By Ms. SNOWE (for herself and Ms. Collins):
S. 26. A bill to establish the Northern Appalachian Economic Development Commission, and for other purposes; to the Committee on Environment and Public Works.
Mr. President, today I am introducing the Northern Appalachian Economic Development Commission Act of 2006 with Senator Collins because the people of the Northern Forest region have not shared in the economic prosperity of many parts of the rest of the United States. The bill establishes a Federal-State partnership commission for the purpose of promoting economic development in the communities in the northern forest area of Maine, New Hampshire, New York and Vermont through the development of public policy tools and grants designed to build local capacity.
The legislation calls for a collaborative regional effort to achieve real progress to enhance not only the forest products industry to preserve the traditional industries of the region, but to catalyze new rural economic and small development and job growth, and slow out-migration.
Today, small businesses are fueling the economic growth of the Nation, producing over 50 percent of the gross domestic product and creating three-fourths of all new jobs. Entrepreneurship is a critical element in the establishment of self-sustaining communities that create jobs and contribute broadly to economic and community development. The bill authorizes appropriations of $40 million for economic development grants for fiscal years 2008-2012 that will support existing entrepreneur and small business development programs and projects and support projects for small business innovation research. Funding will also assist the region in obtaining job training, employment-related education and business development and assist in community development. Assistance will be provided to severely distressed and underdeveloped while maintaining the integrity of the region's resources.
Many residents of the Northeast region live below the poverty level, in areas of significantly higher than average unemployment rates, with limited access to capital, and with low per capita personal income. Maine's economy has long been based on the bounty of its natural resources--fishing, farming, forestry, and tourism. The very nature of these industries has meant that a significant portion of employment opportunities are seasonal and overall earnings lag behind national averages. Currently, Maine leads the country with the fastest growing poverty rate, tied with Arkansas and Mississippi. As a matter of fact, in 2005, according to the Federal Reserve Bank of Boston, Maine was the only State other than Louisiana that experienced a decline in economic activity. The entire northern forest region shares many of these common challenges, and as a result, local and State economic development leaders have been receptive to considering other means to create jobs.
Currently, there are several independent entities focused on regional economic development, such as the Appalachian Regional Commission, the Denali Commission, the Delta Regional Authority, and the Northern Great Plains Regional Authority. However, there is currently no single regional economic development entity focused on the needs of the far Northeast region. Our Northern Appalachian Economic Development Commission is expected to complement existing efforts, and I plan to pursue these efforts in the 2007 Farm bill.
The Appalachian Regional Commission--ARC--developed in 1965 has proven to be a success and has help transform a region once solely dependent on mining, agriculture and heavy industry to one more reliant on the service and retail industries. Since its creation, the ARC has reduced the number of distressed counties from 219 to 100. It has cut the poverty rate from 31 percent to 15 percent and has helped 1,400 businesses create 26,000 new jobs since 1977. This is the type of assistance that could also be very effective in Northern Appalachian area.
By Mr. COLEMAN:
S. 28. A bill to amend section 7209 of the Intelligence Reform and Terrorism Prevention Act of 2004 and for other purposes; to the Committee on Homeland Security and Governmental Affairs.
Mr. President, I ask unanimous consent that the bill I introduce today--the Northern Border Travel Facilitation Act--be printed in the Record.
There being no objection, the bill was ordered to be printed in the Record, as follows:
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
This Act may be cited as the ``Northern Border Travel Facilitation Act''.
By Mrs. FEINSTEIN (for herself, Mrs. Boxer, and Mr. Craig):
S. 4112. A bill to treat payments by charitable organizations with respect to certain firefighters as exempt payments; to the Committee on Finance.
Mr. President, I rise today to introduce legislation that will give tangible relief to the families of the five federal firefighters killed in the devastating Esperanza fire in southern California this October.
The Esperanza fire tragically claimed lives, homes and other buildings, while burning more than 40,000 acres. No one has felt the pain of this heartbreaking disaster more than the families of Mark ``Lotzie'' Loutzenhiser, Jess McLean, Jason McKay, Daniel Hoover-Najera, and Pablo Cerda.
These five men served honorably while exhibiting the utmost bravery in the name of helping others. They gave the ultimate sacrifice, and so have their families, who must now go on without a father or a son, a brother or a husband.
Now, in an outpouring of generosity and compassion, a United Way chapter in Riverside County, together with the surrounding community has raised more than $1 million to help the families of our fallen heroes as they move forward from this tragedy.
This serves as a testament to what these men meant to the community, the State of California and the Nation.
Unfortunately, in what seems to be a cruel twist, IRS rules do not allow this generosity to be passed on to the families of these brave firefighters.
Tax-exempt charitable organizations are prohibited from raising money for small, targeted, groups, such as the families of the fallen firefighters. In fact, if this memorial fund is passed on to the families, it could endanger the tax-exempt status of the Central County United Way and other charitable organizations trying to help these families in their hour of need.
In the wake of this disaster, our Government should be providing assistance to these families, not increasing their burden.
This much-needed legislation provides exemptions to allow this moving gesture to be realized. The United Way will preserve their tax exempt status, those who made these donations will receive the tax deductions they expected, and most importantly the families of the five fallen firefighters can receive individual donations, penalty free.
This legislation encourages the kind of generosity and kindness that we should all commend, not discourage.
We came together to pass similar legislation in the wake of the 9/11 tragedy and we should do so again today.
While this simple measure only makes a minor tax code clarification, the impact of this legislation will be profound for the families of these fallen heroes.
Let us not forget the heroism of these men and the sacrifice of their families. The time to act is now, so that these funds raised will not be withheld during the upcoming holiday season, when this relief is most needed.
I urge my colleagues to join me in doing what is right to help the families of those who have made the ultimate sacrifice to protect their communities.
Mr. President, I ask unanimous consent that the text of the Bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the Record, as follows:
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
This Act may be cited as the ``Fallen Firefighters Assistance Tax Clarification Act of 2006''.
By Mr. McCain (for himself, Mr. Bingaman, Mr. Smith, Mr. Baucus, Mr. Feingold, Mr. Johnson, Mr. Salazar, Mr. Wyden, Mrs. Boxer, Mr. Grassley, Mr. Reid, Mrs. Feinstein, and Mr. Dorgan):
S. 4113. A bill to amend the Omnibus Crime Control and Safe Streets Act of 1968 to clarify that territories and Indian tribes are eligible to receive grants for confronting the use of methamphetamine; considered and passed.
Mr. President, I am joined today by Senators Bingaman, Grassley, Smith, Baucus, Feingold, Johnson, Salazar, Wyden, Boxer, Reid, Feinstein, and Cantwell in introducing and passing a bill to amend the Omnibus Control and Safe Streets Act of 1968 to clarify that Indian tribes and U.S. territories are eligible to receive grants for confronting the use of methamphetamine.
The amendments that this bill makes to section 2996(a) of the Omnibus Crime Control and Safe Streets Act of 1968 would make U.S. territories and Indian tribes eligible to receive grants from the Department of Justice to address the scourge of methamphetamine use, sale, and manufacture. The terrible business of methamphetamine use, distribution, and manufacture has impacted communities all over the country, in urban and nonurban areas alike, and our territories and Indian reservations have not been spared. This bill will make much needed resources available to territorial and tribal governments to help bring the methamphetamine epidemic under control. However, I understand there are some questions about the intent of this bill in respect to a provision in this bill.
Mr. President, I rise for the purpose of engaging Senator McCain in a colloquy over a certain provision, to be sure that its purpose is clear. In section 1(a)( 4) of the bill, there is a provision which states, ``Nothing in this subsection, or in the award or denial of any grant pursuant to this subsection--(A) allows grants authorized under paragraph 3(A) to be made to, or used by, an entity for law enforcement activities that the entity lacks jurisdiction to perform; or (B) has any effect other than to authorize, award, or deny a grant of funds to a state, territory, or Indian tribe for the purposes described in this subsection.''
It is my understanding that the intent behind the amendment made by section 1(a)(4) of the bill is simply to make it clear that by authorizing the Department of Justice's Bureau of Justice Assistance to award grant funds to a State, territory, or Indian tribe to ``investigate, arrest and prosecute individuals'' involved in illegal methamphetamine activities, section 2996(a) does not somehow authorize a State, territory, or Indian tribe to pursue law enforcement activities that it otherwise has no jurisdiction to pursue. And similarly, this provision also clarifies that an award or denial of a grant by the Bureau of Justice Assistance does not somehow allow a State, territory, or Indian tribe to pursue law enforcement activities that it otherwise lacks jurisdiction to pursue. For example, a law enforcement agency in one State, territory, or Indian reservation is not somehow enabled by this section, or by an award made pursuant to this section, to prosecute a methamphetamine crime arising in some other jurisdiction unless that agency already has the jurisdiction to do that.
I would like to ask Senator McCain if my understanding of this provision is correct.
The Senator from New Mexico is correct in his understanding of this provision.
It is also my understanding that the language, ``Nothing in this subsection, or in the award or denial of any grant pursuant to this subsection. . . (B) has any effect other than to authorize, award, or deny a grant of funds to a state, territory, or Indian tribe for the purposes described in this subsection'' is intended to make it clear that the provisions of section 2996(a) and grant awards or denials pursuant to section 2996(a) have no effect beyond simply authorizing, awarding, or denying a grant of funds to a State, territory, or Indian tribe for the purposes described in section 2996(a). So, for example, if a State, territory, or Indian tribe is awarded or denied a grant of funds under this section, that award or denial has no relevance to or effect on the eligibility of the State, territory, or Indian tribe to participate in any other program or activity unrelated to the award or denial of grants under section 2996(a). The award or denial of a grant under this subsection, in other words, is relevant only to the award or denial of the grant under this subsection and nothing else.
I would like to ask Senator McCain whether my understanding of this provision of the bill is correct in this particular regard as well.
The Senator from New Mexico is correct in his understanding of this provision as well.
Mr. President, I urge my colleagues to support this critically needed legislation.
Mr. President, I am joined today by Senators Bingaman, Grassley, Smith, Baucus, Feingold, Johnson, Salazar, Wyden, Boxer, Reid, Feinstein, and Cantwell in introducing this bill to amend the Omnibus Control and Safe Streets Act of 1968 to clarify that Indian tribes and U.S. territories are eligible to receive grants for confronting the use of methamphetamine.
