Congressional Record United States Th of America PROCEEDINGS and DEBATES of the 110 CONGRESS, SECOND SESSION

E PL UR UM IB N U U S Congressional Record United States th of America PROCEEDINGS AND DEBATES OF THE 110 CONGRESS, SECOND SESSION

Vol. 154 WASHINGTON, WEDNESDAY, FEBRUARY 27, 2008 No. 32 Senate The Senate met at 9:30 a.m. and was appoint the Honorable BENJAMIN L. CARDIN, Near the oil-rich city of Kirkuk, gunmen called to order by the Honorable BEN- a Senator from the State of Maryland, to attacked a checkpoint manned by Sunni volunteers, killing the Sunni volunteers. JAMIN L. CARDIN, a Senator from the perform the duties of the Chair. State of Maryland. ROBERT C. BYRD, Mr. President, this is 1 day and a half President pro tempore. billion dollars. That is what is going on PRAYER Mr. CARDIN thereupon assumed the in Iraq. The Chaplain, Dr. Barry C. Black, of- chair as Acting President pro tempore. What impact does that have? General Casey testified here yesterday. General fered the following prayer: f Casey said: Let us pray. RECOGNITION OF THE MAJORITY O God, our help in ages past, our hope The cumulative effects of the last 6-plus LEADER years of war have left the Army out of bal- for years to come, thank You for the The ACTING PRESIDENT pro tem- ance, consumed by the current fight, unable gift of another day. Because of You, we to do the things we know we need to do. live and breathe and have our being, pore. The majority leader is recognized. And I failed to mention in my earlier and we would not take the gift of our comments that below the article about heartbeats for granted. f the suicide bomber is the report of Guide our Senators in their labors. SCHEDULE three more dead American soldiers: Give them the grace to work together CPT Nathan R. Raudenbush, LCpl Drew Mr. REID. Mr. President, following in the strategic mix that is our legisla- W. Weaver, and SPC Keisha M. Morgan. tive process. Make them such models of my remarks and those of the Repub- So that is where we are on the Iraq integrity that their actions will match lican leader, there will be a period of debate today. I will sum up in a short their words. Help them to resist the morning business for an hour, with the time, after I make a few other re- tendency to rely too much on their Republicans controlling the first half, marks, and I will ask consent so that own wisdom, as they permit You to the majority controlling the final half. we have some idea today as to how we lead them to truth. Grant that their Following morning business, we will will proceed. lives this day will be infused with Your resume the motion to proceed to S. I would tell all Senators that we will presence, love, wisdom, and power. 2633, a bill that calls for the safe rede- have, sometime today, either after the We pray in the Redeemer’s Name. ployment of the troops in Iraq. Today, 30 hours or before a vote on the motion Amen. the Senate will stand in recess from to proceed to the matter that is now f 12:30 until 2:15 p.m. before the Senate—immediately after IRAQ that, no matter what happens on that— PLEDGE OF ALLEGIANCE Mr. President, another day in Iraq. we will have a cloture vote on the sec- The Honorable BENJAMIN L. CARDIN As we see from the morning papers— ond matter, which is, as we all know, a led the Pledge of Allegiance, as follows: the Washington Post is a good exam- piece of legislation that calls for peri- I pledge allegiance to the Flag of the ple—headline: ‘‘Suicide Bomber Hits odic reports by the President on the United States of America, and to the Repub- Bus in Iraq’s North.’’ Among other war on terror. Following that, when lic for which it stands, one nation under God, things, the article goes on to state: that is disposed of, we will go to the indivisible, with liberty and justice for all. A suicide bomber detonated his explosives housing stimulus package. That is f belt outside a bus in northern Iraq on Tues- what I would like to spend a few min- APPOINTMENT OF ACTING day, killing at least eight people and injur- utes on because we will get to that PRESIDENT PRO TEMPORE ing many more. sometime this week. It is only a question of when we get to it. The PRESIDING OFFICER. The In a different paragraph: clerk will please read a communication The Tall Afar bombing followed a bloody HOUSING Mr. President, the sights and signs of to the Senate from the President pro weekend of attacks against Shiite pilgrims, the deadliest incident taking place on Sun- America’s housing crisis are all around tempore (Mr. BYRD). day when a suicide bomber killed at least 63 us. There is not a State in the Union The legislative clerk read the fol- pilgrims near the southern town of that doesn’t feel the housing crisis. lowing letter: Iskandariyah. Even as overall violence has Neighborhood streets are dotted with U.S. SENATE, fallen, the recent attacks underscore the one ‘‘For Sale’’ sign after another. And PRESIDENT PRO TEMPORE, tenuous security environment and the resil- Washington, DC, February 27, 2008. iency of the insurgency. once we have one ‘‘For Sale’’ sign or, To the Senate: In volatile Diyala province, armed men set even worse, the bank has a foreclosure Under the provisions of rule I, paragraph 3, up a fake checkpoint and kidnapped 21 peo- sign on it, it affects the whole neigh- of the Standing Rules of the Senate, I hereby ple. borhood.

∑ This ‘‘bullet’’ symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor.

S1217

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00001 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1218 CONGRESSIONAL RECORD — SENATE February 27, 2008 One of my boys lives in Las Vegas, in have credit counselors, and we have funds, expanding refinancing opportu- a nice neighborhood. The housing representatives from FHA. We have a nities, and amending the Bankruptcy prices there in the last 3 months have wide range of experts there to talk to Code to allow more home loans on pri- dropped 20 percent—20 percent. In Las these desperate people to see if any- mary residences to be modified. This Vegas, last month, there were more thing can be done to help them, and will help communities impacted by foreclosures than there were sales of there are some things that can be done foreclosures by allowing parts of the new homes. This is very unusual be- to help. These centers bring borrowers country with high foreclosure rates to cause Las Vegas has been the fire that and mortgage services together to talk access Federal funds to purchase fore- has burned upward for 20 years, cre- about how to help homeowners facing closed properties for rehabilitation, ating such an economic strong point foreclosure. rent, or resale. that it has been known for 20 years as The stories they tell are heart- The bill will help struggling busi- the most rapidly growing State in the breaking. I could tell lots of stories, nesses by making it easier for them to Union. but the one that stands out in my mind utilize losses incurred in 2006, 2007, and In these struggles, construction is a man by the name of Elisario. What 2008 to offset prior years’ income to re- workers are having trouble finding extraordinary challenges this man and coup previously paid income taxes. jobs. Construction workers are having his family face. He is a marine veteran This was the provision that was in our trouble making payments on their of the Iraq war. He has three children, previous stimulus package that our homes. In desperation, hard-working three little girls. Like thousands of colleagues on the other side of the aisle people have been talked into bad mort- others of these heroes returning from stopped us from moving forward on. It gages and are now seeing their homes Iraq and Afghanistan, the war took its is one the home builders liked very just slip away. Every day, new statis- toll on him. He suffers from post-trau- much. tics illuminate the depth of this grow- matic stress disorder and is recovering The legislation that will be before ing crisis in the housing market. from many surgeries related to injuries the Senate shortly will help families The crisis is everyplace. Today, the he sustained in Iraq. As a result of the avoid foreclosure in the future by im- Associated Press reported that the injuries he suffered in service to our proving loan disclosures during the number of homes facing foreclosure country, his family was forced, for a original loan and refinancing process. across our country grew by 57 percent time, to rely on the income from his And one of the provisions that was also in the month of January. That is com- wife’s part-time job. Now, remember in our package that we had, that my pared to a year ago. We also now know the three little girls. They fell behind good friends on the other side of the that sales prices have lost almost 10 in their mortgage payments. That aisle defeated, was one the President percent in the final quarter of last doesn’t surprise anyone. He called his called for in his State of the Union year, and I am sure this quarter is lender but was told it was his responsi- Message—revenue bonds to help people going to be even worse. The last quar- bility to pay the loan. They weren’t get into some of these homes that are ter marked the steepest drop in the 20- willing to work with them at all. He being foreclosed upon. year history of the Standard & Poor’s was told to sell the home and get an Title IV of the legislation makes housing index. apartment. changes to the Bankruptcy Code. These In the crisis in Nevada, I have men- All across the country, people just changes would allow a bankruptcy tioned briefly last month that we saw like Elisario are looking to us for help. judge to modify the terms of a mort- the rate of foreclosures rise 95 percent In far too many cases, people like him gage on a primary residence but only from the previous year; in Reno and saw their mortgage payments sky- under very limited circumstances, lim- Sparks, 611 percent. Now, who suffers rocket after the interest rate on their ited in scope and duration. Only fami- from these foreclosures? Families who loan was reset. The sudden loss of in- lies who can pass a strict means test in own the homes? Of course they do, but come combined with the dramatic in- bankruptcy and are currently strug- they aren’t the only ones. It is the crease in the monthly payment is le- gling with an adjustable rate mortgage whole neighborhood, those who live thal for any homeowner. These are the and subprime loan that already exists near foreclosures, families who have families whom the legislation we will are eligible. That is all. done nothing wrong, who have paid get to—hopefully sooner rather than There are limits to the modifications their bills on time. Yet they are seeing later—this week will help. a judge can make to the interest rate, the value of their property zapped. This legislation we have is not for term, the principal amount of the The Center for Responsible Lending speculators. It is not for speculators mortgage. We do not aim to drive has estimated that 40 million neigh- who lost a bet. Are we going to bail out struggling families into bankruptcy boring homes will experience a loss in lenders who underwrote mortgages? with this proposal. No one should abuse equity if the expected foreclosures ma- No. They shouldn’t have made those the Bankruptcy Code to get out of terialize. That would likely lead to a loans. That is their problem. We are debts they owe. total decline of more than $200 billion not trying to bail out borrowers who The means test provided in this legis- in home equity, and some say that is should have known better. We are try- lation should prevent that from hap- very conservative. This could mean ing to give families like Elisario’s a pening. Remember the reason this is more than $3 billion in losses for Ne- chance to keep their homes and sta- necessary today. For example, in Las vada alone. bilize the Nation’s economy in the Vegas, if you own a home down on the If that is not bad enough for home- process. oceanfront in Malibu, you buy that and owners, it is very bad for local govern- The administration deserves credit finances go bad, you can go to bank- ments that have already been forced to for taking some first steps. I appreciate ruptcy court. The bankruptcy court cut services as a result of the shrinking Secretary Paulson and like him a lot. can readjust that loan on your vaca- tax base. One example: Washaw Coun- He has led the efforts to gather mort- tion property, your second home, but ty—that is Reno—is facing a $26 mil- gage servicers, investors, and housing cannot do that on your primary resi- lion cut to its local budget, and they counselors to form the Hope Now Alli- dence. That is not the way it should be. say it is mainly due to the housing cri- ance and Project Lifeline. These efforts We are also mindful of concerns that sis, and $26 million to Washaw County should help, but it is such a tiny bit of this provision could make access to is a lot of money. help, and they are all voluntary. They mortgages more difficult by increasing These numbers are staggering. We all fall completely short. Some estimate costs, it could inject more uncertainty know the housing crisis isn’t just about that less than 3 percent of at-risk fami- into the market. All the experts say statistics, it is about families. I have lies will be reached under his pro- that is untrue. Georgetown has com- had, in the State of Nevada, six mobile posals—less than 3 percent. We have to pleted a study. resource centers where I bring in peo- help the 971⁄2 percent who won’t be In today’s New York Times, there is ple. We do advertising and let them reached. an article: ‘‘Getting Real About the know we are going to be there. We The legislation before us does that. It Rescue.’’ That is what it is about. And bring in experts to talk, and we have will keep families in their homes by in- they go on to state how important it is people who service the loans there, we creasing preforeclosure counseling that we do this stimulus package but

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00002 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1219 especially we do this bankruptcy provi- Iraq issue back before the Senate, 60 minutes, with Senators permitted to sion. This editorial says, among other there are a number of members of my speak for up to 10 minutes each, with things: conference, many of whom have been the time equally divided and controlled If the bankruptcy provision becomes law, to Iraq recently, who were anxious to between the two leaders or their des- as it should, lenders will have a powerful in- discuss the undeniable progress that ignees, with the Republicans control- centive, which they currently do not have, to has occurred in Iraq over the last 6 ling the first half and the majority modify troubled loans voluntarily. If they months. controlling the final half. can’t or won’t come to new terms with bor- We had a good discussion yesterday. I The ACTING PRESIDENT pro tem- rowers, then they would run the risk that a have more members who would like to pore. The Senator from Tennessee. bankruptcy court would do the modifying for them. continue the discussion today. There is f obviously an opportunity later in the TENNESSEE TORNADOS But most, or all, I repeat, inde- morning or this afternoon to discuss pendent experts agree that any in- further with the majority leader the Mr. CORKER. Mr. President, thank crease in costs would be nonexistent. possibility of shortening the time. you for the opportunity to speak for a Meanwhile, this modified bankruptcy But for the moment, there are a few minutes this morning. language would help more than 200,000 number of Senators on my side of the While I would like to speak about families avoid foreclosure. It would aisle who are anxious to discuss the health care and on some of the com- stabilize the housing market, prevent progress in Iraq, happy to have the de- ments made about the stimulus pack- future, perhaps deeper losses to fami- bate time. Therefore, for the time age that is going to be debated appar- lies, investors—and that is so impor- being, I object. ently in upcoming days, I would first tant, we have to do that. That is why The ACTING PRESIDENT pro tem- like to make mention of the tornado we have to act. pore. Objection is heard. damage that has occurred in our State. There may be no perfect solution to Mr. MCCONNELL. Mr. President, let We have officially 32 deaths. That the growing housing crisis, but stand- me say briefly, the matter before us, number may rise. Certainly, we have ing back and doing nothing would be a the Feingold withdrawal amendment is had numbers of people in our State who real mistake. The legislation that will in basically the form it has been before have gone without housing. They have shortly be before us will make a real us, has been voted on four times before. lost their worldly possessions. They difference to homeowners, neighbor- Each of the times it was voted on in have lost family members. In this time hoods, and our economy. the past, one could argue that things of grief for many people, I think we More than 700,000 families will ben- were going less well in Iraq than they have also seen something that has been efit from the policies in this measure, are today. The highest number of votes very uplifting. 80,000 vacant foreclosed homes will be the Feingold withdrawal proposal has Certainly, after other disasters that put back to productive use, 30,000 jobs, received at any point in these 4 votes is have taken place in this country in re- and $10 billion in economic activity 29 votes. cent times, there, in some cases, has will be created. It will be, should it be voted on, de- been a sense of concern about whether I hope my colleagues will join us to feated once again. It certainly should our Government is able to meet the support cloture on the motion to pro- be because now we have had 6 months needs of these disasters we have seen in ceed to this matter so we can pass the or so of undeniable progress on all various parts of the country and in legislation and bring the relief to hun- fronts. The security situation is dra- some cases the world. dreds of thousands of Americans. matically improved. Even on the polit- In the State of Tennessee FEMA, f ical side, where I think Members on under the leadership of Director Paulison, and TEMA, under the leader- UNANIMOUS-CONSENT REQUEST both sides were frustrated with the new Iraqi democracy, they finally have ship of General Bassham, and then the Mr. REID. Mr. President, yesterday, begun to take the kind of steps that leadership of various local agencies at 3:16 in the afternoon, the Senate are needed—the debaathification law that deal with disasters have responded voted to invoke cloture on the motion was approved, local elections have been in incredible ways. to proceed to S. 2633, which is a bill to scheduled for later in the year. In our State, I think what we have provide for the safe redeployment of They are finally making some seen is an unprecedented cooperation U.S. troops from Iraq. progress on the Government side as that has taken place, one that I think After the cloture vote, I made a pro- well as the undeniable progress on the is going a long ways toward causing posal that we would have postcloture security side, at this point, not brought people to see our Government respond- debate for a period of time, a signifi- about strictly by American troops but ing in a way that is very responsible. cant period of time, agree to the mo- also the sons of Iraq. These people who We have also seen numbers of people tion, and then go to the bill. But once decided to defend their neighborhoods who have given of themselves to help we completed action on this, S. 2633, we and defeat, help us defeat al-Qaida, their neighbors. We have had Red Cross would have a cloture vote on the mo- have grown dramatically in terms of personnel on site, we have had lots of tion to proceed to the next matter that numbers and commitment. volunteers from various organizations I talked about earlier today. That con- So there is, as I indicated, a lot of in- throughout our State helping those in sent was rejected. terest on our side in continuing to at need. I ask unanimous consent that all least point out the progress that has It has caused me to feel great about postcloture time be yielded back, and been made in Iraq, both in terms of se- our leadership, Federal, State and the motion to proceed be agreed to; curity and on the political side. So we local, as it relates to responding to that upon disposition of S. 2633, the will have that discussion later into the these people in times of need. I know Senate proceed to vote on the motion morning, and the majority leader and I this will continue as 16 counties right to invoke cloture on the motion to pro- will have an opportunity later in the now are under the Federal disaster des- ceed to S. 2634; further, that if cloture day to discuss where we go from here. ignation; there may be more coming. is invoked, notwithstanding rule XXII, f But my hat is off to all those who have the Senate then proceed to vote on the been involved in helping people in this motion to invoke cloture on the mo- RESERVATION OF LEADER TIME time of need. tion to proceed to H.R. 3221, the hous- The ACTING PRESIDENT pro tem- f ing bill. pore. Under the previous order, the ECONOMIC STIMULUS The ACTING PRESIDENT pro tem- leadership time is reserved. pore. The Republican leader. f Mr. CORKER. Mr. President, I do Mr. MCCONNELL. Reserving the wish to refer briefly to the stimulus right to object, the question of the Iraq MORNING BUSINESS package that was discussed by our ma- debate, once again at this particular The ACTING PRESIDENT pro tem- jority leader. I have a great deal of re- juncture, was not the decision of the pore. Under the previous order, there spect for him. I was 1 of 16 Senators minority. Nevertheless, having put the will be a period of morning business for who voted against the last stimulus

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00003 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1220 CONGRESSIONAL RECORD — SENATE February 27, 2008 package, which I thought was abso- would like to join in with other Sen- mission is shifting province by prov- lutely a waste of money, causing peo- ators on both sides of the aisle, to en- ince; we are identifying a long-term ple around America to think we were sure we do those things, create the but diminishing role in Iraq; and diplo- possibly doing something to help. mechanisms to allow people who can- matic efforts are stepped up. Those are I noticed all the discussion around not afford health care today to be able basically the three recommendations this crisis, if you will, we are having in to afford it but to do so in a manner of the Iraq Study Group, which I wish our country, or a correction, as some that preserves choice, preserves qual- the President had embraced. He didn’t people may call it, have focused on ity, preserves the doctor-patient rela- embrace the report itself, but he is credit issues. I found it most inter- tionship that now exists. headed in that direction. So we are esting that as you might expect here in We have been able to do that in other glad to talk about it. Washington, with help on the way, we ways dealing with seniors, we have Although I agree it would have been would do something totally unrelated been able to do that certainly with better to talk about the economy and to the problem and instead sprinkle those people throughout our country housing, we are ready to talk about money all around America and ask peo- who cannot afford health care through that as well. But if we are going to talk ple to spend it as quickly as they could programs such as Medicaid. Obviously, about housing and the economy, we are when we have a credit problem. the focus of this effort needs to be on ready to take action this year, and we I will say I had hoped we might focus preserving the private-sector means of have some pretty big differences of on the stimulus, on the stimulus in an delivering health care. But I wish to opinion across the aisle. appropriate way, something that would say to you I am uplifted by what I am We were able to agree on a stimulus create long-term jobs and investment, seeing on both sides of the aisle. package. First, we had to stop $40 bil- not spending by individuals, which I know Republicans and Democrats lion in extra spending, but we were causes them, in some cases, to even go together want to make sure we solve able to agree on allowing individuals, further in debt. this problem. I know, Mr. President, largely, to keep their own money. Mr. But I have to say this housing pack- you have been very involved yourself. I President, 2.7 million Tennesseans will age that is getting ready to be before wish to say to you I think this is a tre- receive a so-called rebate this spring. us, in my opinion, is an unmitigated mendous opportunity for us in this There were provisions I liked so well disaster. I cannot imagine us getting body to come together and do some- that I am going to introduce legisla- between judges and people who borrow thing the American people want to see tion to make them permanent. These money in such a manner as to alter the done but do so in a manner that at the are the small business provisions that relationship that people who borrowed same time preserves the best qualities in Tennessee counties, such as money have with those who lend them of our health care system. Cheatham County where 400 different the money. I wish to offer up my efforts to join small businesses will be eligible for ac- This is one of those things that, to in with others to make sure this hap- celerated depreciation and expensing. me, is unbelievable that we would even pens. This allows those businesses to keep discuss altering that relationship cer- I yield the floor. more money, create more jobs, and tainly on a voluntary basis. This is The ACTING PRESIDENT pro tem- stimulate the economy. In Washington something that might make some pore. The Senator from Tennessee. County, it is several thousand small sense. Certainly, companies that can Mr. ALEXANDER. Mr. President, businesses. These are good provisions loan money excessively in ways that could I be informed when 10 minutes is and a good start. I agree we should get are inappropriate need to be dealt with. up. on with the next steps to make sure we But to unilaterally decide that judges The ACTING PRESIDENT pro tem- have a strong, vibrant economy. This is can alter the amount of money people pore. The Chair will so notify you. the economy that produces about a owe, to me, is an unmitigated disaster. Mr. ALEXANDER. I wish to thank third of the money in the world for just I hope this bill will never see the light my colleague from Tennessee for his 5 percent of all the people in the world. of day. I hope others will join in mak- comments on health care, for his lead- We are in a slowdown right now, but ing sure this does not happen. ership. He has been, on our side of the there are steps we can take to step it f aisle, one of the principal actors in the up. effort to try to combine the idea of, as We would say, on this side of the HEALTH CARE some say, ‘‘universal access,’’ with two aisle, that would be a bigger, bolder, Mr. CORKER. Mr. President, let me other words, ‘‘private sector.’’ Four broader pro-growth economic plan in- mention the real reason I came down words that usually do not go together. cluding such things as lower taxes. For here was to talk about health care. I I agree with him. If there was one example, making permanent the divi- have noticed all the Presidential can- agenda item on the Republican side of dend, capital gains, and estate tax rate didates who are out there today are the aisle we could all agree on this at 15 percent. Or lowering the cor- talking about health care. I am glad to year as a goal that we would like to porate tax rate from 35 to 25 percent, see that. I know a number of Repub- start this year, it would be having so our companies can be competitive licans have gathered around the notion every American insured. with the world and keep their jobs here of making sure every American has ac- We would like to make it possible for instead of going overseas. Or a simpler cess to health care. every American family to have access flatter tax giving taxpayers the option I myself have authored a bill with to and to be able to afford health insur- of filing a one-page return with a 17- Senator BURR from North Carolina, a ance. I would like to speak to that. percent or so flat rate. number of others have joined in. I First, I would like to comment on We would support doubling funding know Senator WYDEN from Oregon has the majority leader’s comments and on the physical sciences to keep our joined in with BOB BENNETT of Utah, those of the Republican leader. We re- brain power advantage and can con- they have authored a bill. spect the majority leader’s right to set tinue to grow jobs here, so these jobs But I think we have a tremendous op- the agenda on the Senate floor, and he would not go to India and China. That portunity during this year to help decided to bring up the Iraq debate this is part of a pro-growth Republican eco- shape the debate on health care legisla- week. But if he brought it up, why nomic plan that would also attract sig- tion, my sense is, in a very bipartisan doesn’t he want to talk about it? We nificant independent and Democratic way, that in this next Congress, in 2009, were here yesterday. We are here support. We would like to continue to we are going to have the opportunity today. in-source brain power by giving green to actually create health care legisla- I came down last night and talked cards to foreign students who are le- tion that focuses on the private sector, about the fact that even though I have gally here and who want to stay here that ensures people have choice in had differences with the President on and work, creating jobs here instead of order to maintain the quality of health Iraq, we are moving in the right direc- going back to India, Ireland, or China care they would like to see. tion. We should say that to our enemy, and creating jobs there. We would like But my guess is we have a tremen- to our troops, and to the world. Troops to make the research and development dous opportunity. I wish to say today I are coming out instead of going in; the tax credit permanent, so companies

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00004 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1221 can create more jobs here. We would surance has gone sky high, over $100,000 I understand his concern for the wel- like to reward outstanding teachers a year because of lawsuits in some fare of our soldiers and for those who and outstanding school leaders. We can States. As a result, the doctors are have sacrificed in Iraq. But the way we debate that. We would like to give Pell leaving the rural areas, and pregnant pay tribute to those who have sac- grants to low-income kids so they can women are having to drive 40, 50, 60 rificed and to our brave men and have more choices of schools. We would miles for prenatal health care or to de- women still fighting in Iraq today is to like to implement the America COM- liver their babies, because the doctors finish what we started so that we honor PETES Act which we agreed on in a bi- aren’t there anymore. In a few places them and bring those who are still in partisan way. We would like to lower such as Mississippi, Texas, and Ken- Iraq home victorious and not defeated. energy costs by more conservation and tucky, steps have been taken to say: As If we are trying to reverse the progress nuclear power. We would like to lower long as you are damaged, you can col- we have made in Iraq, embolden our en- the cost of Government by fewer rules lect, but there is a limit on the puni- emies and the enemies of the Iraqi peo- and regulations. As Senator CORKER tive damages in those States. Where ple, and ensure that our mission fails, was talking about, we would like to the rules have been changed, doctors I probably could not have crafted a bet- lower health care costs. are moving back into those States and ter bill than that of the Senator from The words that we could most easily back into rural areas. That also lowers Wisconsin. agree on on this side of the aisle—and health care costs. As a result of the U.S. troop surge, there might not be so much objection I am here today as a cosponsor of the Al Anbar awakening, significant al- over there either—are ‘‘every American three different health insurance bills Qaida in Iraq defeats, and the unilat- insured.’’ There is a step-by-step proc- which I hope will move us toward the eral cease-fire last August declared by ess to get to that. We have over 800,000 idea of every American insured, and I Muqtada al-Sadr, the security in Iraq Tennesseans without health insurance. would like to talk about two of them has steadily improved. Violence has We have about 47 million Americans today. Senator COBURN, Senator BURR, reached its lowest level since the insur- without health insurance. and Senator CORKER have one of those gency began, and there has been a large We are at a time in our history where bills, and I am a cosponsor. Senator increase in Iraqi security forces trained reports by distinguished journals of WYDEN and Senator BENNETT have an- and equipped. Today that stands at medicine, such as the New England other of those bills, and I am a cospon- about 440,000 men. In the last year Journal of Medicine, the Institute of sor of that as well. It has six Repub- ethnosectarian-related deaths have de- Medicine, and the Trust for America’s licans and six Democrats. I don’t agree creased 95 percent. Suicide attacks in Health say today’s children are likely with every part of the Wyden-Bennett Baghdad have gone from 12 a month in to be the first generation to live short- bill, specifically the mandates from the January of last year to just 4 last er, less healthier lives than their par- beginning, but I agree with the spirit of month, a 66 percent decrease. Attacks ents. That is a health care crisis. At what they are trying to do. Most Amer- have decreased in 17 of the 18 provinces the same time, the most rapidly grow- icans like the fact that they are work- in Iraq, and IED detonations are down ing part of the Federal budget is spending across the aisle to try to make real by 45 percent in Baghdad itself. Secu- ing for Medicare and Medicaid. It is the idea that every American can have rity incidents countrywide and in the growing so rapidly we can’t sustain it, access to health insurance, and they 10 Baghdad security districts have de- so we need an overhaul of our health are willing to include—and we would clined to their lowest level since Feb- care system. We need to lower health emphasize—the private sector in that ruary 2006 when the Samarra Golden care costs for the average family so solution. Mosque was bombed. each family can be able to afford at We have a whole year. This is a Pres- As Sunnis in Al Anbar got frustrated idential year. That doesn’t mean we least a basic health insurance policy with AQI, the troop surge provided the should take a vacation. We got off to a that doesn’t go away when they lose opportunity for them to work with coa- pretty good start with the stimulus their job. lition forces to disrupt AQI operations. On the way to lowering health care package. We got off to a very good Al Anbar now will be transferred to costs and giving every American access start with the FISA bill. Unfortu- Iraqi security control in the near fu- to such a health care insurance policy nately, the House took a vacation ture, bringing 10 of the 18 provinces in are several pieces of legislation, many without acting on it. I suggest that Re- Iraq under the sole control of Iraqis. of them bipartisan, which we could publicans are ready to join with Demo- AQI attempted to shift operations to crats and take steps this year toward pass this year. For example, the Kerry- Baghdad and its surrounding northern the goal of every American insured. Ensign e-prescribing bill would provide provinces, but the Al Anbar awakening The ACTING PRESIDENT pro tem- movement prompted other awakening for electronic transmittal of prescrip- pore. The Senator has used 10 minutes. tion information from the doctor to Mr. ALEXANDER. I yield the floor. movements and concerned local citizen the pharmacists. In addition, we could The ACTING PRESIDENT pro tem- groups began to spring up all over Iraq. pass legislation to allow small business pore. The Senator from Georgia. As a result, AQI has been disrupted. health plans this year. Senator ENZI But as the DNI told the Senate Intel- f has been the leader on this issue, and ligence Committee in February, ‘‘AQI he has worked on legislation that basi- IRAQ TROOP WITHDRAWAL remains capable of conducting desta- cally would allow small businesses to Mr. CHAMBLISS. Mr. President, I bilizing operations and spectacular at- pool their resources in order to offer rise to speak in opposition to the Iraqi tacks, despite disruptions of its net- health insurance to their employees at troop withdrawal bill that we are dis- works.’’ an affordable rate—to let them do the cussing, the bill as proposed by Senator These successes cannot blind us to same thing big businesses can do. Sen- FEINGOLD. We have been here before, AQI’s abilities or to their resolve in at- ator ENZI estimates that could provide simply stated. The Senate has voted to tacking Americans. Kurdish areas in insurance to more than 1 million reject measures similar to this bill at northern Iraq were the safest in Iraq a Americans who are not now insured. least three times over the past year. year ago, but today AQI is taking ad- Senator MARTINEZ has introduced The only thing that has changed since vantage of this safety by establishing legislation to help get rid of fraud and we have had those votes is that condi- around Mosul and launching attacks abuse in Medicare and Medicaid. Tens tions on the ground in Iraq have con- against the population. This is an area of billions of dollars are wasted there, tinued to improve as a result of the where U.S. troops are used sparingly. and it would lower health care costs to President’s new strategy. Even the op- In my humble opinion, that is no coin- pass the Martinez legislation. ponents of the surge have had to ac- cidence. U.S. operations forced AQI out Senator GREGG has offered legisla- knowledge that it is, in fact, working. of al-Anbar, restricted their operations tion which isn’t bipartisan but deserves In the midst of this progress and of al- in Baghdad, and they are now moving to be. I hope it can be. It would put Qaida’s continued retreat in Iraq, the to more rural areas with less U.S. mili- limits on punitive damages from law- Senator from Wisconsin would have us tary. suits against doctors who serve preg- surrender to an enemy that is on the If this legislation passes and our nant women. Medical malpractice in- run. troops must withdraw from Iraq, AQI

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00005 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1222 CONGRESSIONAL RECORD — SENATE February 27, 2008 will have the freedom to terrorize the Political strategies for fighting wars mission in Iraq can continue to suc- rest of Iraq and beyond. The Director such as the rhetoric some are now im- ceed. And our mission is succeeding. of National Intelligence stated that he ploring all have one thing in common: General Petraeus is succeeding. Vio- is ‘‘increasingly concerned that as we They all result in failure. They are lence in Iraq is at the lowest since the inflict significant damage on al-Qa’ida shortsighted, politically motivated, do insurgency began. Suicide bombings in Iraq, it may shift resources to not serve any national security objec- are down 70 percent. IED attacks have mounting more attacks outside of Iraq tive and, most importantly, are a dis- been cut in half. . . . Although the ongoing conflict in service to the men and women who The surge is working. Since it began Iraq will likely absorb most of AQI’s have been called into action and are on less than a year ago, we have succeeded resources [over] the next year, AQI has the ground in Iraq. in putting al-Qaida on the run, while leveraged its broad external net- We are making progress in Iraq. The rooting out the terrorists neighborhood works—including some reaching into strategy our President and our mili- by neighborhood. In return, Iraqis have Europe—in support of external oper- tary commanders have implemented is partnered with U.S. troops, forming ations.’’ Forcing our troops out of Iraq working. We are receiving positive up- their own security forces, and stabi- would result in a resurgent AQI which dates from our leaders in the field. Our lizing their own neighborhoods. These could mount attacks from Iraq against leaders are adjusting their strategy in efforts have served to unite torn com- Americans and our allies. accordance with those developments on munities, such as Anbar Province, and Security is not the only aspect im- the ground as well as the realities back pave the way for political reconcili- proving in Iraq. On the political front, home. They are doing this wisely, not ation. the Council of Representatives is tak- hastily or in response to opinion polls, The other side has said for months ing steps to institute necessary legisla- but according to good judgment and a the surge has failed because it has not tion to help reconcile Iraq. realistic assessment of what will work, created an environment for political Earlier this month, the Council of what will not work, and what is appro- progress in Iraq. Well, they are wrong. Representatives passed a priate at this point in time. The correlation between the surge and debaathification law which will help The Feingold bill will stop our lead- security is obvious. In the past few reintegrate former regime officials into ers’ ability to do this. It will keep weeks, as we continue to see increased society. Two weeks ago, the Council of them from doing the jobs we sent them stability throughout Iraq, the Iraqi Representatives passed three key to do; and that is to lead, to decide, to Government has made great political pieces of legislation: an amnesty law, a make judgments, and to report back to strides. provincial powers law, and the 2008 fis- us on their effectiveness. Most impor- On February 13, the Iraqi Council of cal budget. For the first time, Iraq’s tantly, it will keep them from com- Representatives passed three key main political parties compromised in pleting the job we have sent them to pieces of legislation: An amnesty law, order to support passage of these bills. perform. This is unacceptable. For the 2008 budget, and a provincial pow- The provincial powers law requires the these reasons, I urge my colleagues to ers law. These political milestones are council to pass an election law within vote against this bill. made possible by Sunnis, Shiites, and 90 days and for provincial elections to Mr. President, I yield back. Kurds reaching out to each other and occur no later than October 1, 2008. Mr. President, I suggest the absence working to find solutions that rep- These are encouraging steps. In spite of of a quorum. resent all Iraqis. the fact that the provincial powers law The ACTING PRESIDENT pro tem- This is General Petraeus’s counterin- was vetoed yesterday, it is encour- pore. The clerk will call the roll. surgency at work. It worked when he aging, and I am very hopeful we are The assistant legislative clerk pro- was commander of the 101st Airborne going to see the differences reconciled ceeded to call the roll. Division in Mosul, and now it is work- in short order and that law become per- Mr. BUNNING. Mr. President, I ask ing all across Iraq. manent. unanimous consent that the order for So I ask my colleagues across the By limiting our military actions to the quorum call be rescinded. aisle: Why, when you see our mission specific areas, this bill would ensure The ACTING PRESIDENT pro tem- in Iraq is succeeding, and the Iraqi peo- that every one of these successes and pore. Without objection, it is so or- ple are making real political progress, improvements in security is reversed. dered. do you want to pull the rug out from In the midst of progress in Iraq, which f underneath our commanders and our no one denies, and with a strategy that ORDER OF PROCEDURE troops? is working, it simply does not make Mr. BUNNING. Mr. President, I re- Last July, the Senate overwhelm- sense to tie the hands of the com- quest that the time I use in morning ingly supported, by a vote of 94 to 3, a manders on the ground and force them business not be counted against any of sense-of-the-Senate amendment stat- to implement a strategy which will the Democratic time that has been set ing that it is in our national security lead to failure—a strategy that in the aside. interests that Iraq not become a failed best judgment of our military leaders, The ACTING PRESIDENT pro tem- state and a safe haven for terrorists. our intelligence agencies, and from the pore. Without objection, it is so or- Well, wake up. Cutting and running perspective of countless outside observ- dered. from Iraq will only benefit the terror- ers have stated will lead to the failure The Senator from Kentucky is recog- ists, while jeopardizing our national se- of our mission and the rapid deteriora- nized. curity and that of the Iraqi people. tion of conditions in Iraq and for the Make no mistake, Iraq is the central f Iraqi people. battleground in our fight in the global Hopefully, it is evident to people who IRAQ TROOP WITHDRAWAL war on terror. This is not just my opin- are watching this debate and have ex- Mr. BUNNING. Mr. President, I rise ion. Osama bin Laden has called Iraq amined the Feingold bill that the today to speak in opposition to pulling the ‘‘central front’’ in his war against strategy which inspires the provisions our troops out of Iraq based on polit- America. He knows that the premature and limitations in this bill is not a ical timetables conceived in the Sen- withdrawal of U.S. troops from Iraq military strategy; it is a political ate. will strengthen his terrorist organiza- strategy. The tactics being used by I have voted against similar meas- tion, enabling him to set up training those who would enact conditions and ures in the past. I intend to vote camps in that country. limitations on our involvement in Iraq, against them again this week. These Although it has been over 6 years such as those contained in this bill, are bills do nothing more than tie the since we have experienced a terrorist not based on strategic thought or anal- hands of our commanders on the attack on U.S. soil, we must never for- ysis. Rather, they appeal to a political ground while pandering to special in- get that there are those out there who base that has always opposed the war, terests here in the United States— wish to do us harm on a daily basis. refuses to acknowledge the progress we antiwar groups. And those who wish to do us harm will are making, and wants to see our mis- These are the same commanders who benefit if we pull out of Iraq and leave sion fail. are risking their lives daily that our a failed state behind.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00006 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1223 Al-Qaida and its allies flourish and But we have now been in Iraq for So I know there has been a lot of de- multiply in the chaos of failed States many years. Several years ago I was in bate on this floor about whether the with no rule of law or respect for Iraq. I had a chance to visit our troops President’s surge policy has worked. I human rights. Instead of debating a and take a look at what was happening must tell my colleagues, I think our cut-and-run strategy in Iraq that has on the ground. I saw then that we soldiers are performing, as I said ear- already failed on the floor of this Sen- didn’t have the right equipment there; lier, in a great manner. When you put ate four times, we should be focusing that the administration had sent our American troops in a country, they are on how to provide the defenders of our troops without having the right sup- going to do their job and they are freedom—our commanders and our port. I was proud of the action the Con- going to provide the type of help to troops—with the necessary tools to gress took in providing the military that country and to its communities complete their mission. support and the type of equipment our that American troops are trained to do. Last week, I had the opportunity to troops needed. But the problem is the mission is meet with the new commanding gen- But the discussion of what is best for wrong. The surge has not worked in ac- eral of the 101st Airborne at Fort our troops is whether we have the right complishing the U.S. mission that is in Campbell, KY. Located on the southern mission in Iraq. This campaign is now the best interests of this country. border between Kentucky and Ten- entering its sixth year. We have been I remember when the President said: nessee, the Fort Campbell community in Iraq longer than we were in World We are going to have the surge because has felt the effects of deployments and War II. We have now spent a half tril- we are going to provide stability in the casualties. lion dollars directly on our war in Iraq. country so the Iraqi Government can Right around 200 soldiers from Fort Almost 4,000 Americans have been take control and we can bring our Campbell have given their lives for killed, almost 30,000 have been wound- troops home. That was the mission. their country. Thousands of good men ed, 67 Marylanders have given their That is what we are trying to accom- and women have spent tours of 15 lives, and over 800 have been injured. plish, but we haven’t accomplished months away from their families— Many of these injuries are life chang- that. Let’s look at the facts. Look at some four, some three, others two, and ing. the facts. some one: tours of 15 or 12 months from I have had a chance to visit Andrews Violence in Iraq continues today. The the 101st Airborne in Iraq. Air Force Base as our wounded soldiers majority leader mentioned the head- Speaking with the commanding gen- come home, and I have been able to see lines in today’s paper. Violence con- eral only reinforced my belief that we firsthand the type of injuries they sus- tinues. It is a dangerous country. Sui- have some of the finest patriots serving tained. They will have to deal with cide bombers operate at will. The troop in our Nation’s military. The brave them for the rest of their lives. levels were supposed to be reduced. In men and women who answer the call to When we look at the strength of al- January of 2007 we had 130,000 Amer- defend our Nation, and the families and Qaida, our experts tell us they are ican troops in Iraq. Today we have in communities who support them, are stronger today than they have ever excess of 140,000. There is now a pause our most valuable national asset. I do been. So we haven’t accomplished our in reducing our troop levels. We not want to see their unbelievable ef- mission as far as dealing with the haven’t been able to reduce the troop forts in Iraq fail. We as a nation have threat against the United States. levels. On governance, on the Iraqi invested too much to hand a big vic- Let’s talk about the facts. The ines- Government representing the people of tory to al-Qaida in Iraq. capable conclusion is that President Iraq, they set their own benchmarks. This political show needs to end. Bush was wrong in sending our troops In April, General Petraeus will report We didn’t set them. Of 18 benchmarks, to Iraq in the first place. I am proud I back to Congress on the state of our only 3 have been accomplished. So, no, voted against that authorization when mission in Iraq. As Senators who voted we haven’t accomplished the mission I was in the other body. Our troops are in support of his confirmation, we owe the President established for why we him this opportunity to present his re- involved in trying to referee a civil needed our troops in Iraq. port to us, instead of cutting him off at war. That is their primary focus. Yes, But let’s take a look at our military the knees right before his report. We we are fighting terrorists, and we need and foreign policy experts. They tell us should show him the respect of listen- to continue to do that, but the primary our military today is spread too thin, ing to his report. We owe an honorable need for American troops is to deal that we aren’t looking after the best man, who has spent—I want you to re- with the civil unrest that is currently interests of America’s military inter- member this—who has spent most of taking place in Iraq. ests. Talk to our people who run our the last 5 years away from his family The costs, as I explained before, in National Guard and Reserve units. in Iraq to see that freedom in America lives has been our deepest loss, but also I had a chance to meet with members is preserved. the dollars—a half trillion dollars. of the Maryland National Guard. They I urge my colleagues to join me in Think about what we could have done have, again, answered the call. People giving General Petraeus this oppor- with that money. I think about schools of the Maryland National Guard have tunity and opposing these bills. in Baltimore that should be replaced. been deployed regularly into Iraq and Mr. President, I yield the floor. We could have replaced every school Afghanistan. But I am told today we The PRESIDING OFFICER (Mr. NEL- with the money that has been spent so don’t have the equipment in our Na- SON of Nebraska). The Senator from our children could get a proper edu- tional Guard to continue the proper Maryland is recognized. cation. We could have dealt with the training missions because the equip- f energy crisis in this country and built ment was left in Iraq. We haven’t re- the transit systems we need and be- placed that. Also, recruitment is going IRAQ WAR come energy independent so we are not to be more difficult, and we need to Mr. CARDIN. Mr. President, first of dependent on foreign oil in the Middle deal with the reintegration of the Na- all, I welcome this opportunity to talk East. We could have done something tional Guard people who are coming about the current status of the involve- about the health care system in this back to Maryland in our community, ment of the United States in Iraq. I am country. and that is going to take a real effort. glad we are having this discussion. I A year ago, Diamonte Driver died in Now they have to be prepared for rede- start by thanking the troops for their Prince George’s County, MD, because ployment. incredible service to our country and he couldn’t get dental care. We are suf- We have lost our focus, according to the incredible work they are doing, and fering an economic downturn right now our experts on the war against terror. I think this Congress, by words and because we have large debt, in part, We should have taken care of Osama deeds, has shown its support for our and that debt is accumulating because bin Laden in Afghanistan. We haven’t troops. The budget we provided last we are not only spending a half trillion done that. Now Afghanistan looks as if year provides the resources to take dollars, we are not paying for it. We it is moving in the wrong direction be- care of our veterans and the funds to are borrowing the money. It is making cause we are not focusing on the take care of our active military. That it even more dangerous for our econ- threat, which is terrorism. Instead, we is what we should be doing. omy. have our troops dealing with a civil

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00007 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1224 CONGRESSIONAL RECORD — SENATE February 27, 2008 war in Iraq. There is no disagreement other side. I have actually been ac- loyalties of these fighters is a very among the foreign policy experts that cused of ‘‘legislating defeat in Iraq’’ or open question. We do know, however, America has lost its leadership inter- other variations on that theme, and that this policy actually risks increas- nationally and is galvanizing the inter- somehow trying to micromanage the ing distrust between the local Sunnis national community to help us in the job of the commanders. Actually, we and the national government, which of war against terror. We have lost that have already accomplished our mili- course is led primarily by Shiites. focus. So our mission is wrong. tary mission in Iraq: Removing Sad- I would just like to ask, if Iraqis have The question, though, is where do we dam Hussein. I am interested in achiev- agreed to political reconciliation, as go from here. Well, if we want to follow ing victory in the global effort to com- Senator INHOFE suggested, well then President Bush’s policy, we will have a bat al-Qaida. We have to make a doesn’t that mean we have achieved permanent presence of American choice. The Army Chief of Staff has the objectives of the surge and we can troops in Iraq. I think that is the been clear that ‘‘the numbers of forces start bringing the troops home? When wrong policy. I believe the people of we have committed in Iraq now in- does the other side think we can bring Maryland and of this Nation believe it creases our level of strategic risk.’’ the troops home? They never talk is the wrong policy. The President’s So what does that mean? It means we about that. Five years? Ten years? policy is basically waiting out the must choose between letting the Iraqi Twenty years? One hundred years? burning out of the civil war. We know people resolve their sectarian disputes What kind of success is that? 4 million Iraqis are displaced, some in on their own or, on the other hand, ex- After more than 4 years of waiting the country, some outside the country. hausting our troops in Iraq and losing for the Iraqi Government to make That is not the right answer for the ground in the global fight against al- progress, we have lost nearly 4,000 people of Iraq, and it is certainly not Qaida. Americans, with no end in sight and no clear path for a reconciliation that in- the right answer for U.S. policy. Senator INHOFE said my bill demand- So we have an alternative. Senator ing a strategy to defeat al-Qaida wasn’t corporates all aspects and elements of Iraqi society. FEINGOLD has brought to us a bill needed because we already have a plan Now, another argument we have which I believe warrants our support. to defeat al-Qaida. He failed to explain heard is it has been suggested that Iraq It is the right mission for our troops why, though. If we already have a would collapse or that genocide would and our Nation. Fighting terrorism, I strategy to defeat al-Qaida, why is it occur if U.S. troops leave. Of course, am for that. That is what we should be that al-Qaida has regenerated and reconstituted itself and is planning more that assumes our military presence doing. Protecting our troops, that is there is actually helping the situation what we should be doing. Helping the attacks on our homeland? Admiral Mullen has been quite clear that under rather than simply postponing an inev- Iraqis in the training of their own mili- itable day of reckoning. If we bring our tary, that is what we should be doing. our current strategy, Afghanistan is a second priority where we only ‘‘do troops out of this quagmire, Iraqis and It focuses our mission on what is in the their neighbors would have to confront what we can’’—do what we can. In best interests of the United States. We the crisis head on. Now, I am not call- other words, we are so bogged down in need a political solution, not a mili- ing for the United States to abandon Iraq, we don’t have the forces to retary solution, for the people of Iraq. Iraq, but there is simply no way we can spond to the situation on the ground in The Feingold resolution acknowledges fix the mess we have made without a Afghanistan. If this is a strategy, it that. legitimate political settlement. We need to work with the inter- sure isn’t working, which is why the A U.S. redeployment would actually national community. We work best majority leader and I want to require put new pressure on Iraqis and on coun- when we work with the international the administration to develop a plan tries in the region to engage produc- community. The international commu- that prioritizes the fight against al- tively and to make the decision as to nity is wondering what we are doing in Qaida and protecting ourselves at home whether a full-fledged civil war is real- Iraq. over an endless war in Iraq. ly in the interests of Iraq or its neigh- The Feingold bill does not place a Senators INHOFE and LIEBERMAN have boring countries. I suspect—I really do time limit on the withdrawal of U.S. claimed that we do already have polit- feel strongly about this, having looked troops. It is an honorable and orderly ical reconciliation in Iraq and that we at this issue for many years in both the process for us to complete a mission in have seen benchmark legislation in the Foreign Relations Committee and the Iraq. I believe it is in the best interests Iraqi Parliament. Yes, a debaathifica- Intelligence Committee—that if these of the United States. I believe it is the tion law has passed, an amnesty law countries were faced with that deci- right policy for our soldiers, and I be- has passed, and the provincial powers sion, they would actually try harder to lieve it deserves the support of this election power law passed. Yes, we reconcile their differences peacefully body. have seen movement in the Iraqi Par- rather than further ignite tensions. Mr. President, I yield the floor. liament after waiting for more than 4 Some Members of this body seem to The PRESIDING OFFICER. The Sen- years. It is my great hope that the laws believe the war in Iraq is between U.S. ator from Wisconsin is recognized. recently passed will bring the Sunnis troops on the one side and al-Qaida on Mr. FEINGOLD. Mr. President, I fully into the political process. But as the other. That is not what is going on. thank Senator CARDIN for his excellent we well know, passing a law is one In fact, that is dangerous, wishful remarks and for his leadership on this thing, but actually seeing it success- thinking. The recent patterns of vio- issue. It has been very helpful during a fully implemented is another, particu- lence in Iraq actually confirm what the very tough battle that we have to keep larly given the country’s weak na- intelligence community has said all fighting. tional government. along: that the war in Iraq is sectarian We had an interesting debate yester- I think national reconciliation still and intrasectarian and far from the day on the two bills I have offered with looks far off. The passage of what the oversimplified ‘‘us versus them’’ that the majority leader. I know some of my administration is calling ‘‘benchmark’’ proponents of an endless military en- colleagues expressed concern that we laws does not ensure society-wide sec- gagement in Iraq continue to describe. were spending too much time on this tarian reconciliation. There are still Moreover, in mixed areas such as issue. Well I, for one, am pleased we are significant concerns about how the Mosul, violence is actually increasing. able to discuss one of the most pressing local efforts we have supported to bring And in the south, the increased vio- problems facing this country. Maybe about declining violence will actually lence is among Shiites, and reduction now that they have allowed us to have be integrated into the national frame- in areas such as Anbar, which is almost this debate, the Republicans will allow work. To illustrate this, the Sunni entirely Sunni or in Baghdad, where us to actually consider and vote on Awakening has taken tens of thou- sectarian cleansing has already oc- these bills. sands of former insurgent Sunni mili- curred, do not represent a diminish- While I appreciate the chance to have tia fighters and provided them with ment of the underlying tensions that this debate, I would like to take this U.S. funding in exchange for helping could explode at any time. chance to respond to some of the state- combat al-Qaida and Iraq. But to what Contrary to what we heard yester- ments that have been made on the extent we can rely on the long-term day, Iraq simply is not the central

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00008 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1225 front on the war on terrorism. To the was able to flourish so freely. This is ance, consumed by the current fight and un- extent to which there is such a front in the actual position, this is the actual able to do the things we know we need to do this very global conflict, it is clearly situation in terms of this global fight to properly sustain our all-volunteer force Pakistan and Afghanistan. No rational against those who attacked us on 9/11. and restore our flexibility for an uncertain future. reading of press reports, independent It is not all about Iraq. studies or our own intelligence could Al-Qaida affiliates from Africa to Many U.S. troops currently in Iraq, possibly conclude otherwise. While the Southeast Asia pose a significant ter- as we all know, are now in their third administration has focused on Iraq, al- rorist threat. While we have been so or fourth tours of duty. Approximately Qaida has reconstituted itself along the myopically fixated on Iraq, the threat 95 percent of the Army National Afghanistan-Pakistan border. That from an al-Qaida affiliate in North Af- Guard’s combat battalions and special sounds like a big mistake. That sounds rica has grown and now, according operations units have been mobilized like a real strategic error in an inter- again to the testimony of the Director since 9/11. national battle against terrorism. Yet of National Intelligence, ‘‘represents a Mr. President, 1.4 million Americans far too many people in the administra- significant threat to the United States have served in Iraq and over 420,000 tion and my colleagues somehow be- and European interests in the region.’’ have served multiple tours in Iraq and lieve Iraq is what it is all about. What Since its merger with al-Qaida in Afghanistan. As I said before, nearly a terrible strategic mistake. September 2006, it has expanded its tar- 4,000 of our men and women have been Early this month, the DNI testified gets to include the United States, killed in Iraq, and over 27,000 have been before Congress that the central lead- United Nations, and other interests, wounded. ership based in the border area of Paki- and it likely got a further boost when The Army cannot maintain its cur- stan is al-Qaida’s most dangerous com- al-Qaida leadership announced last No- rent pace of operations in Iraq without ponent. And a few months ago, the DNI vember that the Libyan Islamic Fight- seriously damaging the military. again repeated the intelligence coming Group united with al-Qaida under Young officers are leaving the service munity’s assessment that over the last AQIM’s leadership. Its possible reach at an alarming rate. 2 years ‘‘Al Qaeda’s central leadership covers Tunisia, Morocco, Nigeria, Mau- Readiness levels for the Army are at has been able to regenerate the core ritania, Libya, and other countries. lows not seen since the Vietnam war. operational capabilities needed to con- Meanwhile, it is using deadly tactics Every active Army brigade currently duct attacks in the Homeland’’—in the that suggest it is acquiring knowledge not deployed is unprepared to perform homeland, our homeland, our country, and help from the war in Iraq, basically its wartime mission. the United States of America. a training ground for those who get ex- More than two-thirds of Active Duty The DNI also testified that al-Qaida ported to attack us. Army brigades are unready for mis- ‘‘is improving the last key aspect of its Al-Qaida has affiliates around the sions because of manpower and equip- ability to attack the U.S.: The identi- world—in Saudi Arabia, United Arab ment shortages, most of which, of fication, training, and positioning of Emirates, Yemen, Lebanon, where al- course, can be attributed to Iraq. operatives for an attack in the Home- Qaida poses a ‘‘growing threat,’’ the There are insufficient Reserves to re- land’’—in this country. Horn of Africa, and Southeast Asia. spond to additional conflicts or crises Meanwhile, the Federally Adminis- And a few weeks ago, there were more around the world. tered Tribal Areas—or FATA region— arrests in Europe. None, not one of This failure to prioritize correctly in Pakistan is serving as a staging these developments has been prevented has left vital missions unattended. ground for al-Qaida in support of the by the war in Iraq. Natural disaster response, U.S. border We cannot ignore the rest of the Taliban and providing it with a base security, and international efforts to world to focus solely on Iraq. Al-Qaida similar to the one it used to have combat al-Qaida are all suffering due is and will continue to be a global ter- across the border in Afghanistan. to the strain on military forces caused Over the past year, as we all know, rorist organization with dangerous af- by poor strategy and failed leadership we have seen an unprecedented rise of filiates around the world. The adminis- in Iraq. suicide bombings in Pakistan. The tration claims al-Qaida in Iraq may be In addition, thousands of our troops Taliban is gaining ground in Afghani- on the run, but al-Qaida has not aban- have, as we well know, returned home doned its efforts to fight us globally. In stan, and while we may be sending an with invisible wounds, such as PTSD fact, we are watching al-Qaida additional 3,200 marines to Afghanistan and TBI, traumatic brain injury, which strengthen and develop its affiliates in the near future, we have been fight- will have a long-term impact on vet- around the world, while we remain ing for far too long there with too few erans and their families. These invis- bogged down in Iraq. How foolish can soldiers and too few reconstruction ible wounds are not counted in the cas- we be to allow them to reconstitute all funds. The price of that neglect is a ualty numbers, but we will be strug- over the world as they watch us unable dramatic resurgence of militants that gling with them for generations. to extricate ourselves from a mistake must be urgently addressed. I haven’t even touched on the mas- which was, of course, going into Iraq Yesterday, a Washington Post article sive debt we are running up to pay for the way we did. noted that: We need a robust military presence this war. We are spending approxi- More foreign soldiers and Afghan civilians and effective reconstruction program mately $10 billion a month in Iraq. died in Taliban-related fighting last year Congress has appropriated over $525 bil- than in any year since U.S. and coalition in Afghanistan. We need to build strong partnerships where al-Qaida and lion for this war, and the debt keeps forces ousted the extremist Islamic militia, mounting. which ruled most of the country, in 2001. its affiliates are operating—across Military officials expect the coming year to North Africa, in Southeast Asia, and We heard eloquent floor statements be just as deadly, if not more so, as the along the borders of Pakistan and Af- yesterday on this side about how these Taliban becomes more adept militarily and ghanistan, and we need to address the costs are affecting our ability to ad- more formidable in its deployment of suicide root causes of the terrorist threat, not dress other priorities. I will not repeat bombers and roadside explosives. just rely on military power to get the all of what was said, but I do want to With the Joint Chiefs saying: ‘‘In job done. note that the war in Iraq keeps us from Iraq we do what we must and in Af- I would like to turn now briefly to adequately addressing critical gaps in ghanistan we do what we can,’’ it is no the impact of the Iraq war on our mili- our homeland security and law enforce- wonder Afghanistan is teetering on the tary and National Guard. There is no- ment. While we had 92,000 more troops edge. It has been neglected, shoved to body in the Senate who cares more to the Army and Marine Corps, the city the back burner so the President can about this than the Presiding Officer. I of New York has 5,000 fewer police offi- pursue an open-ended war in Iraq. will start by repeating what GEN cers on the beat than it did on Sep- I remind my colleagues it was from George Casey, the Chief of Staff of the tember 11, 2001. Afghanistan, not Iraq, that the 9/11 at- Army, said yesterday in congressional This year, we will spend a fifth of our tacks were planned, and it was under testimony: $740 billion ‘‘national security budget’’ the Taliban regime, which is once The cumulative effects of the last six-plus on Iraq, twice what the Federal Gov- again gaining ground, that al-Qaida years at war have left our Army out of bal- ernment spends defending our Nation.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00009 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1226 CONGRESSIONAL RECORD — SENATE February 27, 2008 Meanwhile, the administration wants Iraqi Government set by this Govern- would take a minimum of 5 years and to cut grants for first responders, and ment for them have not been met; but have about a 50 percent chance of suc- the Coast Guard is struggling with an most of all, I think we are here to de- cess of bringing stability—not democ- inadequate force size. bate this issue, at least in my judg- racy but at least stability—to large It doesn’t make sense. It simply ment, because we are at a turning portions of Iraq. That is not the mili- doesn’t make sense. The American peo- point in terms of the debate in Iraq. tary’s fault, and that is not America’s ple know that, which is why they voted That turning point—the case against fault. That is because of the age-old en- the way they did last November. More this war—has been building for a long mities within Iraq—the Sunnis, the than 60 percent of Americans are in time. As we debate this bill on Iraq, we Shiites, and the Kurds, and then within favor of a phased withdrawal. They are at a turning point in the argument the groups themselves. It would be don’t want to pass this problem off to against the war. We have always been very hard to create permanent sta- the next President and another Con- aware of the cost in life, both Amer- bility without a permanent and large gress, and they sure don’t want another ican and Iraqi, and we have known how structure of troops. American servicemember to die or lose severe that cost is. Despite the good Now, I ask you, stability in Iraq—a a limb while elected representatives works of our troops, we are continually worthy goal, but is it on your top-five put their own political comfort over troubled by the tragic loss of life. The list for America? Is it on any Ameri- the wishes of their constituents. American people are baffled by the can’s top-five list? A few, maybe, not Polls continue to show voters strong- lack of political progress and, most of the vast majority. We have many other ly oppose the war in Iraq, and that is all, the American people are beginning higher goals that cost the same dollars one of the top issues on which they will to comprehend the eye-popping figures and need the same attention and en- be voting. A recent Washington Post/ of what this war is costing our budget ergy that is now diverted to Iraq. Our ABC poll found that 65 percent of and our economy. It is becoming clear education system is declining, our Americans disapprove of the situation to all Americans—Republicans, Demo- health care system doesn’t cover peo- in Iraq and 56 percent disapprove crats, and Independents—that by con- ple, and we are paying $3.30 for gas be- strongly. The same poll also found this tinuing to spend huge amounts on Iraq, cause we don’t have an energy policy. is the second most important issue to we are prevented from spending on de- And even if your goals are just foreign voters in November, behind the econ- sired goals and needs here at home. policy, shouldn’t we be taking the time omy and jobs. And a recent Gallup poll So the turning point is this: The lack and effort that is all now focused on showed a majority of Americans, 56 of progress, particularly on the polit- Iraq, as well as the dollars, and spend- percent, do not believe the surge is ical front, continues; the tragic loss of ing more focus on the dangerous tri- working and want a timetable to get life continues; but the cost of the war angle composed of Pakistan, Iran, and out of Iraq. Those Americans need to and the inability to use those funds to Afghanistan? Of course. We must ask be heard, and that is what we are try- help us here at home, the cost of the ourselves: Is it worth spending trillions ing to do with this important debate. war and the inability to use those of dollars needed elsewhere on such an Mr. President, I yield the floor and funds to properly go after the most uncertain and unpredictable outcome? suggest the absence of a quorum. dangerous nexus of terror, which is a So the debate is changing. The costs The PRESIDING OFFICER. The thousand miles to the east—Afghani- of Iraq, the simple costs alone, are clerk will call the roll. stan, Pakistan, and Iran—is now be- weighing too heavily on the American The bill clerk proceeded to call the coming a clinching argument that we people, the American Government, and roll. must quickly and soon change the on our national purpose. While admi- Mr. SCHUMER. Mr. President, I ask course, the direction, of this war in rable as a goal, it is hardly the most unanimous consent that the order for Iraq. important goal we have in this chang- the quorum call be rescinded. I went to Iraq over New Year’s. I ing and dangerous and exciting world The PRESIDING OFFICER. Without spent time with our soldiers. They are in which we live. The cost of the war objection, it is so ordered. wonderful. They are awe-inspiring. The has become the $800 billion gorilla in troops are awe-inspiring, from the pri- the room. The backbreaking cost of f vate I met from Queens, just out of this war to the American families, the CONCLUSION OF MORNING high school, who had enlisted 8 months Federal budget, and the entire econ- BUSINESS previously and was in Iraq 3 weeks, to omy is becoming one of the first the majors and captains who had things, after loss of life, people think The PRESIDING OFFICER. Morning served 10 years in the Army or the Ma- about. business is closed. rines and had made the military their A report issued by the Joint Eco- f life’s work—they see a greater good nomic Committee, which I chair, esti- than just themselves, and it is wonder- mated that the total costs of the war PROVIDING FOR THE SAFE REDE- will double what the administration PLOYMENT OF UNITED STATES ful—all the way to the generals. I spent time with General Petraeus at a New has spent directly on the war alone— TROOPS FROM IRAQ—MOTION TO $1.3 trillion through 2008. And that is a PROCEED Year’s Eve dinner. I spent time with General Odierno. They are fine, intel- conservative estimate. According to The PRESIDING OFFICER. Under ligent, good people. budget figures on Iraq spending for the previous order, the Senate will re- When I went to Iraq, I assured our 2000, the Bush administration wants to sume consideration of the motion to soldiers, from the private to the gen- spend $430 million a day on Iraq. For 1 proceed to S. 2633, which the clerk will erals, that one good thing that would day of the war in Iraq, we could enroll report. come out of this war is the esteem that an additional 58,000 children in Head The bill clerk read as follows: we hold for both the military and our Start per year, we could put an addi- Motion to proceed to consider S. 2633, a bill soldiers would be greater when the war tional 88,900 police officers on our to provide for the safe redeployment of finished than when it started—a far dif- streets per year, we could hire another United States troops from Iraq. ferent cry than the Vietnam War, 10,000 Border Patrol agents per year, we The PRESIDING OFFICER. The Sen- which is one of the most disgraceful could make college more affordable for ator from New York. times in America, when our soldiers 163,000 students per year, and we could Mr. SCHUMER. Mr. President, today were too often vilified for simply serv- help nearly 260,000 American families we are here to address the issue of the ing our country. keep their homes per year. In the fiscal Iraq war, and many are saying: Well, But after I left Iraq, I came to this year of 2008, we put $159 billion into why should we address the Iraq war conclusion, Mr. President, and that is Iraq. That doubles our entire domestic again? Because, obviously, it is still that even if we were to follow General transportation spending to fix roads going on; there is still no direction in Petraeus’s game plan—which, of and bridges, and it dwarfs all the funds terms of political progress; the Shiites, course, involves not just military suc- we provide to the National Institutes the Sunnis, and the Kurds still have cess in security but winning over the of Health to discover cures for diseases their age-old enmities; the goals of the hearts and minds of the people—it such as cancer and diabetes. Iraq

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00010 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1227 spending is seven times our spending to During the past year, the Senate has First, Parliament passed a law that help young Americans get a college voted over 40 times on bills to limit the bolsters the power of the provinces to education. The costs are mountainous, generals’ war strategy. Not one has be- provide roads and utilities to the resi- and in this changing world, where we come law or even come close. Since dents. Second, it has passed a partial have to fight to keep America No. 1, we this assembly line of votes started in amnesty for political prisoners, 80 per- cannot afford such costs, as I said, de- February 2007, the situation in Iraq has cent of whom are Sunnis, in an effort spite the great efforts our soldiers are changed considerably and it has to reduce the conflict and promote putting into Iraq. changed for the better. peace among different sects. Finally, it Now, tomorrow morning, Mr. Presi- While some Senators were insisting approved a $48 billion national budget dent, we in the Joint Economic Com- that the war was lost, General that allocates Government revenue, 85 mittee—and I see my colleague from Petraeus was in the process of imple- percent of which is from oil, to the Virginia here, and he is on that com- menting a strategic readjustment that provinces, allowing more local control mittee with me—we are going to hold has produced remarkable progress on and less dependence on the central gov- our first congressional hearing of the the battlefield. It has been said on this ernment. Altogether the recent mili- year, and it will be appropriately de- floor: We need to change the direction. tary and political news out of Iraq pro- voted to the skyrocketing cost of the We are changing the direction. We are vides further evidence that our strate- Iraq war. That will be the Joint Eco- changing the strategy. We are going in gies must be determined by events in nomic Committee. We are going to the right direction. theater, not timetables set by politi- have Nobel Prize-winning economist I got back from Iraq 2 days ago. I saw cians 6,000 miles away. Dr. Joseph Stiglitz talk for a time for myself the enormous military gains In the past year so much has changed about his new book, about to be pub- we have achieved in that country. in Iraq. Yet here on the Senate floor, it lished, and the title speaks for itself: While in Baghdad, I put on a suit of seems nothing has changed at all. We ‘‘The $3 Trillion War.’’ Dr. Stiglitz got body armor. I traveled in an MRAP ve- are still voting on imprudent bills for information out of the Government and hicle with our troops through the premature withdrawal when, in fact, out of the Pentagon, after much long streets of Baghdad. I was able to go to we should be providing a vote of con- work, and has new estimates that a police station where we have embed- fidence in our troops. The mission of make our estimates on the Joint Eco- ded troops there. our troops is vital to our security. If we I met with General Petraeus and Am- nomic Committee seem small—$3 tril- abandon Iraq prematurely, it will be- bassador Crocker, and troops from lion. That is the title of his book. He is come a sanctuary for terrorists to Reese Air Force Base, Ft. Hood, the going to talk about the cost of that launch attacks against the American Red River Army Depot, and others people. war. We are going to have national se- from the Texas National Guard. Be- There is also a real danger that Iraq curity experts, such as Bob Hormats cause of the leadership of our com- could become a satellite of Iran. The and Ron Bier, discuss their views on manders and the courage of our service Iranian Government has a long record how the out-of-control costs of the war men and women, there is new reason of sponsoring terrorism and arming the have impacted our economy, our rep- for optimism in Iraq. utation abroad, our military strength The numbers speak for themselves. insurgents who are killing our brave and readiness, and the future of our The murder rate in Baghdad has soldiers in Iraq. children. Our JEC report estimated $1.3 plunged by 80 percent. Al-Qaida has And what about the practical reali- trillion, but Dr. Stiglitz—and he has been routed in every neighborhood. ties of such an irresponsible act of Con- talked to the experts from the Pen- Iraqi forces have formally taken congress? I am told it would take over a tagon—has even more massive num- trol of security across much of the year to retrieve our arms, equipment, bers. country. Violence is at the lowest level and technology. I ask those who are So we desperately need a change of since 2003. Roadside bomb attacks have voting for this resolution: Would they course in Iraq. That is what this receded to a 3-year low. Discovery of leave our arms there for the terrorists amendment calls for. It calls for lim- weapons caches has more than doubled to be able to use? What about our ad- iting what our troops will do to force in the last year. The Iraqi security vanced technological equipment? What protection, of course, to training the forces have grown to 440,000 trained about our surveillance equipment? Iraqi army, to fighting al-Qaida and and equipped. What is the security threat to the fighting terrorism, but not to be in the At the police station where our troops left behind if the reduction in middle of a civil war where we contin- Armed Forces are embedded with the strength leaves them without enough ually police the age-old enmities of the Iraqi police, I can see that the Iraqis protection? various factions in Iraq. are taking more responsibility for their Those who are voting for this resolu- History will look upon this Iraq war security. The Sons of Iraq are an exam- tion, are they concerned about this in two ways: It will admire the bravery ple of that growth and responsibility. enemy, this enemy that has no rules of of our soldiers, from the privates to the The Sons of Iraq, which is now over engagement, an enemy that is not in generals, and it will be amazed at the 90,000 strong, essentially serve as the armed forces of any country, an mistakes made by this administration neighborhood watches and manned enemy that executes hostages in front in starting and continuing this war, far checkpoints. By providing forces for of television screens? Are they con- too expensive in loss of life and in dol- protecting key infrastructure and in- cerned that this enemy would be lars. formation about al-Qaida, the Sons of emboldened by an adversary that Mr. President, I yield the floor. Iraq has enabled coalition forces to tar- would abandon its commitment? The PRESIDING OFFICER. The Sen- get al-Qaida precisely. This ensures the Are they concerned that they might ator from Texas. right people are targeted, and it helps attack harder, especially if they could Mrs. HUTCHISON. I ask unanimous avoid collateral damage, both of which seize our weapons to use against us or consent that after Senator WEBB’s are helping to strengthen confidence in make us leave faster so we would leave speech, Senator GREGG from New the Iraqi Government. the weapons and technology? Hampshire be recognized. The transition in responsibility from I ask the supporters of this resolu- The PRESIDING OFFICER. Without the U.S. military to Iraqi authority is tion: What about the oil revenue? What objection, it is so ordered. a major step toward decreasing the if al-Qaida is able to get access to the Mrs. HUTCHISON. Mr. President, I presence of the United States in Iraq. millions that it is producing for Iraq? rise today to strongly oppose any Sen- There are other reasons to be hopeful If Iraq collapses and the terrorists take ate amendment that would require the about the future. Our military gains hold with the oil revenue, how far immediate and arbitrary withdrawal of are beginning to contribute to the po- could their heinous crimes go? How far U.S. forces from Iraq. This amendment litical gains. Recently the Iraqi Par- could they spread? is the latest attempt in a year-long ef- liament passed three laws that should I have heard the arguments about the fort to constrain the ability of our gen- begin to bring the Sunnis more fully cost of the war. And the cost is huge. erals and our brave men and women in into the governing process and achieve What about the cost of another ter- uniform to fight this war effectively. national reconciliation. rorist attack on the United States of

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00011 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1228 CONGRESSIONAL RECORD — SENATE February 27, 2008 America? What about the cost in life understands this. We have discussed the greatest maneuver forces in the and treasure of another terrorist at- this. world bogged down, occupying cities in tack on this country? Have we forgot- I wanted to add my comments with one country that was not even threat- ten already the cost of 9/11, around that perspective in mind, because I do ening us, while the people we are sup- 3,000 lives in America, billions to our not agree with a lot of the comments posed to be going after, the forces of economy, and the damages to clean up coming from the other side of the aisle international terrorism, know no inter- New York City? Are we not thinking of with respect to why this amendment national boundaries, work the seams of the consequences of this kind of ac- should be defeated. international law, and are able to mation? This resolution may be an at- I cannot support personally an neuver at will. We are seeing that tempt to make a point. This is the amendment that involves an entrench- clearly. United States Senate. I truly believe ment on an appropriations measure. I Before I went to Iraq in November, I we should be more responsible. We are do not believe the best way for us to was getting briefings. The comments the leaders of our country. We should address this situation is to cut off and the briefings from the Pentagon think of the consequences, the worst funds or to stipulate a series of condi- were that terrorism activity had been that could happen, not just the best. If tions that might be overinclusive or reduced inside Iraq. I mentioned I have we are able to pick up and leave, even underinclusive, depending on the situa- been doing this for 40 years, from the though it would not be the honorable tion on the ground in Iraq. time I was a young marine. If I were thing for the greatest Nation on the But at the same time, I strongly dis- the forces of international terrorism, I Earth to do, maybe it would be flaw- agree with the notion that a with- don’t think I would be in Anbar Prov- less. But we need to think through drawal from Iraq at this time is pre- ince right now either. I think I would these consequences and we need to mature. I believe that with the right be heading to Afghanistan and Paki- know what is the worst case if we are national leadership, first, we never stan. That suggestion was basically the leaders of this country. should have gone into Iraq, but, sec- dismissed in the briefings. Within a few This resolution is not the act of a ondly, that we could have begun a weeks, Benazir Bhutto was assas- thoughtful, informed group of leaders. I withdrawal with the right national sinated by al-Qaida, and we are seeing urge my colleagues to stop voting on strategy more than 4 years ago. heightened activity in Afghanistan this kind of resolution. I urge the ma- What we have been engaged in since such as, less than a week ago a suicide jority leader to stop scheduling the shortly after the invasion is an occupa- bombing at a dog fight near Kandahar, votes that at best serve no legitimate tion, not a war. It has been a military where more than 100 people were killed purpose, and at worst demoralize our holding action. In the context of his- by al-Qaida. That is what a strategic troops and embolden our enemy. tory, a military holding action takes mousetrap is. We have so much that is going for place in order to enable the political When you are going up against people the better in Iraq. Is it as fast as we process and, unfortunately, we have who know what they are doing and who would like? Of course not. I would love not seen that sort of political leader- are very dedicated to it, you get your- to have our troops walking out right ship from this administration. That is self bogged down in one spot where you now. I met with hundreds of them this a totally different concept than the one can’t get out, and then they have the weekend. I know they are committed. that seems to make it into our debates maneuverability. But I also have met with the parents here. The second strategic mousetrap we and the spouses of those who have lost I have written a lot of books in my can clearly see involves how we are ad- their lives, who have given the ulti- life. I made my living before I came to dressing the rest of the world. In terms mate sacrifice in Iraq and Afghanistan. the Senate writing histories and nov- of our military posture, we have They have said to me: Do not leave els. There were many times when I burned out our military. We are not fo- with the job undone, because then I watched this debate that I would think cusing properly on the strategic issues will feel that my son or my daughter or about how this is going to look through facing us globally, particularly the sit- my husband has lost his life or her life the prism of history. How are people uation that we face with an ever-evolv- in vain. going to look back at this period of ing China, and the need to regrow our We cannot do that to those who have years in terms of how our national Navy. And our national economy is served so honorably and we cannot leaders were conducting themselves? going into a tailspin. walk away from our commitment. We One thought that sticks in my mind When I look at this region, I see a re- are the Senate. We should be able to is that we tend, when we debate Iraq, gion in chaos. We can talk about take actions that are responsible, that to look at this issue almost as if Iraq whether you can go to the market in are thoughtful, that will not put our was an island in the middle of an Baghdad. Wherever the U.S. military troops in harm’s way, that will not ocean, disconnected from the rest of has been sent, it has done its job his- leave our equipment to be taken over the region or even the rest of the torically. I had the honor of serving in by the terrorists, that will not leave a world. That is ironically how we ended Vietnam. On the 20th anniversary of country that could turn into a terrorist up in Iraq in the first place, because the fall of Vietnam, the Communist haven and take revenue and spread once we started debating whether we government admitted that it lost 1.4 their terrorism and their heinous would go into Iraq, we changed from a million soldiers dead on the battlefield; crimes to other places in the world and debate about the dangers of inter- this illusive guerilla force, 1.4 million to our country. national terrorism and started focusing soldiers dead. We did our job. That We are here to protect our people. It more and more specifically simply on doesn’t address the larger issues in is our job to act responsibly, and I hope Saddam Hussein, on the conditions in- which the military performs its job and we will do so by rejecting this resolu- side Iraq, which obviously was a coun- doesn’t address that issue in Iraq today tion. try that was not even directly threat- either. I yield the floor. ening us. Most of us sitting on the out- We are very proud of what our mili- The PRESIDING OFFICER (Mr. side who had years of experience in na- tary has done. I am proud of my son. CASEY.) The Senator from Virginia. tional security could see that, even as He served as an enlisted Infantry ma- Mr. WEBB. Mr. President, I ask the debate narrowed into Iraq rather rine in Ramadi in some of the worst unanimous consent that following the than international terrorism. fighting. But this region is in turmoil remarks of the Senator from New We are doing it again. We are doing it from Lebanon to Pakistan. Anyone Hampshire, the senior Senator from again when we talk about the success who has been involved in these issues Montana be recognized on our side. or failure of the surge or where we intimately understands that. People The PRESIDING OFFICER. Without should go from here with respect to are betting against us, not in terms of objection, it is so ordered. this block or that block or this city or our military operations but as a lead- Mr. WEBB. Mr. President, I rise in that city or this specific unit of the ing nation. opposition to this bill but in support of military. We have fallen into what When we were preparing to go into the concepts that have motivated it. I could be called a double strategic Iraq, it cost $24 for a barrel of oil. Yes- think the Senator from Wisconsin fully mousetrap. On the one hand, we have terday the market closed above $101 for

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00012 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1229 a barrel of oil. When we were getting [The Korean War] was never inevitable, it damentalism and its avowed purpose of ready to go into Iraq, as I recall, gold was never inescapable. . . . When the enemy destroying Western culture and specifi- was less than $300 an ounce. It is up al- struck, on that June day of 1950, what did cally targeting America and Americans most at $1,000 an ounce today. The dol- America do? It did what it always has done is probably the overriding issue we lar is in jeopardy. Our budgets are in in all its times of peril. It appealed to the heroism of its youth. . . . The answer to that must address. But right behind that deficits. Our infrastructure is dimin- appeal has been what any American knew it issue is the question of what type of ishing to the point that we have to would be. It has been sheer valor on all the nation are we going to pass on to our worry about whether we can be a lead- Korean mountainsides that, each day, bear children relative to the fiscal strength ing nation in terms of technology, the fresh scars of new graves. Now—in this anx- of our Nation. We confront an issue sorts of things that have always made ious autumn—from these heroic men there there which is as significant for the us great—roads, bridges. All of these comes back an answering appeal. It is no prosperity of our children as the issue issues do tie together. Even when we whine, no whimpering plea. It is a question of terrorism is relative to the security start arguing about how this surge has that addresses itself to simple reason. It asks: Where do we go from here? When comes of our country. affected the conditions inside Iraq, if We are faced with a situation where, we are going to be honest, if we are the end? Is there an end? These questions touch all of us. They demand truthful an- as a result of the pending retirement of going to look at the situation as it swers. Neither glib promises nor glib excuses the baby boom generation, three spe- really is rather than simply as one po- will serve. They would be no better than the cific programs—Medicare, Medicaid, litical side or another wants to make glib prophecies that brought us to this pass. and Social Security—will grow at such it, we have a lot going on in Iraq, a lot . . . The first task of a new Administration exponential rates that they will essen- of moving pieces that don’t exactly add will be to review and re-examine every tially bankrupt our Nation if we don’t up to the possibility of great success in course of action open to us with one goal in the near term. view: To bring the Korean War to an early do something. I have heard people from General and honorable end. This chart reflects those three pro- Petraeus to people on the other side I suggest that is the prospect that grams, the red line here, and their rate talk about how the surge is responsible faces all of us. On what do we need to of growth. This black line reflects what for the period of decreased activity in be focusing? I agree, by the way, that has historically been the amount of Al Anbar, around Ramadi. That began this is not something that is going to money the Federal Government has before the surge was announced. There get us very far in the next couple of spent. The Federal Government has were two reasons for that. One, al- days, other than to air our concerns. historically spent about 20 percent of Qaida overplayed its hand there. The We need to be getting a GI bill for the the gross national product of America. Sunnis made a deal with our side. The people who have been serving since 9/11. These three programs alone, by the Sunni insurgency made a deal with our I would invite people from the other year 2025, 2028—it varies depending on side and they hated al-Qaida more than side of the aisle to support this. We who you talk to—will cost 20 percent of they hate us. We don’t know how long keep calling these people the next the gross national product. Trying to this is going to last. They don’t like an greatest generation. They deserve a GI put this in perspective, by the year occupying force. bill at the same level of those who 2030, when the baby boom generation is The second is, al-Qaida is pretty served during World War II when they fully retired and is receiving its bene- smart. They are fluid. They are mobile got all tuition paid for, books bought fits, the cost of supporting that genera- while we are tied down. If you go up to for them, and a monthly stipend. I in- tion through Medicare, Medicaid and the Kurdish areas, which have been troduced that bill my first day as a Social Security will be so high that if sort of the bulwark of our strength in Senator last year. We have more than you put it in the context of what we terms of relations, we see that the 30 cosponsors. Let’s come together. traditionally spend in this Govern- Turkish parliament has approved mili- Let’s make that happen. Let’s give ment, we will have no money available tary activity by their military inside these people the first-class future they to do anything else as a government. Iraq. They have begun an incursion deserve. We will have no money for national de- more than a week ago where they have We need to focus on the agreement fense, no money for education, no been operating inside northern Iraq. that is now being negotiated between money for laying out roads, no money Imagine what the other side would be this administration and the Maliki for environmental protection. saying right now if the Iranians were government, where they are saying It does not stop there, because the conducting military activities inside they will consult with the Congress. costs incurred continue to go up. They Iraq. We have a region that has been This type of long-term agreement, continue to go up at such a rate that filled with chaos from refugees, exter- going into security issues, is, in fact, a by about the year 2035, we will essen- nal refugees, internal refugees, by some treaty, no matter what we call it. It is tially have a situation where approxi- accounts more than 30 percent of pre- a treaty that they are negotiating, and mately 28 percent or more of the gross Iraq war population refugees, either we in the Senate should advise and national product would have to be outside the country, heavily burdening consent on that. We need to focus on spent to support these three programs. Syria—by the way, more than a million the wartime contracting commission Then, of course, you have the addi- refugees in Syria—but also inside. that just became law where we can tional obligations of Government. Eighty percent of those internal refu- root out fraud, waste, and abuse, the What does that lead to? Well, if that gees in Iraq right now are women and billions of dollars of no-bid and instant were allowed to occur, it would lead to children. contracts that were put into Iraq from We need to be able to address this a situation where our children and our 2003 forward. In other words, let’s cre- honestly, and we need to be able to children’s children would be paying so agree that the way out of this isn’t ate the environment where we can get much in taxes to support the costs of simply through the performance of our the right kind of diplomatic solution maintaining these three programs for military. It is that we need national and remove our combat troops from my generation—the baby boom genera- leadership that will put a formula to- Iraq. Let’s focus on the future. tion—that our children would essen- gether so that we can remove our mili- I yield the floor. tially have no opportunity to send tary. There is no true strategy if you The PRESIDING OFFICER. The Sen- their children to college, to buy their cannot articulate an end point. When ator from New Hampshire. first home, to live the prosperous and you look at it, one of the things I keep BUDGET ISSUES fulfilling lifestyle we have today in going back to is what General Dwight Mr. GREGG. Mr. President, I recog- America because all those discre- Eisenhower said in the dark days of the nize that much of the debate the past 2 tionary dollars would be absorbed Korean war when we were stuck in a days has been about our status in Iraq through taxes to support these pro- stalemate, when he was thinking about and what we should be doing in Iraq grams. running for President and then running relative to the two proposals offered by To put it in a different context, with for President. One might compare this Senator FEINGOLD. Clearly, the issue of numbers which are almost incompre- with comments we hear from the how we fight terrorism and how we hensible but which need to be pointed present administration. He said: confront the threat of Islamic fun- out, we are told by the Comptroller

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00013 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1230 CONGRESSIONAL RECORD — SENATE February 27, 2008 General’s Office that the unfunded li- If you start taking money out of the House side and Senate side. The chair- ability of Medicare, Medicaid, and So- general fund, it is generally acknowl- man of the Finance Committee has in- cial Security is $66 trillion. That edged—not through too many ‘‘gen- troduced a bill, I believe last night, means after you figure in all the erals,’’ but it is generally acknowl- with myself as ranking member of the money you pay for Social Security edged you are basically creating an in- Budget Committee as the primary taxes, and all the money you pay for come transfer event, a redistribution of sponsor on our side. That does not health insurance taxes, the HI tax, the wealth event, where you are taking mean it is agreed to. It means that Medicare taxes—after you figure in all money from basically the general oper- under the law it has to be introduced. that money, there is still a responsi- ation of the Government and you are I happen to think what the adminis- bility, an obligation on the books that putting it into the support of people on tration has sent up makes sense. But is not paid for. That amounts to $66 Medicare who are retired. That was what cannot be denied is that this trillion—trillion with a ‘‘T.’’ never the goal of Medicare. problem is very real. I was extremely Now, $1 trillion is almost an incom- So recognizing that, but also recog- surprised, for example, to hear Senator prehensible term, so to try to make it nizing that a brandnew benefit was KENNEDY say: The proposal sent up by a little more comprehensible, if you being put on the books that was fairly the administration is dead on arrival, took all the money paid in taxes since significant—the drug benefit—it was and the administration has trumped up our country was formed, since we decided to put in place this law that a phony crisis in Medicare. began, that is $42 trillion. That is all said we want to keep Medicare pri- You tell me how $66 trillion of un- the money that has been paid in taxes. marily as an insurance event rather funded liability is a phony crisis in We have a liability on the books that than an event which basically is unsup- Medicare. The Medicare trustees, who exceeds all the money paid in taxes ported, a cost that is basically sup- have a fiduciary responsibility, the throughout the history of our Nation. ported by the general taxpayers of highest standard we have under law to To put it in another context, if you America who need to support the reg- protect the solvency of the Medicare take all the assets of America—every- ular operations of the Government: de- trust fund, tell us the law is being vio- one’s home, everybody’s car, all your fense, education, things such as that. lated and that changes must occur. stocks, all your small businesses—and So this trigger was put in. You tell me that is a phony crisis. you add them up—everybody’s net Well, we have now had the trustees What is unfortunate is this ‘‘bury the worth—that amounts to $59 trillion. evaluate the Medicare fund, and they head in the sand’’ approach that is So we have a debt on the books that have concluded that in the 7-year win- being taken by the majority party, as exceeds our net worth as a nation. That dow, under present projected spending reflected by Senator KENNEDY, in fac- is called bankruptcy, and that is what patterns, Medicare’s support—the dol- ing this issue. This issue must be faced. we are headed toward unless we address lars necessary to support Medicare— We need to act. this issue. will require a call on the general fund Now, what has the administration This week, the administration, under that will exceed 45 percent of the gen- suggested we do? They have suggested a direction from the Congress, sent up eral expenditures of Medicare. three basics in order to bring this in a proposal to try to address the biggest That is a serious issue, and it goes to line. part of this problem, which is the cost the larger serious issue of this un- First—and I cannot understand why of Medicare. funded liability question, because anybody opposes this proposal—they When we passed the Part D drug ben- Medicare makes up $34 trillion of the have suggested that under Part D, efit for seniors, there was language put unfunded liability. Do you remember which is, again, the drug benefit, peo- in that bill—remember that bill was the prior chart, where I pointed out ple pay a portion of the premium of the passed with a strong bipartisan vote— there is $66 trillion of unfunded liabil- cost of the drug benefit. But high-in- that said if Medicare started to have ity? Well, of that $66 trillion, the ma- come people pay a very small portion its financial resources—its support, the jority of it is the obligations under of the cost of the drug benefit com- dollars that paid for Medicare—come Medicare. So it is Medicare spending pared to what they can afford to pay. out of the general fund at a rate that that is driving the problem which we They pay about 25 percent of the cost exceeded 45 percent of the overall cost confront, which is pointed out in this of the premium of the Part D drug ben- of Medicare, then the trustees—if that chart, which is that we are headed to- efit. was projected to occur for 2 years over ward a government that our children Somebody such as Warren Buffett, a 7-year period—the trustees were di- cannot afford and which will bankrupt who qualifies for the Part D benefit—I rected to direct the President to make our children unless we do something. am not picking on him specifically, but a proposal to bring the cost of Medi- So this proposal that was put into he is a national figure of some note, care back under control. It is called a the Part D drug law, in which the and he obviously has a fair amount of trigger. That is what it is referred to. trustees direct the President essen- assets—his premium under Part D, in Why did we put that in or why was tially to propose changes in Medicare order to purchase drugs, is being sub- that language put in? It was put in be- spending, which will allow us to make sidized by John and Mary Jones, who cause Medicare was always conceived the Medicare Program affordable and work in a restaurant in Nashua, NH, or to be an insurance program, even continue it to be an insurance pro- by Bill and Susan Parker, who work in though it gets a fair amount of support gram, is a step, and a fairly significant a gas station in Epping, NH. Their out of the general fund, the general step, if followed correctly, down the taxes are actually subsidizing Warren fund being general taxes. Everybody road toward reducing this outyear Buffett’s drug insurance, his ability to pays their taxes: income taxes, cor- threat of a fiscal meltdown. buy drugs, which is totally wrong. porate taxes. Those taxes are used to It is critical we heed the law we What the administration has sug- operate the Government generally: to passed and, specifically, the statement gested is that people, individuals who pay the defense budget, to pay the edu- and the execution of the statement have incomes over $80,000, and joint cation budget, to pay the environ- that has been made by the Medicare taxpayers who have incomes over mental agency—to pay the different ac- trustees that the trigger must be exer- $160,000, or approximately that tivities the Government undertakes. cised. And the administration has the amount—fairly wealthy people by That is the general fund. Those funds obligation to set up a way to accom- American standards—should pay more were not supposed to be the funds that plish these savings. than 25 percent of the cost of their supported health insurance for seniors. Now, under the law, the administra- drug premium. I think they have sug- Medicare was supposed to be an in- tion sends up its proposal, which it has gested they pay 50 percent or maybe 60 surance program, as is Social Security, done, which proposal is required to percent but not the entire premium. where the funds are collected from peo- bring the Medicare system back into They are still going to be subsidized by ple, working under the HI tax, which balance, so it is not taking more than John and Mary Jones who are probably you pay, which is withheld. Those 45 percent of the general fund. That bill making a lot less than $160,000 working funds are what are supposed to support is then required to be introduced by at a restaurant in Nashua, NH. Medicare. the majority and the minority on the That is their first proposal.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00014 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1231 The second proposal they put forward that is creating the issue because of is the envy of the world. Our drugs are is that we should have an IT proposal, the demands we are going to put on the the envy of the world. But we have a something that basically means using system because we are such a large system which basically is unneces- technology to communicate more ef- generation. We are in the position of sarily expensive and is going to cause fectively the costs of health care, to making Government change, and we us to be anticompetitive in future create a more integrated system where should address this. We should take years. you could get more effective informa- that action, and I certainly hope we I was in Bangalore, India, not long tion on what health care costs in order can over the next few weeks. ago. I brought about 15 or 20 Mon- to drive better purchasing practices. Mr. President, I appreciate the cour- tanans. It was a trade trip partly to We all know that is going to signifi- tesy, and I yield the floor. China and also to India. We went to the cantly improve the delivery of Medi- The PRESIDING OFFICER. The sen- John F. Welch Technology Center, care and all health care, if we do this. ior Senator from Montana is recog- which is one of General Electric’s three It is something that should be done nized. technology centers in the world. Kind and, therefore, is appropriate. Mr. BAUCUS. Mr. President, I ask of ‘‘gee whiz’’ stuff, kind of interesting. The third thing they have suggested unanimous consent to speak as in During the tour, I walked up to the is that we limit basically frivolous law- morning business. manager. He was the only non-Indian suits that are driving up the cost of The PRESIDING OFFICER. Without there. He is a German, Argentine his health care and actually driving some objection, it is so ordered. background. doctors in the area of OB/GYN—baby Mr. BAUCUS. Mr. President, I thank I walked up to him, and I said: Why doctors—out of the practice, that we the Senator from New Hampshire for are you here in India? Why are you essentially adopt what is known as the his comments and for pointing out the here, right here? Why is your research California Plan for medical liability in- budget expenditures and exposure down facility here? surance—again, a very rational ap- the road. The only point I wish to He said: Greatest talent pool. proach. make about his presentation is that I said: Well, what country has the None of the ideas the administration the increase in entitlements is not so next greatest talent pool? has put forward are radical. None of much because of Social Security—that China, he said. them are even targeted in a way that is not the big problem for the next 15 I asked: Where are we as Americans? would significantly affect very many or 20 years. Rather, it is the increases He said: You are kind of down here. beneficiaries. In fact, as to the entire in Medicare and Medicaid that are What does it take, I asked, to get us proposal they put on the table, 94 per- going to be very expensive for us to ac- up there? cent of Medicare beneficiaries would commodate. The real question is, What He looked at me without skipping a not be affected by any of these pro- is the solution? We know what the beat, and he looked me straight in the posals—94 percent. Only 6 percent; that problem is. The question is, What is eye, and he said: Education and health is, the wealthiest 6 percent, those peo- the solution? care. He says: You have to educate ple with incomes over $80,000 individ- It is interesting that Peter Orszag of your people a lot better than you are. ually or $160,000 jointly. Those folks the Congressional Budget Office print- Second, you have a health care system having to pay a portion of their Part D ed a report just about a month ago say- that is making you anticompetitive, premium would be impacted, and they ing that the rise in the number of baby you Americans. should be impacted. boomers is part of the problem, but It is true, our health care costs are so So that proposal has been put for- that is not the big problem. The main much higher than the costs of compa- ward. reason that Medicare is going up at nies in other countries. About 18 per- Three ideas—all of them reasonable, such a rapid rate and that Medicaid is cent of our total health care costs are all of them initiatives which we should also going up at a significant rate is administrative; in other countries, it is be able to accomplish, and which because health care costs in this coun- about 4 or 5 percent. There are a lot of would, if undertaken, actually reduce try are rising at such a rapid rate. So ways to get at this problem. The real this insolvency in Medicare dramati- I think it is important to address not question is, What is a solution? How do cally. I think the estimates are that just the symptoms; that is, the wacky we get health care costs more under over the 75-year life, you might take as Medicare, but it is much more impor- control? much as $8 billion out of this insol- tant to look at the direct causes or I daresay that whoever is elected vency number if you did these pro- what is causing these increases. President is going to be forced to and posals which the administration is sug- Our country today spends about $2 should be and will have an opportunity gesting. That is a huge number over 75 trillion on health care—about $2 tril- to make a major health care proposal years. It would actually be a major lion. About half of that is in the public to our country. We on the Finance step in the right direction. But, more sector and half in the private sector. Committee are starting to hold a lot of importantly, it would respond to what The projections of the Congressional hearings on health care. There are a lot the law says we should do. So I cer- Budget Office, a nonpartisan organiza- of provocative questions. We need to tainly hope we are not going to sit on tion, are that private health care costs not be flat-footed, and we need to work our hands. are going to increase very significantly in tandem with whoever is elected I see the chairman of the Finance over the next 20 years and Medicaid President so we can begin to address Committee is in the Chamber. He says costs are going to also increase signifi- two main points. One is coverage. We he is going to act. I hope his colleagues cantly but, for Medicare, much more. are the only industrialized country in will follow him, because that is the The rate of increase in the private sec- the world where people don’t have type of leadership we need. tor will be a little less because the pri- health insurance that is not universal Now, the administration’s three pro- vate sector tends to control costs a lit- coverage. We need to have that. Second posals aren’t the beginning and the end tle better. For Medicaid, the rate of is to address costs. We need to figure of the process. Anything can be on the growth will be not quite as high as out how we can get a handle on the ex- table to try to get this resolved. But Medicare growth because States pay cessive increase of health care costs in the fact is, we need to resolve it. The for part of the Medicaid costs and our country. trigger has been pulled. We are over States are going to get a little more I commend my friend from New the 45 percent or we are projected to be control of their State budgets. Hampshire for raising the problem, but going over the 45 percent. We need to The real problem is the increase in the real question is, What is the solu- act not only because of that but be- health care costs. We in America spend tion? The President’s letter is not even cause of, more importantly, this out- twice as much per capita on health a glancing blow to solutions; it kind of year problem. We have no right as pol- care costs than the next most expen- touches on some possible solutions. It icymakers to pass our generation’s sive country, and I don’t know that we is critical for us to address the under- problem on to our children, which is are twice as healthy as the next most lying questions. What are the under- exactly what we are going to do if we expensive country. We have great lying causes of increased health care don’t act. Our generation is the one health care in America. Our technology costs? I don’t have the time here to go

