
     teams of mental health professionals envisioned in this bill 
     as an integral part of primary care services. These teams, 
     which include professional social workers, will have the 
     training and competence to meet older Americans' diverse 
     physical and behavioral health needs. The Association 
     commends the senators and representatives for raising these 
     vital health issues, and urges Congress to move quickly to 
     enact this legislation.
       Thank you for your leadership on this vital health care 
     issue.
           Sincerely,
                                                   Carolyn Polowy,
     General Counsel.
                                  ____



                           American Psychological Association,

                                                   March 23, 2007.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
     Hon. Susan M. Collins,
     U.S. Senate,
     Washington, DC.
       Dear Senators Clinton and Collins: On behalf of the 148,000 
     members and affiliates of the American Psychological 
     Association (APA), I am writing to applaud your ongoing 
     commitment to the mental and behavioral health needs of older 
     Americans and express our strong support for the Positive 
     Aging Act of 2007. This important legislation will improve 
     access to vital mental and behavioral health care for older 
     adults by supporting the integration of mental health 
     services into primary care and community settings.
       An estimated 20 percent of community-based older adults in 
     the U.S. have a mental health problem. These disorders can 
     have a significant impact on both physical and mental health, 
     often leading to increases in disease, disability, and 
     mortality. Evidence suggests that up to 75 percent of older 
     adults who commit suicide have visited a primary care 
     professional within 30 days of their death. Although 
     effective treatments exist, the mental health needs of many 
     older Americans go unrecognized and untreated because of 
     poorly integrated systems of care to address the physical and 
     mental health needs of seniors.
       The Positive Aging Act of 2007 takes an important step 
     toward improving access to quality mental and behavioral 
     health care for older adults by integrating mental health 
     services into primary care and community settings where older 
     adults reside and receive services. By supporting 
     collaboration between interdisciplinary teams of mental 
     health professionals and other providers of health and social 
     services, this legislation promotes an integrated approach to 
     addressing the health and well being of our nation's growing 
     older adult population.
       We commend you for your leadership and commitment to the 
     mental and behavioral health needs of older adults and look 
     forward to working with you to ensure enactment of the 
     Positive Aging Act. If we can be of further assistance, 
     please feel free to contact Diane Elmore, Ph.D., in our 
     Government Relations Office at (202) 336-6104 or 
     [email protected].
           Sincerely,

                                      Gwendolyn Puryear Keita,

                                               Executive Director,
     Public Interest Directorate.
                                  ____


    Positive Aging Act of 2007 Organizational Supporters--March 2007

       Alzheimer's Association; Alzheimer's Association, New York 
     City Chapter; American Academy of Child and Adolescent 
     Psychiatry; American Association for Geriatric Psychiatry; 
     American Association of Homes and Services for the Aging; 
     American Association of Pastoral Counselors; American Group 
     Psychotherapy Association; American Mental Health Counselors 
     Association; American Occupational Therapy Association; 
     American Psychological Association; American Psychotherapy 
     Association; American Society on Aging; Anxiety Disorders 
     Association of America; Association for Ambulatory Behavioral 
     Healthcare; Bazelon Center for Mental Health Law; Clinical 
     Social Work Association; Clinical Social Work Guild 49, 
     OPEIU; Depression and Bipolar Support Alliance; Geriatric 
     Mental Health Alliance of New York; Gerontological Society of 
     America.
       Kansas Mental Health and Aging Coalition; Mental Health 
     America; Mental Health and Aging Coalition of Eastern Kansas; 
     National Alliance for Caregiving; National Association for 
     Children's Behavioral Health; National Association of Mental 
     Health Planning and Advisory Councils; National Association 
     of Psychiatric Health Systems; National Association of Social 
     Workers; National Association of State Mental Health Program 
     Directors; National Council on Aging; Oklahoma Mental Health 
     and Aging Coalition; Older Adult Consumers Alliance Older 
     Women's League; Pennsylvania Behavioral Health and Aging 
     Coalition; Psychologists in Long Term Care; Society of 
     Clinical Geropsychology; Suicide Prevention Action Network 
     USA.
                                  ____



[[Page 7538]]


                                              American Association


                                     for Geriatric Psychiatry,

                                     Bethesda, MD, March 20, 2007.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senator Clinton: The American Association for 
     Geriatric Psychiatry (AAGP) is pleased to endorse the 
     ``Positive Aging Act of 2007.''
       The ``Positive Aging Act'' will improve the accessibility 
     and quality of mental health services for the rapidly growing 
     population of older Americans. Through projects administered 
     by the Substance Abuse and Mental Health Services 
     Administration, this legislation will integrate mental health 
     services with other primary care services in community 
     settings that are easily accessible to the elderly.
       Dementia, depression, anxiety and substance abuse among 
     Americans over age 65 are growing problems that result in 
     functional dependence, longterm institutional care and 
     reduced quality of life. Missed opportunities to diagnose and 
     treat mental diseases are taking a tremendous toll on the 
     elderly and increasing the burden on families and the health 
     care system. The ``Positive Aging Act'' will increase 
     opportunities for effective diagnosis and treatment of mental 
     disorders among the elderly.
       AAGP is a professional membership organization dedicated to 
     promoting the mental health and well-being of older people 
     and improving the care of those with late-life mental 
     disorders. AAGP's membership consists of 2,000 geriatric 
     psychiatrists, as well as other health professionals who 
     focus on the mental health problems faced by senior citizens. 
     In addition, AAGP has an active Foundation which focuses on 
     reducing the stigma of mental disorders in the aging 
     population.
       AAGP appreciates your leadership in addressing the mental 
     health needs of older Americans, and we look forward to 
     working with you on this legislation.
           Sincerely,
                                                Christine deVries,
     Executive Director.

                          ____________________