The amendments that this bill makes to section 2996(a) of the Omnibus Crime Control and Safe Streets Act of 1968 would make U.S. territories and Indian tribes eligible to receive grants from the Department of Justice to address the scourge of methamphetamine use, sale, and manufacture. The terrible business of methamphetamine use, distribution, and manufacture has impacted communities all over the country, in urban and nonurban areas alike, and our territories and Indian reservations have not been spared. This bill will make much-needed resources available to territorial and tribal governments to help bring the methamphetamine epidemic under control.
Mr. President, the impacts of methamphetamine use on communities across the Nation are well known and cannot be underestimated. We have worked hard with Senator Bingaman and his staff to craft legislation that makes these critical resources for fighting methamphetamine use, distribution, and manufacture available to sectors on which this drug is having a devastating impact. I would also like to thank Senator Sessions for the long hours he and his staff have devoted to working with my staff and other offices interested in this bill to make this a good bill that this body can and should support.
By Mr. HATCH (for himself, Mr. Levin, Ms. Collins, and Mr. Biden):
S. 4115. A bill to amend the Controlled Substances Act to increase the effectiveness of physician assistance for drug treatment; considered and passed.
Mr. President, among the most consequential tasks Congress will undertake in the coming months is a potentially epoch-defining review of U.S. trade policy occasioned by the looming expiry of numerous trade preference programs, ``fast-track'' Trade Promotion Authority and the Doha Round of World Trade Organization negotiations. The fate of recent trade legislation, mirroring growing acrimony in the public debate over trade policy, portends that Congress will not simply be considering whether to reauthorize certain programs and processes affecting international trade--it will be setting forth a doctrine declaring America's position and powers in an irreversibly interdependent global economy.
The complexity of the market forces that can bring both hope and hardship under the modern trade regime mean that few other issues cut across traditionally drawn party, geographic and ideological lines so dramatically. Where the usual political dichotomies don't apply, new ones have been framed to polarize the issue: free-trade versus fair-trade, globalization versus protectionism, growth versus sustainability.
Yet above this fray of competing economic theories and realities, a solid consensus has grown around the principle that whatever our trade laws may be, they should be consistently and vigorously enforced.
The distressing reality is that U.S. industry and labor groups are often rebuffed in attempts to petition the United States Trade Representative to initiate a formal investigation or bring a dispute resolution action under the relevant multilateral or bilateral trade agreement, as there is considerable institutional momentum among senior officials at USTR and elsewhere in the administration against bringing formal enforcement action against certain trade partners, and China in particular. USTR's handling of the trade effects of China's currency manipulation practices is representative of the problem. In September 2004, a U.S. industry coalition filed a petition under section 301 of the Trade Act of 1974--the statute setting forth general procedures for the enforcement of U.S. trade rights--alleging that Chinese currency manipulation practices constituted a violation of China's obligations to the United States under World Trade Organization rules, and calling for USTR to conduct an investigation of such practices. USTR rejected the petition on the day it was filed, contending that ``an investigation would not be effective in addressing the acts, policies, and practices covered in the petition. The administration is currently involved in efforts to address with the Government of China the currency valuation issues raised in the petition. The USTR believes that initiation of an investigation under--the section 301 process--would hamper, rather than advance, administration efforts to address Chinese currency valuation policies.'' Shortly thereafter, in November of 2004, a congressional coalition of 12 Senators and 23 Representatives filed a similar section 301 petition, which was rejected by USTR on the same grounds.
As noted in USTR's rejection of these petitions, current law allows the Executive to decline to initiate an industry-requested investigation where it determines that action under section 301 would be ineffective in addressing the offending act, policy or practice. The merits of USTR's determination are unreviewable under current law. USTR used this loophole to avoid having to even investigate industry's claim, let alone take formal action against China. And as we now know, the administration's ``soft'' approach to Chinese currency manipulation has itself proven ineffective in addressing the problem in the 2 years since these filings.
It is to prevent further disregard for U.S. businesses and workers seeking a fair and consequential hearing of their concerns with foreign trade practices that I today introduce the Trade Complaint and Litigation Accountability Improvement Measures Act, or the ``Trade CLAIM Act''.
The Trade CLAIM Act would amend the section 301 process to require the U.S. Trade Representative to act upon an interested party's petition to take formal action in cases where a U.S. trade right has been violated, except in instances where: the matter has already been addressed by the relevant trade dispute settlement body; the foreign country is taking imminent steps to end to ameliorate the effects of the practice; taking action would do more harm than good to the U.S. economy; or taking action would cause serious harm to the national security of the United States.
The bill would also grant the Court of International Trade jurisdiction to review de novo USTR's denials of section 301 industry petitions to investigate and take enforcement action against unfair foreign trade laws or practices. Such jurisdiction would include the ability to review USTR determinations that U.S. trade rights have not been violated as alleged in industry petitions, and the sufficiency of formal actions taken by USTR in response to foreign trade laws or practices determined to violate U.S. trade rights.
The Trade CLAIM Act would give U.S. businesses and workers a greater say in whether, when and how U.S. trade rights should be enforced. The bill would be particularly beneficial to small businesses, which--like other petitioners in section 301 cases--currently have no avenue to formally challenge the merits of USTR's decisions, and are often drowned out by large business interests in industry-wide section 301 actions initiated by USTR.
By providing for judicial review of USTR decisions not to enforce U.S. trade rights, the bill provides for impartial third party oversight by a specialty court not subject to political and diplomatic pressures. In delinking discreet trade disputes from the mercurial machinations of international relations, this act would end the sacrifice of individual industries on the negotiating table, and leave it to the free market--uniformly operating under the trade rules to which our trading partners have already agreed--to decide their fate.
By Mr. AKAKA (for himself and Mr. Sununu):
S. 4117. A bill to repeal title II of the REAL ID Act of 2005, to reinstitute the section 7212 of the Intelligence Reform and Terrorism Prevention Act of 2004, which provides States additional regulatory flexibility and funding authorization to more rapidly produce tamper- and counterfeit-resistant driver's licenses and to protect privacy and civil liberties by providing interested stakeholders on a negotiated rulemaking with guidance to achieve improved 21st century licenses to improve national security; to the Committee on the Judiciary.
Mr. President, I rise today to discuss the REAL ID Act of 2005.
The REAL ID Act became law over a year and a half ago, but opposition remains strong and vocal. I hold in my hand a list of hundreds of organizations--ranging from the National Governor's Association--NGA--to the American Civil Liberties Union--ACLU--to the National Rifle Association--that believe the REAL ID Act was a grave mistake. None of these groups were heard by Congress before the bill was passed in May 2005. There were no hearings to understand the repercussions of such sweeping legislation; and no debate on the floor of the Senate.
Rather, the REAL ID Act was attached to a must-pass piece of legislation, the Emergency Supplemental Appropriations Act for Defense, the Global War on Terror, and Tsunami Relief Act--Public Law 109-13, in conference and therefore received virtually no scrutiny before passage. Every Member of Congress who supported providing much needed funding to our troops and relief to the Indonesia tsunami victims was forced to vote in favor of the REAL ID Act, an unrelated bill.
That is why I come to the floor today to spark a real debate on REAL ID. I say to my colleagues there are serious problems with REAL ID and it's time Congress took a closer look.
My two primary concerns with REAL ID are that the law: places an unrealistic and unfunded burden on state governments; and erodes Americans' civil liberties and privacy rights.
There is nothing realistic about REAL ID. This law mandates that State-issued IDs, such as driver's licenses, comply with certain security standards and procedures, as determined by the Department of Homeland Security--DHS--in order to be accepted by the Federal Government for such purposes as boarding an airplane or entering a Federal building. These procedures include electronically verifying the authenticity of each identifying document, such as birth certificates, passports, and social security cards, presented to a local Department of Motor Vehicles--DMV--office. Such a requirement likely will involve developing an extremely costly and complex set of electronic systems that connect the thousands of DMVs to one another and to a host of Federal agencies. This would cost $1.42 billion according to a September 2006 report issued by the NGA, the National Conference of State Legislatures--NCSL--and the American Association of Motor Vehicle Administrators--AAMVA.
In addition, every current driver's license holder must be reenrolled under the new screening process which will more than double the workload at local DMVs across the country and far exceed their current capacity. REAL ID will put an end, at least temporarily, to online and mail license renewals and will cause huge lines and back-up at the DMV. Although security should never be sacrificed for convenience, it is important that states have the time and flexibility to implement the additional security standards in an effective manner. Moreover, reenrollment will be the mostly costly piece of REAL ID, estimated at approximately $8 billion over 5 years by NGA, NCSL, and AAMVA.
There are a number of other requirements imposed on states by REAL ID, such as new design requirements for the ID cards and on-site security. In total, REAL ID will cost over $11 billion according to the NGA study. Congress has appropriated only $40 million for REAL ID implementation to date, and no funds were included for fiscal year 2007. That leaves a hefty pricetag for the States, especially for legislation that was passed with no review.
In addition to the cost imposed on States, REAL ID imposes an unrealistic timeframe. Under the law, states must have REAL ID compliant systems in place by May 2008. Yet implementing regulations have not been issued. DHS is expected to issue the regulations early next year. However, as of today, the Office of Management and Budget, OMB, has not received the draft regulations, and OMB is allowed 90 days by Executive order for review of all proposed regulations. That would give states a little over a year to develop electronic verification systems, redesign driver's license cards, establish protocols on how to handle and secure personal information, increase DMV personnel, and find a way to fund it all. It has taken DHS over a year and a half just to issue the regulations. Expecting the States to execute the new system in even less time is unrealistic.
In addition to the unrealistic burden REAL ID places on States, REAL ID is a serious threat to our privacy rights and civil liberties.
The REAL ID Act will require each State's driver's licensing agency to collect and store substantial numbers of records containing licensees' most sensitive personally identifiable information, including one's social security number, proof of residence, and biometric identifiers such as a digital photograph and signature. If the new State databases are compromised, they will provide one-stop access to virtually all information necessary to commit identity theft. Moreover, the sharing of the aggregated personally identifiable information of licensees between and amongst various government agencies and employees at the Federal, State, and local level, as contemplated by the REAL ID Act, potentially allows millions of individuals access to that information without protections or safeguards. The potential for the private sector to scan and share the information contained on a REAL ID compliant license exponentially increases the risk of identity theft as well. Despite these obvious threats to Americans' privacy, the REAL ID Act fails to mandate privacy protections for individuals' information nor does it provide States with the means to implement data security and antihacking protections that will be required to safeguard the new databases mandated by the act.