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00015 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1232 CONGRESSIONAL RECORD — SENATE February 27, 2008 into all of what I think we need to look a recruiting drive all throughout the say about her children, that is an abso- at and will be focusing on in the Fi- Mideast. lute nightmare for al-Qaida. They see nance Committee, but that is a major Thank God we changed strategy this the outcome in Iraq as very important challenge we face as a country, and it time last year. I wish to compliment to their agenda. I hope we are smart is a great opportunity for all of us to the President, and all of those—par- enough to see the outcome in Iraq in dig deep and help to solve this problem ticularly Senator MCCAIN—who spoke terms of our own national security be- so Americans can be proud of the coun- loudly and clearly that we needed to cause I have said a thousand times, you try we have, with universal coverage, change strategy. It wasn’t a debate cannot kill the terrorists and win this and also get a handle on excessive about changing in Iraq. Everybody war. Killing terrorists is a part of this costs. wanted a change. Some wanted to just war. The war is an ideological struggle. (The remarks of Mr. BAUCUS per- leave and worry about the con- The high ground in this war is the taining to the submission of S. Res. 462 sequences later. Senator MCCAIN and moral high ground. That is why Abu are printed in today’s RECORD under others said: No, we need not only to Ghraib hurt so badly. That is why we ‘‘Submited Resolutions.’’) stay, we need to put more troops on the have to, at every turn, showcase our The PRESIDING OFFICER. The Sen- ground and come up with a way to sup- values as being different from our en- ator from South Carolina is recognized. press this insurgency because without emy’s. When we capture an al-Qaida Mr. GRAHAM. Mr. President, I would security there will never be reconcili- operative, it becomes about us. The like to use about 10 minutes or so, if I ation. I think the results are in, and rules we employ in the capture of an may, to discuss what I think is an im- they are overwhelming, and they ex- al-Qaida member or any other terrorist portant topic for the country. The Sen- ceed all expectations I had in terms of showcases who we are, and we cannot ate has allowed itself to discuss success for the surge. use as an excuse they do terrible things progress in Iraq—or the lack thereof, But to the central point: If you be- and they don’t believe the same things we do; therefore, we are going to throw depending on how you view these lieve, as I do, that this is one battle, the rules out and be like them. That is things—and to discuss a measure pro- the central battle in regard to a global posed by my good friend, Senator RUSS the one way to lose this war. struggle, not an isolated event, it is a I am proud of my Nation standing by FEINGOLD, that would require us to battle you can’t afford to lose. If Iraq moderation in Iraq. I am sorry to the withdraw troops, I think within a 120- fell apart, broke into three parts, be- day period, leaving troops behind in a American people and all those who came a chaotic state, the national se- have gone to Iraq many times that we very limited role and basically telling curity implications for our Nation are the world and our enemies we are leav- got it wrong so long. But wars are that enormous. way. The model we had after the fall of ing Iraq, and the people left behind They start with the following: Al- Baghdad allowed the enemy to grow would have a very limited function in Qaida would be on every street corner and become stronger, and it made it terms of what they could do—a com- in the Mideast saying that we beat difficult to reconcile the country, plete change in strategy. It would be America and ran them out of Iraq. which is in our national interest. saying to the Petraeus strategy: It What would that do in terms of a A year ago about this time, a new failed, it didn’t work, and we are going chilling effect on moderation in the re- general took over with a new strategy: to replace the Petraeus strategy with gion? Who would be the next group of 30,000 troops were interjected into the the Feingold strategy. moderates to stand up and say: Come battle space. But it is not about 30,000 Now, as much as I admire Senator help me fight against extremism, troops. This general understood how to FEINGOLD—and that is a great deal, to America, after our behavior of leaving win. We took the troops out from be- be honest with my colleagues, because Iraq, and those who helped us to try to hind the walls, and they started living he takes his job very seriously, as do make Iraq a better place, a new place? with the Iraqi Army and police forces the rest of us, but he is willing to do They would surely get killed. If we left in neighborhoods. We took each neigh- and say things very few people will do Iraq, withdrew, gave the battle space in borhood block by block, securing peo- or say, and I think that makes the Anbar to al-Qaida totally, they would ple in a way where they felt com- country a better place. Sometimes I have killed everybody who tried to help fortable enough to talk to us about disagree with him. This is an occasion us, and it would have taken decades to their future, about their hopes, and where I find the Feingold strategy re- get over the consequences of that mis- about their dreams, and over time they placing the Petraeus strategy would be take. You cannot leave people behind helped us. a disaster for the country, the region, to be slaughtered by terrorists and ex- This infusion of military might into and our national security interests, pect to ever win this war. Anbar, where al-Qaida was roaming and I say that with all due respect. Here is what bin Laden said in 2002 freely, allowed people who tasted the Now, one of the central theses of Sen- about Iraq: al-Qaida life to say: I don’t want to live ator FEINGOLD and others who support I now address my speech to the whole of this way. The Sunni awakening was an this measure is that Iraq is a side ven- the Islamic Nation. Listen and understand. effort by a very brave sheik, who is ture, not part of the war on terror, and The most important and serious issue today now dead, to break loose from the al- our presence there is making us less se- for the whole world is the Third World War. Qaida agenda and come to the Amer- cure, not more, and that we have taken It is raging in the land of the two rivers. The ican and coalition forces and say: I our eye off the ball. I would argue that world’s millstone and pillar is Baghdad, the would like to align with you because capital of the caliphate. the enemy doesn’t see it that way. It is this is not the way I want to raise my my belief and contention, and has been Bin Laden did not get the memo that kids, these are not the hopes and for a very long time, that Iraq has be- Iraq is not about a global struggle. dreams I have for my people in Anbar. come the central battlefront in the war Clearly, from his point of view, it is the They killed him, and if you go to on terror. That happened when al- defining battle in terms of his goals Anbar, there are photos of this guy ev- Qaida decided to go into Iraq after the and ambition for the al-Qaida move- erywhere. They killed him, but they fall of Baghdad and undermine this at- ment. The reason al-Qaida came into did not kill his idea. As a matter of tempt at moderation in Iraq, tried to Iraq was to make sure we would lose, fact, at his funeral and thereafter, the drive us out, and a year ago this time, that moderation would fail. Their people of Anbar have upheld this sheik I was worried that they were going to worst nightmare is for a mother to as a model of the future, as a hero. Al- succeed. have a say about her children, and if Qaida overplayed their hand. They For about 3, 31⁄2 years, we got it we can pull this off in Iraq, where the tried to intimidate everybody around wrong in Iraq. We didn’t have enough different groups—the Sunnis, the them. They are trying to intimidate troops. We had a training model that Shias, and the Kurds—can live together us: Do it my way or die. Do it my way was not delivering quality in numbers under the rule of law, have a central or watch your children die in front of in terms of the Iraqi Army. The insur- government and local governments you. Do it my way or we will burn your gency was thriving. There was a law- that work together and allow people to children right in front of you. Live my less period. You had the Abu Ghraib raise their children without fear and way religiously or lose everything you episode that allowed al-Qaida to go on prosper together and a woman has a have, including your life.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00016 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1233 You know what, the good news from I strongly believe [that U.S. failure in Iraq] it is difficult, and they keep going back the surge, beyond all other news, is would lead to al Qaeda with what it is they because they know the outcome in Iraq that a Muslim population had a chance said is their goal there, which is the founda- affects us at home. And God bless them to experience this al-Qaida life and said tions of the caliphate, and in operational for doing it. no. That, to me, is the single most im- terms for us, a safe haven from which to plan One brief statement: Well done. You and conduct attacks against the West. portant event that has happened in the have exceeded every expectation I have last year, that Muslims would turn on It is clear to me Iraq is a central bat- had. You have done a marvelous job. al-Qaida and fight them and say: You tlefront. It is clear to me about 3 years You performed your mission beyond are wrong; this is not what the Koran we were losing. It is abundantly clear any measure. You are involved in the teaches, this is not the way we are to me now that we are winning. The most successful counterinsurgency in going to live our lives. And they have Iraqi people have stepped to the plate military history. All those who have done something about it. and produced results that are aston- taken part will go down in military The sheik has given his life. Many ishing, and it has come from a new history. We should be celebrating as a others in Anbar have given their lives strategy that has produced better secu- nation what I think is one of the big- to make sure al-Qaida does not win. Al- rity. gest military achievements in the his- Qaida lost in Anbar because we had The monthly attack levels have been tory of the world. But we cannot quite enough military presence, along with a decreased by 60 percent since June of do that. I don’t know why. new attitude of the people who live 2007. How did that happen? This new Al-Qaida is diminished but not de- there, to beat these guys. They are not strategy of General Petraeus of getting feated, but they are on their way to 10 feet tall. They are thugs, and history military power out into neighborhoods, being defeated. is full of people such as this who have staying on the insurgency, giving them The big debate has been, what will had ideas that certain groups are not no rest, emboldening the citizens to make the Iraqi politicians get their act worthy of living. The Nazis had their fight back has paid great dividends. It together. If we threaten to leave them view of who could live and who would is still a dangerous place but what a there, they will start doing business in die, and it was based on racial stereo- dramatic change: a 75-percent drop in a better way. I have always felt that if typing, prejudice. There have been civilian deaths since the beginning of you threaten to leave Iraq, every mod- other episodes in history where reli- 2006. From January to December, sec- erate will be chilled and every extrem- gious bigotry determined who lived or tarian attacks and deaths have de- ist will be emboldened. If you want to died. creased over 90 percent in the Baghdad bring back life to a diminished enemy, The way you beat these people is not security district. How did that happen? let them read some headline some- for the good people to come home and We had a plan to secure the capital where in the world: ‘‘America begins to leave the battlefield to the enemy; it is city by getting out from behind walls, withdraw,’’ as this Feingold resolution for the good people to rally around the going into neighborhoods, providing would suggest or as Senators OBAMA values that make this place worth liv- firepower and assistance, and the Iraqi and CLINTON would have suggested. ing and fight these people. The way people have done their part. you win this war is you align yourself You would literally breathe life into a Coalition forces cleared approxi- defeated, diminished enemy. It would with people willing to take on the ter- mately 6,956 weapon caches in 2007, rorists and extremists and fight back be music to their ears. For every mod- over twice what we found in 2006. How? erate who has sacrificed, lost family against al-Qaida, and that is what Gen- People are telling us where the weap- eral Petraeus did. When the awakening members as judges, as lawyers, as po- ons are because they want a new coun- licemen, as army members, it would be occurred in Anbar, we put tanks try. They see us as a solution to their around every leader we could find and heartbreaking. problems, not the problem, and they I cannot believe people do not under- told them: We are not leaving; we are are coming forward telling us things here with you. stand the consequences to the world if they did not tell us last year because The Sons of Iraq is an organization the American Congress said: We are they have sensed momentum, they feel that sprung up from the population, going to leave Iraq in a set period of where almost 80,000 people now belong as if they are safer and they don’t want time. I cannot believe we do not under- to this organization where they patrol to go back to the old ways and they are stand how that would resonate the streets at night to make sure al- helping us help them. throughout the world. It would be Qaida does not come back. Anbar is a Iraqi security forces in the last year music to an enemy that is really on the completely different place. Al-Qaida are responsible for security in 10 of the run. It would rip the heart out of those has been diminished and defeated in 18 Iraqi provinces. One of the biggest who brought this about. And you want Anbar, and they are moving to other stories in this year has been the im- political progress in Iraq to go for- places in Iraq. They are not defeated provement of the Iraqi security forces, ward? Tell al-Qaida we are going to yet, but they are certainly on the run. particularly the army. The national leave and see what kind of progress we For America not to appreciate what police have been a real problem. Even get in Iraq. has happened here, for this Congress they are beginning to turn around. The politicians in Baghdad have been not to celebrate what has happened in There are 100,000 new members of the frustrating to deal with, sort of similar the last year I think is sad. We should Iraqi security forces, many of them to here at home. But you know what. I be using this 30 hours to say to General being able to operate independently am here to say something I did not Petraeus, thank you; to Ambassador from us, for a total of a half a million think I would say last year: Well done. Crocker, thank you; to all those under people in uniform. The debaathification law has passed. your command, thank you for having The Iraqi people have stepped to the What does that mean? It means the the courage and the wisdom to turn plate. They are helping themselves in a Shias and the Kurds have welcomed this around, and we acknowledge that way I admire. The casualty rate among people back from the Sunni Baathist you are turning it around. We know Iraqis is three times that of our Amer- Party that ran the Government under you have a long way to go yet, but ican and coalition forces. Every Amer- Saddam to their old jobs, made them thank God you have turned the corner, ican death we mourn, but the reenlist- eligible for their old government jobs, and we have turned the corner. And the ment rates among American soldiers, and they are saying to their Sunni corner I wanted to see turned was when military members who have served in Baathist neighbors: Let’s build a new the people of Iraq would stand up to Iraq and Afghanistan, is through the Iraq; let’s not look backward. the extremists and fight back with our roof. What do they see that we don’t? Can you imagine how hard, I say to help. Why do they go back so many times? I Senator LIEBERMAN, that must have GEN David Petraeus said in May of know what I hear. I hear overwhelm- been, to have grown up in Iraq, and the 2007: ingly: Senator GRAHAM, I want to get people who ran the Government under Iraq is, in fact, the central front in al this right so my kids don’t come. I Saddam Hussein made their life miser- Qaeda’s global campaign. hear from the soldiers, sailors, airmen, able and you have a chance to be on GEN Michael Hayden, Director of the and marines: If we win here, it makes top; you can fire them all and make CIA, said in January 2007: us safer at home. It is hard, it is tough, them miserable, and then suddenly,

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00017 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1234 CONGRESSIONAL RECORD — SENATE February 27, 2008 after a lot of dying, you realize: Wait a Sunnis, who have been tied to the in- wasn’t a good enough title. I was called minute, we have to go forward, not surgency. The Parliament passed a law the chairman of the board of the Yale backward. The debaathification law is that will allow a community of Sunnis, Daily News. And there was a gen- a huge step toward reconciliation. Shias, and Kurds to go through the tleman at the Yale Daily News named A $48 billion budget was passed. files of the people in jail and say to Francis Donahue—Tackie Donahue— Politicians in the Congress can relate some of those who have taken up arms and he had been there forever as the to one thing: money. We are always against the Government: Go home, my permanent business manager. I remem- fighting to get our fair share for our brother, and let us build a new Iraq. ber the day after I was chosen, he told State and our districts. The $48 billion That is a stunning development. me he had informed Bill Buckley of budget that was passed has money allo- Now, how did all this happen? Iraq is this in one of his regular memos back cated to every region of Iraq, and re- war weary. People are tired of living in and forth to Buckley. I was fascinated construction can now go forward. And fear. We have given them better secu- by this and began a communication the ministries delivering the money rity; we put al-Qaida on the run, which with Bill Buckley at that time, and he are better than they have ever been but has been trying to stir up trouble ever took a wonderfully warm, kind of with a long way to go. since Baghdad failed; and people have a brotherly interest in those who were at The fact that Sunnis, Shias, and sense of economic and political hope the Yale Daily News, as he had been in Kurds would share the wealth of the they have never had before. Oil reve- the early 1950s. He invited me and a country with each other seems to me nues are up, have doubled. Oil produc- couple of our friends from the news to to suggest that they view Iraq as a tion is up 50 percent. The economy is come to his house in Stamford, CT, for country. And to give money to some- moving forward at a very fast pace. All a dinner or two, which were stimu- one who may have been involved in of this is due, in my opinion, to relating, thrilling evenings. trying to kill your family just months solve, to the surge, to the bravery of Our friendship went on, and I will ago is very difficult to do. But they the Iraqi people and the American come back to that, but Buckley’s life is have overcome, I think in great meas- military and coalition forces who an extraordinary life. He came out of ure, the biggest impediment that every brought it about. Yale, became very well known for a country eventually has to overcome— To my friends and colleagues in Con- book he wrote about what he thought and that is forgiveness. There is a long gress: We are going to win in Iraq. Fi- was the hostile environment at Yale way to go in Iraq, but we are a lot clos- nally, we have a model that will lead toward people of faith, toward people er to getting there than we were last us to a stable and functioning govern- who were conservative, et cetera, et year. And the only way we are going to ment rejecting terrorism and aligning cetera, ‘‘God and Man at Yale.’’ He lose is for Washington to screw it up. with us in the war on terror. And the went from that to starting the Na- The provincial powers law, it passed only way we will lose now is for Wash- tional Review in the mid-1950s. I be- the Parliament and went to the Coun- ington to lose its will and undercut lieve it was 1955. I remember reading cil of Presidents. It will allow local this model. I hope we understand what once that he had said in the founding elections in every province beginning this debate is about. It is about win- issue that the publication would derive in October. And I predict if that law be- ning and losing a battle that we can’t from original ideas of the moral order. comes reality, Sunnis will vote in large afford to lose. Bill Buckley was a person who stud- numbers, and they boycotted in 2005. I yield the floor. ied history, studied literature, learned The central government run by the The PRESIDING OFFICER. The Sen- from it, and also was infused with a Shias came to the conclusion that we ator from Connecticut. deep and profound commitment to his are going to decentralize power; we are Mr. LIEBERMAN. Again, I thank the Roman Catholic faith. That, I think, going to let each province elect their Presiding Officer for staying in the was the origin of the moral order which local leaders, instead of trying to chair for a period of 10 minutes. he gave expression to in all that he did micromanage everything from Bagh- in writing for the National Review and dad. You know what that means? De- f speaking out and conducting himself as mocracy. TRIBUTE TO WILLIAM F. a provocative, loving American. He be- The PRESIDING OFFICER (Mr. BUCKLEY, JR. lieved that ideas mattered, and they MENENDEZ). The Senator is advised by Mr. LIEBERMAN. Mr. President, this the Chair that there is a preceding did. morning we learned of the death of Wil- The National Review, in some sense, order to recess at 12:30. liam F. Buckley, Jr. I wanted to come Mr. GRAHAM. To be continued. I gave birth to the modern American to the floor and reminisce a bit about yield. conservative movement. But it wasn’t Bill Buckley, whom I have been privi- Mr. LIEBERMAN. Mr. President, always a Republican movement. His leged to know for more than 40 years, with the indulgence of the Chair, I ask was a matter of ideals and ideas and and to pay tribute to a devoted and pa- unanimous consent to speak as in philosophy—conservatism. Inciden- triotic American, a remarkably cre- morning business on another subject tally, he rejected extremism. To his ev- ative and eloquent man of letters, a for up to 10 minutes. erlasting credit, he took on the ex- The PRESIDING OFFICER. Is there person with an extraordinary sense of tremists of the John Birch Society, objection? humor and a kind of spirit to him that which wasn’t popular for him to do at Without objection, it is so ordered. infused anyone around him. the time he did it. Mr. GRAHAM. May I have 2 minutes He was a person who believed in the I am just remembering words of to finish my thoughts? power of ideas and loved the exchange Buckley. He said he was a conservative The PRESIDING OFFICER. Without of ideas. He lived a remarkable life, ideologically, not always favorable to objection, it is so ordered. with great effect for this country that Republican candidates. I remember Mr. GRAHAM. The provincial elec- he loved, and a tremendous impact on reading about an editorial he wrote in tion law was vetoed by Abdul Mahdi, a people who read his novels, his books, the National Review endorsing General Shia Vice President, over the issue of and his columns in the National Re- Eisenhower for President. While every- whether governors elected to the prov- view, or watched him for so many one else was echoing the slogan ‘‘We ince can be replaced by a majority vote years on that wonderfully thoughtful, Like Ike,’’ Buckley’s editorial said, in the Parliament. That is going to cerebral, provocative TV program ‘‘Fir- ‘‘We Prefer Ike.’’ So it was a relative their Supreme Court. It is a unique and ing Line,’’ which was open not just to judgment that he made. novel issue, and, to me, it gives great conservatives such as Bill Buckley, but He was thrilled, of course, much hope because they are resorting to the to people with all shades of opinion more by the candidacy of a former law rather than the gun. It is constitu- who were willing to engage him—Bill Member of this body, a distinguished tional democracy playing out in front Buckley, WFB—on the field of ideas. A Member, Senator Barry Goldwater, and of us. It is something we should cele- remarkable man. most of all by the candidacy of Presi- brate. I was privileged to get to know him dent Reagan. At one point, in the mid- Amnesty: There are thousands of more than 40 years ago when I became 1960s, he ran for mayor of New York. people in the jails of Iraq now, mostly the editor—at Yale, of course, editor And again as a kind of joyous, thought-

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00018 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1235 provoking, elegant, eloquent exercise openness to ideas, to his civility. One the Washington Post, which was at my in being involved in the marketplace of could disagree with Bill Buckley, as I doorstep this morning: ‘‘Suicide Bomb- public ideas, perhaps most famous, did quite frequently, and never lose re- er Hits Bus in Iraq’s North, Killing at though perhaps not the most sub- spect or affection, dare I say love, for a Least Eight.’’ stantive thing he said in that cam- wonderful human being. We would all A suicide bomber detonated his ex- paign, is when they asked what he benefit from that. plosive belt outside a bus in Northern would do when he was elected. Bill I perhaps would close this impromptu Iraq on Tuesday, killing at least eight Buckley famously said: I will demand a tribute to Bill Buckley, mourning his people, injuring at least eight others. recount. And that is a good message for loss today, by offering condolences to You drop down, it tells about all of all of us when we approach campaigns. his family: Chris Buckley, his son, who the violence. Well, I continued to be involved with is a wonderful writer and confuses me The Tall Afar bombing followed a him in communication in many ways. as well as others with the multisyllabic bloody weekend of attacks against Shi- My wife and I had the privilege of words that he uses just as his father ite pilgrims, the deadly incident taking spending wonderful evenings with him did; his sisters, Priscilla L. Buckley of place Sunday when a suicide bomber and his late wife Patricia at their home Sharon, where the family has longed killed at least 63. in Stamford, CT. These were classic lived; Patricia Buckley Bozzell of As we learned yesterday, that one evenings of great food, some drink, and Washington; Carol Buckley of Colum- blast injured more than 100. You drop good spirited conversations—cigar and bia, SC; his brothers, Judge James down in this news article: Even as overall violence has fallen, brandy to follow—but always open to Buckley of Sharon, CT, and F. Reid the recent attacks underscore the ten- ideas and always with a ready willing- Buckley of Camden, SC; and a grand- uous security environment and the re- ness to laugh. In fact, he passed away daughter and grandson. siliency of the insurgency. earlier today, apparently in his study I pray that they will be strengthened In volatile Diyala Province, it goes in his magnificent home on Wallace by their faith and comforted by good on to explain how 21 people were kid- Point in Stamford, CT, probably work- memories and pride and the extraor- naped yesterday. At the bottom of the ing on a column or some other piece of dinary person in Bill Buckley. page, it has the names of three of our writing. I think most fitting of all, I will end soldiers who were killed. And then, of I was particularly grateful to him for with a quote from President Reagan on course, we have General Casey. General all that I learned from him, all the the occasion of the 30th anniversary of Casey, the Army Chief of Staff, said good times I had with him, and in some the National Review in 1985. Reagan yesterday in testimony before the sense, you might say I would not be a says when he first picked up his first Armed Services Committee: United States Senator were it not for issue of National Review, he received it Bill Buckley, although Buckley would The cumulative effect of the last 6 in a plain brown wrapper and still anx- years plus at war have left our Army not say that. When I ran for the Senate iously awaited his biweekly edition but in 1988, let’s just say with the diplo- out of balance, consumed by the cur- no longer in a plain brown wrapper. rent fight and unable to do the things macy that marks this Chamber that But this is what Reagan said of we know we need to do. Bill Buckley was not a fan of the in- Buckley: cumbent Republican Senator, and he We have had some good debate. My You didn’t just part the Red Sea—you called me up and said—I wish I could Republican colleagues think the war is rolled it back, dried it up, and left exposed, going great. I think they are certainly impersonate him—Joe, I’m thinking of for all the world to see, the naked desert endorsing you. Do you think that will that is statism. And then, as if that weren’t entitled to their opinion. But it has help? enough, you gave the world something dif- been a good debate. We, of course, have I said: Well, now, that’s very good of ferent, something in its weariness it des- spent time on Iraq on this side of the you. Then he interrupted and said: perately needed, the sound of laughter and aisle, but also on how the war has done Please understand this is the only time the sight of the rich, green uplands of free- so much to damage our security and I am likely to endorse your career. So dom. our economy. I said that it probably would; what do I thank the Chair for giving me the There is a book coming out tomorrow you have in mind? opportunity to bid farewell in this Sen- or the next day that talks about—it is Well, he actually wrote a column, a ate Chamber to a great American and a by Mr. Stiglitz, who is a Pulitzer Prize very good column in the National Re- dear friend, William F. Buckley, Jr. I winner—maybe Nobel; I think Nobel. It view, and I think in his syndicated col- pray with confidence and the faith that is called ‘‘The $3 Trillion Mistake.’’ umn. He also, with the puckishness Bill Buckley had that his soul will be The book is on the war. Now, in ac- that was part of him, started some- taken up truly in the bonds of eternal tual numbers that I understand, in thing he called Buck PAC, which was, life. about a year they will be up to $1 tril- he said, a PAC open to anyone in Con- I yield the floor. lion. Mr. Stiglitz, an economist, far necticut whose name was Buckley and f smarter than I am, says it is $3 trillion. who was committed to the defeat of the That is what we have talked about. RECESS incumbent Senator at that time. He This war that will soon be going into printed bumper stickers and the like The PRESIDING OFFICER. Under the sixth year has been devastating to and helped out in the campaign. the previous order, the Senate stands our country. I said to him after I won that elec- in recess until 2:15 p.m. We had a meeting that just took tion—and I won it by very little—that Thereupon, the Senate, at 12:47 p.m., place about the budget. The President’s I thought that in a close election—as recessed until 2:15 p.m. and reassem- budget cuts virtually everything. One the Presiding Officer of the Senate bled when called to order by the Acting of the victims in his budget is Public knows, there are so many reasons one President pro tempore. Broadcasting, cut by 70 percent. I is successful—but I said: You have rea- f talked to Senator CONRAD as we were son, Bill, to take part of the credit. I leaving. I said: What did you do with PROVIDING FOR THE SAFE REDE- won by less than 1 percent of the vote. Public Broadcasting? PLOYMENT OF UNITED STATES And I said: You know, I would go so far We restored the money. TROOPS FROM IRAQ—MOTION TO as to say you played a rabbinical role And even restoring it takes into con- PROCEED—Continued for me in this campaign. sideration some of the cuts the Presi- Well, what do you mean by that? So The ACTING PRESIDENT pro tem- dent has made in that program over I said: Your endorsement of me and the pore. The majority leader. the 7 years he has been President. columns you wrote said to Republicans Mr. REID. Mr. President, another day We do not have money to do the ba- in Connecticut who really didn’t like in Iraq. Today American taxpayers’ sics this country needs to do because the incumbent Senator, it is kosher to dollars will be spent in Iraq, almost a we have borrowed $1 trillion to take vote for LIEBERMAN. And he laughed. I half a billion dollars. More than $400 care of the war. remember that well. million will be spent today in Iraq. So we have had a good debate. Each There is so much I could say about Here is what we get from it as seen side has spent a little over 3 hours dis- his contribution to our country, to his by—you pick about any newspaper— cussing these issues. I believe there has

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00019 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1236 CONGRESSIONAL RECORD — SENATE February 27, 2008 been sufficient debate on the motion to front, progress was very slow. When the in Iraq, where provincial governments proceed. going got tough, many called for U.S. continue to spend national revenue on I ask unanimous consent that all withdrawal and abandonment of Iraq. reconstruction, and many people are postcloture time be yielded back and Thankfully, the President did not lis- engaging in local politics. the motion to proceed be agreed to; ten to the calls for defeat and retreat. On the economic front, the central that the Senate now vote on the mo- The President reviewed our strategy Government of Iraq recently reached tion to invoke cloture on the motion to and changed course. This change was its 2007 target of $30.2 billion in budget proceed to S. 2634, and that if cloture is needed. I visited Iraq twice before this revenue 1 month before the end of the invoked, notwithstanding rule XXII, change of strategy. I can tell you it year. The Government of Iraq recently the Senate immediately proceed to was a dangerous place. During one of completed early repayment of its out- vote on the motion to invoke cloture my trips, we had to take a helicopter standing obligations to the Inter- on the motion to proceed to H.R. 3221, from the Green Zone to Baghdad Inter- national Monetary Fund. The Baghdad the vehicle we will use for the housing national Airport because of an IED Chamber of Commerce recently hosted market crisis. threat. a business expo which more than 8,000 The ACTING PRESIDENT pro tem- In January of 2007, the President and executives, entrepreneurs, salesmen, pore. Is there objection? General Petraeus launched the surge of and investors attended. Mr. KYL. Mr. President, reserving American forces into Iraq. The Iraqi Mr. President, approximately 2 weeks the right to object, I will make two people quickly realized that something ago, I traveled again to Iraq and was quick comments. Certainly I respect dramatic had happened. Those who had briefed by General Petraeus, other the majority leader’s comments. He worried that America was preparing to commanders on the ground, and Iraqi talked about the fact that violence is abandon them instead saw tens of security officials. Petraeus and his down in Iraq. But, of course, the sui- thousands of American forces flowing troops are obviously and undoubtedly cide bombers continue to wreak havoc. into their country. They saw our forces doing a remarkable job at turning We all deplore that. moving into the neighborhoods, clear- things around. This was a different trip I was in Israel last week at the boring out the terrorists, and staying be- for me. There was a more secure feeling der town in Gaza—Sderot is the name— hind to ensure that the enemy did not in the air. I felt optimistic, more so and terrorism from Hamas continues to return. They saw our troops, along than at any other time since the war bedevil the people of that town with with provincial reconstruction teams, started. You can tell that things have rockets coming over every day. But coming in to ensure that improved se- remarkably changed for the better. I they cannot leave and leave the terror- curity was followed by improvements visited a town south of Baghdad where ists to prevail there. I think the same in daily life. 3 months ago al-Qaida had been in The surge is now achieving its pri- thing is the situation in Iraq. total control. I felt so safe that, along mary aims of improving population se- The majority leader talks about the with two other Senators and our staffs, curity in Baghdad and reversing the costs, and they are significant. But the we walked through a local market cycle of sectarian violence that costs if we had to come back in and without a helmet and spoke to dozens plagued Iraq. Although there is much clean up after the terrorists take over, of residents, including children, more work to be done, security has im- if we left prematurely, could be far through a translator. One of the Iraqi proved considerably since General greater than what we are expected to Petraeus began implementing this new people’s biggest fears is that America have to pay. In any event, it is very strategy that became fully operational will surrender and leave prematurely. difficult to put a price on freedom and in mid-June. They fear for their lives, their children, security. According to the U.S. military, and the future of the country if we sur- I think we have had a good debate. monthly attack levels have decreased render. We have speakers on our side actually Great, almost unbelievable strides 1 60 percent since that time. Civilian for about another about 4 ⁄2 hours or so. deaths are down approximately 75 per- have obviously been made, and we are But as I told the majority leader, we cent. Although al-Qaida in Iraq re- headed in the right direction. Despite could yield back some time on our side mains a dangerous threat, its capabili- this fact, some of my colleagues on the to work with the majority leader to de- ties are severely diminished. Thou- other side of the aisle continue to in- velop a schedule that would be conven- sands of extremists in Iraq have been troduce defeatist legislation, such as ient for all of the Members. captured or killed, including hundreds what we have before us today, S. 2633, At this time, because of the precise of key al-Qaida leaders and their that call for tying our hands on this nature of the unanimous consent re- operatives. front line of the war on terror. So as quest, I object on behalf of the minor- Iraqi forces now have assumed re- things get better and better, the Demo- ity but would suggest it should be sponsibility for security in 9 of 18 Iraqi crats continue to call for retreat. They possible this afternoon, early this provinces and are now leading combat continue to politicize the war in Iraq, afternoon, for the majority and minor- operations all over the country. Iraqi persisting in calls for troop with- ity leaders to sit down and work out a security forces and concerned local cit- drawal, when the surge is dem- schedule that would meet the needs of izen groups continue to grow, develop onstrating real success, both military all of our Members and convenient for capabilities, and provide more security and political. the entire body. for their country. The Government of Scaling back withdrawing when we The ACTING PRESIDENT pro tem- Iraq is committed to one day assuming are succeeding so brilliantly clearly pore. Objection is heard. fiscal and overall responsibility for equals defeat and makes absolutely no The Senator from Nevada. CLCs, which some now call the Sons of sense. The Democrats have concluded Mr. ENSIGN. Mr. President, I rise Iraq, and has begun structuring voca- that America has lost and refuse to lis- today to speak about Iraq. Following tional training programs for these ten to the judgment of our military the bombing of the Golden Mosque in CLCs who want to rejoin the civilian leaders. Samarra, our enemies tried to plunge workforce. Responding to whether gains made in Iraq into chaos, and in certain parts of The President’s strategy in Iraq has Iraq would be lost if we abruptly with- Iraq they were succeeding. Terrorists put us on a path to success. U.S. and drew our troops, Speaker of the House and extremists were pitting Iraqi Iraqi troops, working together, have NANCY PELOSI recently stated: against Iraqi, Sunni against Shia, Shia achieved significant results. Violence There haven’t been gains. The gains have against Sunni. In Baghdad, Iraqi fami- is down dramatically and political not produced the desired effect, which is the lies were being forced to leave their progress is being made. The Govern- reconciliation of Iraq. This is a failure. This homes and to resettle in areas where ment in Baghdad recently passed is a failure. other members of their religious com- debaathification legislation and a pen- Such defeatist nonsense is not the munity resided. sion law, and is sharing oil revenues way to boost the morale of our troops Iraqi police and army units were no- with the different provinces. on the ground or to show gratitude for where near capable of taking the lead Significant bottom-up political their success. I call on the Speaker to during operations. On the political progress is occurring at the local level visit Iraq, to talk to our troops, to talk

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00020 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1237 to the Iraqi people, and to see how suc- lions, that the philosophy of appease- who are fighting in Iraq and Afghani- cessful the surge is working for her ment only provides a slight respite stan today. own eyes. from the forces of evil before they un- What is General Petraeus’s conclu- Further, I find it peculiar that the leash incalculable pain and suffering sion, if we begin a precipitous with- Democrats keep calling for withdrawal on the innocent? drawal? Almost everybody has praised over and over again when initially they What happens if we adopt the troop General Petraeus. You just have to. My criticized the administration for not withdrawal legislation before us? Do gosh, the man has completely trans- sending more troops to Iraq. When they really think al-Qaida is just going formed the situation in Iraq. He has plans for the surge were announced, to leave us alone? Make no mistake, been right in his approach toward these they roundly attacked it, going so far the majority of the forces that oppose problems over there. He wrote the as to say the war was already lost. us in Iraq are affiliated with al-Qaida. Army’s manual on fighting Then when the surge began to show Do the supporters of this bill think insurgencies. great success, Democrats again criti- al-Qaida will conclude: ‘‘Well, we have As recently as February 15, General cized it and said the only purpose of won in Iraq, now let’s leave the Ameri- Petraeus stated what we all know to be the surge was to enable political rec- cans to live in peace?’’ Does anybody true if we were to begin a precipitous onciliation in Iraq. Now that both mili- really believe that? withdrawal: tary and political successes are being That is the question the American You would see a resurgence of ethno-sec- realized, the Democrats are once again people have to ask themselves. What tarian violence. You would see al Qaeda re- going to have to redefine what failure will happen if we pick an arbitrary gain its safe havens and sanctuaries. There’s looks like. time to leave Iraq based on a policy of no telling what would happen with displaced When General Petraeus first took appeasement rather than accomplish- persons. command, he said, ‘‘Hard is not hope- ments of our new counterinsurgency In other words, if we leave, the chaos less.’’ Today, there is hope and opti- strategy? that could result might make the mism in Iraq. Amazing progress has I have been to Iraq twice. The first wholesale slaughter that occurred after been made. I should not have to say time, I admit to being a little discour- the fall of Indochina look minuscule by this, but we must support our troops, aged. The second time was a year later. comparison. I wonder what fanciful leg- not just in word but in deed. The During this second visit, we actually islative fix our colleagues will offer Democrats need to stop playing games flew into Al Anbar really before it was then. with the brave men and women who are completely as open as it is today. We So what is the alternative? Do oppo- sacrificing so much for this country. walked the streets of Ramadi. We high- nents of this bill offer only empty rhet- They need to stop introducing legisla- fived with the kids who were on the oric? tion that ties strings to money for our street. The difference between my two No, we support the comprehensive troops. They need to stop introducing visits was striking. It was a complete counterinsurgency strategy devised legislation that would prematurely change and that change is because of and implemented by General Petraeus. bring our troops home and ruin all the our current military leadership. It is a strategy that is producing re- gains they have made over the last 5 Again, the question the American markable results, results that point to years. Partisan politics need to be set people have to ask themselves: What only one conclusion. In little over a aside. We need to come together as a will happen if we pick an arbitrary year, the coalition has regained the Congress, as a country, and get behind time to leave Iraq based on a policy of initiative. the effort and the mission in Iraq. Let’s appeasement rather than the accom- For example, General Petraeus stat- finish what we started, not just for plishments of our new counterinsur- ed in his December 30 briefing that today but for the future. We are all gency strategy? overall attacks have decreased by 60 Americans first. It is time we started Simply put, what happens the day percent. Civilian deaths are also down acting like that. after? by 60 percent. The ethno-sectarian I yield the floor. Will not al-Qaida use Iraq, with the component of those fatalities has de- The ACTING PRESIDENT pro tem- world’s third largest oil reserves, as a creased by 80 percent. pore. The Senator from Utah. bank to fund their worldwide activi- Those findings are supported by Mr. HATCH. Mr. President, yesterday ties? Will they not use Iraq as a base to other commanders in Iraq, including one of our colleagues came before this launch attacks against all those who MG Joseph Fil, the commanding officer body and stated for all who cared to disagree with their radical policies? of the 1st Cavalry Division and the offi- listen that he was weary, weary of this What are the answers offered to these cer who until December was respon- war. questions by the proponents of this leg- sible for our operations in Baghdad. He I, too, am weary, but weariness does islation? From what I can discern from stated in an interview late last year not lead me to embrace the policy of the Members who have taken to the with the New York Times that coali- surrender or succumb to the nihilistic floor to defend it, the answer is simple: tion forces have dramatically reduced, business that is defeatism. nothing. They simply do not have a if not eliminated, al-Qaida’s presence History is replete with examples of plan for the day after. in every neighborhood in Baghdad. The leaders who fell victim to the tempta- What of the nearly 4,000 servicemem- general also pointed out that murders tion of defeatism. Shall the Senate bers who volunteered to fight for their in Baghdad are down 80 percent. similarly repeat this folly? country and who have now paid the ul- In addition, during a recent briefing, No, sir. timate sacrifice? Does their memorial LTG Raymond T. Odierno, who just re- In this country, commitment and in history read: Thank you for your turned from Iraq and has been nomi- dedication to noble pursuits have de- service, but some Members of Congress nated to become the Army’s new Vice fined our great Nation. We must not grew weary, and therefore your sac- Chief of Staff, stated that terrorist op- give way to weariness now. rifice and the sacrifices of your family erations in Baghdad have decreased by The Senate is where great ideas and were in vain. 59 percent. In the past year, suicide at- thoughts are to be put forth and con- I know what those sacrifices are like. tacks in Baghdad have been reduced 66 sidered, ideas and thoughts that are de- Our family lost my only living brother percent, from 12 to 4 a month. The signed to lead to a better life for the in World War II on the Ploesti oil raid. number of improvised explosive device American people and secure a safer That was the raid that attempted to attacks in Baghdad has also declined world where the inalienable rights of knock out Hitler’s oil reserves and it by 45 percent. all are respected. was one of the most important oper- Baghdad is not the only area where But I, too, am weary, weary of the ations of World War II. we have seen success. During my trip policies of appeasement that have be- My brother’s loss was hard on our to Iraq last year, I was able to witness come the guiding principles of some in family. But we were proud of my broth- the dramatic changes that have oc- the majority party. Have they learned er. We were proud that he was willing curred in Al Anbar, where al-Qaida has nothing? Has history not taught us, to sacrifice his life for us, just as we been thrown out of vast areas of that through the pain and suffering of mil- are proud of our young men and women province, including its major cities,

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00021 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1238 CONGRESSIONAL RECORD — SENATE February 27, 2008 Ramadi and Fallujah, areas that were throughout Iraq, with over 50 of them As a prep school student, he dem- once deemed refuges for al-Qaida’s vile in Baghdad alone. However, under this onstrated that he was a real entre- perversion of a dignified and peaceful legislation, our forces will no longer be preneur, typing his classmates’ papers religion. able to conduct operations from joint for $1 at a crack. And consistent with The success of Baghdad and Al Anbar security stations. In fact, they would the writer America got to know over is also being repeated throughout Iraq. be banished to bases isolated from the the years, he would charge an extra 25 In the north, Operation Iron Harvest Iraqi people and unable to accompany cents to correct their grammar. has been launched. Iraqi forces on missions. Under this After graduating, he spent time at This operation has already achieved bill, the few remaining forces would the University of Mexico, studying some important successes. For exam- only be able to conduct limited oper- Spanish, and he served his country in ple, during the month of December, the ations against al-Qaida. The security the Army, making second lieutenant. coalition and Iraqi security forces have provided to the Iraqi people, which is Only after serving in the Army did he killed or captured over 20 al-Qaida the foundation of our recent success, go on to college, something widespread emirs in the north. This included the would be entirely lost. in those days—when a hot war was fol- capture of Haider al-Afri, who was the So let’s review the policy advocated lowed by a long, cold war—and largely main security emir in Mosul and was by this bill. No. 1, it guarantees defeat. unknown today with the exception of responsible for organizing the flow of No. 2, it provides al-Qaida with another those in ROTC and benefitting from foreign fighters into the Mosul area. base of operations, and, unlike Afghan- the GI bill. His replacement did not fare much bet- istan, Iraq’s oil wealth will provide As a student at Yale, he distin- ter; he was captured on February 18. substantial financial resources to pur- guished himself. In addition to his The number of attacks in Diyala has chase whatever the terrorists choose. studies in political science, economics, also decreased. No doubt that the re- In the past, it has been publicly re- and history, he cut his teeth as a decent killing of the al-Qaida emir of ported that al-Qaida has actively bater and was elected chairman of the Diyala helped this trend. sought the acquisition of weapons of Yale Daily News. In addition, in the past two weeks, mass destruction. Following college, a year in the CIA, the coalition killed Abu Karrar, who Neville Chamberlain would be proud. and the publication of his book ‘‘God was a senior al-Qaida intelligence oper- So yes, I, like others, am weary, but and Man at Yale,’’ he began a career as ative and an individual who has the in- I am weary of appeasement. I am weary a writer. famous distinction of organizing mur- of such defeatist legislation being de- In 1955, his public life began as he ders to be carried out by female suicide bated on the floor of the Senate. This founded the National Review. The Na- bombers. is a Chamber for great ideas and con- tional Review never had a massive cir- Which leads me to the inevitable cepts that will ensure the betterment culation. It continues to be subsidized question: What do you think these sen- of the American public and lead to the by the contributions of its readers. But ior al-Qaida leaders would be doing freedom of oppressed people all over its significance was titanic. Simply with their time if we left Iraq? I won- the world. This legislation falls far put, there was no conservative move- der if they ever will grow weary as short of that August standard. ment before William F. Buckley, Jr., some in this body have? Just think about it, here we have and the magazine he founded and cul- How are all these successes possible? this country, Iraq, with three different tivated. The answer is our generals over there, factions who are working together, For decades, the progressive left had led by General Petraeus. His strategy who are making headway, who have been triumphant. Herbert Croly, The is based upon the classic counterinsur- enormous oil wealth that could be used New Republic, Woodrow Wilson, and gency tactic of providing security to for their people, who are tired of al- Franklin Roosevelt—there was no real the local population, thereby enabling Qaida, who have been throwing them answer to the arguments they made on the Government to provide services to out of the various provinces, who are behalf of higher taxes, a comprehensive its people, which in turn creates in the cooperating with the United States of state, and a highly regulated economy. population a vested interest in the suc- America, and who are starting to co- For sure, there was a Republican cess of Government institutions. operate with each other, who sit be- Party, and Republicans continued to One of the ways this is accomplished tween two of the most roguish nations have electoral success. But there was is through the use of joint security sta- in the world, Iran and Syria. All of this no real consistent conservative point of tions. Under this tactic, a portion of a success happening, and we have people view. The battlefield of ideas had been city such as a neighborhood is who want to pull us out prematurely. I abandoned to the progressive left. cordoned off, then searched for insur- don’t understand it personally. Bill Buckley, foot by foot, began re- gents. Previously, once this was ac- I respect the sincerity of the sponsors taking some of that ground, and estab- complished, our forces would return to and of those who will vote for this. I lishing a framework of conservative large forward-operating bases, usually think that if we are going to be weary, ideas—themes of limited government, on the periphery of the city. The result let’s be weary of the way to handle the protection of human liberty, eco- was easy to predict. The insurgents things. nomic entrepreneurship, and military would return once the sweep had con- WILLIAM F. BUCKLEY, JR. strength in the face of a totalitarian cluded. Mr. HATCH. Mr. President, I rise to threat bent on world domination. Under General Petraeus’s strategy, reflect on the passing of William F. The development of these ideas was our forces remain in the neighborhoods Buckley, Jr. I am aware of my limita- not always pretty. But through fits and and build joint security stations. These tions in speaking about Bill Buckley. starts a movement grew. We first heard joint security stations then become Anything I might add to the eloquent its voice in the 1964 Presidential elec- home to a company-sized unit of Amer- words that have already come from his tion, an election in which Republicans ican servicemembers as well as Iraqi friends at the National Review and were trounced. But by 1980, these con- Army and police units. These facilities from his friend, and my friend, the Sen- servative ideas had become a majority, not only help secure the surrounding ator from Connecticut, JOE LIEBERMAN, one that helped to put Ronald Reagan areas but simultaneously enable our will seem small by comparison. in the White House. forces to train and evaluate Iraqi Still, as someone who knew Bill, as Bill was no doubt combative, but I forces. Much like the local police offi- someone who admired Bill, and as think most would say he was always cer in a major urban area, our forces someone who learned a great deal from having fun. He was a real intellectual, use the joint security stations to learn Bill, I would be remiss if I did not say but he was no dour academic. He loved about the locale to which they are as- a few words about this extraordinary to sail. He used to make his way signed and can quickly adapt to meet man and his extraordinary life. around New York City on a motor- the unique security needs of the indi- The life of William F. Buckley, Jr., cycle. When he made his long-shot run vidual community. reads like something from one of his for mayor of New York City and was The success of these joint security many fiction novels. Growing up in asked what he would do if he won, he stations can be seen in their creation Mexico, his first language was Spanish. responded, ‘‘Demand a recount.’’

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00022 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1239 He took up the harpsichord at the rently happening on the floor of the most important thing is the loss of life age of 50. He became a novelist. His tel- Senate and what I am hopeful will hap- and what is happening to our troops evision show ‘‘Firing Line’’ ran from pen. and their families. 1966 to 1999. I enjoyed being on ‘‘Firing Our leader, Senator REID, has one As I said, I am extremely proud of Line’’ with him, basking in his wisdom, more time brought us—and rightly so— the fact that we made a very top pri- answering his questions, and on occa- to a point to debate and try to move ority for us in the new majority com- sion irritating him to death. But I forward on changing course in the war ing in the full funding of veterans loved the man. in Iraq. There have been 5 years of war, health care. We have done that. We Bill was a man who loved the written with the largest expenditure now of the have tackled the problems we have word, and it was fitting that he passed Federal Government in terms of seen with Walter Reed and the inabil- away at his desk and at his home. His monthly expenditures, and certainly in ity for our troops, as they move be- son Christopher, also an accomplished terms of loss of life. It goes on every tween systems, to get the effective care writer, noted, ‘‘he might have been day, day after day. All you have to do they need by passing the Wounded War- working on a column.’’ And I have no is look at the newspaper and see that riors legislation. doubt we would have benefitted from families continue to pay a huge price We have continued to bring forward it, Democrats and Republicans alike. for this war. other efforts to be able to address what As the authors of The Federalist Pa- I stood on the floor of this Senate 5 I consider to be the abuse of our troops pers, Abraham Lincoln, Franklin Roo- years ago and was one of 23 Members by continual redeployment without sevelt, and Ronald Reagan understood, who voted ‘‘no’’ on going into this war. enough dwell time, rest time, for them America remains an experiment. It is But I have spent every other moment, to be here at home, as the Army Man- an experiment in republican self-gov- every other vote, doing everything I ual would require. ernment. And that experiment is con- can to support our troops, to make sure But we also have another very impor- stantly being tested. I do everything I can to make sure we tant piece of this which goes to what is Bill lived through extraordinary and honor them through our efforts to happening when we have almost $15 bil- challenging times, times like our own equip them and make sure they have lion a month that is being diverted that tested that experiment, and I have the resources, and that when they from our economy, which from Michi- no doubt he was very important in come home and put on the veteran’s gan surely looks like a recession. I can- helping us through them. cap that we are, in fact, providing the not speak to every other part of the With wit and aplomb, he pushed the health care and the resources they country, but from our economy and our envelope. He argued and fought. He need. I am proud to be part of a caucus, families and our communities, it is made us a better country. He was a a new majority that has placed vet- being spent on a war that a majority of great American who led a great Amer- erans health insurance, health care as Americans—not a majority of Demo- ican life, and America will miss him. a top priority to make that happen. crats—a majority of Americans— But I often think back to the discus- I have to say I knew Bill Buckley. I Democrats, Republicans, and Independ- sions before my vote, and discussions appreciated Bill Buckley. He had an ents—people of all persuasions in all with my husband, who is a 14-year vet- enormous influence on me. As a former States are saying: We no longer want eran of the Air Force and the Air Na- liberal Democrat, he helped me to see to go in this direction. We want to tional Guard, and him reminding me the merit in intelligent conservative change this mission. We want to bring that the best way to support American approaches. troops, the best way to support our our people home. He appealed to so many of us, includ- But we are now getting ready to do a troops is to give them the right mis- ing some of my liberal colleagues, who budget. The distinguished Acting sion. The second thing is to make sure loved to debate him and loved to chat President pro tempore today is on the they have the resources they need. The with him, because he was at bottom a Budget Committee. He has served with third thing is to make sure there is a decent, honorable, funny, person who distinction in the House and now in the clear exit strategy for that mission. was open to basically everybody. I did not support that mission and Senate. Mr. President, you know as No doubt the absence of Bill will be believe there was not the evidence that well as I do that we are now grappling even more painful to the family he has was needed to carry on that mission. I with very tough decisions about how to left behind. But consistent with the have supported those resources, how- address the needs here in America. Catholic faith, one kept deeply by Bill, ever, that they need. I think that on top of the issues of I hope this is also a moment of happi- Now it is important, it is critical, national policy and how to keep us ness for them as they know that Bill is that we as a body, as a Congress, come safe, and the loss of life, and how to now in Heaven with the love of his life, together to support the exit strategy, support our troops, we have to grapple Patricia. the effort to change the mission that with the fact that last year, for in- I offer my condolences to the Buck- needs to occur in Iraq, to be able to stance, when we passed, with over- ley family. All of you and Bill are in bring our people home, to be able to whelming bipartisan support in the my prayers. His brother, James Buck- stop the multiple deployments, re- Senate, an effort to extend health care, ley is in my thoughts in particular. It deployments that are going on, and health insurance to 10 million children was my honor to serve with Bill’s that we refocus on those areas of the of working families, the President ve- brother in a variety of capacities. His world and those groups such as al- toed it, saying it was too much money. brother is a true gentleman, a wonder- Qaida that truly are a threat to us. Yet it was about half of the cost of 1 ful human being. Although he was only That means Afghanistan, that means month of what we are spending in Iraq here for one term, he was a great Sen- other kinds of strategies to be able to today. ator. The examples of both Bill and truly keep us safe. That is what we Investing in children, healthy chil- Jim Buckley show how this unique need to do. dren in our country, of working fami- American family has contributed so The most important thing is to keep lies who unfortunately are working in much to our public life. us safe as a country, to be smart about jobs where they do not have health in- I can assure you that the Congress, our strategy. That is what we are de- surance and do not have enough of a including members who differed with bating, here: whether we are going to wage to be able to afford the $1,000 a Bill Buckley, will miss his humor and be smart about our strategy to keep us month premium or more that they will miss him personally. I know one safe, whether we are going to pay at- would have to pay—do we focus on sup- thing: This Senator from Utah will tention to the daily loss of life in Iraq, porting those families and change this miss him deeply. and whether we are going to pay atten- direction or do we continue down this Mr. President, I thank my colleague tion to the almost $15 billion a month road of saying no to our children? from Michigan and yield the floor. that is being spent on that war, which We have the opportunity to create The ACTING PRESIDENT pro tem- is now a civil war, that is not being in- new jobs in the energy economy. In pore. The Senator from Michigan. vested back home in America. Michigan, we are moving full speed Ms. STABENOW. Mr. President, I That is what I want to speak about ahead on alternative energy, and not rise today to speak about what is cur- for a moment, understanding that the only in our vehicles. But windmills and

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00023 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1240 CONGRESSIONAL RECORD — SENATE February 27, 2008 solar and biofuels and all of these portant, it is good, it is the right thing I would like to ask the President: things take partnerships and invest- to do, but it certainly is something How about just 1 month for America? ments. within the realm of reasonableness. How about just 1 month? We will take We have an energy tax provision—a Yet I know it is going to be difficult to 1 month of $15 billion invested to help measure for which we came one vote be able to get this passed. The cost of us with jobs, keeping American jobs short of being able to override one of it, again, is about 2 weeks in Iraq, to be here, opportunity through education the multitude of filibusters that has able to focus on one of the most dev- and innovation, helping our own fami- gone on on this floor: a historic level of astating crises going on in America lies with health care, and people being filibusters stopping us at every turn— today. able to keep their homes. How about we came one vote short. We are talking Most middle-class families save just 1 month for America? about having some resources to be able through equity in their home. That is This debate we are having on the to put into tax incentives to be able to how most people are able to get into floor about Iraq is incredibly impor- produce alternative energies and the the middle class. We are talking about tant on so many different levels, and infrastructures so the biofuels can ac- people who have worked hard, played that is why I appreciate Senator REID tually get to the pump so you not only by the rules, done all the right things, bringing us to this point. There are can buy a E–85 car but get E–85 at the got a job, saved up the downpayment, other pieces of this that we are com- pump. It takes some investments to be were able to get a home, and then find mitted to addressing such as a modern able to do that. themselves in a situation where they GI bill. My father went to school on We have been told no on being able to are looking around saying: Wait a the GI bill after World War II. We put dollars into that area. Yet the minute. What is going on here? What ought to be doing the same thing for amount of money we are talking about about me? What is happening in our our returning veterans. It will cost is less than 2 months of spending in economy? I need some help. We are try- some dollars. Are we going to hear ing to do that. I hope we are going to Iraq. once again: Well, we can’t afford it. We be able to come together and do that. Infrastructure, roads and bridges. We can’t afford to invest in our veterans. I But if we hear one more time: No, we saw last year what happened in Min- hope not. nesota in terms of a huge bridge col- can’t do that, we can’t afford it—we The reality is there is a great connec- are talking about less than 2 weeks of lapse and what happened with human tion between what is happening now in life and what happened to the commu- what is being spent in Iraq. How many times have we heard all terms of filibustering our effort to nity involved. We have roads and the comments about Leave No Child move forward, to change direction in bridges across our country, water and Behind, about the fact that we are not Iraq—one more time, one more fili- sewer systems that are aging, that keeping our promises as it relates to buster—and what we want to do next, need a facelift, and we need to be able education. We passed new high stand- which is focus on the incredibly serious to get some additional dollars so we ards. We all support the high stand- housing crisis in America. There is a can bring ourselves into the modern ards. What we promised was that with connection because we are saying that age for much of our infrastructure. Yet that would come resources to help chil- not only are we not doing the smartest we are told again: No, there are no re- dren, help schools succeed. We have thing to keep us safe from a strategic, sources to put money into our infra- seen dramatic underfunding. Again, in from a national security standpoint, structure. However, we are rebuilding this President’s budget, he eliminates we are also using dollars—precious dol- roads in Iraq, we are rebuilding schools 48 different education programs, in- lars, taxpayer dollars—in a way that is in Iraq. cluding efforts that focus on vocational actually making us less safe at home In fact, one of the original items I education and other things that are by undercutting our ability to have a will never forget was to put wireless important for the future—48 different strong economy, strong families, to technology into schools. That was in programs. We will be told that if we try support those who are in the middle the budget, but it wasn’t the American to invest in education, that it is too class, who are trying to work hard to budget, it was the Iraqi reconstruction much. It is too much. We can’t afford get into the middle class, struggling to budget. I have been working for years to keep the promise of Leave No Child stay in the middle class. The majority to get technologies in our schools, new Behind. of Americans find themselves in great technology, because every single stu- We passed, on a bipartisan basis, jeopardy right now on a number of dent is going to face, at a minimum, something called the America Com- fronts. This is the time they look to working with a computer, whether you petes Act. I wish to congratulate my their Government to play a role to help work at a gas station or whether you colleagues. This was a great bipartisan create opportunity, to be able to make work at a high-tech company. Yet we effort. I know the Senator from Ten- strategic investments here at home can’t do that in America. We have been nessee, Mr. ALEXANDER, was a real that will make sure we can continue to told by this administration and by champion of that. It focuses on math have the American way of life of which those who had been in the majority for and science and technology and invest- we are so proud. 6 years: No. But at the same time, it ments in the future. I wish we had seen So this matters. This matters. I am was in the budget for Iraq. those investments fully authorized, looking forward to the time when we We now find ourselves in a situation fully funded in the President’s budget— are going to change that direction in with a tremendous housing crisis. In health research to save lives, science Iraq, and I hope it comes soon. I hope my State of Michigan, it has frankly research, the National Science Founda- we are able to say to our men and masked a larger economic crisis, where tion, those things that will make us women who are on their third or fourth people have been losing their jobs, they competitive for the future. Every other redeployment now: Job well done. are losing their incomes, seeing all country is racing to invest in science. Thank you for your service. You can their costs go up, but they have had We see China is racing, along with come home now. Hopefully, they will that equity in their home that was Japan and South Korea and other come home to a veterans system that keeping them going. All of a sudden, countries around the world, to get to works for them, that they will come all of the values go down, and we are that next technology, whether it is ad- home to a GI bill of rights that creates seeing a collapse in the housing market vanced battery technology research, a way for them to have opportunity, which has rippled out way beyond whether it is biotechnology, whether it that they will come home to an econ- housing now into our capital markets, is new cures in health care. Yet we, the omy that works for them and their into our entire economy. Yet when we greatest country in the world, are see- families. That is our goal. We are going come to the floor—and we are going to ing those things cut, but $15 billion a to keep focusing on this issue until we be asking shortly, after we vote to end month is being spent in Iraq which is, create that change. this filibuster that is going on, on the by the way, not paid for and goes right I yield the floor, and I note the ab- change in the Iraq mission—we are on to the deficit for our children to pay sence of a quorum. going to be asking to come together for in the future. These priorities don’t The PRESIDING OFFICER (Mrs. around a housing proposal that, frank- make sense. They make no sense when MCCASKILL). The clerk will call the ly, I think is pretty modest. It is im- we look to the future. roll.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00024 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1241 The assistant legislative clerk pro- civil rights. We do not want to have very strong bipartisan vote—agreed to ceeded to call the roll. the Government eavesdropping on us, extend the law for another 6 years and Mr. KYL. Madam President, I ask and that is appropriate for us to en- add the retroactive liability protec- unanimous consent that the order for sure. tion, precisely what is needed. the quorum call be rescinded. The problem is, because technology However, when the bill was sent over The PRESIDING OFFICER. Without has outpaced the law back when it was to the House of Representatives, the objection, it is so ordered. written in the 1970s and technology House Democratic leadership said: No, FOREIGN INTELLIGENCE SURVEILLANCE ACT now enables us to do electronic inter- we are not going to take this up and Mr. KYL. Madam President, yester- cepts against foreign targets through promptly went on the recess that we day, I inserted into the RECORD a cou- some very sophisticated and new just got back from, a 12-day period in ple of items. I wish to speak to them means, the law that set up the process which Congress was not in session. briefly now. for getting approval to do that takes During that period of time, the law The primary item was a letter that far too long, it is far too complicated lapsed and General Mukasey and Admi- had been sent to the chairman of the and, in fact, the bottom line is it just ral McConnell in this letter made it House Intelligence Committee by At- plain does not work. It is ‘‘paperwork clear that during that period of time, torney General Mukasey and Admiral in an electronic era’’ kind of compari- we lost intelligence that could be very McConnell, the Director of National In- son. meaningful to us. We don’t know telligence. It was a letter that tried to So the President came to the Con- whether it is or not because we lost it. explain the problems we are having in gress and said: You have to get a new We could not collect it. But the kind of gathering intelligence on terrorists as way of doing this activity that enables intelligence that we have been col- a result of the lapse of the Foreign In- us to utilize this new technology we lecting under this program has been telligence Surveillance Act provisions, have to intercept these communica- very helpful for us to know what these the so-called Protect America Act. tions. And last August, we passed the terrorists are up to so that we can pre- What we are debating right now is a Foreign Intelligence Surveillance Act, vent attacks. resolution that focuses on when and the FISA law—it has another acronym, We are now in a situation where we how we should leave Iraq. Presumably, Protect America Act—which enables us are not able to commence certain in- the next resolution we will be debating to utilize this new technology and also, telligence gathering. In addition, and focuses on developing a strategy to importantly, to provide that the tele- perhaps more important in the long fight al-Qaida. Most of us appreciate communications companies that work run, we have not done anything to the fact that the best way to deal with with us do not have to worry about solve the problem of these lawsuits, the terrorists, the very first thing we somebody suing them because they are retroactive liability, with the result should do is to have in place a good in- helping the U.S. Government collect that, as they write in this letter, the telligence-gathering capability, pri- intelligence. telecommunications companies are be- marily in understanding the commu- The law we passed had two problems. coming increasingly concerned about nications that terrorists are having No. 1, it expired after 6 months because their ability to continue to help us. with one another abroad. some in the Congress felt they wanted They are all responsible to their share- The reason that is the No. 1 part of a to take another look at it; and, sec- holders, and their shareholders do not strategy in dealing with terrorists is ondly, it did not have liability protec- like to see their company is getting that unlike a war in which we are tion for these telecommunications sued. It reduces the value of the com- fighting an enemy with uniforms rep- companies for the previous work they pany. It creates problems and costs. resenting another country, these ter- had done for us. It was only for the When they try to do business with rorists are shadowy characters who work going forward. The telecommuni- other companies, the other companies live anywhere in the world, who travel cations companies essentially said to say: Wait a minute, are you involved in all around, who get together in cells the U.S. Government: We are not going these lawsuits? If so, we don’t want to every now and then and plan some kind to continue to do this work for you un- enter into a new contract with you. of activity which is designed to ter- less you can ensure we are not going to They work with companies all over rorize, whether in London or Spain or get sued and that the lawsuits that are the world. A lot of these companies are Malaysia or the United States or wher- currently pending go away. concerned that American tele- ever. I am oversimplifying. The lawsuit communications companies are going In order to fight the terrorists, we said: You shouldn’t have done what you to have this kind of exposure, and they first want to understand what they are did because the U.S. Government don’t want to get involved in it. up to and then prevent it from occur- shouldn’t have been engaged in this It can hurt business substantially, as ring. kind of surveillance. a result of which some of these compa- If we are having to react to a ter- That is not the fault of the tele- nies have conveyed to our intelligence rorist attack after it has occurred, we communications companies. They were community their distress, anxiety, and are in a very bad situation. simply doing what the Government concern about continuing to partici- We created the Department of Home- asked them to do. They were a volun- pate in this program. land Security, and we have a lot of dif- teer to provide their services, their Fortunately, through negotiations, ferent plans and procedures for dealing very essential services, to help us col- according to this letter, companies are with an attack after it has occurred. lect this intelligence. As with any still working with us. They are still But in many respects, then it is too other volunteer, you should not get participating, but without them we late. sued just because you stopped to help have no program. This is not some- So in this war against these radical somebody along the side of the road thing the U.S. Government can do on Islamists, these terrorists who would who got hurt in an accident. The same its own. This is something that only kill anywhere they can and target in- thing is here. The Government asked works if all of the companies that pro- nocent people, the very first thing we them to volunteer their services to vide our telecommunications services want to do is to be able to have good help collect this intelligence, and they are working with us. intelligence on that activity. should not be sued. But lawyers being So we have to act pretty soon or we We collect intelligence in a variety of what they are filed some lawsuits, and could well be in a situation where the ways, but in modern times, one of the those lawsuits need to go away. very companies that are critical to the best ways to collect intelligence is by The President said: When you revise operational success of this program de- intercepting communications. There the law and pass it in February of 2008, cide that discretion is the better part are a variety of means by which that is make sure you have liability protec- of valor on their part and they are just done. One of the things the Congress tion not only going forward but also not going to be able to continue to help did was to develop a law that provides for the suits that have already been us. At that point, we have lost one of protection to American citizens and filed. Sure enough, the Intelligence the most important intelligence-gath- others to ensure that this intelligence Committee in the Senate, by a bipar- ering operations in this war against collection does not impinge on our tisan vote of 13 to 2 or 12 to 2—but a terrorists.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00025 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1242 CONGRESSIONAL RECORD — SENATE February 27, 2008 I want to go back to the days fol- fort in the war is to have good intel- less those lawsuits go away, it is quite lowing September 11, 2001. There was a ligence. In this case, the best offense is possible that one by one the companies lot of finger-pointing. A commission not going to war in some foreign coun- that are assisting us are going to con- was established to try to figure out try, not bombing somebody, but find- clude that it is not in their financial what went wrong. There were a lot of ing out what these bad actors are up to best interests to do so and that, as areas identified where we should have and preventing them from putting much as they would like to, they are known better, and had we done things their plans into effect. simply not in a position to continue to differently, at least potentially 9/11 Partially because it has been quite a be able to do so. That would be disas- could have been prevented. long time since 9/11, and partially be- trous for our intelligence gathering. We found that the FBI and CIA were cause it is not possible to talk about So, as I said, the fix is the legislation not talking to each other, and the Jus- some of these events because they are that passed the Senate. It is a good tice Department had constructed a sort highly classified, the American public bill. It reauthorizes this program for 6 of wall between the two, even within probably is not as aware as it should be more years and adds the one important the FBI itself which prevented one of the kind of activities that go on additional element, and that is the pro- hand from communicating to the other every day. What happens every day is tection from liability. very important information. In fact, that there are all over the world thou- It also adds some additional civil lib- there is information relating to a cou- sands of would-be terrorists meeting, erties protections, by the way, for ple of terrorists that, had they been planning, communicating, training, Americans abroad. One of our col- able to talk to each other, might well and, in some cases, carrying out their leagues, Senator WYDEN, had inserted have resulted in these terrorists being intentions engaging in terrorist activ- the provision that adds an extra layer picked up in the United States, people ity. And because we have had good in- of protection for an American who might happen to be abroad and find who were directly involved in the 9/11 telligence collection, much of which is himself or herself a target of some of attack and, at least theoretically, done through this electronic intercep- this interception because of a call could have been prevented had they tion of communications, we have been made to the individual or that indi- been able to communicate with each able to stop specific terrorist attacks. vidual making a call to somebody else other. Some of these are chronicled by the who is under surveillance and so on. It The bottom line is, retroactive, after communications from the Attorney is a rather rare occurrence, but we 9/11, we could have been doing more but General and the Director of National have provided protections so that a did not. That report was very critical Intelligence. Some are laid out in re- warrant would have to be obtained in of the Congress, of the administration, ports from the CIA and other unclassi- that circumstance, and Americans’ of the intelligence community, of the fied reports—just to mention one: an civil liberties would be protected. FBI, CIA, and others for not doing ev- effort to blow up elements of the Los Angeles Airport, LAX. There are oth- So no one should be under the as- erything that could have been done to sumption here that somehow or other ers. I have kind of forgotten which ones prevent 9/11. reauthorizing this law lets the Govern- are classified and which aren’t, so I am If there were to be, God forbid, an- ment loose to begin spying on people. not going to describe any more. But other terrorist attack on the United Believe me, there is so much informa- the reality is, it is going on all the States and the commission that is in- tion out there which we don’t even time, and only by good intelligence can evitably going to study what happened have the time or the ability to check we find out in advance and then either would look at the days prior to that out that we are not going to go out of infiltrate the cell, work with our coun- event in the Congress, what they would our way to spy on people on whom we terparts in another country to round find is a House of Representatives that have no reason to spy. This is simply a up the bad guys, or perhaps, if the is sitting on its hands, that is unwill- matter of trying to identify those in- ing to take up the Senate-passed bill. plans haven’t gotten to the execution stances in which known terrorists, or That bill passed with 68 Senators vot- stage, use our knowledge to gain addi- people who affiliate with these terror- ing yes, obviously Democrats and Re- tional information to track other ter- ists abroad, are communicating with publicans voting yes, a very strong bi- rorists. In any event, at some point, each other. partisan bill. The President says he when it looks as if the plan may be By the way, importantly, if that will sign it. He said we need it. The in- about to be executed, either we or our communication comes into the United telligence community says we need it. allies have to come in and arrest the States, we want to know whom they Now it has been 2 weeks, and we individuals so that the attack doesn’t are communicating with here because don’t have a law that enables us to en- occur. But we can’t do that if we don’t that could be the late stages of an op- gage in this intelligence collection. know what they are up to. eration. That could be an indication What happens if before we get that It is unfortunate that a lot of the in- that there is an element embedded in law there is an attack or even an at- formation about how we collect intel- the United States—a terrorist cell, per- tack after that based upon communica- ligence has gotten out, but it is fortu- haps, that is ready or at least is in the tions of terrorists that we could have nate that we have companies in the process of planning to engage in some intercepted but didn’t because we United States that are willing to co- kind of attack. didn’t have the means to do it? operate with their Government because So these are the kinds of things we There is going to be a lot of finger- they are in a position to help the Gov- need to know about and which have pointing, and rightfully so. The Senate ernment intercept these communica- protected the American public since said we are going to do our part, we are tions. It just happens to be because of 2001. It is no accident that America has going to pass this law so there are no the way the modern telecommuni- not had an attack on our soil since gaps in our intelligence collection. cations technology now works. 2001. It is also no accident that, frank- The House of Representatives con- We should be doing everything we ly, the number of attacks in other tinues to sit on its hands. What will it can to protect these volunteers, in ef- places around the world is far less than take to get the House leadership to fect. They have relied, in good faith, on would have been the case had we and take up the Senate-passed bill and send the representations of the Government these other countries not had in place it to the President for his signature? I that the President had the authority to good intelligence-gathering operations hope it doesn’t take another terrorist engage in these operations and re- and good cooperation, I might add, event. quested their services. This is not my among our intelligence services once This debate we are having about our conclusion, this is the conclusion of we find out something that needs to be policy in defeating al-Qaida and how the Senate Intelligence Committee in acted upon. Iraq fits into that is part of an overall its report on the legislation we passed. So as we debate these resolutions debate about our approach to the war It pointed out that it had examined the that focus on getting at al-Qaida—our against militant Islam, the terrorists record and found these communica- colleagues on the other side of the aisle who strike innocent people. As I said in tions companies had, in fact, acted in are insistent that we should be focus- the beginning, the most important good faith. So there is no reason for ing our efforts not on extraneous as- thing that we can do in starting our ef- them to be subjected to lawsuits. Un- pects of this war against terrorists but

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00026 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1243 on al-Qaida—I simply say to all of you ing it, and helping the American people the kind of start the American people that focusing on al-Qaida means first got us off to a good start. We did the would have agreed with. and foremost getting good intelligence same thing on the FISA legislation So I believe most Americans under- on what they are up to. In today’s mod- Senator KYL, the Senator from Ari- stand that the failure to deal with the ern world, that cannot be done without zona, just described. He was a major Foreign Intelligence Surveillance Act a reauthorization of this law that enforce in that. That was a principled de- legislation means this: It means fewer ables us to collect this telecommuni- bate as well. surveillances. It means fewer compa- cations intelligence. That is not going Samuel Huntington, the distin- nies and individuals willing to cooper- to happen unless the bill passes and is guished Harvard professor who is the ate with our Government in over- sent to the President. Every day that former president of the American Po- hearing conversations between those goes by that the House leadership sits litical Science Association, says that who would destroy us when they call in on the legislation we here in the Sen- most of our conflicts in our democracy to our country to talk about it. And it ate passed and doesn’t send that to the are conflicts between or among prin- means we are less safe as a result of President is another day of vulnerabil- ciples, with which most of us agree— that. ity. It is a day in which we will never for example, liberty and security. Each My hope would be that we can deal get back the intelligence we might American has a right to liberty, each with this Intelligence bill quickly and have collected. American values security, and we de- promptly. The House of Representa- This is not something where we can bated that here for nearly 6 months, tives is certainly capable of that. There catch up. It is not something where it from August through today: If we are are good men and women there. We rec- is not doing us any harm. As General going to intercept communications ognized that when we basically adopted Mukasey and Admiral McConnell from terrorists overseas calling into the House’s economic stimulus pack- pointed out, it is lost information for- this country, under what conditions age, with minor adjustments. Some ever. That telephone call we might may we do that and still respect our Senators said: Well, the Senate ought have communicated is not going to traditions of liberty? Security versus to have a lot to say about that. Well, happen again. Now, maybe a subse- liberty. Differences of opinion. we—most of us in the Senate—are rare- quent call will, but we will never have The Judiciary Committee got in the ly guilty of an unexpressed thought, the benefit of the communication that middle of it. The Intelligence Com- that is true, but it is not a bad idea for occurred yesterday or the day before or mittee was in the middle of it. In the us also to recognize wisdom and good later on today because we don’t have end, the members of the Intelligence ideas when they come from the other the ability to engage in that collection. Committee produced a piece of legisla- part of the Capitol. We saw in the eco- I can’t think of anything more im- tion by a vote of 13 to 2, a bipartisan nomic stimulus package some wise de- portant to our national security than piece of work they believed respected cision making and, for the most part, getting this legislation adopted. It is liberty and security—and after a good adopted it, with some amendments. My hope would be that the House of one of the reasons we agreed with the debate here on the floor of the Senate, Representatives would do the same majority leader’s cloture petition to nearly 70 Senators agreed. That is with the Senate’s 68-vote decision on debate this question of how we should about as well as you can do in the Sen- the Intelligence bill. My understanding be focusing our effort on al-Qaida, be- ate when you have a major difference is that there is a majority of Demo- cause we wanted to ensure that the of opinion. And off that went to the crats and Republicans in the House of American people understood what is at House of Representatives. Representatives today who agree with stake here and understood what is at Well, if what happened here was an the Senate bill and who would vote for example of what Americans like to see risk by the House of Representatives it if it were brought up. If they will do from their legislators, what happened not taking up and passing the Senate that, that would be very helpful. legislation on intelligence collections in the House of Representatives is not I see the Senator from Oklahoma is abroad. what Americans like to see. here. Would he like to make some re- What I think most Americans want Madam President, I hope the House marks between now and 4 o’clock? leadership will take this up quickly, to see in Washington is not that we al- Mr. INHOFE. Yes, I would. will get the bill to the President so ways agree. I mean, this is a debating Mr. ALEXANDER. I would like to that he can sign it into law and Ameri- society. It is the Senate. The issues are take 4 or 5 minutes to say a word about cans will once again be protected by here because we don’t agree, in many William Buckley and then turn the the most advanced techniques and cases. So we have these debates on lib- floor over to the Senator. technologies we have. erty versus security, for example, and Mr. INHOFE. Would the Senator I see my colleague from Tennessee is then we resolve them. We show that in yield? I would like to know what the here, our distinguished conference the end we resolve them. That is what regular order is here. chairman, and I will relinquish the people like. The PRESIDING OFFICER. There is floor so that he may speak. I thank the Then it goes over to the House of no order. Chair. Representatives. And let me put it in Mr. ALEXANDER. I ask unanimous The PRESIDING OFFICER. The Sen- the words of some Tennessee folks last consent that following my remarks, ator from Tennessee. week. I was in Tennessee last week the Senator from Oklahoma be recog- Mr. ALEXANDER. Madam President, when the Senate was out of session, nized for 15 minutes. I thank the Senator from Arizona, and and the most frequently asked ques- The PRESIDING OFFICER. Without I appreciate his remarks. I agree with tion, the most frequently made com- objection, it is so ordered. his sentiments. ment went something like this—and I TRIBUTE TO WILLIAM F. BUCKLEY, JR. I might start with that. I thought the will paraphrase, but just a little bit: Mr. ALEXANDER. Madam President, Congress got off to a pretty good start Senator ALEXANDER—someone in the the news came today that William F. this year. The President and the House back of the room at Ashland City Buckley died. For most Americans, of Representatives agreed on an eco- might rise and say—I have a question that brings back a lot of memories. nomic stimulus package. All of us had for you. How is it that the House of Since the early 1950s, he has been different ideas about it, but the Presi- Representatives has time to inves- synonomous with public television. dent and the House agreed on some- tigate baseball, has time to play poli- ‘‘God and Man at Yale’’ was an impor- thing, sent it over here, and we had tics with the White House staff mem- tant book, even though he was a very what I would call a principled debate bers, has time to take a 10-day vaca- young man when he wrote it. And Wil- about it—a disagreement over whether tion, but doesn’t have time to deal liam F. Buckley’s style, his choice of to spend $40 billion more on it than the with an intelligence bill? words, his manner of speaking, and his House-passed legislation, and the Sen- And I had to say to them: I am dis- unfailing courtesy have set an example ate objected to that. That was dropped. appointed with what happened in the for debaters of important issues in this Then we passed it, sent it to the Presi- House of Representatives because it did country for more than half a century. dent, and he signed it. That spirit of so well with the economic stimulus In 1984, a couple of years after I had having a principled argument, resolv- package that I thought we were off to been a guest on ‘‘Firing Line,’’ which

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00027 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1244 CONGRESSIONAL RECORD — SENATE February 27, 2008 was William Buckley’s television show, these few minutes on the Senate floor Iraqis are taking an interest in their I sat next to him at a dinner. It was a to remember William F. Buckley’s con- own safety and security. They are Howard Baker fundraising roast in tribution to our public life. forming neighborhood watch groups Washington, DC. William Buckley was I yield the floor. and are looking out for each other. One the master of ceremonies. The PRESIDING OFFICER. The Sen- thing, and this kind of disturbs me, is I wrote about that visit in a little ator from Oklahoma. that much of the information which I book I put out after I was Governor Mr. INHOFE. I understand I have 15 have to get, because I am not able to called ‘‘Steps Along the Way.’’ minutes. I might wish to take a little go to Iraq, is to talk to our own Sen- bit longer than that. I ask unanimous ‘‘When do you write?’’ I asked him. ators who have been there. Because ‘‘Anytime,’’ he replied. ‘‘Books are about consent to speak as in morning busi- even though things have changed, the only thing I write in a methodical way. ness for as long as 30 minutes. Baghdad is safe, we just are not getting I do them in Switzerland, after I ski, be- Mr. DOMENICI. Reserving the right the coverage from the press of the tween about 5:30 and 7 p.m.’’ to object, I was supposed to be recog- United States or the press of the world I told him that when our family had vis- nized next on our side. I was not going that the change deserves. Because ev- ited Chartwell, Winston Churchill’s former to speak long. I had rearranged an ap- erybody in America should know what secretary said that Churchill sometimes dic- pointment. I am saying in this speech. tated 5,000 words in a night. Mr. INHOFE. You go ahead. I want to Buckley was surprised. ‘‘I can do 1,100 or so The very simple fundamental things hear everything you have to say. Let that have happened have happened in a couple of hours,’’ he said, ‘‘Sometimes me suggest that after the Senator from more, maybe up to 2,800 words at a time, but since General Petraeus set about with 5,000 would be a very productive night. With New Mexico, at the conclusion of his his approach that he told the country the advent of computer technology I can remarks, I be recognized for up to 30 about. He named it. He told the Presi- know exactly what I do each time I write. minutes. dent about it, and he did not ask for For example, my last book took 112 hours.’’ The PRESIDING OFFICER. Without too much in order to exhibit and exer- ‘‘When do you make corrections?’’ I asked objection, it is so ordered. cise his leadership. him. The Senator from New Mexico. Moreover, an Iraqi Army brigade re- ‘‘I do that in about thirty minutes the next Mr. DOMENICI. Madam President, cently deployed itself for operations morning, before I go skiing.’’ might I say to the Senator from Okla- against al-Qaida. Partially because of ‘‘You mean that you finish off the last homa, I greatly appreciate what you day’s work so you can be ready to start when these efforts, there is less violence in have done. I thank you very much. Iraq now than when the insurgency you return from skiing?’’ I have always been in complete sup- ‘‘That’s right. Then I send the transcript began. to five friends. When the transcripts come port of our troops who risk their lives The Iraqi Government has passed an back, I put the five edited versions side by every day to defend the United States amnesty law for the country’s Sunnis. side and decide what changes to make.’’ of America. I voted for every dollar re- Many said it would never be done. It ‘‘What about your columns?’’ I asked him. quested to fully fund our troops and was. The Government has further ‘‘How long do they take to write?’’ against every effort to dictate the tac- ‘‘You mean after I get them in mind?’’ He passed a budget—maybe we will not tics of war from the Halls of Congress. even pass ours this year, but they said. However, last year I began to express ‘‘Yes.’’ passed theirs for $50 billion for 2008. my concerns about the deteriorating That is a compromise between the ‘‘About twenty to thirty minutes. conditions in Iraq and called on the Westbrook Pegler once told me it took him Sunnis, the Shiites, and the Kurds. eleven hours to do a column.’’ Iraqi Government to do more and to do They were able to sit down and solve ‘‘Do you make changes?’’ I asked him. more quickly. I pointed to benchmarks their problems, their budget problems, ‘‘No.’’ Said William Buckley. laid out by the President and Congress and to pass a budget. ‘‘I’ve been doing it for nineteen, no, twen- that had a great deal of resonancy to That is truly significant and truly ty-two years. I know the rhythm, the inter- them and that were rather unanimous different and obviously indicates that nal consistency of the column. I have it in terms of support. down. I don’t change it. That would be like things have changed for the better. Oil These were benchmarks on the ways revenues are going to Iraq’s provinces asking a jazz pianist to change his improvi- that the Iraqi Government could and sation.’’ to fund reconstruction efforts. That is should move its country forward. I am That was William Buckley in 1984. He another one everybody said would glad to say that since General Petraeus never happen, they will never be able was a pianist. He really preferred the took charge in Iraq, conditions have harpsichord, the clavichord. He told me to reach agreement on that. They have. improved and the benchmarks have Even the New York Times has noted he played Bach because you played been met. I am glad to say that since progress in Iraq, reporting that the what you loved the most. He loved General Petraeus took charge in Iraq, newly passed legislation in Iraq: music. He loved talking. He loved peo- conditions have improved. Has the potential to spur reconciliation be- ple. He loved his family. He was, of Iraq’s different sects are working to- tween Sunnis and Shiites and set the coun- course, a wonderful conservative lead- gether. There has been a renewed spirit try on a road to a more representative gov- er. He changed the way many Ameri- of reconciliation among Sunnis, Shi- ernment, starting with new provincial elec- cans thought about our Government ites, and Kurds. A debaathification law tions. and our society. And he always seemed has been passed. Iraqis are taking an That is something when the New to have the right thing to say. interest in their own safety and secu- York Times would choose to say that. In 1996, after I had competed for the rity, forming neighborhood watch They have not covered it very well, but Presidency, I was at some dinner. He groups and looking out for each other. at least the words I read are words walked all of the way across the room. There is no question, I know there found in the New York Times, which You never know what to say to some- are some who would not like to admit would clearly indicate that even they, one who has lost an election. It is kind the facts, but the facts are the facts. they of little faith and they of quick of like what do you say to someone at Things have changed since last year in judgment on the war in Iraq, had to say a funeral? But he walked all the way Iraq and they have changed for the bet- what I have quoted. across his room and put his hand on my ter. I have briefly outlined how it hap- Now, I am proud to be here today to shoulder and said: That was a noble pened and who made it happen. note this progress, the progress of the thing that you did. That has always There can be no doubt that the mili- Iraqi Government, because it is the struck me as the one of the nicest tary hero of this war is General progress of the Iraqi people, the people things anybody has said to me after Petraeus. There can be no doubt he whom we went there to help. having lost an election. carries a heavy burden on his shoulders It is their progress, their victory, So I will miss William Buckley. So now to see if things can be wrapped up their win. Yet we are proud it was led will our country. So will the conserv- in a way that is good for the Iraqis, by an American who has apparently an ative movement. My family and I send good for the entire Middle East and ob- exceptional capacity in these areas, the our condolences to the Buckley family. viously in many ways would vindicate areas that festered and caused these We know they are proud of his life. America’s activities and what we have people to remain far apart until the They will miss him. I am glad to have done there. last 18 months.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00028 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1245 They have made significant, notable Mr. MCCONNELL. Madam President, remind us of. That was called an acqui- progress in the past 6 months and are let me echo in part the majority lead- sition holiday or a peace dividend. I on the right path to a stable and secure er’s comments with regard to the proc- think it was more of a holiday in lead- Iraq. General Petraeus and our soldiers ess. As he has indicated, we will have a ership at that time. International ter- deserve our thanks, our thanks and vote at or around 6:30, and then he and rorism took to the forefront as bin support for their efforts in Iraq and in I tomorrow will discuss how we move Laden began his war against freedom. the larger global war on terror. forward on the housing issue. It would Afghanistan was used as a training I yield the floor and thank my friend be our intent to either get to a vote or ground for terrorists, and the Taliban once again for yielding to me. get on, based upon a consent agree- regime allowed al-Qaida unfettered mo- The PRESIDING OFFICER. The ma- ment, that subject matter no later bility. We were on holiday. We were jority leader. than sometime at a civilized hour to- not fighting back. They took advan- Mr. REID. I understand my friend is morrow. tage of this in some major attacks. here wishing to speak. I have a quick Mr. REID. Madam President, I ask Somehow I think the memory of the unanimous consent request. unanimous consent that the time at American people isn’t very long be- I ask unanimous consent that at 6:30 5:55 today—Senator MCCONNELL and I cause they forgot about these attacks tonight, all postcloture debate time be have from 6:10 to 6:30. Senator FEIN- that were taking place. Remember the yielded back and the motion to proceed GOLD has asked that he be recognized first attack on the World Trade Center be withdrawn; the Senate then proceed at 5:55 until we speak. was in 1993, February 26. It was a car to the cloture vote on the motion to The PRESIDING OFFICER. Without bomb that was planted in an under- proceed to S. 2634; further that the objection, it is so ordered. ground parking garage below the World time until 6:30 p.m. be equally divided The Senator from Oklahoma. Trade Center, and that was way back and controlled between the two leaders Mr. INHOFE. Madam President, I in 1993. In 1996, the Khobar Towers, we or their designees, with the final 20 would like to take a little longer view remember that well. They were bombed minutes equally divided between the of what is going on right now in the by Hezbollah with the intelligence leaders, with the first half under the war for the liberation of Iraq, the good pointing toward al-Qaida, still al- control of the Republican leader and things that are happening, the surge, Qaida. At the same time this was going the final 10 minutes under the control and kind of go back to give a better on, in northern Africa their presence of the majority leader. perspective as to how we got here in was visible at that time. Further on The PRESIDING OFFICER. Without the first place. down in southern Africa we had the objection, it is so ordered. There was this euphoria that was Embassy bombings in Kenya and Tan- Mr. REID. Madam President, for all going around back in the early 1990s: zania. That was in 1998. That was in Members, we will have a vote at 6:30 to- The Cold War is over, we don’t need a Dar es Salaam and Nairobi. It went un- night on the second Feingold piece of military any longer. They talked about answered at that time. So we had all of legislation. Following that, if cloture such things as the peace dividend at this going up through 1998. is invoked, of course, there is 30 hours that time, and this is what precipitated Then there is the year 2000, when sui- on the motion to proceed. I have had a 9/11. The Clinton administration came cide bombers used a boat to attack the number of conversations today with in, and this is the amount of the actual USS Cole while it was moored in Yemen. the distinguished Republican leader. DOD budget at that time. This was the Yemen is right at the horn of Africa He and I will discuss later this evening baseline. This is a very simple chart on the other side. And now we know that tells us a lot. If we were to merely and tomorrow how we are going to that as the squeeze has taken place, have maintained the level of defense work through the rest of this week. My that has become a very prominent goal, as has been indicated a number of spending as it took place in the last place for al-Qaida and for the terror- times over the last 24 hours on the Sen- year of the Bush 1 administration and ists. So you had Djibouti, we were ate floor, is to make sure that some- then had nothing except the inflation starting to put troops in there, but we time this week we are on the housing rate, which wasn’t all that great, it had that suicide bombing. That was a stimulus package, and we will do that. would be this black line taking us up major thing. It let us know, it re- We will see if we can do it with an to fiscal year 2001. This was what would minded us that we could have a ship, agreement rather than running out all have happened if we didn’t do anything the USS Cole at that time, and have the time. else. But down here the red line indi- nothing but just a little outrigger As I indicated earlier today, I think cates where President Clinton made his going out there and blowing it up and the debate on this Iraq legislation has budget request. That was his annual causing the deaths and the damage been good. My friends on the minority DOD request. If you forget about the that took place. side think the war is going great. We middle line, the difference between his The response—this was back in the have some concerns on this side. request and if we just maintained the first of the Clinton years—was pretty Just in passing, I had a meeting in same position that we were in in fiscal benign. It was restrained and at best my office about an hour ago. We have year 1993, it would have been $412 bil- inconsistent. Operation Infinite Reach a wonderful facility being built in Las lion less; in other words, in that short included cruise missile attacks against Vegas, a performing arts center. It will timeframe, we would have cut defense Afghanistan and Sudan. There was no be wonderful. It will be like the Ken- real spending in constant dollars by real change. The administration was nedy Center. They have raised all but $412 billion. distracted at that time. This inad- $50 million of this $475 million project. The Congress didn’t let that happen. equate response has been cited as a fac- I told those who were assembled: This This middle line, the green line, is tor emboldening al-Qaida to undertake is about the same amount of money what actually was budgeted. So what further plans. Yet we continued on our being spent in 1 day in Iraq, the $420 we did was to say to the White House: holiday at that time. In Operation Re- million, the money they have raised. You are not taking good enough care of store Hope, we became embroiled in It has been a good debate, a good dis- our military needs. And so we raised it Somalia, and we remember what hap- cussion. I think it is good that the by about $99 billion over that period. pened in the streets of Mogadishu when body spend some time on this very im- That means the real shortfall was $313 finally the people woke up when they portant issue. One thing that has been billion in that timeframe. saw the naked bodies dragged through quite good, and I commend Senators on I show this chart because there was the streets. President Clinton directed both sides, is it has been a very civil an attitude in this country at that U.S. forces to stop all actions except debate. We have a significant disagree- time that there weren’t any real seri- those required in self-defense, and we ment on the situation in Iraq, but we ous problems. People kept saying we withdrew from the country shortly have had a good debate. The American were the world’s greatest superpower, thereafter. people should feel good about the dis- and we appropriated more money than It is kind of hard for America to get cussion. It has been very tempered and anyone else. I wanted it to continue in the habit of withdrawing. We stake dictated by actual feelings on both that way, but there were some things out our position, and we have histori- sides. that were going on that I would like to cally stood strong and carried it out. In

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00029 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1246 CONGRESSIONAL RECORD — SENATE February 27, 2008 1999, as a NATO member, the United that time they were alive and the re- tion. Based on information from the States became involved in a bombing gime was in there, they would go U.S. Army Special Forces, operators campaign against Yugoslavia and a through and bust up weddings and rape who led the attack on Sargat said: It is subsequent U.N. peacekeeping force. all the girls and take them and bury indeed more than plausible that al- The holiday that we were on at that them alive. I actually looked down into Qaida members trained in that par- time ignored the rising threats against those open graves, and people were so ticular training camp. our national security, mortgaged our quick to forget what a monster he was. Now, one of the interesting places military, leaving a bold challenge for I have often said, even if that had not where this was taking place was a the next administration. happened, even if we did not have the place called Salman Pak. In Salman The first Rumsfeld confirmation was problems with the terrorist activity in Pak they had—and I think it is still rather enlightening because what we Iraq and the fact that they were train- there to this day—on the ground an old did at that time was to try to deter- ing people in Iraq to be involved in ter- fuselage of a 707, and that was used to mine what our needs were going to be rorist activity—al-Qaida was very train people on how to hijack air- for the future. We had to rethink where prominent—that even if that had not planes. I have often wondered if that we were before. And at that time we been the case, how could we as a coun- could have been where the perpetrators were trying to reevaluate where we try allow the hundreds of thousands of of 9/11 got their training. I have no way were. We were recalling some of the people to be tortured to death in such of knowing. We never will know. But bad things that had happened. We re- a cruel way? I do not think we could. we do know this: That location, along member so well the 1991 Persian Gulf Certainly, we could not if people had a with the problems in Sargat, had major war. There was a group that went over, chance to see it. training areas for the terrorists. So we a bipartisan group. I remember Tony So the time went by, and they start- were able to shut those down. I would Coelho at the time. He had been the ed talking about, of course, going into say this: That alone would be enough Democratic lead in the House. I was in this liberation movement in Iraq. motivation for us to go and liberate the House at the time. We had the first Now, there has been a lot of discus- the people of Iraq. freedom fight, and we sent a group over sion over the years about weapons of But the third one is to help the Iraqi to Kuwait. It was the day that the war mass destruction. Those of us who were people create a free and democratic was officially over. The problem was over there—I would say to you, Madam country. Iraq is trying to do what we the Iraqis didn’t know that the war was President, that while I have not been tried to do 230 years ago. They are risk- over at that time, and so we had the this many times to Iraq, I have actu- ing their lives, as we risked our lives first freedom fight. We went over there. ally been in the area 27 different trips— some 230 years ago. They are seeking a Al Haig, I ran into him the other day. 27 different times. Sometimes it was at constitution, a parliament, freedom, We kind of relived that experience we CENTCOM, sometimes the Horn of Af- and democracy. These are things they had over there. We had with us a very rica and other areas. But, see, the ter- are trying to accomplish. special guest. He was the Kuwaiti Am- rorist activity and the war was not just I think of that first election that bassador to the United States. He had in Iraq. It was in the whole sur- took place out in Fallujah, when the his daughter. They were a family of no- rounding area. So in all those times I Iraqi security forces were going to bility. They had a palace on the Per- was there, I had a chance to, on a first- vote. I was there. I was in Fallujah ac- sian Gulf. But, of course, they hadn’t hand basis, see what was involved. tually for all three elections, I believe. been there because that was a war We know we had to go in there. We But I remember the Iraqi security zone, that was Kuwait. So we went over know we had to go in there and finish forces in that first election. Everybody there, this group of nine of us, Demo- what had been started in Iraq. remembers the purple fingers so they crats and Republicans, and I remember Now, there are three things that were could identify who was voting in those when the wind shifted, the oil fields started. No. 1, we had to liberate Iraq elections. And these guys—the security were still burning. It was a mess over from a tyrannical leader—we have al- forces—went out and voted the day be- there. But they wanted to go back, the ready talked about him—No. 2, elimi- fore the elections. They did not wait Ambassador wanted to go back and see nate a safe haven for terrorists and for the elections. They were doing it what their house looked like, if it had their training camps; and then, No. 3, the day before so they would be there been damaged in the war. to help the Iraqi people create a free on election day to provide the security. When we got there, we found that his and democratic country strategically People were risking their lives to go house had been used for one of Saddam located right in the Middle East where out and vote. We know the cases of Hussein’s headquarters. His daughter, we have the greatest needs. people being attacked by the terrorists she was either 7, 8, or 9 years old. I re- Well, No. 1, the liberation of Iraq: to keep them from voting. They were member so well because she wanted to After the first Persian Gulf war, I told easy to identify because of the purple go up and see her bedroom and the you, we had what we called the first fingers. But these guys were gladly dolls and all of that. We went up into freedom flight into Kuwait. But that going in there at that time, going to this mansion on the Persian Gulf, a liberation was necessary to put an end vote, and then returning the next day beautiful place, only to find out that to Saddam Hussein’s regime of torture. to protect our people who were there. her bedroom had been used as a torture Now, when they talked about weap- Our men and women serving in Iraq chamber. There were body parts stuck ons of mass destruction, yes, weapons are providing the Iraqis the same inspi- to the walls. I saw a little boy who had of mass destruction were not found. We ration our forefathers provided us. Iraq his ear cut off, maybe 6 or 7 years old, know they were there. They were used is becoming an example to the world of because they found him carrying a tiny on the Kurds in the north. Saddam how to reject terror and confront those American flag. That was back at the Hussein used weapons of mass destruc- who practice it. The world sees now the time when unconscionable murders tion to painfully murder thousands of Iraqi citizens are realizing their poten- were taking place where Saddam Hus- his own people using gas that burned tial, signing up as Concerned Citizens, sein, after that was over, started kill- them alive. That was happening. But, sons of Iraq—72,000. ing anyone who was suspect and tor- nonetheless, for those of us who were It is a pretty amazing thing when turing them to death. There are stories aware, that was not the real reason. you look and see that instead of the documented that people would beg to If you look at the second reason, that mass graves and all these things, you be dropped, lowered into vats of acid Iraq was a major terrorist training are seeing a mass participation in Iraq. head first so they would die quicker. area—a lot of us are familiar with They are returning to normalcy now. A Being put through grinding ma- Samarra and Ramadi, but some have lot of people are asking: Is the surge chines, like you are shredding docu- forgotten or may have never even really working? I do not believe anyone ments; the open graves; the docu- known about some of the other areas. is out there who can conscientiously mentation of weddings that were for a Sargat was an international terrorist deny that the surge has worked. while taking place—many of them out- training camp in northeastern Iraq It was about a year ago that General doors; that is the way they did it over near the Iranian border, run by Ansar Petraeus went in. What happened? in that area—and Saddam’s sons, at al-Islam, a known terrorist organiza- Three things happened. One was that

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00030 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1247 Petraeus—by far, the greatest guy for So we now see these changes that are August 28, 2007—just a short while the job out there; and I do not think taking place. We see that basic eco- ago— anyone except moveon.org disagrees nomics is taking root and Iraqis are Soon, we will see a huge power vacuum in with that now—that Petraeus took spending money on Iraqi projects. the region. over. Secondly, the surge, in certain Iraqis are taking back control of their Now, what he was talking about is strategic areas, increased in numbers. country. We are helping the Iraqi peo- the type of resolution we are consid- But the third thing that happened was ple create a free and democratic coun- ering right now. He is saying a cut-and- there have been so many resolutions try where representation and the rule run resolution would create a huge like the one that is before us right now of law are replacing coercion and ter- power vacuum. What else did he say? that I refer to as ‘‘resolutions of sur- ror. He said that expecting this defeatism, render’’ that got the attention of a lot The Iraqi Parliament has passed leg- expecting that we would vote for this— of the religious leaders. islation that reforms debaathification. which we are not. We are not going to I often draw a distinction from my They have enacted pension reform that vote for this resolution. We know that. own personal experience. I have met allows former Baathists to collect their We have had the same resolution voted with the political leaders, of course, pension. They have enacted laws defin- down 71 to 24 the last time we had a like all the other Members who have ing provincial and central government vote on it. But, nonetheless, he said: gone over there. I have done it more roles and responsibilities to delineate because I have been there more times. ‘‘Of course, we are prepared to fill the what each person is supposed to do— gap. . . .’’ But the religious leaders are the ones the distinction between the police and who have the greatest impact on what So you have Iran filling the gap that the security forces, what their func- is going on in Iraq. Up until—and this would be there if we were to get up and tions are, what their missions are. leave in the victorious moments we are is a statement no one has refuted—up They passed a 2008 budget. They did until about a year ago, our defense in- having now. it sooner than we did it in this country. Iran’s nuclear work continues, intelligence people would attend and They enacted an amnesty law that cluding recent doubling of their enrich- monitor the Friday night mosque could lead to the release of thousands ment of uranium, which could easily be meetings that took place throughout of detainees, removing a stumbling used as part of a nuclear weapons pro- Iraq. These are with the clerics and the block standing in the way of reconcili- gram, a decision in the hands of imams, the religious leaders. Prior to ation. Mahmoud Ahmadinejad. that time, 85 percent of the messages More than any previous legislation, In the last 2 years Iran has continued that were preached, I guess you would these new initiatives have the poten- to develop ballistic missile technology, say, in the mosques were anti-Amer- tial to spur reconciliation between launching missiles over 2,000 kilo- ican. To my knowledge, there has not Sunnis and Shiites and set the country meters. been an anti-American message given on the road to a more representative Coalition forces have intercepted Ira- from a mosque in Iraq since last April government, starting with new provin- nian arms shipments in Iraq, including because they realize if we leave, then cial elections. materials that are used to make explo- the terrorists will move in. Now, in the future, where do we go sively formed penetrators, the EFPs, So that is why we are getting—it has from here? Our Nation has paid, and the most deadly of the IEDs, which are been talked about by many people on continues to pay, a heavy price. People the Senate floor—the attitudinal being used against American troops. in this Chamber have talked about the change. The neighborhood watch pro- This is what Iran is doing today. heavy price. They are right. It is not grams—in my hometown of Tulsa, OK, Coalition forces have also detained we have a neighborhood watch pro- cheap. It is very expensive. We have Iranian agents in Iraq. A lack of a se- gram. We have them in Washington. paid a heavy price in dollars and lives, cure and stable Iraq means instability They have them over there, with pri- with our sons and daughters and broth- in the Middle East and a clear avenue vate citizens who have the courage to ers and sisters. We are doing a difficult for terror and oppression to spread. In- go out without any arms and confront thing. But just as Americans have al- stability in the Middle East will con- terrorists; where they can, through ways tried to do the right thing, we are tinue to spread, as it already has, into their own intelligence and sheer num- doing the right thing in Iraq. Africa, Asia, and Europe, and ulti- bers, determine where there are RPGs Iraq is at a decisive turning point in mately find its way to our shores. and IEDs that are not detonated, and their journey toward democracy. The We know what is happening right then they identify them by little or- fight in Iraq is not about today or to- now in Africa. I know probably more ange paint cans, where they draw a cir- morrow but about many tomorrows to than some of the others do, because I cle around there, and then we can go in come and about the future. It is about have seen firsthand. I have sat down there and detonate these and save our grandchildren’s grandchildren and and talked with such Presidents as many lives. the world they will live in. President Museveni in Uganda. I have Well, we are today experiencing all It is not just Iraq. Right now, a lot of talked to Prime Minister Meles in So- that help. I can remember when our concern is taking place as to Iran and malia—in Ethiopia, and many of the troops who were working out of Bagh- Ahmadinejad and some of the political others, including John Kufuor in dad would come back to the Green leaders and the things they are pro- Ghana, all about the threat they face Zone every night. They do not do that moting. One of the greatest obstacles of terrorism all throughout Africa. In anymore. They go out and they actu- they have in Iran is they are right next our infinite wisdom here, it was our de- ally bed down and live with the Iraqi door to Iraq, and there are so many cision a few years ago to go in and help security forces and their families, de- people who share family members, and the Africans build five African bri- velop intimate relationships with they are looking over wistfully and gades, so that as this moves into their them. It is a totally different thing seeing that people are getting married area, they are able to fight off ter- there altogether. without the disruptions, that girls are rorism without using our troops. We I can remember there was not a way actually getting an education. This is have such programs as the 1206, 1207, in the world you could walk through not the Iraq they knew before. So these and 1208, where we are arming and the markets in Baghdad. The last time things are happening. equipping, training and equipping pro- I was there, I walked through, and I in- Secretary Gates said: grams for these countries. These are tentionally did not take anybody with If we were to withdraw, leaving Iraq in things we are helping them do so we me except an interpreter because I did chaos, al Qaeda almost certainly would use can avoid having to be on the front not want to give that image that you Anbar province . . . as another base from lines of the battle against the terror- have to have armed guards and all which to plan operations not only inside ists. They can do that too. that, and I remember stopping and Iraq, but first of all in the neighborhood and Patrick Henry said: then potentially against the United States. talking to people. I like to single out We shall not fight our battles alone. There people who are holding babies. They Al-Qaida is not the only threat to is a just God who presides over the destinies have this love for us that they did not America and our ideals. I mentioned a of nations, and who will raise up friends to have before. minute ago Ahmadinejad. He said, on fight our battles with us.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00031 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1248 CONGRESSIONAL RECORD — SENATE February 27, 2008 That is what is happening over there period dealing with a piece of legisla- tration has not brought the leader and at this time. tion related to Iraq. I want to speak the leadership of the terrorist organi- So the coalition forces have been about something else today, but let me zation that attacked our country to doing a great job, and right now we are at least begin by describing a some- justice. That is a failure, in my judg- observing the successes of the surge. what different view. ment, and it is a failure that results They watch with great interest as de- The fact is, Saddam Hussein was from taking our eye off the ball and featist legislation is repeatedly hung until he was dead, hung by his having too few troops in Afghanistan brought up on the floor, hoping that neck, and this brutal tyrant is dead. I and allowing Osama bin Laden to es- Congress will do what they cannot: suppose most of us wish that Osama cape through Tora Bora, and then in- give them victory in Iraq and the Mid- bin Laden had been brought to justice, vading Iraq and committing ourselves dle East. So we must not try to micro- but it is Saddam Hussein who has been to that over a lengthy period of time. manage our military. One of the two brought to justice in the country of The result is the greatest terrorist bills that is on the floor right now Iraq. He is dead. The Iraqis have their threat—according to the National In- would actually micromanage it. It is as own Constitution because they voted telligence Estimate, the greatest ter- if we in our infinite wisdom in the Sen- for it. The Iraqis have their own Gov- rorist threat against our country at ate are smarter than General Petraeus, ernment because they voted for it. The this point is the leadership of al-Qaida. General Odierno, and all of the profes- American taxpayer has spent $16 bil- They are in a safe and secure haven in sionals. Yes, I was in the U.S. Army lion training 350,000 police and soldiers northern Pakistan. It seems to me that many years ago, so I have some hands- in Iraq for security purposes. Now the 7 years after 9/11, that has to be consid- on experience in this type of thing, cer- question is: Do the Iraqis who have ered a failure. My hope would be all of tainly not that of the professionals. been trained for police protection and us would engage in ways that begin to The worst thing we can do is try to security—both in the police force and devote our attention to the greatest micromanage our military and place as soldiers—do they have the will to terrorist threat facing our country, restrictions on them, telling them how provide for their own security? If they and that is, as the National Intel- many troops they should withdraw and do not, this country cannot do it for ligence Estimate says, the leadership what our troop strength should be over any great length of time. of al-Qaida. They are recruiting and there, and at the same time anything We have been in Iraq for almost 5 building new training camps and we do over here, the enemy knows we years. Some day we are going to leave strengthening themselves even as we are doing it also. Our professional war- Iraq. The question is not whether; the are tied down in the country of Iraq riors want to and can succeed with our question is when and how. The Amer- spending $16 billion a month. support. ican people are not going to have us in Madam President, I ask unanimous That is what this is all about. I have Iraq for 10 and 15 and 20 years. That is consent to speak in morning business no doubt in my mind we will defeat not the case. We are spending massive for 15 minutes on another subject. these things. In a way, I am glad Sen- amounts of money, about $16 billion a The PRESIDING OFFICER. Without ator FEINGOLD brought these bills to month. Last year the President asked objection, it is so ordered. the floor, because this gives us a forum for more than $190 billion in emergency MEDAL OF HONOR FOR WOODROW WILSON to talk to the American people about funding for the war. That is $16 billion KEEBLE things they may not be getting in the a month, $4 billion a week. Mr. DORGAN. Madam President, this media. It is interesting that it used to It is time we begin to understand we is a picture of a man named Woodrow be when I went over to Iraq, the first have needs here at home, to begin tak- Wilson Keeble, a Sioux Indian. Wood- thing the kids over there would ask me ing care of things here at home. We are row Wilson Keeble died 26 years ago. If is why doesn’t the media like me. They spending money on hundreds of water you take a look at this soldier’s med- don’t talk that way anymore. Even projects in Iraq. We are spending als, you will see two Bronze Stars, a people who were anti this administra- money on road-building in Iraq. We are Silver Star, the Distinguished Service tion, people such as Katie Couric, went spending money on health clinics in Cross, the second highest medal given over and observed what is going on. Iraq. Yet we get a President’s budget in our country, and Purple Hearts. Once you go and observe, you can see sent to us saying we don’t have enough I want to tell my colleagues about we are winning, this is working, and money for those things in our country. Woody Keeble, a big man, well over 6 this liberation is taking place. We will dramatically cut water foot, and well over 200 pounds. On Mon- I know my 30 minutes has expired, projects in the United States. We will day of next week at 2:30 in the after- but we are here to continue what we cut back on all of these investments in noon, at the White House, President have started. The worst thing we could the United States, even as we are mak- Bush will present the Medal of Honor do right now is to take success out of ing those substantial investments in to Woody Keeble. As I said, he has been the hands of the military who are suc- the country of Iraq. dead for 26 years. His wife Blossom cessfully winning the liberation of Iraq My point is that at some point we are Keeble died last summer. We had hoped and start to micromanage this politi- going to have to bring American troops this would be done before his wife died, cally from the Senate floor. This isn’t home. We can’t keep doing as the but that was not to be the case. going to happen. We are winning over President suggests, and that is spend- I want to tell my colleagues about there now. It is so refreshing, after all ing emergency money by sending sol- him because it is so unusual that a these years. Yes, it has been a long diers to Iraq and putting this on top of Medal of Honor will be presented post- time. People keep reminding us this is the debt so that when those soldiers humously to a soldier who dem- longer than World War II. I know that, come back from Iraq, they can help pay onstrated great acts of courage and because each year I have had an oppor- the debt. That is not the right way to heroism in both the Second World War tunity to spend time over there, qual- approach what is happening in the and the Korean war. ity time, and see the changes that are country of Iraq. He was a Lakota Sioux born in taking place via the plan of this genius All of us want the same thing for our Waubay, SD, and grew up in Wahpeton, named David Petraeus, it is working. country. We want our country to suc- ND, and lived most of his life there. He So we don’t want to get in their way, ceed. We want our country to confront was wounded at least twice in World and we won’t get in their way, and we and defeat terrorists. Yes, we want War II and three times in the Korean will go ahead and defeat these bills and Osama bin Laden. Osama bin Laden is War. Let me describe what he did so let the military run the liberation as the person who heads al-Qaida. We are that my colleagues will know why he is they see fit, and we are going to join told by the Director of National Intel- being given the Medal of Honor all of them in our victory. ligence that he is safe and secure in these years later. I yield the floor. northern Pakistan. There ought not be In World War II Woody Keeble served The PRESIDING OFFICER. The Sen- one square inch on the face of this with the famed 164th Infantry Regi- ator from North Dakota is recognized. Earth that is safe or secure for those ment of the North Dakota National Mr. DORGAN. Madam President, I who murdered Americans on 9/11. Yet Guard. Shortly after joining in 1942, he know we are on a 30-hour postcloture more than 6 years later, this adminis- found himself on Guadalcanal, in some

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00032 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1249 of the most aggressive and dangerous Many years later the question was the Senate dealing with Iraq and about hand-to-hand combat in the Second asked: Why was he not given the Medal who stands up for soldiers, who cares World War. He was in combat in the of Honor? Those with whom he served about American soldiers. The fact is, South Pacific until the war ended. He began piecing together the action that every single person in this Chamber saw a great deal of combat. One of his day, all of those who were eyewitnesses cares about American soldiers and fellow soldiers said the safest place to and a part of the action on that hill in wants to support them, understands be was next to Woody. Woody earned a North Korea. that they get up in the morning in Bronze Star and Purple Heart in the A woman named Merry Helm espe- some parts of this world—in Iraq espe- Second World War. Woody was an unbe- cially took it upon herself over the cially—and they strap on body armor lievable soldier. years to try to reconstruct Woody’s before they go out because they know Then the Korean War came along and story. It took a lot of time to do so. there is a chance they can be killed or at age 34 this Lakota Sioux Indian Then it was sent to the U.S. Secretary harmed. All of us understand what sol- signed up again. He said: Somebody has of the Army with a request that he re- diers are doing for this country. I be- to teach the kids how to fight. So he view the original request that had lieve the one thing that unites this went to Korea. He was attached to never been received at the Pentagon Chamber is we want to do right by George Company, 2nd Battalion, 19th that Woody Keeble be awarded the American soldiers. The story of Woody Infantry Regiment of the 24th Division. Medal of Honor. Keeble is a story that ought to inspire They were near the Kumsong River in The Secretary of the Army looked all of us about what soldiers do for our North Korea in October of 1951. He was into the case and decided that Woody country. the acting platoon leader of the 1st pla- Keeble had indeed earned the Medal of I have told my colleagues previously toon of ‘‘G’’ Company. Casualties were Honor. The Chairman of the Joint about another soldier, another Amer- very heavy. Because the company’s of- Chiefs agreed. ican Indian. His name was Edmund ficers were killed, he ended up in But then all the people involved were Young Eagle. He was from the Stand- charge of the 1st Platoon, the 2nd Pla- informed that there is a 3-year statute ing Rock Sioux Tribe of North Dakota. toon, and the 3rd Platoon. It was bru- of limitations on the request for a He went to war. He was in northern Af- tally cold in North Korea at the time, Medal of Honor. The Secretary of de- rica, he was in Normandy, he was in and the enemy, the Chinese, were en- fense could only consider Woody’s case Europe. He came back and lived with trenched on a hill with a rugged cliff, if that statute of limitations was the Standing Rock Sioux Tribe. He and the side of that mountain was a waived. never had very much. He had kind of a very difficult thing that the U.S. At the request of those who had tough life. troops had to take. worked on it, I and my colleague from At the end of his life, he was lying in So Woody Keeble, in charge of these North Dakota, Senator CONRAD, and a hospital bed at the VA hospital in three platoons, made three attempts to our colleagues from South Dakota, Fargo, ND. His sister asked if I would take that hill from the Chinese. The Senator JOHNSON and Senator THUNE, get the medals he earned in the Second Chinese had three machine gun nests introduced legislation on an appropria- World War and never received. I did, on top of the hill and soldiers in tions bill that waived the 3-year stat- and I took them to the VA hospital on trenches defending that hill. Three ute so the Secretary of the Defense a Sunday morning in Fargo, ND. The times these platoons, with Woody lead- could look at this case and decide. doctors and nurses crowded into his ing them, went up the hill, and three The Secretary of the Defense began times they were repulsed and rejected, room, and Edmund Young Eagle—who evaluating what happened on that hill with heavy casualties. at the time I didn’t know was going to After three attempts to take that in North Korea on a cold day when die 7 days later of lung cancer. Edmund hill, Woody Keeble decided he would Woody Keeble was a real hero. He even- Young Eagle was a sick man but very try it by himself. With grenades and a tually decided, having looked at all the proud that morning. We cranked his Browning Automatic Rifle he crawled information, that, indeed, this Lakota bed up to a seated position, and then I back up the hill to the Chinese posi- Sioux Indian who served this country pinned on his pajama top a row of med- tions. Witnesses said he crawled in two wars, was wounded five times, als this American Indian had earned through very heavy machine gun fire deserved the Medal of Honor. He sent it serving his country in the Second and through a blizzard of grenades. to the White House with the rec- World War. As sick as he was, he said Woody Keeble scaled the hill, went ommendation that the President ap- quietly to me: This is one of the proud- around the pillboxes and knocked out prove the Medal of Honor. est days of my life—seated on his hos- all three machine guns by himself and This coming Monday, at 2:30 in the pital bed wearing his pajama tops with then cleared out the trenches between afternoon, I will be at the White House his military medals. them. When he returned they extracted witnessing a ceremony at the invita- There are so many whose names we 83 pieces of shrapnel from his body—83 tion of the President in which the will not talk about on the floor of the pieces of shrapnel. But he wouldn’t President Bush will present a Medal of Senate today, but I do say Woody leave the battlefield until all of his Honor posthumously to a really re- Keeble and Edmund Young Eagle are men were on top of the hill and in a de- markable, courageous American sol- just two of thousands—millions of fensive position and only then would he dier named Woodrow Wilson Keeble, American soldiers over the years who allow himself to be evacuated. the only Sioux Indian ever to have re- have refreshed this democracy by being Right after the engagement all of the ceived the Medal of Honor, someone willing to risk their lives. surviving members of G Company who served this country with unbeliev- I wanted to call to the attention of signed a letter putting him in for the able courage and distinction and valor. the Senate Woodrow Wilson Keeble. I Medal of Honor. It got lost and never After the Korean war, he came back am enormously proud of him and his got from the battlefield to the Pen- to Wahpeton, ND, and worked at the family and his memory, and I am anx- tagon. They did it a second time a Wahpeton Indian School much of his ious to be at the White House on Mon- month later and it too never got from life. He suffered multiple strokes, suf- day when he receives posthumously the the battlefield to the Pentagon. fered significant health problems, and Medal of Honor. But in this photo, my colleagues can died 26 years later. STRATEGIC PETROLEUM RESERVE see the medals he did get: multiple The moment won’t pass without Mr. DORGAN. Madam President, I Purple Hearts, wounded five times; two some notice because the President is wish to make a couple of additional Bronze Stars, a Silver Star; the Distin- making a presentation on Monday. comments on another subject. guished Service Cross, the second high- However, I wanted to say something The price of oil is bouncing around at est medal. He was a well-decorated sol- here on the floor of the Senate so those $100 a barrel, the price of gas is up to dier. He went to Korea to help teach who read the RECORD of the Senate will $3.00, $3.50, or more per gallon. There those kids how to fight and it turns out understand this was an extraordinary are people who kid about having to he is the one who climbed the hill and American. take out a loan at the bank to fill their saved his soldiers, knocked out three We are hearing a lot of discussion gas tank. The question is, What is hap- machine gun nests by himself. these days about the bill on the floor of pening with oil?

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00033 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1250 CONGRESSIONAL RECORD — SENATE February 27, 2008 Let me tell you something. In the they can figure out maybe with some World War II, and it is time for a Energy & Natural Resources Com- common sense what they ought to do change in Iraq. It is time for a good mittee this year, we have had wit- when oil is $100 a barrel, and that is change. What does that mean? It nesses testify that there is not a bit of stop putting oil underground and put it means that it is time for the Iraqis to justification for the price of a barrel of into the marketplace so we put some stand up and fight for themselves. oil to be over $50 or $65 a barrel right downward pressure on gas prices? We know the violence there con- now. So why is it $100 a barrel? Two I introduced legislation that puts an tinues. We know that 15 percent of that reasons. One is that we have unbeliev- end to this practice. I am chairman of violence is being perpetrated by foreign able speculation, a carnival of greed, the appropriations subcommittee that fighters, al-Qaida, and the rest—85 per- with hedge funds and speculators neck funds the Energy Department’s pro- cent—is Iraqi-on-Iraqi ethnic violence. deep in the futures markets specu- grams, including the Strategic Petro- If the Iraqis are not ready to stop hurt- lating on oil. We have investment leum Reserve. I say to the Secretary ing each other and blowing each other banks for the first time that are actu- and to those who made this decision: up, if they are not ready to give that ally buying oil storage tanks so they One way or another, I am going to win up, then we need to be ready to start can buy the oil and keep it off the mar- on this issue. We are not going to allow pulling our troops out. It is pretty ket in order to sell it later when the you to continue to stick oil under- clear to me after 5 years that all our price is higher. There is unbelievable ground when the price of oil is $100 a presence is doing at this point is acting speculation in the futures market barrel and the price of gas is ranging as a recruiting tool for al-Qaida. Be- pushing up oil which has nothing to do up between $3.50 and $4 a gallon. We are cause we have this open-ended commit- with the fundamentals of supply and just not going to allow you to continue ment—some on the other side are talk- demand, and there ought to be a full to do that. This Congress is going to ing about 50 to 100 years—there really and complete investigation. I am ask- use some common sense and say stop is not anything on our side to exert ing the GAO to do that. it. that leverage on the Iraqis. They are The other issue is one that I find pre- Mr. President, that was therapeutic not fulfilling the benchmarks in the posterous, and I am going to do every- to say. My hope would be that at some Government that this administration thing I can in the coming days and point soon I will have a chance to offer said they had to do. weeks to stop it. Do you know that that amendment, and we are all going Here we have a situation where we even as the price of oil is bouncing up to have a chance to vote on it. I will in- have now lost 3,972 fighters on our side. at $100 a barrel of oil, this Government, sist we vote on it. I believe this Con- Twenty-one percent of those were ei- this Department of Energy is putting gress is going to tell this administra- ther born in California or were based in oil underground for storage? We are tion to stop it, use a reservoir of com- California. 29,275 Americans have been awarding royalty-in-kind contracts to mon sense; don’t stick oil underground wounded, some of them grievously companies to take oil out of the Gulf of when it’s $100 per barrel. Put it into wounded, many more have traumatic brain injury and post-traumatic stress. Mexico and instead of them selling the the supply, and put downward pressure The suicide rate is off the charts. oil and putting it into the supply to on the price of oil. How about standing There is no way out. There is no plan. put downward pressure on price, we are up for the American people and Amer- putting 60,000 barrels every single day There never has been a plan. It seems ican drivers? Let’s do that. to me this open-ended commitment has underground in the Strategic Petro- Madam President, I yield the floor. to stop, and the Feingold bill essen- leum Reserve. Having the Strategic Pe- The PRESIDING OFFICER. The Sen- tially says we are going to have a very troleum Reserve is fine. Save it for a ator from Kansas. responsible withdrawal. There is no end rainy day, save for our security, put Mr. BROWNBACK. Madam President, date, but we are going to start it with- some away—I understand that. But is there any prearranged agreement on in 120 days of enactment of the bill, why would you do that when oil prices the speaking order? and we are going to shift the mission are $100 per barrel? The Strategic Pe- The PRESIDING OFFICER. There is so that it continues training Iraqis. troleum Reserve is 97 percent full, and an order that the Senator from Wis- By the way, I don’t know if I men- we are taking 60,000 barrels per day and consin will be recognized at 5 minutes tioned this, the taxpayers of our coun- sticking it underground? That is pre- to 6. There is no other sequence. try have paid to train 440,000 Iraqis. posterous. Toward the second half of Mr. BROWNBACK. I see my colleague We are spending $10 billion a month. this year, the Department of Energy from California. I would like to speak That leads me to my final point of why will be putting approximately 125,000 for a few minutes. We are shortly com- I wanted this time this afternoon. barrels per day underground. There ing to the hour. I don’t know if we have We have to start looking at what this ought not be one additional barrel go been alternating back and forth. is costing us. I say it is time for Amer- underground at that point. It ought to Mrs. BOXER. Madam President, I ica. We are shortchanging our children. go into the supply. only need to speak for less than 10 min- We need to provide health insurance to I used to teach a little economics. I utes, if I may, because I have been sit- many of our children. To provide understand supply and demand. If you ting here for a very long time. health insurance to 10 million unin- decrease supply, you increase price. It Mr. BROWNBACK. Madam President, sured children for 5 years would cost us is just a fact. So this administration, the time of the agreement says at 5 what it costs for 51⁄2 months in Iraq. To by taking this royalty-in-kind oil from o’clock the Senator from Wisconsin enroll all eligible 3- to 4-year-olds in the Gulf of Mexico and sticking it un- gets the floor. Head Start for 1 year would cost us 3 derground into the Strategic Petro- The PRESIDING OFFICER. No, at months in Iraq. To enroll 2.5 million leum Reserve, is pushing up the price 5:55. kids in afterschool programs—and, boy, of oil and gas. Mr. BROWNBACK. At 5:55. I thought do I have a feeling for that one because In fact, we had a witness in the En- the Presiding Officer said 5 o’clock. I I worked with Senator ENSIGN to set up ergy & Natural Resources Committee will be happy to yield. I ask unanimous the first afterschool program, and it who testified that the Department of consent that after the Senator from has been shorted. For 7 days in Iraq, we Energy is taking light, sweet crude off California speaks, I be allowed to speak can enroll 2.5 million kids in after- the market to put into the SPR. That and then my colleague from South school programs for 1 year. is a subset of oil, a much more valuable Carolina be allowed to follow me. What else can I tell you about the kind of oil. One witness said just that The PRESIDING OFFICER. Without funding? We are shortchanging Amer- amount—sticking it underground by objection, it is so ordered. ica’s workers. We can immediately re- this administration could have in- Mrs. BOXER. Madam President, I place structurally deficient bridges in creased the price of oil by as much as thank my friend and colleague. I will the United States and create more $10 per barrel. What is our Government be brief because the message I have is than 3 million good-paying jobs for 61⁄2 doing increasing the price of oil by 10 a pretty straightforward message; that months of the cost in Iraq. Don’t you per barrel? What do they think? Does is, it is time for a change in Iraq. It has think our workers deserve it? I do. somebody have their wires crossed been a long time coming. We have been We could extend 13 additional weeks someplace, and could they please see if there 5 years, longer than we were in of unemployment insurance to the

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00034 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1251 chronically unemployed workers in vesting in homeland security? I am I don’t think that is a responsible high-unemployment States. One month now telling them the truth: Because strategy. If I am hearing the people in Iraq. the money is floating out of here who have served there right, they want We could help an additional 1 million straight to Iraq. to see it through. They want to see us families keep their heat on this winter And by the way, a lot of it is not ac- win, and they want to see us get it through the LIHEAP program. One day counted for—$9 billion missing in cash done right. They want to see us be able in Iraq, Madam President. that was sent. The administration to bring a democracy that can stand on My colleagues come here and they shrugs its shoulders: Oh, well, we don’t its own—certainly not perfect, but one have no end in sight for Iraq. Open know much about it. Scandals in con- that can stand on its own in that re- checkbook for Iraq. Iraq in the morn- tracting, embassies that are larger gion of the world. And they don’t want ing, Iraq in the afternoon, Iraq at than the U.N. complex. Some of the to see us lose the investment we have night, Iraq for 20 years, 50 years, maybe Iraqi people call it GW’s palace. I was made to date. And we have made a 100 years, as one Senator said. We can’t in Saddam’s palace, and I will tell you heavy investment. They don’t want to afford it anymore. something. That was not a happy feel- see us walk away from it and say: OK, OK, let’s look at what else we could ing because that is not something that we didn’t get it quite the way we want- do. For those people like myself who we want to replicate, huge buildings ed to. They do not want to see us walk care about homeland defense, for 6 like that, fancy. How much does it away at such a point that the soldiers weeks in Iraq we could ensure full cost? Almost $800 million. It was sup- or the foreign fighters follow us back interoperability of all our communica- posed to cost $592 million. It doesn’t here and we see another 9/11. tion systems. Our firemen could talk to matter, it is in Iraq. Open the check- The bottom line is the safety and se- our policemen, who could talk to our book and write the checks, says the curity of the young people we have sheriffs, who could talk to our hos- President, the Vice President, and talked about so much. We want to keep pitals, who could talk to our Red Cross. their friends in Congress, who are com- this place safe and secure. And one of Six weeks in Iraq. We could provide ing here and saying: No, no, no, every the best ways to do that is to keep on first responders with 3 million commu- time we want to finally begin to bring the offensive. nications devices for 1 month in Iraq. this war to a close. Mr. President, over the last few We could provide firefighters with 12 Well, I have to tell you, I am ready years, and particularly this last year, million breathing devices for 1 month for change, my constituents are ready we have debated a lot of Iraqi resolutions, and they have all failed except in Iraq. for a change, and right now the Fein- one. One resolution has passed. It is Finally, if you care about America’s gold legislation is responsible because the one I want to talk about. It is the environment, as I do, and many of the it says we will keep troops there to one I did with JOE BIDEN, the Biden- people I represent do, we could extend protect our forces. We will slowly start Brownback resolution on devolving renewable energy production tax cred- bringing them home. We will redeploy power and authority in Iraq. We voted its for 4 years. We could do those tax them and have all the money we need and voted and voted last year. Nothing cuts for investments in renewables for to responsibly do that. And we will go 3 weeks in Iraq. For less than 3 days we passed but this one. And because of it, after al-Qaida. what we were talking about is the could erase the Superfund backlog. And I voted to go to war against Osama model of devolving power and author- for less than 1 day we could triple the bin Laden. What happened to Osama Energy bill authorization to train ity, a federal system, in Iraq. bin Laden dead or alive? Oh, no, this I have met with Iraqis since that pe- green-collar workers. administration turned around, went riod of time, and a number of them The American people have got to into Iraq, and as a result, we are not have challenged and questioned: OK, is connect the dots here. We can’t take safe. Al-Qaida has reconstituted itself, this really the right way to go? We care of our own. We can’t take care of and we are shortchanging the Amer- don’t want to see the country broken our kids. We can’t do what we have to ican people. up in three parts. do for our workers. We can’t do what I thank Senator BROWNBACK for al- I say: We are not talking about we have to do for our businesses. We lowing me to go first, and I yield the breaking the country up in three parts. can’t do what we have to do for our en- floor. We have 50 States, and we are one vironment. And the reason is, our pri- The PRESIDING OFFICER (Mr. country. We are talking about three or ority right now in this government, be- PRYOR). The Senator from Kansas. five states or regions there but one cause of this administration and their Mr. BROWNBACK. Mr. President, I country. You devolve power and au- friends in Congress, is Iraq in the thank my colleague from California for thority from the center so it is not just morning, Iraq at 10 o’clock in the her comments. I respect her thoughts one group, a Shiite-dominated central morning, Iraq at noon, Iraq at 5, Iraq and her opinions and her consistency of government that is dictating to a at night, and we ignore the needs of position. I disagree, and I will articu- Kurdish, Sunni, Shiite country. Let’s our people. late why on that. devolve that power and authority out. There is a time and a place to say to Mr. President, we have been arguing That passed. That passed. a country that is independent, after all and debating on Iraq for some period of Now, what has happened since that we have done for it: Enough is enough. time, since we have gone to war, which has passed on the ground? Well, we are We trained 440,000. We put our Amer- we did on a bipartisan basis, and ag- seeing nice progress actually taking ican lives on the line. Our brave sol- gressively decided that this was an im- place, political progress at the local diers have done everything asked of portant strategy to pursue together. and provincial levels is happening. We them and more. They allowed three We did that 5 years ago. We have in- saw recently the Iraqi Parliament pass elections to be held. They got Saddam vested a lot of time and energy and life a legislative package—three bills to- Hussein, they got Saddam’s family, and and blood and limb from this country. gether. They did something we do here they found there were no weapons of I was with a young man from Wich- often. You can’t get one bill through, mass destruction. They did everything ita, KS, yesterday who has a prosthesis you can’t get two, but three you can we asked them to do. And the Iraqi on the bottom right of his foot. He was somehow get a coalition enough to pass Government takes tiny little steps, pleased to serve in Iraq. He doesn’t like it through. That is what they did, es- baby steps forward, while we continue it that he has lost his foot, but he tablishing the 2008 budget, clarifying having our soldiers die and get wound- wants us to win and he wants us to see provincial powers, and then offering ed and our taxpayers have an open it on through. amnesty for Sunni political prisoners, checkbook. So here we are, 5 years later, a lot of all three very important. My people come and say to me: Why investment, particularly of people and That middle one, clarifying provin- can’t we do more for our kids? Why lives, and it would seem as if a fair cial powers, is a key one. I talked with can’t we do more to protect our envi- number of people now in this body one of the respected scholars on this, ronment? Why can’t we do more for our would say: OK, we have done it long Michael O’Hanlin, on the phone today. workers and our businesses? Why can’t enough, let’s quit. Let’s pull on out and He is one of the authors of the fed- we do more to protect our people by in- let’s hope it all works out. eralism approach in Iraq. We have a

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00035 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1252 CONGRESSIONAL RECORD — SENATE February 27, 2008 military strategy that we are taking ment pass and send the signal to the are on a sort of track now that we can advantage of today that is providing Iraqis that we are moving out; that we look to the future with some bit of op- political space, and he believes we need are going to take care of our own timism, whereas the other route of to devolve authority and power to the areas, you take care of your own areas. pulling out would certainly lead to a regions. You are seeing that now tak- What do we think at this most critical great deal of pessimism by the Iraqis ing place legislatively by the central moment would happen if you pull that and toward me about what we are body in Iraq, clarifying provincial pow- security piece out, the U.S. security going to be doing in providing the long- ers. piece out? Well, I think you would stop term security for the United States As I was talking with Mr. O’Hanlin, this move toward local and provincial. when we know that the terrorist objec- and also in my own thinking, we re- You invite more Iranian-financed prob- tive is to attack and come after us, cently mostly talked about regions, lems into the region, in the hopes that that you are likely to see a devolution and he is saying: Well, whether it is a the Shiite can take over and then to a terrorist state, or an Iranian-type region or a province, it is devolving of dominate and possess all of Iraq— of satellite state in Iraq if we pull out power and authority, and it is hap- Sunni areas and possibly Kurdish areas precipitously, either of which are op- pening. And it is a good thing to get as well, although they are pretty well tions that I think would be completely that out of the centralized area. What fortified amongst themselves. You in- wrong for us to do as a nation and is allowing that to take place is more vite Sadr back in with his militia, something I cannot support. local governance. It is allowing people, where he just recently, for another 6 For those reasons, I certainly would whether they be Sunni or Kurd, or Shi- months, asked his militias to stand be voting against the Feingold amend- ite, or in a mixed area, to be able to down. ment. I urge my colleagues to do that. solve more of their own problems rath- I think you invite back into the pic- I say, let us stick with something that er than being dependent upon the cen- ture at this key political moment for is starting to work. It is not perfect. tral government that may have a bit of Iraq a bunch of forces that are going to Let us stick with something on a polit- ideology or edge that you don’t agree hurt the long-term future. And so it ical strategy that is starting to work. with, as happens around this country seems to me this is a bad idea at a par- It is not perfect, but we have a model at times where people don’t agree with ticularly bad time for us to pull troops for it ourselves in the United States in what happens at the Federal Govern- out of Iraq. our own history. It seems this would be ment, but they are wanting that deci- Now, I had trouble with the surge at a particularly unwise time to move off sion to be made at the State level. the outset. I really questioned whether of that one bit of resolution that we That is starting to happen in Iraq. And it was going to work. But the surge has have agreed upon, on political author- it is diffusing some of the powder keg. worked, and this is coming from some- ity being devolved and to change a Now, we are far from solving this, body who was a cynic as to whether strategy on the military at this point but the political space that has been this was going to work in that region. in time. granted by the military surge in the But that, along with the Sunnis de- I yield the floor. The PRESIDING OFFICER. The Sen- area is allowing this devolution of ciding, okay, we are going to build up ator from South Carolina. power and authority to happen. So we our region here, and these awakening Mr. DEMINT. I want to thank you councils that have taken place, along now have clarifying provincial powers and all my Democratic colleagues for with evolving this political power and taking place. The laws, as I mentioned, allowing me some time on the floor to authority, and our better counterter- are not perfect, but they are giving discuss the progress in the war. This rorism strategy. It is working. So why this power and authority out to the re- allows us as Republicans to contrast on Earth would we change something gions. We are now seeing political our position versus the position of re- we have invested so much in now that progress at the local and provincial treating and announcing that we are levels, and that is driving some of the is starting to produce the results we giving up on Iraq. politics at the national level. None of want? Why on Earth would we change We have heard a lot of talk here that could happen without security at that at this point in time? That does today, and apparently there is too high the national level in Iraq, without U.S. not seem to make much sense, of why a pricetag for freedom. Certainly you troops there on the ground. Iraqis can you would do that at this point in can make an argument that it is expen- gain stability by continuing to decen- time. sive to be in Iraq, just as other wars tralize and move more power closer to I am a strong proponent of con- have been expensive and deadly to our individual Iraqis. tinuing to devolve this power and au- country. I believe provincial elections later thority in Iraq. I think it is the way World War II, the importance of that this year will accelerate the impor- forward for them, as it was the way war can never be underestimated, and tance of local politics in Iraq, and that forward for our country when we had 13 the price on it could not be estimated. is what we want to take place because original colonies that did not nec- The fact that we need to fight wars to what we were seeing coming together essarily agree with each other but said, show our strength as a nation has been was Shiite against Sunni, and the okay, let us have one Federal Govern- proven time and time again. I am wor- Kurds sitting in the north refereeing ment, but each one of us is going to ried that the Senate is not united in from time to time but other times maintain our own power and authority the need to show strength against the staying off to their own and saying: in a number of regions. Then over a pe- war on terror. Look, we are just going to sit up here riod of years, we kind of worked things Last year at this time, my Demo- and hope someday we will be able to out. Over 50 years we have divided cratic colleagues had said that the war have a nation and let those two guys power and authority to State and local, in Iraq was lost, and implicitly the war fight. But now, instead, you are seeing Federal Governments, and this is going against terror, since the front line this going down to Sunni councils and to take time for the Iraqis, but they today on the battle against terror is in Shiite councils, and in some cases need the political space our military Iraq. It was announced here on the mixed neighborhoods. provides. To pull out now, or to send a Senate floor that the war was lost, that You do continue to see an ethnic signal even of pulling out now, I think we were in a hopeless civil war in Iraq. move in neighborhoods, particularly in would be very harmful to the long-term Since then we have had about 40 votes, Baghdad, and some going more Sunni investment we have made. I think it or different variations of votes to cut and others going more Shiite in some would send a signal to the region that funding, to withdraw, to retreat, send- regions or some mixed ethnic or other we are going to allow the Iranian influ- ing a terrible signal to our troops and religious communities that exist there ence to spread. It would also invite our enemies that we lack the resolve and some Christian populations that much more aggressive actions, even to- that is necessary to win this war. are there. But you are seeing it start to ward us, and the pursuit of us here and Whether we call it running and retreat- work because we continue to provide other places around the world. ing or giving up or saying America can- the security umbrella. That piece is speculation. We do not not win, all of those words and ideas Now, let’s take the security umbrella know what is going to happen in the emanated from the Senate floor from off. Let’s have the Feingold amend- future. But it does seem as though we the majority side in the past year.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00036 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1253 Many even voted against the funds to community that was controlled and glad to see us. They were cheerful. surge the troops that has proven to be terrorized by al-Qaida up until about 3 They feel as if they have their commu- such a success over the last several months ago. You would not even go nity back. months. Some of the funding as late as down Main Street in an armored vehi- We have not won this war yet, but we the end of last year was held hostage to cle, we were told by our troops there. can see everywhere we go that Iraqis gross earmarks that were unnecessary Yet we landed at an American out- are standing up and taking back their in a time of war. How can we talk post there, American soldiers were liv- country for themselves. And our about the war on terror being so expen- ing in that community a couple of troops, along with the Iraqi troops sive when we held those funds hostage blocks from the Iraqi Army outpost whom we helped to train, and the Sons to other things that were certainly not where they were living in the commu- of Iraq are guarding and protecting a high priority? nity, and we walked out of our outpost their community. I am afraid my Democratic col- on the main street and talked to the I want to talk about one Marine here. leagues, at least many of them—I know citizens who had opened their markets, This is Major Alston Middleton, who this is not true for all of them, but too talked to the Iraqi soldiers, and talked actually went to Porter-Gaud High many clearly do not understand the to the citizens who were helping to pa- School in Charleston. He is a Marine threat of terrorism in our world today trol the area. In this picture here I am working in the base where we are and what that means to our country talking with one of the local sheiks, training Iraqi soldiers. Every 3 weeks and our freedom. Too many have for- Sheik Ali, who told us that al-Qaida we are producing 2,500 new Iraqi sol- gotten the importance of a strong mili- only a few months before had dragged diers who go straight from that camp tary and how that results in peace his father in front of him and shot him to the battlefield. They are being around the world when nations respect and killed him. trained with the same equipment and the power of the United States of Next to him is an Iraqi soldier whom arms they will be using when they get America. But who can respect America we helped to train. They are as sharp there. any longer, after stating our resolve to as any soldier you would expect to see. He is proud of what he is doing. Ev- stand Iraq up as a free and stable de- This community is well protected. erywhere we went, our troops wanted mocracy, if in the middle of that chal- Colonel Ferrell, who is in charge of the to prove to us that what we were doing lenge we decide to retreat and with- outpost, who took us down the main was necessary, it was right, it was draw? street, was giving us briefings and we working, and we could win it. It was The very fact that we have talked were talking to the sheik as well as the important to them that we know it. about it so many times has sent a sig- Iraqi soldiers. They were proud to tell When I asked them what do they nal of weakness that has empowered us what was happening there. need that they do not have, the answer our enemies and likely put more of our The sheiks and the local tribes are I got—more than any other answer— forces at risk. I hope this is the last the key to working with the American was: Do not forget us. Some of the time we do it this year. surge and have freed much of Iraq in rhetoric on this floor has sent the sig- Everyone has a right to dislike the the last 6 months. These local leaders nal to our troops that we are forgetting war, to say it is too expensive. But our have turned against al-Qaida, because them and do not appreciate what they responsibility here in the Senate is al-Qaida has done such damage and are doing. much different than the average cit- such brutality to their families and This Marine, away from his family, izen. When we send a signal that we are their communities that they are now like all of the other Marines, sailors, not supporting the key mission of our talking with us and helping us to de- soldiers, and airmen we see there, military, we do much to demoralize our feat al-Qaida in that area there. many of them away from their children troops, and to strengthen the resolve of I have another photo here. I know it and spouses for over a year, we know our enemies. is difficult to see. But we were walking what sacrifices they are making. But I Again, I hope this is the last time we down a street that was empty except am afraid these Marines are not re- will do it. My Democratic colleagues for bodies a few months ago. These lit- spected in some parts of this country. I cannot have it both ways. They con- tle markets have opened. As we walked am afraid the Democrats on the Berke- tinue to try to say they support the down the street, in this case it was ley City Council in California—and troops, but everything they actually do mostly American soldiers walking with some here may say that is an isolated undermines them, pulls the rug right us, except for this group—these young situation, but it is not, because they out from under what they are trying to men in the green jackets which they are taking their signals from what do. It’s a lot of empty rhetoric. But in called in this community the ‘‘Sons of they hear right here on the Senate the last week we have seen from the Iraq.’’ Our military pays them to help floor. They called our Marine recruit- Democrats on the House side, a key es- patrol every day. When I asked the ers unwelcome intruders. They called sential part of our intelligence system colonel, when all of these citizens came them thugs. They called them Bush’s is being threatened because we will not running out to us, why were they not murderers. When you see the video and give the administration the tools to worried about them blowing them- what they called our Marines, while use our technology to intercept mes- selves up and killing all of the soldiers our Marines are sweating and bleeding sages from terrorists who might be and us who were walking down the and dying for us and our freedoms. planning to attack us or our interests street, the colonel responded: Because What the Berkeley city council did around the world. we know everyone who is here. was not freedom of speech. The pro- I returned from Iraq a couple of A lot of these folks from the markets testers had their freedom of speech for weeks ago. This is my third trip. I saw came out and hugged our soldiers. I tell months, but that wasn’t good enough a marked difference from anything I you, I couldn’t have felt better to see for them. They wanted the power of had ever seen before. The statistics our soldiers so appreciated in that government behind them to support have been talked about here on the area, to see these young men with their point of view at the expense of floor of the Senate: The monthly at- walkie-talkies. Their job is to patrol, the Marines and all Americans who ap- tacks have decreased 60 percent since to make sure if any stranger comes to preciate our Marines and love what June of last year; civilian deaths are the community, that they notify the they do. We need to recognize that down over 75 percent in the last year; Iraqi Army and the American Army so some of the things that have been said al-Qaida in Iraq remains a threat but that these people can be checked out. right here are sending a signal to peo- their power and ability to do damage We saw a number of trucks with mat- ple like the Berkeley city council to has been greatly diminished. tresses and furniture piled high, of peo- show disrespect for people like Major I wish to talk a little bit about the ple moving back to this little commu- Alston Middleton, who is willing to put trip. I joined Senator ENSIGN and Sen- nity—who had moved out months and his life on the line for us. ator TOM COBURN on this trip. Once we years before because al-Qaida had run I have introduced a bill we call the landed in Baghdad, we took a heli- them out. We walked down several Semper Fi Act, named after the Marine copter to a small community about 30 blocks. Probably 80 to 100 markets motto, which means ‘‘always faithful.’’ miles south of Baghdad. This was a have reopened, and the people were It is just to rattle the cages a little bit

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00037 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1254 CONGRESSIONAL RECORD — SENATE February 27, 2008 of the city council in Berkeley, to tell I thank the men and women at ents to grow old with no children. His them: OK, if you want to take excep- Charleston Air Force Base who are war has caused nearly 29,000 troops to tion to our Federal mission there in making all Americans proud as they leave the combat theater with their Berkeley, certainly you don’t deserve serve all over the world on their mis- wounds. Nearly 700 of them lost limbs, these secret earmarks we have sent to sions. and many more have left with wounds Berkeley in the last several months. I yield the floor. to their minds. Our troops are return- But the Marines are always faithful The PRESIDING OFFICER. The Sen- ing home from the Iraqi desert with and always have been. They are faith- ator from New Jersey. traumatic brain injuries and post-trau- ful to our country, to each other. We Mr. LAUTENBERG. Mr. President, matic stress disorder, making it so dif- need to be faithful to them and all what time remains for our side of the ficult for them to return to their fami- those who are fighting for us. aisle? lies, their jobs, and their lives. This discussion on the floor is again The PRESIDING OFFICER. Fifteen Instead of spending $3 billion each trying to have it both ways, that we and one-half minutes on the Demo- week to wage war on education or support our troops, but then we don’t. cratic side. childhood disease in America, the We don’t support them when we don’t Mr. LAUTENBERG. Mr. President, I President is spending $3 billion a week support the very mission we have rise to talk about Iraq and Senator to wage war in Iraq. Amazingly, I asked them to give their lives for. We FEINGOLD’s legislation to start bring- found someone who doesn’t know that can’t have it both ways. We can’t keep ing our troops home from Iraq. But as sad fact—the President’s own Director having this discussion which questions, I stand here on this floor, I listen to of the Office of Management and Budg- before the whole world, the very mis- one of our colleagues speak of a group et, Mr. Nussle. I recently asked him sion we have asked of our soldiers, sail- out West who may have said something how much we were spending each week ors, Marines, airmen, and Coast disrespectful and offensive about our in Iraq, in a budget hearing. Director Guardsmen and all the civilian support troops and that this group may have Nussle said he didn’t know. Almost ev- staff we have in Iraq and Afghanistan learned it here on this floor and I feel erybody in America besides him knows and throughout the world who are I must respond. That is an insult to all very well—$3 billion each and every fighting the war on terror. We are of us who are part of this body. It is week. It is unacceptable. It is an insult going to win the war on terror because outrageous to say this group learned to the American people who are fund- of the resolve we have to be free and that here. No one here disrespects our ing this war and an insult to our troops peaceful as a nation. troops. No one here wants anything but who are still fighting it. I hope we will get the message here the best for them. We ought not to The President will claim we are mak- that our troops have in Iraq and Af- start off that way, as we discuss the ing military progress in Iraq and that ghanistan and around the world, that Feingold legislation. the surge is working. But let’s tell the sometimes you have to fight for the I wish to begin my remarks with American people the truth. America freedom we have here in this country. President Bush’s now infamous dec- lost 901 mothers and fathers, sisters Now is the time we have to fight. The laration almost 5 years ago when he and brothers in the year 2007 alone; 2007 fact that we have shown resolve in the announced ‘‘mission accomplished.’’ was the deadliest year for America last year has resulted in clear suc- We sadly remember that day, when the since the start of the Iraq war. cesses in Iraq that are undeniable. We More than 3,300 members of New Jer- President landed on the aircraft carrier know we can win this battle, but this sey’s Army Reserves and National USS Lincoln like a conquering hero, battle will not be the last one. The ter- Guard are scheduled to deploy to Iraq standing before a huge banner, which rorists are going to be here for a gen- this year. Just a couple of weeks ago, I eration or more. If they are not in Iraq, we see here portrayed. We remember went to Fort Dix, a major military they are going to be in Afghanistan or watching as President Bush declared base in New Jersey. I talked to people they will be in Africa. They are going that day to be the end. It turned out to who already served there on extended to be somewhere, if they are not here, be a stunningly casual statement, not tours, and they were weary. They were doing their terrorist deeds against the unlike another remark the President willing to do their duty. They re- peaceful people of the world. We have made when he said, talking about the spected their obligation. But their fam- to show resolve. Our enemies must enemy, ‘‘bring them on.’’ I served in ilies were not happy. The people I saw, know that we will never stop until we Europe during World War II, and I the spouses, the children were not root them out and do away with them. never heard a commander invite more happy about their wife or husband, or I also want to make one last com- of the enemy to come to fight. mother or father going away again. ment because the folks from South When the President stood there that Some of them are going to get hurt, Carolina are in so many ways very in- day, the insinuation was that it was and some of them may never come volved with the effort in Iraq. In fact, the end of major combat operations, home. As they do their duty with honor over the last several years the airmen the end of America’s casualties, the and bravery, they count on us to do at Charleston Air Force Base flying C– end of America’s role as the major ours. 17s carry more of the cargo, supplies, player in Iraq’s future. But many of us Their deployment is a reminder that and arms into Iraq than any other base remember fearing that it was not the the President’s surge is fundamentally in our country. This picture is one of end. flawed. His solution is built on mili- the crews that flew us out of Afghani- Today, as we look at the terrible tary strength, when a political and dip- stan back to Kuwait on our way home. costs to our troops, to their families, lomatic solution is what is needed in But we actually had three teams out of to our priorities here at home, to the Iraq. Iraq, not America, needs to ac- Charleston that moved us from Kuwait war against the terrorists who at- complish these goals, and we want to Baghdad, out of Baghdad and to Af- tacked us, and to America’s standing, them to do it. We want them to make ghanistan and back. They are proud of we realize that day in 2003 was only a it possible for us to start bringing our what they do. They wanted us to know, beginning. When the President stood troops home as soon as possible. They and me to tell you, that they believe on the deck of that carrier, America have to do it. It is their responsibility. this mission is important and that we had lost 139 of our troops in Iraq. As we It is their country, and we want to end can win it. Every day they save lives stand here today, we have lost almost our presence there. and deliver freedom. 4,000. To be exact, 3,968 Americans have The surge is also a distraction from All they need is our support, not our died in Iraq; 102 of those troops had ties the war President Bush started in re- empty rhetoric, our real support and to my home State of New Jersey; 95 sponse to 9/11 but never finished. That our belief in them and what they are percent of the mothers, fathers, sons was the war on terror. doing. I came back with that belief and and daughters we have lost were killed When the President spoke to our that resolve, that what we are doing is in action after President Bush said country after September 11, he said: right. If we continue what we are ‘‘mission accomplished.’’ I will never forget this wound to our coun- doing, we will win, and we will con- That mission was not accomplished. try or those who inflicted it. tinue to set the terrorists back on President Bush’s war has left children But it appears that he has forgotten. their heels and keep our country safe. growing up without parents and par- He has forgotten about Osama bin

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00038 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1255 Laden, the man who inflicted those tering home. They have earned the right What is it going to take to get those rible wounds on the victims, their fam- to get back to their loved ones, their folks in Washington to listen to us? I ilies, and this country. He has forgot- kids, their spouses, and their country. I can assure them—and I can assure my ten that the war against al-Qaida and hope we will see that day in the not too colleagues—we will have more debate the hunt for Osama bin Laden began distant future. and votes on Iraq. Members will have and continues outside Iraq. And be- With that, Mr. President, I yield the still more opportunities to listen to cause we have lost our focus, Afghani- floor. their constituents, and to listen to the stan is now spinning back toward vio- Mr. LEAHY. Mr. President, the Sen- warnings about the global threat from lence and chaos. ate once again is debating a bill by al-Qaida and the intolerable strain on After the U.S.-led invasion of 2001, Senator FEINGOLD, Senator REID, my- our military. And they will again have the Taliban was down and wounded. self, and others to change course in to decide whether to keep ignoring Now it seems the Taliban is growing Iraq. And once again, I urge the Senate those warnings and give the President stronger. Over the past 2 years, south- to act. the green light to continue a war with- ern Afghanistan has seen the worst vio- This is a war started under false pre- out end in Iraq. lence since the Taliban was disman- tenses, waged with incompetent polit- In a few minutes, the Senate will tled. Last year was the deadliest year ical policymaking that disserved the vote in relation to another Feingold- for troops in Afghanistan since 2001. bravery and sacrifice of our fighting Reid bill, S. 2634, addressing al-Qaida. Today, al-Qaida has also found sanc- men and women. This is a war that now Before I discuss that bill, I wish to re- tuary in remote areas of Pakistan, and slogs on—week after week, year after spond to some of the criticisms that the Afghani-Pakistani border is so po- year—with nothing but a ‘‘pause’’ on have been leveled against the Feingold- rous that terrorists flow through it the horizon, and still no end in sight. Reid Iraq redeployment bill. like wind. The toll of American casualties rolls I am glad some of my colleagues have If all of this were not bad enough, on, and so does the drain on the Na- apparently taken the time to read the just look at what the President’s war tion’s resources, heading inexorably Iraq bill, but I wish some of them had has done to America’s standing and past the hundreds of billions of dollars read it a little more carefully, or prestige in the world. There used to be toward an unfathomable trillion dol- thought a little harder, before voicing a time when people saw America as the lars. some of their concerns. moral leader, and Americans were The war has sapped our credibility, Of course, some of the criticisms proud of this country’s standing in the strained our alliances, and complicated come from Members who have no inter- world. In World War II, for example, we our security challenges. est in stopping or slowing down the had strength because most of the free Meanwhile, Osama bin Laden re- war. But I have even heard a few com- world was with us. Now is not one of mains at large and al-Qaida has been plaints from Members on our side who those times. Now much of the world is given the opportunity to regenerate. oppose the war. In fact, some Demo- against us. More than 70 percent of The northwestern frontier between crats seem to be trying a lot harder to Iraqis disapprove of American presence Pakistan and Afghanistan is a lawless come up with arguments against this in their country, and 67 percent of citi- extremist haven. bill, and against Congress acting, than zens across the globe believe American A redeployment of American forces they are trying to end the war. One or forces should leave Iraq within a year. along the lines of the Feingold-Reid two senior Democrats are actually lob- Countries that were our allies when we measure would force the Iraqis to real- bying hard behind the scenes against first invaded Iraq, such as Italy, Po- ize that our presence is finite. If they the Feingold-Reid bill. That is dis- appointing, to say the least, and it land, Spain, and Denmark, have left us want to step away from the abyss, it shows us all what we continue to be up in the desert. And Great Britain, one of will take real reconciliation and the against as we try to bring this war to America’s greatest historical allies, will to get it done. sent its troops from Iraq into Afghani- The Bush administration’s failed pol- a close. Let me start by pointing out that the stan. icy in Iraq has stretched our military President Bush, why are we not so Feingold-Reid bill does not—does not— to the breaking point, diluted and di- wise? restrict the Government’s ability to go To date, the President has spent verted our efforts to counter al-Qaida after al-Qaida and its affiliates around more than $526 billion on the war in and its affiliates in Afghanistan and the globe. In fact, one of the main pur- Iraq. That is more than half a trillion elsewhere, and roiled the Middle East poses of the bill is to ensure we have dollars on a war that continues to take with instability. The sooner we change the full capability to do just that. American youth, empower our rivals, course the sooner we can implement a When it comes to our troops in Iraq, turn our friends against us, and let our sound, sensible, and sustainable policy however, we cannot allow this Presi- enemies remain on the loose. that truly advances our security inter- dent to use the narrow exceptions in If that cost were not unbelievable ests. this bill to continue his misguided poli- enough, the President had the audacity Mr. FEINGOLD. Mr. President, I am cies. The language in the bill has been to ask the American people to spend pleased we have had a chance to debate crafted to try to ensure the adminis- even more. He has a pending request of S. 2633, the Feingold-Reid bill requiring tration does not—and cannot—con- $105 billion for the rest of 2008, and De- the safe redeployment of our troops tinue to maintain a heavy military fense Secretary Robert Gates has esti- from Iraq. I am very grateful to the footprint in Iraq. mated that Iraq will cost another $170 majority leader for allowing this de- Specifically, the first exception in billion for 2009. Every dime we spend on bate and for cosponsoring this legisla- the Feingold-Reid bill allows funding Iraq is a dime we cannot spend on our tion. He is a strong opponent of the to continue for ‘‘targeted operations, home—on homeland security for our war, and he understands how it is dis- limited in duration and scope, against cities, police for our streets, education tracting us from our top national secu- members of AQ and affiliated inter- for our children, and health care for rity priority: defeating the global national terrorist organizations.’’ our families. In fact, the President has threat presented by al-Qaida and its af- This provision allows operations requested just now a cut of $800 million filiates. against AQ in Iraq because fighting al- from a critical homeland security While the debate on Iraq is refresh- Qaida is central to our national secu- grant program, leaving Americans ing, the Republicans still will not allow rity. But it does not allow the Presi- more exposed to dangers at home. us to actually vote on the bill. In fact, dent to continue the current opened- It is time for us to realize it is never if you listened to the other side during ended mission because it is not in our going to be enough money. Former this debate, it was apparent they be- national security interest to leave our Secretary of Defense Donald Rumsfeld lieve leaving large numbers of U.S. troops on the front lines in the middle used to say we would stand down when troops in Iraq indefinitely for an open- of an Iraqi civil war. the Iraqis stood up. No one says that ended military mission is somehow in The ‘‘limited in duration and scope’’ anymore. our country’s interest. language prohibits operations without So let me stand up and make it clear: The American people must be a clearly defined counterterrorism ob- It is time for the troops to start com- scratching their heads and thinking: jective, such as the current open-ended

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00039 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1256 CONGRESSIONAL RECORD — SENATE February 27, 2008 mission. And, of course, this provision, been involved in sectarian violence or curity interest, and it is not something like the rest of the bill, only applies to in attacks upon the U.S. Armed Forces. we should permit. We need a full rede- Iraq. It does not affect any other U.S. ...’’ ployment, not a halfhearted half meas- operations around the world. But if my This does not require any kind of ure. colleagues are particularly troubled by guarantee that ISF troops receiving I hope my colleagues will rethink this ‘‘duration and scope’’ language, I training have not been involved in sec- their opposition to the Feingold-Reid am open to discussing with them any tarian violence or attacks upon the bill. If they do have these kinds of con- reasonable modifications that do not U.S., as some have suggested. It just cerns about it, particularly some of the open new loopholes. And this is no rea- requires some good-faith effort to more technical concerns I have ad- son to completely block the Senate make sure we are not assisting some of dressed, well, let’s actually allow the from even considering the bill. My col- the very people responsible for desta- bill to come to the floor and let’s have leagues are free to try to amend it, if bilizing Iraq and killing Americans. amendments and votes. That is our re- they will only let us take it up. That seems pretty reasonable, doesn’t sponsibility as legislators, and we owe If my colleagues think we should it? Just kind of a good-faith effort to it to our constituents and our men and have U.S. troops conducting operations make sure we are not helping people women in uniform to have this debate in Iraq against other organizations who have already killed Americans. in the open and on the record. that are not affiliated with AQ, then One would think that was reasonable. S. 2634 we do, in fact, have a difference of This should not be controversial. We Mr. President, while we may be done opinion. We need to be clear about our have a policy as a government of not debating Iraq for now, the Senate has priorities. Our top national security supporting militaries around the world another opportunity to support a bill priority is the threat posed by al-Qaida that commit undisciplined acts of vio- that would help get our national secu- and its affiliates. Pitting our brave lence, and this administration osten- rity strategy straight. That bill is S. men and women in uniform against sibly vets foreign militaries thoroughly 2634, which I also introduced with groups or entities in Iraq that do not under what is known as the ‘‘Leahy Leader REID, along with Senators pose a direct threat to the United Law.’’ I do not see why we should make BOXER, BROWN, BYRD, CASEY, CLINTON, States is a misuse of our resources, and an exception for Iraq, particularly DODD, HARKIN, LAUTENBERG, LEAHY, it is exactly that mistake I am trying when the GAO and General Jones have MENENDEZ, OBAMA, SCHUMER, and to fix with this legislation. issued reports showing that the ISF is WHITEHOUSE. Obviously, at all times, U.S. troops compromised by militias. If we con- Frankly, it is a pretty modest bill. It in Iraq will be able to defend them- tinue to arm and train the ISF, we may simply requires the administration to selves against any perceived threat, re- simply be contributing to ongoing in- provide Congress with a report out- gardless of who it comes from. But stability in Iraq. At a minimum, then, lining a comprehensive, global strategy when we are talking about planning we need to be careful to ensure we are to defeat al-Qaida and its affiliates, and conducting operations, those oper- not giving some of the worst actors in one that ensures we are bringing all of ations would need to be targeted Iraq the tools to perpetuate further vi- our assets to the table: military, diplo- against members of al-Qaida or affili- olence and bloodshed. ates. If we cannot figure out who we Oh, and by the way, we have already matic, intelligence, and other. The are launching operations against, and trained over 439,000 ISF personnel. This strategy must ensure that U.S. re- if we cannot figure out how to distin- certainly raises questions about how sources and assets are targeted appro- guish between al-Qaida in Iraq and the much more training they need. We priately to meet the regional and coun- many other unsavory actors in Iraq need to make sure the President can- try-specific threats that we face and who do not directly threaten our inter- not keep tens of thousands of troops in that troop deployments do not over- ests, then we have a serious intel- Iraq policing the civil war under the stretch our military. This seems pretty ligence problem which underscores the guise of ‘‘training.’’ straightforward. Don’t we want to degree to which this war is distracting Indeed, the ‘‘training’’ U.S. military make sure we are correctly prioritizing us from our top priority. personnel in Iraq are providing is not the geographic threats posed by al- The Feingold-Reid bill also allows what is traditionally thought of as Qaida and its affiliates around the U.S. troops to remain in Iraq to pro- training, such as boot camp. Our train- world? And don’t we need to make sure vide ‘‘security for personnel and infra- ing is all field training, and there is no all of our assets, including military in- structure of the United States Govern- bright line between training and joint telligence and diplomatic ones, are ment.’’ A question has been raised operations. properly focused on addressing those about whether U.S. troops could also Now, some folks here think that is threats? Shouldn’t we make sure we provide security for non-U.S. coalition fine. They want U.S. troops to continue aren’t imposing an impossible burden forces under this provision. Of course, being embedded with Iraqi troops, con- on our military in the process? It ap- the vast majority of foreign troops in ducting joint operations. The Feingold- pears, however, that the administra- Iraq are U.S. troops. We are the ones Reid bill would not foreclose all joint tion is afraid of what such a strategy holding the bag there, and that is a di- operations or the equipping of ISF. would say; namely, that while it is fo- rect result of this administration’s de- U.S. troops could continue to conduct cusing its attention and resources on cision to rush to war without building joint counterterrorism operations with Iraq, the threat posed by al-Qaida and a strong, sustainable coalition. So rais- ISF so long as the operations target al- its affiliates in Pakistan and many ing concerns about non-Iraqi coalition Qaida or affiliated international ter- places around the world is growing. forces is largely a red herring. How- rorist organizations. But U.S. troops The DNI—the Director of National ever, I respect the contributions of could not be embedded with Iraqi Secu- Intelligence—warned this month that those coalition troops, and I would be rity Forces for ‘‘training’’ purposes. al-Qaida: open, again, to discussing ways in And the U.S. may continue to equip has retained or regenerated key elements of which we can ensure they are protected ISF but may not deploy U.S. troops to its capability, including its top leadership, without opening up a big loophole to Iraq solely for this purpose. operational lieutenants, and a de facto safe keep a lot more U.S. troops there. Some on our side want U.S. troops to haven in the Pakistani border area with Af- ghanistan. Again, technical concerns such as this continue providing ‘‘logistical support’’ are no reason to block us from even to Iraqi forces indefinitely. This, again, Yes, the Chairman of the Joint Chiefs considering the bill. Frankly, it sounds is a backdoor way to keep substantial of Staff, ADM Mike Mullen, testified like an excuse not to deal with the real numbers of U.S. troops on the front recently that: issue, which is our need to get out of lines, performing basic combat support The most likely near-term attack on the this situation. functions, such as providing air sup- United States will come from al-Qaida via The Feingold-Reid bill also permits port. Even seemingly run-of-the-mill its safe havens in Pakistan. U.S. troops to be stationed in Iraq to logistical operations can be extremely In a recent report led by former provide ‘‘training to members of the dangerous in the chaotic environment NATO Commander GEN James Jones, Iraqi Security Forces who have not in Iraq. That is not in our national se- he called Afghanistan a ‘‘strategic

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00040 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1257 stalemate’’ and warned that ‘‘Afghani- Petraeus has renewed our hopes for a ing a vote on the bipartisan, Senate- stan remains a failing State. It could unified Iraq to govern, defend, and sus- passed FISA bill. We know there is a become a failed State.’’ tain itself as an ally in the war on ter- bipartisan majority in the House of So while our military and intel- ror. Our men and women in uniform Representatives to pass the same bill ligence experts are saying this, the have protected the Iraqi people, scat- that passed the Senate by a large bi- President’s Iraq policies have stretched tered al-Qaida, deterred militias, and partisan majority. A good way to our military to the breaking point. helped to create an environment that strengthen our efforts against al-Qaida Yesterday, the Senate heard testimony has led to progress not only at the tac- would be to take up and pass that bill. from top Army officials that the Army tical level but in government and in It would be irresponsible to cut off is under serious strain and must reduce reconciliation as well. We owe them all funds for troops in the field. We will the length of combat tours as soon as a great debt. not pass a bill that does so. But we wel- possible. Listen to what GEN George In September, General Petraeus outcome debate on the al-Qaida report be- Casey, Chief of Staff of the Army, had lined his plan for bringing these men cause we are ready to provide all of the to say: and women back after a job well done resources required to defeat al-Qaida, The cumulative effects of the last 6 plus and for transitioning our mission to to include quick passage of the Defense years at war have left our Army out of bal- one of partnership and overwatch. I appropriations supplemental, full fund- ance, consumed by the current fight, and un- might say parenthetically, I was just ing of the 2009 Defense Appropriations able to do the things we know we need to do with General Petraeus’s wife a few mo- Act, and passage of a FISA bill that to properly sustain our all-volunteer force ments ago, who is at a reception here will allow our intelligence community and restore our flexibility for an uncertain in the Capitol complex for people from to continue to hunt terrorists. future. the Fort Campbell area. Earlier in Gen- We must also consider the full cost of These are the words of GEN George eral Petraeus’s career, he was the com- our Nation’s global commitments and Casey: out of balance, unable to do the mander of the 101st Division of the sto- our need to modernize our ground, air, things we need to do. ried Screaming Eagles who have been and naval forces. We should also give We need to heed these dire warnings at the tip of the spear in both Afghani- the administration ample time to com- and recognize that the President’s Iraq stan and Iraq over the last 4 years. plete this study which should serve as policies are unsustainable. The Fein- General Petraeus has had three dif- a sound guidance for the incoming ad- gold-Reid bill, S. 2634, would force the ferent assignments in Iraq. We are all ministration. administration to confront that reality thoroughly familiar with his current So we welcome a debate on how to and to confront the dangerous threat assignment, but his wife is a good sol- best hunt al-Qaida and defend the Na- posed by al-Qaida while our troops are dier indeed as well, and I had an oppor- tion, and if we are to get on this bill, bogged down in Iraq. tunity a few moments ago to thank her we will be debating amendments that Unfortunately, the administration again not only for his contribution but make this report more meaningful. has its head stuck in the sands of Iraq. I yield the floor. for her sacrifice as well. The PRESIDING OFFICER. The ma- It actually threatened yesterday to This reduction in forces that General veto this commonsense bill. I guess the jority leader. Petraeus’s mission has made possible Mr. REID. Madam President, some President doesn’t want the American has already begun, and the Iraqi people parts of the Iraq war are open for de- people to know how off track we are. are prepared for provincial elections in bate, but there is a lot we know for Well, believe me, they actually know. October. Due to the success of the sure. These are the facts: Nearly 4,000 They have been watching over the past Petraeus plan, Sunnis now serving as American soldiers have been killed, few years as this administration has Sons of Iraq and defending their own 30,000 wounded, and the wounds of a confused the war in Iraq with the fight Nation will now have a real stake in third of them are very serious. We have against al-Qaida. They want a change, those elections. When General Petraeus thousands and thousands of amputees, and they don’t want to wait another and Ambassador Crocker return this more than 3,000 double amputees, blind, year for another President and another April, we should listen to their rec- hearing loss, head trauma that will af- Congress to finally act on their con- ommendations to ensure that the hard- fect them the rest of their lives. I cerns. earned gains of the surge are main- talked this morning about a returning I hope my colleagues listen to them tained. Iraqi soldier who has post-traumatic and listen to our intelligence experts But one thing is already clear from stress disorder. He cannot work. He is when they warn us about the serious the successes we have recently seen. losing his home. These are the facts. threat posed by al-Qaida in Pakistan, Congress needs to stop considering this We still have 150,000 more troops in Afghanistan, and elsewhere. If they do, war in fits and starts and through Iraq. News from the Pentagon is that this bill will pass 100 to nothing, and piecemeal debates. We need to under- there will be 8,000 more troops in Iraq the American people will breathe a stand that our interests in the Persian in July than before the surge started. sigh of relief that finally their voices Gulf and Iraq are long-standing and GEN Colin Powell told us last year are being heard. will not vanish because we have a Pres- the Army is ‘‘about broken.’’ General Madam President, I yield the floor, idential election in November. We Casey, Chief of Staff of the Army, con- and I suggest the absence of a quorum. can’t wish the dangers away. firmed what General Powell said. Yes- The PRESIDING OFFICER (Ms. This leads me to the second Feingold terday, he said: CANTWELL). The clerk will call the roll. measure calling for a new strategy in The demand for our forces exceeds the sus- The legislative clerk proceeded to defeating al-Qaida. We deal with global tainable supply. call the roll. strategies and long-range plans General Casey basically confirms Mr. MCCONNELL. Madam President, through the national security strategy, what General Powell said: The Army is I ask unanimous consent that the order the national military strategy, the broken. for the quorum call be rescinded. Quadrennial Defense Review, and The day before yesterday, on public The PRESIDING OFFICER. Without through the annual defense legislation. broadcasting, there was a good report objection, it is so ordered. If the Senator from Wisconsin wanted that dealt with ADM Tim Keating, Mr. MCCONNELL. Madam President, to know how our global strategy to commander of the Pacific Command, a in a few minutes we will have a proce- combat al-Qaida fits into the context huge command, and basically the dural vote on another proposal by the of these reports and reviews, he might whole report is how hamstrung he is in junior Senator from Wisconsin, a bill have asked the administration to trying to do his job. He cannot do it that would direct the administration produce such a document in the annual anymore because, as indicated in the to produce in 60 days a new global Defense Authorization Act. Also, I report, there are not enough resources strategy for defeating al-Qaida. But might suggest that one sure way of anymore because they are all being first, a word about the first Feingold strengthening our fight against al- shipped to Iraq and now some to Af- bill which dictates withdrawal. Qaida and other terrorists would be for ghanistan. Those are the facts. Last year’s bold decision to launch a the Democratic leadership over in the I had visiting me today some people counterinsurgency plan under General House of Representatives to stop block- who were so excited—Don Schneider,

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00041 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1258 CONGRESSIONAL RECORD — SENATE February 27, 2008 who used to be president of a bank in strategy of the United States to com- fact, the worst foreign policy decision Las Vegas and is now chairman of a bat and defeat al-Qaida and its affili- of our time, maybe beyond that. We board of trustees of an organization ates. will pay a heavy price for it, but we that is building a performing arts cen- Section 1. Report on United States Global will not pay a price as a nation as ter in Las Vegas. One foundation gave Strategy to Combat al-Qaeda and Its Affili- great as the price paid by the families as a start $150 million to the organiza- ates. who have lost in combat a son or tion. They have raised $420 million. (a) Report Required—Not later than 60 daughter or husband or wife they dear- days after the date of the enactment of this They need $50 million more for this or- Act, the Secretary of Defense, the Secretary ly loved. Those men and women are ganization. I said to him: $420 million of State, and the Secretary of Homeland Se- true heroes. is how much we spend in Iraq in 1 day— curity, in coordination with the Chairman of The PRESIDING OFFICER. The ma- 1 day. That is what this beautiful per- the Joint Chiefs of Staff and the Director of jority’s time has expired. forming arts center in Las Vegas costs. National Intelligence, shall join and submit Mr. REID. I thought the vote was at Madam President, $400 million a day, to Congress a report setting forth the global 6:30 p.m. 7 days a week. There are not weekends strategy of the United States to combat and The PRESIDING OFFICER. The re- off. These are taxpayers’ dollars we are defeat al Qaeda its affiliates. maining time is under the control of borrowing. There are no holidays. New That is pretty simple and direct. the minority. Year’s, Christmas, Easter—it doesn’t That is what we are voting on. That is Mr. MCCONNELL. Madam President, matter, we work right through, and an- what the legislation is all about. Why I yield back the remaining time on this other $400 million of taxpayers’ money would anybody be opposed to this legis- side. is borrowed. And the number is going lation? It is straightforward legisla- The PRESIDING OFFICER. All time up, not down. The world should under- tion. is yielded back. Under the previous stand that America has done its share. It is clear that my colleagues on the order, the motion to proceed to S. 2633 I personally dispute the wisdom of other side of the aisle are not serious is withdrawn. about any of this Iraq legislation. They going into Iraq. I said, and I have said f many times, the worst foreign policy had an opportunity to talk on it. As I blunder in the history of this country said earlier today, it has been a good REQUIRING A REPORT SETTING is the invasion of Iraq. But we are debate. They believe there still is not FORTH THE GLOBAL STRATEGY there. When is enough going to be enough of American blood and treasure OF THE UNITED STATES TO enough? How many more days spending in Iraq. I do. The American people do. COMBAT AND DEFEAT AL QAEDA $400 million are we going to need in Twenty-five percent of Republicans be- AND ITS AFFILIATES—MOTION Iraq? When is enough enough? Is 4,000 lieve we should be coming home from TO PROCEED soldiers enough killed? Is 30,000 wound- Iraq. This is not some Democratic idea; The PRESIDING OFFICER. Under ed? How many blind soldiers do we it is an idea of the American people. the previous order, pursuant to rule need? How can they object to this matter XXII, the Chair lays before the Senate No one disputes the heroic efforts of on which we are going to vote in a few the pending cloture motion, which the our troops, but as I indicated yester- minutes? How can they not vote over- clerk will report. day, my friend—I named my son after whelmingly for this legislation? If they The assistant legislative clerk read him, and he named his son after me. He had an honest reason to disagree with a as follows: used to be a model. He joined the mili- report on the fight against terrorism, CLOTURE MOTION tary. He is a helicopter pilot. He served that would be one thing. That is not We, the undersigned Senators, in accord- a tour of duty in Afghanistan, and he what is going on here. This is a stall ance with the provisions of rule XXII of the sent me e-mails about what he was that has been going on so that we will Standing Rules of the Senate, hereby move doing over there. He came home, and I not have the opportunity to start the to bring to a close debate on the motion to had dinner with him in Las Vegas. He debate on a stimulus package dealing proceed to Calendar No. 576, S. 2634, global was being shipped to Iraq. I don’t get e- with housing. strategy report. Of course, we brought up these mat- Russell D. Feingold, Edward M. Kennedy, mails from him anymore. I asked his Patrick J. Leahy, Robert Menendez, dad why. He said he wants to come ters, and if they were allowing us to go forward with these pieces of legislation Ron Wyden, Sherrod Brown, Richard home. All of them should come home is Durbin, Bernard Sanders, Patty Mur- what he said. So he is not sending me dealing with Iraq and have amend- ray, Joseph R. Biden, Jr., Frank R. e-mails anymore. He thinks I might be ments like, of course, what has hap- Lautenberg, Christopher J. Dodd, John disappointed in him. I am not dis- pened—but, no, motions to proceed, 30 D. Rockefeller, Amy Klobuchar, appointed in him. He is a valiant sol- hours. We broke the record last year in Charles E. Schumer, Tom Harkin, Bar- dier. 1 year of a 2-year filibuster plan. They bara Boxer. How much more do we need to do? broke all records, and they are at it The PRESIDING OFFICER. By unan- When is enough enough? Five years of again. imous consent, the mandatory quorum war, I guess, according to the Repub- Keith Olbermann, an MSNBC anchor, call is waived. licans, is not enough. We are going to says at the end of every one of his tele- The question is, Is it the sense of the start in a few days the sixth year of casts: Senate that the debate on the motion this war. When is enough enough? This is the 1,764th day since President to proceed to S. 2634, a bill to require a Back here a number of years ago—it Bush declared ‘‘mission accomplished’’ report setting forth the global strategy has been 5 years ago now—I met the aboard an aircraft carrier. We all know the of the United States to combat and de- Iraqi Governing Council. I can remem- mission has not been accomplished. We all feat al-Qaida and its affiliates, shall be know we’re not safer today than we were ber that meeting as well as if it was when we began this misguided war now five brought to a close? yesterday. We were in Senator Frist’s years ago. It’s time to turn the page and The yeas and nays are mandatory office. The head of the delegation from begin to rebuild a moral authority to address under the rule. Iraq said: I know people think we have the growing challenges we face throughout The clerk will call the roll. the second largest supply of oil in the the world. The assistant legislative clerk called world, but that is wrong. We have the The PRESIDING OFFICER. The ma- the roll. largest supply of oil. We have more oil jority whip. Mr. DURBIN. I announce that the than Saudi Arabia. Mr. DURBIN. Madam President, I Senator from West Virginia (Mr. Iraq is a wealthy Nation. When is thank my majority leader, Senator BYRD), the Senator from New York there enough American blood and REID, not only for his statement but (Mrs. CLINTON), the Senator from Mas- treasure for Iraq? Can’t this wealthy also for bringing this matter to the sachusetts (Mr. KENNEDY), and the Sen- nation take care of itself? floor. I especially thank Senator FEIN- ator from Illinois (Mr. OBAMA) are nec- The matter on which we are going to GOLD. I have been happy to cosponsor essarily absent. be voting in just a few minutes is not this measure. Mr. KYL. The following Senators are very complicated. This bill is to re- I believe, as do many of us today, necessarily absent: the Senator from quire a report setting forth the global that the decision to invade Iraq was, in Missouri (Mr. BOND), the Senator from