REAL ID exacerbates the threat of identity theft which threatens our security. As the Honolulu Star Bulletin noted in a October 1, 2006, editorial, the REAL ID Act gives us ``a false sense of security.''
I come to the floor today to inject some reality into REAL ID. Unfunded mandates, privacy, and security are real problems that deserve real consideration and real solutions. It is my hope that when DHS issues the REAL ID regulations, the following issues are addressed: (1) limiting access to the REAL ID networks; (2) securing data that is electronically stored on driver's licenses and ID cards; (3) allowing flexibility in the technological solutions employed by the States; (4) defining the role Federal agencies will play in developing and connecting with the electronic verification systems; (5) ensuring that individuals' privacy rights provided by the Federal Government and State governments are protected; (6) providing a means to correct inaccurate information held in the REAL ID networks; and (7) ensuring that the information contained in the license cannot be scanned or shared by private entities.
I hope that the regulations will be well thought out and reflect the stakeholder input provided to DHS over the past year and a half which included the issues I just raised.
However, given what I have heard from participants about the rule-making process thus far, I am concerned that the regulations are being developed by too few people without enough stakeholder engagement.
When DHS began this process, the State Working Group was developed to gather input from stakeholders. However, the engagement process was not as robust as it could have been. Participants in the working group never received feedback from DHS on their proposals and DHS never reconvened the group to evaluate a draft of the regulations.
I also am concerned that given the shortsightedness of the law DHS was given by Congress, it may be the case that a complete replacement of the REAL ID Act is necessary. I am looking to DHS to issue workable regulations. However, if our personal privacy is not protected and the burden placed on states is too great, a legislative change to REAL ID may prove necessary.
Congress established a negotiated rulemaking process to improve the security of drivers licenses and ID cards in the Intelligence Reform and Terrorism Prevention Act of 2004. According to participants, that process was making headway when the REAL ID Act passed repealing the negotiated rulemaking language and imposing much stricter guidelines.
Today Senator Sununu and I introduce the Identification Security Enhancement Act, which will repeal the REAL ID Act and reinstitute the shared rulemaking and more reasonable guidelines established in the Intelligence Reform Act. It is my intention to review the forthcoming DHS regulations before pursuing any action on our bill. I am hopeful that new legislation will not be necessary, and I look forward to working with DHS to produce workable guidelines. However, I believe that introducing the Identification Security Enhancement Act now is important because it will send a message that the intent of the entirety of Congress is not reflected in the REAL ID Act.
Congress has a responsibility to ensure that driver's licenses and ID cards issued in the United States are secure--both from would-be terrorists and identity thieves--affordable, and practical. I ask my colleagues to join us in injecting reality into the REAL ID Act.
I ask unanimous consent that the text of the bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the Record, as follows:
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
This Act may be cited as the ``Identification Security Enhancement Act of 2006''.
Title II of the REAL ID Act of 2005 (Division B of Public Law 109-13; 49 U.S.C. 30301 note) is repealed.
(a) Definitions.--In this section: (1) Driver's license.--The term ``driver's license'' means a motor vehicle operator's license (as defined in section 30301(5) of title 49, United States Code). (2) Personal identification card.--The term ``personal identification card'' means an identification document (as defined in section 1028(d)(3) of title 18, United States Code) issued by a State. (b) Standards for Acceptance by Federal Agencies.-- (1) In general.-- (A) Limitation on acceptance.--No Federal agency may accept, for any official purpose, a driver's license or personal identification card newly issued by a State more than 2 years after the promulgation of the minimum standards under paragraph (2) unless the driver's license or personal identification card conforms to such minimum standards. (B) Date for full conformance.-- (i) In general.--Except as provided under clause (ii), beginning on the date that is 5 years after the promulgation of minimum standards under paragraph (2), no Federal agency may accept, for any official purpose, a driver's license or personal identification card issued by a State unless such driver's license or personal identification card conforms to such minimum standards. (ii) Alternative date for full conformance.--If the Secretary of Homeland Security determines that it is impracticable for States to replace all State-issued driver's licenses and personal identification cards before the deadline set forth in clause (i), the Secretary of Homeland Security, in consultation with the Secretary of Transportation, may set a later, alternative deadline to the extent necessary for States to complete such replacement with reasonable efforts. (C) State certification.-- (i) In general.--Each State shall certify to the Secretary of Homeland Security that the State is in compliance with the requirements of this section. (ii) Frequency.--Certifications under clause (i) shall be made at such intervals and in such a manner as the Secretary of Homeland Security, with the concurrence of the Secretary of Transportation, may prescribe by regulation. (iii) Audits.--The Secretary of Homeland Security may conduct periodic audits of each State's compliance with the requirements of this section. (2) Minimum standards.--Not later than 12 months after the date of enactment of this Act, the Secretary of Homeland Security, in consultation with the Secretary of Transportation, shall by regulation, establish by minimum standards for driver's licenses or personal identification cards issued by a State for use by Federal agencies for identification purposes that shall include-- (A) standards for documentation required as proof of identity of an applicant for a driver's license or personal identification card; (B) standards for the verifiability of documents used to obtain a driver's license or personal identification card; (C) standards for the processing of applications for driver's licenses and personal identification cards to prevent fraud; (D) standards for information to be included on each driver's license or personal identification card, including-- (i) the person's full legal name; (ii) the person's date of birth; (iii) the person's gender; (iv) the person's driver's license or personal identification card number; (v) a photograph of the person; (vi) the person's address of principal residence; and (vii) the person's signature; (E) standards for common machine-readable identity information to be included on each driver's license or personal identification card, including defined minimum data elements; (F) security standards to ensure that driver's licenses and personal identification cards are-- (i) resistant to tampering, alteration, or counterfeiting; and (ii) capable of accommodating and ensuring the security of a photograph or other unique identifier; and (G) a requirement that a State confiscate a driver's license or personal identification card if any component or security feature of the license or identification card is compromised. (c) Negotiated Rulemaking.-- (1) In general.--Before publishing the proposed regulations required by subsection (b)(2) to carry out this title, the Secretary of Homeland Security shall establish a negotiated rulemaking process pursuant to subchapter IV of chapter 5 of title 5, United States Code (5 U.S.C. 561 et seq.). (2) Time requirement.--The process described in paragraph (1) shall be conducted in a timely manner to ensure that-- (A) any recommendation for a proposed rule or report-- (i) is provided to the Secretary of Homeland Security not later than 9 months after the date of enactment of this Act; and (ii) includes an assessment of the benefits and costs of the recommendation; and (B) a final rule is promulgated not later than 12 months after the date of enactment of this Act. (3) Representation on negotiated rulemaking committee.--Any negotiated rulemaking committee established by the Secretary of Homeland Security pursuant to paragraph (1) shall include equal numbers of representatives from-- (A) among State offices that issue driver's licenses or personal identification cards; (B) among State elected officials; (C) the Department of Transportation; and (D) among interested parties, including experts in privacy protection, experts in civil liberties and protection of constitutional rights, and experts in immigration law. (4) Content of regulations.--The regulations required by subsection (b)(2)-- (A) shall facilitate communication between the chief driver licensing official of a State, an appropriate official of a Federal agency and other relevant officials, to verify the authenticity of documents, as appropriate, issued by such Federal agency or entity and presented to prove the identity of an individual; (B) may not infringe on a State's power to set criteria concerning what categories of individuals are eligible to obtain a driver's license or personal identification card from that State; (C) may not require a State to comply with any such regulation that conflicts with or otherwise interferes with the full enforcement of State criteria concerning the categories of individuals that are eligible to obtain a driver's license or personal identification card from that State; (D) may not require a single design to which driver's licenses or personal identification cards issued by all States must conform; and (E) shall include procedures and requirements to protect the privacy rights of individuals who apply for and hold driver's licenses and personal identification cards. (F) shall include procedures and requirements to protect the federal and state constitutional rights and civil liberties of individuals who apply for and hold driver's licenses and personal identification cards; (G) shall not permit the transmission of any personally identifiable information except for in encrypted format; (H) shall provide individuals with procedural and substantive due process, including promulgating rules and rights of appeal, to challenge errors in data records contained within the databases created to implement this Act; (I) shall not permit private entities to scan the information contained on the face of a license, or in the machine readable component of the license, and resell, share or trade that information with any other third parties, nor shall private entities be permitted to store the information collected for any other than fraud prevention purposes; (J) shall not preempt state privacy laws that are more protective of personal privacy than the standards, or regulations promulgated to implement this Act; and (K) shall neither permit nor require verification of birth certificates until a nation wide system is designed to facilitate such verification. (d) Grants to States.-- (1) Assistance in meeting federal standards.--Beginning on the date a final regulation is promulgated under subsection (b)(2), the Secretary of Homeland Security shall award grants to States to assist them in conforming to the minimum standards for driver's licenses and personal identification cards set forth in the regulation. (2) Allocation of grants.--The Secretary of Homeland Security shall award grants to States under this subsection based on the proportion that the estimated average annual number of driver's licenses and personal identification cards issued by a State applying for a grant bears to the average annual number of such documents issued by all States. (3) Minimum allocation.--Notwithstanding paragraph (2), each State shall receive not less than 0.5 percent of the grant funds made available under this subsection. (4) Separate funding.--Funds appropriated for grants under this section may not be commingled with other grant funds administered by the Department of Homeland Security and may not be used for any purpose other than the purpose set forth in paragraph (1). (e) Extension of Effective Date.--The Secretary of Homeland Security may extend the date specified under subsection (b)(1)(A) for up to 2 years for driver's licenses issued by a State if the Secretary determines that the State made reasonable efforts to comply with the date under such subsection but was unable to do so.
By Mr. LAUTENBERG (for himself, Mrs. Boxer, and Mr. Menendez):
S. 4118. A bill to amend the Emergency Planning and Community Right-to-Know Act of 1986 to strike a provision relating to modifications in reporting frequency; to the Committee on Environment and Public Works.