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00042 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1259 Minnesota (Mr. COLEMAN), the Senator there was an attempt to castigate and turn against groups such as al- from Texas (Mr. CORNYN), and the Sen- those who voted for this debate and Qaida. ator from Arizona (Mr. MCCAIN). who wanted the full 30 hours to talk Our efforts are reuniting torn com- Further, if present and voting, the about this vital issue. Some in this munities and enabling political proc- Senator from Minnesota (Mr. COLEMAN) body seem to have perhaps been a little ess. Obviously, this Nation would have and the Senator from Texas (Mr. too clever and tried to summon as been better served had the surge strat- CORNYN) would have voted: ‘‘yea.’’ much outrage against debating this egy been implemented earlier. But the The PRESIDING OFFICER. Are there matter as they were prepared to use in ability to criticize strategy is not the any other Senators in the Chamber de- support of debate. same as the ability to strategize. siring to vote? I do question exactly what those in So I applaud those who did finally The yeas and nays resulted—yeas 89, support of this bill hoped to realisti- implement the surge strategy and con- nays 3, as follows: cally accomplish with this debate and gratulate them on their vision. As we [Rollcall Vote No. 34 Leg.] this legislation before us given the know, Iraq must stand up before we YEAS—89 gains that have been made through the can stand down. Again, David Petraeus has stated there cannot be solely a Akaka Durbin Murkowski surge strategy. Last May when the Alexander Ensign Murray surge was being implemented, only 29 military solution to violence without Allard Feingold Nelson (FL) Senators voted for similar legislation. political action. And he is absolutely Baucus Feinstein Nelson (NE) Undoubtedly, much has changed for the correct in his assertion. Bayh Graham Pryor better since that point. Violence in In recent weeks, Iraqis have made Bennett Grassley Reed Biden Gregg Reid Iraq is down 60 percent since the start tremendous political strides under Bingaman Harkin Roberts of the surge and 80 percent in and what are still difficult and onerous Boxer Hatch Rockefeller around Iraq. There has been a 30-per- conditions and as a result increased se- Brown Hutchison Salazar Brownback Inhofe cent increase since June in insurgent curity in their nation. February 13 saw Sanders Bunning Inouye the Council of Representatives pass Schumer weapon caches discovered. Economic Burr Isakson Sessions improvements continue. Oil production three key pieces of legislation: am- Cantwell Johnson Shelby nesty for Sunni security detainees, a Cardin Kerry is constantly increasing, up 50 percent Carper Klobuchar Smith from this time last year. And oil reve- provincial powers law, and a budget. Casey Kohl Snowe nues are nearly double what they were Debaathification reform was enacted Chambliss Kyl Specter Stabenow last year. In Baghdad alone, 21 new last month as well. Coburn Landrieu Let’s talk about those political ac- Cochran Lautenberg Stevens health clinics opened this year, 1,885 Collins Leahy Sununu new schools have been built, and an- complishments. The general amnesty Conrad Levin Tester other 1,604 have been refurbished law passed by the Shiite-majority Par- Corker Lieberman Thune liament sets the guidelines in pro- Craig Lincoln Vitter throughout Iraq. Crapo Lugar Voinovich Because of reconstruction and re- viding amnesty for thousands of de- DeMint Martinez Warner building, electricity demand is up 25 tainees held in Iraq detention facili- Dodd McCaskill Webb percent. A year ago, it would have been ties. This helps to remove one of the Dole McConnell Whitehouse greatest stumbling blocks to reconcili- Domenici Menendez Wicker laughable to suggest that Anbar Prov- Dorgan Mikulski Wyden ince be transferred to Iraqi control. ation between Sunnis and Shiites. The Iraqi Parliament has also passed NAYS—3 But that will happen in May. When this occurs, Anbar will be 10 out of 18 prov- the provincial powers law which out- Barrasso Enzi Hagel inces under full Iraqi control. lines the balance of authorities be- NOT VOTING—8 The city of Ramadi in Anbar was tween the central and local govern- Bond Coleman McCain once one of the most dangerous cities ments while also specifying that pro- Byrd Cornyn Obama in Iraq. It is now one of its safest fol- vincial elections be held on October 1 Clinton Kennedy lowing the surge. The number of U.S. of this year. The Iraqi Parliament ap- The PRESIDING OFFICER. On this combat battalions operating in Ramadi proved a $48 billion budget, rep- vote, the yeas are 89, the nays are 3. has decreased from five to two in less resenting a step toward Iraq using its Three-fifths of the Senators duly cho- than a year. own resources to provide for security sen and sworn having voted in the af- An Army combat brigade that has and infrastructure reconstruction. This firmative, the motion is agreed to. been stationed in Ramadi for over a Sunni-Shia compromise budget allows The PRESIDING OFFICER. The Sen- year is scheduled to leave the area in the Kurds a larger share of the budget, ator from Colorado. March and is not scheduled to be re- which is 17 percent. Iraqi oil revenues Mr. ALLARD. Mr. President, I was placed. The United States is on pace to have soared with the rise of global scheduled to speak at 6:30. We had a transfer control of all Iraqi provinces prices, and Iraqi production has in- vote at 6:30. It is my understanding by the end of the year. creased due to gains in security. The that I now have the floor to speak on The surge strategy is brilliant in its money is now going to the provinces on the bill on which we just voted. simplicity: Exert our military forces to a regular basis where it will fund ur- The PRESIDING OFFICER (Mr. quell insurgent violence in order to gently needed reconstruction and hu- CASEY). The Senator is recognized. create an environment suitable for fos- manitarian relief. The Iraqi Govern- Mr. ALLARD. I rise to discuss the tering and sustaining a legitimate gov- ment is now providing the kind of serv- war in Iraq and specifically the legisla- ernment capable of governing its citi- ices that give the Iraqi people a stake tion at hand which directs the Presi- zens. Real political progress will only in their own success. dent to transition the mission of U.S. be reached when Iraqis feel secure, and Finally, the President’s council ap- forces in Iraq. the results of the surge are proving proved the law of accountability and The Senate has voted on this same this to be exactly the case. justice on February 3, 2008. This law issue on four separate occasions in this Thus far the surge is producing its could allow thousands of former Ba’ath session alone. Not one of those times intended results by eliminating terror- party officials to return to Government did the measure receive even one-third ists, interrupting communications be- jobs and receive pensions, helping the of the Senate’s support. Nonetheless, tween insurgents in many areas in reconciliation process and stimulating here we are again debating the policies Iraq, and ensuring safety for the people the economy. In addition, even more of the war. which, in turn, allows far broader, far groundbreaking legislation is slated for Let me be clear. There is certainly greater cooperation and association consideration in the very near future. nothing wrong with openly debating with the United States. These initiatives include a hydro- those policies. It is our responsibility Only with these security improve- carbons law to determine the level of as Members of this body to discuss ments do Iraqis have a reasonable control allocated to the central Gov- thoroughly what is arguably the most chance of finding a political solution. ernment as well as an election law that important and defining issue of our This strategy is convincing many is being drafted currently by the Prime day. In fact, I find it highly curious Iraqis to abandon terrorist methods Minister’s office. While the job is far

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00043 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1260 CONGRESSIONAL RECORD — SENATE February 27, 2008 from over and much work is still re- For a moment let’s consider the se- and not in the best interests of our Na- quired, these recent accomplishments verity of the issue at hand. We are de- tion. Our military does not exist just on the political and economic fronts bating whether to deploy our forces to come marching home, and our mili- continue to gather momentum and which would essentially concede the tary understands this. They exist to show important signs of progress and country to whatever group eventually fight our enemies and secure our vital create reasons for optimism. There is gains control that would likely plunge national interests. Removing Saddam much criticism of flaws in the Iraqi the country into further unrest and Hussein from power was in our na- Government’s processes and outcomes, chaos. It seems we are acting under the tional interest. Stability in the Middle but any Member of this body who con- assumption that if we get all of our East is in our national interest. Secur- siders throwing stones in that direc- forces out, we can slam the door behind ing Iraq from terrorist control is in our tion should first glance at any news- us and all will be fine. This policy fails national interest. Pandering speeches paper, news show, citizen rally, or pub- to lend any consideration to what about bringing the troops home that lic opinion poll, and reflect on who would certainly be dire consequences strive for mere political points and fail among us is producing perfect and that would ensue as a result of our Na- to acknowledge strategic realities are flawless legislation. tion abandoning Iraq at this critical not in our national interest. Even the media, which has often been juncture. To do this would simply be We still have a job that needs to be one-sided on the war, has for several irresponsible and shortsighted. Iraq is completed. We still have work to do. months now been forced to report that the pivotal front in our global war on When the time is right, we will rede- the surge and coalition efforts have terror. To intentionally abandon our ploy responsibly. The Iraqi Govern- been succeeding. Let’s look at some of progress and lose the battle would ment is making progress. We are begin- the headlines: surely cause irrevocable harm to our ning to be able to stand down to a The Washington Post, February 23, efforts to secure our Nation. Osama bin greater extent than we have in the 2007, ‘‘Sadr Extends Truce in Iraq’’; the Laden had referred to Iraq as the cen- past. General Petraeus and Ambas- Los Angeles Times, February 22, 2008, tral front in the war against America sador Crocker will return to Wash- ‘‘U.S. Micro-Loan Effort Yields Big Re- and the West. Al-Qaida in Iraq shares ington and report on the progress in sults in Iraqi Province’’; the Colorado this view of the situation. Leaving pre- Iraq in April. We owe to it our men and Springs Gazette, February 18, 2008, maturely would only strengthen al- women in harm’s way to listen to the ‘‘Baghdad Neighborhood is a Model of Qaida and enable terrorists to set up experts and make our decisions off of Progress’’; Reuters, February 16 of this training camps in Iraq and plot further their findings. year, ‘‘Attacks in Baghdad Fall 80 Per- attacks on the United States. I yield the floor. cent’’; Reuters, a February 13 article, The National Intelligence Council The PRESIDING OFFICER. The Sen- ‘‘Iraq Lawmakers Pass Key Budget and stated: ator from Wisconsin. Amnesty Laws’’; Reuters on January 17 If such a rapid withdrawal were to take Mr. FEINGOLD. Mr. President, I am of 2008, ‘‘Iraqi Forces Could Control All place, we judge that al Qaeda in Iraq would pleased the Senate has voted over- Provinces This Year’’; even the New attempt to use parts of the country—par- whelmingly to allow some debate of York Times, February 14, 2008, ‘‘Mak- ticularly al-Anbar province—to plan in- the Feingold-Reid al-Qaida bill, but it ing (Some) Progress in Iraq’’; the creased attacks in and outside Iraq. is pretty clear to everyone that this Washington Post on February 10, 2008, By passing this legislation, we would body still doesn’t fully understand and ‘‘Diary of an Insurgent in Retreat: Al- be running away from a war from the is not ready to address head on the Qaeda in Iraq Figure Lists Woes’’; the floor of the Senate. When has it ever threat posed by al-Qaida. As was made AP, February 2, 2008, ‘‘Lynch: US Surge been sound policy for legislators to clear during debate on the Iraq rede- Tipped Scales in Iraq’’; an AP article micromanage a war from Washington? ployment legislation, too many Mem- on January 21, 2008, ‘‘U.N. Envoy Ap- I don’t ever recall in our history this bers confuse the war in Iraq with the plauds Cut in Iraqi Violence’’; the Win- tactic being successful in achieving our fight against al-Qaida. That is true of ston-Salem Journal, February 12, 2008, strategic goals. In fact, let me remind the administration too. While it is fo- ‘‘Iraq is Much Changed Since Surge our colleagues, we have seen terrible cused on Iraq, al-Qaida has reconsti- Started One Year Ago’’; Tacoma News results from political motives being tuted itself along the Afghanistan- Tribune, February 14, 2008, ‘‘Iraq placed above military necessity. In- Pakistan border. Don’t take my word Reaches Benchmark for Healing.’’ stalling an artificial deadline is not for it. Listen to our intelligence com- Coalition success is being seen all what we need. It is not what is good for munity. over Iraq. It is being reported. The only the Nation. It is not good for the future Early this month, the Director of Na- people who seem to refuse to see it or of Iraq and the long-term stability of tional Intelligence testified before Con- admit we are winning in Iraq are my that region. We have heard from our gress that the central leadership based colleagues on the other side of the aisle military intelligence professionals who in the border area of Pakistan is al- who continue time and again to bring have warned about the possible con- Qaida’s most dangerous component. A this issue to the floor claiming that sequences of hasty withdrawal and the few months ago, the DNI again re- the surge has not worked and urging potentially catastrophic results that peated the intelligence community’s immediate troop withdrawal. Certain may ensue. We should also listen to our assessment that over the last few years Members of Congress continue to deny folks on the ground. I have heard time ‘‘Al Qaeda’s central leadership has been that any progress has been made. Ear- and time again from our service men able to regenerate the core operational lier this month the Speaker of the and women from all branches of the capabilities needed to conduct attacks House described the surge as a failure. military who have returned from Iraq in the Homeland’’—our homeland, Mr. Opponents long criticized the adminis- that progress is being made, and they President, the United States of Amer- tration for not sending more troops to are proud of the contributions they are ica. Iraq. But when this strategy was in- making to this Nation and to the long- The DNI also testified that al-Qaida stalled, it was also attacked as oppo- term stability of Iraq and the Middle ‘‘is improving the last key aspect of its nents declared that this effort was es- East. ability to attack the U.S.: the identi- sentially too little, too late. When the In my lifetime I have witnessed few fication, training, and positioning of surge began to show great military events that compare to the joy and ju- operatives for an attack in the Home- success, it faded from the floor of this bilation that accompany the homeland.’’ body. coming of a military unit. When I have Meanwhile, the Federally Adminis- That is why we welcome the chance seen a brigade return home to Fort tered Tribal Areas in Pakistan is serv- to spend 30 hours on this topic. It is a Carson or a wing to Peterson Air Force ing as a staging ground for al-Qaida in shame that now, when both military base, there are no words to describe the support of the Taliban and providing it and political success is being realized, sheer emotion of seeing families re- with a base similar to the one it used we are only debating whether to returned to loved ones and friends. How- to have across the border in Afghani- treat. If that is the ground the major- ever, redeploying our forces at this stan. The Chairman of the Joint Chiefs ity wishes to stand on, so be it. point is not the proper course of action of Staff, ADM Mike Mullen, testified

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00044 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1261 recently that ‘‘the most likely near tion to provide Congress with a report a classified annex. Much of our stra- term attack on the United States will outlining a comprehensive global strat- tegic planning, however, is not classi- come from Al Qaeda via’’ its safe ha- egy to defeat al-Qaida and its affili- fied, consistent with our country’s be- vens in Pakistan—not in Iraq, in Paki- ates. The strategy must ensure U.S. relief in open government and account- stan. Over the past year, we have seen sources and assets are targeted appro- ability. an unprecedented rise in suicide bomb- priately to meet the regional and coun- The American people deserve to be ings in Pakistan. The Taliban is gain- try-specific threats we face, and that told, to the extent possible without di- ing ground in Afghanistan. While we troop deployments do not overstretch vulging classified information, what may be sending an additional 3,200 ma- our military. their government is doing to protect rines to Afghanistan in the near future, Who could oppose a commonsense them. The President’s veto threat is we have been fighting for far too long bill such as this? Well, as I noted ear- further evidence of his unwillingness to there with too few soldiers and too few lier, the administration actually issued be straight with the American people reconstruction funds. a veto threat for this bill. That threat about the fact that the war in Iraq is With the Joint Chiefs of Staff saying makes the baffling argument that pre- actually undermining our national sein ‘‘Iraq we do what we must and in Af- paring a report on the threat of al- curity. The President’s current strat- ghanistan we do what we can,’’ it is no Qaida may somehow ‘‘inhibit the Presi- egy is to prioritize operations in Iraq, wonder that Afghanistan is teetering dent’s constitutional authority as even to the detriment of operations in on the edge. Let me remind my col- Commander in Chief.’’ That is not all. Afghanistan against those who at- leagues that it was from Afghanistan— The administration also argues that tacked us on 9/11. Afghanistan, not Iraq—that the 9/11 at- preparing a plan that prioritizes oper- Now, that does not make sense. It tacks were planned. And it was under ations against al-Qaida would tie the has to change, and we have to change the Taliban regime, which is once hands of commanders. it today by passing this Feingold-Reid again gaining ground, that al-Qaida This is just plain double-talk. We are bill, refocusing our attention and re- was able to flourish so freely. trying to help our commanders and the sources on al-Qaida. Al-Qaida affiliates from Africa to rest of our Government to properly Mr. President, I yield the floor. Southeast Asia pose a significant ter- dedicate their resources to our most The PRESIDING OFFICER. The Sen- rorist threat. While we have been so pressing national security concern. ator from North Carolina. myopically fixated on Iraq, the threat This bill does not tell our commanders HEALTH CARE REFORM from an al-Qaida affiliate in north Af- Mr. BURR. Mr. President, one of the rica has grown and now, according to how to carry out any operations; it the DNI’s testimony, ‘‘represents a sig- merely requires a report. The Congress most pressing issues in America today nificant threat to the United States has a constitutional responsibility, in is: What will Congress do to address and European interests in the region.’’ collaboration with the President, to de- health care? The American people de- Since its merger with al-Qaida in Sep- termine what are our national security serve a 21st century health care sys- tember 2006, it has expanded its targets priorities. That is what we should be tem—not just a delivery system of doc- to include the United States, the doing. That is what this bill would do. tors and hospitals but a system that is United Nations, and other interests. Unless the President has completely integrated, one that recognizes society And it likely got a further boost when abandoned the idea of civilian control has changed. al-Qaida leadership announced last No- of the military, and of the shared re- This body, several years ago, ex- vember that the Libyan Islamic Fight- sponsibilities between the legislative tended a new benefit to Medicare, ing Group united with al-Qaida under and executive branches, then he should where we covered prescription drugs in AQIM’s leadership. Its possible reach have no objection to my bill. a health care delivery system that was covers Tunisia, Morocco, Nigeria, Mau- The administration does say that it created in the 1960s, when drugs were ritania, Libya, and other countries. ‘‘supports the bill’s goals and intent, not a common treatment for disease. It Meanwhile, it is using deadly tactics with regard to updating and informing took us until the 21st century to recog- that suggest it is acquiring knowledge Congress and the American people on nize that if we would enhance the ben- from the war in Iraq. That is right. The the strategy to combat terrorism.’’ I efit so we could match the disease with war in Iraq may be being used as a guess that is good news. But then it some of the breakthroughs, that the training ground by forces that wish to cites two documents it has already pre- outcome was different, that Americans do us harm. Another way of saying it pared on this topic. One is the Sep- actually got better, that the cost actu- is, our troops are being used as a way tember 2006 National Strategy for Com- ally went down because we eliminated to train people to give them the skills bating Terrorism, which sets broad the number of incidents. to launch attacks in other places. goals but does not include the detail America’s health is at risk. When I Al-Qaida has affiliates around the called for in our bill about how limited say America’s health is at risk, I am world—in Saudi Arabia, the United resources will be allocated to achieve talking about the physical health and Arab Emirates, Yemen, Lebanon, this strategic vision. That 2006 docu- the economic health of this country. It where al-Qaida poses a growing threat, ment also does not prioritize the geo- is impossible to believe that unless you the Horn of Africa, and Southeast Asia. graphic—country and region-specific— transform health care so it works for We cannot ignore the rest of the world threats we face from AQ and its affili- everybody in this country that Amer- to focus solely on Iraq. Al-Qaida is and ates, which is essential because how ican business can be competitive in a will continue to be a global terrorist else—how else, Mr. President—will we global marketplace that is not coming, organization with dangerous affiliates know where to focus our resources? that we are part of today. around the world. We are watching al- The other document cited by the ad- Now, Republicans want to propose to Qaida strengthen and develop its affili- ministration is the National Imple- this body and to America one main ates around the world while we remain mentation Plan. I am a member of both goal. That goal is that we are com- bogged down in Iraq. the Senate Intelligence and Foreign mitted—Republicans are committed— We need a robust military presence Relations Committees, and I am not to providing every American with gen- and an effective reconstruction pro- even allowed to see that document. The uine access to quality, affordable gram in Afghanistan. We need to build administration will not even share it health care that protects the sacred strong partnerships where al-Qaida and with the full Intelligence Committee. doctor-patient relationship. This is its affiliates are operating—across So the idea this document is an accept- what everybody thinks of when they north Africa, in Southeast Asia, and able substitute for what is called for in think of a health care plan: health care along the border between Afghanistan the Feingold-Reid bill is absurd. coverage that recognizes them as an in- and Pakistan, and we need to address The administration suggests our bill dividual and coverage they need to pro- the root causes of the terrorist threat, limits the President’s authority to vide security for their family. not just rely on military power to get withhold information. Now, I agree we Let me restate it. We are committed the job done. need to protect classified information, to providing every American with gen- We can start doing that by passing S. and there is nothing in my bill—noth- uine access to quality, affordable 2634. This bill requires the administra- ing—that would prevent the addition of health care that protects the sacred

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00045 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1262 CONGRESSIONAL RECORD — SENATE February 27, 2008 doctor-patient relationship. Nothing the doctors, patients hold the hospitals to have coverage it was going to cost else should get between that. It should accountable; more importantly, pa- $5,400. If it was his decision alone, he not be determined based upon an arbi- tients hold the insurers accountable. would have said: No way. Affordability trary third-party reimburser or the This belief that a patient cannot ne- was not met from the standpoint of Federal Government. The reality is, gotiate with an insurer—well, quite what he was getting in coverage for when we provide every American with frankly, these days are over. We need what it was costing. this opportunity, we have a system to drive down costs. We need to give I did not stop there. I picked up the that functions like the marketplace is Americans control over their own phone. I called the university he was at designed. health care choices. We need to make and found out a local insurer, insur- How do we get there? No. 1: access sure patients have the information ance agent, had negotiated with Blue and choice. All Americans have a right they need to make good choices—the Cross Blue Shield coverage for kids to choose their doctor, to choose their right choices for them, for their fam- who fell into this situation where they hospital, and, I believe, to choose the ily, for their age, for their illness or did not have insurance. I described to health care plan they want, and, more their health conditions, and, more im- him the plan. He quoted me the exact importantly, they deserve. No Wash- portantly, for their income, guaran- same plan that as a Member of the Sen- ington, DC, bureaucrat should deny teeing vigorous competition that bene- ate I had, which, before, my son was that right. fits patients. The focus here is on pa- covered under, with the same deduct- Americans like choice. We know tients, holding the entire health care ible, the same copay, the same limits— that. Americans do not like to have system accountable to patients’ needs. the exact same plan. But this was ne- one choice. They like multiple choices. I would suggest if health care could gotiated by an independent insurance As a matter of fact, when you have be more like a television—with a tele- agent in Chapel Hill, NC, against the one, you really do not have a choice. vision, you have real competition. You same Blue Cross Blue Shield that the Some politicians want to give America have a choice of over the air, you have Federal Government, representing 1.3 one choice. It is the debate potentially a choice of basic, you have a choice of million employees, negotiated with; of this next election cycle. cable, you have a choice of cable with and on behalf of my son, he negotiated Let me teach America a new word. It premiums, and you have a choice of a cost of $1,500 per year—$1,500 versus is called ‘‘universal control.’’ Universal DirectTV. In fact, with television, you $5,400, a fairly significant savings. control: when one entity is in charge of know exactly what comes with each We sit here and wonder: What can the the only choice, and now they control option. You know exactly how much it American people do with the right in- how they provide that; they control costs, and you know you get what you formation relative to the decisions what it looks like; they control where pay for. That can be the only reason they have to make as it relates to you get it; they control what the cost that on-demand sports has become so health care coverage? If it is that dif- is. All of a sudden, this innovative, cre- popular. It is because when you want to ficult to figure out how to have the ative health care system we have had watch a sporting event, and you see ex- coverage you need at the cost you can in America—that has not worked for actly what the cost is, you can make a afford, envision how difficult it is for a everybody because our target has not calculation as an individual as to patient without information to decide been to make sure every American is whether that is worth it to you. Ameri- what type of chemotherapy they are covered—all of a sudden it totally cans should have all the competition, going to take, when all of a sudden the breaks down. the choice, the control, and the infor- doctor walks in and says: You have Well, one health care package, one mation they need when it comes to cancer and you are going to die with- set of doctors, one set of treatments, health care decisions. So affordable out treatment. This is a difficult thing one set of prescriptions is not what coverage. without the ability to go out and America is looking for. America is Let me tell you a story. My oldest search for the information. looking for choice. North Carolinians son is now 23. Shortly before he became The third item is quality care and do not want one choice, and they cer- 22, I was notified by the Office of Per- prevention. Here is a unique word in tainly do not want bureaucrats in sonnel Management in Washington health care, ‘‘prevention.’’ It is some- Washington, DC, defining what their that in the Federal Government, re- thing that probably for decades we choices are going to be. gardless of where you were in the Fed- should have incorporated into the cov- A majority of Americans are willing eral Government, your children, when erage each of us has. We believe in to pay a little bit more to have more they turned the age of 22, even if they strengthening health care by providing choices. I strongly believe doctors and were in school—which mine were—had consistent, dependable quality and pro- patients—not lawyers and bureau- to be dropped from your health insur- moting the principles of prevention. crats—should have the power to make ance. What is prevention? Let’s change our health care decisions. Now, forget the fact—I can see the habits. Let’s educate ourselves. Let’s The challenge is that Americans be- Presiding Officer is struggling with do the things that keep us healthy. lieve that is the most important thing. this. That does not save any money. And let’s actually pay annually to let Clearly, access to health care is di- You are exactly right. You are taking somebody go in and see the doctor and rectly dependent upon cost. Americans the healthiest of America, and you are make sure there is not a health condi- must have access and choice, but they taking them out of the risk pool that tion they have that could be prevented, also have to have affordable coverage. helps hold down the risk for us older early, without the incidence of an inpa- Republicans believe the best health guys who are more susceptible to dis- tient stay in the hospital. care in the world is worthless if Ameri- ease. But somewhere the Federal Gov- We will harness the powerful promise cans cannot afford it, and I think we ernment got this idea that they are of advanced research and modern tech- would all agree. going to save money by dropping peo- nology to create innovative new treat- It would drive down costs by giving ple when they become 22 years old—the ments and breakthrough cures, pro- Americans control over their own healthiest of the American population. mote wellness, and empower consumers health care choices, making sure pa- So I went through the realization with accurate, comprehensive informa- tients have the information they need that this is actually going to happen. tion on quality health care that is to make good decisions, guaranteeing There is no way you can change it. So available for them. vigorous competition that benefits pa- I called OPM to say: Surely, you have Choice, information: I believe tients, and holding the entire health negotiated coverage for our children. I strengthening health care by providing care system accountable to the pa- would like something that resembles consistent, dependable quality and pro- tients’ needs. the plan I had with Blue Cross Blue moting prevention is absolutely essen- You see, in many cases we have used Shield. They quoted me the exact same tial. Government as the accountability plan: $5,400 a year. Twenty-two years Creating innovative new treatments measure. We miss the boat. The ac- old, healthy as a bull, still in college, and breakthrough cures: Let me ask countability measure is making sure and all of a sudden, as a parent, I was my colleagues, if innovation didn’t patients hold the system, patients hold strapped with the decision that for him take place, what would the diabetics do

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00046 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1263 today, those who currently have a dia- and development of treatments and the cost of the delivery of that benefit, betic pump that is implanted in their cures. hospitals, doctors, every delivery point side, that automatically reads their I just mentioned prevention and in health care does what they call cost- blood sugar 24 hours a day, administers wellness. Those words need to be the shift. They charge that cost of deliv- the insulin when they need it. No first thing Americans think about ering that service over to the people longer do they go through a finger when they think ‘‘health care’’ or when who have coverage or who can pay. prick. No longer do they get an incon- they think ‘‘doctors.’’ Prevention and When all of a sudden you have a goal sistent reading. No longer do they in- wellness. Doctors should be paid to and a commitment that every Amer- ject themselves later than they need to help people stay healthy instead of just ican is insured, the cost-shift goes keep a balance. Why is that important? paying them to treat individuals who away. What is the score on that? It is Because for somebody with diabetes are sick. $200 billion a year. So that is $200 bil- who can constantly maintain their My final thought for this section: Pa- lion that today does not go to the de- blood sugar at the right level, it means tients should have as much informa- livery of one ounce of care. It is shifted none of the horrors we heard about and tion prior to using doctors and hos- to people who can pay or who are cov- saw and that many families lived with pitals as they do prior to buying cars. ered. All of a sudden now we know the before when the management was not What a novel idea. The Centers for answer to why health care increases at as precise. The result was, eventually Medicare and Medicaid Services is double-digit rates of inflation on an an- they began to go blind, eventually starting to provide quality, Web-based nual basis. It is because as the pool of began to have a toe, two toes, all their information about nursing homes and uninsured continues to grow, the toes, a foot, a leg amputated because of hospitals. The initiative needs to keep amount of cost-shift continues to grow, the effects of diabetes. Forget the num- growing so all patients have the ability and the cost-shift is directly dumped ber of times the person might have to research all aspects of health care. on those companies that provide cov- been admitted to the hospital to get That happens in real time at the tips of erage for their employees, for us as in- their blood sugar in balance so they our fingers. Access and choice, afford- dividuals if we go to the marketplace could at least delay the deterioration. able coverage, quality care and preven- and we buy coverage or to us who pay Now technology allows a diabetic to in- tion. out of pocket when we access health sert a pump and to keep a constant The fourth piece—and we shouldn’t care because it is shifted evenly across read and a constant regulation of their be shocked because this is America— the system. blood sugar. The net result is the sys- personal ownership and security. But Forget the fact that if we adopt this, tem saves a tremendous amount of this is something our system has never if we achieve it, that, one, we have a money. The individual saves a tremen- incorporated. We believe Americans more manageable system—a system, dous amount of money. The individ- should own and control their health quite honestly, that incorporates ac- ual’s quality of life is that much bet- care coverage and should have the free- cess and choice, affordability, quality ter. dom and the flexibility to take it with and prevention and wellness, personal For a student who had diabetes, the them when they change jobs, just like ownership, and the security of knowing likelihood was that they would never a 401(k). you have coverage. We drive the costs play organized sports because the de- Hard-working Americans deserve the down for every American. mands on an athlete mean they have a peace of mind to know the care they The goal is to continue to have the blood sugar spike that is incredible, need will be the care they receive and best health care system in the world, and without the ability to regulate that their financial security will be to continue to drive innovation and that, it was impossible. Now kids are protected from catastrophic events. medical breakthroughs, and to do it in playing soccer at every age and run- Americans will achieve this security a way that brings the overall cost of ning around with a pump that is auto- and will receive better care if the health care down. If we can begin to matically reading their blood sugar. health care system is highly personal- see the trend line on inflation and How about for some of us who are a ized and guarantees patient control. health care begin to go south, it is little bit older and we probably are sus- What does that mean? With the right amazing what type of an incentive it ceptible—because we haven’t done ev- information, with the right resources, will be to individuals who now engage erything we should do regarding any American should have the ability in the prevention and wellness section healthy habits, we are susceptible to to construct a health care plan that and begin to look at ways that they high cholesterol. Where would we be meets their age, their health, their in- can control the cost of their health without the pharmaceuticals’ break- come, and have the financial security care because it is now theirs, they own through of cholesterol drugs? I will tell of knowing they are covered. Some it, they have constructed it, they can my colleagues where we would be. We might call this ala carte, the ability to change it as they need to, and—oh, yes, would be funding $8,000-plus bypass sur- construct something that meets—for by the way, to accomplish this, we geries at an alarming rate that would those of us who are over a certain age, have to have 50 States that have high- bankrupt the system, both public and we have probably already been in- risk pools that take those individuals private. But today we have this little structed by our spouses that we have with preexisting conditions, and we pill we can take. It doesn’t take the had all the children we are going to collectively buy their cost of insurance place of exercise, it doesn’t take the have. That is a little tough in this body down to an equal amount for those of place of diet, but it certainly enhances because we have had some Members us who are healthy. A lot of States our chances that we are not going to be who had them at quite a late stage in around the country currently do it. selected to have bypass surgery, open- life. But I fall into that category. I Mine just happened to pass it last year. heart surgery; that we are not going to can’t buy health insurance coverage We are late coming to the game. But have the recovery time, the loss of pro- that doesn’t come with maternity cov- the reality is that all 50 States should ductivity at work because innovation erage. I pay for it knowing I am never and will and have to do it if we want allowed us now to inject in that qual- going to use it. the system to work. ity arena a different outcome based Now, maybe I am helping to subsidize There is a way to maintain the high- upon innovation. somebody else. But while we are here est level of care in the world, the high- We want to promote wellness. We talking about every American being in- est commitment to innovation and want to empower consumers with accu- sured, the reason we are here is be- breakthroughs, to look down the road rate, comprehensive information. The cause that subsidy is going on today. It and know we are going to cure things United States has the best health care goes on in every company. In goes on tomorrow, that today there is only one system in the world. I will tell my col- with everybody who pays out of pock- outcome and it is to live. If we don’t leagues, North Carolina is a big reason et. It is something that happens to change and transform our health care as to why health care is so good. We each of us who have health insurance, system and begin to promote preven- need to make sure quality stays high and it is triggered by somebody who re- tion and wellness and to drive the costs while improving the access. Congress ceives a service in health care and ei- down, the first thing that will leave is needs to foster—not hinder—research ther won’t or can’t pay. So to recover innovation, the innovation that treats

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00047 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1264 CONGRESSIONAL RECORD — SENATE February 27, 2008 many of us today in a totally different Nevada State opened its doors with 177 For her achievements, Ms. Albertson way, with a multitude of options we students; 5 years later, NSC’s enroll- was awarded the SBA’s Silver Medal never had. If, in fact, we don’t begin to ment has swelled to over 1,900. In true for Meritorious Service and the inau- change this, the system will reflect one pioneer fashion, Nevada State’s stu- gural SBA Lifetime Achievement choice, one doctor, one hospital, one dents tend to focus on professions that Award. She was also the first female to delivery port. are needed most in the community. sell advertising space for the Wash- I challenge my colleagues today that NSC’s two largest majors, nursing and ington Post, New York Times, and the is universal control, control where one teaching, are two areas of critical need New York Tribune. These awards, cou- entity—the Federal Government—dic- in Nevada. But Nevada State is more pled with her work in the private sec- tates where we go, who we see, what than simply a nursing and teaching tor, forged a path for others to follow. they are reimbursed for delivering the college. Johnnie Albertson will be remem- service, and the outcome will be the Nevada State students also practice bered by those closest to her for her en- lack of innovation, the lack of break- civic responsibility. Before they grad- thusiasm for reading, her wonderful throughs, and no reason for the Amer- uate, NSC students are required to sense of humor, and her love of jazz ican people to make healthy choices take a course called Community Based music. Those who benefited personally and to engage in prevention and Learning, CBL, 400. In this course, stu- by knowing Ms. Albertson, along with wellness. dents work with different organiza- those who profited by her good works, That is where we are. I hope my col- tions to improve their community. For will forever be indebted to her gen- leagues on both sides of the aisle will example, Nevada State graduates have erosity, devotion, and diligence in pro- engage and encourage our leadership to worked at their local libraries, volun- moting equal opportunities for all. Mr. have a healthy debate on health care. I teered at nonprofits, and tutored public President, I extend my deepest sym- haven’t locked in to any prescribed leg- school students in the areas of math, pathies to the friends and family of Ms. islation tonight. It is the principles of science, and engineering. This service- Albertson and express my gratitude for the Republican Conference that I am oriented program has been such a suc- the passion with which she served our here to present and will continue to cess, it was named to the Presidential country. come back to the Senate floor to Higher Education Community Service f present. I encourage my colleagues on Honor Roll for 2007. INDIAN HEALTH CARE both sides of the aisle: let’s come to Nevada State College has experienced IMPROVEMENT ACT rapid growth in its first 5 years, and I the floor. Bring your legislation. Let’s Mr. KERRY. Mr. President, I wel- am sure it will continue to grow in examine it, let’s debate it, let’s let come the Senate passage of the Indian America see it. Let them be the judge. both students and stature. Soon, NSC Health Care Improvement Act. The bill At the end of the day, it is the Amer- will begin expanding into its 500-acre is a long overdue response to a health ican people who will influence where parcel situated in the beautiful foot- crisis for our country’s American Indi- this debate goes, and that is exactly hills of Henderson. I look forward to ans and would at last strengthen and who should influence it. They are the the completion of the new campus. Ne- expand health services to those who patients of the future health care sys- vada State College is only 5 years old, need it most and those to whom prom- tem. but it has already made its mark as ises were made but far too few prom- I yield the floor. one of Nevada’s shining academic ises have been kept. The last com- The PRESIDING OFFICER. The Sen- gems. prehensive reauthorization of IHCIA ator from Colorado is recognized. f took place in 1992—and since then, f IN HONOR OF JOHNNIE progress has been ground to a halt in MORNING BUSINESS ALBERTSON the Senate while health disparities for American Indians have dramatically Mr. REID. Mr. President, I rise today Mr. SALAZAR. Mr. President, I ask widened. unanimous consent that the Senate to recognize the life and accomplish- The situation is dire. Today, Amer- proceed to a period for the transaction ments of Ms. Johnnie Albertson. ican Indians suffer from disproportion- of morning business, with Senators Johnnie, a valued employee of the ately higher rates of diabetes, heart permitted to speak for up to 10 minutes Small Business Administration for 32 disease, suicide, and several types of each. years, succumbed to illnesses resulting cancer than all other groups in the The PRESIDING OFFICER. Without from pneumonia. A native North Caro- United States: 2.6 times more likely to objection, it is so ordered. linian, Ms. Albertson was able, through be diagnosed with diabetes; 630 percent f her own perseverance, to overcome more likely to die from alcoholism; poverty and the loss of her parents to and a life expectancy nearly 6 years 5TH ANNIVERSARY OF NEVADA establish herself as a champion of STATE COLLEGE shorter than the rest of the U.S. popu- equal rights. lation. The gap between the needs of Mr. REID. Mr. President, I rise today Ms. Albertson will be remembered for this community and the resources dedi- to commemorate the 5th anniversary her dedication to her work with the cated to addressing them is stark: of Nevada State College, the newest in- Small Business Administration. fewer mental health professionals stitution in the Nevada System of Johnnie was a modern pioneer who available to treat Indians than the rest Higher Education overcame gender and class restrictions of the U.S. population; health care ex- Nevada State College was born out of and went on to hold numerous senior penditures for Indians less than half of a dire need. In recent years, southern positions at the SBA. She served as the what America spends for Federal pris- Nevada has been growing at a break- first Associate Administrator for the oners. neck pace. In 1990, Clark County’s pop- Small Business Development Center It goes without saying that we should ulation was just over 740,000 people; Program and was the first woman to invest the necessary funds in improv- today, it is over 2 million. With such achieve the rank of senior executive ing health coverage and care for Amer- tremendous growth came considerable within the SBA—the highest rank pos- ican Indians, which is why it is so im- growing pains. Enrollment in Nevada’s sible without a congressional appoint- portant that the Indian Health Care two universities and four community ment. Improvement Act modernizes Indian colleges swelled 16 percent from 1994 to Through the many programs she ini- health care services and helps ensure 2000. Clark County was facing both tiated at the SBA, Johnnie was instru- at least that money is no longer the teacher and nursing shortages. Nevada mental in guaranteeing the rights of biggest impediment to quality health needed another place to train the next minority and female small business care in Indian Country. generation of nurses, teachers, and owners across the country. Thousands In my home State, the status of In- business professionals. That place is of business owners owe their success, in dian health care is particularly Nevada State College. part, to Ms. Albertson’s resolve to en- daunting: inadequate health facilities, In many ways, Nevada State College sure equal opportunities for all entre- mental health services and assisted liv- is representative of our State. In 2002, preneurial Americans. ing care for the elderly; the percentage

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00048 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1265 of American Indians with poor emo- Senator. As ranking member of the cluding 25,000 from my home State of tional health is on average 2.1 times Senate Committee on Homeland Secu- California, have served their country in higher than the adult Massachusetts rity, I have worked closely with emer- the cause of peace by living and work- population; an obesity rate twice as gency management agencies and non- ing in 139 developing countries. high as the rate for Massachusetts profit organizations for years. I know The world has changed since 1961— adults in general. Moreover, the per- the Red Cross has not only saved many and the Peace Corps has succeeded in centage of Mashpee Wampanoag adults lives and comforted millions but has keeping up with these changes. with diabetes is nearly two times high- taken steps to improve its structure While education and agriculture are er than the rest of the adult population and capabilities for disaster response. still an important part of what a Peace in our State. During the 5 years be- The record of recent years for ter- Corp volunteer does, today’s volunteers tween 1999 and 2004, American Indian rorism, fires, earthquakes, floods, and also work on HIV/AIDS awareness, in- mothers were over three times more other disasters underscores the need formation technology, and business de- likely to smoke during pregnancy than for preparedness not only at all levels velopment. all mothers giving birth in Massachu- of government but among individual Many volunteers work in orphanages setts. American Indian students have citizens and families. with HIV-positive children, implement much higher percentages of smoking, I therefore commend the Red Cross programs for at-risk youth, and create drinking alcohol before age 13, and life- for focusing their public-communica- support groups for HIV-positive people. time cocaine use than all other stu- tion efforts this year on the theme of Business volunteers conduct semi- dents in Massachusetts. Also, 1 in 4 ‘‘Be Red Cross Ready.’’ It is a well-cho- nars on subjects like marketing, stra- American Indian high school students sen theme: Red Cross survey work finds tegic planning, and tourism develop- have reported attempting suicide com- that up to 60 percent of Americans are ment. They work with women and mi- pared to 1 out of 10 for all other stu- entirely unprepared for disaster. They nority groups to strengthen their par- dents. The Indian health bill is an im- have no emergency supplies, no firstaid ticipation in the economic system. portant step we must take to begin re- or CPR training, no rendezvous or com- Agriculture volunteers may find versing these troubling statistics in munication plans or other precautions. themselves working with farmers to Massachusetts and across the Nation. The catastrophe of Hurricane implement techniques to improve soil This bill can mark a new day of at Katrina reminded us that government quality and conserve water—or on the last addressing the health care needs of and other first responders, no matter business end conducting production Indian Country programs to increase how efficient and heroic, cannot appear cost-and-price analyses. the outreach and enrollment of Indians instantly at every point affected by a The Peace Corps also assists coun- in Medicaid and CHIP and improve the disaster. Every citizen should be pre- tries in need by supplying Crisis Corps ability for tribes to participate in man- pared to serve as a first responder for volunteers—former volunteers who re- aged care health plans. The Indian family and neighbors if official or vol- turn to the field on a short-term basis. Health Care Improvement Act brings unteer responders cannot offer imme- In 2005, for the first time in its history, greater access to health care services, diate assistance. Peace Corps deployed 272 Crisis Corps improved medical insurance coverage, Encouraging individual responsi- volunteers domestically to assist in and education of disease prevention bility and preparedness to augment Hurricane Katrina relief efforts along and healthy lifestyles. government and private organization the gulf coast. The Senate came together across par- efforts can reinforce our national re- Also in 2005, Crisis Corps volunteers tisan lines to take a step forward with sponse framework to provide truly were deployed to Sri Lanka and Thai- Indian Country, and I look forward to comprehensive and all-hazards protec- land to assist with rebuilding tsunami the quick passage of the bill and ulti- tion. devastated areas, and to Guatemala mately to seeing it signed into law by For promoting readiness, and for all following Hurricane Stan. As part of President Bush. This must be the be- its good works, the American Red PEPFAR, Crisis Corps has deployed ginning, not the end, of a new compact Cross deserves the thanks of all Ameri- volunteers to Uganda, Kenya, Namibia with Indian Country—and a renewed cans and the recognition of Red Cross and Zambia. Finally, Crisis Corps is commitment to making sure that no Month. working with Peace Corps posts in Cen- American’s health suffers because they f tral America and the Caribbean to ad- are born on a farm, in a city, or on a dress disaster preparedness in the re- NATIONAL PEACE CORPS WEEK reservation. gion. f Mrs. FEINSTEIN. Mr. President, as a Today’s Peace Corps is more vital part of National Peace Corps Week, I than ever, working in emerging and es- RED CROSS MONTH wish to join many of my colleagues in sential areas such as information tech- Ms. COLLINS. Mr. President, I rise celebrating the 47th anniversary of the nology and business development. They to speak on the Red Cross and its cam- Peace Corps and honoring the impor- have made significant and lasting con- paign to encourage citizen prepared- tant work of Peace Corps volunteers. tributions around the world in agri- ness for disasters. During this week, Peace Corps volun- culture, education, health, HIV/AIDS, For 65 years, since the first procla- teers from around the world who have and the environment. mation by Franklin D. Roosevelt, served over the years will share their Peace Corps volunteers continue to Presidents of the United States have overseas experiences with schools and help countless individuals who want to designated March as Red Cross Month. community groups around the United build a better life for themselves, their I am proud to support this year’s States. children, and their communities. proclamation in recognizing this great By giving presentations during Peace At a time when the United States is organization, whose activities include Corps Week, former Peace Corps volun- seeking to reclaim the respect and ad- lifesaving courses, blood drives, shel- teers will help Americans better under- miration of the world and once again tering families displaced by fire or stand the people and cultures they be seen as a champion and a leader of flood, and responding to major disas- have experienced, and the many bene- democracy, justice, and human rights, ters. This January, for example, Red fits of Peace Corps service. Peace Corps volunteers revitalize faith Cross work in my home State of Maine By making presentations in class- in this country. included an urgent blood drive amid ice rooms, former volunteers will help cre- They are leaders and diplomats, and and snow that had reduced some hos- ate greater global awareness among they serve as an inspiration not only to pitals’ blood supply to a single day. students. their fellow American citizens but to Other Maine Red Cross workers were The Peace Corps is one of our most citizens all across the world. taking care of a seven-member family effective and successful foreign aid pro- I urge all my colleagues to support in the town of Skowhegan who had lost grams. the Peace Corps and celebrate National their home and possessions in a fire. Since the establishment of the Peace Peace Corps Week. I know the good works of the Red Corps by President John F. Kennedy in Mr. SMITH. Mr. President, I rise Cross both as a Maine resident and as a 1961, more than 190,000 U.S. citizens, in- today to commemorate National Peace

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00049 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1266 CONGRESSIONAL RECORD — SENATE February 27, 2008 Corps Week and to recognize the 47th wards of bringing aid to those suffering mission in Rwanda during his visit to anniversary of this distinguished orga- from political unrest, natural disas- the country last week. I believe the nization. Since 1961, the Peace Corps ters, disease, and a lack of economic Peace Corps will make an important has dispatched over 190,000 volunteers opportunities are well worth it. contribution to the recovery of that to promote a greater understanding be- The Peace Corps volunteers’ reputa- country. tween the United States and the rest of tion as ambassadors of good will dem- Today, there are 8,079 Peace Corps the world. onstrates the ability of individuals to volunteers and trainees in 68 posts As part of National Peace Corps make a difference in the world. Their serving 74 countries. Of those volun- Week, returning volunteers will be vis- firsthand knowledge of the challenges teers, 160 are from my home State of iting Washington for several days of people face on a day-to-day basis give Georgia. I want to take this oppor- events. Many of them will use this op- those of us in the United States a bet- tunity to thank those Georgians and portunity to share their experiences in ter understanding of our world. I ap- all Americans who have served in the local classrooms. I heartily applaud plaud their efforts and dedication. Peace Corps. The Peace Corps is a crit- these fine men and women for their ini- I would like to recognize the men and ical piece of our diplomatic and hu- tiative in seeking to make the world a women from Wyoming who are cur- manitarian efforts worldwide. I look better place to live and for the positive rently serving as U.S. Peace Corps vol- forward to supporting the Peace Corps impact they have had beyond our bor- unteers: Pamela J. Anderson, Jason N. as a Member of the Senate. ders. Arnold, Alexandria L. Blute, Katie E. Mr. CASEY. Mr. President, I wish to Now more than ever, the work of Boysen, Bria M. Chimenti, Joanne A. commemorate the past 47 years of serv- Peace Corps volunteers is an important Cook, Jenna M. Dillon, Heather Dixon, ice of over 190,000 Peace Corps volun- asset within the diplomatic toolbox of Jeannie M. Freeman, Annie B. teers who have served our Nation and the United States. Their efforts aug- Gierhart, Alexis L. Grieve, Daniel J. aided developing nations worldwide. ment official diplomatic acts of our Healy, Kevin U. Malatesta, Joshuah C. This week our Nation celebrates their Government and add a personal dimen- Marshall, Korie C. Merrill, Michael O. contributions toward the elimination sion which could not be duplicated in Nielsen, Katherine G. Oglietti, Kath- of global poverty and disease that con- any other way. When a volunteer trav- leen F. Petersen, Rachel L. Petersen, tinues to deprive millions of people the els abroad, they provide others with a Michael S. Quinn, Garrett C. Schiche, opportunity to fulfill their goals and glimpse of what it means to be an Brian M. Steen, Dayna C. Wolter, An- dreams. gela E. Zivkovich, and Aaron R. Zueck. American and the values we cherish Henry David Thoreau noted that Mr. ISAKSON. Mr. President, I stand here at home. I encourage all Ameri- ‘‘One is not born into the world to do before you today to congratulate the everything, but to do something.’’ To cans to make the kind of selfless con- Peace Corps on 47 years of service. The tributions these volunteers provide to do something is the foundation of the Peace Corps was founded on March 1, Peace Corps’ mission. In 1961, President the international community. The 1961, when President John F. Kennedy John F. Kennedy established the Peace Peace Corps has proven that individual signed an Executive order establishing Corps to promote peace and friendship citizens working together can promote the Peace Corps as a new Government and challenged Americans, young and and strengthen the image of the United agency. Over the years, 190,000 volun- old, to help their Nation and the world States. teers, including nearly 2,700 Georgians, by sharing their talents with those in Peace Corps volunteers inspire us all, have served in more than 139 countries developing countries. Many Americans and I am proud to say that 213 volun- around the world. Throughout its his- have heeded his call to service. Cur- teers from the State of Oregon are cur- tory, Peace Corps volunteers have re- rently, approximately 8,000 volunteers rently serving in over 50 developing sponded to the issues of this world with serve in 74 countries to help train and countries. These Oregonians com- energy, purpose, and compassion. plement the thousands of others who From February 25 to March 3, 2008, provide skills to those in need and act have served in the Peace Corps, and thousands of former Peace Corps volun- as American cultural ambassadors to they brighten our hopes for a better to- teers will share their experiences with those nations. However, their work morrow. Peace Corps volunteers have schools and community groups across does not end there. shown a level of dedication and accom- the United States during Peace Corps I am very proud that 261 Peace Corps plishment that is truly extraordinary. Week. Through these activities, former volunteers from Pennsylvania are cur- I invite all Oregonians, and all Ameri- Peace Corps volunteers will help our rently serving abroad. These men and cans, to join me this week in com- citizens better understand the advan- women will join the ranks of former mending their efforts. tages of becoming a Peace Corps volun- Pennsylvanian volunteers who con- Mr. BARRASSO. Mr. President, I teer. They will also have the oppor- tinue to leave their mark on the world wish to acknowledge Peace Corps vol- tunity to educate about the people and such as Christina Luongo from unteers during National Peace Corps cultures they have encountered during Stroudsburg, PA, who served as a nu- Week. their service. Additionally, by making trition education volunteer in Bolivia Currently, 25 active U.S. Peace Corps presentations in classrooms, former from 2002 to 2005; Abigail Calkins, from volunteers are from Wyoming. They volunteers will help create greater Philadelphia, PA, who served as a com- have joined a unique organization of global awareness among students. munity development volunteer in Cam- people who have taken the initiative I also want to take this opportunity eroon from 1987 to 1990 and is now and make the personal commitment to to pay tribute to the late U.S. Senator working at the University of Pennsyl- assist those around the world who are Paul Coverdell of Georgia, who was my vania researching breast and less fortunate. good friend and colleague for many endometrial cancer; and Betrice Peace Corps volunteers are the face years. As the corps’ first post-Cold War Grabish, from North Wales, PA, who of America in many countries. They director, Paul steered the Peace Corps served as an English teacher in are often on the frontline in the most into a new era. I was pleased the Presi- Uzbekistan from 1992 to 1994. primitive of environments, working dent honored Paul posthumously in As we celebrate National Peace Corps tirelessly with local leaders to build a 2001 by renaming the Peace Corps head- Week, I would also like to highlight better future. Their optimism is often quarters in Washington, DC, as the the vital contributions that a prede- contagious as they assist communities Paul D. Coverdell Peace Corps Head- cessor of mine, Senator Harris Wofford, in building infrastructure, developing quarters as well as renaming the Peace made toward launching the Peace resources, and improving basic health Corps World Wise Schools program as Corps in 1961. As special assistant to care, education, and business opportu- the Paul D. Coverdell World Wise President John F. Kennedy, Senator nities. Schools program. I am proud to sup- Wofford helped plan and launch the I commend all the men and women of port an organization that such a distin- Peace Corps and later moved with his the Peace Corps for their personal sac- guished Georgian was so instrumental family to Ethiopia, where he served as rifices. It is not easy to leave behind in shaping. the Peace Corps’ special representative friends and family and the comforts of I am pleased that the President an- to Africa and director of its Ethiopia home. Yet I often hear that the re- nounced the reopening of a Peace Corps program. Ever since, Senator Wofford

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00050 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1267 has been a leading voice advocating for and those without who are married and environmental impacts of common more Americans to become involved in who have children. Many people with chemical processes and to foster the national service. Committing to serve even the most severe disabilities live development of a new generation of en- one’s nation is an honor, and I join independently, have jobs, get married, vironmentally responsible chemical Senator Wofford in calling on more have children, and pay taxes. products. Americans to make this commitment. Parent support groups and disability My fellow cosponsors and I seek to As our world becomes inter- advocacy groups have tried to reach help the chemical industry reduce its connected, more Americans will need out to parents who have received pre- use and production of hazardous sub- to interact with those who live outside natal diagnoses of various conditions, stances and the overall effect on the our borders. Peace Corps volunteers but they often have difficulty getting environment of the business of chem- learn more than 250 languages, which practical information about raising a istry. As it was in the past when Sen- provides them the skills to compete child with a disability and information ator SNOWE and I previously introduced globally as well as assist the U.S. Gov- about available services and resources legislation to promote ‘‘Green Chem- ernment in national security areas to new and expecting parents. This bill istry,’’ this legislation is supported by where critical language skills are es- will help to remediate this situation in the chemical, pharmaceutical, and bio- sential. Many Peace Corps volunteers five concrete ways. technology industries and academic in- go on to serve in Congress, the execu- First, the bill establishes a toll-free stitutions because it is designed to has- tive branch, and the Foreign Service. I resource telephone hotline parents can ten the attainment of a goal we all salute the Peace Corps for its tremen- call after they have been given a pre- share: making the production of the dous work and the dedication of its vol- natal or postnatal diagnosis for their chemical products we need in ways not unteers who have not hesitated to help child. The bill also calls for the expan- detrimental to the environment using improve our world. On this week mark- sion of the leading information clear- engineering processes that save both ing the 47th anniversary of the found- inghouse on disability, so that it can money and the planet. The products ing of the Peace Corps, I call on every- more effectively provide parents with and engineering processes we believe one to join me in celebrating its his- accurate, up-to-date information on will be developed will produce benefits toric achievements. their child’s condition along with across the entire economy. f available resources and services. The What we call ‘‘green chemistry’’ is bill also provides for the expansion and nothing more than what every industry PRENATALLY AND POSTNATALLY development of national and local par- in the United States should strive to DIAGNOSED CONDITIONS AWARE- ent support programs and disability ad- be. Chemical companies employing NESS ACT vocacy groups, so that they can more green chemistry techniques will chal- Mr. BROWNBACK. Mr. President, I effectively reach out to new parents. A lenge their best scientists, engineers, am excited and encouraged that the national registry of parents willing to and product developers to make new Committee on Health, Education, adopt children with these disabilities products that are better suited to the Labor, and Pension today voted unani- would also be established under this task for which they are created than mously to pass the Prenatally and bill. Finally, this bill will help create the products they will replace using Postnatally Diagnosed Conditions awareness and education programs for state-of-the-art manufacturing that Awareness Act. This legislation will health care providers who give parents minimizes or completely eliminates help parents receiving the news that the results of these tests. both the use of environmentally their unborn child may be born with a It is difficult, sometimes over- unsustainable substances as inputs or disability by supplying them with cur- whelming, for new and expecting par- results in environmentally rent and reliable information about the ents to receive the news that their new unsustainable substances as byprod- many services and support networks baby or their unborn child will have a ucts. Our purpose in introducing this available. This information will also be disability. I hope that this bill will pro- legislation is to make certain that the made available to parents whose chil- vide these parents with the informa- nascent green technology revolution dren were diagnosed at birth or up tion and support they so desperately does not bypass the chemical industry until 12 months of age. need during this critical time. I hope by providing significant and ongoing The American College of Obstetri- this information will encourage par- support for green chemistry research, cians and Gynecologists now rec- ents that their child can live a mean- development, demonstration, edu- ommends that the screening procedure ingful and fulfilling life and that this cation, and technology transfer. used to detect Downsyndrome be of- bill will heighten society’s awareness When enacted, the Green Chemistry fered to all pregnant women, not just of the capabilities value and worth of Research and Development Act will those over the age of 35, as was rec- people with disabilities. create a Federal Interagency Working ommended in the past. According to I would like to thank Senator KEN- Group—made up of representatives the American Journal of Medical Ge- NEDY, Senator ENZI, and all other mem- from the National Science Foundation, netics, 80–90 percent of patients who bers of the HELP Committee who have the National Institute of Standards are told that the child they are car- worked so diligently with my office to and Technology, the Department of En- rying has Downsyndrome choose to get this important legislation past the ergy, and the Environmental Protec- have abortions. The percentage is simi- HELP Committee. I am hopeful that tion Agency—to fund and oversee re- larly high for children with other pre- this bill will soon receive consideration search through merit-based grants to natally diagnosable conditions. A re- by the full Senate. The quicker my col- universities, industry, and nonprofit cent study by Prenatal Diagnosis actu- leagues and I move to pass this bill, the organizations to promote the develop- ally puts the figure at between 91 to 93 more people we can help with these ment and adoption of green chemistry percent. critical services and information. processes and products. Further, the I believe that one of the main reasons f Interagency Working Group will help for these disturbingly high figures is expand education, training in, and the that many people in society still be- GREEN CHEMISTRY RESEARCH flow of information about sustainable lieve the outdated stereotypes and mis- AND DEVELOPMENT ACT chemical engineering, including devel- conceptions that continue to exist Mr. ROCKEFELLER. Mr. President, I opment of green chemistry curricula about people with disabilities. In a am proud to join my friend Senator for undergraduate and graduate stu- study done by Louis Harris and Associ- SNOWE and our colleagues Senator dents. Finally, Federal resources in ates, the vast majority of adults with PRYOR, Senator COLLINS, and Senator funding and technical expertise will even the most severe disabilities re- KERRY in introducing the Green Chem- seek to identify barriers to the com- ported being ‘‘very satisfied’’ or ‘‘some- istry Research and Development Act. mercialization of the products of a re- what satisfied’’ with their lives. The This legislation is a bipartisan effort to juvenated, more environmentally re- same study shows that there is vir- promote the efforts of some of the most sponsible domestic chemical industry. tually no difference between the pro- brilliant minds in academia, govern- These are challenging times for the portion of Americans with disabilities ment, and industry to both reduce the domestic chemical industry. High

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00051 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1268 CONGRESSIONAL RECORD — SENATE February 27, 2008 prices for necessary feedstocks and ice Medal, three Sea Service Deploy- Union and NATO, and a force for sta- transportation to customers, along ment Medals, NATO Medal, Expert bility and democratic reform across with all the other hurdles that must be Rifle Medal and the Sharpshooter Pis- the Balkans. overcome in the global economy, have tol Medal. The world looks at Slovenia’s success put this industry, which began here During our country’s difficult Revo- in the nearly 17 years since she de- and which supplied vital products to lutionary War, Thomas Paine wrote clared independence, and it wonders: customers the world over, at risk of ‘‘These are the times that try men’s How could a nation of just 2 million being another industry the United souls. The summer soldier and the sun- people accomplish so much in so short States could lose to our foreign trading shine patriot will, in this crisis, shrink period of time? As an American, I know competitors. However, this industry from the service of their country; but the answer. Bear in mind that, when meets challenges every day. This legis- he that stands it now, deserves the love Jefferson wrote the Declaration of lation will allow American chemical and thanks of man and woman.’’ In Independence, America was also a na- companies to once again demonstrate a these turbulent times Chief Hardy tion of just 2 million people. Like Slo- passion for excellence, safety, and in- stood with the country he loved, served venians in 1991, Americans in 1776 novation that will be a source of envy it with distinction and valor, and dared to break away from a much larg- around the world and create a genera- earned and deserves our love and er and more powerful mother country. tion’s worth of good-paying jobs that thanks. Because of his efforts, the lib- Like Slovenians, Americans demanded States like West Virginia can build an erty of this country is made more se- a democratic course for their new economy around. cure. country. Mr. President, I call on my col- My sympathy, condolences, and pray- But the most important parallel be- leagues to take up and pass the Green ers go out to Nate’s wife Mindi, son tween our two countries is this: Histo- Chemistry Research and Development Parker, parents Steve and Donna, rians of the American Revolution have Act. brother Ben, and to his other family marveled that a tiny nation of just 2 f members and many friends who have million people was blessed with such an suffered this most grievous loss. All extraordinary collection of thinkers HONORING OUR ARMED FORCES will sorely miss Nate Hardy—devoted and leaders, including Washington, Jef- SPECIAL WARFARE OPERATOR CHIEF PETTY husband, caring father, dedicated son, ferson, and Franklin. At this crucial OFFICER NATHAN H. HARDY loyal brother, good friend, outstanding crossroads in Slovenia’s history, it, Mr. GREGG. Mr. President, I rise SEAL. Laid to rest at Arlington Na- too, has been blessed with extraor- today to pay a heartfelt tribute to spe- tional Cemetery, Chief Hardy joins his dinary leaders. And Dr. Drnovs˘ek will cial warfare operator CPO, SEAL, Na- fellow heroes in eternal peace at our be remembered as one of the most tal- than H. Hardy of Durham, NH. Sadly military’s most sacred place. His sac- ented of these Founding Fathers. on February 4, 2008 while supporting rifice will live on forever among the On a personal note, I was very fortu- Operation Iraqi Freedom, this brave 29- many dedicated heroes this Nation has nate to spend time with President year old patriot gave his life for his sent abroad to defend freedom. In the Drnovs˘ek during my trip to Slovenia in team and for our Nation during combat words of another son of New Hamp- August 2005. Clearly, he was an inde- operations in Iraq. Chief Hardy was a shire, Daniel Webster—may his remem- pendent thinker and a free spirit. One member of Naval Special Warfare Tac- brance be as longlasting as the land he obituary in the Washington Post on tical Development and Evaluation honored. God bless Nathan Hardy. Sunday noted that in his youth and Squadron THREE, Dam Neck, VA, and f early adulthood, he was a member of was serving our country in his fourth ˘ the Communist Party, which was the deployment to Iraq. REMEMBERING JANEZ DRNOVSEK only political force in the former Yugo- Nathan, or Nate to family and Mr. HARKIN. Mr. President, I have slavia. But he was never a Communist friends, was a 1997 graduate of Oyster come to the floor to pay tribute to a at heart, and he made a point of going River High School, Durham, NH, where good friend, Janez Drnovs˘ek, who off to ski whenever the party held a he excelled in soccer and lacrosse. He passed away on Saturday. Dr. Drnovs˘ek congress. enlisted in the U.S. Navy on November served as the second Prime Minister of Mr. President, with the passing of Dr. 4, 1997, received basic training in Great Slovenia from 1992 to 2002, and as Janez Drnovs˘ek, the world has lost an Lakes, IL, Undersea Demolition/SEAL President from 2002 to 2007. In these important leader and a wonderfully de- training in Coronado, CA, and attended and other capacities, he played a truly cent human being. He was instru- the Defense Language Institute in historic role in giving birth to a free mental in founding and nurturing a Monterey, CA. During his Navy career and independent Slovenia, while avoid- free, democratic, successful Slovenia. he served entirely with east coast- ing the bloodshed and warfare that en- History will not forget him, nor will based SEAL teams. gulfed other nations as they seceded the citizens of his grateful nation. Friends say from his youth Nate from the former Yugoslavia. f dreamed of becoming a U.S. Navy Dr. Drnovs˘ek was born on May 17, SEAL, one of the most challenging, 1950, in Celje. He graduated from the A TRIBUTE TO J. SHANE CREAMER rigorous, and elite fighting organiza- University of Ljubljana’s Faculty of Mr. SPECTER. Mr. President, I seek tions in the history of the world. He Economics. In 1986, he finished his doc- recognition today to express my applied his fierce competitiveness and toral studies in economic science at thanks to Shane Creamer, on his ex- team spirit to achieve success and the University of Maribor. In 1994, he traordinary volunteer service to the served our Nation with deep pride and received an honorary doctorate from Commonwealth of Pennsylvania as the great courage. He loved what he did, Boston University. In 2004 he was State president for the American Asso- and that was obvious. named Protector and Honorary Sen- ciation of Retired Persons, the AARP. The awards and decorations Nate re- ator of the European Academy of I also express deep regret that Mr. ceived serve as testimony to his strong Sciences and Arts in Salzburg. Creamer will no longer serve on the Ex- character and extraordinary perform- But Dr. Drnovs˘ek will be best re- ecutive Council as the Pennsylvania ance. They include two Bronze Star membered as a statesman of enormous State president for the AARP as he Medals, Purple Heart, two Navy Marine ability, vision, and courage. A brilliant will be stepping down February 22, 2008. Corps Achievement Medals, Combat economist, he unleashed the entrepre- He currently holds the highest volun- Action Ribbon—approval pending— neurial spirit of the Slovenian people teer position within the AARP and has three Good Conduct Medals, two Na- and played a historic role in estab- since 2002. tional Defense Service Medals, Armed lishing his new nation as a robust de- In 1951, Shane Creamer graduated Forces Expeditionary Medal, Afghani- mocracy with one of the most success- from Villanova University and in 1953 stan Campaign Medal, Iraq Campaign ful economies in Central and Eastern graduated from Temple University Medal, Kosovo Campaign Medal, Global Europe. Today, thanks in large meas- School of Law. During his time at each War on Terrorism Expeditionary ure to Dr. Drnovs˘ek’s leadership, Slo- institution he served as student body Medal, Global War on Terrorism Serv- venia is a full member of the European president. Immediately after earning

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00052 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1269 his law degree, Shane spent 2 years in the U.S. District Court for the North- Living Nutz employs a time-intensive the U.S. Army assigned to the Staff ern District of Indiana. As he enters process to produce several thousand Judge Advocate. Before entering pri- this next phase of his career, I know pounds of nuts each week. First, the vate practice, Creamer spent 11 years that Judge Sharp will continue to nuts are soaked overnight in water. with the U.S. Justice Department in serve the people of our State and Na- Then, the next morning, employees Philadelphia, including 8 years as the tion. place the nuts in large bowls and add first assistant U.S. attorney and in 1968 Upon graduating from the Indiana all-natural flavoring. The nuts are fi- served as the first director of the Penn- University School of Law in 1957, Judge nally placed into dehydrators for 5 sylvania Crime Commission. In 1968 he Sharp entered private practice in Wil- days before being packaged and published the first edition of his first liamsport, IN, successfully arguing shipped. The Pruzansky brothers be- book ‘‘The Law of Arrest, Search and Hopkins v. Cohen before the U.S. Su- lieve that the soaking method delivers Seizure,’’ which was used as a training preme Court in 1968. In 1969 Sharp be- a more desirous product, and one that manual for the U.S. Secret Service for came a Judge of the Appellate Court of is easier to digest. They say that these a number of years in the 1970s and Indiana, serving the people of Indiana ‘‘living nuts’’ are significantly richer 1980s. In 1971, he published his second in that capacity until he was confirmed in enzymes and nutrients than nuts book, ‘‘A Citizens Guide to Legal as a U.S. District Judge in 1973. that are cooked. In the end, this Rights.’’ Over the course of nearly three and a lengthy procedure yields healthy and From 1971 to 1973 Shane served as the half decades on the U.S. District Court taste-filled nuts, as well as repeat cus- attorney general of the Commonwealth for the Northern District of Indiana, tomers and devoted fans of the com- of Pennsylvania, which was followed by including 15 years as chief judge, Judge pany. a successful career as a trial lawyer Sharp has served with distinction. In Living Nutz recently played a cameo specializing in civil and criminal cases the performance of his duties, he has role in the 2008 Screen Actors Guild with the law firms Carroll, Creamer presided over civil and criminal jury awards, as the Guild selected the com- and Duffy; Sprague, Creamer and trials in four different U.S. District pany to contribute 1,500 bags of its Sprague; Montgomery McCracken; and Courts and sat by special designation mixed nuts for the actors’ and Dilworth, Paxson, LLP. In 1980 he re- on four U.S. Appeals Courts. attendees’ gift bags. What makes this In addition to his exemplary service turned to Villanova University as a occasion so unique is that the Screen to our Nation as a member of the Fed- professor at the law school for 5 years. Actors Guild actually approached the eral judiciary, Judge Sharp also served Shane has also served as chairman of Pruzansky brothers with the oppor- with the U.S. Air Force Reserve, rising the board of trustees of the Philadel- tunity, instead of vice versa. As a re- to the rank of Lieutenant Colonel. phia Prison System and as a member of sult of this exposure, the brothers hope Outside of the courtroom, Judge to take on new customers and even ce- the board of Goodwill Industries. He Sharp has also distinguished himself as continues his dedication to service as a lebrity clientele, and are seeking to ex- a scholar, teaching at Butler Univer- pand by adding new facilities, equip- member of both the board of the Penn- sity, Indiana University South Bend, sylvania Prison Society and Joint ment, and employees. and Milligan College. He has also au- The Pruzansky brothers and Living State Government Commission’s Advi- thored both books and scholarly arti- Nutz are symbols of Maine’s great sory Committee on Wrongful Convic- cles, several of which focus on histor- small business achievements. They tions. ical aspects of the law and government. have proven beyond a doubt that As president of AARP Pennsylvania, I am pleased to join with my col- healthy food can taste great. The Shane championed the interests of leagues in congratulating Judge Sharp brothers’ unique spin on healthy food, Pennsylvania’s 1,905,000 seniors. Older and his family as we celebrate his re- combined with their great sense of Pennsylvanians have certainly bene- ∑ markable service. business skills, has made Living Nutz fited from Shane’s passion and tireless f such a successful company. Therefore, I dedication. During his tenure, AARP congratulate the company on its suc- fought for Medicare Part D drug cov- RECOGNIZING LIVING NUTZ cess from Maine to Hollywood, and erage and won approval of a new State ∑ Ms. SNOWE. Mr. President, today I wish everyone at Living Nutz the best law that ends discrimination against recognize a small business from my for years to come.∑ older workers receiving Social Secu- home State of Maine that has revolu- rity. The AARP has recently helped tionized the health snack food market. f strengthen the Pharmaceutical Assist- Living Nutz, a company that sells all- MESSAGES FROM THE PRESIDENT ance Contract for the Elderly, PACE, natural, organic nuts and seeds in a va- Messages from the President of the and the PACE Needs Enhancement Tier riety of delicious flavors, provides its United States were communicated to customers with delicious treats that in Pennsylvania, expanded the prop- the Senate by Mrs. Neiman, one of his are exceedingly nutritious without sac- erty tax and rent rebate program, and secretaries. improved the State’s long-term care rificing an ounce of taste. f system. Seth Leaf Pruzansky and Davy Shane Creamer is an outstanding ad- Pruzansky, brothers who founded Liv- EXECUTIVE MESSAGES REFERRED vocate in the fight to protect the inter- ing Nutz in 2002 in the basement of As in executive session the Presiding ests of older Pennsylvanians and truly their house in Bowdoinham, ME, rep- Officer laid before the Senate messages a great supporter for the elderly. He resent the hard work and passionate from the President of the United will be missed in his capacity as Penn- drive that go into small businesses in States submitting sundry nominations sylvania’s AARP president as he goes Maine and across the Nation. It takes which were referred to the appropriate forward in his future endeavors. I con- Living Nutz’s core group of seven em- committees. gratulate him on a brilliant tenure and ployees about a week to clean, season, (The nominations received today are applaud Shane’s outstanding service to and prepare nuts for distribution to re- printed at the end of the Senate pro- the people of Pennsylvania. I wish him, tail stores throughout the United ceedings.) States and Canada, as well as for sales his wife Mary-Ellen, and all his family f the very best in the years to come. through Living Nutz’s website. From almonds to walnuts and raisins to MESSAGE FROM THE HOUSE f pumpkin seeds, Living Nutz offers 19 At 5:23 p.m., a message from the ADDITIONAL STATEMENTS varieties, including sweet ones like Ba- House of Representatives, delivered by nana Bread and Cina-Pecan-Bun, and Mrs. Cole, one of its reading clerks, an- spicy ones like Lemon Tahini Twist nounced that the House has passed the TRIBUTE TO JUDGE ALLEN SHARP and Spicy Onion Garlic. The company following bill, in which it requests the ∑ Mr. LUGAR. Mr. President, today I is also certified by the Maine Organic concurrence of the Senate: pay tribute to a remarkable Hoosier, Farmers and Gardeners Association, H.R. 5264. An act to extend the Andean Judge Allen Sharp, as he assumes Sen- ensuring both the quality and authen- Trade Preference Act, and for other pur- ior Status after 34 years as a judge on ticity of its snacks. poses.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00053 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1270 CONGRESSIONAL RECORD — SENATE February 27, 2008 ENROLLED BILLS SIGNED EC–5251. A communication from the Chief ments, FM Broadcast Stations; Peach Operating Officer, Resolution Funding Cor- Springs, Arizona’’ (MB Docket No. 07–164) re- The message also announced that the poration, transmitting, pursuant to law, the ceived on February 26, 2008; to the Com- Speaker has signed the following en- Corporation’s Statement on the System of mittee on Commerce, Science, and Transpor- rolled bills: Internal Controls; to the Committee on tation. S. 2571. An act to make technical correc- Banking, Housing, and Urban Affairs. EC–5262. A communication from the Chief tions to the Federal Insecticide, Fungicide, EC–5252. A communication from the Chief of Staff, Media Bureau, Federal Communica- and Rodenticide Act. Operating Officer, Financing Corporation, tions Commission, transmitting, pursuant to H.R. 2082. An act to authorize appropria- transmitting, pursuant to law, the Corpora- law, the report of a rule entitled ‘‘Cable Hor- tions for fiscal year 2008 for intelligence and tion’s Statement on the System of Internal izontal/Vertical Ownership Limits, Imple- intelligence-related activities of the United Controls; to the Committee on Banking, mentation of Section 11—Cable TV Consumer States Government, the Community Man- Housing, and Urban Affairs. Protection and Competition Act of 1992, Im- agement Account, and the Central Intel- EC–5253. A communication from the Chief plementation of Cable Act Reform, Provi- ligence Agency Retirement and Disability Counsel, Federal Emergency Management sions of the Telecom Act of 1996, Review of System, and for other purposes. Agency, Department of Homeland Security, Regulations—Attribution of Broadcast and transmitting, pursuant to law, the report of Cable/MDS Interests, Review of Regulations/ f a rule entitled ‘‘Changes in Flood Elevation Policies—Investment in the Broadcast Indus- EXECUTIVE AND OTHER Determinations’’ (73 FR 7476) received on try, Reexamination of Cross-Interest Policy’’ COMMUNICATIONS February 26, 2008; to the Committee on (FCC 07–219) received on February 26, 2008; to Banking, Housing, and Urban Affairs. the Committee on Commerce, Science, and The following communications were EC–5254. A communication from the Chief Transportation. laid before the Senate, together with Counsel, Federal Emergency Management EC–5263. A communication from the Direc- accompanying papers, reports, and doc- Agency, Department of Homeland Security, tor, Office of Sustainable Fisheries, Depart- uments, and were referred as indicated: transmitting, pursuant to law, the report of ment of Commerce, transmitting, pursuant a rule entitled ‘‘Final Flood Elevation Deter- to law, the report of a rule entitled ‘‘Fish- EC–5242. A communication from the Chair- minations’’ (73 FR 5455) received on February eries of the Exclusive Economic Zone Off man, Broadcasting Board of Governors, 26, 2008; to the Committee on Banking, Hous- Alaska; Shallow-Water Species Fishery by transmitting, pursuant to law, proposed leging, and Urban Affairs. Amendment 80 Vessels Subject to Sideboard islation to clarify the authority of the Board EC–5255. A communication from the Chief Limits in the Gulf of Alaska’’ (RIN0648– to hire non-citizens in its efforts to produce Counsel, Federal Emergency Management XF44) received on February 26, 2008; to the and broadcast programming; to the Com- Agency, Department of Homeland Security, Committee on Commerce, Science, and mittee on Foreign Relations. transmitting, pursuant to law, the report of Transportation. EC–5243. A communication from the Direc- a rule entitled ‘‘Suspension of Community EC–5264. A communication from the Acting tor of Selective Service, transmitting, pursu- Eligibility’’ (73 FR 4697) received on Feb- Director, Office of Sustainable Fisheries, De- ant to law, the report of several violations of ruary 25, 2008; to the Committee on Banking, partment of Commerce, transmitting, pursu- the Antideficiency Act; to the Committee on Housing, and Urban Affairs. ant to law, the report of a rule entitled Appropriations. EC–5256. A communication from the Sec- ‘‘Fisheries of the Exclusive Economic Zone EC–5244. A communication from the Chair- retary of the Treasury, transmitting, pursu- Off Alaska; Pacific Cod by Non-American man, Defense Nuclear Facilities Safety ant to law, a six-month periodic report on Fisheries Act Crab Vessels Catching Pacific Board, transmitting, pursuant to law, a the national emergency that was declared in Cod for Processing by the Inshore Compo- quarterly report relative to the status of sig- Executive Order 13288 relative to blocking nent in the Western Regulatory Area of the nificant unresolved issues with the Depart- the property of those who are undermining Gulf of Alaska’’ (RIN0648–XF49) received on ment of Energy’s Design and Construction democratic processes or institutions in February 26, 2008; to the Committee on Com- Projects; to the Committee on Armed Serv- Zimbabwe; to the Committee on Banking, merce, Science, and Transportation. EC–5265. A communication from the Dep- ices. Housing, and Urban Affairs. uty Chief, National Forest System, Depart- EC–5245. A communication from the Direc- EC–5257. A communication from the Acting ment of Agriculture, transmitting, pursuant tor, Defense Procurement and Acquisition Director, Office of Management, Federal to law, a report relative to the boundary for Policy, Department of Defense, transmit- Housing Finance Board, transmitting, pursu- the Wildcat River in New Hampshire; to the ting, pursuant to law, the report of a rule en- ant to law, a report relative to its 2008 com- Committee on Energy and Natural Re- titled ‘‘Mandatory Use of Wide Area pensation program; to the Committee on WorkFlow’’ (DFARS Case 2006-D049) received sources. Banking, Housing, and Urban Affairs. EC–5266. A communication from the Gen- on February 26, 2008; to the Committee on EC–5258. A communication from the Chief Armed Services. eral Counsel, Federal Energy Regulatory of Staff, Media Bureau, Federal Communica- Commission, transmitting, pursuant to law, EC–5246. A communication from the Under tions Commission, transmitting, pursuant to Secretary of Defense (Acquisition, Tech- the report of a rule entitled ‘‘Blanket Au- law, the report of a rule entitled ‘‘Leased thorization Under FPA Section 203’’ (Docket nology and Logistics), transmitting, pursu- Commercial Access’’ (MB Docket No. 07–42) ant to law, a report relative to the Reli- No. RM07–21–000) received on February 26, received on February 22, 2008; to the Com- 2008; to the Committee on Energy and Nat- ability Enhancement and Re-engining Pro- mittee on Commerce, Science, and Transpor- gram; to the Committee on Armed Services. ural Resources. tation. EC–5267. A communication from the Chair- EC–5247. A communication from the Chief, EC–5259. A communication from the Chief man, Nuclear Regulatory Commission, trans- Congressional Action Division, Department of Staff, Media Bureau, Federal Communica- mitting, pursuant to law, the Commission’s of the Air Force, transmitting, pursuant to tions Commission, transmitting, pursuant to Strategic Plan for the period of fiscal year law, a report relative to a public-private law, the report of a rule entitled ‘‘2006 Quad- 2008 through fiscal year 2013; to the Com- competition that was commenced on August rennial Regulatory Review—Review of the mittee on Environment and Public Works. 25, 2005, at Luke Air Force Base; to the Com- Commission’s Broadcast Ownership Rules EC–5268. A communication from the Pro- mittee on Armed Services. and Other Rules Adopted Pursuant to Sec- gram Manager, Centers for Medicare and EC–5248. A communication from the Prin- tion 202 of the Telecommunications Act of Medicaid Services, Department of Health cipal Deputy, Office of the Under Secretary 1996’’ (MB Docket No. 06–121) received on and Human Services, transmitting, pursuant of Defense (Personnel and Readiness), trans- February 22, 2008; to the Committee on Com- to law, the report of a rule entitled ‘‘Med- mitting, the report of an officer authorized merce, Science, and Transportation. icaid Program; Health Care Related Taxes’’ to wear the insignia of the grade of brigadier EC–5260. A communication from the Dep- (RIN0938–AO80) received on February 22, 2008; general in accordance with title 10, United uty Bureau Chief, Wireline Competition Bu- to the Committee on Finance. States Code, section 777; to the Committee reau, Federal Communications Commission, EC–5269. A communication from the Pro- on Armed Services. transmitting, pursuant to law, the report of gram Manager, Centers for Medicare and EC–5249. A communication from the Under a rule entitled ‘‘Telephone Number Require- Medicaid Services, Department of Health Secretary of Defense (Acquisition, Tech- ments for IP-Enabled Services Providers; and Human Services, transmitting, pursuant nology and Logistics), transmitting, pursu- Local Number Portability Porting Interval to law, the report of a rule entitled ‘‘Medi- ant to law, a report relative to the Program and Validation Requirements; IP-Enabled care Program; Medicare Secondary Payer Acquisition Unit Cost and the Procurement Services; Telephone Number Portability; Amendments’’ (RIN0938–AN27) received on Unit Cost for the Joint Tactical Radio Sys- Numbering Resource Optimization’’ (FCC 07– February 22, 2008; to the Committee on Fi- tem Ground Mobile Radio; to the Committee 188) received on February 26, 2008; to the nance. on Armed Services. Committee on Commerce, Science, and EC–5270. A communication from the Chief EC–5250. A communication from the Prin- Transportation. of the Publications and Regulations Branch, cipal Deputy, Office of the Under Secretary EC–5261. A communication from the Chief Internal Revenue Service, Department of the of Defense (Personnel and Readiness), trans- of Staff, Media Bureau, Federal Communica- Treasury, transmitting, pursuant to law, the mitting, pursuant to law, a report relative to tions Commission, transmitting, pursuant to report of a rule entitled ‘‘Coordinated Issue: the Critical Skills Retention Bonus program; law, the report of a rule entitled ‘‘Amend- Variable Prepaid Forward Contracts Incor- to the Committee on Armed Services. ment of Section 73.202(b), Table of Allot- porating Share Lending Arrangements’’

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00054 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1271 (LMSB–04–1207–077) received on February 26, EC–5282. A communication from the Direc- SUBMISSION OF CONCURRENT AND 2008; to the Committee on Finance. tor of Human Resources, Railroad Retire- SENATE RESOLUTIONS EC–5271. A communication from the Chief ment Board, transmitting, pursuant to law, a of the Publications and Regulations Branch, report relative to the category rating sys- The following concurrent resolutions Internal Revenue Service, Department of the tem; to the Committee on Homeland Secu- and Senate resolutions were read, and Treasury, transmitting, pursuant to law, the rity and Governmental Affairs. referred (or acted upon), as indicated: report of a rule entitled ‘‘2008 Economic EC–5283. A communication from the Chair- By Mr. BAUCUS (for himself, Mr. REID, Stimulus Payments: Filing Instructions for man, Merit Systems Protection Board, Mr. LEAHY, Mr. TESTER, Mrs. MUR- Certain Individuals’’ (Notice 2008–28) re- transmitting, pursuant to law, a report enti- RAY, Mr. ISAKSON, Mr. DURBIN, Mrs. ceived on February 26, 2008; to the Com- tled ‘‘Attracting the Next Generation: A FEINSTEIN, and Mr. KENNEDY): mittee on Finance. Look at Federal Entry-Level New Hires’’; to S. Res. 462. A resolution designating the EC–5272. A communication from the Chief the Committee on Homeland Security and first week of April 2008 as ‘‘National Asbes- of the Publications and Regulations Branch, Governmental Affairs. tos Awareness Week’’; to the Committee on Internal Revenue Service, Department of the EC–5284. A communication from the Direc- the Judiciary. Treasury, transmitting, pursuant to law, the tor, Division for Strategic Human Resources report of a rule entitled ‘‘2008 Census Count’’ Policy, Office of Personnel Management, f (Notice 2008–22) received on February 26, 2008; transmitting, pursuant to law, the report of ADDITIONAL COSPONSORS to the Committee on Finance. a rule entitled ‘‘Allotments From Federal EC–5273. A communication from the Chief Employees’’ (RIN3206-AJ88) received on Feb- S. 644 of the Publications and Regulations Branch, ruary 26, 2008; to the Committee on Home- At the request of Mrs. LINCOLN, the Internal Revenue Service, Department of the land Security and Governmental Affairs. name of the Senator from Oregon (Mr. Treasury, transmitting, pursuant to law, the EC–5285. A communication from the Direc- SMITH) was added as a cosponsor of S. report of a rule entitled ‘‘Performance-Based tor, Strategic Human Resources Policy Divi- 644, a bill to amend title 38, United Compensation Under Internal Revenue Code sion, Office of Personnel Management, trans- Section 162(m)’’ (Rev. Rul. 2008–13) received States Code, to recodify as part of that mitting, pursuant to law, the report of a rule title certain educational assistance on February 26, 2008; to the Committee on entitled ‘‘Career and Career-Conditional Em- Finance. ployment and Adverse Actions’’ (RIN3206- programs for members of the reserve EC–5274. A communication from the Chief AL30) received on February 26, 2008; to the components of the Armed Forces, to of the Publications and Regulations Branch, Committee on Homeland Security and Gov- improve such programs, and for other Internal Revenue Service, Department of the ernmental Affairs. purposes. Treasury, transmitting, pursuant to law, the EC–5286. A communication from the Chair- S. 1223 report of a rule entitled ‘‘Special Rule for man, Nuclear Regulatory Commission, trans- At the request of Ms. LANDRIEU, the Bank Required to Change from the Reserve mitting, pursuant to law, the Commission’s Method of Accounting on Becoming an S Annual Report for calendar year 2007; to the names of the Senator from Minnesota Corporation’’ (Rev. Proc. 2008–18) received on Committee on Homeland Security and Gov- (Ms. KLOBUCHAR) and the Senator from February 26, 2008; to the Committee on Fi- ernmental Affairs. Texas (Mrs. HUTCHISON) were added as nance. EC–5287. A communication from the Prin- cosponsors of S. 1223, a bill to amend EC–5275. A communication from the Chief cipal Deputy Assistant Attorney General, Of- the Robert T. Stafford Disaster Relief of the Publications and Regulations Branch, fice of Legislative Affairs, Department of and Emergency Assistance Act to sup- Internal Revenue Service, Department of the Justice, transmitting, pursuant to law, a re- Treasury, transmitting, pursuant to law, the port efforts by local or regional tele- port relative to the Bureau of Prisons’ com- vision or radio broadcasters to provide report of a rule entitled ‘‘Vacation Homes pliance with the privatization requirements and Section 1031’’ (Rev. Proc. 2008-16) re- of the Revitalization Act; to the Committee essential public information program- ceived on February 25, 2008; to the Com- on the Judiciary. ming in the event of a major disaster, mittee on Finance. EC–5288. A communication from the Prin- and for other purposes. EC–5276. A communication from the Chief cipal Deputy Assistant Attorney General, Of- S. 1382 of the Publications and Regulations Branch, fice of Legislative Affairs, Department of Internal Revenue Service, Department of the At the request of Mr. REID, the name Justice, transmitting, pursuant to law, an Treasury, transmitting, pursuant to law, the of the Senator from Mississippi (Mr. annual report on the Department’s activities report of a rule entitled ‘‘Substitute for Re- WICKER) was added as a cosponsor of S. during calendar year 2006 relative to prison turn’’ (TD 9380) received on February 25, 2008; rape abatement; to the Committee on the 1382, a bill to amend the Public Health to the Committee on Finance. Judiciary. Service Act to provide for the estab- EC–5277. A communication from the Chief EC–5289. A communication from the Chair- lishment of an Amyotrophic Lateral of the Publications and Regulations Branch, man, Commission on Civil Rights, transmit- Sclerosis Registry. Internal Revenue Service, Department of the ting, pursuant to law, a report relative to a Treasury, transmitting, pursuant to law, the S. 1395 new Strategic Plan that was adopted by the report of a rule entitled ‘‘Reissuance Stand- At the request of Mr. LEVIN, the Commission; to the Committee on the Judi- ards for State and Local Bonds’’ (Notice 2008- name of the Senator from Vermont ciary. 27) received on February 26, 2008; to the Com- (Mr. SANDERS) was added as a cospon- mittee on Finance. sor of S. 1395, a bill to prevent unfair f EC–5278. A communication from the Assist- practices in credit card accounts, and ant Secretary, Office of Legislative Affairs, for other purposes. Department of State, transmitting, pursuant INTRODUCTION OF BILLS AND S. 1854 to law, the certification of a proposed tech- JOINT RESOLUTIONS nical assistance agreement for the export of At the request of Mr. REID, the name technical data in support of the Integrated The following bills and joint resolu- of the Senator from California (Mrs. Surveillance System for the A400M Military tions were introduced, read the first BOXER) was added as a cosponsor of S. Transport Aircraft; to the Committee on and second times by unanimous con- 1854, a bill to amend the Social Secu- Foreign Relations. rity Act and the Public Health Service EC–5279. A communication from the Direc- sent, and referred as indicated: tor of National Intelligence, transmitting, a By Mr. JOHNSON (for himself and Ms. Act to improve elderly suicide early report relative to the Administration’s oppo- STABENOW): intervention and prevention strategies, sition to S. 274; to the Committee on Home- S. 2670. A bill to amend the Pittman-Rob- and for other purposes. land Security and Governmental Affairs. ertson Wildlife Restoration Act to ensure S. 2004 adequate funding for conservation and res- EC–5280. A communication from the Sec- At the request of Mrs. MURRAY, the toration of wildlife, and for other purposes; retary of Commerce, transmitting, pursuant name of the Senator from Rhode Island to law, the Department’s Performance and to the Committee on Environment and Pub- Accountability Report for fiscal year 2007; to lic Works. (Mr. WHITEHOUSE) was added as a co- the Committee on Homeland Security and By Mrs. MURRAY: sponsor of S. 2004, a bill to amend title Governmental Affairs. S. 2671. A bill to provide grants to promote 38, United States Code, to establish epi- EC–5281. A communication from the Assist- financial literacy; to the Committee on lepsy centers of excellence in the Vet- ant Administrator for Legislative and Inter- Health, Education, Labor, and Pensions. erans Health Administration of the De- governmental Affairs, National Aeronautics By Mr. CONRAD (for himself and Mr. partment of Veterans Affairs, and for and Space Administration, transmitting, BROWNBACK): other purposes. pursuant to law, a report relative to the Ad- S. 2672. A bill to provide incentives to phy- ministration’s use of the category rating sicians to practice in rural and medically un- S. 2170 system; to the Committee on Homeland Se- derserved communities; to the Committee on At the request of Mrs. HUTCHISON, the curity and Governmental Affairs. the Judiciary. name of the Senator from Louisiana

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00055 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1272 CONGRESSIONAL RECORD — SENATE February 27, 2008 (Mr. VITTER) was added as a cosponsor in employment for, residents of rural STATEMENTS ON INTRODUCED of S. 2170, a bill to amend the Internal areas. BILLS AND JOINT RESOLUTIONS Revenue Code of 1986 to modify the S. 2623 By Mr. CONRAD (for himself and treatment of qualified restaurant prop- At the request of Mr. NELSON of Ne- Mr. BROWNBACK): erty as 15-year property for purposes of braska, the name of the Senator from S. 2672. A bill to provide incentives to the depreciation deduction. Kansas (Mr. BROWNBACK) was added as physicians to practice in rural and S. 2337 a cosponsor of S. 2623, a bill to amend medically underserved communities; to At the request of Mr. GRASSLEY, the title 37, United States Code, to author- the Committee on the Judiciary. name of the Senator from Nebraska ize travel and transportation allow- Mr. CONRAD. Mr. President, today I (Mr. HAGEL) was added as a cosponsor ances for mobilized members of the re- am introducing the Conrad State 30 of S. 2337, a bill to amend the Internal serve components of the Armed Forces Improvement Act to extend and expand Revenue Code of 1986 to allow long- on leave for suspension of training or this program’s success in bringing doc- term care insurance to be offered under to meet minimal staffing require- tors to communities that would other- cafeteria plans and flexible spending ments, and for other purposes. wise not have access to health care services. arrangements and to provide additional S. 2625 consumer protections for long-term The Conrad State 30 program, which At the request of Mr. HARKIN, the care insurance. I helped create in 1994, has brought name of the Senator from Illinois (Mr. thousands of physicians to underserved S. 2366 DURBIN) was added as a cosponsor of S. communities in all 50 states, across our At the request of Mr. VITTER, the 2625, a bill to ensure that deferred De- great country. These doctors are for- name of the Senator from Tennessee partment of Veterans Affairs disability eign born, but have all received train- (Mr. ALEXANDER) was added as a co- benefits that are received in a lump ing in the United States. Under the sponsor of S. 2366, a bill to provide im- sum amount or in prospective monthly Conrad 30 program, foreign doctors al- migration reform by securing Amer- amounts, be excluded from consider- ready in the country for medical train- ica’s borders, clarifying and enforcing ation as annual income when deter- ing are granted a waiver from a visa re- existing laws, and enabling a practical mining eligibility for low-income hous- quirement to return to their home verification program. ing programs. country for 2 years. In exchange for S. 2369 S. 2636 this waiver, the doctors must commit At the request of Mr. BAUCUS, the At the request of Mr. REID, the name to providing health care to underserved name of the Senator from Ohio (Mr. of the Senator from Florida (Mr. NEL- populations in the United States for 3 BROWN) was added as a cosponsor of S. SON) was added as a cosponsor of S. years. 2369, a bill to amend title 35, United 2636, a bill to provide needed housing By 2020, some projections show that States Code, to provide that certain reform. the United States may have 200,000 tax planning inventions are not patent- S. 2640 fewer doctors than it needs; that is a able, and for other purposes. staggering statistic, and one that can- At the request of Mr. BURR, the name S. 2401 not be taken lightly. If this shortfall is of the Senator from Georgia (Mr. At the request of Ms. CANTWELL, the allowed to materialize, rural areas, ISAKSON) was added as a cosponsor of S. like my State of North Dakota, will name of the Senator from Idaho (Mr. 2640, a bill to amend title 38, United CRAIG) was added as a cosponsor of S. undoubtedly be among the hardest hit. States Code, to enhance and improve Given the looming deficit of doctors 2401, a bill to amend the Internal Rev- insurance, housing, labor and edu- enue Code of 1986 to allow a refund of and an increasingly competitive global cation, and other benefits for veterans, marketplace, it is vital that we main- motor fuel excise taxes for the actual and for other purposes. off-highway use of certain mobile ma- tain the incentives for qualified foreign chinery vehicles. S.J. RES. 26 physicians to serve patients in this At the request of Mrs. DOLE, the S. 2433 country. The immigration benefits his- name of the Senator from South Da- torically provided by the Conrad pro- At the request of Mrs. MURRAY, her kota (Mr. THUNE) was added as a co- name was added as a cosponsor of S. gram, and enhanced in this bill, pro- sponsor of S.J. Res. 26, a joint resolu- 2433, a bill to require the President to vide crucial incentives to foreign doc- tion supporting a base Defense Budget develop and implement a comprehen- tors. And when they do come to our that at the very minimum matches 4 sive strategy to further the United country, it is vital that we make sure percent of gross domestic product. States foreign policy objective of pro- that they end up in the places that moting the reduction of global poverty, S. RES. 252 need them most. This bill makes the Conrad 30 pro- the elimination of extreme global pov- At the request of Mr. BOND, the name gram permanent, something that I be- erty, and the achievement of the Mil- of the Senator from Utah (Mr. BEN- lieve is long overdue. It also invites a lennium Development Goal of reducing NETT) was added as a cosponsor of S. new group of foreign doctors to take by one-half the proportion of people Res. 252, a resolution recognizing the part in the program, a change that worldwide, between 1990 and 2015, who increasingly mutually beneficial rela- could dramatically expand the pool of live on less than $1 per day. tionship between the United States of America and the Republic of Indonesia. doctors practicing in rural and under- S. 2505 served areas. Further, the bill creates a S. RES. 439 At the request of Ms. CANTWELL, the mechanism by which the current cap of name of the Senator from Georgia (Mr. At the request of Mr. LUGAR, the 30 doctors per state can significantly ISAKSON) was added as a cosponsor of S. name of the Senator from New York expand, while protecting the interests 2505, a bill to allow employees of a (Mrs. CLINTON) was added as a cospon- of those states that have had difficulty commercial passenger airline carrier sor of S. Res. 439, a resolution express- recruiting doctors under the program. who receive payments in a bankruptcy ing the strong support of the Senate The bill also creates an important new proceeding to roll over such payments for the North Atlantic Treaty Organi- incentive for doctors to participate in into an individual retirement plan, and zation to enter into a Membership Ac- the program by granting them a green for other purposes. tion Plan with Georgia and Ukraine. card cap exemption when they have S. 2580 S. RES. 455 completed their service. Finally, the At the request of Mr. BROWN, the At the request of Mr. DURBIN, the bill gives increased flexibility to State names of the Senator from Montana names of the Senator from California health authorities to determine the (Mr. BAUCUS) and the Senator from Ne- (Mrs. FEINSTEIN), the Senator from needs of their State in utilizing Conrad braska (Mr. HAGEL) were added as co- Maine (Ms. SNOWE), the Senator from waivers. sponsors of S. 2580, a bill to amend the Illinois (Mr. OBAMA) and the Senator I strongly believe the Conrad State 30 Higher Education Act of 1965 to im- from Pennsylvania (Mr. SPECTER) were Improvement Act can be of great ben- prove the participation in higher edu- added as cosponsors of S. Res. 455, a efit to every state in the country and cation of, and to increase opportunities resolution calling for peace in Darfur. help combat the growing shortage of

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00056 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1273 health care providers in the United am submitting. It is the asbestos asbestos. Finally, people in Montana States. awareness week resolution. This reso- are getting disability benefits because f lution has passed the Senate for 3 of the asbestos diseases they have. years, and I am pleased to submit it So I am very proud to submit this SUBMITTED RESOLUTIONS again this year. resolution. As I said, I have been doing This is a very deeply personal issue this for several years, and we are mak- SENATE RESOLUTION 462—DESIG- for me. About 8 years ago, I was in ing this National Asbestos Recognition NATING THE FIRST WEEK OF Libby, MT, in the living room of Les Week in April, the first week in April. APRIL 2008 AS ‘‘NATIONAL AS- Skramstad, and there were several peo- I believe it is so important to highlight BESTOS AWARENESS WEEK’’ ple in the room who were suffering this dread disease so we can stamp out from asbestos-related diseases. This the scourge and, in my view, finally Mr. BAUCUS (for himself, Mr. REID, was in Libby. Since then, about 200 banish asbestos. If we can accomplish Mr. LEAHY, Mr. TESTER, Mrs. MURRAY, people have died of asbestos-related that, then in some small way we have Mr. ISAKSON, Mr. DURBIN, Mrs. FEIN- diseases. vindicated the people of Libby, MT. STEIN, and Mr. KENNEDY) submitted the Les Skramstad, whom I met that day following resolution; which was re- about 8 or 9 years ago, was dying from f ferred to the Committee on the Judici- mesothelioma. He looked at me and ary: said: As a U.S. Senator, I expect you do NOTICE OF HEARING S. RES. 462 something to help us in Libby. COMMITTEE ON ENERGY AND NATURAL Whereas dangerous asbestos fibers are in- I said: You bet. RESOURCES visible and cannot be smelled or tasted; He looked me straight in the eye, and Mr. BINGAMAN. Mr. President, I Whereas the inhalation of airborne asbes- because he has been around a little bit, would like to announce for the infor- tos fibers can cause significant damage; he said: Senator, I am going to be mation of the Senate and the public Whereas these fibers can cause mesothe- watching you to make sure that is not that an oversight hearing has been lioma, asbestosis, and other health problems; just an idle promise. I will be watching Whereas asbestos-related diseases can take scheduled before the Senate Committee 10 to 50 years to present themselves; you. Boy, I got the message loudly and on Energy and Natural Resources. The Whereas the expected survival time for hearing will be held on Wednesday, those diagnosed with mesothelioma is be- clearly. I decided right then at that moment that I need to do all I can to March 5, 2008, at 3 p.m., in room SD–366 tween 6 and 24 months; of the Dirksen Senate Office Building. Whereas generally little is known about help make sure that people in Libby, The purpose is to receive testimony late stage treatment and there is no cure for MT, get justice. As I said, over 200 peo- on the impacts of the capability of the asbestos-related diseases; ple died since then. Whereas early detection of asbestos-re- He was an employee of a W.R. Grace United States to maintain a domestic lated diseases may give some patients in- mine. W.R. Grace clearly knew it was enrichment capability as a result of creased treatment options and might im- poisoning people in Libby, MT, in its the recently initialed amendment be- prove their prognosis; mine there. It did not admit it. There tween the United States and the Rus- Whereas the United States has substan- sian Federation on the Agreement Sus- tially reduced its consumption of asbestos is a criminal case going on right now against the officers of W.R. Grace pending the Antidumping Investigation yet continues to consume almost 2,000 met- on Uranium from the Russian Federa- ric tons of the fibrous mineral for use in cer- claiming that they did know what they tain products throughout the Nation; were doing. tion. Whereas asbestos-related diseases have Asbestos from this mine is called Because of the limited time available killed thousands of people in the United tremolite. It is not the ordinary crys- for the hearing, witnesses may testify States; tal asbestos. This is tremolite asbestos, by invitation only. However, those Whereas asbestos exposures continue and which is much more pernicious. It gets wishing to submit written testimony safety and prevention will reduce and has re- for the hearing record may do so by duced significantly asbestos exposure and as- more deeply embedded in your lungs, more angles to the dust that gets into sending it to the Committee on Energy bestos-related diseases; and Natural Resources, United States Whereas asbestos has been a cause of occu- your lungs. It is harder to detect. Sometimes the latency period can be Senate, Washington, DC 20510–6150, or pational cancer; by e-mail to Rose- Whereas thousands of workers in the from 20 to 30 years. _ United States face significant asbestos expo- Les would come home all dusty from marie [email protected]. sure; the mine, and he would go home and For further information, please con- Whereas thousands of people in the United embrace his wife, and his kids would tact Jonathan Epstein (202) 228–3031 or States die from asbestos-related diseases jump into his lap. Guess what. Les is Rosemarie Calabro at (202) 224–5039. every year; now dead. He died last month from Whereas a significant percentage of all as- f bestos-related disease victims were exposed mesothelioma. Les’s wife is dying from asbestos-related diseases. Three of his to asbestos on naval ships and in shipyards; AUTHORITY FOR COMMITTEES TO Whereas asbestos was used in the construc- four children are now dying. tion of a significant number of office build- It is the dust, the asbestos dust that MEET ings and public facilities built before 1975; is in Libby, MT. This stuff was used on COMMITTEE ON ARMED SERVICES Whereas people in the small community of playgrounds. It was used on golf Mr. BAUCUS. Mr. President, I ask Libby, Montana have asbestos-related dis- courses. It was used for insulation in unanimous consent that the Com- eases at a significantly higher rate than the attics in homes. People have died and mittee on Armed Services be author- national average and suffer from mesothe- are dying. We are doing all we can to ized to meet during the session of the lioma at a significantly higher rate than the national average; and address this, and we are trying to get Senate on Wednesday, February 27, Whereas the establishment of a ‘‘National them proper medical care. 2008, at 9:30 a.m., in open session, and Asbestos Awareness Week’’ would raise pub- There is a clinic called the CARD possibly closed session, to receive tes- lic awareness about the prevalence of asbes- Clinic in Libby which is doing a really timony on the current and future tos-related diseases and the dangers of asbes- good job in screening people, trying to worldwide threats to the national secu- tos exposure: Now, therefore, be it find out who has it and who doesn’t. rity of the United States. Resolved, That the Senate— Again, it is very hard to find. You need The PRESIDING OFFICER. Without (1) designates the first week of April 2008 special techniques. We had to change objection, it is so ordered. as ‘‘National Asbestos Awareness Week’’; the disability laws in America be- COMMITTEE ON COMMERCE, SCIENCE, AND (2) urges the Surgeon General, as a public TRANSPORTATION health issue, to warn and educate people cause—not change but point out to the that asbestos exposure may be hazardous to Social Security Administration that Mr. BAUCUS. Mr. President, I ask their health; and this is a different kind of asbestos, it is unanimous consent that the Com- (3) respectfully requests the Secretary of not ordinary asbestos, and then decide mittee on Commerce, Science, and the Senate to transmit a copy of this resolu- whether to grant disability payments. Transportation be authorized to meet tion to the Surgeon General. They were looking at ordinary asbes- during the session of the Senate on Mr. BAUCUS. Mr. President, I rise to tos. They didn’t know about this asbes- Wednesday, February 27, 2008, at 2:30 talk about an important resolution I tos. They didn’t know about tremolite p.m., in room 253 of the Russell

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00057 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1274 CONGRESSIONAL RECORD — SENATE February 27, 2008 Senate Office Building, in order to con- Truman Scholarship Foundation: COMMITTEE ON SMALL BUSINESS AND duct a hearing. Javaid Anwar, and Assistant Secretary ENTREPRENEURSHIP The hearing will focus on the Na- of Labor ODEP: Neil Romano. Mr. BAUCUS. Mr. President, I ask tional Aeronautics and Space Adminis- The PRESIDING OFFICER. Without unanimous consent that the Com- tration’s fiscal year 2009 budget pro- objection, it is so ordered. mittee on Small Business and Entre- preneurship be authorized to meet dur- posal. COMMITTEE ON HOMELAND SECURITY AND The PRESIDING OFFICER. Without GOVERNMENTAL AFFAIRS ing the session of the Senate in order objection, it is so ordered. Mr. BAUCUS. Mr. President, I ask to conduct a hearing entitled ‘‘The COMMITTEE ON ENERGY AND NATURAL unanimous consent that the Com- President’s FY2009 Budget Request for RESOURCES mittee on Homeland Security and Gov- the Small Business Administration on Mr. BAUCUS. Mr. President, I ask ernmental Affairs be authorized to Wednesday, February 27, 2008, begin- unanimous consent that the Com- meet during the session of the Senate ning at 10:00 a.m., in room 428A of the mittee on Energy and Natural Re- on Wednesday, February 27, 2008, at 10 Russell Senate Office Building. The PRESIDING OFFICER. Without sources be authorized to meet during a.m. in order to conduct a hearing enti- objection, it is so ordered. the session of the Senate in order to tled ‘‘An Uneasy Relationship: U.S. Re- conduct a hearing on Wednesday, Feb- liance on Private Security Firms in COMMITTEE ON VETERANS’ AFFAIRS ruary 27, 2008, at 9:45 a.m., in room Overseas Operations.’’ Mr. BAUCUS. Mr. President, I ask SD366 of the Dirksen Senate Office The PRESIDING OFFICER. Without unanimous consent for the Committee Building. At this hearing, the Com- objection, it is so ordered. on Veterans’ Affairs to be authorized mittee will hear testimony to consider to meet during the session of the Sen- two nominations: Stanley C. Suboleski, COMMITTEE ON INDIAN AFFAIRS ate on Wednesday, February 27, 2008, in of Virginia, to be an Assistant Sec- Mr. BAUCUS. Mr. President, I ask order to conduct an oversight hearing retary of Energy (Fossil Energy), vice unanimous consent that the Com- entitled ‘‘Review of Veterans’ Dis- Jeffrey D. Jarrett, resigned; and, J. mittee on Indian Affairs be authorized ability Compensation: Expert Reports Gregory Copeland, of Texas, to be Gen- to meet during the session of the Sen- on PTSD and other issues.’’ The Com- eral Counsel of the Department of En- ate on Wednesday, February 27, at 9:30 mittee will meet in room 216 of the ergy, vice David R. Hill. a.m. in room 485 of the Russell Senate Hart Senate Office Building, at 9:30 The PRESIDING OFFICER. Without Office Building in order to conduct a a.m. objection, it is so ordered. hearing on S. 2232, the Foreign Aid Les- The PRESIDING OFFICER. Without COMMITTEE ON ENVIRONMENT AND PUBLIC sons for Domestic Economic Assistance objection, it is so ordered. Act of 2007. WORKS PERSONNEL SUBCOMMITTEE Mr. BAUCUS. Mr. President, I ask The PRESIDING OFFICER. Without Mr. BAUCUS. Mr. President, I ask unanimous consent that the Com- objection, it is so ordered. unanimous consent that the Personnel mittee on Environment and Public COMMITTEE ON THE JUDICIARY Subcommittee of the Committee on Works be authorized to meet during Mr. BAUCUS. Mr. President, I ask Armed Services be authorized to meet the session of the Senate on Wednes- unanimous consent that the Senate during the session of the Senate on day, February 27, 2008 at 10:00 a.m. in Committee on the Judiciary be author- Wednesday, February 27, 2008, at 3:00 room 406 of the Dirksen Senate Office ized to meet during the session of the p.m., in open session to receive testi- Building in order to conduct a hearing Senate, in order to conduct a hearing mony on active component, reserve entitled, ‘‘Hearing on the President’s entitled ‘‘The False Claims Act Correc- component, and civilian personnel pro- Proposed EPA Budget for FY 2009.’’ tion Act (S. 2041): Strengthening the grams in review of the defense author- The PRESIDING OFFICER. Without Government’s Most Effective Tool ization request for Fiscal Year 2009 and objection, it is so ordered. Against Fraud for the 21st Century’’ on the Future Years Defense Program. COMMITTEE ON HEALTH, EDUCATION, LABOR, Wednesday, February 27, 2008 at 10 a.m. The PRESIDING OFFICER. Without AND PENSIONS in room SD–226 of the Dirksen Senate objection, it is so ordered. Mr. BAUCUS. Mr. President, I ask Office Building. SELECT COMMITTEE ON INTELLIGENCE unanimous consent that the Com- Witness List Mr. BAUCUS. Mr. President, I ask mittee on Health, Education, Labor, unanimous consent that the Select and Pensions be authorized to meet in Michael F. Hertz, Deputy Assistant Committee on Intelligence be author- executive session during the session of Attorney General, Civil Division, U.S. ized to meet during the session of the the Senate on Wednesday, February 27, Department of Justice, Washington, Senate on February 27, 2008, at 2:30 2008 at 10 a.m. in SD–430. DC. p.m. in order to hold a closed business Agenda Panel II: Tina M. Gonter, Jackson- meeting. ville, FL; The Honorable John E. The PRESIDING OFFICER. Without S. 579, Breast Cancer and Environ- Clark, Of Counsel, Goode, Casseb, objection, it is so ordered. mental Research Act of 2007; S. 1810, Jones, Riklin, Choate & Watson, P.C., Prenatally and Postnatally Diagnosed SUBCOMMITTEE ON CRIME AND DRUGS San Antonio, TX; John T. Boese, Part- Mr. BAUCUS. Mr. President, I ask Conditions Awareness Act; S. 999, ner, Fried, Frank, Harris, Shriver & Stroke Treatment and Ongoing Preven- unanimous consent that the Senate Jacobson LLP, Washington, DC; and Committee on the Judiciary, Sub- tion Act of 2007; S. 1760, Healthy Start Pamela H. Bucy, Bainbridge Professor Reauthorization Act of 2007; H.R. 20, committee on Crime and Drugs, be au- of Law, University of Alabama School thorized to meet during the session of Melanie Blocker-Stokes Postpartum of Law, Tuscaloosa, AL. Depression Research and Care Act; and the Senate, in order to conduct a hear- The PRESIDING OFFICER. Without S. 1042, Consistency, Accuracy, Respon- ing entitled ‘‘Supporting the Front objection, it is so ordered. sibility, and Excellence in Medical Im- Line in the Fight Against Crime: Re- aging and Radiation Therapy Act of COMMITTEE ON RULES AND ADMINISTRATION storing Federal Funding for State and 2007. Mr. BAUCUS. Mr. President, I ask Local Law Enforcement’’ on Wednes- National Board for Education unanimous consent that the Com- day, February 27, 2008 at 2 p.m. in the Sciences: Jonathan Baron, Frank mittee on Rules and Administration be Dirksen Senate Office Building, Room Handy, Sally Shaywitz. authorized to meet during the session 226. National Foundation on the Arts and of the Senate on Wednesday, February The PRESIDING OFFICER. Without Humanities: Jamsheed Choksy, Gary 27, 2008, at 10:00 a.m., in order to hear objection, it is so ordered. Glenn, David Hertz, Marvin Scott, testimony on Protecting Voters at SUBCOMMITTEE ON PUBLIC LANDS AND FORESTS Carol Swain. Home and at the Polls: Limiting Abu- Mr. BAUCUS. Mr. President, I ask National Museum and Library sive Robocalls and Vote Caging Prac- unanimous consent that the Sub- Science Board: Julia Bland, Jan tices. committee on Public Lands and For- Cellucci, William Hagenah, Mark Her- The PRESIDING OFFICER. Without ests of the Committee on Energy and ring, objection, it is so ordered. Natural Resources be authorized to

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00058 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1275 meet during the session of the Senate Sec. 102. Soboba sanitation facilities. ‘‘SECTION 1. SHORT TITLE; TABLE OF CONTENTS. in order to conduct a hearing on Sec. 103. Native American Health and ‘‘(a) SHORT TITLE.—This Act may be cited Wellness Foundation. as the ‘Indian Health Care Improvement Wednesday, February 27, 2008, at 2:30 Sec. 104. Modification of term. Act’. p.m., in room SD366 of the Dirksen Sec. 105. GAO study and report on payments ‘‘(b) TABLE OF CONTENTS.—The table of Senate Office Building. At this hearing, for contract health services. contents for this Act is as follows: Sec. 106. GAO study of membership criteria the Committee will hear testimony re- ‘‘Sec. 1. Short title; table of contents. for federally recognized Indian garding the following legislation: ‘‘Sec. 2. Findings. tribes. S. 832, to provide for the sale of ap- Sec. 107. GAO study of tribal justice sys- ‘‘Sec. 3. Declaration of national Indian proximately 25 acres of public land to tems. health policy. ‘‘Sec. 4. Definitions. the Turnabout Ranch, Escalante, Utah, TITLE II—IMPROVEMENT OF INDIAN at fair market value; HEALTH CARE PROVIDED UNDER THE ‘‘TITLE I—INDIAN HEALTH, HUMAN S. 2229, to withdraw certain Federal SOCIAL SECURITY ACT RESOURCES, AND DEVELOPMENT land in the Wyoming Range from leas- Sec. 201. Expansion of payments under Medi- ‘‘Sec. 101. Purpose. ing and provide an opportunity to re- care, Medicaid, and SCHIP for ‘‘Sec. 102. Health professions recruitment tire certain leases in the Wyoming all covered services furnished program for Indians. Range; by Indian Health Programs. ‘‘Sec. 103. Health professions preparatory S. 2379, to authorize the Secretary of Sec. 202. Increased outreach to Indians scholarship program for Indi- the Interior to cancel certain grazing under Medicaid and SCHIP and ans. improved cooperation in the ‘‘Sec. 104. Indian health professions scholar- leases on land in Cascade-Siskiyou Na- provision of items and services ships. tional Monument that are voluntarily to Indians under Social Secu- ‘‘Sec. 105. American Indians Into Psy- waived by the lessees, to provide for rity Act health benefit pro- chology Program. the exchange of certain Monument grams. ‘‘Sec. 106. Scholarship programs for Indian land in exchange for private land, to Sec. 203. Additional provisions to increase Tribes. designate certain Monument land as outreach to, and enrollment of, ‘‘Sec. 107. Indian Health Service extern pro- Indians in SCHIP and Medicaid. grams. wilderness, and for other purposes; Sec. 204. Premiums and cost sharing protec- S. 2508 and H.R. 903, to provide for a ‘‘Sec. 108. Continuing education allowances. tions under Medicaid, eligi- ‘‘Sec. 109. Community Health Representa- study of options for protecting the bility determinations under open space characteristics of certain tive Program. Medicaid and SCHIP, and pro- ‘‘Sec. 110. Indian Health Service Loan Re- lands in and adjacent to the Arapaho tection of certain Indian prop- payment Program. and Roosevelt National Forests in Col- erty from Medicaid estate re- ‘‘Sec. 111. Scholarship and Loan Repayment orado, and for other purposes; covery. Recovery Fund. S. 2601 and H.R. 1285, to provide for Sec. 205. Nondiscrimination in qualifica- ‘‘Sec. 112. Recruitment activities. the conveyance of a parcel of National tions for payment for services ‘‘Sec. 113. Indian recruitment and retention Forest System land in Kittitas County, under Federal health care pro- program. grams. ‘‘Sec. 114. Advanced training and research. Washington, to facilitate the construc- Sec. 206. Consultation on Medicaid, SCHIP, ‘‘Sec. 115. Quentin N. Burdick American In- tion of a new fire and rescue station, and other health care programs dians Into Nursing Program. and for other purposes; funded under the Social Secu- ‘‘Sec. 116. Tribal cultural orientation. H.R. 523, to require the Secretary of rity Act involving Indian ‘‘Sec. 117. INMED Program. the Interior to convey certain. public Health Programs and Urban In- ‘‘Sec. 118. Health training programs of com- land located wholly or partially within dian Organizations. Sec. 207. Exclusion waiver authority for af- munity colleges. the boundaries of the Wells Hydro- ‘‘Sec. 119. Retention bonus. electric Project of Public Utility Dis- fected Indian Health Programs and safe harbor transactions ‘‘Sec. 120. Nursing residency program. ‘‘Sec. 121. Community Health Aide Program. trict No. 1 of Douglas County, Wash- under the Social Security Act. ington, to the utility district; Sec. 208. Rules applicable under Medicaid ‘‘Sec. 122. Tribal Health Program adminis- H.R. 838, to provide for the convey- and SCHIP to managed care en- tration. ance of the Bureau of Land Manage- tities with respect to Indian en- ‘‘Sec. 123. Health professional chronic short- ment parcels known as the White Acre rollees and Indian health care age demonstration programs. and Gambel Oak properties and related providers and Indian managed ‘‘Sec. 124. National Health Service Corps. ‘‘Sec. 125. Substance abuse counselor edu- real property to Park City, Utah, and care entities. Sec. 209. Annual report on Indians served by cational curricula demonstra- for other purposes. Social Security Act health ben- tion programs. The PRESIDING OFFICER. Without efit programs. ‘‘Sec. 126. Behavioral health training and objection, it is so ordered. Sec. 210. Development of recommendations community education pro- SPECIAL COMMITTEE ON AGING to improve interstate coordina- grams. Mr. BAUCUS. Mr. President, I ask tion of Medicaid and SCHIP ‘‘Sec. 127. Authorization of appropriations. unanimous consent that the Special coverage of Indian children and ‘‘TITLE II—HEALTH SERVICES Committee on Aging be authorized to other children who are outside ‘‘Sec. 201. Indian Health Care Improvement meet during the session of the Senate of their State of residency be- Fund. on Wednesday, February 27, 2008 from cause of educational or other ‘‘Sec. 202. Catastrophic Health Emergency needs. Fund. 10:30 a.m.–12:30 p.m. In Dirksen 628 for Sec. 211. Establishment of National Child ‘‘Sec. 203. Health promotion and disease pre- the purpose of conducting a hearing. Welfare Resource Center for vention services. The PRESIDING, OFFICER. Without Tribes. objection, it is so ordered. Sec. 212. Adjustment to the Medicare Advan- ‘‘Sec. 204. Diabetes prevention, treatment, and control. f tage stabilization fund. Sec. 213. Moratorium on implementation of ‘‘Sec. 205. Shared services for long-term INDIAN HEALTH CARE IMPROVEMENT changes to case management care. ACT AMENDMENTS OF 2007 and targeted case management ‘‘Sec. 206. Health services research. On Tuesday, February 26, 2008, the payment requirements under ‘‘Sec. 207. Mammography and other cancer Senate passed S. 1200, as amendmed, as Medicaid. screening. follows: Sec. 214. Increased civil money penalties and ‘‘Sec. 208. Patient travel costs. S. 1200 criminal fines for Medicare ‘‘Sec. 209. Epidemiology centers. Be it enacted by the Senate and House of Rep- fraud and abuse. ‘‘Sec. 210. Comprehensive school health edu- resentatives of the United States of America in Sec. 215. Increased sentences for felonies in- cation programs. Congress assembled, volving Medicare fraud and ‘‘Sec. 211. Indian youth program. SECTION 1. SHORT TITLE; TABLE OF CONTENTS. abuse. ‘‘Sec. 212. Prevention, control, and elimi- (a) SHORT TITLE.—This Act may be cited as TITLE III—MISCELLANEOUS nation of communicable and in- the ‘‘Indian Health Care Improvement Act Sec. 301. Resolution of apology to Native fectious diseases. Amendments of 2008’’. Peoples of United States. ‘‘Sec. 213. Other authority for provision of (b) TABLE OF CONTENTS.—The table of con- TITLE I—AMENDMENTS TO INDIAN LAWS services. tents of this Act is as follows: ‘‘Sec. 214. Indian women’s health care. Sec. 1. Short title; table of contents. SEC. 101. INDIAN HEALTH CARE IMPROVEMENT ACT AMENDED. ‘‘Sec. 215. Environmental and nuclear health TITLE I—AMENDMENTS TO INDIAN LAWS The Indian Health Care Improvement Act hazards. Sec. 101. Indian Health Care Improvement (25 U.S.C. 1601 et seq.) is amended to read as ‘‘Sec. 216. Arizona as a contract health serv- Act amended. follows: ice delivery area.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00059 Fmt 4624 Sfmt 0655 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1276 CONGRESSIONAL RECORD — SENATE February 27, 2008 ‘‘Sec. 216A. North Dakota and South Dakota ‘‘Sec. 414. Treatment under Medicaid and ‘‘Sec. 802. Regulations. as a contract health service de- SCHIP managed care. ‘‘Sec. 803. Plan of implementation. livery area. ‘‘Sec. 415. Navajo Nation Medicaid Agency ‘‘Sec. 804. Availability of funds. ‘‘Sec. 217. California contract health serv- feasibility study. ices program. ‘‘Sec. 416. General exceptions. ‘‘Sec. 805. Limitation relating to abortion. ‘‘Sec. 218. California as a contract health ‘‘Sec. 417. Authorization of appropriations. ‘‘Sec. 806. Eligibility of California Indians. service delivery area. ‘‘Sec. 219. Contract health services for the ‘‘TITLE V—HEALTH SERVICES FOR ‘‘Sec. 807. Health services for ineligible per- Trenton service area. URBAN INDIANS sons. ‘‘Sec. 220. Programs operated by Indian ‘‘Sec. 501. Purpose. ‘‘Sec. 808. Reallocation of base resources. Tribes and Tribal Organiza- ‘‘Sec. 502. Contracts with, and grants to, ‘‘Sec. 809. Results of demonstration projects. tions. Urban Indian Organizations. ‘‘Sec. 221. Licensing. ‘‘Sec. 503. Contracts and grants for the pro- ‘‘Sec. 810. Provision of services in Montana. ‘‘Sec. 222. Notification of provision of emer- vision of health care and refer- ‘‘Sec. 811. Tribal employment. gency contract health services. ‘‘Sec. 223. Prompt action on payment of ral services. ‘‘Sec. 812. Severability provisions. ‘‘Sec. 504. Contracts and grants for the de- claims. ‘‘Sec. 813. Establishment of National Bipar- termination of unmet health ‘‘Sec. 224. Liability for payment. tisan Commission on Indian ‘‘Sec. 225. Office of Indian Men’s Health. care needs. ‘‘Sec. 226. Authorization of appropriations. ‘‘Sec. 505. Evaluations; renewals. Health Care. ‘‘TITLE III—FACILITIES ‘‘Sec. 506. Other contract and grant require- ‘‘Sec. 814. Confidentiality of medical quality ‘‘Sec. 301. Consultation; construction and ments. assurance records; qualified im- renovation of facilities; reports. ‘‘Sec. 507. Reports and records. munity for participants. ‘‘Sec. 302. Sanitation facilities. ‘‘Sec. 508. Limitation on contract authority. ‘‘Sec. 815. Sense of Congress regarding law ‘‘Sec. 303. Preference to Indians and Indian ‘‘Sec. 509. Facilities. enforcement and methamphet- firms. ‘‘Sec. 510. Division of Urban Indian Health. amine issues in Indian Country. ‘‘Sec. 511. Grants for alcohol and substance ‘‘Sec. 304. Expenditure of non-Service funds ‘‘Sec. 816. Tribal Health Program option for abuse-related services. for renovation. cost sharing. ‘‘Sec. 305. Funding for the construction, ex- ‘‘Sec. 512. Treatment of certain demonstra- pansion, and modernization of tion projects. ‘‘Sec. 817. Testing for sexually transmitted small ambulatory care facili- ‘‘Sec. 513. Urban NIAAA transferred pro- diseases in cases of sexual vio- ties. grams. lence. ‘‘Sec. 306. Indian health care delivery dem- ‘‘Sec. 514. Conferring with Urban Indian Or- ‘‘Sec. 818. Study on tobacco-related disease onstration projects. ganizations. and disproportionate health ef- ‘‘Sec. 307. Land transfer. ‘‘Sec. 515. Urban youth treatment center fects on tribal populations. ‘‘Sec. 308. Leases, contracts, and other demonstration. ‘‘Sec. 819. Appropriations; availability. agreements. ‘‘Sec. 516. Grants for diabetes prevention, ‘‘Sec. 309. Study on loans, loan guarantees, treatment, and control. ‘‘Sec. 820. GAO report on coordination of and loan repayment. ‘‘Sec. 517. Community Health Representa- services. ‘‘Sec. 310. Tribal leasing. tives. ‘‘Sec. 821. Authorization of appropriations. ‘‘Sec. 311. Indian Health Service/tribal fa- ‘‘Sec. 518. Effective date. ‘‘SEC. 2. FINDINGS. cilities joint venture program. ‘‘Sec. 519. Eligibility for services. ‘‘Congress makes the following findings: ‘‘Sec. 312. Location of facilities. ‘‘Sec. 520. Authorization of appropriations. ‘‘(1) Federal health services to maintain ‘‘Sec. 313. Maintenance and improvement of ‘‘TITLE VI—ORGANIZATIONAL and improve the health of the Indians are health care facilities. consonant with and required by the Federal ‘‘Sec. 314. Tribal management of Federally- IMPROVEMENTS Government’s historical and unique legal re- owned quarters. ‘‘Sec. 601. Establishment of the Indian lationship with, and resulting responsibility ‘‘Sec. 315. Applicability of Buy American Health Service as an agency of to, the American Indian people. Act requirement. the Public Health Service. ‘‘(2) A major national goal of the United ‘‘Sec. 316. Other funding for facilities. ‘‘Sec. 602. Automated management informa- States is to provide the resources, processes, ‘‘Sec. 317. Authorization of appropriations. tion system. and structure that will enable Indian Tribes ‘‘Sec. 603. Authorization of appropriations. and tribal members to obtain the quantity ‘‘TITLE IV—ACCESS TO HEALTH and quality of health care services and op- SERVICES ‘‘TITLE VII—BEHAVIORAL HEALTH portunities that will eradicate the health ‘‘Sec. 401. Treatment of payments under So- PROGRAMS disparities between Indians and the general cial Security Act health bene- ‘‘Sec. 701. Behavioral health prevention and population of the United States. fits programs. treatment services. ‘‘(3) A major national goal of the United ‘‘Sec. 402. Grants to and contracts with the ‘‘Sec. 702. Memoranda of agreement with the States is to provide the quantity and quality Service, Indian Tribes, Tribal of health services which will permit the Department of the Interior. health status of Indians to be raised to the Organizations, and Urban In- ‘‘Sec. 703. Comprehensive behavioral health highest possible level and to encourage the dian Organizations to facilitate prevention and treatment pro- maximum participation of Indians in the outreach, enrollment, and cov- gram. planning and management of those services. erage of Indians under Social ‘‘Sec. 704. Mental health technician pro- ‘‘(4) Federal health services to Indians Security Act health benefit gram. have resulted in a reduction in the preva- programs and other health ben- ‘‘Sec. 705. Licensing requirement for mental lence and incidence of preventable illnesses efits programs. health care workers. among, and unnecessary and premature ‘‘Sec. 403. Reimbursement from certain ‘‘Sec. 706. Indian women treatment pro- deaths of, Indians. third parties of costs of health grams. ‘‘(5) Despite such services, the unmet services. ‘‘Sec. 707. Indian youth program. health needs of the American Indian people ‘‘Sec. 404. Crediting of reimbursements. are severe and the health status of the Indi- ‘‘Sec. 708. Indian youth telemental health ans is far below that of the general popu- ‘‘Sec. 405. Purchasing health care coverage. demonstration project. lation of the United States. ‘‘Sec. 406. Sharing arrangements with Fed- ‘‘Sec. 709. Inpatient and community-based ‘‘SEC. 3. DECLARATION OF NATIONAL INDIAN eral agencies. mental health facilities design, HEALTH POLICY. ‘‘Sec. 407. Eligible Indian veteran services. construction, and staffing. ‘‘Congress declares that it is the policy of ‘‘Sec. 408. Payor of last resort. ‘‘Sec. 710. Training and community edu- this Nation, in fulfillment of its special trust ‘‘Sec. 409. Nondiscrimination under Federal cation. responsibilities and legal obligations to Indi- health care programs in quali- ‘‘Sec. 711. Behavioral health program. ans— fications for reimbursement for ‘‘Sec. 712. Fetal alcohol spectrum disorders ‘‘(1) to assure the highest possible health services. programs. status for Indians and Urban Indians and to ‘‘Sec. 410. Consultation. ‘‘Sec. 713. Child sexual abuse and prevention provide all resources necessary to effect that ‘‘Sec. 411. State Children’s Health Insurance policy; treatment programs. Program (SCHIP). ‘‘(2) to raise the health status of Indians ‘‘Sec. 412. Exclusion waiver authority for af- ‘‘Sec. 714. Domestic and sexual violence pre- and Urban Indians to at least the levels set fected Indian Health Programs vention and treatment. forth in the goals contained within the ‘‘Sec. 715. Testimony by service employees and safe harbor transactions Healthy People 2010 or successor objectives; in cases of rape and sexual as- under the Social Security Act. ‘‘(3) to ensure maximum Indian participa- ‘‘Sec. 413. Premium and cost sharing protec- sault. tion in the direction of health care services ‘‘Sec. 716. Behavioral health research. so as to render the persons administering tions and eligibility determina- such services and the services themselves tions under Medicaid and ‘‘Sec. 717. Definitions. ‘‘Sec. 718. Authorization of appropriations. more responsive to the needs and desires of SCHIP and protection of cer- Indian communities; tain Indian property from Med- ‘‘TITLE VIII—MISCELLANEOUS ‘‘(4) to increase the proportion of all de- icaid estate recovery. ‘‘Sec. 801. Reports. grees in the health professions and allied and

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00060 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1277 associated health professions awarded to In- ing their knowledge and providing them with ‘‘(14) The term ‘Indian Tribe’ has the dians so that the proportion of Indian health valid information; meaning given the term in the Indian Self- professionals in each Service Area is raised ‘‘(B) encouraging adequate and appropriate Determination and Education Assistance Act to at least the level of that of the general diet, exercise, and sleep; (25 U.S.C. 450 et seq.). population; ‘‘(C) promoting education and work in con- ‘‘(15) The term ‘junior or community col- ‘‘(5) to require that all actions under this formity with physical and mental capacity; lege’ has the meaning given the term by sec- Act shall be carried out with active and ‘‘(D) making available safe water and sani- tion 312(e) of the Higher Education Act of meaningful consultation with Indian Tribes tary facilities; 1965 (20 U.S.C. 1058(e)). and Tribal Organizations, and conference ‘‘(16) The term ‘reservation’ means any fed- with Urban Indian Organizations, to imple- ‘‘(E) improving the physical, economic, cultural, psychological, and social environ- erally recognized Indian Tribe’s reservation, ment this Act and the national policy of In- Pueblo, or colony, including former reserva- dian self-determination; ment; ‘‘(F) promoting culturally competent care; tions in Oklahoma, Indian allotments, and ‘‘(6) to ensure that the United States and Alaska Native Regions established pursuant Indian Tribes work in a government-to-gov- and ‘‘(G) providing adequate and appropriate to the Alaska Native Claims Settlement Act ernment relationship to ensure quality (43 U.S.C. 1601 et seq.). health care for all tribal members; and programs, which may include— ‘‘(17) The term ‘Secretary’, unless other- ‘‘(7) to provide funding for programs and ‘‘(i) abuse prevention (mental and physical); wise designated, means the Secretary of facilities operated by Indian Tribes and Trib- Health and Human Services. al Organizations in amounts that are not ‘‘(ii) community health; less than the amounts provided to programs ‘‘(iii) community safety; ‘‘(18) The term ‘Service’ means the Indian and facilities operated directly by the Serv- ‘‘(iv) consumer health education; Health Service. ice. ‘‘(v) diet and nutrition; ‘‘(19) The term ‘Service Area’ means the ‘‘SEC. 4. DEFINITIONS. geographical area served by each Area Of- ‘‘(vi) immunization and other prevention of fice. ‘‘For purposes of this Act: communicable diseases, including HIV/AIDS; ‘‘(1) The term ‘accredited and accessible’ ‘‘(vii) environmental health; ‘‘(20) The term ‘Service Unit’ means an ad- means on or near a reservation and accred- ministrative entity of the Service, or a Trib- ‘‘(viii) exercise and physical fitness; al Health Program through which services ited by a national or regional organization ‘‘(ix) avoidance of fetal alcohol spectrum with accrediting authority. are provided, directly or by contract, to eli- disorders; gible Indians within a defined geographic ‘‘(2) The term ‘Area Office’ means an ad- ‘‘(x) first aid and CPR education; area. ministrative entity, including a program of- ‘‘(xi) human growth and development; fice, within the Service through which serv- ‘‘(21) The term ‘telehealth’ has the mean- ices and funds are provided to the Service ‘‘(xii) injury prevention and personal safe- ing given the term in section 330K(a) of the Units within a defined geographic area. ty; Public Health Service Act (42 U.S.C. 254c– ‘‘(3)(A) The term ‘behavioral health’ means ‘‘(xiii) behavioral health; 16(a)). the blending of substance (alcohol, drugs, ‘‘(xiv) monitoring of disease indicators be- ‘‘(22) The term ‘telemedicine’ means a tele- inhalants, and tobacco) abuse and mental tween health care provider visits, through communications link to an end user through health prevention and treatment, for the appropriate means, including Internet-based the use of eligible equipment that electroni- purpose of providing comprehensive services. health care management systems; cally links health professionals or patients ‘‘(B) The term ‘behavioral health’ includes ‘‘(xv) personal health and wellness prac- and health professionals at separate sites in the joint development of substance abuse tices; order to exchange health care information in and mental health treatment planning and ‘‘(xvi) personal capacity building; audio, video, graphic, or other format for the coordinated case management using a multi- ‘‘(xvii) prenatal, pregnancy, and infant purpose of providing improved health care disciplinary approach. care; services. ‘‘(4) The term ‘California Indians’ means ‘‘(xviii) psychological well-being; ‘‘(23) The term ‘tribal college or university’ those Indians who are eligible for health ‘‘(xix) family planning; has the meaning given the term in section services of the Service pursuant to section ‘‘(xx) safe and adequate water; 316(b)(3) of the Higher Education Act (20 806. ‘‘(xxi) healthy work environments; U.S.C. 1059c(b)(3)). ‘‘(5) The term ‘community college’ ‘‘(xxii) elimination, reduction, and preven- ‘‘(24) The term ‘Tribal Health Program’ means— tion of contaminants that create unhealthy means an Indian Tribe or Tribal Organiza- ‘‘(A) a tribal college or university, or household conditions (including mold and tion that operates any health program, serv- ‘‘(B) a junior or community college. other allergens); ice, function, activity, or facility funded, in ‘‘(6) The term ‘contract health service’ ‘‘(xxiii) stress control; whole or part, by the Service through, or means health services provided at the ex- provided for in, a contract or compact with ‘‘(xxiv) substance abuse; the Service under the Indian Self-Determina- pense of the Service or a Tribal Health Pro- ‘‘(xxv) sanitary facilities; gram by public or private medical providers tion and Education Assistance Act (25 U.S.C. or hospitals, other than the Service Unit or ‘‘(xxvi) sudden infant death syndrome pre- 450 et seq.). the Tribal Health Program at whose expense vention; ‘‘(25) The term ‘Tribal Organization’ has the services are provided. ‘‘(xxvii) tobacco use cessation and reduc- the meaning given the term in the Indian ‘‘(7) The term ‘Department’ means, unless tion; Self-Determination and Education Assist- otherwise designated, the Department of ‘‘(xxviii) violence prevention; and ance Act (25 U.S.C. 450 et seq.). Health and Human Services. ‘‘(xxix) such other activities identified by ‘‘(26) The term ‘Urban Center’ means any ‘‘(8) The term ‘Director’ means the Direc- the Service, a Tribal Health Program, or an community which has a sufficient Urban In- tor of the Service. Urban Indian Organization, to promote dian population with unmet health needs to ‘‘(9) The term ‘disease prevention’ means achievement of any of the objectives de- warrant assistance under title V of this Act, the reduction, limitation, and prevention of scribed in section 3(2). as determined by the Secretary. disease and its complications and reduction ‘‘(12) The term ‘Indian’, unless otherwise ‘‘(27) The term ‘Urban Indian’ means any in the consequences of disease, including— designated, means any person who is a mem- individual who resides in an Urban Center ‘‘(A) controlling— ber of an Indian Tribe or is eligible for and who meets 1 or more of the following cri- health services under section 806, except ‘‘(i) the development of diabetes; teria: that, for the purpose of sections 102 and 103, ‘‘(A) Irrespective of whether the individual ‘‘(ii) high blood pressure; the term also means any individual who— ‘‘(iii) infectious agents; lives on or near a reservation, the individual ‘‘(A)(i) irrespective of whether the indi- is a member of a tribe, band, or other orga- ‘‘(iv) injuries; vidual lives on or near a reservation, is a nized group of Indians, including those ‘‘(v) occupational hazards and disabilities; member of a tribe, band, or other organized tribes, bands, or groups terminated since 1940 ‘‘(vi) sexually transmittable diseases; and group of Indians, including those tribes, and those tribes, bands, or groups that are ‘‘(vii) toxic agents; and bands, or groups terminated since 1940 and recognized by the States in which they re- ‘‘(B) providing— those recognized now or in the future by the side, or who is a descendant in the first or State in which they reside; or ‘‘(i) fluoridation of water; and second degree of any such member. ‘‘(ii) is a descendant, in the first or second ‘‘(B) The individual is an Eskimo, Aleut, or ‘‘(ii) immunizations. degree, of any such member; ‘‘(10) The term ‘health profession’ means other Alaska Native. ‘‘(B) is an Eskimo or Aleut or other Alaska ‘‘(C) The individual is considered by the allopathic medicine, family medicine, inter- Native; nal medicine, pediatrics, geriatric medicine, Secretary of the Interior to be an Indian for obstetrics and gynecology, podiatric medi- ‘‘(C) is considered by the Secretary of the any purpose. cine, nursing, public health nursing, den- Interior to be an Indian for any purpose; or ‘‘(D) The individual is determined to be an tistry, psychiatry, osteopathy, optometry, ‘‘(D) is determined to be an Indian under Indian under regulations promulgated by the pharmacy, psychology, public health, social regulations promulgated by the Secretary. Secretary. work, marriage and family therapy, chiro- ‘‘(13) The term ‘Indian Health Program’ ‘‘(28) The term ‘Urban Indian Organization’ practic medicine, environmental health and means— means a nonprofit corporate body that (A) is engineering, allied health professions, and ‘‘(A) any health program administered di- situated in an Urban Center; (B) is governed any other health profession. rectly by the Service; by an Urban Indian-controlled board of direc- ‘‘(11) The term ‘health promotion’ means— ‘‘(B) any Tribal Health Program; or tors; (C) provides for the participation of all ‘‘(A) fostering social, economic, environ- ‘‘(C) any Indian Tribe or Tribal Organiza- interested Indian groups and individuals; and mental, and personal factors conducive to tion to which the Secretary provides funding (D) is capable of legally cooperating with health, including raising public awareness pursuant to section 23 of the Act of June 25, other public and private entities for the pur- about health matters and enabling the peo- 1910 (25 U.S.C. 47) (commonly known as the pose of performing the activities described in ple to cope with health problems by increas- ‘Buy Indian Act’). section 503(a).

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00061 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1278 CONGRESSIONAL RECORD — SENATE February 27, 2008 ‘‘TITLE I—INDIAN HEALTH, HUMAN related expenses of a recipient while attend- scribed in paragraph (1) by service in a pro- RESOURCES, AND DEVELOPMENT ing school; gram specified under that paragraph that— ‘‘SEC. 101. PURPOSE. ‘‘(2) shall not be denied solely on the basis ‘‘(i) is located on the reservation of the In- ‘‘The purpose of this title is to increase, to of the applicant’s scholastic achievement if dian Tribe in which the recipient is enrolled; the maximum extent feasible, the number of such applicant has been admitted to, or or Indians entering the health professions and maintained good standing at, an accredited ‘‘(ii) serves the Indian Tribe in which the providing health services, and to assure an institution; and recipient is enrolled. optimum supply of health professionals to ‘‘(3) shall not be denied solely by reason of ‘‘(3) PRIORITY WHEN MAKING ASSIGNMENTS.— the Indian Health Programs and Urban In- such applicant’s eligibility for assistance or Subject to paragraph (2), the Secretary, in dian Organizations involved in the provision benefits under any other Federal program. making assignments of Indian Health Schol- of health services to Indians. ‘‘SEC. 104. INDIAN HEALTH PROFESSIONS SCHOL- arship recipients required to meet the active ‘‘SEC. 102. HEALTH PROFESSIONS RECRUITMENT ARSHIPS. duty service obligation described in para- PROGRAM FOR INDIANS. ‘‘(a) IN GENERAL.— graph (1), shall give priority to assigning in- ‘‘(a) IN GENERAL.—The Secretary, acting ‘‘(1) AUTHORITY.—The Secretary, acting dividuals to service in those programs speci- through the Service, shall make grants to through the Service, shall make scholarship fied in paragraph (1) that have a need for public or nonprofit private health or edu- grants to Indians who are enrolled full or health professionals to provide health care cational entities, Tribal Health Programs, or part time in accredited schools pursuing services as a result of individuals having Urban Indian Organizations to assist such courses of study in the health professions. breached contracts entered into under this entities in meeting the costs of— Such scholarships shall be designated Indian section. ‘‘(1) identifying Indians with a potential Health Scholarships and shall be made in ac- ‘‘(c) PART-TIME STUDENTS.—In the case of for education or training in the health pro- cordance with section 338A of the Public an individual receiving a scholarship under fessions and encouraging and assisting Health Services Act (42 U.S.C. 254l), except this section who is enrolled part time in an them— as provided in subsection (b) of this section. approved course of study— ‘‘(A) to enroll in courses of study in such ‘‘(2) DETERMINATIONS BY SECRETARY.—The ‘‘(1) such scholarship shall be for a period health professions; or Secretary, acting through the Service, shall of years not to exceed the part-time equiva- ‘‘(B) if they are not qualified to enroll in determine— lent of 4 years, as determined by the Sec- any such courses of study, to undertake such ‘‘(A) who shall receive scholarship grants retary; postsecondary education or training as may under subsection (a); and ‘‘(2) the period of obligated service de- be required to qualify them for enrollment; ‘‘(B) the distribution of the scholarships scribed in subsection (b)(1) shall be equal to ‘‘(2) publicizing existing sources of finan- among health professions on the basis of the the greater of— cial aid available to Indians enrolled in any relative needs of Indians for additional serv- ‘‘(A) the part-time equivalent of 1 year for course of study referred to in paragraph (1) ice in the health professions. each year for which the individual was provided a scholarship (as determined by the or who are undertaking training necessary ‘‘(3) CERTAIN DELEGATION NOT ALLOWED.— to qualify them to enroll in any such course The administration of this section shall be a Secretary); or of study; or responsibility of the Director and shall not ‘‘(B) 2 years; and ‘‘(3) establishing other programs which the be delegated in a contract or compact under ‘‘(3) the amount of the monthly stipend Secretary determines will enhance and fa- the Indian Self-Determination and Edu- specified in section 338A(g)(1)(B) of the Pub- cilitate the enrollment of Indians in, and the cation Assistance Act (25 U.S.C. 450 et seq.). lic Health Service Act (42 U.S.C. 254l(g)(1)(B)) subsequent pursuit and completion by them ‘‘(b) ACTIVE DUTY SERVICE OBLIGATION.— shall be reduced pro rata (as determined by of, courses of study referred to in paragraph the Secretary) based on the number of hours (1). ‘‘(1) OBLIGATION MET.—The active duty service obligation under a written contract such student is enrolled. ‘‘(b) GRANTS.— with the Secretary under this section that ‘‘(d) BREACH OF CONTRACT.— ‘‘(1) APPLICATION.—The Secretary shall not an Indian has entered into shall, if that indi- ‘‘(1) SPECIFIED BREACHES.—An individual make a grant under this section unless an vidual is a recipient of an Indian Health shall be liable to the United States for the application has been submitted to, and ap- Scholarship, be met in full-time practice amount which has been paid to the indi- proved by, the Secretary. Such application equal to 1 year for each school year for vidual, or on behalf of the individual, under shall be in such form, submitted in such which the participant receives a scholarship a contract entered into with the Secretary manner, and contain such information, as award under this part, or 2 years, whichever under this section on or after the date of en- the Secretary shall by regulation prescribe is greater, by service in 1 or more of the fol- actment of the Indian Health Care Improve- pursuant to this Act. The Secretary shall lowing: ment Act Amendments of 2008 if that indi- give a preference to applications submitted ‘‘(A) In an Indian Health Program. vidual— by Tribal Health Programs or Urban Indian ‘‘(A) fails to maintain an acceptable level Organizations. ‘‘(B) In a program assisted under title V of this Act. of academic standing in the educational in- ‘‘(2) AMOUNT OF GRANTS; PAYMENT.—The stitution in which he or she is enrolled (such amount of a grant under this section shall be ‘‘(C) In the private practice of the applicable profession if, as determined by the Sec- level determined by the educational institu- determined by the Secretary. Payments pur- tion under regulations of the Secretary); suant to this section may be made in ad- retary, in accordance with guidelines pro- vance or by way of reimbursement, and at mulgated by the Secretary, such practice is ‘‘(B) is dismissed from such educational in- such intervals and on such conditions as pro- situated in a physician or other health pro- stitution for disciplinary reasons; vided for in regulations issued pursuant to fessional shortage area and addresses the ‘‘(C) voluntarily terminates the training in this Act. To the extent not otherwise prohib- health care needs of a substantial number of such an educational institution for which he ited by law, grants shall be for 3 years, as Indians. or she is provided a scholarship under such provided in regulations issued pursuant to ‘‘(D) In a teaching capacity in a tribal col- contract before the completion of such train- this Act. lege or university nursing program (or a re- ing; or ‘‘SEC. 103. HEALTH PROFESSIONS PREPARATORY lated health profession program) if, as deter- ‘‘(D) fails to accept payment, or instructs SCHOLARSHIP PROGRAM FOR INDI- mined by the Secretary, the health service the educational institution in which he or ANS. provided to Indians would not decrease. she is enrolled not to accept payment, in ‘‘(a) SCHOLARSHIPS AUTHORIZED.—The Sec- ‘‘(2) OBLIGATION DEFERRED.—At the request whole or in part, of a scholarship under such retary, acting through the Service, shall pro- of any individual who has entered into a con- contract, in lieu of any service obligation vide scholarship grants to Indians who— tract referred to in paragraph (1) and who re- arising under such contract. ‘‘(1) have successfully completed their high ceives a degree in medicine (including osteo- ‘‘(2) OTHER BREACHES.—If for any reason school education or high school equivalency; pathic or allopathic medicine), dentistry, op- not specified in paragraph (1) an individual and tometry, podiatry, or pharmacy, the Sec- breaches a written contract by failing either ‘‘(2) have demonstrated the potential to retary shall defer the active duty service ob- to begin such individual’s service obligation successfully complete courses of study in the ligation of that individual under that con- required under such contract or to complete health professions. tract, in order that such individual may such service obligation, the United States ‘‘(b) PURPOSES.—Scholarship grants pro- complete any internship, residency, or other shall be entitled to recover from the indi- vided pursuant to this section shall be for advanced clinical training that is required vidual an amount determined in accordance the following purposes: for the practice of that health profession, for with the formula specified in subsection (l) ‘‘(1) Compensatory preprofessional edu- an appropriate period (in years, as deter- of section 110 in the manner provided for in cation of any recipient, such scholarship not mined by the Secretary), subject to the fol- such subsection. to exceed 2 years on a full-time basis (or the lowing conditions: ‘‘(3) CANCELLATION UPON DEATH OF RECIPI- part-time equivalent thereof, as determined ‘‘(A) No period of internship, residency, or ENT.—Upon the death of an individual who by the Secretary pursuant to regulations other advanced clinical training shall be receives an Indian Health Scholarship, any issued under this Act). counted as satisfying any period of obligated outstanding obligation of that individual for ‘‘(2) Pregraduate education of any recipi- service under this subsection. service or payment that relates to that ent leading to a baccalaureate degree in an ‘‘(B) The active duty service obligation of scholarship shall be canceled. approved course of study preparatory to a that individual shall commence not later ‘‘(4) WAIVERS AND SUSPENSIONS.— field of study in a health profession, such than 90 days after the completion of that ad- ‘‘(A) IN GENERAL.—The Secretary shall pro- scholarship not to exceed 4 years. An exten- vanced clinical training (or by a date speci- vide for the partial or total waiver or suspension of up to 2 years (or the part-time equiv- fied by the Secretary). sion of any obligation of service or payment alent thereof, as determined by the Sec- ‘‘(C) The active duty service obligation of a recipient of an Indian Health Scholar- retary pursuant to regulations issued pursu- will be served in the health profession of ship if the Secretary determines that— ant to this Act) may be approved. that individual in a manner consistent with ‘‘(i) it is not possible for the recipient to ‘‘(c) OTHER CONDITIONS.—Scholarships paragraph (1). meet that obligation or make that payment; under this section— ‘‘(D) A recipient of a scholarship under this ‘‘(ii) requiring that recipient to meet that ‘‘(1) may cover costs of tuition, books, section may, at the election of the recipient, obligation or make that payment would re- transportation, board, and other necessary meet the active duty service obligation de- sult in extreme hardship to the recipient; or

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00062 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1279 ‘‘(iii) the enforcement of the requirement graduate who receives a stipend described in ‘‘(ii) may not exceed, for any year of at- to meet the obligation or make the payment subsection (d)(4) that is funded under this tendance for which the scholarship is pro- would be unconscionable. section. Such obligation shall be met by vided, the total amount required for the year ‘‘(B) FACTORS FOR CONSIDERATION.—Before service— for the purposes authorized in clause (i); waiving or suspending an obligation of serv- ‘‘(1) in an Indian Health Program; ‘‘(C) require the recipient of such scholar- ice or payment under subparagraph (A), the ‘‘(2) in a program assisted under title V of ship to maintain an acceptable level of aca- Secretary shall consult with the affected this Act; or demic standing as determined by the edu- Area Office, Indian Tribes, or Tribal Organi- ‘‘(3) in the private practice of psychology cational institution in accordance with regu- zations, or confer with the affected Urban In- if, as determined by the Secretary, in accord- lations issued pursuant to this Act; and dian Organizations, and may take into con- ance with guidelines promulgated by the ‘‘(D) require the recipient of such scholar- sideration whether the obligation may be Secretary, such practice is situated in a phy- ship to meet the educational and licensure satisfied in a teaching capacity at a tribal sician or other health professional shortage requirements appropriate to each health pro- college or university nursing program under fession. subsection (b)(1)(D). area and addresses the health care needs of a substantial number of Indians. ‘‘(3) SERVICE IN OTHER SERVICE AREAS.—The ‘‘(5) EXTREME HARDSHIP.—Notwithstanding contract may allow the recipient to serve in any other provision of law, in any case of ex- ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.— There is authorized to be appropriated to another Service Area, provided the Tribal treme hardship or for other good cause Health Program and Secretary approve and shown, the Secretary may waive, in whole or carry out this section $2,700,000 for each of fiscal years 2008 through 2017. services are not diminished to Indians in the in part, the right of the United States to re- Service Area where the Tribal Health Pro- cover funds made available under this sec- ‘‘SEC. 106. SCHOLARSHIP PROGRAMS FOR INDIAN gram providing the scholarship is located. TRIBES. tion. ‘‘(e) BREACH OF CONTRACT.— ‘‘(a) IN GENERAL.— ‘‘(6) BANKRUPTCY.—Notwithstanding any ‘‘(1) SPECIFIC BREACHES.—An individual other provision of law, with respect to a re- ‘‘(1) GRANTS AUTHORIZED.—The Secretary, who has entered into a written contract with cipient of an Indian Health Scholarship, no acting through the Service, shall make the Secretary and a Tribal Health Program obligation for payment may be released by a grants to Tribal Health Programs for the under subsection (d) shall be liable to the discharge in bankruptcy under title 11, purpose of providing scholarships for Indians United States for the Federal share of the United States Code, unless that discharge is to serve as health professionals in Indian amount which has been paid to him or her, granted after the expiration of the 5-year pe- communities. or on his or her behalf, under the contract if riod beginning on the initial date on which ‘‘(2) AMOUNT.—Amounts available under that individual— that payment is due, and only if the bank- paragraph (1) for any fiscal year shall not ex- ‘‘(A) fails to maintain an acceptable level ruptcy court finds that the nondischarge of ceed 5 percent of the amounts available for of academic standing in the educational in- the obligation would be unconscionable. each fiscal year for Indian Health Scholar- stitution in which he or she is enrolled (such ‘‘SEC. 105. AMERICAN INDIANS INTO PSY- ships under section 104. level as determined by the educational insti- CHOLOGY PROGRAM. ‘‘(3) APPLICATION.—An application for a tution under regulations of the Secretary); ‘‘(a) GRANTS AUTHORIZED.—The Secretary, grant under paragraph (1) shall be in such ‘‘(B) is dismissed from such educational in- acting through the Service, shall make form and contain such agreements, assur- stitution for disciplinary reasons; grants of not more than $300,000 to each of 9 ances, and information as consistent with colleges and universities for the purpose of ‘‘(C) voluntarily terminates the training in this section. such an educational institution for which he developing and maintaining Indian psy- ‘‘(b) REQUIREMENTS.— chology career recruitment programs as a or she is provided a scholarship under such means of encouraging Indians to enter the ‘‘(1) IN GENERAL.—A Tribal Health Program contract before the completion of such train- behavioral health field. These programs shall receiving a grant under subsection (a) shall ing; or be located at various locations throughout provide scholarships to Indians in accord- ‘‘(D) fails to accept payment, or instructs the country to maximize their availability ance with the requirements of this section. the educational institution in which he or to Indian students and new programs shall ‘‘(2) COSTS.—With respect to costs of pro- she is enrolled not to accept payment, in be established in different locations from viding any scholarship pursuant to sub- whole or in part, of a scholarship under such time to time. section (a)— contract, in lieu of any service obligation arising under such contract. ‘‘(b) QUENTIN N. BURDICK PROGRAM ‘‘(A) 80 percent of the costs of the scholar- GRANT.—The Secretary shall provide a grant ship shall be paid from the funds made avail- ‘‘(2) OTHER BREACHES.—If for any reason authorized under subsection (a) to develop able pursuant to subsection (a)(1) provided to not specified in paragraph (1), an individual and maintain a program at the University of the Tribal Health Program; and breaches a written contract by failing to ei- North Dakota to be known as the ‘Quentin ‘‘(B) 20 percent of such costs may be paid ther begin such individual’s service obliga- N. Burdick American Indians Into Psy- from any other source of funds. tion required under such contract or to complete such service obligation, the United chology Program’. Such program shall, to ‘‘(c) COURSE OF STUDY.—A Tribal Health the maximum extent feasible, coordinate Program shall provide scholarships under States shall be entitled to recover from the with the Quentin N. Burdick Indian Health this section only to Indians enrolled or ac- individual an amount determined in accord- Programs authorized under section 117(b), cepted for enrollment in a course of study ance with the formula specified in subsection the Quentin N. Burdick American Indians (approved by the Secretary) in 1 of the (l) of section 110 in the manner provided for Into Nursing Program authorized under sec- health professions contemplated by this Act. in such subsection. ‘‘(3) CANCELLATION UPON DEATH OF RECIPI- tion 115(e), and existing university research ‘‘(d) CONTRACT.— and communications networks. ENT.—Upon the death of an individual who ‘‘(1) IN GENERAL.—In providing scholarships receives an Indian Health Scholarship, any ‘‘(c) REGULATIONS.—The Secretary shall under subsection (b), the Secretary and the outstanding obligation of that individual for issue regulations pursuant to this Act for the Tribal Health Program shall enter into a competitive awarding of grants provided service or payment that relates to that written contract with each recipient of such scholarship shall be canceled. under this section. scholarship. ‘‘(4) INFORMATION.—The Secretary may ‘‘(d) CONDITIONS OF GRANT.—Applicants ‘‘(2) REQUIREMENTS.—Such contract shall— carry out this subsection on the basis of in- under this section shall agree to provide a ‘‘(A) obligate such recipient to provide program which, at a minimum— formation received from Tribal Health Pro- service in an Indian Health Program or grams involved or on the basis of informa- ‘‘(1) provides outreach and recruitment for Urban Indian Organization, in the same tion collected through such other means as health professions to Indian communities in- Service Area where the Tribal Health Pro- the Secretary deems appropriate. cluding elementary, secondary, and accred- gram providing the scholarship is located, ‘‘(f) RELATION TO SOCIAL SECURITY ACT.— ited and accessible community colleges that for— will be served by the program; The recipient of a scholarship under this sec- ‘‘(i) a number of years for which the schol- tion shall agree, in providing health care ‘‘(2) incorporates a program advisory board arship is provided (or the part-time equiva- pursuant to the requirements herein— comprised of representatives from the tribes lent thereof, as determined by the Sec- ‘‘(1) not to discriminate against an indi- and communities that will be served by the retary), or for a period of 2 years, whichever program; vidual seeking care on the basis of the abil- period is greater; or ity of the individual to pay for such care or ‘‘(3) provides summer enrichment programs ‘‘(ii) such greater period of time as the re- on the basis that payment for such care will to expose Indian students to the various cipient and the Tribal Health Program may be made pursuant to a program established fields of psychology through research, clin- agree; in title XVIII of the Social Security Act or ical, and experimental activities; ‘‘(B) provide that the amount of the schol- pursuant to the programs established in title ‘‘(4) provides stipends to undergraduate arship— XIX or title XXI of such Act; and and graduate students to pursue a career in ‘‘(i) may only be expended for— ‘‘(2) to accept assignment under section psychology; ‘‘(I) tuition expenses, other reasonable edu- 1842(b)(3)(B)(ii) of the Social Security Act for ‘‘(5) develops affiliation agreements with cational expenses, and reasonable living ex- all services for which payment may be made tribal colleges and universities, the Service, penses incurred in attendance at the edu- under part B of title XVIII of such Act, and university affiliated programs, and other ap- cational institution; and to enter into an appropriate agreement with propriate accredited and accessible entities ‘‘(II) payment to the recipient of a month- the State agency that administers the State to enhance the education of Indian students; ly stipend of not more than the amount au- plan for medical assistance under title XIX, ‘‘(6) to the maximum extent feasible, uses thorized by section 338(g)(1)(B) of the Public or the State child health plan under title existing university tutoring, counseling, and Health Service Act (42 U.S.C. 254m(g)(1)(B)), XXI, of such Act to provide service to indi- student support services; and with such amount to be reduced pro rata (as viduals entitled to medical assistance or ‘‘(7) to the maximum extent feasible, em- determined by the Secretary) based on the child health assistance, respectively, under ploys qualified Indians in the program. number of hours such student is enrolled, the plan. ‘‘(e) ACTIVE DUTY SERVICE REQUIREMENT.— and not to exceed, for any year of attendance ‘‘(g) CONTINUANCE OF FUNDING.—The Sec- The active duty service obligation prescribed for which the scholarship is provided, the retary shall make payments under this sec- under section 338C of the Public Health Serv- total amount required for the year for the tion to a Tribal Health Program for any fis- ice Act (42 U.S.C. 254m) shall be met by each purposes authorized in this clause; and cal year subsequent to the first fiscal year of

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such payments unless the Secretary deter- the Indian communities served by the Pro- ‘‘(2) CLEAR LANGUAGE.—The application mines that, for the immediately preceding gram; form, contract form, and all other informa- fiscal year, the Tribal Health Program has ‘‘(2) in order to provide such training, de- tion furnished by the Secretary under this not complied with the requirements of this velop and maintain a curriculum that— section shall be written in a manner cal- section. ‘‘(A) combines education in the theory of culated to be understood by the average indi- ‘‘SEC. 107. INDIAN HEALTH SERVICE EXTERN health care with supervised practical experi- vidual applying to participate in the Loan PROGRAMS. ence in the provision of health care; and Repayment Program. ‘‘(a) EMPLOYMENT PREFERENCE.—Any indi- ‘‘(B) provides instruction and practical ex- ‘‘(3) TIMELY AVAILABILITY OF FORMS.—The vidual who receives a scholarship pursuant perience in health promotion and disease Secretary shall make such application to section 104 or 106 shall be given preference prevention activities, with appropriate con- forms, contract forms, and other information for employment in the Service, or may be sideration given to lifestyle factors that available to individuals desiring to partici- employed by a Tribal Health Program or an have an impact on Indian health status, such pate in the Loan Repayment Program on a Urban Indian Organization, or other agencies as alcoholism, family dysfunction, and pov- date sufficiently early to ensure that such of the Department as available, during any erty; individuals have adequate time to carefully nonacademic period of the year. ‘‘(3) maintain a system which identifies the review and evaluate such forms and informa- ‘‘(b) NOT COUNTED TOWARD ACTIVE DUTY needs of community health representatives tion. SERVICE OBLIGATION.—Periods of employ- for continuing education in health care, ‘‘(d) PRIORITIES.— ment pursuant to this subsection shall not health promotion, and disease prevention ‘‘(1) LIST.—Consistent with subsection (k), be counted in determining fulfillment of the and develop programs that meet the needs the Secretary shall annually— service obligation incurred as a condition of for continuing education; ‘‘(A) identify the positions in each Indian the scholarship. ‘‘(4) maintain a system that provides close Health Program or Urban Indian Organiza- ‘‘(c) TIMING; LENGTH OF EMPLOYMENT.—Any supervision of Community Health Represent- tion for which there is a need or a vacancy; individual enrolled in a program, including a atives; and high school program, authorized under sec- ‘‘(5) maintain a system under which the ‘‘(B) rank those positions in order of pri- tion 102(a) may be employed by the Service work of Community Health Representatives ority. or by a Tribal Health Program or an Urban is reviewed and evaluated; and ‘‘(2) APPROVALS.—Notwithstanding the pri- Indian Organization during any nonacademic ‘‘(6) promote traditional health care prac- period of the year. Any such employment ority determined under paragraph (1), the tices of the Indian Tribes served consistent Secretary, in determining which applica- shall not exceed 120 days during any calendar with the Service standards for the provision year. tions under the Loan Repayment Program to of health care, health promotion, and disease approve (and which contracts to accept), ‘‘(d) NONAPPLICABILITY OF COMPETITIVE prevention. shall— PERSONNEL SYSTEM.—Any employment pur- ‘‘SEC. 110. INDIAN HEALTH SERVICE LOAN RE- suant to this section shall be made without ‘‘(A) give first priority to applications PAYMENT PROGRAM. made by individual Indians; and regard to any competitive personnel system ‘‘(a) ESTABLISHMENT.—The Secretary, act- or agency personnel limitation and to a posi- ing through the Service, shall establish and ‘‘(B) after making determinations on all tion which will enable the individual so em- administer a program to be known as the applications submitted by individual Indians ployed to receive practical experience in the Service Loan Repayment Program (herein- as required under subparagraph (A), give pri- health profession in which he or she is en- after referred to as the ‘Loan Repayment ority to— gaged in study. Any individual so employed Program’) in order to ensure an adequate ‘‘(i) individuals recruited through the ef- shall receive payment for his or her services supply of trained health professionals nec- forts of an Indian Health Program or Urban comparable to the salary he or she would re- essary to maintain accreditation of, and pro- Indian Organization; and ceive if he or she were employed in the com- vide health care services to Indians through, ‘‘(ii) other individuals based on the pri- petitive system. Any individual so employed Indian Health Programs and Urban Indian ority rankings under paragraph (1). shall not be counted against any employ- Organizations. ‘‘(e) RECIPIENT CONTRACTS.— ment ceiling affecting the Service or the De- ‘‘(b) ELIGIBLE INDIVIDUALS.—To be eligible ‘‘(1) CONTRACT REQUIRED.—An individual partment. to participate in the Loan Repayment Pro- becomes a participant in the Loan Repay- ‘‘SEC. 108. CONTINUING EDUCATION ALLOW- gram, an individual must— ment Program only upon the Secretary and ANCES. ‘‘(1)(A) be enrolled— the individual entering into a written con- ‘‘In order to encourage scholarship and sti- ‘‘(i) in a course of study or program in an tract described in paragraph (2). pend recipients under sections 104, 105, 106, accredited educational institution (as deter- ‘‘(2) CONTENTS OF CONTRACT.—The written and 115 and health professionals, including mined by the Secretary under section contract referred to in this section between community health representatives and emer- 338B(b)(1)(c)(i) of the Public Health Service the Secretary and an individual shall con- gency medical technicians, to join or con- Act (42 U.S.C. 254l–1(b)(1)(c)(i))) and be sched- tain— tinue in an Indian Health Program, in the uled to complete such course of study in the ‘‘(A) an agreement under which— case of nurses, to obtain training and certifi- same year such individual applies to partici- ‘‘(i) subject to subparagraph (C), the Sec- cation as sexual assault nurse examiners, pate in such program; or and to provide their services in the rural and retary agrees— remote areas where a significant portion of ‘‘(ii) in an approved graduate training pro- ‘‘(I) to pay loans on behalf of the individual Indians reside, the Secretary, acting through gram in a health profession; or in accordance with the provisions of this sec- the Service, may— ‘‘(B) have— tion; and ‘‘(1) provide programs or allowances to ‘‘(i) a degree in a health profession; and ‘‘(II) to accept (subject to the availability transition into an Indian Health Program, ‘‘(ii) a license to practice a health profes- of appropriated funds for carrying out this including licensing, board or certification sion; section) the individual into the Service or examination assistance, and technical assist- ‘‘(2)(A) be eligible for, or hold, an appoint- place the individual with a Tribal Health ance in fulfilling service obligations under ment as a commissioned officer in the Reg- Program or Urban Indian Organization as sections 104, 105, 106, and 115; and ular or Reserve Corps of the Public Health provided in clause (ii)(III); and ‘‘(2) provide programs or allowances to Service; ‘‘(ii) subject to subparagraph (C), the indi- health professionals employed in an Indian ‘‘(B) be eligible for selection for civilian vidual agrees— Health Program to enable them for a period service in the Regular or Reserve Corps of ‘‘(I) to accept loan payments on behalf of of time each year prescribed by regulation of the Public Health Service; the individual; the Secretary to take leave of their duty sta- ‘‘(C) meet the professional standards for ‘‘(II) in the case of an individual described tions for professional consultation, manage- civil service employment in the Service; or in subsection (b)(1)— ment, leadership, refresher training courses, ‘‘(D) be employed in an Indian Health Pro- ‘‘(aa) to maintain enrollment in a course of and, in the case of nurses, additional clinical gram or Urban Indian Organization without study or training described in subsection sexual assault nurse examiner experience to a service obligation; and (b)(1)(A) until the individual completes the maintain competency or certification. ‘‘(3) submit to the Secretary an application course of study or training; and ‘‘SEC. 109. COMMUNITY HEALTH REPRESENTA- for a contract described in subsection (e). ‘‘(bb) while enrolled in such course of study TIVE PROGRAM. ‘‘(c) APPLICATION.— or training, to maintain an acceptable level ‘‘(a) IN GENERAL.—Under the authority of of academic standing (as determined under ‘‘(1) INFORMATION TO BE INCLUDED WITH the Act of November 2, 1921 (25 U.S.C. 13) regulations of the Secretary by the edu- (commonly known as the ‘Snyder Act’), the FORMS.—In disseminating application forms and contract forms to individuals desiring to cational institution offering such course of Secretary, acting through the Service, shall study or training); and maintain a Community Health Representa- participate in the Loan Repayment Program, the Secretary shall include with such forms ‘‘(III) to serve for a time period (herein- tive Program under which Indian Health after in this section referred to as the ‘period Programs— a fair summary of the rights and liabilities of an individual whose application is ap- of obligated service’) equal to 2 years or such ‘‘(1) provide for the training of Indians as proved (and whose contract is accepted) by longer period as the individual may agree to community health representatives; and the Secretary, including in the summary a serve in the full-time clinical practice of ‘‘(2) use such community health represent- clear explanation of the damages to which such individual’s profession in an Indian atives in the provision of health care, health the United States is entitled under sub- Health Program or Urban Indian Organiza- promotion, and disease prevention services section (l) in the case of the individual’s tion to which the individual may be assigned to Indian communities. breach of contract. The Secretary shall pro- by the Secretary; ‘‘(b) DUTIES.—The Community Health Rep- vide such individuals with sufficient infor- ‘‘(B) a provision permitting the Secretary resentative Program of the Service, shall— mation regarding the advantages and dis- to extend for such longer additional periods, ‘‘(1) provide a high standard of training for advantages of service as a commissioned offi- as the individual may agree to, the period of community health representatives to ensure cer in the Regular or Reserve Corps of the obligated service agreed to by the individual that the community health representatives Public Health Service or a civilian employee under subparagraph (A)(ii)(III); provide quality health care, health pro- of the Service to enable the individual to ‘‘(C) a provision that any financial obliga- motion, and disease prevention services to make a decision on an informed basis. tion of the United States arising out of a

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contract entered into under this section and uals who have entered into written contracts ‘‘(5) RECOVERY OF DELINQUENCY.— any obligation of the individual which is with the Secretary under this section shall ‘‘(A) IN GENERAL.—If damages described in conditioned thereon is contingent upon funds not be counted against any employment ceil- paragraph (4) are delinquent for 3 months, being appropriated for loan repayments ing affecting the Department while those in- the Secretary shall, for the purpose of recov- under this section; dividuals are undergoing academic training. ering such damages— ‘‘(D) a statement of the damages to which ‘‘(i) RECRUITMENT.—The Secretary shall ‘‘(i) use collection agencies contracted the United States is entitled under sub- conduct recruiting programs for the Loan with by the Administrator of General Serv- section (l) for the individual’s breach of the Repayment Program and other manpower ices; or contract; and programs of the Service at educational insti- ‘‘(ii) enter into contracts for the recovery ‘‘(E) such other statements of the rights tutions training health professionals or spe- of such damages with collection agencies se- and liabilities of the Secretary and of the in- cialists identified in subsection (a). lected by the Secretary. dividual, not inconsistent with this section. ‘‘(j) APPLICABILITY OF LAW.—Section 214 of ‘‘(B) REPORT.—Each contract for recov- ‘‘(f) DEADLINE FOR DECISION ON APPLICA- the Public Health Service Act (42 U.S.C. 215) ering damages pursuant to this subsection TION.—The Secretary shall provide written shall not apply to individuals during their shall provide that the contractor will, not notice to an individual within 21 days on— period of obligated service under the Loan less than once each 6 months, submit to the ‘‘(1) the Secretary’s approving, under sub- Repayment Program. Secretary a status report on the success of section (e)(1), of the individual’s participa- ‘‘(k) ASSIGNMENT OF INDIVIDUALS.—The the contractor in collecting such damages. tion in the Loan Repayment Program, in- Secretary, in assigning individuals to serve Section 3718 of title 31, United States Code, cluding extensions resulting in an aggregate in Indian Health Programs or Urban Indian shall apply to any such contract to the ex- period of obligated service in excess of 4 Organizations pursuant to contracts entered tent not inconsistent with this subsection. years; or into under this section, shall— ‘‘(m) WAIVER OR SUSPENSION OF OBLIGA- ‘‘(2) the Secretary’s disapproving an indi- ‘‘(1) ensure that the staffing needs of Trib- TION.— vidual’s participation in such Program. al Health Programs and Urban Indian Orga- ‘‘(1) IN GENERAL.—The Secretary shall by ‘‘(g) PAYMENTS.— nizations receive consideration on an equal regulation provide for the partial or total ‘‘(1) IN GENERAL.—A loan repayment pro- basis with programs that are administered waiver or suspension of any obligation of vided for an individual under a written con- directly by the Service; and service or payment by an individual under tract under the Loan Repayment Program ‘‘(2) give priority to assigning individuals the Loan Repayment Program whenever shall consist of payment, in accordance with to Indian Health Programs and Urban Indian compliance by the individual is impossible or paragraph (2), on behalf of the individual of Organizations that have a need for health would involve extreme hardship to the indi- the principal, interest, and related expenses professionals to provide health care services vidual and if enforcement of such obligation on government and commercial loans re- as a result of individuals having breached with respect to any individual would be un- ceived by the individual regarding the under- contracts entered into under this section. conscionable. graduate or graduate education of the indi- ‘‘(l) BREACH OF CONTRACT.— ‘‘(2) CANCELED UPON DEATH.—Any obliga- vidual (or both), which loans were made for— ‘‘(1) SPECIFIC BREACHES.—An individual tion of an individual under the Loan Repay- ‘‘(A) tuition expenses; who has entered into a written contract with ment Program for service or payment of ‘‘(B) all other reasonable educational ex- the Secretary under this section and has not damages shall be canceled upon the death of penses, including fees, books, and laboratory received a waiver under subsection (m) shall the individual. expenses, incurred by the individual; and be liable, in lieu of any service obligation ‘‘(3) HARDSHIP WAIVER.—The Secretary may ‘‘(C) reasonable living expenses as deter- arising under such contract, to the United waive, in whole or in part, the rights of the mined by the Secretary. States for the amount which has been paid United States to recover amounts under this ‘‘(2) AMOUNT.—For each year of obligated on such individual’s behalf under the con- section in any case of extreme hardship or service that an individual contracts to serve tract if that individual— other good cause shown, as determined by under subsection (e), the Secretary may pay ‘‘(A) is enrolled in the final year of a the Secretary. up to $35,000 or an amount equal to the course of study and— ‘‘(4) BANKRUPTCY.—Any obligation of an in- amount specified in section 338B(g)(2)(A) of ‘‘(i) fails to maintain an acceptable level of dividual under the Loan Repayment Pro- the Public Health Service Act, whichever is academic standing in the educational insti- gram for payment of damages may be re- more, on behalf of the individual for loans tution in which he or she is enrolled (such leased by a discharge in bankruptcy under described in paragraph (1). In making a de- level determined by the educational institu- title 11 of the United States Code only if termination of the amount to pay for a year tion under regulations of the Secretary); such discharge is granted after the expira- of such service by an individual, the Sec- ‘‘(ii) voluntarily terminates such enroll- tion of the 5-year period beginning on the retary shall consider the extent to which ment; or first date that payment of such damages is each such determination— ‘‘(iii) is dismissed from such educational required, and only if the bankruptcy court ‘‘(A) affects the ability of the Secretary to institution before completion of such course finds that nondischarge of the obligation maximize the number of contracts that can of study; or would be unconscionable. be provided under the Loan Repayment Pro- ‘‘(B) is enrolled in a graduate training pro- ‘‘(n) REPORT.—The Secretary shall submit gram from the amounts appropriated for to the President, for inclusion in the report such contracts; gram and fails to complete such training program. required to be submitted to Congress under ‘‘(B) provides an incentive to serve in In- section 801, a report concerning the previous dian Health Programs and Urban Indian Or- ‘‘(2) OTHER BREACHES; FORMULA FOR AMOUNT OWED.—If, for any reason not specified in fiscal year which sets forth by Service Area ganizations with the greatest shortages of the following: health professionals; and paragraph (1), an individual breaches his or her written contract under this section by ‘‘(1) A list of the health professional posi- ‘‘(C) provides an incentive with respect to tions maintained by Indian Health Programs the health professional involved remaining failing either to begin, or complete, such individual’s period of obligated service in ac- and Urban Indian Organizations for which re- in an Indian Health Program or Urban In- cruitment or retention is difficult. dian Organization with such a health profes- cordance with subsection (e)(2), the United sional shortage, and continuing to provide States shall be entitled to recover from such ‘‘(2) The number of Loan Repayment Pro- primary health services, after the comple- individual an amount to be determined in ac- gram applications filed with respect to each tion of the period of obligated service under cordance with the following formula: type of health profession. the Loan Repayment Program. A=3Z(t¥s/t) in which— ‘‘(3) The number of contracts described in ‘‘(3) TIMING.—Any arrangement made by ‘‘(A) ‘A’ is the amount the United States is subsection (e) that are entered into with re- the Secretary for the making of loan repay- entitled to recover; spect to each health profession. ments in accordance with this subsection ‘‘(B) ‘Z’ is the sum of the amounts paid ‘‘(4) The amount of loan payments made shall provide that any repayments for a year under this section to, or on behalf of, the in- under this section, in total and by health of obligated service shall be made no later dividual and the interest on such amounts profession. than the end of the fiscal year in which the which would be payable if, at the time the ‘‘(5) The number of scholarships that are individual completes such year of service. amounts were paid, they were loans bearing provided under sections 104 and 106 with re- ‘‘(4) REIMBURSEMENTS FOR TAX LIABILITY.— interest at the maximum legal prevailing spect to each health profession. For the purpose of providing reimbursements rate, as determined by the Secretary of the ‘‘(6) The amount of scholarship grants pro- for tax liability resulting from a payment Treasury; vided under section 104 and 106, in total and under paragraph (2) on behalf of an indi- ‘‘(C) ‘t’ is the total number of months in by health profession. vidual, the Secretary— the individual’s period of obligated service in ‘‘(7) The number of providers of health care ‘‘(A) in addition to such payments, may accordance with subsection (f); and that will be needed by Indian Health Pro- make payments to the individual in an ‘‘(D) ‘s’ is the number of months of such pe- grams and Urban Indian Organizations, by amount equal to not less than 20 percent and riod served by such individual in accordance location and profession, during the 3 fiscal not more than 39 percent of the total amount with this section. years beginning after the date the report is of loan repayments made for the taxable ‘‘(3) DEDUCTIONS IN MEDICARE PAYMENTS.— filed. year involved; and Amounts not paid within such period shall ‘‘(8) The measures the Secretary plans to ‘‘(B) may make such additional payments be subject to collection through deductions take to fill the health professional positions as the Secretary determines to be appro- in Medicare payments pursuant to section maintained by Indian Health Programs or priate with respect to such purpose. 1892 of the Social Security Act. Urban Indian Organizations for which re- ‘‘(5) PAYMENT SCHEDULE.—The Secretary ‘‘(4) TIME PERIOD FOR REPAYMENT.—Any cruitment or retention is difficult. may enter into an agreement with the holder amount of damages which the United States ‘‘SEC. 111. SCHOLARSHIP AND LOAN REPAYMENT of any loan for which payments are made is entitled to recover under this subsection RECOVERY FUND. under the Loan Repayment Program to es- shall be paid to the United States within the ‘‘(a) ESTABLISHMENT.—There is established tablish a schedule for the making of such 1-year period beginning on the date of the in the Treasury of the United States a fund payments. breach or such longer period beginning on to be known as the Indian Health Scholar- ‘‘(h) EMPLOYMENT CEILING.—Notwith- such date as shall be specified by the Sec- ship and Loan Repayment Recovery Fund standing any other provision of law, individ- retary. (hereafter in this section referred to as the