Mr. President, I rise today to introduce legislation that would preserve the public's right to know exactly what types and amounts of chemicals are being stored and released into their neighborhoods and communities.
The legislation would stop the Environmental Protection Agency's dangerous attempts to undermine the Toxic Release Inventory--TRI--program--which I authored in 1986--by allowing facilities that release up to 5,000 pounds of a toxic chemical to simply provide notice of a chemical's presence at the facility, rather than disclose the actual amounts released to the land, air, and water. The 5,000 pounds standard represents a ten-fold increase of the current reporting threshold; this change would eliminate detailed reporting for thousands of facilities in communities around the country, including 92 facilities in New Jersey, and could eliminate entirely the disclosure of the releases of more than a dozen potentially dangerous chemicals. The EPA also has proposed to require reports on chemical emissions only every other year, instead of the current annual requirement. Under this wildly irresponsible proposed rule change, corporations would only be required to disclose their chemical emissions every other year. This means that communities would have no knowledge of what chemicals have been released in the 50 percent of years where emissions are not disclosed; additionally, companies would have a perverse incentive to concentrate their most egregious releases of toxic chemicals into the environment in years which are not reported. Furthermore, the EPA has published a proposal to reduce the information available to the public regarding the management of some of the most toxic chemicals that accumulate in the environment, including lead and mercury. Needless to say, I strongly oppose all three of these rule changes; the legislation I am introducing will stop them from taking place.
I firmly believe that it is simply unacceptable for the EPA to reduce the amount of information available to the public about chemicals--including mercury, lead and other carcinogens--stored nearby or released into their community. When Congress passed the original Emergency Planning and Community Right-to-Know Act in 1986, as a response to the 1984 Union Carbide chemical disaster in Bhopal, India, some accountability was finally established in the chemical industry. And now, the EPA is attempting to weaken these rules and reduce the amount of information available to the public on these critical issues. For instance, in my home State of New Jersey, a chemical facility that released 2,000 pounds of arsenic via air emissions in 2003 would no longer be required to disclose this pollution to the general public. Fourteen facilities that released a combined 8,600 pounds of carcinogenic styrene would no longer have to report these emissions in detail. I find these proposals absolutely outrageous. It truly begs the question: who is the EPA really ``protecting''? The general public and the environment, or corporate interests that pollute our communities?
While the EPA touts the benefits of its proposal as ``burden reduction'' for industry, I strongly believe that the benefit of annual, detailed reporting vastly outweighs the marginal reduction in burden that will be provided to industry. In fact, according to the EPA's own estimates, the average cost saved for facilities no longer required to report the release of toxic chemicals in amounts less than 5,000 pounds would be approximately $2.32 per day. It is simply stunning that the EPA is willing to jeopardize public health and safety for a daily cost savings roughly equivalent to a couple cups of coffee.
There are constructive ways to improve the TRI program, and lessen the burdens on industry, without reducing the amount of information available to the public. These include improving the system for electronic reporting, and offering technical assistance to help businesses comply with the requirements.
The bill I am introducing is simple. First, it would codify the requirement that companies which release emissions of more than 500 pounds of any standard TRI chemical must disclose the details of their releases. Releases in amounts less than 500 pounds would continue to be allowed to use the less detailed reporting form. Second, it would codify the current prohibition on using the less detailed form for the most persistent chemicals, including lead, mercury, and dioxin. Finally, it would prevent EPA from making the frequency of reporting less than every year.
I would be remiss not to thank my congressional colleagues in the House of Representatives, Frank Pallone of New Jersey, and Hilda Solis of California, with whom I have been pleased to work on this issue. Representatives Pallone and Solis have introduced the companion of this bill in the House; I now look forward to continuing to work with them to ensure its passage. I would also like to thank my colleagues Senator Menendez and Senator Boxer, for being original cosponsors of this important legislation.
As a result of the EPA's dereliction of its duty to protect the public and the environment, Congress must act to do so. I strongly encourage my colleagues to do just that by enacting this legislation.
I ask unanimous consent that the full text of the bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the Record, as follows:
This Act may be cited as the ``Toxic Right-to-Know Protection Act''.
(a) In General.--Section 313 of the Emergency Planning and Community Right-to-Know Act of 1986 (42 U.S.C. 11023) is amended-- (1) by striking subsection (i); and (2) by redesignating subsections (j) through (l) as subsections (i) through (k), respectively. (b) Conforming Amendments.--Sections 322(h)(2) and 326(a)(1)(B)(iv) of the Emergency Planning and Community Right-to-Know Act of 1986 (42 U.S.C. 11042(h)(2), 11046(a)(1)(B)(iv)) are amended by striking ``313(j)'' each place it appears and inserting ``313(i)''.
By Ms. LANDRIEU:
S. 4119. A bill to clarify the tax treatment of certain payments made to homeowners by the Louisiana Recovery Authority and the Mississippi Development Authority; to the Committee on Finance.
Mr. President, the Internal Revenue Service had another big surprise for citizens in my State of Louisiana and in Mississippi who are trying to rebuild after Katrina: a tax surprise.
The problem is simple. Louisiana and Mississippi have both established programs to help families rebuild their homes and their lives after Katrina and Rita. Congress appropriated the money for these initiatives--more than $10 billion in all and we are very grateful for the assistance. The Louisiana program, which we call the Road Home, is administered by the Louisiana Recovery Authority, LRA. The program is now starting to get going. Under the Road Home, up to $150,000 in grants are available to people to rebuild or repair their homes. There is also funding available for rental properties. Grants can also be used to buy out homes. The Louisianians who were displaced by the storms want to go home and the Road Home program will get them there.
But the IRS is putting a pothole in the middle of the Road Home by making some of these payments taxable. The way this tax surprise works is by requiring that any hurricane victim who claimed a casualty loss deduction for damage to their home on their tax return for 2005 will have to reduce that loss by the amount of any payment from the LRA. So if they had their taxes reduced in one year and received a Road Home grant the next year, they have to essentially eliminate any benefit of the earlier casualty loss deduction. Their taxes will go up.
Now I realize that under normal circumstances, when a person's home bums down, the roof caves in, or they are a victim of theft, they can take a casualty loss deduction, provided it meets certain requirements. The loss must exceed ten percent of the taxpayers adjusted gross income, and a per loss floor of $100. In some circumstances, taxpayers are permitted to include a current-year casualty loss on an amended prior year return.
Immediately after Katrina, we enacted the Katrina Emergency Tax Relief Act, KETRA, that suspended the ten percent floor for casualty losses incurred in the Hurricane Katrina disaster area, including those claimed on amended returns. The purpose of the change in KETRA was simple: we wanted to put money in the hands of Katrina victims as quickly as possible. We essentially encouraged taxpayers to take this loss, even by amending a past return. The IRS would then provide them with a refund.
Hurricane victims needed that money. They had to find a place to live, often at higher rents. Many of them had lost their jobs and needed this money to see them through until they started working again. They used the money to begin the rebuilding of their lives. These people didn't take this money and invest it in the stock market or put it in a trust fund somewhere. They spent it because they had to. Congress encouraged people to take the deduction by changing the law. Now the IRS wants to take it back.
I fully understand the policy behind all of this. Casualty loss deductions are reduced by the amount of any insurance or other recovery they make on the loss. In fact, at the time the taxpayer makes the deduction he or she is supposed to reduce the amount of the loss by any insurance recovery they reasonably expect to receive. If you receive a larger payment than you expected at a future time, you must claim it on your income tax return when you receive it.
The problem is that this policy will seriously hamper our recovery by discouraging people from staying in Louisiana. If you took a casualty loss and you receive a $150,000 Road Home payment to rebuild your house, you will have a tax consequence. But if you took the casualty loss and sold your house to the LRA for the $150,000 payment, it is treated like a home sale and there is no tax. This policy creates a disincentive to recovery. This tax policy will encourage people to take the road out of town and not to return to the gulf coast. On top of this, if a person did not claim the casualty loss, but receives a grant, the grant is tax free.
By Mr. McCAIN (for himself, Mr. Dorgan, Mr. Enzi, and Ms. Murkowski):
S. 4122. A bill to amend the Indian Health Care Improvement Act to revise and extend that Act; to the Committee on Indian Affairs.
Mr. President, today I introduce the Indian Health Care Improvement Act Amendments of 2006. I am proud to be joined in introducing this bill by Senators Enzi and Murkowski. This bill reflects the work of three committees of jurisdiction and countless meetings with the administration over the past four Congresses. Nevertheless, I must express my profound disappointment in seeing yet another Congress go by without passage of this critical reauthorization.
Thirty years ago, Congress first enacted the Indian Health Care Improvement Act to meet the moral commitment and trust obligation of the United States to provide comprehensive health care to Indian people. The act was last reauthorized in 1992, and efforts on the latest reauthorization have been ongoing since the 106th Congress. Over the course of nearly 7 years and four Congresses, the Committee on Indian Affairs, along with the Committees on Finance and Health, Education, Labor and Pensions and the Indian tribes, has labored to reauthorize the Indian Health Care Improvement Act. I have been encouraged by the recent discussions with the administration on the reauthorization, however, we were simply left without sufficient time to achieve final passage.
The Indian Health Care Improvement Act is the fundamental statutory framework for the Indian health care system and governs nearly every aspect of Indian health care. The Vice-Chairman of the Committee on Indian Affairs, Senator Dorgan, and I introduced the predecessor bill, S.1057, over 1 year ago to build upon that framework by updating the delivery of health services to be consistent with currently accepted health policy and practices everywhere in our great nation except Indian Country. This new iteration of the reauthorization of the Indian Health Care Improvement Act contained critically needed improvements including increased access to care, alternative financing for health care facilities and services, integrated programs for behavioral health, and progressive recruitment and retention programs for health professionals serving Indian communities.
Extensive work went into crafting these bills. Six years ago, a steering committee of Indian tribal leaders, after extensive consultation with the Indian Health Service, developed a broad consensus about the needed improvements to the Indian health care system. Bills based on this steering committee's recommendations have been introduced in the Senate since the 106th Congress, but none have been enacted.