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00065 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1282 CONGRESSIONAL RECORD — SENATE February 27, 2008 ‘LRRF’). The LRRF shall consist of such individual fails to complete such obligated ‘‘(1) in the Service; amounts as may be collected from individ- service, the individual shall be liable to the ‘‘(2) in a program of an Indian Tribe or uals under section 104(d), section 106(e), and United States for the period of service re- Tribal Organization conducted under the In- section 110(l) for breach of contract, such maining. In such event, with respect to indi- dian Self-Determination and Education As- funds as may be appropriated to the LRRF, viduals entering the program after the date sistance Act (25 U.S.C. 450 et seq.) (including and interest earned on amounts in the of enactment of the Indian Health Care Im- programs under agreements with the Bureau LRRF. All amounts collected, appropriated, provement Act Amendments of 2008, the of Indian Affairs); or earned relative to the LRRF shall remain United States shall be entitled to recover available until expended. from such individual an amount to be deter- ‘‘(3) in a program assisted under title V of this Act; ‘‘(b) USE OF FUNDS.— mined in accordance with the formula speci- ‘‘(4) in the private practice of nursing if, as ‘‘(1) BY SECRETARY.—Amounts in the LRRF fied in subsection (l) of section 110 in the manner provided for in such subsection. determined by the Secretary, in accordance may be expended by the Secretary, acting with guidelines promulgated by the Sec- through the Service, to make payments to ‘‘(c) EQUAL OPPORTUNITY FOR PARTICIPA- an Indian Health Program— TION.—Health professionals from Tribal retary, such practice is situated in a physician or other health shortage area and ad- ‘‘(A) to which a scholarship recipient under Health Programs and Urban Indian Organiza- tions shall be given an equal opportunity to dresses the health care needs of a substantial section 104 and 106 or a loan repayment pro- number of Indians; or gram participant under section 110 has been participate in the program under subsection assigned to meet the obligated service re- (a). ‘‘(5) in a teaching capacity in a tribal col- quirements pursuant to such sections; and ‘‘SEC. 115. QUENTIN N. BURDICK AMERICAN INDI- lege or university nursing program (or a re- ‘‘(B) that has a need for a health profes- ANS INTO NURSING PROGRAM. lated health profession program) if, as deter- sional to provide health care services as a re- ‘‘(a) GRANTS AUTHORIZED.—For the purpose mined by the Secretary, health services pro- sult of such recipient or participant having of increasing the number of nurses, nurse vided to Indians would not decrease. breached the contract entered into under midwives, and nurse practitioners who de- ‘‘SEC. 116. TRIBAL CULTURAL ORIENTATION. section 104, 106, or section 110. liver health care services to Indians, the Sec- ‘‘(a) CULTURAL EDUCATION OF EMPLOYEES.— retary, acting through the Service, shall pro- ‘‘(2) BY TRIBAL HEALTH PROGRAMS.—A Trib- The Secretary, acting through the Service, al Health Program receiving payments pur- vide grants to the following: shall require that appropriate employees of suant to paragraph (1) may expend the pay- ‘‘(1) Public or private schools of nursing. the Service who serve Indian Tribes in each ments to provide scholarships or recruit and ‘‘(2) Tribal colleges or universities. Service Area receive educational instruction employ, directly or by contract, health pro- ‘‘(3) Nurse midwife programs and advanced in the history and culture of such Indian fessionals to provide health care services. practice nurse programs that are provided by Tribes and their relationship to the Service. ‘‘(c) INVESTMENT OF FUNDS.—The Secretary any tribal college or university accredited ‘‘(b) PROGRAM.—In carrying out subsection of the Treasury shall invest such amounts of nursing program, or in the absence of such, (a), the Secretary shall establish a program the LRRF as the Secretary of Health and any other public or private institutions. which shall, to the extent feasible— Human Services determines are not required ‘‘(b) USE OF GRANTS.—Grants provided ‘‘(1) be developed in consultation with the to meet current withdrawals from the LRRF. under subsection (a) may be used for 1 or affected Indian Tribes, Tribal Organizations, Such investments may be made only in in- more of the following: and Urban Indian Organizations; terest bearing obligations of the United ‘‘(1) To recruit individuals for programs States. For such purpose, such obligations ‘‘(2) be carried out through tribal colleges which train individuals to be nurses, nurse or universities; may be acquired on original issue at the midwives, or advanced practice nurses. issue price, or by purchase of outstanding ob- ‘‘(2) To provide scholarships to Indians en- ‘‘(3) include instruction in American In- ligations at the market price. rolled in such programs that may pay the dian studies; and ‘‘(d) SALE OF OBLIGATIONS.—Any obligation tuition charged for such program and other ‘‘(4) describe the use and place of tradi- acquired by the LRRF may be sold by the expenses incurred in connection with such tional health care practices of the Indian Secretary of the Treasury at the market program, including books, fees, room and Tribes in the Service Area. price. board, and stipends for living expenses. ‘‘SEC. 117. INMED PROGRAM. ‘‘(e) EFFECTIVE DATE.—This section takes ‘‘(3) To provide a program that encourages ‘‘(a) GRANTS AUTHORIZED.—The Secretary, effect on October 1, 2009. nurses, nurse midwives, and advanced prac- acting through the Service, is authorized to ‘‘SEC. 112. RECRUITMENT ACTIVITIES. tice nurses to provide, or continue to pro- provide grants to colleges and universities ‘‘(a) REIMBURSEMENT FOR TRAVEL.—The vide, health care services to Indians. for the purpose of maintaining and expand- Secretary, acting through the Service, may ‘‘(4) To provide a program that increases ing the Indian health careers recruitment reimburse health professionals seeking posi- the skills of, and provides continuing edu- program known as the ‘Indians Into Medi- tions with Indian Health Programs or Urban cation to, nurses, nurse midwives, and ad- cine Program’ (hereinafter in this section re- Indian Organizations, including individuals vanced practice nurses. ferred to as ‘INMED’) as a means of encour- considering entering into a contract under ‘‘(5) To provide any program that is de- aging Indians to enter the health profes- section 110 and their spouses, for actual and signed to achieve the purpose described in sions. reasonable expenses incurred in traveling to subsection (a). ‘‘(b) QUENTIN N. BURDICK GRANT.—The Sec- and from their places of residence to an area ‘‘(c) APPLICATIONS.—Each application for a retary shall provide 1 of the grants author- in which they may be assigned for the pur- grant under subsection (a) shall include such ized under subsection (a) to maintain the pose of evaluating such area with respect to information as the Secretary may require to INMED program at the University of North such assignment. establish the connection between the pro- Dakota, to be known as the ‘Quentin N. Bur- ‘‘(b) RECRUITMENT PERSONNEL.—The Sec- gram of the applicant and a health care facil- dick Indian Health Programs’, unless the retary, acting through the Service, shall as- ity that primarily serves Indians. Secretary makes a determination, based sign 1 individual in each Area Office to be re- ‘‘(d) PREFERENCES FOR GRANT RECIPI- upon program reviews, that the program is sponsible on a full-time basis for recruit- ENTS.—In providing grants under subsection not meeting the purposes of this section. ment activities. (a), the Secretary shall extend a preference Such program shall, to the maximum extent ‘‘SEC. 113. INDIAN RECRUITMENT AND RETEN- to the following: feasible, coordinate with the Quentin N. Bur- TION PROGRAM. ‘‘(1) Programs that provide a preference to dick American Indians Into Psychology Pro- ‘‘(a) IN GENERAL.—The Secretary, acting Indians. gram established under section 105(b) and the through the Service, shall fund, on a com- ‘‘(2) Programs that train nurse midwives or Quentin N. Burdick American Indians Into petitive basis, innovative demonstration advanced practice nurses. Nursing Program established under section projects for a period not to exceed 3 years to ‘‘(3) Programs that are interdisciplinary. 115. enable Tribal Health Programs and Urban ‘‘(4) Programs that are conducted in co- ‘‘(c) REGULATIONS.—The Secretary, pursu- Indian Organizations to recruit, place, and operation with a program for gifted and tal- ant to this Act, shall develop regulations to retain health professionals to meet their ented Indian students. govern grants pursuant to this section. staffing needs. ‘‘(5) Programs conducted by tribal colleges ‘‘(d) REQUIREMENTS.—Applicants for grants ‘‘(b) ELIGIBLE ENTITIES; APPLICATION.—Any and universities. provided under this section shall agree to Tribal Health Program or Urban Indian Or- ‘‘(e) QUENTIN N. BURDICK PROGRAM provide a program which— ganization may submit an application for GRANT.—The Secretary shall provide 1 of the funding of a project pursuant to this section. ‘‘(1) provides outreach and recruitment for grants authorized under subsection (a) to es- health professions to Indian communities in- ‘‘SEC. 114. ADVANCED TRAINING AND RESEARCH. tablish and maintain a program at the Uni- cluding elementary and secondary schools ‘‘(a) DEMONSTRATION PROGRAM.—The Sec- versity of North Dakota to be known as the and community colleges located on reserva- retary, acting through the Service, shall es- ‘Quentin N. Burdick American Indians Into tions which will be served by the program; tablish a demonstration project to enable Nursing Program’. Such program shall, to ‘‘(2) incorporates a program advisory board health professionals who have worked in an the maximum extent feasible, coordinate Indian Health Program or Urban Indian Or- comprised of representatives from the Indian with the Quentin N. Burdick Indian Health Tribes and Indian communities which will be ganization for a substantial period of time to Programs established under section 117(b) pursue advanced training or research areas and the Quentin N. Burdick American Indi- served by the program; of study for which the Secretary determines ans Into Psychology Program established ‘‘(3) provides summer preparatory pro- a need exists. under section 105(b). grams for Indian students who need enrich- ‘‘(b) SERVICE OBLIGATION.—An individual ‘‘(f) ACTIVE DUTY SERVICE OBLIGATION.— ment in the subjects of math and science in who participates in a program under sub- The active duty service obligation prescribed order to pursue training in the health profes- section (a), where the educational costs are under section 338C of the Public Health Serv- sions; borne by the Service, shall incur an obliga- ice Act (42 U.S.C. 254m) shall be met by each ‘‘(4) provides tutoring, counseling, and sup- tion to serve in an Indian Health Program or individual who receives training or assist- port to students who are enrolled in a health Urban Indian Organization for a period of ob- ance described in paragraph (1) or (2) of sub- career program of study at the respective ligated service equal to at least the period of section (b) that is funded by a grant provided college or university; and time during which the individual partici- under subsection (a). Such obligation shall ‘‘(5) to the maximum extent feasible, em- pates in such program. In the event that the be met by service— ploys qualified Indians in the program.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00066 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1283 ‘‘SEC. 118. HEALTH TRAINING PROGRAMS OF ‘‘(2) the Secretary determines is needed by ‘‘(3) provides for the establishment of tele- COMMUNITY COLLEGES. Indian Health Programs and Urban Indian conferencing capacity in health clinics lo- ‘‘(a) GRANTS TO ESTABLISH PROGRAMS.— Organizations; cated in or near such villages for use by com- ‘‘(1) IN GENERAL.—The Secretary, acting ‘‘(3) has— munity health aides or community health through the Service, shall award grants to ‘‘(A) completed 2 years of employment practitioners. accredited and accessible community col- with an Indian Health Program or Urban In- ‘‘(b) SPECIFIC PROGRAM REQUIREMENTS.— leges for the purpose of assisting such com- dian Organization; or The Secretary, acting through the Commu- munity colleges in the establishment of pro- ‘‘(B) completed any service obligations in- nity Health Aide Program of the Service, grams which provide education in a health shall— profession leading to a degree or diploma in curred as a requirement of— a health profession for individuals who desire ‘‘(i) any Federal scholarship program; or ‘‘(1) using trainers accredited by the Pro- to practice such profession on or near a res- ‘‘(ii) any Federal education loan repay- gram, provide a high standard of training to ervation or in an Indian Health Program. ment program; and community health aides and community health practitioners to ensure that such ‘‘(2) AMOUNT OF GRANTS.—The amount of ‘‘(4) enters into an agreement with an In- any grant awarded to a community college dian Health Program or Urban Indian Orga- aides and practitioners provide quality under paragraph (1) for the first year in nization for continued employment for a pe- health care, health promotion, and disease which such a grant is provided to the com- riod of not less than 1 year. prevention services to the villages served by the Program; munity college shall not exceed $250,000. ‘‘(b) RATES.—The Secretary may establish ‘‘(b) GRANTS FOR MAINTENANCE AND RE- rates for the retention bonus which shall ‘‘(2) in order to provide such training, de- CRUITING.— provide for a higher annual rate for velop a curriculum that— ‘‘(1) IN GENERAL.—The Secretary, acting multiyear agreements than for single year ‘‘(A) combines education in the theory of through the Service, shall award grants to agreements referred to in subsection (a)(4), health care with supervised practical experi- accredited and accessible community col- but in no event shall the annual rate be more ence in the provision of health care; leges that have established a program de- than $25,000 per annum. ‘‘(B) provides instruction and practical ex- scribed in subsection (a)(1) for the purpose of ‘‘(c) DEFAULT OF RETENTION AGREEMENT.— perience in the provision of acute care, emer- maintaining the program and recruiting stu- Any health professional failing to complete gency care, health promotion, disease pre- dents for the program. the agreed upon term of service, except vention, and the efficient and effective man- ‘‘(2) REQUIREMENTS.—Grants may only be where such failure is through no fault of the agement of clinic pharmacies, supplies, made under this section to a community col- individual, shall be obligated to refund to equipment, and facilities; and lege which— the Government the full amount of the re- ‘‘(C) promotes the achievement of the ‘‘(A) is accredited; tention bonus for the period covered by the health status objectives specified in section ‘‘(B) has a relationship with a hospital fa- agreement, plus interest as determined by 3(2); cility, Service facility, or hospital that could the Secretary in accordance with section ‘‘(3) establish and maintain a Community provide training of nurses or health profes- 110(l)(2)(B). Health Aide Certification Board to certify as sionals; ‘‘(d) OTHER RETENTION BONUS.—The Sec- community health aides or community ‘‘(C) has entered into an agreement with an retary may pay a retention bonus to any health practitioners individuals who have accredited college or university medical health professional employed by a Tribal successfully completed the training de- school, the terms of which— Health Program if such health professional scribed in paragraph (1) or can demonstrate ‘‘(i) provide a program that enhances the is serving in a position which the Secretary equivalent experience; transition and recruitment of students into determines is— ‘‘(4) develop and maintain a system which advanced baccalaureate or graduate pro- ‘‘(1) a position for which recruitment or re- identifies the needs of community health grams that train health professionals; and tention is difficult; and aides and community health practitioners ‘‘(ii) stipulate certifications necessary to ‘‘(2) necessary for providing health care for continuing education in the provision of approve internship and field placement op- services to Indians. health care, including the areas described in portunities at Indian Health Programs; ‘‘SEC. 120. NURSING RESIDENCY PROGRAM. paragraph (2)(B), and develop programs that ‘‘(D) has a qualified staff which has the ap- ‘‘(a) ESTABLISHMENT OF PROGRAM.—The meet the needs for such continuing edu- propriate certifications; Secretary, acting through the Service, shall cation; ‘‘(E) is capable of obtaining State or re- establish a program to enable Indians who ‘‘(5) develop and maintain a system that gional accreditation of the program de- are licensed practical nurses, licensed voca- provides close supervision of community scribed in subsection (a)(1); and tional nurses, and registered nurses who are health aides and community health practi- ‘‘(F) agrees to provide for Indian preference working in an Indian Health Program or tioners; for applicants for programs under this sec- Urban Indian Organization, and have done so ‘‘(6) develop a system under which the tion. for a period of not less than 1 year, to pursue work of community health aides and commu- ‘‘(c) TECHNICAL ASSISTANCE.—The Sec- advanced training. Such program shall in- nity health practitioners is reviewed and retary shall encourage community colleges clude a combination of education and work evaluated to assure the provision of quality described in subsection (b)(2) to establish study in an Indian Health Program or Urban health care, health promotion, and disease and maintain programs described in sub- Indian Organization leading to an associate prevention services; and or bachelor’s degree (in the case of a licensed section (a)(1) by— ‘‘(7) ensure that pulpal therapy (not includ- ‘‘(1) entering into agreements with such practical nurse or licensed vocational nurse), a bachelor’s degree (in the case of a reg- ing pulpotomies on deciduous teeth) or ex- colleges for the provision of qualified per- traction of adult teeth can be performed by sonnel of the Service to teach courses of istered nurse), or advanced degrees or certifications in nursing and public health. a dental health aide therapist only after con- study in such programs; and sultation with a licensed dentist who deter- ‘‘(2) providing technical assistance and ‘‘(b) SERVICE OBLIGATION.—An individual mines that the procedure is a medical emer- support to such colleges. who participates in a program under sub- gency that cannot be resolved with palliative section (a), where the educational costs are ‘‘(d) ADVANCED TRAINING.— treatment, and further that dental health paid by the Service, shall incur an obligation aide therapists are strictly prohibited from ‘‘(1) REQUIRED.—Any program receiving as- to serve in an Indian Health Program or sistance under this section that is conducted performing all other oral or jaw surgeries, Urban Indian Organization for a period of ob- provided that uncomplicated extractions with respect to a health profession shall also ligated service equal to 1 year for every year offer courses of study which provide ad- shall not be considered oral surgery under that nonprofessional employee (licensed this section. vanced training for any health professional practical nurses, licensed vocational nurses, who— nursing assistants, and various health care ‘‘(c) PROGRAM REVIEW.— ‘‘(A) has already received a degree or di- technicals), or 2 years for every year that ‘‘(1) NEUTRAL PANEL.— ploma in such health profession; and professional nurse (associate degree and ‘‘(A) ESTABLISHMENT.—The Secretary, act- ‘‘(B) provides clinical services on or near a bachelor-prepared registered nurses), partici- ing through the Service, shall establish a reservation or for an Indian Health Program. pates in such program. In the event that the neutral panel to carry out the study under ‘‘(2) MAY BE OFFERED AT ALTERNATE SITE.— individual fails to complete such obligated paragraph (2). Such courses of study may be offered in con- service, the United States shall be entitled ‘‘(B) MEMBERSHIP.—Members of the neutral junction with the college or university with to recover from such individual an amount panel shall be appointed by the Secretary which the community college has entered determined in accordance with the formula from among clinicians, economists, commu- into the agreement required under sub- specified in subsection (l) of section 110 in nity practitioners, oral epidemiologists, and section (b)(2)(C). the manner provided for in such subsection. Alaska Natives. ‘‘(e) PRIORITY.—Where the requirements of ‘‘SEC. 121. COMMUNITY HEALTH AIDE PROGRAM. ‘‘(2) STUDY.— subsection (b) are met, grant award priority ‘‘(a) GENERAL PURPOSES OF PROGRAM.— ‘‘(A) IN GENERAL.—The neutral panel estab- shall be provided to tribal colleges and uni- Under the authority of the Act of November lished under paragraph (1) shall conduct a versities in Service Areas where they exist. 2, 1921 (25 U.S.C. 13) (commonly known as the study of the dental health aide therapist ‘‘SEC. 119. RETENTION BONUS. ‘Snyder Act’), the Secretary, acting through services provided by the Community Health ‘‘(a) BONUS AUTHORIZED.—The Secretary the Service, shall develop and operate a Aide Program under this section to ensure may pay a retention bonus to any health Community Health Aide Program in Alaska that the quality of care provided through professional employed by, or assigned to, and under which the Service— those services is adequate and appropriate. serving in, an Indian Health Program or ‘‘(1) provides for the training of Alaska Na- ‘‘(B) PARAMETERS OF STUDY.—The Sec- Urban Indian Organization either as a civil- tives as health aides or community health retary, in consultation with interested par- ian employee or as a commissioned officer in practitioners; ties, including professional dental organiza- the Regular or Reserve Corps of the Public ‘‘(2) uses such aides or practitioners in the tions, shall develop the parameters of the Health Service who— provision of health care, health promotion, study. ‘‘(1) is assigned to, and serving in, a posi- and disease prevention services to Alaska ‘‘(C) INCLUSIONS.—The study shall include a tion for which recruitment or retention of Natives living in villages in rural Alaska; determination by the neutral panel with re- personnel is difficult; and spect to—

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00067 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1284 CONGRESSIONAL RECORD — SENATE February 27, 2008 ‘‘(i) the ability of the dental health aide programs to develop educational curricula 450 et seq.), the appropriate Secretary shall therapist services under this section to ad- for substance abuse counseling. ensure that such training costs are included dress the dental care needs of Alaska Na- ‘‘(b) USE OF FUNDS.—Funds provided under in the contract or compact, as the Secretary tives; this section shall be used only for developing determines necessary. ‘‘(ii) the quality of care provided through and providing educational curriculum for ‘‘(2) POSITION SPECIFIC TRAINING CRITERIA.— those services, including any training, im- substance abuse counseling (including pay- Position specific training criteria shall be provement, or additional oversight required ing salaries for instructors). Such curricula culturally relevant to Indians and Indian to improve the quality of care; and may be provided through satellite campus Tribes and shall ensure that appropriate in- ‘‘(iii) whether safer and less costly alter- programs. formation regarding traditional health care natives to the dental health aide therapist ‘‘(c) TIME PERIOD OF ASSISTANCE; RE- practices is provided. services exist. NEWAL.—A contract entered into or a grant ‘‘(d) COMMUNITY EDUCATION ON MENTAL ILL- ‘‘(D) CONSULTATION.—In carrying out the provided under this section shall be for a pe- NESS.—The Service shall develop and imple- study under this paragraph, the neutral riod of 3 years. Such contract or grant may ment, on request of an Indian Tribe, Tribal panel shall consult with Alaska Tribal Orga- be renewed for an additional 2-year period Organization, or Urban Indian Organization, nizations with respect to the adequacy and upon the approval of the Secretary. or assist the Indian Tribe, Tribal Organiza- accuracy of the study. ‘‘(d) CRITERIA FOR REVIEW AND APPROVAL tion, or Urban Indian Organization to de- ‘‘(3) REPORT.—The neutral panel shall sub- OF APPLICATIONS.—Not later than 180 days velop and implement, a program of commu- mit to the Secretary, the Committee on In- after the date of enactment of the Indian nity education on mental illness. In carrying dian Affairs of the Senate, and the Com- Health Care Improvement Act Amendments out this subsection, the Service shall, upon mittee on Natural Resources of the House of of 2008, the Secretary, after consultation request of an Indian Tribe, Tribal Organiza- Representatives a report describing the re- with Indian Tribes and administrators of tion, or Urban Indian Organization, provide sults of the study under paragraph (2), in- tribal colleges and universities and eligible technical assistance to the Indian Tribe, cluding a description of— accredited and accessible community col- Tribal Organization, or Urban Indian Organi- zation to obtain and develop community edu- ‘‘(A) any determination of the neutral leges, shall develop and issue criteria for the review and approval of applications for fund- cational materials on the identification, pre- panel under paragraph (2)(C); and vention, referral, and treatment of mental ‘‘(B) any comments received from an Alas- ing (including applications for renewals of funding) under this section. Such criteria illness and dysfunctional and self-destruc- ka Tribal Organization under paragraph tive behavior. (2)(D). shall ensure that demonstration programs established under this section promote the ‘‘(e) PLAN.—Not later than 90 days after ‘‘(d) NATIONALIZATION OF PROGRAM.— development of the capacity of such entities the date of enactment of the Indian Health ‘‘(1) IN GENERAL.—Except as provided in to educate substance abuse counselors. Care Improvement Act Amendments of 2008, paragraph (2), the Secretary, acting through the Secretary shall develop a plan under ‘‘(e) ASSISTANCE.—The Secretary shall pro- the Service, may establish a national Com- which the Service will increase the health vide such technical and other assistance as care staff providing behavioral health serv- munity Health Aide Program in accordance may be necessary to enable grant recipients with the program under this section, as the ices by at least 500 positions within 5 years to comply with the provisions of this sec- after the date of enactment of this section, Secretary determines to be appropriate. tion. ‘‘(2) EXCEPTION.—The national Community with at least 200 of such positions devoted to ‘‘(f) REPORT.—Each fiscal year, the Sec- child, adolescent, and family services. The Health Aide Program under paragraph (1) retary shall submit to the President, for in- shall not include dental health aide therapist plan developed under this subsection shall be clusion in the report which is required to be implemented under the Act of November 2, services. submitted under section 801 for that fiscal ‘‘(3) REQUIREMENT.—In establishing a na- 1921 (25 U.S.C. 13) (commonly known as the year, a report on the findings and conclu- ‘Snyder Act’). tional program under paragraph (1), the Sec- sions derived from the demonstration pro- retary shall not reduce the amount of funds grams conducted under this section during ‘‘SEC. 127. AUTHORIZATION OF APPROPRIATIONS. provided for the Community Health Aide that fiscal year. ‘‘There are authorized to be appropriated Program described in subsections (a) and (b). such sums as may be necessary for each fis- ‘‘(g) DEFINITION.—For the purposes of this ‘‘SEC. 122. TRIBAL HEALTH PROGRAM ADMINIS- cal year through fiscal year 2017 to carry out section, the term ‘educational curriculum’ this title. TRATION. means 1 or more of the following: ‘‘The Secretary, acting through the Serv- ‘‘TITLE II—HEALTH SERVICES ice, shall, by contract or otherwise, provide ‘‘(1) Classroom education. ‘‘(2) Clinical work experience. ‘‘SEC. 201. INDIAN HEALTH CARE IMPROVEMENT training for Indians in the administration FUND. ‘‘(3) Continuing education workshops. and planning of Tribal Health Programs. ‘‘(a) USE OF FUNDS.—The Secretary, acting ‘‘SEC. 123. HEALTH PROFESSIONAL CHRONIC ‘‘SEC. 126. BEHAVIORAL HEALTH TRAINING AND through the Service, is authorized to expend SHORTAGE DEMONSTRATION PRO- COMMUNITY EDUCATION PRO- GRAMS. funds, directly or under the authority of the GRAMS. Indian Self-Determination and Education ‘‘(a) STUDY; LIST.—The Secretary, acting ‘‘(a) DEMONSTRATION PROGRAMS AUTHOR- Assistance Act (25 U.S.C. 450 et seq.), which IZED.—The Secretary, acting through the through the Service, and the Secretary of the Interior, in consultation with Indian are appropriated under the authority of this Service, may fund demonstration programs section, for the purposes of— for Tribal Health Programs to address the Tribes and Tribal Organizations, shall con- chronic shortages of health professionals. duct a study and compile a list of the types ‘‘(1) eliminating the deficiencies in health of staff positions specified in subsection (b) status and health resources of all Indian ‘‘(b) PURPOSES OF PROGRAMS.—The pur- Tribes; poses of demonstration programs funded whose qualifications include, or should in- under subsection (a) shall be— clude, training in the identification, preven- ‘‘(2) eliminating backlogs in the provision of health care services to Indians; ‘‘(1) to provide direct clinical and practical tion, education, referral, or treatment of experience at a Service Unit to health pro- mental illness, or dysfunctional and self de- ‘‘(3) meeting the health needs of Indians in fession students and residents from medical structive behavior. an efficient and equitable manner, including schools; ‘‘(b) POSITIONS.—The positions referred to the use of telehealth and telemedicine when appropriate; ‘‘(2) to improve the quality of health care in subsection (a) are— for Indians by assuring access to qualified ‘‘(1) staff positions within the Bureau of In- ‘‘(4) eliminating inequities in funding for health care professionals; and dian Affairs, including existing positions, in both direct care and contract health service programs; and ‘‘(3) to provide academic and scholarly op- the fields of— portunities for health professionals serving ‘‘(A) elementary and secondary education; ‘‘(5) augmenting the ability of the Service Indians by identifying all academic and ‘‘(B) social services and family and child to meet the following health service respon- scholarly resources of the region. welfare; sibilities with respect to those Indian Tribes ‘‘(C) law enforcement and judicial services; with the highest levels of health status defi- ‘‘(c) ADVISORY BOARD.—The demonstration ciencies and resource deficiencies: programs established pursuant to subsection and (a) shall incorporate a program advisory ‘‘(D) alcohol and substance abuse; ‘‘(A) Clinical care, including inpatient board composed of representatives from the care, outpatient care (including audiology, ‘‘(2) staff positions within the Service; and clinical eye, and vision care), primary care, Indian Tribes and Indian communities in the ‘‘(3) staff positions similar to those identi- area which will be served by the program. secondary and tertiary care, and long-term fied in paragraphs (1) and (2) established and care. ‘‘SEC. 124. NATIONAL HEALTH SERVICE CORPS. maintained by Indian Tribes and Tribal Or- ‘‘(B) Preventive health, including mam- ‘‘The Secretary shall not— ganizations (without regard to the funding mography and other cancer screening in ac- ‘‘(1) remove a member of the National source). cordance with section 207. Health Service Corps from an Indian Health ‘‘(c) TRAINING CRITERIA.— ‘‘(C) Dental care. Program or Urban Indian Organization; or ‘‘(1) IN GENERAL.—The appropriate Sec- ‘‘(D) Mental health, including community ‘‘(2) withdraw funding used to support such retary shall provide training criteria appro- mental health services, inpatient mental member, unless the Secretary, acting priate to each type of position identified in health services, dormitory mental health through the Service, has ensured that the In- subsection (b)(1) and (b)(2) and ensure that services, therapeutic and residential treat- dians receiving services from such member appropriate training has been, or shall be ment centers, and training of traditional will experience no reduction in services. provided to any individual in any such posi- health care practitioners. tion. With respect to any such individual in ‘‘SEC. 125. SUBSTANCE ABUSE COUNSELOR EDU- ‘‘(E) Emergency medical services. CATIONAL CURRICULA DEMONSTRA- a position identified pursuant to subsection TION PROGRAMS. (b)(3), the respective Secretaries shall pro- ‘‘(F) Treatment and control of, and reha- ‘‘(a) CONTRACTS AND GRANTS.—The Sec- vide appropriate training to, or provide funds bilitative care related to, alcoholism and retary, acting through the Service, may to, an Indian Tribe or Tribal Organization drug abuse (including fetal alcohol spectrum enter into contracts with, or make grants to, for training of appropriate individuals. In disorders) among Indians. accredited tribal colleges and universities the case of positions funded under a contract ‘‘(G) Injury prevention programs, including and eligible accredited and accessible com- or compact under the Indian Self-Determina- training. munity colleges to establish demonstration tion and Education Assistance Act (25 U.S.C. ‘‘(H) Home health care.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00068 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1285 ‘‘(I) Community health representatives. ‘‘(B) the number of Indians eligible for shall not be used to offset or limit appropria- ‘‘(J) Maintenance and improvement. health services in each Service Unit or In- tions made to the Service under the author- ‘‘(b) NO OFFSET OR LIMITATION.—Any funds dian Tribe or Tribal Organization; and ity of the Act of November 2, 1921 (25 U.S.C. appropriated under the authority of this sec- ‘‘(C) the number of Indians using the Serv- 13) (commonly known as the ‘Snyder Act’), tion shall not be used to offset or limit any ice resources made available to each Service or any other law. other appropriations made to the Service Unit, Indian Tribe or Tribal Organization, ‘‘(f) DEPOSIT OF REIMBURSEMENT FUNDS.— under this Act or the Act of November 2, 1921 and, to the extent available, information on There shall be deposited into CHEF all reim- (25 U.S.C. 13) (commonly known as the ‘Sny- the waiting lists and number of Indians bursements to which the Service is entitled der Act’), or any other provision of law. turned away for services due to lack of re- from any Federal, State, local, or private sources. source (including third party insurance) by ‘‘(c) ALLOCATION; USE.— ‘‘(g) INCLUSION IN BASE BUDGET.—Funds ap- reason of treatment rendered to any victim ‘‘(1) IN GENERAL.—Funds appropriated propriated under this section for any fiscal of a disaster or catastrophic illness the cost under the authority of this section shall be year shall be included in the base budget of of which was paid from CHEF. allocated to Service Units, Indian Tribes, or the Service for the purpose of determining ‘‘SEC. 203. HEALTH PROMOTION AND DISEASE Tribal Organizations. The funds allocated to appropriations under this section in subse- PREVENTION SERVICES. each Indian Tribe, Tribal Organization, or quent fiscal years. ‘‘(a) FINDINGS.—Congress finds that health Service Unit under this paragraph shall be ‘‘(h) CLARIFICATION.—Nothing in this sec- promotion and disease prevention activi- used by the Indian Tribe, Tribal Organiza- tion is intended to diminish the primary re- ties— tion, or Service Unit under this paragraph to sponsibility of the Service to eliminate ex- ‘‘(1) improve the health and well-being of improve the health status and reduce the re- isting backlogs in unmet health care needs, Indians; and source deficiency of each Indian Tribe served nor are the provisions of this section in- ‘‘(2) reduce the expenses for health care of by such Service Unit, Indian Tribe, or Tribal tended to discourage the Service from under- Indians. Organization. taking additional efforts to achieve equity ‘‘(b) PROVISION OF SERVICES.—The Sec- ‘‘(2) APPORTIONMENT OF ALLOCATED among Indian Tribes and Tribal Organiza- retary, acting through the Service and Trib- FUNDS.—The apportionment of funds allo- tions. al Health Programs, shall provide health cated to a Service Unit, Indian Tribe, or ‘‘(i) FUNDING DESIGNATION.—Any funds ap- promotion and disease prevention services to Tribal Organization under paragraph (1) propriated under the authority of this sec- Indians to achieve the health status objec- among the health service responsibilities de- tion shall be designated as the ‘Indian tives set forth in section 3(2). scribed in subsection (a)(5) shall be deter- Health Care Improvement Fund’. ‘‘(c) EVALUATION.—The Secretary, after ob- mined by the Service in consultation with, ‘‘SEC. 202. CATASTROPHIC HEALTH EMERGENCY taining input from the affected Tribal Health and with the active participation of, the af- FUND. Programs, shall submit to the President for fected Indian Tribes and Tribal Organiza- ‘‘(a) ESTABLISHMENT.—There is established inclusion in the report which is required to tions. an Indian Catastrophic Health Emergency be submitted to Congress under section 801 ‘‘(d) PROVISIONS RELATING TO HEALTH STA- Fund (hereafter in this section referred to as an evaluation of— TUS AND RESOURCE DEFICIENCIES.—For the the ‘CHEF’) consisting of— ‘‘(1) the health promotion and disease pre- purposes of this section, the following defini- ‘‘(1) the amounts deposited under sub- vention needs of Indians; tions apply: section (f); and ‘‘(2) the health promotion and disease pre- ‘‘(1) DEFINITION.—The term ‘health status ‘‘(2) the amounts appropriated to CHEF vention activities which would best meet and resource deficiency’ means the extent to under this section. such needs; which— ‘‘(b) ADMINISTRATION.—CHEF shall be ad- ‘‘(3) the internal capacity of the Service ‘‘(A) the health status objectives set forth ministered by the Secretary, acting through and Tribal Health Programs to meet such in section 3(2) are not being achieved; and the headquarters of the Service, solely for needs; and ‘‘(B) the Indian Tribe or Tribal Organiza- the purpose of meeting the extraordinary ‘‘(4) the resources which would be required tion does not have available to it the health medical costs associated with the treatment to enable the Service and Tribal Health Pro- resources it needs, taking into account the of victims of disasters or catastrophic ill- grams to undertake the health promotion actual cost of providing health care services nesses who are within the responsibility of and disease prevention activities necessary given local geographic, climatic, rural, or the Service. to meet such needs. other circumstances. ‘‘(c) CONDITIONS ON USE OF FUND.—No part ‘‘SEC. 204. DIABETES PREVENTION, TREATMENT, ‘‘(2) AVAILABLE RESOURCES.—The health re- of CHEF or its administration shall be sub- AND CONTROL. sources available to an Indian Tribe or Trib- ject to contract or grant under any law, in- ‘‘(a) DETERMINATIONS REGARDING DIABE- al Organization include health resources pro- cluding the Indian Self-Determination and TES.—The Secretary, acting through the vided by the Service as well as health re- Education Assistance Act (25 U.S.C. 450 et Service, and in consultation with Indian sources used by the Indian Tribe or Tribal seq.), nor shall CHEF funds be allocated, ap- Tribes and Tribal Organizations, shall deter- Organization, including services and financ- portioned, or delegated on an Area Office, mine— ing systems provided by any Federal pro- Service Unit, or other similar basis. ‘‘(1) by Indian Tribe and by Service Unit, grams, private insurance, and programs of ‘‘(d) REGULATIONS.—The Secretary shall the incidence of, and the types of complica- State or local governments. promulgate regulations consistent with the tions resulting from, diabetes among Indi- ‘‘(3) PROCESS FOR REVIEW OF DETERMINA- provisions of this section to— ans; and TIONS.—The Secretary shall establish proce- ‘‘(1) establish a definition of disasters and ‘‘(2) based on the determinations made pur- dures which allow any Indian Tribe or Tribal catastrophic illnesses for which the cost of suant to paragraph (1), the measures (includ- Organization to petition the Secretary for a the treatment provided under contract would ing patient education and effective ongoing review of any determination of the extent of qualify for payment from CHEF; monitoring of disease indicators) each Serv- the health status and resource deficiency of ‘‘(2) provide that a Service Unit shall not ice Unit should take to reduce the incidence such Indian Tribe or Tribal Organization. be eligible for reimbursement for the cost of of, and prevent, treat, and control the complications resulting from, diabetes among In- ‘‘(e) ELIGIBILITY FOR FUNDS.—Tribal Health treatment from CHEF until its cost of treat- Programs shall be eligible for funds appro- ing any victim of such catastrophic illness or dian Tribes within that Service Unit. priated under the authority of this section disaster has reached a certain threshold cost ‘‘(b) DIABETES SCREENING.—To the extent on an equal basis with programs that are ad- which the Secretary shall establish at— medically indicated and with informed con- ministered directly by the Service. ‘‘(A) the 2000 level of $19,000; and sent, the Secretary shall screen each Indian who receives services from the Service for di- ‘‘(f) REPORT.—By no later than the date ‘‘(B) for any subsequent year, not less than the threshold cost of the previous year in- abetes and for conditions which indicate a that is 3 years after the date of enactment of high risk that the individual will become di- the Indian Health Care Improvement Act creased by the percentage increase in the medical care expenditure category of the abetic and establish a cost-effective ap- Amendments of 2008, the Secretary shall sub- proach to ensure ongoing monitoring of dis- mit to Congress the current health status consumer price index for all urban consumers (United States city average) for the ease indicators. Such screening and moni- and resource deficiency report of the Service toring may be conducted by a Tribal Health for each Service Unit, including newly recog- 12-month period ending with December of the previous year; Program and may be conducted through ap- nized or acknowledged Indian Tribes. Such propriate Internet-based health care man- report shall set out— ‘‘(3) establish a procedure for the reim- agement programs. ‘‘(1) the methodology then in use by the bursement of the portion of the costs that exceeds such threshold cost incurred by— ‘‘(c) DIABETES PROJECTS.—The Secretary Service for determining Tribal health status shall continue to maintain each model diabe- and resource deficiencies, as well as the most ‘‘(A) Service Units; or tes project in existence on the date of enact- recent application of that methodology; ‘‘(B) whenever otherwise authorized by the ment of the Indian Health Care Improvement ‘‘(2) the extent of the health status and re- Service, non-Service facilities or providers; Act Amendments of 2008, any such other dia- source deficiency of each Indian Tribe served ‘‘(4) establish a procedure for payment betes programs operated by the Service or by the Service or a Tribal Health Program; from CHEF in cases in which the exigencies Tribal Health Programs, and any additional ‘‘(3) the amount of funds necessary to of the medical circumstances warrant treat- diabetes projects, such as the Medical Van- eliminate the health status and resource de- ment prior to the authorization of such guard program provided for in title IV of ficiencies of all Indian Tribes served by the treatment by the Service; and Public Law 108–87, as implemented to serve Service or a Tribal Health Program; and ‘‘(5) establish a procedure that will ensure Indian Tribes. Tribal Health Programs shall ‘‘(4) an estimate of— that no payment shall be made from CHEF receive recurring funding for the diabetes ‘‘(A) the amount of health service funds ap- to any provider of treatment to the extent projects that they operate pursuant to this propriated under the authority of this Act, that such provider is eligible to receive pay- section, both at the date of enactment of the or any other Act, including the amount of ment for the treatment from any other Fed- Indian Health Care Improvement Act any funds transferred to the Service for the eral, State, local, or private source of reim- Amendments of 2008 and for projects which preceding fiscal year which is allocated to bursement for which the patient is eligible. are added and funded thereafter. each Service Unit, Indian Tribe, or Tribal ‘‘(e) NO OFFSET OR LIMITATION.—Amounts ‘‘(d) DIALYSIS PROGRAMS.—The Secretary is Organization; appropriated to CHEF under this section authorized to provide, through the Service,

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00069 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1286 CONGRESSIONAL RECORD — SENATE February 27, 2008 Indian Tribes, and Tribal Organizations, di- formance of the health service responsibil- ment Act Amendments of 2008 may be oper- alysis programs, including the purchase of ities of Indian Health Programs. ated under a grant authorized by subsection dialysis equipment and the provision of nec- ‘‘(b) COORDINATION OF RESOURCES AND AC- (d), but funding under such a grant shall not essary staffing. TIVITIES.—The Secretary shall also, to the be divisible. ‘‘(e) OTHER DUTIES OF THE SECRETARY.— maximum extent practicable, coordinate de- ‘‘(b) FUNCTIONS OF CENTERS.—In consulta- ‘‘(1) IN GENERAL.—The Secretary shall, to partmental research resources and activities tion with and upon the request of Indian the extent funding is available— to address relevant Indian Health Program Tribes, Tribal Organizations, and Urban In- ‘‘(A) in each Area Office, consult with In- research needs. dian communities, each Service Area epide- dian Tribes and Tribal Organizations regard- ‘‘(c) AVAILABILITY.—Tribal Health Pro- miology center established under this sec- ing programs for the prevention, treatment, grams shall be given an equal opportunity to tion shall, with respect to such Service and control of diabetes; compete for, and receive, research funds Area— ‘‘(B) establish in each Area Office a reg- under this section. ‘‘(1) collect data relating to, and monitor istry of patients with diabetes to track the ‘‘(d) USE OF FUNDS.—This funding may be progress made toward meeting, each of the incidence of diabetes and the complications used for both clinical and nonclinical re- health status objectives of the Service, the search. Indian Tribes, Tribal Organizations, and from diabetes in that area; and Urban Indian communities in the Service ‘‘(C) ensure that data collected in each ‘‘(e) EVALUATION AND DISSEMINATION.—The Area; Secretary shall periodically— Area Office regarding diabetes and related ‘‘(2) evaluate existing delivery systems, complications among Indians are dissemi- ‘‘(1) evaluate the impact of research con- data systems, and other systems that impact nated to all other Area Offices, subject to ap- ducted under this section; and the improvement of Indian health; plicable patient privacy laws. ‘‘(2) disseminate to Tribal Health Pro- ‘‘(3) assist Indian Tribes, Tribal Organiza- ‘‘(2) DIABETES CONTROL OFFICERS.— grams information regarding that research tions, and Urban Indian Organizations in ‘‘(A) IN GENERAL.—The Secretary may es- as the Secretary determines to be appro- identifying their highest priority health sta- tablish and maintain in each Area Office a priate. tus objectives and the services needed to position of diabetes control officer to coordi- ‘‘SEC. 207. MAMMOGRAPHY AND OTHER CANCER achieve such objectives, based on epidemio- nate and manage any activity of that Area SCREENING. logical data; Office relating to the prevention, treatment, ‘‘The Secretary, acting through the Serv- ‘‘(4) make recommendations for the tar- or control of diabetes to assist the Secretary ice or Tribal Health Programs, shall provide geting of services needed by the populations in carrying out a program under this section for screening as follows: served; or section 330C of the Public Health Service ‘‘(1) Screening mammography (as defined ‘‘(5) make recommendations to improve Act (42 U.S.C. 254c–3). in section 1861(jj) of the Social Security Act) health care delivery systems for Indians and ‘‘(B) CERTAIN ACTIVITIES.—Any activity for Indian women at a frequency appropriate Urban Indians; carried out by a diabetes control officer to such women under accepted and appro- ‘‘(6) provide requested technical assistance under subparagraph (A) that is the subject of priate national standards, and under such to Indian Tribes, Tribal Organizations, and a contract or compact under the Indian Self- terms and conditions as are consistent with Urban Indian Organizations in the develop- Determination and Education Assistance Act standards established by the Secretary to en- ment of local health service priorities and (25 U.S.C. 450 et seq.), and any funds made sure the safety and accuracy of screening incidence and prevalence rates of disease and available to carry out such an activity, shall mammography under part B of title XVIII of other illness in the community; and not be divisible for purposes of that Act. such Act. ‘‘(7) provide disease surveillance and assist ‘‘SEC. 205. SHARED SERVICES FOR LONG-TERM ‘‘(2) Other cancer screening that receives Indian Tribes, Tribal Organizations, and CARE. an A or B rating as recommended by the Urban Indian communities to promote public ‘‘(a) LONG-TERM CARE.—Notwithstanding United States Preventive Services Task health. any other provision of law, the Secretary, Force established under section 915(a)(1) of ‘‘(c) TECHNICAL ASSISTANCE.—The Director acting through the Service, is authorized to the Public Health Service Act (42 U.S.C. of the Centers for Disease Control and Pre- provide directly, or enter into contracts or 299b–4(a)(1)). The Secretary shall ensure that vention shall provide technical assistance to compacts under the Indian Self-Determina- screening provided for under this paragraph the centers in carrying out the requirements tion and Education Assistance Act (25 U.S.C. complies with the recommendations of the of this section. 450 et seq.) with Indian Tribes or Tribal Or- Task Force with respect to— ‘‘(d) GRANTS FOR STUDIES.— ganizations for, the delivery of long-term ‘‘(A) frequency; ‘‘(1) IN GENERAL.—The Secretary may make care (including health care services associ- ‘‘(B) the population to be served; ated with long-term care) provided in a facil- grants to Indian Tribes, Tribal Organiza- ‘‘(C) the procedure or technology to be tions, Indian organizations, and eligible ity to Indians. Such agreements shall pro- used; vide for the sharing of staff or other services intertribal consortia to conduct epidemio- between the Service or a Tribal Health Pro- ‘‘(D) evidence of effectiveness; and logical studies of Indian communities. gram and a long-term care or related facility ‘‘(E) other matters that the Secretary de- ‘‘(2) ELIGIBLE INTERTRIBAL CONSORTIA.—An owned and operated (directly or through a termines appropriate. intertribal consortium or Indian organiza- contract or compact under the Indian Self- ‘‘SEC. 208. PATIENT TRAVEL COSTS. tion is eligible to receive a grant under this Determination and Education Assistance Act ‘‘(a) DEFINITION OF QUALIFIED ESCORT.—In subsection if— (25 U.S.C. 450 et seq.)) by such Indian Tribe this section, the term ‘qualified escort’ ‘‘(A) the intertribal consortium is incor- or Tribal Organization. means— porated for the primary purpose of improv- ‘‘(b) CONTENTS OF AGREEMENTS.—An agree- ‘‘(1) an adult escort (including a parent, ing Indian health; and ment entered into pursuant to subsection guardian, or other family member) who is re- ‘‘(B) the intertribal consortium is rep- (a)— quired because of the physical or mental con- resentative of the Indian Tribes or urban In- ‘‘(1) may, at the request of the Indian Tribe dition, or age, of the applicable patient; dian communities in which the intertribal or Tribal Organization, delegate to such In- ‘‘(2) a health professional for the purpose of consortium is located. dian Tribe or Tribal Organization such pow- providing necessary medical care during ‘‘(3) APPLICATIONS.—An application for a ers of supervision and control over Service travel by the applicable patient; or grant under this subsection shall be sub- employees as the Secretary deems necessary ‘‘(3) other escorts, as the Secretary or ap- mitted in such manner and at such time as to carry out the purposes of this section; plicable Indian Health Program determines the Secretary shall prescribe. ‘‘(2) shall provide that expenses (including to be appropriate. ‘‘(4) REQUIREMENTS.—An applicant for a grant under this subsection shall— salaries) relating to services that are shared ‘‘(b) PROVISION OF FUNDS.—The Secretary, between the Service and the Tribal Health acting through the Service and Tribal Health ‘‘(A) demonstrate the technical, adminis- Program be allocated proportionately be- Programs, is authorized to provide funds for trative, and financial expertise necessary to tween the Service and the Indian Tribe or the following patient travel costs, including carry out the functions described in para- Tribal Organization; and qualified escorts, associated with receiving graph (5); ‘‘(3) may authorize such Indian Tribe or health care services provided (either through ‘‘(B) consult and cooperate with providers Tribal Organization to construct, renovate, direct or contract care or through a contract of related health and social services in order or expand a long-term care or other similar or compact under the Indian Self-Determina- to avoid duplication of existing services; and facility (including the construction of a fa- tion and Education Assistance Act (25 U.S.C. ‘‘(C) demonstrate cooperation from Indian cility attached to a Service facility). 450 et seq.)) under this Act— Tribes or Urban Indian Organizations in the ‘‘(c) MINIMUM REQUIREMENT.—Any nursing ‘‘(1) emergency air transportation and non- area to be served. facility provided for under this section shall emergency air transportation where ground ‘‘(5) USE OF FUNDS.—A grant awarded under meet the requirements for nursing facilities transportation is infeasible; paragraph (1) may be used— under section 1919 of the Social Security Act. ‘‘(2) transportation by private vehicle ‘‘(A) to carry out the functions described ‘‘(d) OTHER ASSISTANCE.—The Secretary (where no other means of transportation is in subsection (b); shall provide such technical and other assist- available), specially equipped vehicle, and ‘‘(B) to provide information to and consult ance as may be necessary to enable appli- ambulance; and with tribal leaders, urban Indian community cants to comply with the provisions of this ‘‘(3) transportation by such other means as leaders, and related health staff on health section. may be available and required when air or care and health service management issues; ‘‘(e) USE OF EXISTING OR UNDERUSED FA- motor vehicle transportation is not avail- and CILITIES.—The Secretary shall encourage the able. ‘‘(C) in collaboration with Indian Tribes, use of existing facilities that are underused ‘‘SEC. 209. EPIDEMIOLOGY CENTERS. Tribal Organizations, and urban Indian com- or allow the use of swing beds for long-term ‘‘(a) ESTABLISHMENT OF CENTERS.—The Sec- munities, to provide the Service with infor- or similar care. retary shall establish an epidemiology cen- mation regarding ways to improve the ‘‘SEC. 206. HEALTH SERVICES RESEARCH. ter in each Service Area to carry out the health status of Indians. ‘‘(a) IN GENERAL.—The Secretary, acting functions described in subsection (b). Any ‘‘(e) ACCESS TO INFORMATION.—The Sec- through the Service, shall make funding new center established after the date of en- retary shall grant epidemiology centers op- available for research to further the per- actment of the Indian Health Care Improve- erated by a grantee pursuant to a grant

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00070 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1287 awarded under subsection (d) access to use of ‘‘(D) substance abuse prevention programs; Prevention and State and local health agen- the data, data sets, monitoring systems, de- ‘‘(E) injury prevention and safety edu- cies. livery systems, and other protected health cation programs; and ‘‘(d) TECHNICAL ASSISTANCE; REPORT.—In information in the possession of the Sec- ‘‘(F) activities for the prevention and con- carrying out this section, the Secretary— retary. Such activities shall be for the pur- trol of communicable diseases. ‘‘(1) may, at the request of an Indian Tribe poses of research and for preventing and controlling disease, injury, or disability for pur- ‘‘(3) DUTIES OF THE SECRETARY.—The Sec- or Tribal Organization, provide technical as- poses of the Health Insurance Portability retary of the Interior shall— sistance; and and Accountability Act of 1996 (Public Law ‘‘(A) provide training to teachers in com- ‘‘(2) shall prepare and submit a report to 104–191; 110 Stat. 2033), as such activities are prehensive school health education mate- Congress biennially on the use of funds under described in part 164.512 of title 45, Code of rials; this section and on the progress made toward Federal regulations (or a successor regula- ‘‘(B) ensure the integration and coordina- the prevention, control, and elimination of tion). tion of school-based programs with existing communicable and infectious diseases among ‘‘SEC. 210. COMPREHENSIVE SCHOOL HEALTH services and health programs available in Indians and Urban Indians. EDUCATION PROGRAMS. the community; and ‘‘SEC. 213. OTHER AUTHORITY FOR PROVISION OF ‘‘(a) FUNDING FOR DEVELOPMENT OF PRO- ‘‘(C) encourage healthy, tobacco-free SERVICES. GRAMS.—In addition to carrying out any school environments. ‘‘(a) FUNDING AUTHORIZED.—The Secretary, other program for health promotion or dis- ‘‘SEC. 211. INDIAN YOUTH PROGRAM. acting through the Service, Indian Tribes, ease prevention, the Secretary, acting ‘‘(a) PROGRAM AUTHORIZED.—The Sec- and Tribal Organizations, may provide fund- through the Service, is authorized to award retary, acting through the Service, is au- ing under this Act to meet the objectives set grants to Indian Tribes and Tribal Organiza- thorized to establish and administer a pro- forth in section 3 of this Act through health tions to develop comprehensive school gram to provide grants to Indian Tribes, care-related services and programs not oth- health education programs for children from Tribal Organizations, and Urban Indian Or- erwise described in this Act for the following pre-school through grade 12 in schools for ganizations for innovative mental and phys- services: the benefit of Indian and Urban Indian chil- ical disease prevention and health promotion dren. ‘‘(1) Hospice care. and treatment programs for Indian pre- ‘‘(2) Assisted living services. ‘‘(b) USE OF GRANT FUNDS.—A grant award- adolescent and adolescent youths. ed under this section may be used for pur- ‘‘(3) Long-term care services. ‘‘(b) USE OF FUNDS.— poses which may include, but are not limited ‘‘(4) Home- and community-based services. ‘‘(1) ALLOWABLE USES.—Funds made avail- to, the following: ‘‘(b) ELIGIBILITY.—The following individ- ‘‘(1) Developing health education materials able under this section may be used to— ‘‘(A) develop prevention and treatment uals shall be eligible to receive long-term both for regular school programs and aftercare under this section: school programs. programs for Indian youth which promote mental and physical health and incorporate ‘‘(1) Individuals who are unable to perform ‘‘(2) Training teachers in comprehensive a certain number of activities of daily living school health education materials. cultural values, community and family involvement, and traditional health care prac- without assistance. ‘‘(3) Integrating school-based, community- titioners; and ‘‘(2) Individuals with a mental impairment, based, and other public and private health such as dementia, Alzheimer’s disease, or an- promotion efforts. ‘‘(B) develop and provide community training and education. other disabling mental illness, who may be ‘‘(4) Encouraging healthy, tobacco-free able to perform activities of daily living school environments. ‘‘(2) PROHIBITED USE.—Funds made available under this section may not be used to under supervision. ‘‘(5) Coordinating school-based health pro- ‘‘(3) Such other individuals as an applica- grams with existing services and programs provide services described in section 707(c). available in the community. ‘‘(c) DUTIES OF THE SECRETARY.—The Sec- ble Indian Health Program determines to be appropriate. ‘‘(6) Developing school programs on nutri- retary shall— tion education, personal health, oral health, ‘‘(1) disseminate to Indian Tribes and Trib- ‘‘(c) DEFINITIONS.—For the purposes of this and fitness. al Organizations information regarding mod- section, the following definitions shall apply: ‘‘(7) Developing behavioral health wellness els for the delivery of comprehensive health ‘‘(1) The term ‘assisted living services’ programs. care services to Indian and Urban Indian means any service provided by an assisted adolescents; ‘‘(8) Developing chronic disease prevention living facility (as defined in section 232(b) of programs. ‘‘(2) encourage the implementation of such the National Housing Act (12 U.S.C. ‘‘(9) Developing substance abuse prevention models; and 1715w(b))), except that such an assisted living programs. ‘‘(3) at the request of an Indian Tribe or facility— ‘‘(10) Developing injury prevention and Tribal Organization, provide technical as- ‘‘(A) shall not be required to obtain a li- safety education programs. sistance in the implementation of such mod- cense; but els. ‘‘(11) Developing activities for the preven- ‘‘(B) shall meet all applicable standards for tion and control of communicable diseases. ‘‘(d) CRITERIA FOR REVIEW AND APPROVAL licensure. OF APPLICATIONS.—The Secretary, in con- ‘‘(12) Developing community and environ- ‘‘(2) The term ‘home- and community- sultation with Indian Tribes and Tribal Or- based services’ means 1 or more of the serv- mental health education programs that in- ganizations, and in conference with Urban clude traditional health care practitioners. ices specified in paragraphs (1) through (9) of Indian Organizations, shall establish criteria section 1929(a) of the Social Security Act (42 ‘‘(13) Violence prevention. for the review and approval of applications ‘‘(14) Such other health issues as are appro- or proposals under this section. U.S.C. 1396t(a)) (whether provided by the priate. Service or by an Indian Tribe or Tribal Orga- ‘‘SEC. 212. PREVENTION, CONTROL, AND ELIMI- nization pursuant to the Indian Self-Deter- ‘‘(c) TECHNICAL ASSISTANCE.—Upon request, NATION OF COMMUNICABLE AND IN- the Secretary, acting through the Service, FECTIOUS DISEASES. mination and Education Assistance Act (25 U.S.C. 450 et seq.)) that are or will be pro- shall provide technical assistance to Indian ‘‘(a) GRANTS AUTHORIZED.—The Secretary, Tribes and Tribal Organizations in the devel- acting through the Service, and after con- vided in accordance with applicable stand- opment of comprehensive health education sultation with the Centers for Disease Con- ards. plans and the dissemination of comprehen- trol and Prevention, may make grants avail- ‘‘(3) The term ‘hospice care’ means the sive health education materials and informa- able to Indian Tribes and Tribal Organiza- items and services specified in subpara- tion on existing health programs and re- tions for the following: graphs (A) through (H) of section 1861(dd)(1) sources. ‘‘(1) Projects for the prevention, control, of the Social Security Act (42 U.S.C. ‘‘(d) CRITERIA FOR REVIEW AND APPROVAL and elimination of communicable and infec- 1395x(dd)(1)), and such other services which OF APPLICATIONS.—The Secretary, acting tious diseases, including tuberculosis, hepa- an Indian Tribe or Tribal Organization deter- through the Service, and in consultation titis, HIV, respiratory syncytial virus, hanta mines are necessary and appropriate to pro- with Indian Tribes and Tribal Organizations, virus, sexually transmitted diseases, and H. vide in furtherance of this care. shall establish criteria for the review and ap- Pylori. ‘‘(4) The term ‘long-term care services’ has proval of applications for grants awarded ‘‘(2) Public information and education pro- the meaning given the term ‘qualified long- under this section. grams for the prevention, control, and elimi- term care services’ in section 7702B(c) of the ‘‘(e) DEVELOPMENT OF PROGRAM FOR BIA- nation of communicable and infectious dis- Internal Revenue Code of 1986. FUNDED SCHOOLS.— eases. ‘‘(d) AUTHORIZATION OF CONVENIENT CARE ‘‘(1) IN GENERAL.—The Secretary of the In- ‘‘(3) Education, training, and clinical skills SERVICES.—The Secretary, acting through terior, acting through the Bureau of Indian improvement activities in the prevention, the Service, Indian Tribes, and Tribal Orga- Affairs and in cooperation with the Sec- control, and elimination of communicable nizations, may also provide funding under retary, acting through the Service, and af- and infectious diseases for health profes- this Act to meet the objectives set forth in fected Indian Tribes and Tribal Organiza- sionals, including allied health professionals. section 3 of this Act for convenient care tions, shall develop a comprehensive school ‘‘(4) Demonstration projects for the screen- services programs pursuant to section health education program for children from ing, treatment, and prevention of hepatitis C 306(c)(2)(A). preschool through grade 12 in schools for virus (HCV). ‘‘SEC. 214. INDIAN WOMEN’S HEALTH CARE. which support is provided by the Bureau of ‘‘(b) APPLICATION REQUIRED.—The Sec- ‘‘The Secretary, acting through the Serv- Indian Affairs. retary may provide funding under subsection ice and Indian Tribes, Tribal Organizations, ‘‘(2) REQUIREMENTS FOR PROGRAMS.—Such (a) only if an application or proposal for and Urban Indian Organizations, shall mon- programs shall include— funding is submitted to the Secretary. itor and improve the quality of health care ‘‘(A) school programs on nutrition edu- ‘‘(c) COORDINATION WITH HEALTH AGEN- for Indian women of all ages through the cation, personal health, oral health, and fit- CIES.—Indian Tribes and Tribal Organiza- planning and delivery of programs adminis- ness; tions receiving funding under this section tered by the Service, in order to improve and ‘‘(B) behavioral health wellness programs; are encouraged to coordinate their activities enhance the treatment models of care for In- ‘‘(C) chronic disease prevention programs; with the Centers for Disease Control and dian women.

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‘‘SEC. 215. ENVIRONMENTAL AND NUCLEAR ‘‘(D) The Assistant Secretary for Occupa- ‘‘(b) REIMBURSEMENT CONTRACT.—The Sec- HEALTH HAZARDS. tional Safety and Health. retary shall enter into an agreement with ‘‘(a) STUDIES AND MONITORING.—The Sec- ‘‘(E) The Secretary of the Interior. the CRIHB to reimburse the CRIHB for costs retary and the Service shall conduct, in con- (including reasonable administrative costs) junction with other appropriate Federal ‘‘(F) The Secretary of Health and Human Services. incurred pursuant to this section, in pro- agencies and in consultation with concerned viding medical treatment under contract to Indian Tribes and Tribal Organizations, stud- ‘‘(G) The Director. California Indians described in section 806(a) ies and ongoing monitoring programs to de- ‘‘(2) DUTIES.—The Task Force shall— throughout the California contract health termine trends in the health hazards to In- ‘‘(A) identify existing and potential oper- services delivery area described in section dian miners and to Indians on or near res- ations related to nuclear resource develop- 218 with respect to high cost contract care ervations and Indian communities as a result ment or other environmental hazards that cases. of environmental hazards which may result affect or may affect the health of Indians on ‘‘(c) ADMINISTRATIVE EXPENSES.—Not more in chronic or life threatening health prob- or near a reservation or in an Indian commu- than 5 percent of the amounts provided to lems, such as nuclear resource development, nity; and the CRIHB under this section for any fiscal petroleum contamination, and contamina- ‘‘(B) enter into activities to correct exist- year may be for reimbursement for adminis- tion of water sources and of the food chain. ing health hazards and ensure that current trative expenses incurred by the CRIHB dur- Such studies shall include— and future health problems resulting from ing such fiscal year. ‘‘(1) an evaluation of the nature and extent nuclear resource or other development ac- ‘‘(d) LIMITATION ON PAYMENT.—No payment of health problems caused by environmental tivities are minimized or reduced. may be made for treatment provided here- hazards currently exhibited among Indians ‘‘(3) CHAIRMAN; MEETINGS.—The Secretary under to the extent payment may be made and the causes of such health problems; of Health and Human Services shall be the for such treatment under the Indian Cata- ‘‘(2) an analysis of the potential effect of Chairman of the Task Force. The Task Force strophic Health Emergency Fund described ongoing and future environmental resource shall meet at least twice each year. in section 202 or from amounts appropriated development on or near reservations and In- ‘‘(e) HEALTH SERVICES TO CERTAIN EMPLOY- or otherwise made available to the Cali- dian communities, including the cumulative EES.—In the case of any Indian who— fornia contract health service delivery area effect over time on health; ‘‘(1) as a result of employment in or near a for a fiscal year. ‘‘(3) an evaluation of the types and nature uranium mine or mill or near any other envi- ‘‘(e) ADVISORY BOARD.—There is estab- of activities, practices, and conditions caus- ronmental hazard, suffers from a work-re- lished an advisory board which shall advise ing or affecting such health problems, in- lated illness or condition; the CRIHB in carrying out this section. The cluding uranium mining and milling, ura- advisory board shall be composed of rep- nium mine tailing deposits, nuclear power ‘‘(2) is eligible to receive diagnosis and resentatives, selected by the CRIHB, from plant operation and construction, and nu- treatment services from an Indian Health not less than 8 Tribal Health Programs serv- clear waste disposal; oil and gas production Program; and ing California Indians covered under this ‘‘(3) by reason of such Indian’s employ- or transportation on or near reservations or section at least 1⁄2 of whom of whom are not Indian communities; and other development ment, is entitled to medical care at the ex- affiliated with the CRIHB. pense of such mine or mill operator or entity that could affect the health of Indians and ‘‘SEC. 218. CALIFORNIA AS A CONTRACT HEALTH their water supply and food chain; responsible for the environmental hazard, SERVICE DELIVERY AREA. ‘‘(4) a summary of any findings and rec- the Indian Health Program shall, at the re- ‘‘The State of California, excluding the ommendations provided in Federal and State quest of such Indian, render appropriate counties of Alameda, Contra Costa, Los An- studies, reports, investigations, and inspec- medical care to such Indian for such illness geles, Marin, Orange, Sacramento, San Fran- tions during the 5 years prior to the date of or condition and may be reimbursed for any cisco, San Mateo, Santa Clara, Kern, Merced, enactment of the Indian Health Care Im- medical care so rendered to which such In- Monterey, Napa, San Benito, San Joaquin, provement Act Amendments of 2008 that di- dian is entitled at the expense of such oper- San Luis Obispo, Santa Cruz, Solano, rectly or indirectly relate to the activities, ator or entity from such operator or entity. Stanislaus, and Ventura, shall be designated practices, and conditions affecting the Nothing in this subsection shall affect the as a contract health service delivery area by health or safety of such Indians; and rights of such Indian to recover damages the Service for the purpose of providing con- ‘‘(5) the efforts that have been made by other than such amounts paid to the Indian tract health services to California Indians. Federal and State agencies and resource and Health Program from the employer for pro- However, any of the counties listed herein economic development companies to effec- viding medical care for such illness or condi- may only be included in the contract health tively carry out an education program for tion. services delivery area if funding is specifi- such Indians regarding the health and safety ‘‘SEC. 216. ARIZONA AS A CONTRACT HEALTH cally provided by the Service for such serv- hazards of such development. SERVICE DELIVERY AREA. ices in those counties. ‘‘(b) HEALTH CARE PLANS.—Upon comple- ‘‘(a) IN GENERAL.—For fiscal years begin- ‘‘SEC. 219. CONTRACT HEALTH SERVICES FOR tion of such studies, the Secretary and the ning with the fiscal year ending September THE TRENTON SERVICE AREA. Service shall take into account the results of 30, 1983, and ending with the fiscal year end- ‘‘(a) AUTHORIZATION FOR SERVICES.—The such studies and develop health care plans to ing September 30, 2016, the State of Arizona Secretary, acting through the Service, is di- address the health problems studied under shall be designated as a contract health serv- rected to provide contract health services to subsection (a). The plans shall include— ice delivery area by the Service for the pur- members of the Turtle Mountain Band of pose of providing contract health care serv- ‘‘(1) methods for diagnosing and treating Chippewa Indians that reside in the Trenton ices to members of federally recognized In- Service Area of Divide, McKenzie, and Wil- Indians currently exhibiting such health dian Tribes of Arizona. problems; liams counties in the State of North Dakota ‘‘(b) MAINTENANCE OF SERVICES.—The Serv- and the adjoining counties of Richland, Roo- ‘‘(2) preventive care and testing for Indians ice shall not curtail any health care services who may be exposed to such health hazards, sevelt, and Sheridan in the State of Mon- provided to Indians residing on reservations tana. including the monitoring of the health of in- in the State of Arizona if such curtailment is dividuals who have or may have been ex- ‘‘(b) NO EXPANSION OF ELIGIBILITY.—Noth- due to the provision of contract services in ing in this section may be construed as exposed to excessive amounts of radiation or such State pursuant to the designation of affected by other activities that have had or panding the eligibility of members of the such State as a contract health service deliv- Turtle Mountain Band of Chippewa Indians could have a serious impact upon the health ery area pursuant to subsection (a). of such individuals; and for health services provided by the Service ‘‘(3) a program of education for Indians ‘‘SEC. 216A. NORTH DAKOTA AND SOUTH DAKOTA beyond the scope of eligibility for such AS A CONTRACT HEALTH SERVICE health services that applied on May 1, 1986. who, by reason of their work or geographic DELIVERY AREA. proximity to such nuclear or other develop- ‘‘SEC. 220. PROGRAMS OPERATED BY INDIAN ‘‘(a) IN GENERAL.—Beginning in fiscal year TRIBES AND TRIBAL ORGANIZA- ment activities, may experience health prob- 2003, the States of North Dakota and South lems. TIONS. Dakota shall be designated as a contract ‘‘The Service shall provide funds for health ‘‘(c) SUBMISSION OF REPORT AND PLAN TO health service delivery area by the Service care programs and facilities operated by CONGRESS.—The Secretary and the Service for the purpose of providing contract health Tribal Health Programs on the same basis as shall submit to Congress the study prepared care services to members of federally recog- such funds are provided to programs and fa- under subsection (a) no later than 18 months nized Indian Tribes of North Dakota and cilities operated directly by the Service. after the date of enactment of the Indian South Dakota. Health Care Improvement Act Amendments ‘‘SEC. 221. LICENSING. ‘‘(b) LIMITATION.—The Service shall not ‘‘Health care professionals employed by a of 2008. The health care plan prepared under curtail any health care services provided to subsection (b) shall be submitted in a report Tribal Health Program shall, if licensed in Indians residing on any reservation, or in any State, be exempt from the licensing reno later than 1 year after the study prepared any county that has a common boundary under subsection (a) is submitted to Con- quirements of the State in which the Tribal with any reservation, in the State of North Health Program performs the services de- gress. Such report shall include rec- Dakota or South Dakota if such curtailment ommended activities for the implementation scribed in its contract or compact under the is due to the provision of contract services in Indian Self-Determination and Education of the plan, as well as an evaluation of any such States pursuant to the designation of activities previously undertaken by the Assistance Act (25 U.S.C. 450 et seq.). such States as a contract health service de- ‘‘SEC. 222. NOTIFICATION OF PROVISION OF Service to address such health problems. livery area pursuant to subsection (a). ‘‘(d) INTERGOVERNMENTAL TASK FORCE.— EMERGENCY CONTRACT HEALTH ‘‘SEC. 217. CALIFORNIA CONTRACT HEALTH SERV- SERVICES. ‘‘(1) ESTABLISHMENT; MEMBERS.—There is ICES PROGRAM. ‘‘With respect to an elderly Indian or an established an Intergovernmental Task ‘‘(a) FUNDING AUTHORIZED.—The Secretary Indian with a disability receiving emergency Force to be composed of the following indi- is authorized to fund a program using the medical care or services from a non-Service viduals (or their designees): California Rural Indian Health Board (here- provider or in a non-Service facility under ‘‘(A) The Secretary of Energy. after in this section referred to as the the authority of this Act, the time limita- ‘‘(B) The Secretary of the Environmental ‘CRIHB’) as a contract care intermediary to tion (as a condition of payment) for noti- Protection Agency. improve the accessibility of health services fying the Service of such treatment or ad- ‘‘(C) The Director of the Bureau of Mines. to California Indians. mission shall be 30 days.

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‘‘SEC. 223. PROMPT ACTION ON PAYMENT OF ‘‘(b) CLOSURES AND REDUCTIONS IN HOURS ‘‘(i) was identified in the fiscal year 2008 CLAIMS. OF SERVICE.— Service budget justification as— ‘‘(a) DEADLINE FOR RESPONSE.—The Service ‘‘(1) EVALUATION REQUIRED.—Notwith- ‘‘(I) 1 of the 10 top-priority inpatient shall respond to a notification of a claim by standing any other provision of law, no facil- projects; a provider of a contract care service with ei- ity operated by the Service, or any portion ther an individual purchase order or a denial ‘‘(II) 1 of the 10 top-priority outpatient of such facility, may be closed or have the projects; of the claim within 5 working days after the hours of service of the facility reduced if the receipt of such notification. ‘‘(III) 1 of the 10 top-priority staff quarters Secretary has not submitted to Congress not developments; or ‘‘(b) EFFECT OF UNTIMELY RESPONSE.—If less than 1 year, and not more than 2 years, the Service fails to respond to a notification ‘‘(IV) 1 of the 10 top-priority Youth Re- before the date of the proposed closure or regional Treatment Centers; of a claim in accordance with subsection (a), duction in hours of service an evaluation, the Service shall accept as valid the claim completed not more than 2 years before the ‘‘(ii) had completed both Phase I and Phase submitted by the provider of a contract care II of the construction priority system in ef- service. submission, of the impact of the proposed closure or reduction in hours of service that fect on the date of enactment of such Act; or ‘‘(c) DEADLINE FOR PAYMENT OF VALID specifies, in addition to other consider- ‘‘(iii) is not included in clause (i) or (ii) and CLAIM.—The Service shall pay a valid con- ations— is selected, as determined by the Secretary— tract care service claim within 30 days after ‘‘(I) on the initiative of the Secretary; or the completion of the claim. ‘‘(A) the accessibility of alternative health care resources for the population served by ‘‘(II) pursuant to a request of an Indian ‘‘SEC. 224. LIABILITY FOR PAYMENT. such facility; Tribe or Tribal Organization. ‘‘(a) NO PATIENT LIABILITY.—A patient who ‘‘(2) REPORT; CONTENTS.— receives contract health care services that ‘‘(B) the cost-effectiveness of such closure are authorized by the Service shall not be or reduction in hours of service; ‘‘(A) INITIAL COMPREHENSIVE REPORT.— liable for the payment of any charges or ‘‘(C) the quality of health care to be pro- ‘‘(i) DEFINITIONS.—In this subparagraph: costs associated with the provision of such vided to the population served by such facil- ‘‘(I) FACILITIES APPROPRIATION ADVISORY services. ity after such closure or reduction in hours BOARD.—The term ‘Facilities Appropriation ‘‘(b) NOTIFICATION.—The Secretary shall of service; Advisory Board’ means the advisory board, notify a contract care provider and any pa- ‘‘(D) the availability of contract health comprised of 12 members representing Indian tient who receives contract health care serv- care funds to maintain existing levels of tribes and 2 members representing the Serv- ices authorized by the Service that such pa- service; ice, established at the discretion of the Di- tient is not liable for the payment of any ‘‘(E) the views of the Indian Tribes served rector— charges or costs associated with the provi- by such facility concerning such closure or ‘‘(aa) to provide advice and recommenda- sion of such services not later than 5 busi- reduction in hours of service; tions for policies and procedures of the pro- ness days after receipt of a notification of a ‘‘(F) the level of use of such facility by all grams funded pursuant to facilities appro- claim by a provider of contract care services. eligible Indians; and priations; and ‘‘(c) NO RECOURSE.—Following receipt of ‘‘(G) the distance between such facility and ‘‘(bb) to address other facilities issues. the notice provided under subsection (b), or, the nearest operating Service hospital. ‘‘(II) FACILITIES NEEDS ASSESSMENT if a claim has been deemed accepted under WORKGROUP.—The term ‘Facilities Needs As- section 223(b), the provider shall have no fur- ‘‘(2) EXCEPTION FOR CERTAIN TEMPORARY CLOSURES AND REDUCTIONS.—Paragraph (1) sessment Workgroup’ means the workgroup ther recourse against the patient who re- established at the discretion of the Direc- ceived the services. shall not apply to any temporary closure or reduction in hours of service of a facility or tor— ‘‘SEC. 225. OFFICE OF INDIAN MEN’S HEALTH. any portion of a facility if such closure or re- ‘‘(aa) to review the health care facilities ‘‘(a) ESTABLISHMENT.—The Secretary may duction in hours of service is necessary for construction priority system; and establish within the Service an office to be medical, environmental, or construction ‘‘(bb) to make recommendations to the Fa- known as the ‘Office of Indian Men’s Health’ cilities Appropriation Advisory Board for re- (referred to in this section as the ‘Office’). safety reasons. ‘‘(c) HEALTH CARE FACILITY PRIORITY SYS- vising the priority system. ‘‘(b) DIRECTOR.— TEM.— ‘‘(ii) INITIAL REPORT.— ‘‘(1) IN GENERAL.—The Office shall be head- ‘‘(I) IN GENERAL.—Not later than 1 year ed by a director, to be appointed by the Sec- ‘‘(1) IN GENERAL.— ‘‘(A) PRIORITY SYSTEM.—The Secretary, after the date of enactment of the Indian retary. Health Care Improvement Act Amendments ‘‘(2) DUTIES.—The director shall coordinate acting through the Service, shall maintain a health care facility priority system, which— of 2008, the Secretary shall submit to the and promote the status of the health of In- Committee on Indian Affairs of the Senate dian men in the United States. ‘‘(i) shall be developed in consultation with Indian Tribes and Tribal Organizations; and the Committee on Natural Resources of ‘‘(c) REPORT.—Not later than 2 years after the House of Representatives a report that the date of enactment of the Indian Health ‘‘(ii) shall give Indian Tribes’ needs the describes the comprehensive, national, Care Improvement Act Amendments of 2008, highest priority; ranked list of all health care facilities needs the Secretary, acting through the director of ‘‘(iii)(I) may include the lists required in for the Service, Indian Tribes, and Tribal Or- the Office, shall submit to Congress a report paragraph (2)(B)(ii); and ganizations (including inpatient health care describing— ‘‘(II) shall include the methodology re- facilities, outpatient health care facilities, ‘‘(1) any activity carried out by the direc- quired in paragraph (2)(B)(v); and specialized health care facilities (such as for tor as of the date on which the report is pre- ‘‘(III) may include such health care facili- long-term care and alcohol and drug abuse pared; and ties, and such renovation or expansion needs treatment), wellness centers, and staff quar- ‘‘(2) any finding of the director with re- of any health care facility, as the Service ters, and the renovation and expansion spect to the health of Indian men. may identify; and needs, if any, of such facilities) developed by ‘‘SEC. 226. AUTHORIZATION OF APPROPRIATIONS. ‘‘(iv) shall provide an opportunity for the the Service, Indian Tribes, and Tribal Orga- ‘‘There are authorized to be appropriated nomination of planning, design, and con- nizations for the Facilities Needs Assess- such sums as may be necessary for each fis- struction projects by the Service, Indian ment Workgroup and the Facilities Appro- cal year through fiscal year 2017 to carry out Tribes, and Tribal Organizations for consid- priation Advisory Board. this title. eration under the priority system at least ‘‘(II) INCLUSIONS.—The initial report shall ‘‘TITLE III—FACILITIES once every 3 years, or more frequently as the include— Secretary determines to be appropriate. ‘‘SEC. 301. CONSULTATION; CONSTRUCTION AND ‘‘(aa) the methodology and criteria used by RENOVATION OF FACILITIES; RE- ‘‘(B) NEEDS OF FACILITIES UNDER ISDEAA the Service in determining the needs and es- PORTS. AGREEMENTS.—The Secretary shall ensure tablishing the ranking of the facilities needs; ‘‘(a) PREREQUISITES FOR EXPENDITURE OF that the planning, design, construction, ren- and FUNDS.—Prior to the expenditure of, or the ovation, and expansion needs of Service and ‘‘(bb) such other information as the Sec- making of any binding commitment to ex- non-Service facilities operated under con- retary determines to be appropriate. pend, any funds appropriated for the plan- tracts or compacts in accordance with the ‘‘(iii) UPDATES OF REPORT.—Beginning in ning, design, construction, or renovation of Indian Self-Determination and Education calendar year 2011, the Secretary shall— facilities pursuant to the Act of November 2, Assistance Act (25 U.S.C. 450 et seq.) are ‘‘(I) update the report under clause (ii) not 1921 (25 U.S.C. 13) (commonly known as the fully and equitably integrated into the less frequently that once every 5 years; and ‘Snyder Act’), the Secretary, acting through health care facility priority system. the Service, shall— ‘‘(II) include the updated report in the ap- ‘‘(C) CRITERIA FOR EVALUATING NEEDS.—For propriate annual report under subparagraph ‘‘(1) consult with any Indian Tribe that purposes of this subsection, the Secretary, in (B) for submission to Congress under section would be significantly affected by such ex- evaluating the needs of facilities operated 801. penditure for the purpose of determining under a contract or compact under the In- and, whenever practicable, honoring tribal dian Self-Determination and Education As- ‘‘(B) ANNUAL REPORTS.—The Secretary preferences concerning size, location, type, sistance Act (25 U.S.C. 450 et seq.), shall use shall submit to the President, for inclusion and other characteristics of any facility on the criteria used by the Secretary in evalu- in the report required to be transmitted to which such expenditure is to be made; and ating the needs of facilities operated directly Congress under section 801, a report which sets forth the following: ‘‘(2) ensure, whenever practicable and ap- by the Service. ‘‘(i) A description of the health care facil- plicable, that such facility meets the con- ‘‘(D) PRIORITY OF CERTAIN PROJECTS PRO- ity priority system of the Service estab- struction standards of any accrediting body TECTED.—The priority of any project estab- recognized by the Secretary for the purposes lished under the construction priority sys- lished under paragraph (1). of the Medicare, Medicaid, and SCHIP pro- tem in effect on the date of enactment of the ‘‘(ii) Health care facilities lists, which may grams under titles XVIII, XIX, and XXI of Indian Health Care Improvement Act include— the Social Security Act by not later than 1 Amendments of 2008 shall not be affected by ‘‘(I) the 10 top-priority inpatient health year after the date on which the construc- any change in the construction priority sys- care facilities; tion or renovation of such facility is com- tem taking place after that date if the ‘‘(II) the 10 top-priority outpatient health pleted. project— care facilities;

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00073 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1290 CONGRESSIONAL RECORD — SENATE February 27, 2008 ‘‘(III) the 10 top-priority specialized health ‘‘(4) Many Indian homes and Indian com- ‘‘(7) all Federal agencies are authorized to care facilities (such as long-term care and al- munities still lack sanitation facilities. transfer to the Secretary funds identified, cohol and drug abuse treatment); and ‘‘(5) It is in the interest of the United granted, loaned, or appropriated whereby the ‘‘(IV) the 10 top-priority staff quarters de- States, and it is the policy of the United Department’s applicable policies, rules, and velopments associated with health care fa- States, that all Indian communities and In- regulations shall apply in the implementa- cilities. dian homes, new and existing, be provided tion of such projects; ‘‘(iii) The justification for such order of with sanitation facilities. ‘‘(8) the Secretary of Health and Human priority. ‘‘(b) FACILITIES AND SERVICES.—In further- Services shall enter into interagency agree- ‘‘(iv) The projected cost of such projects. ance of the findings made in subsection (a), ments with Federal and State agencies for ‘‘(v) The methodology adopted by the Serv- Congress reaffirms the primary responsi- the purpose of providing financial assistance ice in establishing priorities under its health bility and authority of the Service to provide for sanitation facilities and services under care facility priority system. the necessary sanitation facilities and serv- this Act; ices as provided in section 7 of the Act of Au- ‘‘(9) the Secretary of Health and Human ‘‘(3) REQUIREMENTS FOR PREPARATION OF RE- gust 5, 1954 (42 U.S.C. 2004a). Under such au- Services shall, by regulation, establish PORTS.—In preparing the report required under paragraph (2), the Secretary shall— thority, the Secretary, acting through the standards applicable to the planning, design, Service, is authorized to provide the fol- and construction of sanitation facilities ‘‘(A) consult with and obtain information lowing: funded under this Act; and on all health care facilities needs from In- dian Tribes and Tribal Organizations; and ‘‘(1) Financial and technical assistance to ‘‘(10) the Secretary of Health and Human Indian Tribes, Tribal Organizations, and In- Services is authorized to accept payments ‘‘(B) review the total unmet needs of all In- dian communities in the establishment, for goods and services furnished by the Serv- dian Tribes and Tribal Organizations for training, and equipping of utility organiza- ice from appropriate public authorities, non- health care facilities (including staff quar- tions to operate and maintain sanitation fa- profit organizations or agencies, or Indian ters), including needs for renovation and ex- cilities, including the provision of existing Tribes, as contributions by that authority, pansion of existing facilities. plans, standard details, and specifications organization, agency, or tribe to agreements ‘‘(d) REVIEW OF METHODOLOGY USED FOR available in the Department, to be used at made under section 7 of the Act of August 5, HEALTH FACILITIES CONSTRUCTION PRIORITY the option of the Indian Tribe, Tribal Orga- 1954 (42 U.S.C. 2004a), and such payments SYSTEM.— nization, or Indian community. shall be credited to the same or subsequent ‘‘(1) IN GENERAL.—Not later than 1 year ‘‘(2) Ongoing technical assistance and appropriation account as funds appropriated after the establishment of the priority sys- training to Indian Tribes, Tribal Organiza- under the authority of section 7 of the Act of tem under subsection (c)(1)(A), the Comp- tions, and Indian communities in the man- August 5, 1954 (42 U.S.C. 2004a). troller General of the United States shall agement of utility organizations which oper- ‘‘(d) CERTAIN CAPABILITIES NOT PRE- prepare and finalize a report reviewing the ate and maintain sanitation facilities. REQUISITE.—The financial and technical ca- methodologies applied, and the processes fol- ‘‘(3) Priority funding for operation and pability of an Indian Tribe, Tribal Organiza- lowed, by the Service in making each assess- maintenance assistance for, and emergency tion, or Indian community to safely operate, ment of needs for the list under subsection repairs to, sanitation facilities operated by manage, and maintain a sanitation facility (c)(2)(A)(ii) and developing the priority sys- an Indian Tribe, Tribal Organization or In- shall not be a prerequisite to the provision tem under subsection (c)(1), including a re- dian community when necessary to avoid an or construction of sanitation facilities by view of— imminent health threat or to protect the in- the Secretary. ‘‘(A) the recommendations of the Facilities vestment in sanitation facilities and the in- ‘‘(e) FINANCIAL ASSISTANCE.—The Sec- Appropriation Advisory Board and the Fa- vestment in the health benefits gained retary is authorized to provide financial as- cilities Needs Assessment Workgroup (as through the provision of sanitation facili- sistance to Indian Tribes, Tribal Organiza- those terms are defined in subsection ties. tions, and Indian communities for operation, (c)(2)(A)(i)); and ‘‘(c) FUNDING.—Notwithstanding any other management, and maintenance of their sani- ‘‘(B) the relevant criteria used in ranking provision of law— tation facilities. or prioritizing facilities other than hospitals ‘‘(1) the Secretary of Housing and Urban ‘‘(f) OPERATION, MANAGEMENT, AND MAINTE- or clinics. Development is authorized to transfer funds NANCE OF FACILITIES.—The Indian Tribe has ‘‘(2) SUBMISSION TO CONGRESS.—The Comp- appropriated under the Native American the primary responsibility to establish, col- troller General of the United States shall Housing Assistance and Self-Determination lect, and use reasonable user fees, or other- submit the report under paragraph (1) to— Act of 1996 (25 U.S.C. 4101 et seq.) to the Sec- wise set aside funding, for the purpose of op- ‘‘(A) the Committees on Indian Affairs and retary of Health and Human Services; erating, managing, and maintaining sanita- Appropriations of the Senate; ‘‘(2) the Secretary of Health and Human tion facilities. If a sanitation facility serving ‘‘(B) the Committees on Natural Resources Services is authorized to accept and use such a community that is operated by an Indian and Appropriations of the House of Rep- funds for the purpose of providing sanitation Tribe or Tribal Organization is threatened resentatives; and facilities and services for Indians under sec- with imminent failure and such operator ‘‘(C) the Secretary. tion 7 of the Act of August 5, 1954 (42 U.S.C. lacks capacity to maintain the integrity or ‘‘(e) FUNDING CONDITION.—All funds appro- 2004a); the health benefits of the sanitation facility, priated under the Act of November 2, 1921 (25 ‘‘(3) unless specifically authorized when then the Secretary is authorized to assist U.S.C. 13) (commonly known as the ‘Snyder funds are appropriated, the Secretary shall the Indian Tribe, Tribal Organization, or In- Act’), for the planning, design, construction, not use funds appropriated under section 7 of dian community in the resolution of the or renovation of health facilities for the ben- the Act of August 5, 1954 (42 U.S.C. 2004a), to problem on a short-term basis through co- efit of 1 or more Indian Tribes shall be sub- provide sanitation facilities to new homes operation with the emergency coordinator or ject to the provisions of section 102 of the In- constructed using funds provided by the De- by providing operation, management, and dian Self-Determination and Education As- partment of Housing and Urban Develop- maintenance service. sistance Act (25 U.S.C. 450f) or sections 504 ment; ‘‘(g) ISDEAA PROGRAM FUNDED ON EQUAL and 505 of that Act (25 U.S.C. 458aaa–3, ‘‘(4) the Secretary of Health and Human BASIS.—Tribal Health Programs shall be eli- 458aaa–4). Services is authorized to accept from any gible (on an equal basis with programs that ‘‘(f) DEVELOPMENT OF INNOVATIVE AP- source, including Federal and State agen- are administered directly by the Service) PROACHES.—The Secretary shall consult and cies, funds for the purpose of providing sani- for— cooperate with Indian Tribes and Tribal Or- tation facilities and services and place these ‘‘(1) any funds appropriated pursuant to ganizations, and confer with Urban Indian funds into contracts or compacts under the this section; and Organizations, in developing innovative ap- Indian Self-Determination and Education ‘‘(2) any funds appropriated for the purpose proaches to address all or part of the total Assistance Act (25 U.S.C. 450 et seq.); of providing sanitation facilities. unmet need for construction of health facili- ‘‘(5) the Secretary is authorized to estab- ‘‘(h) REPORT.— ties, that may include— lish a program under which the Secretary ‘‘(1) REQUIRED CONTENTS.—The Secretary, ‘‘(1) the establishment of an area distribu- may, in accordance with this subsection and in consultation with the Secretary of Hous- tion fund in which a portion of health facil- with paragraphs (2), (3), (4), and (5) of section ing and Urban Development, Indian Tribes, ity construction funding could be devoted to 330(d) of the Public Health Service Act (42 Tribal Organizations, and tribally designated all Service Areas; U.S.C. 254b(d)) related to a loan guarantee housing entities (as defined in section 4 of ‘‘(2) approaches provided for in other provi- program, guarantee the principal and inter- the Native American Housing Assistance and sions of this title; and est on loans made by lenders to Indian Self-Determination Act of 1996 (25 U.S.C. ‘‘(3) other approaches, as the Secretary de- Tribes for new projects to construct eligible 4103)) shall submit to the President, for in- termines to be appropriate. sanitation facilities to serve Indian homes, clusion in the report required to be trans- but only to the extent that appropriations ‘‘SEC. 302. SANITATION FACILITIES. mitted to Congress under section 801, a re- are provided in advance specifically for such port which sets forth— ‘‘(a) FINDINGS.—Congress finds the fol- program, and without reducing funds made lowing: available for the provision of domestic and ‘‘(A) the current Indian sanitation facility ‘‘(1) The provision of sanitation facilities is community sanitation facilities for Indians, priority system of the Service; primarily a health consideration and func- as authorized by section 7 of the Act of Au- ‘‘(B) the methodology for determining tion. gust 5, 1954 (42 U.S.C. 2004a), the Indian Self- sanitation deficiencies and needs; ‘‘(2) Indian people suffer an inordinately Determination and Education Assistance Act ‘‘(C) the criteria on which the deficiencies high incidence of disease, injury, and illness (25 U.S.C. 450 et seq.), and this Act; and needs will be evaluated; directly attributable to the absence or inad- ‘‘(6) except as otherwise prohibited by this ‘‘(D) the level of initial and final sanita- equacy of sanitation facilities. section, the Secretary may use funds appro- tion deficiency for each type of sanitation ‘‘(3) The long-term cost to the United priated under the authority of section 7 of facility for each project of each Indian Tribe States of treating and curing such disease, the Act of August 5, 1954 (42 U.S.C. 2004a) to or Indian community; injury, and illness is substantially greater meet matching or cost participation require- ‘‘(E) the amount and most effective use of than the short-term cost of providing sanita- ments under other Federal and non-Federal funds, derived from whatever source, nec- tion facilities and other preventive health programs for new projects to construct eligi- essary to accommodate the sanitation facili- measures. ble sanitation facilities; ties needs of new homes assisted with funds

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00074 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1291 under the Native American Housing Assist- the Service, may utilize the negotiating au- applicable regulations prescribed by the Sec- ance and Self-Determination Act (25 U.S.C. thority of section 23 of the Act of June 25, retary with respect to construction or ren- 4101 et seq.), and to reduce the identified 1910 (25 U.S.C. 47), to give preference to any ovation of Service facilities. sanitation deficiency levels of all Indian Indian or any enterprise, partnership, cor- ‘‘(d) ADDITIONAL REQUIREMENT FOR EXPAN- Tribes and Indian communities to level I poration, or other type of business organiza- SION.—In addition to the requirements under sanitation deficiency as defined in paragraph tion owned and controlled by an Indian or subsection (c), for any expansion, the Indian (3)(A); and Indians including former or currently feder- Tribe or Tribal Organization shall provide to ‘‘(F) a 10-year plan to provide sanitation ally recognized Indian Tribes in the State of the Secretary additional information pursu- facilities to serve existing Indian homes and New York (hereinafter referred to as an ‘In- ant to regulations, including additional Indian communities and new and renovated dian firm’) in the construction and renova- staffing, equipment, and other costs associ- Indian homes. tion of Service facilities pursuant to section ated with the expansion. ‘‘(2) UNIFORM METHODOLOGY.—The method- 301 and in the construction of safe water and ‘‘(e) CLOSURE OR CONVERSION OF FACILI- ology used by the Secretary in determining, sanitary waste disposal facilities pursuant to TIES.—If any Service facility which has been preparing cost estimates for, and reporting section 302. Such preference may be accorded expanded, renovated, or modernized by an In- sanitation deficiencies for purposes of para- by the Secretary unless the Secretary finds, dian Tribe or Tribal Organization under this graph (1) shall be applied uniformly to all In- pursuant to rules and regulations promul- section ceases to be used as a Service facility dian Tribes and Indian communities. gated by the Secretary, that the project or during the 20-year period beginning on the function to be contracted for will not be sat- ‘‘(3) SANITATION DEFICIENCY LEVELS.—For date such expansion, renovation, or mod- purposes of this subsection, the sanitation isfactory or that the project or function can- ernization is completed, such Indian Tribe or deficiency levels for an individual, Indian not be properly completed or maintained Tribal Organization shall be entitled to re- Tribe, or Indian community sanitation facil- under the proposed contract. The Secretary, cover from the United States an amount ity to serve Indian homes are determined as in arriving at such a finding, shall consider which bears the same ratio to the value of follows: whether the Indian or Indian firm will be de- such facility at the time of such cessation as ficient with respect to— ‘‘(A) A level I deficiency exists if a sanita- the value of such expansion, renovation, or tion facility serving an individual, Indian ‘‘(1) ownership and control by Indians; modernization (less the total amount of any Tribe, or Indian community— ‘‘(2) equipment; funds provided specifically for such facility ‘‘(i) complies with all applicable water sup- ‘‘(3) bookkeeping and accounting proce- under any Federal program that were ex- ply, pollution control, and solid waste dis- dures; pended for such expansion, renovation, or posal laws; and ‘‘(4) substantive knowledge of the project modernization) bore to the value of such fa- or function to be contracted for; cility at the time of the completion of such ‘‘(ii) deficiencies relate to routine replace- expansion, renovation, or modernization. ment, repair, or maintenance needs. ‘‘(5) adequately trained personnel; or ‘‘SEC. 305. FUNDING FOR THE CONSTRUCTION, ‘‘(B) A level II deficiency exists if a sanita- ‘‘(6) other necessary components of con- EXPANSION, AND MODERNIZATION tion facility serving an individual, Indian tract performance. OF SMALL AMBULATORY CARE FA- Tribe, or Indian community substantially or ‘‘(b) PAY RATES.—For the purpose of imple- CILITIES. recently complied with all applicable water menting the provisions of this title, the Sec- ‘‘(a) GRANTS.— supply, pollution control, and solid waste retary shall assure that the rates of pay for ‘‘(1) IN GENERAL.—The Secretary, acting laws and any deficiencies relate to— personnel engaged in the construction or through the Service, shall make grants to ‘‘(i) small or minor capital improvements renovation of facilities constructed or ren- Indian Tribes and Tribal Organizations for needed to bring the facility back into com- ovated in whole or in part by funds made the construction, expansion, or moderniza- pliance; available pursuant to this title are not less tion of facilities for the provision of ambula- ‘‘(ii) capital improvements that are nec- than the prevailing local wage rates for simi- tory care services to eligible Indians (and essary to enlarge or improve the facilities in lar work as determined in accordance with noneligible persons pursuant to subsections order to meet the current needs for domestic sections 3141 through 3144, 3146, and 3147 of (b)(2) and (c)(1)(C)). A grant made under this sanitation facilities; or title 40, United States Code. section may cover up to 100 percent of the ‘‘(iii) the lack of equipment or training by ‘‘SEC. 304. EXPENDITURE OF NON-SERVICE costs of such construction, expansion, or an Indian Tribe, Tribal Organization, or an FUNDS FOR RENOVATION. modernization. For the purposes of this sec- Indian community to properly operate and ‘‘(a) IN GENERAL.—Notwithstanding any tion, the term ‘construction’ includes the re- maintain the sanitation facilities. other provision of law, if the requirements of placement of an existing facility. ‘‘(C) A level III deficiency exists if a sani- subsection (c) are met, the Secretary, acting ‘‘(2) GRANT AGREEMENT REQUIRED.—A grant tation facility serving an individual, Indian through the Service, is authorized to accept under paragraph (1) may only be made avail- Tribe or Indian community meets 1 or more any major expansion, renovation, or mod- able to a Tribal Health Program operating of the following conditions— ernization by any Indian Tribe or Tribal Or- an Indian health facility (other than a facil- ganization of any Service facility or of any ity owned or constructed by the Service, in- ‘‘(i) water or sewer service in the home is other Indian health facility operated pursu- provided by a haul system with holding cluding a facility originally owned or con- ant to a contract or compact under the In- structed by the Service and transferred to an tanks and interior plumbing; dian Self-Determination and Education As- ‘‘(ii) major significant interruptions to Indian Tribe or Tribal Organization). sistance Act (25 U.S.C. 450 et seq.), includ- ‘‘(b) USE OF GRANT FUNDS.— water supply or sewage disposal occur fre- ing— quently, requiring major capital improve- ‘‘(1) ALLOWABLE USES.—A grant awarded ‘‘(1) any plans or designs for such expan- under this section may be used for the con- ments to correct the deficiencies; or sion, renovation, or modernization; and ‘‘(iii) there is no access to or no approved struction, expansion, or modernization (in- ‘‘(2) any expansion, renovation, or mod- cluding the planning and design of such con- or permitted solid waste facility available. ernization for which funds appropriated ‘‘(D) A level IV deficiency exists— struction, expansion, or modernization) of an under any Federal law were lawfully ex- ambulatory care facility— ‘‘(i) if a sanitation facility for an indi- pended. ‘‘(A) located apart from a hospital; vidual home, an Indian Tribe, or an Indian ‘‘(b) PRIORITY LIST.— community exists but— ‘‘(B) not funded under section 301 or sec- ‘‘(1) IN GENERAL.—The Secretary shall tion 306; and ‘‘(I) lacks— maintain a separate priority list to address ‘‘(aa) a safe water supply system; or ‘‘(C) which, upon completion of such con- the needs for increased operating expenses, struction or modernization will— ‘‘(bb) a waste disposal system; personnel, or equipment for such facilities. The methodology for establishing priorities ‘‘(i) have a total capacity appropriate to ‘‘(II) contains no piped water or sewer fa- its projected service population; cilities; or shall be developed through regulations. The list of priority facilities will be revised annu- ‘‘(ii) provide annually no fewer than 150 pa- ‘‘(III) has become inoperable due to a tient visits by eligible Indians and other major component failure; or ally in consultation with Indian Tribes and Tribal Organizations. users who are eligible for services in such fa- ‘‘(ii) if only a washeteria or central facility cility in accordance with section 807(c)(2); ‘‘(2) REPORT.—The Secretary shall submit exists in the community. and ‘‘(E) A level V deficiency exists in the ab- to the President, for inclusion in the report required to be transmitted to Congress under ‘‘(iii) provide ambulatory care in a Service sence of a sanitation facility, where indi- Area (specified in the contract or compact vidual homes do not have access to safe section 801, the priority list maintained pursuant to paragraph (1). under the Indian Self-Determination and drinking water or adequate wastewater (in- Education Assistance Act (25 U.S.C. 450 et cluding sewage) disposal. ‘‘(c) REQUIREMENTS.—The requirements of this subsection are met with respect to any seq.)) with a population of no fewer than ‘‘(i) DEFINITIONS.—For purposes of this sec- expansion, renovation, or modernization if— 1,500 eligible Indians and other users who are tion, the following terms apply: eligible for services in such facility in ac- ‘‘(1) the Indian Tribe or Tribal Organiza- ‘‘(1) INDIAN COMMUNITY.—The term ‘Indian cordance with section 807(c)(2). tion— community’ means a geographic area, a sig- ‘‘(2) ADDITIONAL ALLOWABLE USE.—The Sec- nificant proportion of whose inhabitants are ‘‘(A) provides notice to the Secretary of its retary may also reserve a portion of the Indians and which is served by or capable of intent to expand, renovate, or modernize; funding provided under this section and use being served by a facility described in this and those reserved funds to reduce an out- section. ‘‘(B) applies to the Secretary to be placed standing debt incurred by Indian Tribes or ‘‘(2) SANITATION FACILITIES.—The terms on a separate priority list to address the Tribal Organizations for the construction, ‘sanitation facility’ and ‘sanitation facili- needs of such new facilities for increased op- expansion, or modernization of an ambula- ties’ mean safe and adequate water supply erating expenses, personnel, or equipment; tory care facility that meets the require- systems, sanitary sewage disposal systems, and ments under paragraph (1). The provisions of and sanitary solid waste systems (and all re- ‘‘(2) the expansion, renovation, or mod- this section shall apply, except that such ap- lated equipment and support infrastructure). ernization— plications for funding under this paragraph ‘‘SEC. 303. PREFERENCE TO INDIANS AND INDIAN ‘‘(A) is approved by the appropriate area shall be considered separately from applica- FIRMS. Director for Federal facilities; and tions for funding under paragraph (1). ‘‘(a) DISCRETIONARY AUTHORITY; COVERED ‘‘(B) is administered by the Indian Tribe or ‘‘(3) USE ONLY FOR CERTAIN PORTION OF ACTIVITIES.—The Secretary, acting through Tribal Organization in accordance with any COSTS.—A grant provided under this section

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00075 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1292 CONGRESSIONAL RECORD — SENATE February 27, 2008 may be used only for the cost of that portion ‘‘(6) permit the use of Service funds to included, subject to the terms of that sec- of a construction, expansion, or moderniza- match other funds, including Federal funds. tion, in any demonstration project approved tion project that benefits the Service popu- ‘‘(c) HEALTH CARE DEMONSTRATION pursuant to this section. lation identified above in subsection (b)(1)(C) PROJECTS.— ‘‘(g) EQUITABLE TREATMENT.—For purposes (ii) and (iii). The requirements of clauses (ii) ‘‘(1) GENERAL PROJECTS.— of subsection (c), the Secretary, in evalu- and (iii) of paragraph (1)(C) shall not apply ‘‘(A) CRITERIA.—The Secretary may ap- ating facilities operated under any contract to an Indian Tribe or Tribal Organization approve under this section demonstration or compact under the Indian Self-Determina- plying for a grant under this section for a projects that meet the following criteria: tion and Education Assistance Act (25 U.S.C. health care facility located or to be con- ‘‘(i) There is a need for a new facility or 450 et seq.), shall use the same criteria that structed on an island or when such facility is program, such as a program for convenient the Secretary uses in evaluating facilities not located on a road system providing di- care services, or the reorientation of an ex- operated directly by the Service. rect access to an inpatient hospital where isting facility or program. ‘‘(h) EQUITABLE INTEGRATION OF FACILI- care is available to the Service population. ‘‘(ii) A significant number of Indians, in- TIES.—The Secretary shall ensure that the ‘‘(c) GRANTS.— cluding Indians with low health status, will planning, design, construction, renovation, ‘‘(1) APPLICATION.—No grant may be made be served by the project. and expansion needs of Service and non-Serv- under this section unless an application or ‘‘(iii) The project has the potential to de- ice facilities that are the subject of a con- proposal for the grant has been approved by liver services in an efficient and effective tract or compact under the Indian Self-De- the Secretary in accordance with applicable manner. termination and Education Assistance Act regulations and has set forth reasonable as- (25 U.S.C. 450 et seq.) for health services are surance by the applicant that, at all times ‘‘(iv) The project is economically viable. fully and equitably integrated into the im- after the construction, expansion, or mod- ‘‘(v) For projects carried out by an Indian plementation of the health care delivery ernization of a facility carried out using a Tribe or Tribal Organization, the Indian demonstration projects under this section. Tribe or Tribal Organization has the admin- grant received under this section— ‘‘SEC. 307. LAND TRANSFER. ‘‘(A) adequate financial support will be istrative and financial capability to administer the project. ‘‘Notwithstanding any other provision of available for the provision of services at such law, the Bureau of Indian Affairs and all facility; ‘‘(vi) The project is integrated with pro- other agencies and departments of the ‘‘(B) such facility will be available to eligi- viders of related health and social services United States are authorized to transfer, at ble Indians without regard to ability to pay and is coordinated with, and avoids duplica- no cost, land and improvements to the Serv- or source of payment; and tion of, existing services in order to expand ice for the provision of health care services. the availability of services. ‘‘(C) such facility will, as feasible without The Secretary is authorized to accept such diminishing the quality or quantity of serv- ‘‘(B) PRIORITY.—In approving demonstra- land and improvements for such purposes. tion projects under this paragraph, the Sec- ices provided to eligible Indians, serve non- ‘‘SEC. 308. LEASES, CONTRACTS, AND OTHER eligible persons on a cost basis. retary shall give priority to demonstration AGREEMENTS. projects, to the extent the projects meet the ‘‘(2) PRIORITY.—In awarding grants under criteria described in subparagraph (A), lo- ‘‘The Secretary, acting through the Serv- this section, the Secretary shall give pri- cated in any of the following Service Units: ice, may enter into leases, contracts, and ority to Indian Tribes and Tribal Organiza- other agreements with Indian Tribes and tions that demonstrate— ‘‘(i) Cass Lake, Minnesota. Tribal Organizations which hold (1) title to, ‘‘(A) a need for increased ambulatory care ‘‘(ii) Mescalero, New Mexico. (2) a leasehold interest in, or (3) a beneficial services; and ‘‘(iii) Owyhee, Nevada. interest in (when title is held by the United ‘‘(B) insufficient capacity to deliver such ‘‘(iv) Schurz, Nevada. States in trust for the benefit of an Indian services. ‘‘(v) Ft. Yuma, California. Tribe) facilities used or to be used for the administration and delivery of health services ‘‘(3) PEER REVIEW PANELS.—The Secretary ‘‘(2) CONVENIENT CARE SERVICE PROJECTS.— by an Indian Health Program. Such leases, may provide for the establishment of peer re- ‘‘(A) DEFINITION OF CONVENIENT CARE SERV- contracts, or agreements may include provi- view panels, as necessary, to review and ICE.—In this paragraph, the term ‘convenient evaluate applications and proposals and to care service’ means any primary health care sions for construction or renovation and pro- advise the Secretary regarding such applica- service, such as urgent care services, non- vide for compensation to the Indian Tribe or tions using the criteria developed pursuant emergent care services, prevention services Tribal Organization of rental and other costs to subsection (a)(1). and screenings, and any service authorized consistent with section 105(l) of the Indian by sections 203 or 213(d), that is— Self-Determination and Education Assist- ‘‘(d) REVERSION OF FACILITIES.—If any fa- ance Act (25 U.S.C. 450j(l)) and regulations cility (or portion thereof) with respect to ‘‘(i) provided outside the regular hours of thereunder. which funds have been paid under this sec- operation of a health care facility; or tion, ceases, at any time after completion of ‘‘SEC. 309. STUDY ON LOANS, LOAN GUARANTEES, ‘‘(ii) offered at an alternative setting, in- AND LOAN REPAYMENT. the construction, expansion, or moderniza- cluding through telehealth. ‘‘(a) IN GENERAL.—The Secretary, in con- tion carried out with such funds, to be used ‘‘(B) APPROVAL.—In addition to projects for the purposes of providing health care sultation with the Secretary of the Treas- described in paragraph (1), in any fiscal year, ury, Indian Tribes, and Tribal Organizations, services to eligible Indians, all of the right, the Secretary is authorized to approve not title, and interest in and to such facility (or shall carry out a study to determine the fea- more than 10 applications for health care de- sibility of establishing a loan fund to provide portion thereof) shall transfer to the United livery demonstration projects that— States unless otherwise negotiated by the to Indian Tribes and Tribal Organizations di- ‘‘(i) include a convenient care services pro- rect loans or guarantees for loans for the Service and the Indian Tribe or Tribal Orga- gram as an alternative means of delivering nization. construction of health care facilities, includ- health care services to Indians; and ing— ‘‘(e) FUNDING NONRECURRING.—Funding ‘‘(ii) meet the criteria described in sub- ‘‘(1) inpatient facilities; provided under this section shall be non- paragraph (C). recurring and shall not be available for in- ‘‘(2) outpatient facilities; clusion in any individual Indian Tribe’s trib- ‘‘(C) CRITERIA.—The Secretary shall ap- ‘‘(3) staff quarters; and al share for an award under the Indian Self- prove under subparagraph (B) demonstration ‘‘(4) specialized care facilities, such as be- Determination and Education Assistance Act projects that meet all of the following cri- havioral health and elder care facilities. teria: (25 U.S.C. 450 et seq.) or for reallocation or ‘‘(b) DETERMINATIONS.—In carrying out the redesign thereunder. ‘‘(i) The criteria set forth in paragraph study under subsection (a), the Secretary (1)(A). ‘‘SEC. 306. INDIAN HEALTH CARE DELIVERY DEM- shall determine— ONSTRATION PROJECTS. ‘‘(ii) There is a lack of access to health ‘‘(1) the maximum principal amount of a ‘‘(a) IN GENERAL.—The Secretary, acting care services at existing health care facili- loan or loan guarantee that should be offered through the Service, is authorized to carry ties, which may be due to limited hours of to a recipient from the loan fund; operation at those facilities or other factors. out, or to enter into construction agree- ‘‘(2) the percentage of eligible costs, not to ments under the Indian Self-Determination ‘‘(iii) The project— exceed 100 percent, that may be covered by a and Education Assistance Act (25 U.S.C. 450 ‘‘(I) expands the availability of services; or loan or loan guarantee from the loan fund et seq.) with Indian Tribes or Tribal Organi- ‘‘(II) reduces— (including costs relating to planning, design, zations to carry out, a health care delivery ‘‘(aa) the burden on Contract Health Serv- financing, site land development, construc- demonstration project to test alternative ices; or tion, rehabilitation, renovation, conversion, means of delivering health care and services ‘‘(bb) the need for emergency room visits. improvements, medical equipment and fur- to Indians through facilities. ‘‘(d) PEER REVIEW PANELS.—The Secretary nishings, and other facility-related costs and ‘‘(b) USE OF FUNDS.—The Secretary, in ap- may provide for the establishment of peer re- capital purchase (but excluding staffing)); proving projects pursuant to this section, view panels, as necessary, to review and ‘‘(3) the cumulative total of the principal may authorize such construction agreements evaluate applications using the criteria de- of direct loans and loan guarantees, respec- for the construction and renovation of hos- scribed in paragraphs (1)(A) and (2)(C) of sub- tively, that may be outstanding at any 1 pitals, health centers, health stations, and section (c). time; other facilities to deliver health care serv- ‘‘(4) the maximum term of a loan or loan ices and is authorized to— ‘‘(e) TECHNICAL ASSISTANCE.—The Sec- retary shall provide such technical and other guarantee that may be made for a facility ‘‘(1) waive any leasing prohibition; assistance as may be necessary to enable ap- from the loan fund; ‘‘(2) permit carryover of funds appropriated plicants to comply with this section. ‘‘(5) the maximum percentage of funds for the provision of health care services; ‘‘(f) SERVICE TO INELIGIBLE PERSONS.—Sub- from the loan fund that should be allocated ‘‘(3) permit the use of other available ject to section 807, the authority to provide for payment of costs associated with plan- funds; services to persons otherwise ineligible for ning and applying for a loan or loan guar- ‘‘(4) permit the use of funds or property do- the health care benefits of the Service, and antee; nated from any source for project purposes; the authority to extend hospital privileges in ‘‘(6) whether acceptance by the Secretary ‘‘(5) provide for the reversion of donated Service facilities to non-Service health prac- of an assignment of the revenue of an Indian real or personal property to the donor; and titioners as provided in section 807, may be Tribe or Tribal Organization as security for

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The preceding sentence the occupants of such quarters by providing any projection of patient population; does not apply to any funds expended for the notice to the Secretary of its election to ex- ‘‘(8) whether funds of the Service provided delivery of health care services, personnel, ercise such authority. through loans or loan guarantees from the or staffing. ‘‘(2) OBJECTIVES.—In establishing rental loan fund should be eligible for use in match- ‘‘(e) RECOVERY FOR NONUSE.—An Indian rates pursuant to authority of this sub- ing other Federal funds under other pro- Tribe or Tribal Organization that has en- section, a Tribal Health Program shall en- grams; tered into a written agreement with the Sec- deavor to achieve the following objectives: ‘‘(9) the appropriateness of, and best meth- retary under this subsection shall be entitled ‘‘(A) To base such rental rates on the rea- ods for, coordinating the loan fund with the to recover from the United States an amount sonable value of the quarters to the occu- health care priority system of the Service that is proportional to the value of such fa- pants thereof. under section 301; and cility if, at any time within the 10-year term ‘‘(B) To generate sufficient funds to pru- ‘‘(10) any legislative or regulatory changes of the agreement, the Service ceases to use dently provide for the operation and mainte- required to implement recommendations of the facility or otherwise breaches the agree- nance of the quarters, and subject to the dis- the Secretary based on results of the study. ment. cretion of the Tribal Health Program, to sup- ‘‘(c) REPORT.—Not later than September 30, ‘‘(f) DEFINITION.—For the purposes of this ply reserve funds for capital repairs and re- 2009, the Secretary shall submit to the Com- section, the term ‘health facility’ or ‘health placement of the quarters. mittee on Indian Affairs of the Senate and facilities’ includes quarters needed to pro- ‘‘(3) EQUITABLE FUNDING.—Any quarters the Committee on Natural Resources and the vide housing for staff of the relevant Tribal whose rental rates are established by a Trib- Committee on Energy and Commerce of the Health Program. al Health Program pursuant to this sub- House of Representatives a report that de- ‘‘SEC. 312. LOCATION OF FACILITIES. section shall remain eligible for quarters im- scribes— ‘‘(a) IN GENERAL.—In all matters involving provement and repair funds to the same ex- ‘‘(1) the manner of consultation made as the reorganization or development of Service tent as all federally-owned quarters used to required by subsection (a); and facilities or in the establishment of related house personnel in Services-supported pro- ‘‘(2) the results of the study, including any employment projects to address unemploy- grams. recommendations of the Secretary based on ment conditions in economically depressed ‘‘(4) NOTICE OF RATE CHANGE.—A Tribal results of the study. areas, the Bureau of Indian Affairs and the Health Program which exercises the authority provided under this subsection shall pro- ‘‘SEC. 310. TRIBAL LEASING. Service shall give priority to locating such facilities and projects on Indian lands, or vide occupants with no less than 60 days no- ‘‘A Tribal Health Program may lease per- tice of any change in rental rates. manent structures for the purpose of pro- lands in Alaska owned by any Alaska Native viding health care services without obtain- village, or village or regional corporation ‘‘(b) DIRECT COLLECTION OF RENT.— ing advance approval in appropriation Acts. under the Alaska Native Claims Settlement ‘‘(1) IN GENERAL.—Notwithstanding any Act (43 U.S.C. 1601 et seq.), or any land allot- ‘‘SEC. 311. INDIAN HEALTH SERVICE/TRIBAL FA- other provision of law, and subject to para- CILITIES JOINT VENTURE PROGRAM. ted to any Alaska Native, if requested by the graph (2), a Tribal Health Program shall ‘‘(a) IN GENERAL.—The Secretary, acting Indian owner and the Indian Tribe with ju- have the authority to collect rents directly through the Service, shall make arrange- risdiction over such lands or other lands from Federal employees who occupy such ments with Indian Tribes and Tribal Organi- owned or leased by the Indian Tribe or Tribal quarters in accordance with the following: zations to establish joint venture demonstra- Organization. Top priority shall be given to ‘‘(A) The Tribal Health Program shall notion projects under which an Indian Tribe or Indian land owned by 1 or more Indian tify the Secretary and the subject Federal Tribal Organization shall expend tribal, pri- Tribes. employees of its election to exercise its au- vate, or other available funds, for the acqui- ‘‘(b) DEFINITION.—For purposes of this sec- thority to collect rents directly from such sition or construction of a health facility for tion, the term ‘Indian lands’ means— Federal employees. a minimum of 10 years, under a no-cost ‘‘(1) all lands within the exterior bound- ‘‘(B) Upon receipt of a notice described in lease, in exchange for agreement by the aries of any reservation; and subparagraph (A), the Federal employees Service to provide the equipment, supplies, ‘‘(2) any lands title to which is held in shall pay rents for occupancy of such quar- and staffing for the operation and mainte- trust by the United States for the benefit of ters directly to the Tribal Health Program nance of such a health facility. An Indian any Indian Tribe or individual Indian or held and the Secretary shall have no further au- Tribe or Tribal Organization may use tribal by any Indian Tribe or individual Indian sub- thority to collect rents from such employees funds, private sector, or other available reject to restriction by the United States through payroll deduction or otherwise. sources, including loan guarantees, to fulfill against alienation. ‘‘(C) Such rent payments shall be retained its commitment under a joint venture en- ‘‘SEC. 313. MAINTENANCE AND IMPROVEMENT OF by the Tribal Health Program and shall not tered into under this subsection. An Indian HEALTH CARE FACILITIES. be made payable to or otherwise be deposited Tribe or Tribal Organization shall be eligible ‘‘(a) REPORT.—The Secretary shall submit with the United States. to establish a joint venture project if, when to the President, for inclusion in the report ‘‘(D) Such rent payments shall be deposited it submits a letter of intent, it— required to be transmitted to Congress under into a separate account which shall be used ‘‘(1) has begun but not completed the proc- section 801, a report which identifies the by the Tribal Health Program for the main- ess of acquisition or construction of a health backlog of maintenance and repair work re- tenance (including capital repairs and re- facility to be used in the joint venture quired at both Service and tribal health care placement) and operation of the quarters and project; or facilities, including new health care facili- facilities as the Tribal Health Program shall ‘‘(2) has not begun the process of acquisi- ties expected to be in operation in the next determine. tion or construction of a health facility for fiscal year. The report shall also identify the ‘‘(2) RETROCESSION OF AUTHORITY.—If a use in the joint venture project. need for renovation and expansion of exist- Tribal Health Program which has made an ‘‘(b) REQUIREMENTS.—The Secretary shall ing facilities to support the growth of health election under paragraph (1) requests ret- make such an arrangement with an Indian care programs. rocession of its authority to directly collect Tribe or Tribal Organization only if— ‘‘(b) MAINTENANCE OF NEWLY CONSTRUCTED rents from Federal employees occupying fed- ‘‘(1) the Secretary first determines that SPACE.—The Secretary, acting through the erally-owned quarters, such retrocession the Indian Tribe or Tribal Organization has Service, is authorized to expend mainte- shall become effective on the earlier of— the administrative and financial capabilities nance and improvement funds to support ‘‘(A) the first day of the month that begins necessary to complete the timely acquisition maintenance of newly constructed space no less than 180 days after the Tribal Health or construction of the relevant health facil- only if such space falls within the approved Program notifies the Secretary of its desire ity; and supportable space allocation for the Indian to retrocede; or ‘‘(2) the Indian Tribe or Tribal Organiza- Tribe or Tribal Organization. Supportable ‘‘(B) such other date as may be mutually tion meets the need criteria determined space allocation shall be defined through the agreed by the Secretary and the Tribal using the criteria developed under the health health care facility priority system under Health Program. care facility priority system under section section 301(c). ‘‘(c) RATES IN ALASKA.—To the extent that 301, unless the Secretary determines, pursu- ‘‘(c) REPLACEMENT FACILITIES.—In addition a Tribal Health Program, pursuant to au- ant to regulations, that other criteria will to using maintenance and improvement thority granted in subsection (a), establishes result in a more cost-effective and efficient funds for renovation, modernization, and ex- rental rates for federally-owned quarters method of facilitating and completing con- pansion of facilities, an Indian Tribe or Trib- provided to a Federal employee in Alaska, struction of health care facilities. al Organization may use maintenance and such rents may be based on the cost of com- ‘‘(c) CONTINUED OPERATION.—The Secretary improvement funds for construction of a re- parable private rental housing in the nearest shall negotiate an agreement with the Indian placement facility if the costs of renovation established community with a year-round Tribe or Tribal Organization regarding the of such facility would exceed a maximum population of 1,500 or more individuals. continued operation of the facility at the end renovation cost threshold. The maximum ‘‘SEC. 315. APPLICABILITY OF BUY AMERICAN of the initial 10 year no-cost lease period. renovation cost threshold shall be deter- ACT REQUIREMENT. ‘‘(d) BREACH OF AGREEMENT.—An Indian mined through the negotiated rulemaking ‘‘(a) APPLICABILITY.—The Secretary shall Tribe or Tribal Organization that has en- process provided for under section 802. ensure that the requirements of the Buy tered into a written agreement with the Sec- ‘‘SEC. 314. TRIBAL MANAGEMENT OF FEDERALLY- American Act apply to all procurements retary under this section, and that breaches OWNED QUARTERS. made with funds provided pursuant to sec- or terminates without cause such agreement, ‘‘(a) RENTAL RATES.— tion 317. Indian Tribes and Tribal Organiza- shall be liable to the United States for the ‘‘(1) ESTABLISHMENT.—Notwithstanding tions shall be exempt from these require- amount that has been paid to the Indian any other provision of law, a Tribal Health ments. Tribe or Tribal Organization, or paid to a Program which operates a hospital or other ‘‘(b) EFFECT OF VIOLATION.—If it has been third party on the Indian Tribe’s or Tribal health facility and the federally-owned quar- finally determined by a court or Federal Organization’s behalf, under the agreement. ters associated therewith pursuant to a con- agency that any person intentionally affixed

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a label bearing a ‘Made in America’ inscrip- may be necessary to achieve or maintain ‘‘(4) WITHDRAWAL FROM PROGRAM.—A Tribal tion or any inscription with the same mean- compliance with the applicable conditions Health Program that bills directly under the ing, to any product sold in or shipped to the and requirements of titles XVIII and XIX of program established under this subsection United States that is not made in the United the Social Security Act. Any amounts so re- may withdraw from participation in the States, such person shall be ineligible to received that are in excess of the amount nec- same manner and under the same conditions ceive any contract or subcontract made with essary to achieve or maintain such condi- that an Indian Tribe or Tribal Organization funds provided pursuant to section 317, pur- tions and requirements shall, subject to con- may retrocede a contracted program to the suant to the debarment, suspension, and in- sultation with the Indian Tribes being served Secretary under the authority of the Indian eligibility procedures described in sections by the Service Unit, be used for reducing the Self-Determination and Education Assist- 9.400 through 9.409 of title 48, Code of Federal health resource deficiencies (as determined ance Act (25 U.S.C. 450 et seq.). All cost ac- Regulations. under section 201(d)) of such Indian Tribes. counting and billing authority under the program established under this subsection ‘‘(c) DEFINITIONS.—For purposes of this sec- ‘‘(2) DIRECT PAYMENT OPTION.—Paragraph tion, the term ‘Buy American Act’ means (1) shall not apply to a Tribal Health Pro- shall be returned to the Secretary upon the title III of the Act entitled ‘An Act making gram upon the election of such Program Secretary’s acceptance of the withdrawal of appropriations for the Treasury and Post Of- under subsection (d) to receive payments di- participation in this program. fice Departments for the fiscal year ending rectly. No payment may be made out of the ‘‘(5) TERMINATION FOR FAILURE TO COMPLY June 30, 1934, and for other purposes’, ap- special fund described in such paragraph WITH REQUIREMENTS.—The Secretary may proved March 3, 1933 (41 U.S.C. 10a et seq.). with respect to reimbursement made for terminate the participation of a Tribal ‘‘SEC. 316. OTHER FUNDING FOR FACILITIES. services provided by such Program during Health Program or in the direct billing pro- ‘‘(a) AUTHORITY TO ACCEPT FUNDS.—The the period of such election. gram established under this subsection if the Secretary determines that the Program has Secretary is authorized to accept from any ‘‘(d) DIRECT BILLING.— source, including Federal and State agen- failed to comply with the requirements of ‘‘(1) IN GENERAL.—Subject to complying paragraph (2). The Secretary shall provide a cies, funds that are available for the con- with the requirements of paragraph (2), a struction of health care facilities and use Tribal Health Program with notice of a de- such funds to plan, design, and construct Tribal Health Program may elect to directly termination that the Program has failed to health care facilities for Indians and to place bill for, and receive payment for, health care comply with any such requirement and a such funds into a contract or compact under items and services provided by such Program reasonable opportunity to correct such non- the Indian Self-Determination and Edu- for which payment is made under title XVIII compliance prior to terminating the Pro- cation Assistance Act (25 U.S.C. 450 et seq.). or XIX of the Social Security Act or from gram’s participation in the direct billing Receipt of such funds shall have no effect on any other third party payor. program established under this subsection. the priorities established pursuant to section ‘‘(2) DIRECT REIMBURSEMENT.— ‘‘(e) RELATED PROVISIONS UNDER THE SO- 301. ‘‘(A) USE OF FUNDS.—Each Tribal Health CIAL SECURITY ACT.—For provisions related ‘‘(b) INTERAGENCY AGREEMENTS.—The Sec- Program making the election described in to subsections (c) and (d), see sections 1880, retary is authorized to enter into inter- paragraph (1) with respect to a program 1911, and 2107(e)(1)(D) of the Social Security agency agreements with other Federal agen- under a title of the Social Security Act shall Act. cies or State agencies and other entities and be reimbursed directly by that program for ‘‘SEC. 402. GRANTS TO AND CONTRACTS WITH to accept funds from such Federal or State items and services furnished without regard THE SERVICE, INDIAN TRIBES, TRIB- agencies or other sources to provide for the to subsection (c)(1), but all amounts so reim- AL ORGANIZATIONS, AND URBAN IN- bursed shall be used by the Tribal Health DIAN ORGANIZATIONS TO FACILI- planning, design, and construction of health TATE OUTREACH, ENROLLMENT, care facilities to be administered by Indian Program for the purpose of making any im- AND COVERAGE OF INDIANS UNDER Health Programs in order to carry out the provements in facilities of the Tribal Health SOCIAL SECURITY ACT HEALTH BEN- purposes of this Act and the purposes for Program that may be necessary to achieve EFIT PROGRAMS AND OTHER which the funds were appropriated or for or maintain compliance with the conditions HEALTH BENEFITS PROGRAMS. which the funds were otherwise provided. and requirements applicable generally to ‘‘(a) INDIAN TRIBES AND TRIBAL ORGANIZA- TIONS.—From funds appropriated to carry ‘‘(c) ESTABLISHMENT OF STANDARDS.—The such items and services under the program Secretary, through the Service, shall estab- under such title and to provide additional out this title in accordance with section 417, lish standards by regulation for the plan- health care services, improvements in health the Secretary, acting through the Service, care facilities and Tribal Health Programs, shall make grants to or enter into contracts ning, design, and construction of health care with Indian Tribes and Tribal Organizations facilities serving Indians under this Act. any health care related purpose, or otherwise to achieve the objectives provided in section to assist such Tribes and Tribal Organiza- ‘‘SEC. 317. AUTHORIZATION OF APPROPRIATIONS. 3 of this Act. tions in establishing and administering pro- ‘‘There are authorized to be appropriated grams on or near reservations and trust such sums as may be necessary for each fis- ‘‘(B) AUDITS.—The amounts paid to a Trib- al Health Program making the election de- lands, including programs to provide out- cal year through fiscal year 2017 to carry out reach and enrollment through video, elec- this title. scribed in paragraph (1) with respect to a program under a title of the Social Security tronic delivery methods, or telecommuni- ‘‘TITLE IV—ACCESS TO HEALTH SERVICES Act shall be subject to all auditing require- cation devices that allow real-time or time- ‘‘SEC. 401. TREATMENT OF PAYMENTS UNDER SO- ments applicable to the program under such delayed communication between individual CIAL SECURITY ACT HEALTH BENE- title, as well as all auditing requirements ap- Indians and the benefit program, to assist in- FITS PROGRAMS. plicable to programs administered by an In- dividual Indians— ‘‘(a) DISREGARD OF MEDICARE, MEDICAID, dian Health Program. Nothing in the pre- ‘‘(1) to enroll for benefits under a program AND SCHIP PAYMENTS IN DETERMINING AP- ceding sentence shall be construed as lim- established under title XVIII, XIX, or XXI of PROPRIATIONS.—Any payments received by an iting the application of auditing require- the Social Security Act and other health Indian Health Program or by an Urban In- ments applicable to amounts paid under title benefits programs; and dian Organization under title XVIII, XIX, or XVIII, XIX, or XXI of the Social Security ‘‘(2) with respect to such programs for XXI of the Social Security Act for services Act. which the charging of premiums and cost provided to Indians eligible for benefits ‘‘(C) IDENTIFICATION OF SOURCE OF PAY- sharing is not prohibited under such pro- under such respective titles shall not be con- MENTS.—Any Tribal Health Program that re- grams, to pay premiums or cost sharing for sidered in determining appropriations for the ceives reimbursements or payments under coverage for such benefits, which may be provision of health care and services to Indi- title XVIII, XIX, or XXI of the Social Secu- based on financial need (as determined by ans. rity Act, shall provide to the Service a list of the Indian Tribe or Tribes or Tribal Organi- ‘‘(b) NONPREFERENTIAL TREATMENT.—Noth- each provider enrollment number (or other zations being served based on a schedule of ing in this Act authorizes the Secretary to identifier) under which such Program re- income levels developed or implemented by provide services to an Indian with coverage ceives such reimbursements or payments. such Tribe, Tribes, or Tribal Organizations). under title XVIII, XIX, or XXI of the Social ‘‘(b) CONDITIONS.—The Secretary, acting ‘‘(3) EXAMINATION AND IMPLEMENTATION OF through the Service, shall place conditions Security Act in preference to an Indian with- CHANGES.— out such coverage. as deemed necessary to effect the purpose of ‘‘(A) IN GENERAL.—The Secretary, acting ‘‘(c) USE OF FUNDS.— this section in any grant or contract which through the Service and with the assistance the Secretary makes with any Indian Tribe ‘‘(1) SPECIAL FUND.— of the Administrator of the Centers for Medi- or Tribal Organization pursuant to this sec- ‘‘(A) 100 PERCENT PASS-THROUGH OF PAY- care & Medicaid Services, shall examine on tion. Such conditions shall include require- MENTS DUE TO FACILITIES.—Notwithstanding an ongoing basis and implement any admin- ments that the Indian Tribe or Tribal Orga- any other provision of law, but subject to istrative changes that may be necessary to nization successfully undertake— paragraph (2), payments to which a facility facilitate direct billing and reimbursement ‘‘(1) to determine the population of Indians of the Service is entitled by reason of a pro- under the program established under this eligible for the benefits described in sub- vision of the Social Security Act shall be subsection, including any agreements with section (a); placed in a special fund to be held by the States that may be necessary to provide for Secretary. In making payments from such direct billing under a program under a title ‘‘(2) to educate Indians with respect to the fund, the Secretary shall ensure that each of the Social Security Act. benefits available under the respective programs; Service Unit of the Service receives 100 per- ‘‘(B) COORDINATION OF INFORMATION.—The cent of the amount to which the facilities of Service shall provide the Administrator of ‘‘(3) to provide transportation for such in- the Service, for which such Service Unit the Centers for Medicare & Medicaid Serv- dividual Indians to the appropriate offices makes collections, are entitled by reason of ices with copies of the lists submitted to the for enrollment or applications for such bene- a provision of the Social Security Act. Service under paragraph (2)(C), enrollment fits; and ‘‘(B) USE OF FUNDS.—Amounts received by data regarding patients served by the Serv- ‘‘(4) to develop and implement methods of a facility of the Service under subparagraph ice (and by Tribal Health Programs, to the improving the participation of Indians in re- (A) shall first be used (to such extent or in extent such data is available to the Service), ceiving benefits under such programs. such amounts as are provided in appropria- and such other information as the Adminis- ‘‘(c) APPLICATION TO URBAN INDIAN ORGANI- tion Acts) for the purpose of making any im- trator may require for purposes of admin- ZATIONS.— provements in the programs of the Service istering title XVIII, XIX, or XXI of the So- ‘‘(1) IN GENERAL.—The provisions of sub- operated by or through such facility which cial Security Act. section (a) shall apply with respect to grants

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and other funding to Urban Indian Organiza- ‘‘(d) NO EFFECT ON PRIVATE RIGHTS OF AC- zations with respect to populations served by tions with respect to populations served by TION.—No action taken by the United States, such Organizations in the same manner they such organizations in the same manner they an Indian Tribe, or Tribal Organization to apply to Indian Tribes and Tribal Organiza- apply to grants and contracts with Indian enforce the right of recovery provided under tions with respect to populations served by Tribes and Tribal Organizations with respect this section shall operate to deny to the in- such Indian Tribes and Tribal Organizations. to programs on or near reservations. jured person the recovery for that portion of ‘‘(j) STATUTE OF LIMITATIONS.—The provi- ‘‘(2) REQUIREMENTS.—The Secretary shall the person’s damage not covered hereunder. sions of section 2415 of title 28, United States include in the grants or contracts made or ‘‘(e) ENFORCEMENT.— Code, shall apply to all actions commenced provided under paragraph (1) requirements ‘‘(1) IN GENERAL.—The United States, an under this section, and the references there- that are— Indian Tribe, or Tribal Organization may en- in to the United States are deemed to in- ‘‘(A) consistent with the requirements im- force the right of recovery provided under clude Indian Tribes, Tribal Organizations, posed by the Secretary under subsection (b); subsection (a) by— and Urban Indian Organizations. ‘‘(B) appropriate to Urban Indian Organiza- ‘‘(A) intervening or joining in any civil ac- ‘‘(k) SAVINGS.—Nothing in this section tions and Urban Indians; and tion or proceeding brought— shall be construed to limit any right of re- ‘‘(C) necessary to effect the purposes of ‘‘(i) by the individual for whom health covery available to the United States, an In- this section. services were provided by the Secretary, an dian Tribe, or Tribal Organization under the ‘‘(d) FACILITATING COOPERATION.—The Sec- Indian Tribe, or Tribal Organization; or provisions of any applicable, Federal, State, retary, acting through the Centers for Medi- ‘‘(ii) by any representative or heirs of such or Tribal law, including medical lien laws. care & Medicaid Services, shall develop and individual, or ‘‘SEC. 404. CREDITING OF REIMBURSEMENTS. disseminate best practices that will serve to ‘‘(B) instituting a civil action, including a ‘‘(a) USE OF AMOUNTS.— facilitate cooperation with, and agreements civil action for injunctive relief and other re- between, States and the Service, Indian lief and including, with respect to a political ‘‘(1) RETENTION BY PROGRAM.—Except as Tribes, Tribal Organizations, or Urban In- subdivision or local governmental entity of a provided in section 202(f) (relating to the dian Organizations with respect to the provi- State, such an action against an official Catastrophic Health Emergency Fund) and sion of health care items and services to In- thereof. section 807 (relating to health services for ineligible persons), all reimbursements re- dians under the programs established under ‘‘(2) NOTICE.—All reasonable efforts shall title XVIII, XIX, or XXI of the Social Secu- be made to provide notice of action insti- ceived or recovered under any of the pro- rity Act. tuted under paragraph (1)(B) to the indi- grams described in paragraph (2), including ‘‘(e) AGREEMENTS RELATING TO IMPROVING vidual to whom health services were pro- under section 807, by reason of the provision ENROLLMENT OF INDIANS UNDER SOCIAL SECU- vided, either before or during the pendency of health services by the Service, by an In- RITY ACT HEALTH BENEFITS PROGRAMS.—For of such action. dian Tribe or Tribal Organization, or by an Urban Indian Organization, shall be credited provisions relating to agreements between ‘‘(3) RECOVERY FROM TORTFEASORS.— the Secretary, acting through the Service, to the Service, such Indian Tribe or Tribal ‘‘(A) IN GENERAL.—In any case in which an Organization, or such Urban Indian Organi- and Indian Tribes, Tribal Organizations, and Indian Tribe or Tribal Organization that is Urban Indian Organizations for the collec- zation, respectively, and may be used as pro- tion, preparation, and submission of applica- authorized or required under a compact or vided in section 401. In the case of such a tions by Indians for assistance under the contract issued pursuant to the Indian Self- service provided by or through a Service Medicaid and State children’s health insur- Determination and Education Assistance Act Unit, such amounts shall be credited to such ance programs established under titles XIX (25 U.S.C. 450 et seq.) to furnish or pay for unit and used for such purposes. and XXI of the Social Security Act, and ben- health services to a person who is injured or suffers a disease on or after the date of en- ‘‘(2) PROGRAMS COVERED.—The programs re- efits under the Medicare program established ferred to in paragraph (1) are the following: under title XVIII of such Act, see sub- actment of the Indian Health Care Improve- ment Act Amendments of 2008 under cir- ‘‘(A) Titles XVIII, XIX, and XXI of the So- sections (a) and (b) of section 1139 of the So- cial Security Act. cial Security Act. cumstances that establish grounds for a claim of liability against the tortfeasor with ‘‘(B) This Act, including section 807. ‘‘(f) DEFINITION OF PREMIUMS AND COST respect to the injury or disease, the Indian ‘‘(C) Public Law 87–693. SHARING.—In this section: Tribe or Tribal Organization shall have a ‘‘(D) Any other provision of law. ‘‘(1) PREMIUM.—The term ‘premium’ in- right to recover from the tortfeasor (or an ‘‘(b) NO OFFSET OF AMOUNTS.—The Service cludes any enrollment fee or similar charge. insurer of the tortfeasor) the reasonable ‘‘(2) COST SHARING.—The term ‘cost shar- may not offset or limit any amount obli- value of the health services so furnished, gated to any Service Unit or entity receiving ing’ includes any deduction, deductible, co- paid for, or to be paid for, in accordance with payment, coinsurance, or similar charge. the Federal Medical Care Recovery Act (42 funding from the Service because of the receipt of reimbursements under subsection ‘‘SEC. 403. REIMBURSEMENT FROM CERTAIN U.S.C. 2651 et seq.), to the same extent and THIRD PARTIES OF COSTS OF under the same circumstances as the United (a). HEALTH SERVICES. States may recover under that Act. ‘‘SEC. 405. PURCHASING HEALTH CARE COV- ERAGE. ‘‘(a) RIGHT OF RECOVERY.—Except as pro- ‘‘(B) TREATMENT.—The right of an Indian vided in subsection (f), the United States, an Tribe or Tribal Organization to recover ‘‘(a) IN GENERAL.—Insofar as amounts are Indian Tribe, or Tribal Organization shall under subparagraph (A) shall be independent made available under law (including a provi- have the right to recover from an insurance of the rights of the injured or diseased per- sion of the Social Security Act, the Indian company, health maintenance organization, son served by the Indian Tribe or Tribal Or- Self-Determination and Education Assist- employee benefit plan, third-party ganization. ance Act (25 U.S.C. 450 et seq.), or other law, tortfeasor, or any other responsible or liable ‘‘(f) LIMITATION.—Absent specific written other than under section 402) to Indian third party (including a political subdivision authorization by the governing body of an Tribes, Tribal Organizations, and Urban In- or local governmental entity of a State) the Indian Tribe for the period of such authoriza- dian Organizations for health benefits for reasonable charges billed by the Secretary, tion (which may not be for a period of more Service beneficiaries, Indian Tribes, Tribal an Indian Tribe, or Tribal Organization in than 1 year and which may be revoked at any Organizations, and Urban Indian Organiza- providing health services through the Serv- time upon written notice by the governing tions may use such amounts to purchase ice, an Indian Tribe, or Tribal Organization body to the Service), the United States shall health benefits coverage for such bene- to any individual to the same extent that not have a right of recovery under this sec- ficiaries in any manner, including through— such individual, or any nongovernmental tion if the injury, illness, or disability for ‘‘(1) a tribally owned and operated health provider of such services, would be eligible which health services were provided is cov- care plan; to receive damages, reimbursement, or in- ered under a self-insurance plan funded by an ‘‘(2) a State or locally authorized or li- demnification for such charges or expenses Indian Tribe, Tribal Organization, or Urban censed health care plan; if— Indian Organization. Where such authoriza- ‘‘(3) a health insurance provider or man- ‘‘(1) such services had been provided by a tion is provided, the Service may receive and nongovernmental provider; and aged care organization; expend such amounts for the provision of ad- ‘‘(4) a self-insured plan; or ‘‘(2) such individual had been required to ditional health services consistent with such pay such charges or expenses and did pay authorization. ‘‘(5) a high deductible or health savings account plan. such charges or expenses. ‘‘(g) COSTS AND ATTORNEYS’ FEES.—In any ‘‘(b) LIMITATIONS ON RECOVERIES FROM action brought to enforce the provisions of The purchase of such coverage by an Indian STATES.—Subsection (a) shall provide a right this section, a prevailing plaintiff shall be Tribe, Tribal Organization, or Urban Indian of recovery against any State, only if the in- awarded its reasonable attorneys’ fees and Organization may be based on the financial jury, illness, or disability for which health costs of litigation. needs of such beneficiaries (as determined by services were provided is covered under— the Indian Tribe or Tribes being served based ‘‘(h) NONAPPLICATION OF CLAIMS FILING RE- on a schedule of income levels developed or ‘‘(1) workers’ compensation laws; or QUIREMENTS.—An insurance company, health implemented by such Indian Tribe or Tribes). ‘‘(2) a no-fault automobile accident insur- maintenance organization, self-insurance ance plan or program. plan, managed care plan, or other health ‘‘(b) EXPENSES FOR SELF-INSURED PLAN.—In the case of a self-insured plan under sub- ‘‘(c) NONAPPLICATION OF OTHER LAWS.—No care plan or program (under the Social Secu- law of any State, or of any political subdivi- rity Act or otherwise) may not deny a claim section (a)(4), the amounts may be used for sion of a State and no provision of any con- for benefits submitted by the Service or by expenses of operating the plan, including ad- tract, insurance or health maintenance orga- an Indian Tribe or Tribal Organization based ministration and insurance to limit the fi- nization policy, employee benefit plan, self- on the format in which the claim is sub- nancial risks to the entity offering the plan. insurance plan, managed care plan, or other mitted if such format complies with the for- ‘‘(c) CONSTRUCTION.—Nothing in this sec- health care plan or program entered into or mat required for submission of claims under tion shall be construed as affecting the use renewed after the date of the enactment of title XVIII of the Social Security Act or rec- of any amounts not referred to in subsection the Indian Health Care Amendments of 1988, ognized under section 1175 of such Act. (a). shall prevent or hinder the right of recovery ‘‘(i) APPLICATION TO URBAN INDIAN ORGANI- ‘‘SEC. 406. SHARING ARRANGEMENTS WITH FED- of the United States, an Indian Tribe, or ZATIONS.—The previous provisions of this ERAL AGENCIES. Tribal Organization under subsection (a). section shall apply to Urban Indian Organi- ‘‘(a) AUTHORITY.—

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‘‘(1) IN GENERAL.—The Secretary may enter ‘‘(c) ELIGIBLE INDIAN VETERANS’ EX- any Federal health care program or whose into (or expand) arrangements for the shar- PENSES.— State license is under suspension shall be eli- ing of medical facilities and services between ‘‘(1) IN GENERAL.—Notwithstanding any gible to receive payment or reimbursement the Service, Indian Tribes, and Tribal Orga- other provision of law, the Secretary shall under any such program for health care serv- nizations and the Department of Veterans provide for veteran-related expenses incurred ices furnished by that individual, directly or Affairs and the Department of Defense. by eligible Indian veterans as described in through an entity that is otherwise eligible ‘‘(2) CONSULTATION BY SECRETARY RE- subsection (b)(1)(B). to receive payment for health care services, QUIRED.—The Secretary may not finalize any ‘‘(2) METHOD OF PAYMENT.—The Secretary to an Indian. arrangement between the Service and a De- shall establish such guidelines as the Sec- ‘‘(3) FEDERAL HEALTH CARE PROGRAM DE- partment described in paragraph (1) without retary determines to be appropriate regard- FINED.—In this subsection, the term, ‘Fed- first consulting with the Indian Tribes which ing the method of payments to the Secretary eral health care program’ has the meaning will be significantly affected by the arrange- of Veterans Affairs under paragraph (1). given that term in section 1128B(f) of the So- ment. ‘‘(d) TRIBAL APPROVAL OF MEMORANDA.—In cial Security Act (42 U.S.C. 1320a–7b(f)), ex- ‘‘(b) LIMITATIONS.—The Secretary shall not negotiating a local memorandum of under- cept that, for purposes of this subsection, take any action under this section or under standing with the Secretary of Veterans Af- such term shall include the health insurance subchapter IV of chapter 81 of title 38, fairs regarding the provision of services to program under chapter 89 of title 5, United United States Code, which would impair— eligible Indian veterans, the Secretary shall States Code. ‘‘(1) the priority access of any Indian to consult with each Indian tribe that would be ‘‘(c) RELATED PROVISIONS.—For provisions health care services provided through the affected by the local memorandum of under- related to nondiscrimination against pro- Service and the eligibility of any Indian to standing. viders operated by the Service, an Indian Tribe, Tribal Organization, or Urban Indian receive health services through the Service; ‘‘(e) FUNDING.— ‘‘(2) the quality of health care services pro- Organization, see section 1139(c) of the So- ‘‘(1) TREATMENT.—Expenses incurred by the cial Security Act (42 U.S.C. 1320b–9(c)). vided to any Indian through the Service; Secretary in carrying out subsection (c)(1) ‘‘(3) the priority access of any veteran to shall not be considered to be Contract Health ‘‘SEC. 410. CONSULTATION. health care services provided by the Depart- Service expenses. ‘‘For provisions related to consultation with representatives of Indian Health Pro- ment of Veterans Affairs; ‘‘(2) USE OF FUNDS.—Of funds made avail- ‘‘(4) the quality of health care services programs and Urban Indian Organizations with able to the Secretary in appropriations Acts respect to the health care programs estab- vided by the Department of Veterans Affairs for the Service (excluding funds made avail- or the Department of Defense; or lished under titles XVIII, XIX, and XXI of able for facilities, Contract Health Services, the Social Security Act, see section 1139(d) of ‘‘(5) the eligibility of any Indian who is a or contract support costs), the Secretary the Social Security Act (42 U.S.C. 1320b–9(d)). veteran to receive health services through shall use such sums as are necessary to carry ‘‘SEC. 411. STATE CHILDREN’S HEALTH INSUR- the Department of Veterans Affairs. out this section. ANCE PROGRAM (SCHIP). ‘‘(c) REIMBURSEMENT.—The Service, Indian ‘‘SEC. 408. PAYOR OF LAST RESORT. ‘‘For provisions relating to— Tribe, or Tribal Organization shall be reim- ‘‘Indian Health Programs and health care ‘‘(1) outreach to families of Indian children bursed by the Department of Veterans Af- programs operated by Urban Indian Organi- likely to be eligible for child health assist- fairs or the Department of Defense (as the zations shall be the payor of last resort for ance under the State children’s health insur- case may be) where services are provided services provided to persons eligible for serv- ance program established under title XXI of through the Service, an Indian Tribe, or a ices from Indian Health Programs and Urban the Social Security Act, see sections Tribal Organization to beneficiaries eligible Indian Organizations, notwithstanding any 2105(c)(2)(C) and 1139(a) of such Act (42 U.S.C. for services from either such Department, Federal, State, or local law to the contrary. 1397ee(c)(2), 1320b–9); and notwithstanding any other provision of law. ‘‘SEC. 409. NONDISCRIMINATION UNDER FED- ‘‘(2) ensuring that child health assistance ‘‘(d) CONSTRUCTION.—Nothing in this sec- ERAL HEALTH CARE PROGRAMS IN is provided under such program to targeted tion may be construed as creating any right QUALIFICATIONS FOR REIMBURSE- MENT FOR SERVICES. low-income children who are Indians and of a non-Indian veteran to obtain health that payments are made under such program services from the Service. ‘‘(a) REQUIREMENT TO SATISFY GENERALLY APPLICABLE PARTICIPATION REQUIREMENTS.— to Indian Health Programs and Urban Indian ‘‘SEC. 407. ELIGIBLE INDIAN VETERAN SERVICES. Organizations operating in the State that ‘‘(a) FINDINGS; PURPOSE.— ‘‘(1) IN GENERAL.—A Federal health care program must accept an entity that is oper- provide such assistance, see sections ‘‘(1) FINDINGS.—Congress finds that— ated by the Service, an Indian Tribe, Tribal 2102(b)(3)(D) and 2105(c)(6)(B) of such Act (42 ‘‘(A) collaborations between the Secretary Organization, or Urban Indian Organization U.S.C. 1397bb(b)(3)(D), 1397ee(c)(6)(B)). and the Secretary of Veterans Affairs regard- as a provider eligible to receive payment ‘‘SEC. 412. EXCLUSION WAIVER AUTHORITY FOR ing the treatment of Indian veterans at fa- AFFECTED INDIAN HEALTH PRO- under the program for health care services GRAMS AND SAFE HARBOR TRANS- cilities of the Service should be encouraged furnished to an Indian on the same basis as to the maximum extent practicable; and ACTIONS UNDER THE SOCIAL SECU- any other provider qualified to participate as RITY ACT. ‘‘(B) increased enrollment for services of a provider of health care services under the ‘‘For provisions relating to— the Department of Veterans Affairs by vet- program if the entity meets generally appli- erans who are members of Indian tribes ‘‘(1) exclusion waiver authority for affected cable State or other requirements for par- Indian Health Programs under the Social Se- should be encouraged to the maximum ex- ticipation as a provider of health care serv- tent practicable. curity Act, see section 1128(k) of the Social ices under the program. Security Act (42 U.S.C. 1320a–7(k)); and ‘‘(2) PURPOSE.—The purpose of this section ‘‘(2) SATISFACTION OF STATE OR LOCAL LI- ‘‘(2) certain transactions involving Indian is to reaffirm the goals stated in the docu- CENSURE OR RECOGNITION REQUIREMENTS.— ment entitled ‘Memorandum of Under- Health Programs deemed to be in safe har- Any requirement for participation as a pro- bors under that Act, see section 1128B(b)(4) of standing Between the VA/Veterans Health vider of health care services under a Federal Administration And HHS/Indian Health the Social Security Act (42 U.S.C. 1320a– health care program that an entity be li- 7b(b)(4)). Service’ and dated February 25, 2003 (relating censed or recognized under the State or local to cooperation and resource sharing between law where the entity is located to furnish ‘‘SEC. 413. PREMIUM AND COST SHARING PRO- the Veterans Health Administration and TECTIONS AND ELIGIBILITY DETER- health care services shall be deemed to have MINATIONS UNDER MEDICAID AND Service). been met in the case of an entity operated by SCHIP AND PROTECTION OF CER- ‘‘(b) DEFINITIONS.—In this section: the Service, an Indian Tribe, Tribal Organi- TAIN INDIAN PROPERTY FROM MED- ‘‘(1) ELIGIBLE INDIAN VETERAN.—The term zation, or Urban Indian Organization if the ICAID ESTATE RECOVERY. ‘eligible Indian veteran’ means an Indian or entity meets all the applicable standards for ‘‘For provisions relating to— Alaska Native veteran who receives any such licensure or recognition, regardless of ‘‘(1) premiums or cost sharing protections medical service that is— whether the entity obtains a license or other for Indians furnished items or services di- ‘‘(A) authorized under the laws adminis- documentation under such State or local rectly by Indian Health Programs or through tered by the Secretary of Veterans Affairs; law. In accordance with section 221, the ab- referral under the contract health service and sence of the licensure of a health care profes- under the Medicaid program established ‘‘(B) administered at a facility of the Serv- sional employed by such an entity under the under title XIX of the Social Security Act, ice (including a facility operated by an In- State or local law where the entity is located see sections 1916(j) and 1916A(a)(1) of the So- dian tribe or tribal organization through a shall not be taken into account for purposes cial Security Act (42 U.S.C. 1396o(j), 1396o– contract or compact with the Service under of determining whether the entity meets 1(a)(1)); the Indian Self-Determination and Edu- such standards, if the professional is licensed ‘‘(2) rules regarding the treatment of cer- cation Assistance Act (25 U.S.C. 450 et seq.)) in another State. tain property for purposes of determining pursuant to a local memorandum of under- ‘‘(b) APPLICATION OF EXCLUSION FROM PAR- eligibility under such programs, see sections standing. TICIPATION IN FEDERAL HEALTH CARE PRO- 1902(e)(13) and 2107(e)(1)(B) of such Act (42 ‘‘(2) LOCAL MEMORANDUM OF UNDER- GRAMS.— U.S.C. 1396a(e)(13), 1397gg(e)(1)(B)); and STANDING.—The term ‘local memorandum of ‘‘(1) EXCLUDED ENTITIES.—No entity oper- ‘‘(3) the protection of certain property understanding’ means a memorandum of un- ated by the Service, an Indian Tribe, Tribal from estate recovery provisions under the derstanding between the Secretary (or a des- Organization, or Urban Indian Organization Medicaid program, see section 1917(b)(3)(B) of ignee, including the director of any Area Of- that has been excluded from participation in such Act (42 U.S.C. 1396p(b)(3)(B)). fice of the Service) and the Secretary of Vet- any Federal health care program or for ‘‘SEC. 414. TREATMENT UNDER MEDICAID AND erans Affairs (or a designee) to implement which a license is under suspension or has SCHIP MANAGED CARE. the document entitled ‘Memorandum of Un- been revoked by the State where the entity ‘‘For provisions relating to the treatment derstanding Between the VA/Veterans is located shall be eligible to receive pay- of Indians enrolled in a managed care entity Health Administration And HHS/Indian ment or reimbursement under any such pro- under the Medicaid program under title XIX Health Service’ and dated February 25, 2003 gram for health care services furnished to an of the Social Security Act and Indian Health (relating to cooperation and resource sharing Indian. Programs and Urban Indian Organizations between the Veterans Health Administration ‘‘(2) EXCLUDED INDIVIDUALS.—No individual that are providers of items or services to and Indian Health Service). who has been excluded from participation in such Indian enrollees, see sections 1932(h)

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00080 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1297 and 2107(e)(1)(H) of the Social Security Act Urban Centers, of programs which meet the administering contracts entered into or re- (42 U.S.C. 1396u–2(h), 1397gg(e)(1)(H)). requirements set forth in this title. Subject ceiving grants under this section. ‘‘SEC. 415. NAVAJO NATION MEDICAID AGENCY to section 506, the Secretary, acting through ‘‘(2) DEFINITION.—For purposes of this sub- FEASIBILITY STUDY. the Service, shall include such conditions as section, the term ‘immunization services’ ‘‘(a) STUDY.—The Secretary shall conduct a the Secretary considers necessary to effect means services to provide without charge study to determine the feasibility of treating the purpose of this title in any contract into immunizations against vaccine-preventable the Navajo Nation as a State for the pur- which the Secretary enters with, or in any diseases. poses of title XIX of the Social Security Act, grant the Secretary makes to, any Urban In- ‘‘(e) BEHAVIORAL HEALTH SERVICES.— to provide services to Indians living within dian Organization pursuant to this title. ‘‘(1) ACCESS OR SERVICES PROVIDED.—The the boundaries of the Navajo Nation through ‘‘SEC. 503. CONTRACTS AND GRANTS FOR THE an entity established having the same au- Secretary, acting through the Service, shall PROVISION OF HEALTH CARE AND facilitate access to, or provide, behavioral thority and performing the same functions REFERRAL SERVICES. as single-State medicaid agencies respon- health services for Urban Indians through ‘‘(a) REQUIREMENTS FOR GRANTS AND CON- grants made to Urban Indian Organizations sible for the administration of the State plan TRACTS.—Under authority of the Act of No- under title XIX of the Social Security Act. administering contracts entered into or re- vember 2, 1921 (25 U.S.C. 13) (commonly ceiving grants under subsection (a). ‘‘(b) CONSIDERATIONS.—In conducting the known as the ‘Snyder Act’), the Secretary, study, the Secretary shall consider the feasi- acting through the Service, shall enter into ‘‘(2) ASSESSMENT REQUIRED.—Except as pro- bility of— contracts with, and make grants to, Urban vided by paragraph (3)(A), a grant may not ‘‘(1) assigning and paying all expenditures Indian Organizations for the provision of be made under this subsection to an Urban for the provision of services and related ad- health care and referral services for Urban Indian Organization until that organization ministration funds, under title XIX of the Indians. Any such contract or grant shall in- has prepared, and the Service has approved, Social Security Act, to Indians living within clude requirements that the Urban Indian an assessment of the following: the boundaries of the Navajo Nation that are Organization successfully undertake to— ‘‘(A) The behavioral health needs of the currently paid to or would otherwise be paid ‘‘(1) estimate the population of Urban Indi- Urban Indian population concerned. to the State of Arizona, New Mexico, or ans residing in the Urban Center or centers ‘‘(B) The behavioral health services and Utah; that the organization proposes to serve who other related resources available to that pop- ‘‘(2) providing assistance to the Navajo Na- are or could be recipients of health care or ulation. tion in the development and implementation referral services; ‘‘(C) The barriers to obtaining those serv- of such entity for the administration, eligi- ‘‘(2) estimate the current health status of ices and resources. bility, payment, and delivery of medical as- Urban Indians residing in such Urban Center ‘‘(D) The needs that are unmet by such sistance under title XIX of the Social Secu- or centers; services and resources. rity Act; ‘‘(3) estimate the current health care needs ‘‘(3) PURPOSES OF GRANTS.—Grants may be ‘‘(3) providing an appropriate level of of Urban Indians residing in such Urban Cen- made under this subsection for the following: matching funds for Federal medical assist- ter or centers; ‘‘(A) To prepare assessments required ance with respect to amounts such entity ex- ‘‘(4) provide basic health education, includ- under paragraph (2). pends for medical assistance for services and ing health promotion and disease prevention related administrative costs; and ‘‘(B) To provide outreach, educational, and education, to Urban Indians; referral services to Urban Indians regarding ‘‘(4) authorizing the Secretary, at the op- ‘‘(5) make recommendations to the Sec- the availability of direct behavioral health tion of the Navajo Nation, to treat the Nav- retary and Federal, State, local, and other ajo Nation as a State for the purposes of services, to educate Urban Indians about be- resource agencies on methods of improving havioral health issues and services, and ef- title XIX of the Social Security Act (relating health service programs to meet the needs of to the State children’s health insurance pro- fect coordination with existing behavioral Urban Indians; and health providers in order to improve services gram) under terms equivalent to those de- ‘‘(6) where necessary, provide, or enter into scribed in paragraphs (2) through (4). to Urban Indians. contracts for the provision of, health care ‘‘(C) To provide outpatient behavioral ‘‘(c) REPORT.—Not later then 3 years after services for Urban Indians. the date of enactment of the Indian Health health services to Urban Indians, including ‘‘(b) CRITERIA.—The Secretary, acting the identification and assessment of illness, Care Improvement Act Amendments of 2008, through the Service, shall, by regulation, the Secretary shall submit to the Committee therapeutic treatments, case management, prescribe the criteria for selecting Urban In- support groups, family treatment, and other on Indian Affairs and Committee on Finance dian Organizations to enter into contracts or of the Senate and the Committee on Natural treatment. receive grants under this section. Such cri- ‘‘(D) To develop innovative behavioral Resources and Committee on Energy and teria shall, among other factors, include— Commerce of the House of Representatives a health service delivery models which incor- report that includes— ‘‘(1) the extent of unmet health care needs porate Indian cultural support systems and of Urban Indians in the Urban Center or cen- resources. ‘‘(1) the results of the study under this sec- ters involved; tion; ‘‘(f) PREVENTION OF CHILD ABUSE.— ‘‘(2) the size of the Urban Indian popu- ‘‘(2) a summary of any consultation that ‘‘(1) ACCESS OR SERVICES PROVIDED.—The lation in the Urban Center or centers in- Secretary, acting through the Service, shall occurred between the Secretary and the Nav- volved; ajo Nation, other Indian Tribes, the States of facilitate access to or provide services for Arizona, New Mexico, and Utah, counties ‘‘(3) the extent, if any, to which the activi- Urban Indians through grants to Urban In- which include Navajo Lands, and other inter- ties set forth in subsection (a) would dupli- dian Organizations administering contracts ested parties, in conducting this study; cate any project funded under this title, or entered into or receiving grants under sub- under any current public health service ‘‘(3) projected costs or savings associated section (a) to prevent and treat child abuse project funded in a manner other than pursu- (including sexual abuse) among Urban Indi- with establishment of such entity, and any ant to this title; estimated impact on services provided as de- ans. scribed in this section in relation to probable ‘‘(4) the capability of an Urban Indian Or- ‘‘(2) EVALUATION REQUIRED.—Except as pro- costs or savings; and ganization to perform the activities set forth vided by paragraph (3)(A), a grant may not in subsection (a) and to enter into a contract be made under this subsection to an Urban ‘‘(4) legislative actions that would be re- with the Secretary or to meet the require- quired to authorize the establishment of Indian Organization until that organization ments for receiving a grant under this sec- has prepared, and the Service has approved, such entity if such entity is determined by tion; the Secretary to be feasible. an assessment that documents the preva- ‘‘(5) the satisfactory performance and suc- lence of child abuse in the Urban Indian pop- ‘‘SEC. 416. GENERAL EXCEPTIONS. cessful completion by an Urban Indian Orga- ulation concerned and specifies the services ‘‘The requirements of this title shall not nization of other contracts with the Sec- and programs (which may not duplicate ex- apply to any excepted benefits described in retary under this title; isting services and programs) for which the paragraph (1)(A) or (3) of section 2791(c) of ‘‘(6) the appropriateness and likely effec- grant is requested. the Public Health Service Act (42 U.S.C. tiveness of conducting the activities set ‘‘(3) PURPOSES OF GRANTS.—Grants may be 300gg–91). forth in subsection (a) in an Urban Center or made under this subsection for the following: ‘‘SEC. 417. AUTHORIZATION OF APPROPRIATIONS. centers; and ‘‘(A) To prepare assessments required ‘‘There are authorized to be appropriated ‘‘(7) the extent of existing or likely future under paragraph (2). such sums as may be necessary for each fis- participation in the activities set forth in ‘‘(B) For the development of prevention, cal year through fiscal year 2017 to carry out subsection (a) by appropriate health and training, and education programs for Urban this title. health-related Federal, State, local, and Indians, including child education, parent ‘‘TITLE V—HEALTH SERVICES FOR URBAN other agencies. education, provider training on identifica- INDIANS ‘‘(c) ACCESS TO HEALTH PROMOTION AND tion and intervention, education on report- ‘‘SEC. 501. PURPOSE. DISEASE PREVENTION PROGRAMS.—The Sec- ing requirements, prevention campaigns, and ‘‘The purpose of this title is to establish retary, acting through the Service, shall fa- establishing service networks of all those in- and maintain programs in Urban Centers to cilitate access to or provide health pro- volved in Indian child protection. make health services more accessible and motion and disease prevention services for ‘‘(C) To provide direct outpatient treat- available to Urban Indians. Urban Indians through grants made to Urban ment services (including individual treat- ‘‘SEC. 502. CONTRACTS WITH, AND GRANTS TO, Indian Organizations administering con- ment, family treatment, group therapy, and URBAN INDIAN ORGANIZATIONS. tracts entered into or receiving grants under support groups) to Urban Indians who are ‘‘Under authority of the Act of November subsection (a). child victims of abuse (including sexual 2, 1921 (25 U.S.C. 13) (commonly known as the ‘‘(d) IMMUNIZATION SERVICES.— abuse) or adult survivors of child sexual ‘Snyder Act’), the Secretary, acting through ‘‘(1) ACCESS OR SERVICES PROVIDED.—The abuse, to the families of such child victims, the Service, shall enter into contracts with, Secretary, acting through the Service, shall and to Urban Indian perpetrators of child or make grants to, Urban Indian Organiza- facilitate access to, or provide, immuniza- abuse (including sexual abuse). tions to assist such organizations in the es- tion services for Urban Indians through ‘‘(4) CONSIDERATIONS WHEN MAKING tablishment and administration, within grants made to Urban Indian Organizations GRANTS.—In making grants to carry out this

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00081 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1298 CONGRESSIONAL RECORD — SENATE February 27, 2008 subsection, the Secretary shall take into gram under title XVIII of the Social Secu- Urban Indian Organizations and regulations consideration— rity Act. adopted pursuant to this title shall include ‘‘(A) the support for the Urban Indian Or- ‘‘(c) NONCOMPLIANCE; UNSATISFACTORY PER- provisions to assure the fair and uniform ganization demonstrated by the child protec- FORMANCE.—If, as a result of the evaluations provision to Urban Indians of services and tion authorities in the area, including com- conducted under this section, the Secretary assistance under such contracts or grants by mittees or other services funded under the determines that an Urban Indian Organiza- such organizations. Indian Child Welfare Act of 1978 (25 U.S.C. tion has not complied with the requirements ‘‘SEC. 507. REPORTS AND RECORDS. 1901 et seq.), if any; of a grant or complied with or satisfactorily ‘‘(a) REPORTS.— ‘‘(B) the capability and expertise dem- performed a contract under section 503, the ‘‘(1) IN GENERAL.—For each fiscal year dur- onstrated by the Urban Indian Organization Secretary shall, prior to renewing such con- ing which an Urban Indian Organization re- to address the complex problem of child sex- tract or grant, attempt to resolve with the ceives or expends funds pursuant to a con- ual abuse in the community; and organization the areas of noncompliance or tract entered into or a grant received pursu- ‘‘(C) the assessment required under para- unsatisfactory performance and modify the ant to this title, such Urban Indian Organi- graph (2). contract or grant to prevent future occur- zation shall submit to the Secretary not rences of noncompliance or unsatisfactory more frequently than every 6 months, a re- ‘‘(g) OTHER GRANTS.—The Secretary, act- performance. If the Secretary determines ing through the Service, may enter into a port that includes the following: that the noncompliance or unsatisfactory ‘‘(A) In the case of a contract or grant contract with or make grants to an Urban performance cannot be resolved and pre- Indian Organization that provides or ar- under section 503, recommendations pursu- vented in the future, the Secretary shall not ant to section 503(a)(5). ranges for the provision of health care serv- renew the contract or grant with the organi- ices (through satellite facilities, provider ‘‘(B) Information on activities conducted zation and is authorized to enter into a con- by the organization pursuant to the contract networks, or otherwise) to Urban Indians in tract or make a grant under section 503 with more than 1 Urban Center. or grant. another Urban Indian Organization which is ‘‘(C) An accounting of the amounts and ‘‘SEC. 504. CONTRACTS AND GRANTS FOR THE DE- situated in the same Urban Center as the TERMINATION OF UNMET HEALTH purpose for which Federal funds were ex- Urban Indian Organization whose contract or pended. CARE NEEDS. grant is not renewed under this section. ‘‘(a) GRANTS AND CONTRACTS AUTHORIZED.— ‘‘(D) A minimum set of data, using uni- ‘‘(d) CONSIDERATIONS FOR RENEWALS.—In formly defined elements, as specified by the Under authority of the Act of November 2, determining whether to renew a contract or 1921 (25 U.S.C. 13) (commonly known as the Secretary after consultation with Urban In- grant with an Urban Indian Organization dian Organizations. ‘Snyder Act’), the Secretary, acting through under section 503 which has completed per- the Service, may enter into contracts with formance of a contract or grant under sec- ‘‘(2) HEALTH STATUS AND SERVICES.— or make grants to Urban Indian Organiza- tion 504, the Secretary shall review the ‘‘(A) IN GENERAL.—Not later than 18 tions situated in Urban Centers for which records of the Urban Indian Organization, months after the date of enactment of the contracts have not been entered into or the reports submitted under section 507, and Indian Health Care Improvement Act grants have not been made under section 503. shall consider the results of the onsite eval- Amendments of 2008, the Secretary, acting ‘‘(b) PURPOSE.—The purpose of a contract uations or accreditations under subsection through the Service and working with a na- or grant made under this section shall be the (b). tional membership-based consortium of Urban Indian Organizations, shall submit to determination of the matters described in ‘‘SEC. 506. OTHER CONTRACT AND GRANT RE- subsection (c)(1) in order to assist the Sec- QUIREMENTS. Congress a report evaluating— retary in assessing the health status and ‘‘(a) PROCUREMENT.—Contracts with Urban ‘‘(i) the health status of Urban Indians; health care needs of Urban Indians in the Indian Organizations entered into pursuant ‘‘(ii) the services provided to Indians pur- Urban Center involved and determining to this title shall be in accordance with all suant to this title; and whether the Secretary should enter into a Federal contracting laws and regulations re- ‘‘(iii) areas of unmet needs in the delivery contract or make a grant under section 503 lating to procurement except that in the dis- of health services to Urban Indians, includ- with respect to the Urban Indian Organiza- cretion of the Secretary, such contracts may ing unmet health care facilities needs. tion which the Secretary has entered into a be negotiated without advertising and need ‘‘(B) CONSULTATION AND CONTRACTS.—In contract with, or made a grant to, under this not conform to the provisions of sections preparing the report under paragraph (1), the section. 1304 and 3131 through 3133 of title 40, United Secretary— ‘‘(c) GRANT AND CONTRACT REQUIRE- States Code. ‘‘(i) shall confer with Urban Indian Organi- MENTS.—Any contract entered into, or grant ‘‘(b) PAYMENTS UNDER CONTRACTS OR zations; and made, by the Secretary under this section GRANTS.— ‘‘(ii) may enter into a contract with a na- shall include requirements that— ‘‘(1) IN GENERAL.—Payments under any tional organization representing Urban In- ‘‘(1) the Urban Indian Organization suc- contracts or grants pursuant to this title, dian Organizations to conduct any aspect of cessfully undertakes to— notwithstanding any term or condition of the report. ‘‘(A) document the health care status and such contract or grant— ‘‘(b) AUDIT.—The reports and records of the unmet health care needs of Urban Indians in ‘‘(A) may be made in a single advance pay- Urban Indian Organization with respect to a the Urban Center involved; and ment by the Secretary to the Urban Indian contract or grant under this title shall be ‘‘(B) with respect to Urban Indians in the Organization by no later than the end of the subject to audit by the Secretary and the Urban Center involved, determine the mat- first 30 days of the funding period with re- Comptroller General of the United States. ters described in paragraphs (2), (3), (4), and spect to which the payments apply, unless ‘‘(c) COSTS OF AUDITS.—The Secretary shall (7) of section 503(b); and the Secretary determines through an evalua- allow as a cost of any contract or grant en- ‘‘(2) the Urban Indian Organization com- tion under section 505 that the organization tered into or awarded under section 502 or 503 plete performance of the contract, or carry is not capable of administering such a single the cost of an annual independent financial out the requirements of the grant, within 1 advance payment; and audit conducted by— year after the date on which the Secretary ‘‘(B) if any portion thereof is unexpended ‘‘(1) a certified public accountant; or and such organization enter into such con- by the Urban Indian Organization during the ‘‘(2) a certified public accounting firm tract, or within 1 year after such organiza- funding period with respect to which the qualified to conduct Federal compliance au- tion receives such grant, whichever is appli- payments initially apply, shall be carried dits. cable. forward for expenditure with respect to al- ‘‘SEC. 508. LIMITATION ON CONTRACT AUTHOR- ‘‘(d) NO RENEWALS.—The Secretary may lowable or reimbursable costs incurred by ITY. not renew any contract entered into or grant the organization during 1 or more subse- ‘‘The authority of the Secretary to enter made under this section. quent funding periods without additional into contracts or to award grants under this ‘‘SEC. 505. EVALUATIONS; RENEWALS. justification or documentation by the orga- title shall be to the extent, and in an ‘‘(a) PROCEDURES FOR EVALUATIONS.—The nization as a condition of carrying forward amount, provided for in appropriation Acts. Secretary, acting through the Service, shall the availability for expenditure of such ‘‘SEC. 509. FACILITIES. develop procedures to evaluate compliance funds. ‘‘(a) GRANTS.—The Secretary, acting with grant requirements and compliance ‘‘(2) SEMIANNUAL AND QUARTERLY PAYMENTS through the Service, may make grants to with and performance of contracts entered AND REIMBURSEMENTS.—If the Secretary de- contractors or grant recipients under this into by Urban Indian Organizations under termines under paragraph (1)(A) that an title for the lease, purchase, renovation, con- this title. Such procedures shall include pro- Urban Indian Organization is not capable of struction, or expansion of facilities, includ- visions for carrying out the requirements of administering an entire single advance paying leased facilities, in order to assist such this section. ment, on request of the Urban Indian Organi- contractors or grant recipients in complying ‘‘(b) EVALUATIONS.—The Secretary, acting zation, the payments may be made— with applicable licensure or certification re- through the Service, shall evaluate the com- ‘‘(A) in semiannual or quarterly payments quirements. pliance of each Urban Indian Organization by not later than 30 days after the date on ‘‘(b) LOAN FUND STUDY.—The Secretary, which has entered into a contract or received which the funding period with respect to acting through the Service, may carry out a a grant under section 503 with the terms of which the payments apply begins; or study to determine the feasibility of estab- such contract or grant. For purposes of this ‘‘(B) by way of reimbursement. lishing a loan fund to provide to Urban In- evaluation, the Secretary shall— ‘‘(c) REVISION OR AMENDMENT OF CON- dian Organizations direct loans or guaran- ‘‘(1) acting through the Service, conduct an TRACTS.—Notwithstanding any provision of tees for loans for the construction of health annual onsite evaluation of the organization; law to the contrary, the Secretary may, at care facilities in a manner consistent with or the request and consent of an Urban Indian section 309, including by submitting a report ‘‘(2) accept in lieu of such onsite evalua- Organization, revise or amend any contract in accordance with subsection (c) of that section evidence of the organization’s provi- entered into by the Secretary with such or- tion. sional or full accreditation by a private inde- ganization under this title as necessary to ‘‘SEC. 510. DIVISION OF URBAN INDIAN HEALTH. pendent entity recognized by the Secretary carry out the purposes of this title. ‘‘There is established within the Service a for purposes of conducting quality reviews of ‘‘(d) FAIR AND UNIFORM SERVICES AND AS- Division of Urban Indian Health, which shall providers participating in the Medicare pro- SISTANCE.—Contracts with or grants to be responsible for—

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‘‘(1) carrying out the provisions of this ‘‘(d) REPORT.—The Secretary shall evalu- the employment of Indians trained as health title; ate and report to Congress on the activities service providers through the Community ‘‘(2) providing central oversight of the pro- of programs funded under this section not Health Representatives Program under sec- grams and services authorized under this less than every 5 years. tion 109 in the provision of health care, title; and ‘‘SEC. 514. CONFERRING WITH URBAN INDIAN OR- health promotion, and disease prevention ‘‘(3) providing technical assistance to GANIZATIONS. services to Urban Indians. Urban Indian Organizations working with a ‘‘(a) IN GENERAL.—The Secretary shall en- ‘‘SEC. 518. EFFECTIVE DATE. national membership-based consortium of sure that the Service confers or conferences, ‘‘The amendments made by the Indian Urban Indian Organizations. to the greatest extent practicable, with Health Care Improvement Act Amendments ‘‘SEC. 511. GRANTS FOR ALCOHOL AND SUB- Urban Indian Organizations. of 2008 to this title shall take effect begin- STANCE ABUSE-RELATED SERVICES. ‘‘(b) DEFINITION OF CONFER; CONFERENCE.— ning on the date of enactment of that Act, ‘‘(a) GRANTS AUTHORIZED.—The Secretary, In this section, the terms ‘confer’ and ‘con- regardless of whether the Secretary has pro- acting through the Service, may make ference’ mean an open and free exchange of mulgated regulations implementing such grants for the provision of health-related information and opinions that— amendments. services in prevention of, treatment of, reha- ‘‘(1) leads to mutual understanding and ‘‘SEC. 519. ELIGIBILITY FOR SERVICES. bilitation of, or school- and community- comprehension; and ‘‘Urban Indians shall be eligible for, and based education regarding, alcohol and sub- ‘‘(2) emphasizes trust, respect, and shared the ultimate beneficiaries of, health care or stance abuse, including fetal alcohol spec- responsibility. referral services provided pursuant to this trum disorders, in Urban Centers to those ‘‘SEC. 515. URBAN YOUTH TREATMENT CENTER title. Urban Indian Organizations with which the DEMONSTRATION. ‘‘SEC. 520. AUTHORIZATION OF APPROPRIATIONS. Secretary has entered into a contract under ‘‘(a) CONSTRUCTION AND OPERATION.— ‘‘There are authorized to be appropriated this title or under section 201. ‘‘(1) IN GENERAL.—The Secretary, acting such sums as may be necessary for each fis- ‘‘(b) GOALS.—Each grant made pursuant to through the Service, through grant or con- cal year through fiscal year 2017 to carry out subsection (a) shall set forth the goals to be tract, shall fund the construction and oper- this title. accomplished pursuant to the grant. The ation of at least 1 residential treatment cen- goals shall be specific to each grant as ‘‘TITLE VI—ORGANIZATIONAL ter in each Service Area that meets the eligi- IMPROVEMENTS agreed to between the Secretary and the bility requirements set forth in subsection grantee. ‘‘SEC. 601. ESTABLISHMENT OF THE INDIAN (b) to demonstrate the provision of alcohol HEALTH SERVICE AS AN AGENCY OF ‘‘(c) CRITERIA.—The Secretary shall estab- and substance abuse treatment services to THE PUBLIC HEALTH SERVICE. lish criteria for the grants made under sub- Urban Indian youth in a culturally com- ‘‘(a) ESTABLISHMENT.— section (a), including criteria relating to the petent residential setting. following: ‘‘(1) IN GENERAL.—In order to more effec- ‘‘(2) TREATMENT.—Each residential treat- tively and efficiently carry out the respon- ‘‘(1) The size of the Urban Indian popu- ment center described in paragraph (1) shall lation. sibilities, authorities, and functions of the be in addition to any facilities constructed United States to provide health care services ‘‘(2) Capability of the organization to ade- under section 707(b). to Indians and Indian Tribes, as are or may quately perform the activities required ‘‘(b) ELIGIBILITY REQUIREMENTS.—To be eli- be hereafter provided by Federal statute or under the grant. gible to obtain a facility under subsection treaties, there is established within the Pub- ‘‘(3) Satisfactory performance standards (a)(1), a Service Area shall meet the fol- lic Health Service of the Department the In- for the organization in meeting the goals set lowing requirements: dian Health Service. forth in such grant. The standards shall be ‘‘(1) There is an Urban Indian Organization ‘‘(2) DIRECTOR.—The Service shall be ad- negotiated and agreed to between the Sec- in the Service Area. ministered by a Director, who shall be ap- retary and the grantee on a grant-by-grant pointed by the President, by and with the ad- basis. ‘‘(2) There reside in the Service Area Urban Indian youth with need for alcohol and sub- vice and consent of the Senate. The Director ‘‘(4) Identification of the need for services. stance abuse treatment services in a residen- shall report to the Secretary. Effective with ‘‘(d) ALLOCATION OF GRANTS.—The Sec- tial setting. respect to an individual appointed by the retary shall develop a methodology for allo- ‘‘(3) There is a significant shortage of cul- President, by and with the advice and con- cating grants made pursuant to this section turally competent residential treatment sent of the Senate, after January 1, 2008, the based on the criteria established pursuant to services for Urban Indian youth in the Serv- term of service of the Director shall be 4 subsection (c). ice Area. years. A Director may serve more than 1 ‘‘(e) GRANTS SUBJECT TO CRITERIA.—Any term. ‘‘SEC. 516. GRANTS FOR DIABETES PREVENTION, grant received by an Urban Indian Organiza- TREATMENT, AND CONTROL. ‘‘(3) INCUMBENT.—The individual serving in tion under this Act for substance abuse pre- the position of Director of the Service on the vention, treatment, and rehabilitation shall ‘‘(a) GRANTS AUTHORIZED.—The Secretary may make grants to those Urban Indian Or- day before the date of enactment of the In- be subject to the criteria set forth in sub- dian Health Care Improvement Act Amend- section (c). ganizations that have entered into a contract or have received a grant under this ments of 2008 shall serve as Director. ‘‘SEC. 512. TREATMENT OF CERTAIN DEMONSTRA- title for the provision of services for the pre- ‘‘(4) ADVOCACY AND CONSULTATION.—The po- TION PROJECTS. vention and treatment of, and control of the sition of Director is established to, in a man- ‘‘Notwithstanding any other provision of complications resulting from, diabetes ner consistent with the government-to-gov- law, the Tulsa Clinic and Oklahoma City among Urban Indians. ernment relationship between the United Clinic demonstration projects shall— States and Indian Tribes— ‘‘(b) GOALS.—Each grant made pursuant to ‘‘(1) be permanent programs within the subsection (a) shall set forth the goals to be ‘‘(A) facilitate advocacy for the develop- Service’s direct care program; accomplished under the grant. The goals ment of appropriate Indian health policy; ‘‘(2) continue to be treated as Service Units shall be specific to each grant as agreed to and and Operating Units in the allocation of re- between the Secretary and the grantee. ‘‘(B) promote consultation on matters resources and coordination of care; and lating to Indian health. ‘‘(c) ESTABLISHMENT OF CRITERIA.—The ‘‘(3) continue to meet the requirements and Secretary shall establish criteria for the ‘‘(b) AGENCY.—The Service shall be an definitions of an Urban Indian Organization grants made under subsection (a) relating agency within the Public Health Service of in this Act, and shall not be subject to the to— the Department, and shall not be an office, provisions of the Indian Self-Determination ‘‘(1) the size and location of the Urban In- component, or unit of any other agency of and Education Assistance Act (25 U.S.C. 450 the Department. et seq.). dian population to be served; ‘‘(2) the need for prevention of and treat- ‘‘(c) DUTIES.—The Director shall— ‘‘SEC. 513. URBAN NIAAA TRANSFERRED PRO- ‘‘(1) perform all functions that were, on the GRAMS. ment of, and control of the complications resulting from, diabetes among the Urban In- day before the date of enactment of the In- ‘‘(a) GRANTS AND CONTRACTS.—The Sec- dian Health Care Improvement Act Amend- retary, through the Division of Urban Indian dian population to be served; ‘‘(3) performance standards for the organi- ments of 2008, carried out by or under the di- Health, shall make grants to, or enter into rection of the individual serving as Director contracts with, Urban Indian Organizations, zation in meeting the goals set forth in such grant that are negotiated and agreed to by of the Service on that day; to take effect not later than September 30, ‘‘(2) perform all functions of the Secretary 2010, for the administration of Urban Indian the Secretary and the grantee; ‘‘(4) the capability of the organization to relating to the maintenance and operation of alcohol programs that were originally estab- hospital and health facilities for Indians and lished under the National Institute on Alco- adequately perform the activities required under the grant; and the planning for, and provision and utiliza- holism and Alcohol Abuse (hereafter in this tion of, health services for Indians; section referred to as ‘NIAAA’) and trans- ‘‘(5) the willingness of the organization to ferred to the Service. collaborate with the registry, if any, estab- ‘‘(3) administer all health programs under lished by the Secretary under section 204(e) which health care is provided to Indians ‘‘(b) USE OF FUNDS.—Grants provided or based upon their status as Indians which are contracts entered into under this section in the Area Office of the Service in which the organization is located. administered by the Secretary, including shall be used to provide support for the con- programs under— tinuation of alcohol prevention and treat- ‘‘(d) FUNDS SUBJECT TO CRITERIA.—Any ment services for Urban Indian populations funds received by an Urban Indian Organiza- ‘‘(A) this Act; and such other objectives as are agreed upon tion under this Act for the prevention, treat- ‘‘(B) the Act of November 2, 1921 (25 U.S.C. between the Service and a recipient of a ment, and control of diabetes among Urban 13); grant or contract under this section. Indians shall be subject to the criteria devel- ‘‘(C) the Act of August 5, 1954 (42 U.S.C. ‘‘(c) ELIGIBILITY.—Urban Indian Organiza- oped by the Secretary under subsection (c). 2001 et seq.); tions that operate Indian alcohol programs ‘‘SEC. 517. COMMUNITY HEALTH REPRESENTA- ‘‘(D) the Act of August 16, 1957 (42 U.S.C. originally funded under the NIAAA and sub- TIVES. 2005 et seq.); and sequently transferred to the Service are eli- ‘‘The Secretary, acting through the Serv- ‘‘(E) the Indian Self-Determination and gible for grants or contracts under this sec- ice, may enter into contracts with, and make Education Assistance Act (25 U.S.C. 450 et tion. grants to, Urban Indian Organizations for seq.);