In October, 2005, the Committee on Indian Affairs favorably reported out S. 1057. As with many bills, aspects of S. 1057 fell under the jurisdiction of other committees, and in years past, this appears to have complicated and delayed consideration. However, in the 109th Congress S.1057 was reviewed and debated by the Senate Committees on Indian Affairs, Finance and Health, Education, Labor and Pensions. We worked closely with those committees to advance and improve upon the reauthorization legislation.
In July, 2005, the HELP Committee reached out to us and we held a joint hearing on S.1057. The HELP Committee worked diligently with us to improve upon and advance that bill. In addition, despite last minute delays by the Department of Health and Human Services, on June 8, 2006, the Finance Committee unanimously reported the amendments to the Social Security Act that were needed to effectively implement S. 1057.
However, when we sought consideration of the bill on the floor, additional concerns were raised about the bill, even after it had been considered by the committees of jurisdiction and after years of discussion with the administration. These concerns prevented the Senate from considering S.1057 prior to its recess on September 29, 2006.
I have not been averse to a constructive dialogue aimed at improving the measure introduced, but I am deeply concerned about the repeated delays in passing this legislation and the seemingly unending series of obstacles thrown in the way of getting this business done. The committee has held at least nine hearings on the reauthorization since the 106th Congress, conducted extensive negotiations with the administration, and provided ample opportunity to engage in constructive dialogue from all interested parties. We have demonstrated our willingness to accommodate any reasonable concerns, even when raised belatedly as they so often have been, without compromising congressional oversight, and the quality, accessibility and flexibility for the Indian health programs deserved by Indian people. Nevertheless, we could not reach a final resolution to some provisions which would in our view have regressed from current law and good health policy.
Therefore, Senator Enzi and I decided to introduce this bill, which reflects the reasonable compromises we have agreed to with the administration. Specifically, to address concerns raised by the Department of Justice, this bill protects the United States from unnecessary lawsuits, while at the same time insuring that Indian patients receiving health care in IHS or tribal facilities, or in home- or community-based settings, will have the quality of care they deserve.
I believe that it is extremely important to remember, when looking at this bill, that improving, rather than regressing from, current law and policy is particularly important in light of studies which drive home the desperate need for improving the Indian health care system. For example, a Government Accountability Office report issued in August, 2005 documented the lower life expectancies and substantially higher disease rates among Indians, and found that health care services were not always available for Indian people. The GAO further reported that the treatment delays or service gaps could exacerbate the severity of Indian patients' conditions and create a need for more intensive treatment.
These findings should concern Congress. We retain the ultimate authority and responsibility to deal with Indian tribes and provide oversight of the Federal agencies which discharge the responsibilities outlined in our laws. It is Congress's responsibility to ensure that the Indian health care system is updated to accommodate practices that have become a part of the mainstream health care industry.
This concern and commitment was evident in the work of many Members of the Senate. We are very pleased that Senator Murkowski has joined us in the introduction of this bill. I want to thank Senators Enzi, Grassley, Baucus, and Kennedy, for their efforts and that of their staff on this legislation. I was proud to advance a bill which reflected the bipartisan work of the multiple committees of jurisdiction. During this Congress, we were joined in pushing toward passage by other Senators and I want to thank, in particular, Senators Burns, Crapo, Bingaman, and Senator Domenici, who has long supported Indian health and has been instrumental in advancing the bill. Finally, I express special thanks to Senator Dorgan and his staff for their unwavering support and unstinted efforts on the reauthorization of the Indian Health Care Improvement Act.
At the end of this Congress I relinquish the chair of the committee knowing that there is much work to do for Indian health. However, I am confident that Senator Dorgan will continue these efforts, and I look forward to working with him on these and other Indian issues. I ask consent that the bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the Record, as follows:
(a) Short Title.--This Act may be cited as the ``Indian Health Care Improvement Act Amendments of 2006''. (b) Table of Contents.--The table of contents of this Act is as follows:
(a) Short Title.--This Act may be cited as the ``Indian Health Care Improvement Act Amendments of 2006''. (b) Table of Contents.--The table of contents of this Act is as follows:Sec. 1. Short title; table of contents.
(a) Short Title.--This Act may be cited as the ``Indian Health Care Improvement Act Amendments of 2006''. (b) Table of Contents.--The table of contents of this Act is as follows:Sec. 1. Short title; table of contents. TITLE I--AMENDMENTS TO INDIAN LAWS
(a) Short Title.--This Act may be cited as the ``Indian Health Care Improvement Act Amendments of 2006''. (b) Table of Contents.--The table of contents of this Act is as follows:Sec. 1. Short title; table of contents. TITLE I--AMENDMENTS TO INDIAN LAWSSec. 101. Indian Health Care Improvement Act amended.Sec. 102. Soboba sanitation facilities.Sec. 103. Native American Health and Wellness Foundation.
The Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is amended to read as follows:
The Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is amended to read as follows: ``SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
The Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is amended to read as follows: ``SECTION 1. SHORT TITLE; TABLE OF CONTENTS. ``(a) Short Title.--This Act may be cited as the `Indian Health Care Improvement Act'. ``(b) Table of Contents.--The table of contents for this Act is as follows:
The Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is amended to read as follows: ``SECTION 1. SHORT TITLE; TABLE OF CONTENTS. ``(a) Short Title.--This Act may be cited as the `Indian Health Care Improvement Act'. ``(b) Table of Contents.--The table of contents for this Act is as follows:``Sec. 1. Short title; table of contents.``Sec. 2. Findings.``Sec. 3. Declaration of national Indian health policy.``Sec. 4. Definitions.
The Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is amended to read as follows: ``SECTION 1. SHORT TITLE; TABLE OF CONTENTS. ``(a) Short Title.--This Act may be cited as the `Indian Health Care Improvement Act'. ``(b) Table of Contents.--The table of contents for this Act is as follows:``Sec. 1. Short title; table of contents.``Sec. 2. Findings.``Sec. 3. Declaration of national Indian health policy.``Sec. 4. Definitions. ``TITLE I-INDIAN HEALTH, HUMAN RESOURCES, AND DEVELOPMENT
The Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) is amended to read as follows: ``SECTION 1. SHORT TITLE; TABLE OF CONTENTS. ``(a) Short Title.--This Act may be cited as the `Indian Health Care Improvement Act'. ``(b) Table of Contents.--The table of contents for this Act is as follows:``Sec. 1. Short title; table of contents.``Sec. 2. Findings.``Sec. 3. Declaration of national Indian health policy.``Sec. 4. Definitions. ``TITLE I-INDIAN HEALTH, HUMAN RESOURCES, AND DEVELOPMENT``Sec. 101. Purpose.``Sec. 102. Health professions recruitment program for Indians.``Sec. 103. Health professions preparatory scholarship program for Indians.``Sec. 104. Indian health professions scholarships.``Sec. 105. American Indians Into Psychology Program.``Sec. 106. Scholarship programs for Indian Tribes.``Sec. 107. Indian Health Service extern programs.``Sec. 108. Continuing education allowances.``Sec. 109. Community Health Representative Program.``Sec. 110. Indian Health Service Loan Repayment Program.``Sec. 111. Scholarship and Loan Repayment Recovery Fund.``Sec. 112. Recruitment activities.``Sec. 113. Indian recruitment and retention program.``Sec. 114. Advanced training and research.``Sec. 115. Quentin N. Burdick American Indians Into Nursing Program.``Sec. 116. Tribal cultural orientation.``Sec. 117. INMED Program.``Sec. 118. Health training programs of community colleges.``Sec. 119. Retention bonus.``Sec. 120. Nursing residency program.``Sec. 121. Community Health Aide Program.``Sec. 122. Tribal Health Program administration.``Sec. 123. Health professional chronic shortage demonstration programs.``Sec. 124. National Health Service Corps.``Sec. 125. Substance abuse counselor educational curricula demonstration programs.``Sec. 126. Behavioral health training and community education programs.``Sec. 127. Authorization of appropriations.
``(a) Disregard of Medicare, Medicaid, and SCHIP Payments in Determining Appropriations.--Any payments received by an Indian Health Program or by an Urban Indian Organization under title XVIII, XIX, or XXI of the Social Security Act for services provided to Indians eligible for benefits under such respective titles shall not be considered in determining appropriations for the provision of health care and services to Indians. ``(b) Nonpreferential Treatment.--Nothing in this Act authorizes the Secretary to provide services to an Indian with coverage under title XVIII, XIX, or XXI of the Social Security Act in preference to an Indian without such coverage. ``(c) Use of Funds.-- ``(1) Special fund.-- ``(A) 100 percent pass-through of payments due to facilities.--Notwithstanding any other provision of law, but subject to paragraph (2), payments to which a facility of the Service is entitled by reason of a provision of the Social Security Act shall be placed in a special fund to be held by the Secretary. In making payments from such fund, the Secretary shall ensure that each Service Unit of the Service receives 100 percent of the amount to which the facilities of the Service, for which such Service Unit makes collections, are entitled by reason of a provision of the Social Security Act. ``(B) Use of funds.--Amounts received by a facility of the Service under subparagraph (A) shall first be used (to such extent or in such amounts as are provided in appropriation Acts) for the purpose of making any improvements in the programs of the Service operated by or through such facility which may be necessary to achieve or maintain compliance with the applicable conditions and requirements of titles XVIII and XIX of the Social Security Act. Any amounts so received that are in excess of the amount necessary to achieve or maintain such conditions and requirements shall, subject to consultation with the Indian Tribes being served by the Service Unit, be used for reducing the health resource deficiencies (as determined under section 201(d)) of such Indian Tribes. ``(2) Direct payment option.--Paragraph (1) shall not apply to a Tribal Health Program upon the election of such Program under subsection (d) to receive payments directly. No payment may be made out of the special fund described in such paragraph with respect to reimbursement made for services provided by such Program during the period of such election. ``(d) Direct Billing.-- ``(1) In general.--Subject to complying with the requirements of paragraph (2), a Tribal Health Program may elect to directly bill for, and receive payment for, health care items and services provided by such Program for which payment is made under title XVIII or XIX of the Social Security Act or from any other third party payor. ``(2) Direct reimbursement.-- ``(A) Use of funds.--Each Tribal Health Program making the election described in paragraph (1) with respect to a program under a title of the Social Security Act shall be reimbursed directly by that program for items and services furnished without regard to subsection (c)(1), but all amounts so reimbursed shall be used by the Tribal Health Program for the purpose of making any improvements in facilities of the Tribal Health Program that may be necessary to achieve or maintain compliance with the conditions and requirements applicable generally to such items and services under the program under such title and to provide additional health care services, improvements in health care facilities and Tribal Health Programs, any health care related purpose, or otherwise to achieve the objectives provided in section 3 of this Act. ``(B) Audits.--The amounts paid to a Tribal Health Program making the election described in paragraph (1) with respect to a program under a title of the Social Security Act shall be subject to all auditing requirements applicable to the program under such title, as well as all auditing requirements applicable to programs administered by an Indian Health Program. Nothing in the preceding sentence shall be construed as limiting the application of auditing requirements applicable to amounts paid under title XVIII, XIX, or XXI of the Social Security Act. ``(C) Identification of source of payments.--Any Tribal Health Program that receives reimbursements or payments under title XVIII, XIX, or XXI of the Social Security Act, shall provide to the Service a list of each provider enrollment number (or other identifier) under which such Program receives such reimbursements or payments. ``(3) Examination and implementation of changes.-- ``(A) In general.--The Secretary, acting through the Service and with the assistance of the Administrator of the Centers for Medicare & Medicaid Services, shall examine on an ongoing basis and implement any administrative changes that may be necessary to facilitate direct billing and reimbursement under the program established under this subsection, including any agreements with States that may be necessary to provide for direct billing under a program under a title of the Social Security Act. ``(B) Coordination of information.--The Service shall provide the Administrator of the Centers for Medicare & Medicaid Services with copies of the lists submitted to the Service under paragraph (2)(C), enrollment data regarding patients served by the Service (and by Tribal Health Programs, to the extent such data is available to the Service), and such other information as the Administrator may require for purposes of administering title XVIII, XIX, or XXI of the Social Security Act. ``(4) Withdrawal from program.--A Tribal Health Program that bills directly under the program established under this subsection may withdraw from participation in the same manner and under the same conditions that an Indian Tribe or Tribal Organization may retrocede a contracted program to the Secretary under the authority of the Indian Self- Determination and Education Assistance Act (25 U.S.C. 450 et seq.). All cost accounting and billing authority under the program established under this subsection shall be returned to the Secretary upon the Secretary's acceptance of the withdrawal of participation in this program. ``(5) Termination for failure to comply with requirements.--The Secretary may terminate the participation of a Tribal Health Program or in the direct billing program established under this subsection if the Secretary determines that the Program has failed to comply with the requirements of paragraph (2). The Secretary shall provide a Tribal Health Program with notice of a determination that the Program has failed to comply with any such requirement and a reasonable opportunity to correct such noncompliance prior to terminating the Program's participation in the direct billing program established under this subsection. ``(e) Related Provisions Under the Social Security Act.-- For provisions related to subsections (c) and (d), see sections 1880, 1911, and 2107(e)(1)(D) of the Social Security Act.
``(a) Indian Tribes and Tribal Organizations.--From funds appropriated to carry out this title in accordance with section 415, the Secretary, acting through the Service, shall make grants to or enter into contracts with Indian Tribes and Tribal Organizations to assist such Tribes and Tribal Organizations in establishing and administering programs on or near reservations and trust lands to assist individual Indians-- ``(1) to enroll for benefits under a program established under title XVIII, XIX, or XXI of the Social Security Act and other health benefits programs; and ``(2) with respect to such programs for which the charging of premiums and cost sharing is not prohibited under such programs, to pay premiums or cost sharing for coverage for such benefits, which may be based on financial need (as determined by the Indian Tribe or Tribes or Tribal Organizations being served based on a schedule of income levels developed or implemented by such Tribe, Tribes, or Tribal Organizations). ``(b) Conditions.--The Secretary, acting through the Service, shall place conditions as deemed necessary to effect the purpose of this section in any grant or contract which the Secretary makes with any Indian Tribe or Tribal Organization pursuant to this section. Such conditions shall include requirements that the Indian Tribe or Tribal Organization successfully undertake-- ``(1) to determine the population of Indians eligible for the benefits described in subsection (a); ``(2) to educate Indians with respect to the benefits available under the respective programs; ``(3) to provide transportation for such individual Indians to the appropriate offices for enrollment or applications for such benefits; and ``(4) to develop and implement methods of improving the participation of Indians in receiving benefits under such programs. ``(c) Application to Urban Indian Organizations.-- ``(1) In general.--The provisions of subsection (a) shall apply with respect to grants and other funding to Urban Indian Organizations with respect to populations served by such organizations in the same manner they apply to grants and contracts with Indian Tribes and Tribal Organizations with respect to programs on or near reservations. ``(2) Requirements.--The Secretary shall include in the grants or contracts made or provided under paragraph (1) requirements that are-- ``(A) consistent with the requirements imposed by the Secretary under subsection (b); ``(B) appropriate to Urban Indian Organizations and Urban Indians; and ``(C) necessary to effect the purposes of this section. ``(d) Facilitating Cooperation.--The Secretary, acting through the Centers for Medicare & Medicaid Services, shall take such steps as are necessary to facilitate cooperation with, and agreements between, States and the Service, Indian Tribes, Tribal Organizations, or Urban Indian Organizations with respect to the provision of health care items and services to Indians under the programs established under title XVIII, XIX, or XXI of the Social Security Act. ``(e) Agreements Relating to Improving Enrollment of Indians Under Social Security Act Health Benefits Programs.-- For provisions relating to agreements between the Secretary, acting through the Service, and Indian Tribes, Tribal Organizations, and Urban Indian Organization for the collection, preparation, and submission of applications by Indians for assistance under the Medicaid and State children's health insurance programs established under titles XIX and XXI of the Social Security Act, and benefits under the Medicare program established under title XVIII of such Act, see subsections (a) and (b) of section 1139 of the Social Security Act. ``(f) Definition of Premiums and Cost Sharing.--In this section: ``(1) Premium.--The term `premium' includes any enrollment fee or similar charge. ``(2) Cost sharing.--The term `cost sharing' includes any deduction, deductible, copayment, coinsurance, or similar charge.
``For provisions relating to-- ``(1) exclusion waiver authority for affected Indian Health Programs under the Social Security Act, see section 1128(k) of the Social Security Act (42 U.S.C. 1320a-7(k)); and ``(2) certain transactions involving Indian Health Programs deemed to be in safe harbors under that Act, see section 1128B(b)(4) of the Social Security Act (42 U.S.C. 1320a- 7b(b)(4)).
The Act of December 17, 1970 (84 Stat. 1465), is amended by adding at the end the following: ``Sec. 9. Nothing in this Act shall preclude the Soboba Band of Mission Indians and the Soboba Indian Reservation from being provided with sanitation facilities and services under the authority of section 7 of the Act of August 5, 1954 (68 Stat. 674), as amended by the Act of July 31, 1959 (73 Stat. 267).''.
(a) In General.--The Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.) is amended by adding at the end the following:
``TITLE VIII--NATIVE AMERICAN HEALTH AND WELLNESS FOUNDATION
``In this title: ``(1) Board.--The term `Board' means the Board of Directors of the Foundation. ``(2) Committee.--The term `Committee' means the Committee for the Establishment of Native American Health and Wellness Foundation established under section 802(f). ``(3) Foundation.--The term `Foundation' means the Native American Health and Wellness Foundation established under section 802. ``(4) Secretary.--The term `Secretary' means the Secretary of Health and Human Services. ``(5) Service.--The term `Service' means the Indian Health Service of the Department of Health and Human Services.
(a) Medicaid.-- (1) Expansion to all covered services.--Section 1911 of the Social Security Act (42 U.S.C. 1396j) is amended-- (A) by amending the heading to read as follows:
Section 1139 of the Social Security Act (42 U.S.C. 1320b-9) is amended to read as follows:
(a) Nonapplication of 10 Percent Limit on Outreach and Certain Other Expenditures.--Section 2105(c)(2) of the Social Security Act (42 U.S.C. 1397ee(c)(2)) is amended by adding at the end the following new subparagraph: ``(C) Nonapplication to expenditures for outreach to increase the enrollment of indian children under this title and title xix.--The limitation under subparagraph (A) on expenditures for items described in subsection (a)(1)(D) shall not apply in the case of expenditures for outreach activities to families of Indian children likely to be eligible for child health assistance under the plan or medical assistance under the State plan under title XIX (or under a waiver of such plan), to inform such families of the availability of, and to assist them in enrolling their children in, such plans, including such activities conducted under grants, contracts, or agreements entered into under section 1139(a).''. (b) Assurance of Payments to Indian Health Care Providers for Child Health Assistance.--Section 2102(b)(3)(D) of such Act (42 U.S.C. 1397bb(b)(3)(D)) is amended by striking ``(as defined in section 4(c) of the Indian Health Care Improvement Act, 25 U.S.C. 1603(c))'' and inserting ``, including how the State will ensure that payments are made to Indian Health Programs and Urban Indian Organizations operating in the State for the provision of such assistance''. (c) Inclusion of Other Indian Financed Health Care Programs in Exemption From Prohibition on Certain Payments.--Section 2105(c)(6)(B) of such Act (42 U.S.C. 1397ee(c)(6)(B)) is amended by striking ``insurance program, other than an insurance program operated or financed by the Indian Health Service'' and inserting ``program, other than a health care program operated or financed by the Indian Health Service or by an Indian Tribe, Tribal Organization, or Urban Indian Organization''. (d) Satisfaction of Medicaid Documentation Requirements.-- (1) In general.--Section 1903(x)(3)(B) of the Social Security Act (42 U.S.C. 1396b(x)(3)(B)) is amended-- (A) by redesignating clause (v) as clause (vi); and (B) by inserting after clause (iv), the following new clause: ``(v)(I) Except as provided in subclause (II), a document issued by a federally-recognized Indian tribe evidencing membership or enrollment in, or affiliation with, such tribe. ``(II) With respect to those federally-recognized Indian tribes located within States having an international border whose membership includes individuals who are not citizens of the United States, the Secretary shall, after consulting with such tribes, issue regulations authorizing the presentation of such other forms of documentation (including tribal documentation, if appropriate) that the Secretary determines to be satisfactory documentary evidence of citizenship or nationality for purposes of satisfying the requirement of this subsection.''. (2) Transition rule.--During the period that begins on July 1, 2006, and ends on the effective date of final regulations issued under subclause (II) of section 1903(x)(3)(B)(v) of the Social Security Act (42 U.S.C. 1396b(x)(3)(B)(v)) (as added by paragraph (1)), an individual who is a member of a federally-recognized Indian tribe described in subclause (II) of that section who presents a document described in subclause (I) of such section that is issued by such Indian tribe, shall be deemed to have presented satisfactory evidence of citizenship or nationality for purposes of satisfying the requirement of subsection (x) of section 1903 of such Act. (e) Definitions.--Section 2110(c) of such Act (42 U.S.C. 1397jj(c)) is amended by adding at the end the following new paragraph: ``(9) Indian; indian health program; indian tribe; etc.-- The terms `Indian', `Indian Health Program', `Indian Tribe', `Tribal Organization', and `Urban Indian Organization' have the meanings given those terms in section 4 of the Indian Health Care Improvement Act.''.
(a) Premiums and Cost Sharing Protection Under Medicaid.-- (1) In general.--Section 1916 of the Social Security Act (42 U.S.C. 1396o) is amended-- (A) in subsection (a), in the matter preceding paragraph (1), by striking ``and (i)'' and inserting ``, (i), and (j)''; and (B) by adding at the end the following new subsection: ``(j) No Premiums or Cost Sharing for Indians Furnished Items or Services Directly by Indian Health Programs or Through Referral Under the Contract Health Service.-- ``(1) No cost sharing for items or services furnished to indians through indian health programs.-- ``(A) In general.--No enrollment fee, premium, or similar charge, and no deduction, copayment, cost sharing, or similar charge shall be imposed against an Indian who is furnished an item or service directly by the Indian Health Service, an Indian Tribe, Tribal Organization, or Urban Indian Organization or through referral under the contract health service for which payment may be made under this title. ``(B) No reduction in amount of payment to indian health providers.--Payment due under this title to the Indian Health Service, an Indian Tribe, Tribal Organization, or Urban Indian Organization, or a health care provider through referral under the contract health service for the furnishing of an item or service to an Indian who is eligible for assistance under such title, may not be reduced by the amount of any enrollment fee, premium, or similar charge, or any deduction, copayment, cost sharing, or similar charge that would be due from the Indian but for the operation of subparagraph (A). ``(2) Rule of construction.--Nothing in this subsection shall be construed as restricting the application of any other limitations on the imposition of premiums or cost sharing that may apply to an individual receiving medical assistance under this title who is an Indian. ``(3) Definitions.--In this subsection, the terms `contract health service', `Indian', `Indian Tribe', `Tribal Organization', and `Urban Indian Organization' have the meanings given those terms in section 4 of the Indian Health Care Improvement Act.''. (2) Conforming amendment.--Section 1916A (a)(1) of such Act (42 U.S.C. 1396o-1(a)(1)) is amended by striking ``section 1916(g)'' and inserting ``subsections (g), (i), or (j) of section 1916''. (b) Treatment of Certain Property for Medicaid and SCHIP Eligibility.-- (1) Medicaid.--Section 1902(e) of the Social Security Act (42 U.S.C. 1396a) is amended by adding at the end the following new paragraph: ``(13) Notwithstanding any other requirement of this title or any other provision of Federal or State law, a State shall disregard the following property for purposes of determining the eligibility of an individual who is an Indian (as defined in section 4 of the Indian Health Care Improvement Act) for medical assistance under this title: ``(A) Property, including real property and improvements, that is held in trust, subject to Federal restrictions, or otherwise under the supervision of the Secretary of the Interior, located on a reservation, including any federally recognized Indian Tribe's reservation, pueblo, or colony, including former reservations in Oklahoma, Alaska Native regions established by the Alaska Native Claims Settlement Act, and Indian allotments on or near a reservation as designated and approved by the Bureau of Indian Affairs of the Department of the Interior. ``(B) For any federally recognized Tribe not described in subparagraph (A), property located within the most recent boundaries of a prior Federal reservation. ``(C) Ownership interests in rents, leases, royalties, or usage rights related to natural resources (including extraction of natural resources or harvesting of timber, other plants and plant products, animals, fish, and shellfish) resulting from the exercise of federally protected rights. ``(D) Ownership interests in or usage rights to items not covered by subparagraphs (A) through (C) that have unique religious, spiritual, traditional, or cultural significance or rights that support subsistence or a traditional lifestyle according to applicable tribal law or custom.''. (2) Application to schip.--Section 2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)) is amended-- (A) by redesignating subparagraphs (B) through (E), as subparagraphs (C) through (F), respectively; and (B) by inserting after subparagraph (A), the following new subparagraph: ``(B) Section 1902(e)(13) (relating to disregard of certain property for purposes of making eligibility determinations).''. (c) Continuation of Current Law Protections of Certain Indian Property From Medicaid Estate Recovery.--Section 1917(b)(3) of the Social Security Act (42 U.S.C. 1396p(b)(3)) is amended-- (1) by inserting ``(A)'' after ``(3)''; and (2) by adding at the end the following new subparagraph: ``(B) The standards specified by the Secretary under subparagraph (A) shall require that the procedures established by the State agency under subparagraph (A) exempt income, resources, and property that are exempt from the application of this subsection as of April 1, 2003, under manual instructions issued to carry out this subsection (as in effect on such date) because of the Federal responsibility for Indian Tribes and Alaska Native Villages. Nothing in this subparagraph shall be construed as preventing the Secretary from providing additional estate recovery exemptions under this title for Indians.''.
Section 1139 of the Social Security Act (42 U.S.C. 1320b- 9), as amended by section 202, is amended by redesignating subsection (c) as subsection (d), and inserting after subsection (b) the following new subsection: ``(c) Nondiscrimination in Qualifications for Payment for Services Under Federal Health Care Programs.-- ``(1) Requirement to satisfy generally applicable participation requirements.-- ``(A) In general.--A Federal health care program must accept an entity that is operated by the Indian Health Service, an Indian Tribe, Tribal Organization, or Urban Indian Organization as a provider eligible to receive payment under the program for health care services furnished to an Indian on the same basis as any other provider qualified to participate as a provider of health care services under the program if the entity meets generally applicable State or other requirements for participation as a provider of health care services under the program. ``(B) Satisfaction of state or local licensure or recognition requirements.--Any requirement for participation as a provider of health care services under a Federal health care program that an entity be licensed or recognized under the State or local law where the entity is located to furnish health care services shall be deemed to have been met in the case of an entity operated by the Indian Health Service, an Indian Tribe, Tribal Organization, or Urban Indian Organization if the entity meets all the applicable standards for such licensure or recognition, regardless of whether the entity obtains a license or other documentation under such State or local law. In accordance with section 221 of the Indian Health Care Improvement Act, the absence of the licensure of a health care professional employed by such an entity under the State or local law where the entity is located shall not be taken into account for purposes of determining whether the entity meets such standards, if the professional is licensed in another State. ``(2) Prohibition on federal payments to entities or individuals excluded from participation in federal health care programs or whose state licenses are under suspension or have been revoked.-- ``(A) Excluded entities.--No entity operated by the Indian Health Service, an Indian Tribe, Tribal Organization, or Urban Indian Organization that has been excluded from participation in any Federal health care program or for which a license is under suspension or has been revoked by the State where the entity is located shall be eligible to receive payment under any such program for health care services furnished to an Indian. ``(B) Excluded individuals.--No individual who has been excluded from participation in any Federal health care program or whose State license is under suspension or has been revoked shall be eligible to receive payment under any such program for health care services furnished by that individual, directly or through an entity that is otherwise eligible to receive payment for health care services, to an Indian. ``(C) Federal health care program defined.--In this subsection, the term, `Federal health care program' has the meaning given that term in section 1128B(f), except that, for purposes of this subsection, such term shall include the health insurance program under chapter 89 of title 5, United States Code.''.
(a) In General.--Section 1139 of the Social Security Act (42 U.S.C. 1320b-9), as amended by sections 202 and 205, is amended by redesignating subsection (d) as subsection (e), and inserting after subsection (c) the following new subsection: ``(d) Consultation With Tribal Technical Advisory Group (TTAG).--The Secretary shall maintain within the Centers for Medicaid & Medicare Services (CMS) a Tribal Technical Advisory Group, established in accordance with requirements of the charter dated September 30, 2003, and in such group shall include a representative of the Urban Indian Organizations and the Service. The representative of the Urban Indian Organization shall be deemed to be an elected officer of a tribal government for purposes of applying section 204(b) of the Unfunded Mandates Reform Act of 1995 (2 U.S.C. 1534(b)).''. (b) Solicitation of Advice Under Medicaid and SCHIP.-- (1) Medicaid state plan amendment.--Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended-- (A) in paragraph (69), by striking ``and'' at the end; (B) in paragraph (70)(B)(iv), by striking the period at the end and inserting ``; and''; and (C) by inserting after paragraph (70)(B)(iv), the following new paragraph: ``(71) in the case of any State in which the Indian Health Service operates or funds health care programs, or in which 1 or more Indian Health Programs or Urban Indian Organizations (as such terms are defined in section 4 of the Indian Health Care Improvement Act) provide health care in the State for which medical assistance is available under such title, provide for a process under which the State seeks advice on a regular, ongoing basis from designees of such Indian Health Programs and Urban Indian Organizations on matters relating to the application of this title that are likely to have a direct effect on such Indian Health Programs and Urban Indian Organizations and that-- ``(A) shall include solicitation of advice prior to submission of any plan amendments, waiver requests, and proposals for demonstration projects likely to have a direct effect on Indians, Indian Health Programs, or Urban Indian Organizations; and ``(B) may include appointment of an advisory committee and of a designee of such Indian Health Programs and Urban Indian Organizations to the medical care advisory committee advising the State on its State plan under this title.''. (2) Application to schip.--Section 2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)), as amended by section 204(b)(2), is amended-- (A) by redesignating subparagraphs (B) through (F) as subparagraphs (C) through (G), respectively; and (B) by inserting after subparagraph (A), the following new subparagraph: ``(B) Section 1902(a)(71) (relating to the option of certain States to seek advice from designees of Indian Health Programs and Urban Indian Organizations).''. (c) Rule of Construction.--Nothing in the amendments made by this section shall be construed as superseding existing advisory committees, working groups, guidance, or other advisory procedures established by the Secretary of Health and Human Services or by any State with respect to the provision of health care to Indians.
(a) Exclusion Waiver Authority.--Section 1128 of the Social Security Act (42 U.S.C. 1320a-7) is amended by adding at the end the following new subsection: ``(k) Additional Exclusion Waiver Authority for Affected Indian Health Programs.--In addition to the authority granted the Secretary under subsections (c)(3)(B) and (d)(3)(B) to waive an exclusion under subsection (a)(1), (a)(3), (a)(4), or (b), the Secretary may, in the case of an Indian Health Program, waive such an exclusion upon the request of the administrator of an affected Indian Health Program (as defined in section 4 of the Indian Health Care Improvement Act) who determines that the exclusion would impose a hardship on individuals entitled to benefits under or enrolled in a Federal health care program.''. (b) Certain Transactions Involving Indian Health Care Programs Deemed to Be in Safe Harbors.--Section 1128B(b) of the Social Security Act (42 U.S.C. 1320a-7b(b)) is amended by adding at the end the following new paragraph: ``(4) Subject to such conditions as the Secretary may promulgate from time to time as necessary to prevent fraud and abuse, for purposes of paragraphs (1) and (2) and section 1128A(a), the following transfers shall not be treated as remuneration: ``(A) Transfers between indian health programs, indian tribes, tribal organizations, and urban indian organizations.--Transfers of anything of value between or among an Indian Health Program, Indian Tribe, Tribal Organization, or Urban Indian Organization, that are made for the purpose of providing necessary health care items and services to any patient served by such Program, Tribe, or Organization and that consist of-- ``(i) services in connection with the collection, transport, analysis, or interpretation of diagnostic specimens or test data; ``(ii) inventory or supplies; ``(iii) staff; or ``(iv) a waiver of all or part of premiums or cost sharing. ``(B) Transfers between indian health programs, indian tribes, tribal organizations, or urban indian organizations and patients.--Transfers of anything of value between an Indian Health Program, Indian Tribe, Tribal Organization, or Urban Indian Organization and any patient served or eligible for service from an Indian Health Program, Indian Tribe, Tribal Organization, or Urban Indian Organization, including any patient served or eligible for service pursuant to section 807 of the Indian Health Care Improvement Act, but only if such transfers-- ``(i) consist of expenditures related to providing transportation for the patient for the provision of necessary health care items or services, provided that the provision of such transportation is not advertised, nor an incentive of which the value is disproportionately large in relationship to the value of the health care item or service (with respect to the value of the item or service itself or, for preventative items or services, the future health care costs reasonably expected to be avoided); ``(ii) consist of expenditures related to providing housing to the patient (including a pregnant patient) and immediate family members or an escort necessary to assuring the timely provision of health care items and services to the patient, provided that the provision of such housing is not advertised nor an incentive of which the value is disproportionately large in relationship to the value of the health care item or service (with respect to the value of the item or service itself or, for preventative items or services, the future health care costs reasonably expected to be avoided); or ``(iii) are for the purpose of paying premiums or cost sharing on behalf of such a patient, provided that the making of such payment is not subject to conditions other than conditions agreed to under a contract for the delivery of contract health services. ``(C) Contract health services.--A transfer of anything of value negotiated as part of a contract entered into between an Indian Health Program, Indian Tribe, Tribal Organization, Urban Indian Organization, or the Indian Health Service and a contract care provider for the delivery of contract health services authorized by the Indian Health Service, provided that-- ``(i) such a transfer is not tied to volume or value of referrals or other business generated by the parties; and ``(ii) any such transfer is limited to the fair market value of the health care items or services provided or, in the case of a transfer of items or services related to preventative care, the value of the future health care costs reasonably expected to be avoided. ``(D) Other transfers.--Any other transfer of anything of value involving an Indian Health Program, Indian Tribe, Tribal Organization, or Urban Indian Organization, or a patient served or eligible for service from an Indian Health Program, Indian Tribe, Tribal Organization, or Urban Indian Organization, that the Secretary, in consultation with the Attorney General, determines is appropriate, taking into account the special circumstances of such Indian Health Programs, Indian Tribes, Tribal Organizations, and Urban Indian Organizations, and of patients served by such Programs, Tribes, and Organizations.''.
(a) In General.--Section 1932 of the Social Security Act (42 U.S.C. 1396u-2) is amended by adding at the end the following new subsection: ``(h) Special Rules With Respect to Indian Enrollees, Indian Health Care Providers, and Indian Managed Care Entities.-- ``(1) Enrollee option to select an indian health care provider as primary care provider.--In the case of a non- Indian Medicaid managed care entity that-- ``(A) has an Indian enrolled with the entity; and ``(B) has an Indian health care provider that is participating as a primary care provider within the network of the entity,
Section 1139 of the Social Security Act (42 U.S.C. 1320b- 9), as amended by the sections 202, 205, and 206, is amended by redesignating subsection (e) as subsection (f), and inserting after subsection (d) the following new subsection: ``(e) Annual Report on Indians Served by Health Benefit Programs Funded Under This Act.--Beginning January 1, 2007, and annually thereafter, the Secretary, acting through the Administrator of the Centers for Medicare & Medicaid Services and the Director of the Indian Health Service, shall submit a report to Congress regarding the enrollment and health status of Indians receiving items or services under health benefit programs funded under this Act during the preceding year. Each such report shall include the following: ``(1) The total number of Indians enrolled in, or receiving items or services under, such programs, disaggregated with respect to each such program. ``(2) The number of Indians described in paragraph (1) that also received health benefits under programs funded by the Indian Health Service. ``(3) General information regarding the health status of the Indians described in paragraph (1), disaggregated with respect to specific diseases or conditions and presented in a manner that is consistent with protections for privacy of individually identifiable health information under section 264(c) of the Health Insurance Portability and Accountability Act of 1996. ``(4) A detailed statement of the status of facilities of the Indian Health Service or an Indian Tribe, Tribal Organization, or an Urban Indian Organization with respect to such facilities' compliance with the applicable conditions and requirements of titles XVIII, XIX, and XXI, and, in the case of title XIX or XXI, under a State plan under such title or under waiver authority, and of the progress being made by such facilities (under plans submitted under section 1880(b), 1911(b) or otherwise) toward the achievement and maintenance of such compliance. ``(5) Such other information as the Secretary determines is appropriate.''.
Mr. President, today my good colleague Senator McCain and I are reintroducing the Indian Health Care Improvement Act Amendments of 2006. This legislation is a reflection of our dedication to the health care of American Indians and Alaskan Natives. It also is a reflection of the work that has been done by Members and the many stakeholders to move this legislation forward.
I want to thank Chairman McCain and his staff, as well as Senator Dorgan and the rest of the members on the Indian Affairs Committee and their staff for their effort and commitment to the health care and well being of every American Indian and Alaskan Native. Their hard work has not gone unnoticed.
The Indian Health Care Improvement Act is the fundamental statutory framework for the delivery of health care services to American Indians and Alaskan Natives. Since 1992, this law has been expired. This means that for the past 14 years there has been no comprehensive change to the Federal Government's approach to delivering health care to approximately 1.8 million American Indians and Alaskan Natives.
This troubles me. When I talk to members of the Northern Arapaho tribe and Eastern Shoshone tribe from my home State of Wyoming, they tell me that quality health care is a top priority for them. For me, as chairman of the Committee on Health, Education, Labor and Pensions, I believe that our health care systems should grow as science and technologies grow and that our Federal Government programs also should be kept current in line with today's health care quality standards in the private sector.
Last spring, Chairman McCain and I held a joint hearing about this legislation, at which time Mr. Richard Brannan, the chairman of the Northern Arapaho Business Council of Fort Washakie testified about the problems those living on reservations face. He spoke about how they rely on these health care services. He also discussed the progress that has been made in reducing health disparities experienced by American Indians, and how this legislation can support such progress.
Since 1992, there have been many advances made in health care, especially in mental health. In the past 14 years we have come to better understand how to prevent, diagnose, and treat individuals with a behavioral health problem. We have learned that individuals have the best chance of recovery when a comprehensive, integrated approach is taken. This legislation authorizes programs to provide such services. This is especially important as we better understand the interconnectedness of alcohol, substance abuse, child welfare and suicide prevention.
This legislation also recognizes the alarming suicide rates among Indian youth. According to the Centers for Disease Control and Prevention, American Indian and Alaskan Native suicide rates in some areas are five to seven times higher than the overall United States rates. This is not acceptable. This legislation aims to change that by encouraging more Indian people to enter into the psychology profession. Through such provisions youth have access to culturally competent professionals in a familiar environment.
Recruiting and retaining qualified health professionals--Indian health professionals, in particular--to work in Indian communities is difficult. Secretary Michael Leavitt of the Department of Health and Human Services recognizes this challenge. Thanks to his efforts, this bill ensures that tribes can better rely on the services of health care professionals. Currently, a health care professional who receives a scholarship through the Indian Health Service may provide their services equal to the number of terms they received a scholarship. Thus some health care professionals are only required to work in a service area for one term. Most people understand it usually takes an individual anywhere from 3 months to one year to become accustomed to a job. Thus, it is not fair to those tribal communities to have a health care professional leave as soon as they become acclimated. This legislation would ensure that individuals serve a length of time that will allow their services to be depended on. Health care professionals will be more reliably available in areas where such professionals are scarce.
There are many other recommendations that the Department of Health and Human Services has made that I think will strengthen this legislation and improve the quality of care provided through the Indian Health Service. I look forward to working with Secretary Leavitt next Congress.
I believe that by the working together along with other members of the HELP Committee, the Indian Affairs Committee, the tribal community and any others interested in this legislation, we can maximize the funds available to the Indian Health Service and coordinate resources at the local and State level to provide tribes the tools they need to be self sufficient.
I would also like to thank the Department of Justice for their tireless work on this bill. This is truly a reflection of their commitment to ensuring every Native American and Alaskan Native who is an employee of the Indian Health Service is held to a high standard, and thus every individual who receives services through this program receives quality care.
I hope that this legislation can be a starting point next Congress. I also strongly encourage my colleagues to continue to work to get this invaluable piece of legislation signed into law.
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