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‘‘(4) administer all scholarship and loan ‘‘TITLE VII—BEHAVIORAL HEALTH ‘‘(1) COMPREHENSIVE CARE.—A comprehen- functions carried out under title I; PROGRAMS sive continuum of behavioral health care ‘‘(5) directly advise the Secretary con- ‘‘SEC. 701. BEHAVIORAL HEALTH PREVENTION which provides— cerning the development of all policy- and AND TREATMENT SERVICES. ‘‘(A) community-based prevention, inter- budget-related matters affecting Indian ‘‘(a) PURPOSES.—The purposes of this sec- vention, outpatient, and behavioral health health; tion are as follows: aftercare; ‘‘(6) collaborate with the Assistant Sec- ‘‘(1) To authorize and direct the Secretary, ‘‘(B) detoxification (social and medical); retary for Health concerning appropriate acting through the Service, Indian Tribes ‘‘(C) acute hospitalization; matters of Indian health that affect the and Tribal Organizations to develop a com- agencies of the Public Health Service; ‘‘(D) intensive outpatient/day treatment; prehensive behavioral health prevention and ‘‘(E) residential treatment; ‘‘(7) advise each Assistant Secretary of the treatment program which emphasizes col- Department concerning matters of Indian laboration among alcohol and substance ‘‘(F) transitional living for those needing a health with respect to which that Assistant abuse, social services, and mental health temporary, stable living environment that is Secretary has authority and responsibility; programs. supportive of treatment and recovery goals; ‘‘(8) advise the heads of other agencies and ‘‘(2) To provide information, direction, and ‘‘(G) emergency shelter; programs of the Department concerning guidance relating to mental illness and dys- ‘‘(H) intensive case management; matters of Indian health with respect to function and self-destructive behavior, in- ‘‘(I) diagnostic services; and which those heads have authority and re- cluding child abuse and family violence, to ‘‘(J) promotion of healthy approaches to sponsibility; those Federal, tribal, State, and local agen- risk and safety issues, including injury pre- ‘‘(9) coordinate the activities of the De- cies responsible for programs in Indian com- vention. partment concerning matters of Indian munities in areas of health care, education, ‘‘(2) CHILD CARE.—Behavioral health serv- health; and social services, child and family welfare, al- ices for Indians from birth through age 17, ‘‘(10) perform such other functions as the cohol and substance abuse, law enforcement, including— Secretary may designate. and judicial services. ‘‘(A) preschool and school age fetal alcohol ‘‘(d) AUTHORITY.— ‘‘(3) To assist Indian Tribes to identify spectrum disorder services, including assess- ‘‘(1) IN GENERAL.—The Secretary, acting services and resources available to address ment and behavioral intervention; through the Director, shall have the author- mental illness and dysfunctional and self-de- ‘‘(B) mental health and substance abuse ity— structive behavior. services (emotional, organic, alcohol, drug, ‘‘(A) except to the extent provided for in ‘‘(4) To provide authority and opportuni- inhalant, and tobacco); paragraph (2), to appoint and compensate ties for Indian Tribes and Tribal Organiza- ‘‘(C) identification and treatment of co-oc- employees for the Service in accordance with tions to develop, implement, and coordinate curring disorders and comorbidity; title 5, United States Code; with community-based programs which include identification, prevention, education, ‘‘(D) prevention of alcohol, drug, inhalant, ‘‘(B) to enter into contracts for the pro- and tobacco use; curement of goods and services to carry out referral, and treatment services, including the functions of the Service; and through multidisciplinary resource teams. ‘‘(E) early intervention, treatment, and aftercare; and ‘‘(C) to manage, expend, and obligate all ‘‘(5) To ensure that Indians, as citizens of funds appropriated for the Service. the United States and of the States in which ‘‘(F) identification and treatment of neglect and physical, mental, and sexual abuse. ‘‘(2) PERSONNEL ACTIONS.—Notwithstanding they reside, have the same access to behav- any other provision of law, the provisions of ioral health services to which all citizens ‘‘(3) ADULT CARE.—Behavioral health serv- section 12 of the Act of June 18, 1934 (48 Stat. have access. ices for Indians from age 18 through 55, in- 986; 25 U.S.C. 472), shall apply to all per- ‘‘(6) To modify or supplement existing pro- cluding— sonnel actions taken with respect to new po- grams and authorities in the areas identified ‘‘(A) early intervention, treatment, and sitions created within the Service as a result in paragraph (2). aftercare; of its establishment under subsection (a). ‘‘(b) PLANS.— ‘‘(B) mental health and substance abuse ‘‘SEC. 602. AUTOMATED MANAGEMENT INFORMA- ‘‘(1) DEVELOPMENT.—The Secretary, acting services (emotional, alcohol, drug, inhalant, TION SYSTEM. through the Service, Indian Tribes, and Trib- and tobacco), including sex specific services; ‘‘(a) ESTABLISHMENT.— al Organizations, shall encourage Indian ‘‘(C) identification and treatment of co-oc- ‘‘(1) IN GENERAL.—The Secretary shall es- Tribes and Tribal Organizations to develop curring disorders (dual diagnosis) and comor- tablish an automated management informa- tribal plans and to participate in developing bidity; tion system for the Service. areawide plans for Indian Behavioral Health ‘‘(D) promotion of healthy approaches for ‘‘(2) REQUIREMENTS OF SYSTEM.—The infor- Services. The plans shall include, to the ex- risk-related behavior; mation system established under paragraph tent feasible, the following components: ‘‘(E) treatment services for women at risk (1) shall include— ‘‘(A) An assessment of the scope of alcohol of a fetal alcohol-exposed pregnancy; and ‘‘(A) a financial management system; or other substance abuse, mental illness, and ‘‘(F) sex specific treatment for sexual as- ‘‘(B) a patient care information system for dysfunctional and self-destructive behavior, sault and domestic violence. each area served by the Service; including suicide, child abuse, and family vi- ‘‘(4) FAMILY CARE.—Behavioral health serv- olence, among Indians, including— ‘‘(C) a privacy component that protects the ices for families, including— privacy of patient information held by, or on ‘‘(i) the number of Indians served who are ‘‘(A) early intervention, treatment, and behalf of, the Service; directly or indirectly affected by such illness aftercare for affected families; or behavior; or ‘‘(D) a services-based cost accounting com- ‘‘(B) treatment for sexual assault and do- ponent that provides estimates of the costs ‘‘(ii) an estimate of the financial and mestic violence; and associated with the provision of specific human cost attributable to such illness or ‘‘(C) promotion of healthy approaches re- medical treatments or services in each Area behavior. lating to parenting, domestic violence, and office of the Service; ‘‘(B) An assessment of the existing and ad- other abuse issues. ditional resources necessary for the preven- ‘‘(E) an interface mechanism for patient ‘‘(5) ELDER CARE.—Behavioral health serv- billing and accounts receivable system; and tion and treatment of such illness and behav- ices for Indians 56 years of age and older, in- ior, including an assessment of the progress cluding— ‘‘(F) a training component. toward achieving the availability of the full ‘‘(b) PROVISION OF SYSTEMS TO TRIBES AND continuum of care described in subsection ‘‘(A) early intervention, treatment, and ORGANIZATIONS.—The Secretary shall provide (c). aftercare; each Tribal Health Program automated man- ‘‘(C) An estimate of the additional funding ‘‘(B) mental health and substance abuse agement information systems which— needed by the Service, Indian Tribes, and services (emotional, alcohol, drug, inhalant, ‘‘(1) meet the management information Tribal Organizations to meet their respon- and tobacco), including sex specific services; needs of such Tribal Health Program with re- sibilities under the plans. ‘‘(C) identification and treatment of co-occurring disorders (dual diagnosis) and comor- spect to the treatment by the Tribal Health ‘‘(2) COORDINATION WITH NATIONAL CLEAR- bidity; Program of patients of the Service; and INGHOUSES AND INFORMATION CENTERS.—The ‘‘(2) meet the management information Secretary, acting through the Service, shall ‘‘(D) promotion of healthy approaches to needs of the Service. coordinate with existing national clearing- managing conditions related to aging; ‘‘(c) ACCESS TO RECORDS.—Notwithstanding houses and information centers to include at ‘‘(E) sex specific treatment for sexual as- any other provision of law, each patient the clearinghouses and centers plans and re- sault, domestic violence, neglect, physical shall have reasonable access to the medical ports on the outcomes of such plans devel- and mental abuse and exploitation; and or health records of such patient which are oped by Indian Tribes, Tribal Organizations, ‘‘(F) identification and treatment of de- held by, or on behalf of, the Service. and Service Areas relating to behavioral mentias regardless of cause. ‘‘(d) AUTHORITY TO ENHANCE INFORMATION health. The Secretary shall ensure access to ‘‘(d) COMMUNITY BEHAVIORAL HEALTH TECHNOLOGY.—The Secretary, acting through these plans and outcomes by any Indian PLAN.— the Director, shall have the authority to Tribe, Tribal Organization, or the Service. ‘‘(1) ESTABLISHMENT.—The governing body enter into contracts, agreements, or joint ‘‘(3) TECHNICAL ASSISTANCE.—The Secretary of any Indian Tribe or Tribal Organization ventures with other Federal agencies, shall provide technical assistance to Indian may adopt a resolution for the establishment States, private and nonprofit organizations, Tribes and Tribal Organizations in prepara- of a community behavioral health plan pro- for the purpose of enhancing information tion of plans under this section and in devel- viding for the identification and coordina- technology in Indian Health Programs and oping standards of care that may be used and tion of available resources and programs to facilities. adopted locally. identify, prevent, or treat substance abuse, ‘‘SEC. 603. AUTHORIZATION OF APPROPRIATIONS. ‘‘(c) PROGRAMS.—The Secretary, acting mental illness, or dysfunctional and self-de- ‘‘There is authorized to be appropriated through the Service, Indian Tribes, and Trib- structive behavior, including child abuse and such sums as may be necessary for each fis- al Organizations, shall provide, to the extent family violence, among its members or its cal year through fiscal year 2017 to carry out feasible and if funding is available, programs service population. This plan should include this title. including the following: behavioral health services, social services,

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00084 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1301 intensive outpatient services, and continuing respect to the referral and treatment of du- vide assistance to Indian Tribes and Tribal aftercare. ally diagnosed individuals requiring behav- Organizations to develop criteria for the cer- ‘‘(2) TECHNICAL ASSISTANCE.—At the re- ioral health and substance abuse treatment; tification of behavioral health service pro- quest of an Indian Tribe or Tribal Organiza- and viders and accreditation of service facilities tion, the Bureau of Indian Affairs and the ‘‘(B) ensuring that the Bureau of Indian Af- which meet minimum standards for such Service shall cooperate with and provide fairs and Service programs and services (in- services and facilities. technical assistance to the Indian Tribe or cluding multidisciplinary resource teams) ‘‘SEC. 704. MENTAL HEALTH TECHNICIAN PRO- Tribal Organization in the development and addressing child abuse and family violence GRAM. implementation of such plan. are coordinated with such non-Federal pro- ‘‘(a) IN GENERAL.—Under the authority of ‘‘(3) FUNDING.—The Secretary, acting grams and services. the Act of November 2, 1921 (25 U.S.C. 13) through the Service, may make funding ‘‘(7) Directing appropriate officials of the (commonly known as the ‘Snyder Act’), the available to Indian Tribes and Tribal Organi- Bureau of Indian Affairs and the Service, Secretary shall establish and maintain a zations which adopt a resolution pursuant to particularly at the agency and Service Unit mental health technician program within paragraph (1) to obtain technical assistance levels, to cooperate fully with tribal requests the Service which— for the development of a community behav- made pursuant to community behavioral ‘‘(1) provides for the training of Indians as ioral health plan and to provide administra- health plans adopted under section 701(c) and mental health technicians; and tive support in the implementation of such section 4206 of the Indian Alcohol and Sub- plan. stance Abuse Prevention and Treatment Act ‘‘(2) employs such technicians in the provi- of 1986 (25 U.S.C. 2412). sion of community-based mental health care ‘‘(e) COORDINATION FOR AVAILABILITY OF that includes identification, prevention, edu- SERVICES.—The Secretary, acting through ‘‘(8) Providing for an annual review of such cation, referral, and treatment services. the Service, Indian Tribes, and Tribal Orga- agreement by the Secretaries which shall be nizations, shall coordinate behavioral health provided to Congress and Indian Tribes and ‘‘(b) PARAPROFESSIONAL TRAINING.—In car- planning, to the extent feasible, with other Tribal Organizations. rying out subsection (a), the Secretary, acting through the Service, Indian Tribes, and Federal agencies and with State agencies, to ‘‘(b) SPECIFIC PROVISIONS REQUIRED.—The encourage comprehensive behavioral health memoranda of agreement updated or entered Tribal Organizations, shall provide high- services for Indians regardless of their place into pursuant to subsection (a) shall include standard paraprofessional training in mental of residence. specific provisions pursuant to which the health care necessary to provide quality care Service shall assume responsibility for— to the Indian communities to be served. ‘‘(f) MENTAL HEALTH CARE NEED ASSESS- Such training shall be based upon a cur- MENT.—Not later than 1 year after the date ‘‘(1) the determination of the scope of the riculum developed or approved by the Sec- of enactment of the Indian Health Care Im- problem of alcohol and substance abuse retary which combines education in the the- provement Act Amendments of 2008, the Sec- among Indians, including the number of Indi- ory of mental health care with supervised retary, acting through the Service, shall ans within the jurisdiction of the Service who are directly or indirectly affected by al- practical experience in the provision of such make an assessment of the need for inpatient care. mental health care among Indians and the cohol and substance abuse and the financial availability and cost of inpatient mental and human cost; ‘‘(c) SUPERVISION AND EVALUATION OF TECH- health facilities which can meet such need. ‘‘(2) an assessment of the existing and NICIANS.—The Secretary, acting through the In making such assessment, the Secretary needed resources necessary for the preven- Service, Indian Tribes, and Tribal Organiza- shall consider the possible conversion of ex- tion of alcohol and substance abuse and the tions, shall supervise and evaluate the men- isting, underused Service hospital beds into treatment of Indians affected by alcohol and tal health technicians in the training pro- psychiatric units to meet such need. substance abuse; and gram. ‘‘SEC. 702. MEMORANDA OF AGREEMENT WITH ‘‘(3) an estimate of the funding necessary ‘‘(d) TRADITIONAL HEALTH CARE PRAC- THE DEPARTMENT OF THE INTE- to adequately support a program of preven- TICES.—The Secretary, acting through the RIOR. tion of alcohol and substance abuse and Service, shall ensure that the program estab- ‘‘(a) CONTENTS.—Not later than 12 months treatment of Indians affected by alcohol and lished pursuant to this subsection involves after the date of enactment of the Indian substance abuse. the use and promotion of the traditional health care practices of the Indian Tribes to Health Care Improvement Act Amendments ‘‘(c) PUBLICATION.—Each memorandum of of 2008, the Secretary, acting through the agreement entered into or renewed (and be served. Service, and the Secretary of the Interior amendments or modifications thereto) under ‘‘SEC. 705. LICENSING REQUIREMENT FOR MEN- shall develop and enter into a memoranda of subsection (a) shall be published in the Fed- TAL HEALTH CARE WORKERS. agreement, or review and update any exist- eral Register. At the same time as publica- ‘‘(a) IN GENERAL.—Subject to the provi- ing memoranda of agreement, as required by tion in the Federal Register, the Secretary sions of section 221, and except as provided in section 4205 of the Indian Alcohol and Sub- shall provide a copy of such memoranda, subsection (b), any individual employed as a stance Abuse Prevention and Treatment Act amendment, or modification to each Indian psychologist, social worker, or marriage and of 1986 (25 U.S.C. 2411) under which the Secre- Tribe, Tribal Organization, and Urban Indian family therapist for the purpose of providing taries address the following: Organization. mental health care services to Indians in a ‘‘(1) The scope and nature of mental illness ‘‘SEC. 703. COMPREHENSIVE BEHAVIORAL clinical setting under this Act is required to and dysfunctional and self-destructive be- HEALTH PREVENTION AND TREAT- be licensed as a psychologist, social worker, havior, including child abuse and family vio- MENT PROGRAM. or marriage and family therapist, respec- lence, among Indians. ‘‘(a) ESTABLISHMENT.— tively. ‘‘(2) The existing Federal, tribal, State, ‘‘(1) IN GENERAL.—The Secretary, acting ‘‘(b) TRAINEES.—An individual may be em- local, and private services, resources, and through the Service, Indian Tribes, and Trib- ployed as a trainee in psychology, social programs available to provide behavioral al Organizations, shall provide a program of work, or marriage and family therapy to pro- health services for Indians. comprehensive behavioral health, preven- vide mental health care services described in ‘‘(3) The unmet need for additional serv- tion, treatment, and aftercare, which shall subsection (a) if such individual— ices, resources, and programs necessary to include— ‘‘(1) works under the direct supervision of meet the needs identified pursuant to para- ‘‘(A) prevention, through educational a licensed psychologist, social worker, or graph (1). intervention, in Indian communities; marriage and family therapist, respectively; ‘‘(4)(A) The right of Indians, as citizens of ‘‘(B) acute detoxification, psychiatric hos- ‘‘(2) is enrolled in or has completed at least the United States and of the States in which pitalization, residential, and intensive out- 2 years of course work at a post-secondary, they reside, to have access to behavioral patient treatment; accredited education program for psy- health services to which all citizens have ac- ‘‘(C) community-based rehabilitation and chology, social work, marriage and family cess. aftercare; therapy, or counseling; and ‘‘(B) The right of Indians to participate in, ‘‘(D) community education and involve- ‘‘(3) meets such other training, super- and receive the benefit of, such services. ment, including extensive training of health vision, and quality review requirements as ‘‘(C) The actions necessary to protect the care, educational, and community-based per- the Secretary may establish. exercise of such right. sonnel; ‘‘SEC. 706. INDIAN WOMEN TREATMENT PRO- ‘‘(5) The responsibilities of the Bureau of ‘‘(E) specialized residential treatment pro- GRAMS. Indian Affairs and the Service, including grams for high-risk populations, including ‘‘(a) GRANTS.—The Secretary, consistent mental illness identification, prevention, pregnant and postpartum women and their with section 701, may make grants to Indian education, referral, and treatment services children; and Tribes, Tribal Organizations, and Urban In- (including services through multidisci- ‘‘(F) diagnostic services. dian Organizations to develop and imple- plinary resource teams), at the central, area, ‘‘(2) TARGET POPULATIONS.—The target pop- ment a comprehensive behavioral health pro- and agency and Service Unit, Service Area, ulation of such programs shall be members gram of prevention, intervention, treatment, and headquarters levels to address the prob- of Indian Tribes. Efforts to train and educate and relapse prevention services that specifi- lems identified in paragraph (1). key members of the Indian community shall cally addresses the cultural, historical, so- ‘‘(6) A strategy for the comprehensive co- also target employees of health, education, cial, and child care needs of Indian women, ordination of the behavioral health services judicial, law enforcement, legal, and social regardless of age. provided by the Bureau of Indian Affairs and service programs. ‘‘(b) USE OF GRANT FUNDS.—A grant made the Service to meet the problems identified ‘‘(b) CONTRACT HEALTH SERVICES.— pursuant to this section may be used to— pursuant to paragraph (1), including— ‘‘(1) IN GENERAL.—The Secretary, acting ‘‘(1) develop and provide community train- ‘‘(A) the coordination of alcohol and sub- through the Service, Indian Tribes, and Trib- ing, education, and prevention programs for stance abuse programs of the Service, the al Organizations, may enter into contracts Indian women relating to behavioral health Bureau of Indian Affairs, and Indian Tribes with public or private providers of behav- issues, including fetal alcohol spectrum dis- and Tribal Organizations (developed under ioral health treatment services for the pur- orders; the Indian Alcohol and Substance Abuse Pre- pose of carrying out the program required ‘‘(2) identify and provide psychological vention and Treatment Act of 1986 (25 U.S.C. under subsection (a). services, counseling, advocacy, support, and 2401 et seq.)) with behavioral health initia- ‘‘(2) PROVISION OF ASSISTANCE.—In carrying relapse prevention to Indian women and tives pursuant to this Act, particularly with out this subsection, the Secretary shall pro- their families; and

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00085 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1302 CONGRESSIONAL RECORD — SENATE February 27, 2008 ‘‘(3) develop prevention and intervention ‘‘(C) emergency care; bacco, among Indian youths residing in In- models for Indian women which incorporate ‘‘(D) suicide prevention and crisis interven- dian communities, on or near reservations, traditional health care practices, cultural tion; and and in urban areas and provide appropriate values, and community and family involve- ‘‘(E) prevention and treatment of mental mental health services to address the inci- ment. illness and dysfunctional and self-destruc- dence of mental illness among such youths. ‘‘(c) CRITERIA.—The Secretary, in consulta- tive behavior, including child abuse and fam- ‘‘(h) INDIAN YOUTH MENTAL HEALTH.—The tion with Indian Tribes and Tribal Organiza- ily violence. Secretary, acting through the Service, shall tions, shall establish criteria for the review ‘‘(2) USE OF FUNDS.—Funds provided under collect data for the report under section 801 and approval of applications and proposals this subsection may be used— with respect to— for funding under this section. ‘‘(A) to construct or renovate an existing ‘‘(1) the number of Indian youth who are ‘‘(d) ALLOCATION OF CERTAIN FUNDS.— health facility to provide intermediate be- being provided mental health services Twenty percent of the funds appropriated havioral health services; through the Service and Tribal Health Pro- pursuant to this section shall be used to ‘‘(B) to hire behavioral health profes- grams; make grants to Urban Indian Organizations. sionals; ‘‘(2) a description of, and costs associated ‘‘SEC. 707. INDIAN YOUTH PROGRAM. ‘‘(C) to staff, operate, and maintain an in- with, the mental health services provided for ‘‘(a) DETOXIFICATION AND REHABILITATION.— Indian youth through the Service and Tribal termediate mental health facility, group Health Programs; The Secretary, acting through the Service, home, sober housing, transitional housing or consistent with section 701, shall develop and similar facilities, or youth shelter where in- ‘‘(3) the number of youth referred to the implement a program for acute detoxifica- termediate behavioral health services are Service or Tribal Health Programs for mention and treatment for Indian youths, in- being provided; tal health services; cluding behavioral health services. The pro- ‘‘(D) to make renovations and hire appro- ‘‘(4) the number of Indian youth provided gram shall include regional treatment cen- residential treatment for mental health and ters designed to include detoxification and priate staff to convert existing hospital beds into adolescent psychiatric units; and behavioral problems through the Service and rehabilitation for both sexes on a referral Tribal Health Programs, reported separately basis and programs developed and imple- ‘‘(E) for intensive home- and community- for on- and off-reservation facilities; and mented by Indian Tribes or Tribal Organiza- based services. ‘‘(5) the costs of the services described in tions at the local level under the Indian Self- ‘‘(3) CRITERIA.—The Secretary, acting paragraph (4). Determination and Education Assistance Act through the Service, shall, in consultation ‘‘SEC. 708. INDIAN YOUTH TELEMENTAL HEALTH (25 U.S.C. 450 et seq.). Regional centers shall with Indian Tribes and Tribal Organizations, DEMONSTRATION PROJECT. be integrated with the intake and rehabilita- establish criteria for the review and approval ‘‘(a) PURPOSE.—The purpose of this section tion programs based in the referring Indian of applications or proposals for funding made is to authorize the Secretary to carry out a community. available pursuant to this subsection. demonstration project to test the use of tele- ‘‘(b) ALCOHOL AND SUBSTANCE ABUSE ‘‘(d) FEDERALLY-OWNED STRUCTURES.— mental health services in suicide prevention, TREATMENT CENTERS OR FACILITIES.— ‘‘(1) IN GENERAL.—The Secretary, in con- intervention and treatment of Indian youth, ‘‘(1) ESTABLISHMENT.— sultation with Indian Tribes and Tribal Or- including through— ‘‘(A) IN GENERAL.—The Secretary, acting ganizations, shall— ‘‘(1) the use of psychotherapy, psychiatric through the Service, Indian Tribes, and Trib- ‘‘(A) identify and use, where appropriate, assessments, diagnostic interviews, therapies al Organizations, shall construct, renovate, federally-owned structures suitable for local for mental health conditions predisposing to or, as necessary, purchase, and appropriately residential or regional behavioral health suicide, and alcohol and substance abuse staff and operate, at least 1 youth regional treatment for Indian youths; and treatment; treatment center or treatment network in ‘‘(B) establish guidelines for determining ‘‘(2) the provision of clinical expertise to, each area under the jurisdiction of an Area the suitability of any such federally-owned consultation services with, and medical ad- Office. structure to be used for local residential or vice and training for frontline health care ‘‘(B) AREA OFFICE IN CALIFORNIA.—For the regional behavioral health treatment for In- providers working with Indian youth; purposes of this subsection, the Area Office dian youths. ‘‘(3) training and related support for com- in California shall be considered to be 2 Area ‘‘(2) TERMS AND CONDITIONS FOR USE OF Offices, 1 office whose jurisdiction shall be munity leaders, family members and health STRUCTURE.—Any structure described in and education workers who work with Indian considered to encompass the northern area paragraph (1) may be used under such terms of the State of California, and 1 office whose youth; and conditions as may be agreed upon by the ‘‘(4) the development of culturally-relevant jurisdiction shall be considered to encompass Secretary and the agency having responsi- the remainder of the State of California for educational materials on suicide; and bility for the structure and any Indian Tribe ‘‘(5) data collection and reporting. the purpose of implementing California or Tribal Organization operating the pro- treatment networks. gram. ‘‘(b) DEFINITIONS.—For the purpose of this ‘‘(2) FUNDING.—For the purpose of staffing section, the following definitions shall apply: ‘‘(e) REHABILITATION AND AFTERCARE SERV- and operating such centers or facilities, ‘‘(1) DEMONSTRATION PROJECT.—The term ICES.— funding shall be pursuant to the Act of No- ‘demonstration project’ means the Indian vember 2, 1921 (25 U.S.C. 13). ‘‘(1) IN GENERAL.—The Secretary, Indian youth telemental health demonstration Tribes, or Tribal Organizations, in coopera- ‘‘(3) LOCATION.—A youth treatment center project authorized under subsection (c). tion with the Secretary of the Interior, shall constructed or purchased under this sub- ‘‘(2) TELEMENTAL HEALTH.—The term ‘tele- section shall be constructed or purchased at develop and implement within each Service Unit, community-based rehabilitation and mental health’ means the use of electronic a location within the area described in para- information and telecommunications tech- graph (1) agreed upon (by appropriate tribal follow-up services for Indian youths who are having significant behavioral health prob- nologies to support long distance mental resolution) by a majority of the Indian health care, patient and professional-related Tribes to be served by such center. lems, and require long-term treatment, community reintegration, and monitoring to education, public health, and health admin- ‘‘(4) SPECIFIC PROVISION OF FUNDS .— support the Indian youths after their return istration. ‘‘(A) IN GENERAL.—Notwithstanding any to their home community. ‘‘(c) AUTHORIZATION.— other provision of this title, the Secretary ‘‘(1) IN GENERAL.—The Secretary is author- may, from amounts authorized to be appro- ‘‘(2) ADMINISTRATION.—Services under paragraph (1) shall be provided by trained staff ized to award grants under the demonstra- priated for the purposes of carrying out this tion project for the provision of telemental section, make funds available to— within the community who can assist the In- dian youths in their continuing development health services to Indian youth who— ‘‘(i) the Tanana Chiefs Conference, Incor- of self-image, positive problem-solving ‘‘(A) have expressed suicidal ideas; porated, for the purpose of leasing, con- skills, and nonalcohol or substance abusing ‘‘(B) have attempted suicide; or structing, renovating, operating, and main- behaviors. Such staff may include alcohol taining a residential youth treatment facil- ‘‘(C) have mental health conditions that ity in Fairbanks, Alaska; and and substance abuse counselors, mental increase or could increase the risk of suicide. health professionals, and other health profes- ‘‘(ii) the Southeast Alaska Regional Health ‘‘(2) ELIGIBILITY FOR GRANTS.—Such grants sionals and paraprofessionals, including shall be awarded to Indian Tribes and Tribal Corporation to staff and operate a residen- community health representatives. tial youth treatment facility without regard Organizations that operate 1 or more facili- to the proviso set forth in section 4(l) of the ‘‘(f) INCLUSION OF FAMILY IN YOUTH TREAT- ties— Indian Self-Determination and Education MENT PROGRAM.—In providing the treatment ‘‘(A) located in Alaska and part of the Assistance Act (25 U.S.C. 450b(l)). and other services to Indian youths author- Alaska Federal Health Care Access Network; ized by this section, the Secretary, acting ‘‘(B) PROVISION OF SERVICES TO ELIGIBLE ‘‘(B) reporting active clinical telehealth through the Service, Indian Tribes, and Trib- capabilities; or YOUTHS.—Until additional residential youth al Organizations, shall provide for the inclu- treatment facilities are established in Alas- sion of family members of such youths in the ‘‘(C) offering school-based telemental ka pursuant to this section, the facilities treatment programs or other services as may health services relating to psychiatry to In- specified in subparagraph (A) shall make be appropriate. Not less than 10 percent of dian youth. every effort to provide services to all eligible the funds appropriated for the purposes of ‘‘(3) GRANT PERIOD.—The Secretary shall Indian youths residing in Alaska. carrying out subsection (e) shall be used for award grants under this section for a period ‘‘(c) INTERMEDIATE ADOLESCENT BEHAV- outpatient care of adult family members re- of up to 4 years. IORAL HEALTH SERVICES.— lated to the treatment of an Indian youth ‘‘(4) AWARDING OF GRANTS.—Not more than ‘‘(1) IN GENERAL.—The Secretary, acting under that subsection. 5 grants shall be provided under paragraph through the Service, Indian Tribes, and Trib- ‘‘(g) MULTIDRUG ABUSE PROGRAM.—The (1), with priority consideration given to In- al Organizations, may provide intermediate Secretary, acting through the Service, In- dian Tribes and Tribal Organizations that— behavioral health services to Indian children dian Tribes, and Tribal Organizations, shall ‘‘(A) serve a particular community or geo- and adolescents, including— provide, consistent with section 701, pro- graphic area where there is a demonstrated ‘‘(A) pretreatment assistance; grams and services to prevent and treat the need to address Indian youth suicide; ‘‘(B) inpatient, outpatient, and aftercare abuse of multiple forms of substances, in- ‘‘(B) enter in to collaborative partnerships services; cluding alcohol, drugs, inhalants, and to- with Indian Health Service or Tribal Health

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00086 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1303 Programs or facilities to provide services ‘‘(6) a plan for sustaining the project after providers including traditional practitioners, under this demonstration project; Federal assistance for the demonstration and other critical members of each tribal ‘‘(C) serve an isolated community or geo- project has terminated. community. Such program may also include graphic area which has limited or no access ‘‘(f) COLLABORATION; REPORTING TO NA- community-based training to develop local to behavioral health services; or TIONAL CLEARINGHOUSE.— capacity and tribal community provider ‘‘(D) operate a detention facility at which ‘‘(1) COLLABORATION.—The Secretary, act- training for prevention, intervention, treat- Indian youth are detained. ing through the Service, shall encourage In- ment, and aftercare. ‘‘(b) INSTRUCTION.—The Secretary, acting ‘‘(d) USE OF FUNDS.— dian Tribes and Tribal Organizations receiving grants under this section to collaborate through the Service, shall, either directly or ‘‘(1) IN GENERAL.—An Indian Tribe or Trib- to enable comparisons about best practices through Indian Tribes and Tribal Organiza- al Organization shall use a grant received across projects. tions, provide instruction in the area of be- under subsection (c) for the following pur- havioral health issues, including instruction poses: ‘‘(2) REPORTING TO NATIONAL CLEARING- HOUSE.—The Secretary, acting through the in crisis intervention and family relations in ‘‘(A) To provide telemental health services Service, shall also encourage Indian Tribes the context of alcohol and substance abuse, to Indian youth, including the provision of— and Tribal Organizations receiving grants child sexual abuse, youth alcohol and sub- ‘‘(i) psychotherapy; under this section to submit relevant, de- stance abuse, and the causes and effects of ‘‘(ii) psychiatric assessments and diag- classified project information to the na- fetal alcohol spectrum disorders to appro- nostic interviews, therapies for mental tional clearinghouse authorized under sec- priate employees of the Bureau of Indian Af- health conditions predisposing to suicide, tion 701(b)(2) in order to better facilitate pro- fairs and the Service, and to personnel in and treatment; and gram performance and improve suicide pre- schools or programs operated under any contract with the Bureau of Indian Affairs or ‘‘(iii) alcohol and substance abuse treat- vention, intervention, and treatment services. the Service, including supervisors of emer- ment. gency shelters and halfway houses described ‘‘(g) ANNUAL REPORT.—Each grant recipi- ‘‘(B) To provide clinician-interactive med- in section 4213 of the Indian Alcohol and ical advice, guidance and training, assist- ent shall submit to the Secretary an annual report that— Substance Abuse Prevention and Treatment ance in diagnosis and interpretation, crisis Act of 1986 (25 U.S.C. 2433). counseling and intervention, and related as- ‘‘(1) describes the number of telemental health services provided; and ‘‘(c) TRAINING MODELS.—In carrying out sistance to Service, tribal, or urban clini- the education and training programs re- cians and health services providers working ‘‘(2) includes any other information that quired by this section, the Secretary, in con- with youth being served under this dem- the Secretary may require. sultation with Indian Tribes, Tribal Organi- onstration project. ‘‘(h) REPORT TO CONGRESS.—Not later than zations, Indian behavioral health experts, ‘‘(C) To assist, educate and train commu- 270 days after the termination of the dem- and Indian alcohol and substance abuse pre- nity leaders, health education professionals onstration project, the Secretary shall sub- vention experts, shall develop and provide and paraprofessionals, tribal outreach work- mit to the Committee on Indian Affairs of community-based training models. Such ers, and family members who work with the the Senate and the Committee on Natural models shall address— youth receiving telemental health services Resources and Committee on Energy and ‘‘(1) the elevated risk of alcohol and behav- under this demonstration project, including Commerce of the House of Representatives a ioral health problems faced by children of al- with identification of suicidal tendencies, final report, based on the annual reports pro- coholics; crisis intervention and suicide prevention, vided by grant recipients under subsection ‘‘(2) the cultural, spiritual, and emergency skill development, and building (h), that— multigenerational aspects of behavioral and expanding networks among these indi- ‘‘(1) describes the results of the projects health problem prevention and recovery; and viduals and with State and local health serv- funded by grants awarded under this section, ‘‘(3) community-based and multidisci- ices providers. including any data available which indicates plinary strategies for preventing and treat- ‘‘(D) To develop and distribute culturally the number of attempted suicides; ing behavioral health problems. appropriate community educational mate- ‘‘(2) evaluates the impact of the telemental ‘‘SEC. 711. BEHAVIORAL HEALTH PROGRAM. health services funded by the grants in re- rials on— ‘‘(a) INNOVATIVE PROGRAMS.—The Sec- ‘‘(i) suicide prevention; ducing the number of completed suicides retary, acting through the Service, Indian among Indian youth; ‘‘(ii) suicide education; Tribes, and Tribal Organizations, consistent ‘‘(3) evaluates whether the demonstration ‘‘(iii) suicide screening; with section 701, may plan, develop, imple- project should be— ment, and carry out programs to deliver in- ‘‘(iv) suicide intervention; and ‘‘(A) expanded to provide more than 5 novative community-based behavioral health ‘‘(v) ways to mobilize communities with re- grants; and services to Indians. spect to the identification of risk factors for ‘‘(B) designated a permanent program; and ‘‘(b) AWARDS; CRITERIA.—The Secretary suicide. ‘‘(4) evaluates the benefits of expanding the may award a grant for a project under sub- ‘‘(E) For data collection and reporting re- demonstration project to include Urban In- section (a) to an Indian Tribe or Tribal Orga- lated to Indian youth suicide prevention ef- dian Organizations. nization and may consider the following cri- forts. ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— teria: ‘‘(2) TRADITIONAL HEALTH CARE PRAC- There is authorized to be appropriated to ‘‘(1) The project will address significant TICES.—In carrying out the purposes de- carry out this section $1,500,000 for each of unmet behavioral health needs among Indi- scribed in paragraph (1), an Indian Tribe or fiscal years 2008 through 2011. ans. Tribal Organization may use and promote ‘‘SEC. 709. INPATIENT AND COMMUNITY-BASED ‘‘(2) The project will serve a significant the traditional health care practices of the MENTAL HEALTH FACILITIES DE- number of Indians. Indian Tribes of the youth to be served. SIGN, CONSTRUCTION, AND STAFF- ‘‘(3) The project has the potential to de- ‘‘(e) APPLICATIONS.—To be eligible to re- ING. liver services in an efficient and effective ceive a grant under subsection (c), an Indian ‘‘Not later than 1 year after the date of en- manner. Tribe or Tribal Organization shall prepare actment of the Indian Health Care Improve- ‘‘(4) The Indian Tribe or Tribal Organiza- and submit to the Secretary an application, ment Act Amendments of 2008, the Sec- tion has the administrative and financial ca- at such time, in such manner, and con- retary, acting through the Service, Indian pability to administer the project. taining such information as the Secretary Tribes, and Tribal Organizations, may pro- ‘‘(5) The project may deliver services in a may require, including— vide, in each area of the Service, not less manner consistent with traditional health ‘‘(1) a description of the project that the than 1 inpatient mental health care facility, care practices. or the equivalent, for Indians with behav- Indian Tribe or Tribal Organization will ‘‘(6) The project is coordinated with, and carry out using the funds provided under the ioral health problems. For the purposes of avoids duplication of, existing services. grant; this subsection, California shall be considered to be 2 Area Offices, 1 office whose loca- ‘‘(c) EQUITABLE TREATMENT.—For purposes ‘‘(2) a description of the manner in which of this subsection, the Secretary shall, in the project funded under the grant would— tion shall be considered to encompass the northern area of the State of California and evaluating project applications or proposals, ‘‘(A) meet the telemental health care needs 1 office whose jurisdiction shall be consid- use the same criteria that the Secretary uses of the Indian youth population to be served ered to encompass the remainder of the in evaluating any other application or pro- by the project; or State of California. The Secretary shall con- posal for such funding. ‘‘(B) improve the access of the Indian sider the possible conversion of existing, ‘‘SEC. 712. FETAL ALCOHOL SPECTRUM DIS- youth population to be served to suicide pre- underused Service hospital beds into psy- ORDERS PROGRAMS. vention and treatment services; chiatric units to meet such need. ‘‘(a) PROGRAMS.— ‘‘(3) evidence of support for the project ‘‘SEC. 710. TRAINING AND COMMUNITY EDU- ‘‘(1) ESTABLISHMENT.—The Secretary, con- from the local community to be served by CATION. sistent with section 701, acting through the the project; ‘‘(a) PROGRAM.—The Secretary, in coopera- Service, Indian Tribes, and Tribal Organiza- ‘‘(4) a description of how the families and tion with the Secretary of the Interior, shall tions, is authorized to establish and operate leadership of the communities or popu- develop and implement or assist Indian fetal alcohol spectrum disorders programs as lations to be served by the project would be Tribes and Tribal Organizations to develop provided in this section for the purposes of involved in the development and ongoing op- and implement, within each Service Unit or meeting the health status objectives speci- erations of the project; tribal program, a program of community fied in section 3. ‘‘(5) a plan to involve the tribal community education and involvement which shall be ‘‘(2) USE OF FUNDS.— of the youth who are provided services by designed to provide concise and timely infor- ‘‘(A) IN GENERAL.—Funding provided pursu- the project in planning and evaluating the mation to the community leadership of each ant to this section shall be used for the fol- mental health care and suicide prevention tribal community. Such program shall in- lowing: efforts provided, in order to ensure the inte- clude education about behavioral health ‘‘(i) To develop and provide for Indians gration of community, clinical, environ- issues to political leaders, Tribal judges, law community and in-school training, edu- mental, and cultural components of the enforcement personnel, members of tribal cation, and prevention programs relating to treatment; and health and education boards, health care fetal alcohol spectrum disorders.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00087 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1304 CONGRESSIONAL RECORD — SENATE February 27, 2008 ‘‘(ii) To identify and provide behavioral of methods to prevent, intervene, treat, or victims of domestic violence and sexual health treatment to high-risk Indian women provide rehabilitation and behavioral health abuse. and high-risk women pregnant with an Indi- aftercare for Indians and Urban Indians af- ‘‘(2) REPORT.—Not later than 18 months an’s child. fected by fetal alcohol spectrum disorders. after the date of enactment of the Indian ‘‘(iii) To identify and provide appropriate ‘‘(e) FUNDING FOR URBAN INDIAN ORGANIZA- Health Care Improvement Act Amendments psychological services, educational and voca- TIONS.—Ten percent of the funds appro- of 2008, the Secretary shall submit to the tional support, counseling, advocacy, and in- priated pursuant to this section shall be used Committee on Indian Affairs of the Senate formation to fetal alcohol spectrum dis- to make grants to Urban Indian Organiza- and the Committee on Natural Resources of orders-affected Indians and their families or tions funded under title V. the House of Representatives a report that caretakers. ‘‘SEC. 713. CHILD SEXUAL ABUSE PREVENTION describes the means and extent to which the ‘‘(iv) To develop and implement counseling AND TREATMENT PROGRAMS. Secretary has carried out paragraph (1). and support programs in schools for fetal al- ‘‘(a) ESTABLISHMENT.—The Secretary, act- ‘‘(d) COORDINATION.— cohol spectrum disorders-affected Indian ing through the Service, and the Secretary ‘‘(1) IN GENERAL.—The Secretary, in coordi- children. of the Interior, Indian Tribes, and Tribal Or- nation with the Attorney General, Federal ‘‘(v) To develop prevention and interven- ganizations, shall establish, consistent with and tribal law enforcement agencies, Indian tion models which incorporate practitioners section 701, in every Service Area, programs Health Programs, and domestic violence or of traditional health care practices, cultural involving treatment for victims of sexual sexual assault victim organizations, shall de- values, and community involvement. abuse who are Indian children or children in velop appropriate victim services and victim ‘‘(vi) To develop, print, and disseminate an Indian household. advocate training programs— education and prevention materials on fetal ‘‘(b) USE OF FUNDS.—Funding provided pur- ‘‘(A) to improve domestic violence or sex- alcohol spectrum disorders. suant to this section shall be used for the ual abuse responses; ‘‘(vii) To develop and implement, in con- following: ‘‘(B) to improve forensic examinations and sultation with Indian Tribes and Tribal Or- ‘‘(1) To develop and provide community collection; ganizations, and in conference with Urban ‘‘(C) to identify problems or obstacles in Indian Organizations, culturally sensitive as- education and prevention programs related sessment and diagnostic tools including to sexual abuse of Indian children or children the prosecution of domestic violence or sex- dysmorphology clinics and multidisciplinary in an Indian household. ual abuse; and fetal alcohol spectrum disorders clinics for ‘‘(2) To identify and provide behavioral ‘‘(D) to meet other needs or carry out other use in Indian communities and Urban Cen- health treatment to victims of sexual abuse activities required to prevent, treat, and im- ters. who are Indian children or children in an In- prove prosecutions of domestic violence and sexual abuse. ‘‘(B) ADDITIONAL USES.—In addition to any dian household, and to their family members purpose under subparagraph (A), funding pro- who are affected by sexual abuse. ‘‘(2) REPORT.—Not later than 2 years after vided pursuant to this section may be used ‘‘(3) To develop prevention and interven- the date of enactment of the Indian Health for 1 or more of the following: tion models which incorporate traditional Care Improvement Act Amendments of 2008, ‘‘(i) Early childhood intervention projects health care practices, cultural values, and the Secretary shall submit to the Committee from birth on to mitigate the effects of fetal community involvement. on Indian Affairs of the Senate and the Com- alcohol spectrum disorders among Indians. ‘‘(4) To develop and implement culturally mittee on Natural Resources of the House of ‘‘(ii) Community-based support services for sensitive assessment and diagnostic tools for Representatives a report that describes, with Indians and women pregnant with Indian use in Indian communities and Urban Cen- respect to the matters described in para- children. ters. graph (1), the improvements made and needed, problems or obstacles identified, and ‘‘(iii) Community-based housing for adult ‘‘(5) To identify and provide behavioral health treatment to Indian perpetrators and costs necessary to address the problems or Indians with fetal alcohol spectrum dis- obstacles, and any other recommendations orders. perpetrators who are members of an Indian household— that the Secretary determines to be appro- ‘‘(3) CRITERIA FOR APPLICATIONS.—The Sec- priate. retary shall establish criteria for the review ‘‘(A) making efforts to begin offender and behavioral health treatment while the perpe- ‘‘SEC. 715. TESTIMONY BY SERVICE EMPLOYEES and approval of applications for funding IN CASES OF RAPE AND SEXUAL AS- under this section. trator is incarcerated or at the earliest possible date if the perpetrator is not incarcer- SAULT. ‘‘(b) SERVICES.—The Secretary, acting ‘‘(a) APPROVAL BY DIRECTOR.— through the Service, Indian Tribes, and Trib- ated; and ‘‘(B) providing treatment after the perpe- ‘‘(1) IN GENERAL.—The Director shall ap- al Organizations, shall— prove or disapprove, in writing, any request ‘‘(1) develop and provide services for the trator is released, until it is determined that the perpetrator is not a threat to children. or subpoena for a sexual assault nurse exam- prevention, intervention, treatment, and iner employed by the Service to provide tes- aftercare for those affected by fetal alcohol ‘‘(c) COORDINATION.—The programs estab- timony in a deposition, trial, or other simi- spectrum disorders in Indian communities; lished under subsection (a) shall be carried lar proceeding regarding information ob- and out in coordination with programs and serv- tained in carrying out the official duties of ‘‘(2) provide supportive services, including ices authorized under the Indian Child Pro- the nurse examiner. services to meet the special educational, vo- tection and Family Violence Prevention Act (25 U.S.C. 3201 et seq.). ‘‘(2) REQUIREMENT.—The Director shall ap- cational, school-to-work transition, and prove a request or subpoena under paragraph independent living needs of adolescent and ‘‘SEC. 714. DOMESTIC AND SEXUAL VIOLENCE (1) if the request or subpoena does not vio- adult Indians with fetal alcohol spectrum PREVENTION AND TREATMENT. late the policy of the Department to main- disorders. ‘‘(a) IN GENERAL.—The Secretary, in ac- tain strict impartiality with respect to pri- ‘‘(c) TASK FORCE.—The Secretary shall es- cordance with section 701, is authorized to vate causes of action. establish in each Service Area programs in- tablish a task force to be known as the Fetal ‘‘(3) TREATMENT.—If the Director fails to Alcohol Spectrum Disorders Task Force to volving the prevention and treatment of— approve or disapprove a request or subpoena advise the Secretary in carrying out sub- ‘‘(1) Indian victims of domestic violence or by the date that is 30 days after the date of section (b). Such task force shall be com- sexual abuse; and receipt of the request or subpoena, the re- posed of representatives from the following: ‘‘(2) perpetrators of domestic violence or quest or subpoena shall be considered to be ‘‘(1) The National Institute on Drug Abuse. sexual abuse who are Indian or members of approved for purposes of this subsection. ‘‘(2) The National Institute on Alcohol and an Indian household. ‘‘(b) POLICIES AND PROTOCOL.—The Direc- Alcoholism. ‘‘(b) USE OF FUNDS.—Funds made available tor, in coordination with the Director of the ‘‘(3) The Office of Substance Abuse Preven- to carry out this section shall be used— Office on Violence Against Women of the De- tion. ‘‘(1) to develop and implement prevention partment of Justice, in consultation with In- ‘‘(4) The National Institute of Mental programs and community education pro- dian Tribes and Tribal Organizations, and in Health. grams relating to domestic violence and sex- conference with Urban Indian Organizations, ‘‘(5) The Service. ual abuse; shall develop standardized sexual assault ‘‘(2) to provide behavioral health services, policies and protocol for the facilities of the ‘‘(6) The Office of Minority Health of the Service. Department of Health and Human Services. including victim support services, and medical treatment (including examinations per- ‘‘SEC. 716. BEHAVIORAL HEALTH RESEARCH. ‘‘(7) The Administration for Native Ameri- formed by sexual assault nurse examiners) to cans. ‘‘The Secretary, in consultation with ap- Indian victims of domestic violence or sexual propriate Federal agencies, shall make ‘‘(8) The National Institute of Child Health abuse; and Human Development (NICHD). grants to, or enter into contracts with, In- ‘‘(3) to purchase rape kits, dian Tribes, Tribal Organizations, and Urban ‘‘(9) The Centers for Disease Control and ‘‘(4) to develop prevention and intervention Indian Organizations or enter into contracts Prevention. models, which may incorporate traditional with, or make grants to appropriate institu- ‘‘(10) The Bureau of Indian Affairs. health care practices; and tions for, the conduct of research on the inci- ‘‘(11) Indian Tribes. ‘‘(5) to identify and provide behavioral dence and prevalence of behavioral health ‘‘(12) Tribal Organizations. health treatment to perpetrators who are In- problems among Indians served by the Serv- ‘‘(13) Urban Indian communities. dian or members of an Indian household. ice, Indian Tribes, or Tribal Organizations ‘‘(14) Indian fetal alcohol spectrum dis- ‘‘(c) TRAINING AND CERTIFICATION.— and among Indians in urban areas. Research priorities under this section shall include— orders experts. ‘‘(1) IN GENERAL.—Not later than 1 year ‘‘(d) APPLIED RESEARCH PROJECTS.—The after the date of enactment of the Indian ‘‘(1) the multifactorial causes of Indian Secretary, acting through the Substance Health Care Improvement Act Amendments youth suicide, including— Abuse and Mental Health Services Adminis- of 2008, the Secretary shall establish appro- ‘‘(A) protective and risk factors and sci- tration, shall make grants to Indian Tribes, priate protocols, policies, procedures, stand- entific data that identifies those factors; and Tribal Organizations, and Urban Indian Or- ards of practice, and, if not available else- ‘‘(B) the effects of loss of cultural identity ganizations for applied research projects where, training curricula and training and and the development of scientific data on which propose to elevate the understanding certification requirements for services for those effects;

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00088 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1305 ‘‘(2) the interrelationship and interdepend- a review of programs established or assisted less otherwise required, the Secretary may ence of behavioral health problems with al- pursuant to this Act and assessments and promulgate regulations to carry out titles I, coholism and other substance abuse, suicide, recommendations of additional programs or III, IV, and V, and section 202, using the pro- homicides, other injuries, and the incidence additional assistance necessary to, at a min- cedures required by chapter V of title 5, of family violence; and imum, provide health services to Indians and United States Code (commonly known as the ‘‘(3) the development of models of preven- ensure a health status for Indians, which are ‘Administrative Procedure Act’). tion techniques. at a parity with the health services available ‘‘(2) PROPOSED REGULATIONS.—Proposed The effect of the interrelationships and to and the health status of the general popu- regulations to implement this Act shall be interdependencies referred to in paragraph lation. published in the Federal Register by the Sec- (2) on children, and the development of pre- ‘‘(2) A report on whether, and to what ex- retary no later than 2 years after the date of vention techniques under paragraph (3) ap- tent, new national health care programs, enactment of the Indian Health Care Im- plicable to children, shall be emphasized. benefits, initiatives, or financing systems provement Act Amendments of 2008 and shall ‘‘SEC. 717. DEFINITIONS. have had an impact on the purposes of this have no less than a 120-day comment period. ‘‘For the purpose of this title, the fol- Act and any steps that the Secretary may ‘‘(3) FINAL REGULATIONS.—The Secretary lowing definitions shall apply: have taken to consult with Indian Tribes, shall publish in the Federal Register final Tribal Organizations, and Urban Indian Or- regulations to implement this Act by not ‘‘(1) ASSESSMENT.—The term ‘assessment’ ganizations to address such impact, includ- means the systematic collection, analysis, later than 3 years after the date of enact- ing a report on proposed changes in alloca- ment of the Indian Health Care Improvement and dissemination of information on health tion of funding pursuant to section 808. status, health needs, and health problems. Act Amendments of 2008. ‘‘(3) A report on the use of health services ‘‘(b) COMMITTEE.—A negotiated rulemaking ‘‘(2) ALCOHOL-RELATED by Indians— NEURODEVELOPMENTAL DISORDERS OR ARND.— committee established pursuant to section The term ‘alcohol-related ‘‘(A) on a national and area or other rel- 565 of title 5, United States Code, to carry neurodevelopmental disorders’ or ‘ARND’ evant geographical basis; out this section shall have as its members means any 1 of a spectrum of effects that— ‘‘(B) by gender and age; only representatives of the Federal Govern- ‘‘(A) may occur when a woman drinks alco- ‘‘(C) by source of payment and type of serv- ment and representatives of Indian Tribes, hol during pregnancy; and ice; and Tribal Organizations, a majority of ‘‘(D) comparing such rates of use with whom shall be nominated by and be rep- ‘‘(B) involves a central nervous system ab- resentatives of Indian Tribes and Tribal Or- normality that may be structural, neuro- rates of use among comparable non-Indian logical, or functional. populations; and ganizations from each Service Area. ‘‘(c) ADAPTATION OF PROCEDURES.—The ‘‘(3) BEHAVIORAL HEALTH AFTERCARE.—The ‘‘(E) provided under contracts. term ‘behavioral health aftercare’ includes ‘‘(4) A report of contractors to the Sec- Secretary shall adapt the negotiated rule- those activities and resources used to sup- retary on Health Care Educational Loan Re- making procedures to the unique context of port recovery following inpatient, residen- payments every 6 months required by section self-governance and the government-to-gov- tial, intensive substance abuse, or mental 110. ernment relationship between the United States and Indian Tribes. health outpatient or outpatient treatment. ‘‘(5) A general audit report of the Sec- The purpose is to help prevent or deal with retary on the Health Care Educational Loan ‘‘(d) LACK OF REGULATIONS.—The lack of relapse by ensuring that by the time a client Repayment Program as required by section promulgated regulations shall not limit the or patient is discharged from a level of care, 110(n). effect of this Act. such as outpatient treatment, an aftercare ‘‘(6) A report of the findings and conclu- ‘‘(e) INCONSISTENT REGULATIONS.—The pro- plan has been developed with the client. An sions of demonstration programs on develop- visions of this Act shall supersede any con- aftercare plan may use such resources as a ment of educational curricula for substance flicting provisions of law in effect on the day community-based therapeutic group, transi- abuse counseling as required in section 125(f). before the date of enactment of the Indian tional living facilities, a 12-step sponsor, a Health Care Improvement Act Amendments local 12-step or other related support group, ‘‘(7) A separate statement which specifies of 2008, and the Secretary is authorized to re- and other community-based providers. the amount of funds requested to carry out peal any regulation inconsistent with the the provisions of section 201. ‘‘(4) DUAL DIAGNOSIS.—The term ‘dual diag- provisions of this Act. ‘‘(8) A report of the evaluations of health nosis’ means coexisting substance abuse and ‘‘SEC. 803. PLAN OF IMPLEMENTATION. mental illness conditions or diagnosis. Such promotion and disease prevention as required in section 203(c). ‘‘Not later than 9 months after the date of clients are sometimes referred to as men- enactment of the Indian Health Care Im- tally ill chemical abusers (MICAs). ‘‘(9) A biennial report to Congress on infec- provement Act Amendments of 2008, the Sec- ‘‘(5) FETAL ALCOHOL SPECTRUM DISORDERS.— tious diseases as required by section 212. retary, in consultation with Indian Tribes ‘‘(A) IN GENERAL.—The term ‘fetal alcohol ‘‘(10) A report on environmental and nu- and Tribal Organizations, and in conference spectrum disorders’ includes a range of ef- clear health hazards as required by section with Urban Indian Organizations, shall sub- fects that can occur in an individual whose 215. mit to Congress a plan explaining the man- mother drank alcohol during pregnancy, in- ‘‘(11) An annual report on the status of all ner and schedule, by title and section, by cluding physical, mental, behavioral, and/or health care facilities needs as required by which the Secretary will implement the pro- learning disabilities with possible lifelong section 301(c)(2)(B) and 301(d). visions of this Act. This consultation may be implications. ‘‘(12) Reports on safe water and sanitary conducted jointly with the annual budget ‘‘(B) INCLUSIONS.—The term ‘fetal alcohol waste disposal facilities as required by sec- consultation pursuant to the Indian Self-De- spectrum disorders’ may include— tion 302(h). termination and Education Assistance Act ‘‘(i) fetal alcohol syndrome (FAS); ‘‘(13) An annual report on the expenditure (25 U.S.C. 450 et seq). ‘‘(ii) fetal alcohol effect (FAE); of non-Service funds for renovation as re- ‘‘SEC. 804. AVAILABILITY OF FUNDS. ‘‘(iii) alcohol-related birth defects; and quired by sections 304(b)(2). ‘‘The funds appropriated pursuant to this ‘‘(iv) alcohol-related neurodevelopmental ‘‘(14) A report identifying the backlog of Act shall remain available until expended. disorders (ARND). maintenance and repair required at Service ‘‘SEC. 805. LIMITATION RELATING TO ABORTION. and tribal facilities required by section ‘‘(a) DEFINITION OF HEALTH BENEFITS COV- ‘‘(6) FETAL ALCOHOL SYNDROME OR FAS.— 313(a). The term ‘fetal alcohol syndrome’ or ‘FAS’ ERAGE.—In this section, the term ‘health means any 1 of a spectrum of effects that ‘‘(15) A report providing an accounting of benefits coverage’ means a health-related may occur when a woman drinks alcohol reimbursement funds made available to the service or group of services provided pursu- during pregnancy, the diagnosis of which in- Secretary under titles XVIII, XIX, and XXI ant to a contract, compact, grant, or other volves the confirmed presence of the fol- of the Social Security Act. agreement. lowing 3 criteria: ‘‘(16) A report on any arrangements for the ‘‘(b) LIMITATION.— ‘‘(A) Craniofacial abnormalities. sharing of medical facilities or services, as ‘‘(1) IN GENERAL.—Except as provided in authorized by section 406. ‘‘(B) Growth deficits. paragraph (2), no funds or facilities of the ‘‘(17) A report on evaluation and renewal of Service may be used— ‘‘(C) Central nervous system abnormali- Urban Indian programs under section 505. ties. ‘‘(A) to provide any abortion; or ‘‘(18) A report on the evaluation of pro- ‘‘(B) to provide, or pay any administrative ‘‘(7) REHABILITATION.—The term ‘rehabili- grams as required by section 513(d). tation’ means to restore the ability or capac- cost of, any health benefits coverage that in- ity to engage in usual and customary life ac- ‘‘(19) A report on alcohol and substance cludes coverage of an abortion. tivities through education and therapy. abuse as required by section 701(f). ‘‘(2) EXCEPTIONS.—The limitation described ‘‘(20) A report on Indian youth mental ‘‘(8) SUBSTANCE ABUSE.—The term ‘sub- in paragraph (1) shall not apply in any case stance abuse’ includes inhalant abuse. health services as required by section 707(h). in which— ‘‘(21) A report on the reallocation of base ‘‘(A) a pregnancy is the result of an act of ‘‘SEC. 718. AUTHORIZATION OF APPROPRIATIONS. resources if required by section 808. ‘‘There is authorized to be appropriated rape, or an act of incest against a minor; or such sums as may be necessary for each fis- ‘‘SEC. 802. REGULATIONS. ‘‘(B) the woman suffers from a physical dis- cal year through fiscal year 2017 to carry out ‘‘(a) DEADLINES.— order, physical injury, or physical illness the provisions of this title. ‘‘(1) PROCEDURES.—Not later than 90 days that, as certified by a physician, would place after the date of enactment of the Indian the woman in danger of death unless an ‘‘TITLE VIII—MISCELLANEOUS Health Care Improvement Act Amendments abortion is performed, including a life-en- ‘‘SEC. 801. REPORTS. of 2008, the Secretary shall initiate proce- dangering physical condition caused by or ‘‘For each fiscal year following the date of dures under subchapter III of chapter 5 of arising from the pregnancy itself. enactment of the Indian Health Care Im- title 5, United States Code, to negotiate and ‘‘(c) TRADITIONAL HEALTH CARE PRAC- provement Act Amendments of 2008, the Sec- promulgate such regulations or amendments TICES.—Although the Secretary may pro- retary shall transmit to Congress a report thereto that are necessary to carry out titles mote traditional health care practices, con- containing the following: II (except section 202) and VII, the sections sistent with the Service standards for the ‘‘(1) A report on the progress made in of title III for which negotiated rulemaking provision of health care, health promotion, meeting the objectives of this Act, including is specifically required, and section 807. Un- and disease prevention under this Act, the

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00089 Fmt 4624 Sfmt 8472 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1306 CONGRESSIONAL RECORD — SENATE February 27, 2008 United States is not liable for any provision ‘‘(i) the provision of such health services pact pursuant to the Indian Self-Determina- of traditional health care practices pursuant will not result in a denial or diminution of tion and Education Assistance Act (25 U.S.C. to this Act that results in damage, injury, or health services to eligible Indians; and 450 et seq.) may be extended to non-Service death to a patient. Nothing in this sub- ‘‘(ii) there is no reasonable alternative health care practitioners who provide serv- section shall be construed to alter any liabil- health facilities or services, within or with- ices to individuals described in subsection ity or other obligation that the United out the Service Unit, available to meet the (a), (b), (c), or (d). Such non-Service health States may otherwise have under the Indian health needs of such individuals. care practitioners may, as part of the privi- Self-Determination and Education Assist- ‘‘(2) ISDEAA PROGRAMS.—In the case of leging process, be designated as employees of ance Act (25 U.S.C. 450 et seq.) or this Act. health programs and facilities operated the Federal Government for purposes of sec- ‘‘(d) FIREARM PROGRAMS.—None of the under a contract or compact entered into tion 1346(b) and chapter 171 of title 28, United funds made available to carry out this Act under the Indian Self-Determination and States Code (relating to Federal tort claims) may be used to carry out any antifirearm Education Assistance Act (25 U.S.C. 450 et only with respect to acts or omissions which program, gun buy-back program, or program seq.), the governing body of the Indian Tribe occur in the course of providing services to to discourage or stigmatize the private own- or Tribal Organization providing health serv- eligible individuals as a part of the condi- ership of firearms for collecting, hunting, or ices under such contract or compact is au- tions under which such hospital privileges self-defense purposes. thorized to determine whether health serv- are extended. ices should be provided under such contract ‘‘(f) ELIGIBLE INDIAN.—For purposes of this ‘‘SEC. 806. ELIGIBILITY OF CALIFORNIA INDIANS. to individuals who are not eligible for such ‘‘(a) IN GENERAL.—The following California section, the term ‘eligible Indian’ means any health services under any other subsection of Indian who is eligible for health services pro- Indians shall be eligible for health services this section or under any other provision of provided by the Service: vided by the Service without regard to the law. In making such determinations, the provisions of this section. ‘‘(1) Any member of a federally recognized governing body of the Indian Tribe or Tribal Indian Tribe. Organization shall take into account the ‘‘SEC. 808. REALLOCATION OF BASE RESOURCES. ‘‘(2) Any descendant of an Indian who was considerations described in paragraph (1)(B). ‘‘(a) REPORT REQUIRED.—Notwithstanding residing in California on June 1, 1852, if such ‘‘(3) PAYMENT FOR SERVICES.— any other provision of law, any allocation of descendant— ‘‘(A) IN GENERAL.—Persons receiving health Service funds for a fiscal year that reduces ‘‘(A) is a member of the Indian community services provided by the Service under this by 5 percent or more from the previous fiscal served by a local program of the Service; and subsection shall be liable for payment of year the funding for any recurring program, such health services under a schedule of project, or activity of a Service Unit may be ‘‘(B) is regarded as an Indian by the com- implemented only after the Secretary has munity in which such descendant lives. charges prescribed by the Secretary which, in the judgment of the Secretary, results in submitted to Congress, under section 801, a ‘‘(3) Any Indian who holds trust interests reimbursement in an amount not less than report on the proposed change in allocation in public domain, national forest, or reserva- the actual cost of providing the health serv- of funding, including the reasons for the tion allotments in California. ices. Notwithstanding section 404 of this Act change and its likely effects. ‘‘(4) Any Indian in California who is listed or any other provision of law, amounts col- ‘‘(b) EXCEPTION.—Subsection (a) shall not on the plans for distribution of the assets of lected under this subsection, including Medi- apply if the total amount appropriated to rancherias and reservations located within care, Medicaid, or SCHIP reimbursements the Service for a fiscal year is at least 5 per- the State of California under the Act of Au- under titles XVIII, XIX, and XXI of the So- cent less than the amount appropriated to gust 18, 1958 (72 Stat. 619), and any descend- cial Security Act, shall be credited to the ac- the Service for the previous fiscal year. ant of such an Indian. count of the program providing the service ‘‘SEC. 809. RESULTS OF DEMONSTRATION ‘‘(b) CLARIFICATION.—Nothing in this sec- and shall be used for the purposes listed in PROJECTS. tion may be construed as expanding the eli- section 401(d)(2) and amounts collected under ‘‘The Secretary shall provide for the dis- gibility of California Indians for health serv- this subsection shall be available for expend- semination to Indian Tribes, Tribal Organi- ices provided by the Service beyond the iture within such program. zations, and Urban Indian Organizations of scope of eligibility for such health services ‘‘(B) INDIGENT PEOPLE.—Health services that applied on May 1, 1986. the findings and results of demonstration may be provided by the Secretary through projects conducted under this Act. ‘‘SEC. 807. HEALTH SERVICES FOR INELIGIBLE the Service under this subsection to an indi- PERSONS. gent individual who would not be otherwise ‘‘SEC. 810. PROVISION OF SERVICES IN MONTANA. ‘‘(a) CHILDREN.—Any individual who— eligible for such health services but for the ‘‘(a) CONSISTENT WITH COURT DECISION.— ‘‘(1) has not attained 19 years of age; provisions of paragraph (1) only if an agree- The Secretary, acting through the Service, shall provide services and benefits for Indi- ‘‘(2) is the natural or adopted child, step- ment has been entered into with a State or local government under which the State or ans in Montana in a manner consistent with child, foster child, legal ward, or orphan of the decision of the United States Court of an eligible Indian; and local government agrees to reimburse the Service for the expenses incurred by the Appeals for the Ninth Circuit in McNabb for ‘‘(3) is not otherwise eligible for health McNabb v. Bowen, 829 F.2d 787 (9th Cir. 1987). services provided by the Service, Service in providing such health services to such indigent individual. ‘‘(b) CLARIFICATION.—The provisions of sub- shall be eligible for all health services pro- ‘‘(4) REVOCATION OF CONSENT FOR SERV- section (a) shall not be construed to be an vided by the Service on the same basis and expression of the sense of Congress on the subject to the same rules that apply to eligi- ICES.— ‘‘(A) SINGLE TRIBE SERVICE AREA.—In the application of the decision described in sub- ble Indians until such individual attains 19 section (a) with respect to the provision of years of age. The existing and potential case of a Service Area which serves only 1 In- dian Tribe, the authority of the Secretary to services or benefits for Indians living in any health needs of all such individuals shall be State other than Montana. taken into consideration by the Service in provide health services under paragraph (1) determining the need for, or the allocation shall terminate at the end of the fiscal year ‘‘SEC. 811. TRIBAL EMPLOYMENT. of, the health resources of the Service. If succeeding the fiscal year in which the gov- ‘‘For purposes of section 2(2) of the Act of such an individual has been determined to be erning body of the Indian Tribe revokes its July 5, 1935 (49 Stat. 450, chapter 372), an In- legally incompetent prior to attaining 19 concurrence to the provision of such health dian Tribe or Tribal Organization carrying years of age, such individual shall remain el- services. out a contract or compact pursuant to the igible for such services until 1 year after the ‘‘(B) MULTITRIBAL SERVICE AREA.—In the Indian Self-Determination and Education date of a determination of competency. case of a multitribal Service Area, the au- Assistance Act (25 U.S.C. 450 et seq.) shall ‘‘(b) SPOUSES.—Any spouse of an eligible thority of the Secretary to provide health not be considered an ‘employer’. Indian who is not an Indian, or who is of In- services under paragraph (1) shall terminate ‘‘SEC. 812. SEVERABILITY PROVISIONS. dian descent but is not otherwise eligible for at the end of the fiscal year succeeding the ‘‘If any provision of this Act, any amend- the health services provided by the Service, fiscal year in which at least 51 percent of the ment made by the Act, or the application of shall be eligible for such health services if number of Indian Tribes in the Service Area such provision or amendment to any person all such spouses or spouses who are married revoke their concurrence to the provisions of or circumstances is held to be invalid, the re- to members of each Indian Tribe being such health services. mainder of this Act, the remaining amend- served are made eligible, as a class, by an ap- ‘‘(d) OTHER SERVICES.—The Service may ments made by this Act, and the application propriate resolution of the governing body of provide health services under this subsection of such provisions to persons or cir- the Indian Tribe or Tribal Organization pro- to individuals who are not eligible for health cumstances other than those to which it is viding such services. The health needs of per- services provided by the Service under any held invalid, shall not be affected thereby. other provision of law in order to— sons made eligible under this paragraph shall ‘‘SEC. 813. ESTABLISHMENT OF NATIONAL BIPAR- not be taken into consideration by the Serv- ‘‘(1) achieve stability in a medical emer- TISAN COMMISSION ON INDIAN ice in determining the need for, or allocation gency; HEALTH CARE. of, its health resources. ‘‘(2) prevent the spread of a communicable ‘‘(a) ESTABLISHMENT.—There is established ‘‘(c) PROVISION OF SERVICES TO OTHER INDI- disease or otherwise deal with a public the National Bipartisan Indian Health Care VIDUALS.— health hazard; Commission (the ‘Commission’). ‘‘(1) IN GENERAL.—The Secretary is author- ‘‘(3) provide care to non-Indian women ‘‘(b) DUTIES OF COMMISSION.—The duties of ized to provide health services under this pregnant with an eligible Indian’s child for the Commission are the following: subsection through health programs oper- the duration of the pregnancy through ‘‘(1) To establish a study committee com- ated directly by the Service to individuals postpartum; or posed of those members of the Commission who reside within the Service Unit and who ‘‘(4) provide care to immediate family appointed by the Director and at least 4 are not otherwise eligible for such health members of an eligible individual if such members of Congress from among the mem- services if— care is directly related to the treatment of bers of the Commission, the duties of which ‘‘(A) the Indian Tribes served by such Serv- the eligible individual. shall be the following: ice Unit request such provision of health ‘‘(e) HOSPITAL PRIVILEGES FOR PRACTI- ‘‘(A) To the extent necessary to carry out services to such individuals; and TIONERS.—Hospital privileges in health fa- its duties, collect and compile data nec- ‘‘(B) the Secretary and the served Indian cilities operated and maintained by the essary to understand the extent of Indian Tribes have jointly determined that— Service or operated under a contract or com- needs with regard to the provision of health

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services, regardless of the location of Indi- ‘‘(2) CHAIR; VICE CHAIR.—The Chair and the Commission, including at least 1 member ans, including holding hearings and solic- Vice Chair of the Commission shall be se- of Congress, must be present. Hearings held iting the views of Indians, Indian Tribes, lected by the congressional members of the by the study committee established in this Tribal Organizations, and Urban Indian Or- Commission. section may count toward the number of re- ganizations, which may include authorizing ‘‘(3) TERMS.—The terms of members of the gional hearings required by this subsection. and making funds available for feasibility Commission shall be for the life of the Com- ‘‘(2)(A) The Director of the Congressional studies of various models for providing and mission. Budget Office or the Chief Actuary of the funding health services for all Indian bene- ‘‘(4) DEADLINE FOR APPOINTMENTS.—Con- Centers for Medicare & Medicaid Services, or ficiaries, including those who live outside of gressional members of the Commission shall both, shall provide to the Commission, upon a reservation, temporarily or permanently. be appointed not later than 180 days after the the request of the Commission, such cost es- ‘‘(B) To make legislative recommendations date of enactment of the Indian Health Care timates as the Commission determines to be to the Commission regarding the delivery of Improvement Act Amendments of 2008, and necessary to carry out its duties. Federal health care services to Indians. Such the remaining members of the Commission ‘‘(B) The Commission shall reimburse the recommendations shall include those related shall be appointed not later than 60 days fol- to issues of eligibility, benefits, the range of Director of the Congressional Budget Office lowing the appointment of the congressional for expenses relating to the employment in service providers, the cost of such services, members. financing such services, and the optimal the office of that Director of such additional ‘‘(5) VACANCY.—A vacancy in the Commis- staff as may be necessary for the Director to manner in which to provide such services. sion shall be filled in the manner in which ‘‘(C) To determine the effect of the enact- comply with requests by the Commission the original appointment was made. under subparagraph (A). ment of such recommendations on (i) the ex- ‘‘(d) COMPENSATION.— isting system of delivery of health services ‘‘(3) Upon the request of the Commission, ‘‘(1) CONGRESSIONAL MEMBERS.—Each con- the head of any Federal agency is authorized for Indians, and (ii) the sovereign status of gressional member of the Commission shall Indian Tribes. to detail, without reimbursement, any of the receive no additional pay, allowances, or personnel of such agency to the Commission ‘‘(D) Not later than 12 months after the ap- benefits by reason of their service on the pointment of all members of the Commis- to assist the Commission in carrying out its Commission and shall receive travel ex- duties. Any such detail shall not interrupt or sion, to submit a written report of its find- penses and per diem in lieu of subsistence in ings and recommendations to the full Com- otherwise affect the civil service status or accordance with sections 5702 and 5703 of privileges of the Federal employee. mission. The report shall include a state- title 5, United States Code. ‘‘(4) Upon the request of the Commission, ment of the minority and majority position ‘‘(2) OTHER MEMBERS.—Remaining members of the Committee and shall be disseminated, of the Commission, while serving on the the head of a Federal agency shall provide at a minimum, to every Indian Tribe, Tribal business of the Commission (including travel such technical assistance to the Commission Organization, and Urban Indian Organization time), shall be entitled to receive compensa- as the Commission determines to be nec- for comment to the Commission. tion at the per diem equivalent of the rate essary to carry out its duties. ‘‘(E) To report regularly to the full Com- provided for level IV of the Executive Sched- ‘‘(5) The Commission may use the United mission regarding the findings and rec- ule under section 5315 of title 5, United States mails in the same manner and under ommendations developed by the study com- States Code, and while so serving away from the same conditions as Federal agencies and mittee in the course of carrying out its du- home and the member’s regular place of shall, for purposes of the frank, be consid- ties under this section. business, a member may be allowed travel ered a commission of Congress as described ‘‘(2) To review and analyze the rec- expenses, as authorized by the Chairman of in section 3215 of title 39, United States ommendations of the report of the study the Commission. For purpose of pay (other Code. committee. than pay of members of the Commission) and ‘‘(6) The Commission may secure directly ‘‘(3) To make legislative recommendations employment benefits, rights, and privileges, from any Federal agency information nec- to Congress regarding the delivery of Federal all personnel of the Commission shall be essary to enable it to carry out its duties, if health care services to Indians. Such rec- treated as if they were employees of the the information may be disclosed under sec- ommendations shall include those related to United States Senate. tion 552 of title 4, United States Code. Upon issues of eligibility, benefits, the range of ‘‘(e) MEETINGS.—The Commission shall request of the Chairman of the Commission, service providers, the cost of such services, meet at the call of the Chair. the head of such agency shall furnish such financing such services, and the optimal ‘‘(f) QUORUM.—A quorum of the Commis- information to the Commission. manner in which to provide such services. sion shall consist of not less than 15 mem- ‘‘(7) Upon the request of the Commission, ‘‘(4) Not later than 18 months following the bers, provided that no less than 6 of the the Administrator of General Services shall date of appointment of all members of the members of Congress who are Commission provide to the Commission on a reimburs- Commission, submit a written report to Con- members are present and no less than 9 of able basis such administrative support serv- gress regarding the delivery of Federal the members who are Indians are present. ices as the Commission may request. health care services to Indians. Such rec- ‘‘(g) EXECUTIVE DIRECTOR; STAFF; FACILI- ‘‘(8) For purposes of costs relating to print- ommendations shall include those related to TIES.— ing and binding, including the cost of per- issues of eligibility, benefits, the range of ‘‘(1) APPOINTMENT; PAY.—The Commission sonnel detailed from the Government Print- service providers, the cost of such services, shall appoint an executive director of the ing Office, the Commission shall be deemed financing such services, and the optimal Commission. The executive director shall be to be a committee of Congress. manner in which to provide such services. paid the rate of basic pay for level V of the ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— ‘‘(c) MEMBERS.— Executive Schedule. There is authorized to be appropriated ‘‘(1) APPOINTMENT.—The Commission shall ‘‘(2) STAFF APPOINTMENT.—With the ap- $4,000,000 to carry out the provisions of this be composed of 25 members, appointed as fol- proval of the Commission, the executive di- section, which sum shall not be deducted lows: rector may appoint such personnel as the ex- from or affect any other appropriation for ‘‘(A) Ten members of Congress, including 3 ecutive director deems appropriate. health care for Indian persons. from the House of Representatives and 2 ‘‘(3) STAFF PAY.—The staff of the Commis- ‘‘(j) NONAPPLICABILITY OF FACA.—The Fed- from the Senate, appointed by their respec- sion shall be appointed without regard to the eral Advisory Committee Act (5 U.S.C. App.) tive majority leaders, and 3 from the House provisions of title 5, United States Code, gov- shall not apply to the Commission. of Representatives and 2 from the Senate, erning appointments in the competitive ‘‘SEC. 814. CONFIDENTIALITY OF MEDICAL QUAL- appointed by their respective minority lead- service, and shall be paid without regard to ITY ASSURANCE RECORDS; QUALI- ers, and who shall be members of the stand- the provisions of chapter 51 and subchapter FIED IMMUNITY FOR PARTICIPANTS. ing committees of Congress that consider III of chapter 53 of such title (relating to ‘‘(a) CONFIDENTIALITY OF RECORDS.—Med- legislation affecting health care to Indians. classification and General Schedule pay ical quality assurance records created by or ‘‘(B) Twelve persons chosen by the congres- rates). for any Indian Health Program or a health sional members of the Commission, 1 from ‘‘(4) TEMPORARY SERVICES.—With the ap- program of an Urban Indian Organization as each Service Area as currently designated by proval of the Commission, the executive di- part of a medical quality assurance program the Director to be chosen from among 3 rector may procure temporary and intermit- are confidential and privileged. Such records nominees from each Service Area put for- tent services under section 3109(b) of title 5, may not be disclosed to any person or entity, ward by the Indian Tribes within the area, United States Code. except as provided in subsection (c). with due regard being given to the experi- ‘‘(5) FACILITIES.—The Administrator of ‘‘(b) PROHIBITION ON DISCLOSURE AND TESTI- ence and expertise of the nominees in the General Services shall locate suitable office MONY.— provision of health care to Indians and to a space for the operation of the Commission. ‘‘(1) IN GENERAL.—No part of any medical reasonable representation on the commis- The facilities shall serve as the headquarters quality assurance record described in sub- sion of members who are familiar with var- of the Commission and shall include all nec- section (a) may be subject to discovery or ad- ious health care delivery modes and who rep- essary equipment and incidentals required mitted into evidence in any judicial or ad- resent Indian Tribes of various size popu- for the proper functioning of the Commis- ministrative proceeding, except as provided lations. sion. in subsection (c). ‘‘(C) Three persons appointed by the Direc- ‘‘(h) HEARINGS.—(1) For the purpose of car- ‘‘(2) TESTIMONY.—A person who reviews or tor who are knowledgeable about the provi- rying out its duties, the Commission may creates medical quality assurance records sion of health care to Indians, at least 1 of hold such hearings and undertake such other for any Indian Health Program or Urban In- whom shall be appointed from among 3 nomi- activities as the Commission determines to dian Organization who participates in any nees put forward by those programs whose be necessary to carry out its duties, provided proceeding that reviews or creates such funds are provided in whole or in part by the that at least 6 regional hearings are held in records may not be permitted or required to Service primarily or exclusively for the ben- different areas of the United States in which testify in any judicial or administrative pro- efit of Urban Indians. large numbers of Indians are present. Such ceeding with respect to such records or with ‘‘(D) All those persons chosen by the con- hearings are to be held to solicit the views of respect to any finding, recommendation, gressional members of the Commission and Indians regarding the delivery of health care evaluation, opinion, or action taken by such by the Director shall be members of feder- services to them. To constitute a hearing person or body in connection with such ally recognized Indian Tribes. under this subsection, at least 5 members of records except as provided in this section.

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‘‘(c) AUTHORIZED DISCLOSURE AND TESTI- mony described by this section may not dis- operating any health program, service, func- MONY.— close the contents of such record or testi- tion, activity, or facility funded, in whole or ‘‘(1) IN GENERAL.—Subject to paragraph (2), mony in any manner or for any purpose ex- part, by the Service through, or provided for a medical quality assurance record described cept as provided in this section. in, a compact with the Service pursuant to in subsection (a) may be disclosed, and a per- ‘‘(f) EXEMPTION FROM FREEDOM OF INFOR- title V of the Indian Self-Determination and son referred to in subsection (b) may give MATION ACT.—Medical quality assurance Education Assistance Act (25 U.S.C. 458aaa testimony in connection with such a record, records described in subsection (a) may not et seq.) to charge an Indian for services pro- only as follows: be made available to any person under sec- vided by the Tribal Health Program. ‘‘(A) To a Federal executive agency or pri- tion 552 of title 5. ‘‘(b) SERVICE.—Nothing in this Act author- vate organization, if such medical quality as- ‘‘(g) LIMITATION ON CIVIL LIABILITY.—A per- izes the Service— surance record or testimony is needed by son who participates in or provides informa- ‘‘(1) to charge an Indian for services; or such agency or organization to perform lition to a person or body that reviews or cre- ‘‘(2) to require any Tribal Health Program censing or accreditation functions related to ates medical quality assurance records de- to charge an Indian for services. any Indian Health Program or to a health scribed in subsection (a) shall not be civilly ‘‘SEC. 817. TESTING FOR SEXUALLY TRANS- program of an Urban Indian Organization to liable for such participation or for providing perform monitoring, required by law, of such MITTED DISEASES IN CASES OF SEX- such information if the participation or pro- UAL VIOLENCE. program or organization. vision of information was in good faith based ‘‘(B) To an administrative or judicial pro- on prevailing professional standards at the ‘‘The Attorney General shall ensure that, ceeding commenced by a present or former time the medical quality assurance program with respect to any Federal criminal action Indian Health Program or Urban Indian Or- activity took place. involving a sexual assault, rape, or other in- ganization provider concerning the termi- ‘‘(h) APPLICATION TO INFORMATION IN CER- cident of sexual violence against an Indian— nation, suspension, or limitation of clinical TAIN OTHER RECORDS.—Nothing in this sec- ‘‘(1)(A) at the request of the victim, a de- privileges of such health care provider. tion shall be construed as limiting access to fendant is tested for the human immuno- ‘‘(C) To a governmental board or agency or the information in a record created and deficiency virus (HIV) and such other sexu- to a professional health care society or orga- maintained outside a medical quality assur- ally transmitted diseases as are requested by nization, if such medical quality assurance ance program, including a patient’s medical record or testimony is needed by such board, records, on the grounds that the information the victim not later than 48 hours after the agency, society, or organization to perform was presented during meetings of a review date on which the applicable information or licensing, credentialing, or the monitoring of body that are part of a medical quality as- indictment is presented; professional standards with respect to any surance program. ‘‘(B) a notification of the test results is health care provider who is or was an em- ‘‘(i) REGULATIONS.—The Secretary, acting provided to the victim or the parent or ployee of any Indian Health Program or through the Service, is authorized to pro- guardian of the victim and the defendant as Urban Indian Organization. mulgate regulations pursuant to section 802. soon as practicable after the results are gen- ‘‘(D) To a hospital, medical center, or ‘‘(j) DEFINITIONS.—In this section: erated; and other institution that provides health care ‘‘(1) The term ‘health care provider’ means services, if such medical quality assurance ‘‘(C) such follow-up tests for HIV and other any health care professional, including com- sexually transmitted diseases are provided as record or testimony is needed by such insti- munity health aides and practitioners cer- tution to assess the professional qualifica- tified under section 121, who are granted are medically appropriate, with the test re- tions of any health care provider who is or clinical practice privileges or employed to sults made available in accordance with sub- was an employee of any Indian Health Pro- provide health care services in an Indian paragraph (B); and gram or Urban Indian Organization and who Health Program or health program of an ‘‘(2) pursuant to section 714(a), HIV and has applied for or been granted authority or Urban Indian Organization, who is licensed other sexually transmitted disease testing, employment to provide health care services or certified to perform health care services in or on behalf of such program or organiza- treatment, and counseling is provided for by a governmental board or agency or profes- victims of sexual abuse. tion. sional health care society or organization. ‘‘(E) To an officer, employee, or contractor ‘‘(2) The term ‘medical quality assurance ‘‘SEC. 818. STUDY ON TOBACCO-RELATED DIS- of the Indian Health Program or Urban In- program’ means any activity carried out be- EASE AND DISPROPORTIONATE dian Organization that created the records fore, on, or after the date of enactment of HEALTH EFFECTS ON TRIBAL POPU- or for which the records were created. If that this Act by or for any Indian Health Pro- LATIONS. officer, employee, or contractor has a need gram or Urban Indian Organization to assess ‘‘Not later than 180 days after the date of for such record or testimony to perform offi- the quality of medical care, including activi- enactment of the Indian Health Care Im- cial duties. ties conducted by or on behalf of individuals, provement Act Amendments of 2008, the Sec- ‘‘(F) To a criminal or civil law enforce- Indian Health Program or Urban Indian Or- retary, in consultation with appropriate Fed- ment agency or instrumentality charged ganization medical or dental treatment re- eral departments and agencies and acting under applicable law with the protection of view committees, or other review bodies re- the public health or safety, if a qualified rep- through the epidemiology centers estab- sponsible for review of adverse incidents, lished under section 209, shall solicit from resentative of such agency or instrumen- claims, quality assurance, credentials, infec- tality makes a written request that such tion control, patient safety, patient care as- independent organizations bids to conduct, record or testimony be provided for a pur- sessment (including treatment procedures, and shall submit to Congress no later than 5 pose authorized by law. blood, drugs, and therapeutics), medical years after enactment a report describing ‘‘(G) In an administrative or judicial pro- records, health resources management re- the results of, a study to determine possible ceeding commenced by a criminal or civil view and identification and prevention of causes for the high prevalence of tobacco use law enforcement agency or instrumentality medical or dental incidents and risks. among Indians. referred to in subparagraph (F), but only ‘‘(3) The term ‘medical quality assurance ‘‘SEC. 819. APPROPRIATIONS; AVAILABILITY. with respect to the subject of such pro- record’ means the proceedings, records, min- ceeding. utes, and reports that emanate from quality ‘‘Any new spending authority (described in ‘‘(2) IDENTITY OF PARTICIPANTS.—With the assurance program activities described in subparagraph (A) or (B) of section 401(c)(2) of exception of the subject of a quality assur- paragraph (2) and are produced or compiled the Congressional Budget Act of 1974 (Public ance action, the identity of any person re- by or for an Indian Health Program or Urban Law 93–344; 88 Stat. 317)) which is provided ceiving health care services from any Indian Indian Organization as part of a medical under this Act shall be effective for any fis- Health Program or Urban Indian Organiza- quality assurance program. cal year only to such extent or in such tion or the identity of any other person asso- ‘‘(k) RELATIONSHIP TO OTHER LAW.—This amounts as are provided in appropriation ciated with such program or organization for section shall continue in force and effect, ex- Acts. purposes of a medical quality assurance pro- cept as otherwise specifically provided in gram that is disclosed in a medical quality any Federal law enacted after the date of en- ‘‘SEC. 820. GAO REPORT ON COORDINATION OF assurance record described in subsection (a) actment of the Indian Health Care Improve- SERVICES. shall be deleted from that record or document Act Amendments of 2008. ‘‘(a) STUDY AND EVALUATION.—The Comp- ment before any disclosure of such record is ‘‘SEC. 815. SENSE OF CONGRESS REGARDING LAW troller General of the United States shall made outside such program or organization. ENFORCEMENT AND METHAMPHET- conduct a study, and evaluate the effective- ‘‘(d) DISCLOSURE FOR CERTAIN PURPOSES.— AMINE ISSUES IN INDIAN COUNTRY. ness, of coordination of health care services ‘‘(1) IN GENERAL.—Nothing in this section ‘‘It is the sense of Congress that Congress provided to Indians— encourages State, local, and Indian tribal shall be construed as authorizing or requir- ‘‘(1) through Medicare, Medicaid, or ing the withholding from any person or enti- law enforcement agencies to enter into ty aggregate statistical information regard- memoranda of agreement between and SCHIP; ing the results of any Indian Health Pro- among those agencies for purposes of stream- ‘‘(2) by the Service; or gram’s or Urban Indian Organization’s med- lining law enforcement activities and maxi- ‘‘(3) using funds provided by— ical quality assurance programs. mizing the use of limited resources— ‘‘(A) State or local governments; or ‘‘(2) WITHHOLDING FROM CONGRESS.—Noth- ‘‘(1) to improve law enforcement services ‘‘(B) Indian Tribes. ing in this section shall be construed as au- provided to Indian tribal communities; and ‘‘(b) REPORT.—Not later than 18 months thority to withhold any medical quality as- ‘‘(2) to increase the effectiveness of meas- after the date of enactment of the Indian surance record from a committee of either ures to address problems relating to meth- Health Care Improvement Act Amendments House of Congress, any joint committee of amphetamine use in Indian Country (as de- of 2007, the Comptroller General shall submit Congress, or the Government Accountability fined in section 1151 of title 18, United States Office if such record pertains to any matter Code). to Congress a report— ‘‘(1) describing the results of the evalua- within their respective jurisdictions. ‘‘SEC. 816. TRIBAL HEALTH PROGRAM OPTION ‘‘(e) PROHIBITION ON DISCLOSURE OF RECORD FOR COST SHARING. tion under subsection (a); and OR TESTIMONY.—A person or entity having ‘‘(a) IN GENERAL.—Nothing in this Act lim- ‘‘(2) containing recommendations of the possession of or access to a record or testi- its the ability of a Tribal Health Program Comptroller General regarding measures to

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00092 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1309 support and increase coordination of the pro- ‘‘(3) participate with and assist Federal, ‘‘(1) shall adopt a constitution and bylaws vision of health care services to Indians as State, and tribal governments, agencies, en- for the management of the property of the described in subsection (a). tities, and individuals in undertaking and Foundation and the regulation of the affairs ‘‘SEC. 821. AUTHORIZATION OF APPROPRIATIONS. conducting activities that will further the of the Foundation; ‘‘There are authorized to be appropriated health and wellness activities and opportuni- ‘‘(2) may adopt and alter a corporate seal; such sums as may be necessary for each fis- ties of Native Americans. ‘‘(3) may enter into contracts; cal year through fiscal year 2017 to carry out ‘‘(f) COMMITTEE FOR THE ESTABLISHMENT OF ‘‘(4) may acquire (through a gift or other- this title.’’. NATIVE AMERICAN HEALTH AND WELLNESS wise), own, lease, encumber, and transfer FOUNDATION.— SEC. 102. SOBOBA SANITATION FACILITIES. real or personal property as necessary or ‘‘(1) IN GENERAL.—The Secretary shall es- convenient to carry out the purposes of the The Act of December 17, 1970 (84 Stat. 1465), tablish the Committee for the Establishment Foundation; is amended by adding at the end the fol- of Native American Health and Wellness ‘‘(5) may sue and be sued; and lowing: Foundation to assist the Secretary in estab- ‘‘(6) may perform any other act necessary ‘‘SEC. 9. Nothing in this Act shall preclude lishing the Foundation. and proper to carry out the purposes of the the Soboba Band of Mission Indians and the ‘‘(2) DUTIES.—Not later than 180 days after Soboba Indian Reservation from being pro- Foundation. the date of enactment of this section, the ‘‘(j) PRINCIPAL OFFICE.— vided with sanitation facilities and services Committee shall— ‘‘(1) IN GENERAL.—The principal office of under the authority of section 7 of the Act of ‘‘(A) carry out such activities as are nec- the Foundation shall be in the District of Co- August 5, 1954 (68 Stat. 674), as amended by essary to incorporate the Foundation under lumbia. the Act of July 31, 1959 (73 Stat. 267).’’. the laws of the District of Columbia, includ- ‘‘(2) ACTIVITIES; OFFICES.—The activities of SEC. 103. NATIVE AMERICAN HEALTH AND ing acting as incorporators of the Founda- the Foundation may be conducted, and of- WELLNESS FOUNDATION. tion; fices may be maintained, throughout the (a) IN GENERAL.—The Indian Self-Deter- ‘‘(B) ensure that the Foundation qualifies United States in accordance with the con- mination and Education Assistance Act (25 for and maintains the status required to stitution and bylaws of the Foundation. U.S.C. 450 et seq.) is amended by adding at carry out this section, until the Board is es- ‘‘(k) SERVICE OF PROCESS.—The Foundation the end the following: tablished; shall comply with the law on service of proc- ‘‘TITLE VIII—NATIVE AMERICAN HEALTH ‘‘(C) establish the constitution and initial ess of each State in which the Foundation is AND WELLNESS FOUNDATION bylaws of the Foundation; incorporated and of each State in which the ‘‘(D) provide for the initial operation of the ‘‘SEC. 801. DEFINITIONS. Foundation carries on activities. Foundation, including providing for tem- ‘‘(l) LIABILITY OF OFFICERS, EMPLOYEES, ‘‘In this title: porary or interim quarters, equipment, and AND AGENTS.— ‘‘(1) BOARD.—The term ‘Board’ means the staff; and ‘‘(1) IN GENERAL.—The Foundation shall be Board of Directors of the Foundation. ‘‘(E) appoint the initial members of the liable for the acts of the officers, employees, ‘‘(2) COMMITTEE.—The term ‘Committee’ Board in accordance with the constitution and agents of the Foundation acting within means the Committee for the Establishment and initial bylaws of the Foundation. the scope of their authority. of Native American Health and Wellness ‘‘(g) BOARD OF DIRECTORS.— ‘‘(2) PERSONAL LIABILITY.—A member of the Foundation established under section 802(f). ‘‘(1) IN GENERAL.—The Board of Directors Board shall be personally liable only for ‘‘(3) FOUNDATION.—The term ‘Foundation’ shall be the governing body of the Founda- gross negligence in the performance of the means the Native American Health and tion. duties of the member. Wellness Foundation established under sec- ‘‘(2) POWERS.—The Board may exercise, or ‘‘(m) RESTRICTIONS.— tion 802. provide for the exercise of, the powers of the ‘‘(1) LIMITATION ON SPENDING.—Beginning ‘‘(4) SECRETARY.—The term ‘Secretary’ Foundation. with the fiscal year following the first full means the Secretary of Health and Human ‘‘(3) SELECTION.— fiscal year during which the Foundation is in Services. ‘‘(A) IN GENERAL.—Subject to subparagraph operation, the administrative costs of the ‘‘(5) SERVICE.—The term ‘Service’ means (B), the number of members of the Board, the Foundation shall not exceed the percentage the Indian Health Service of the Department manner of selection of the members (includ- described in paragraph (2) of the sum of— of Health and Human Services. ing the filling of vacancies), and the terms of ‘‘(A) the amounts transferred to the Foun- ‘‘SEC. 802. NATIVE AMERICAN HEALTH AND office of the members shall be as provided in dation under subsection (o) during the pre- WELLNESS FOUNDATION. the constitution and bylaws of the Founda- ceding fiscal year; and ‘‘(a) ESTABLISHMENT.— tion. ‘‘(B) donations received from private ‘‘(1) IN GENERAL.—As soon as practicable ‘‘(B) REQUIREMENTS.— sources during the preceding fiscal year. after the date of enactment of this title, the ‘‘(i) NUMBER OF MEMBERS.—The Board shall ‘‘(2) PERCENTAGES.—The percentages re- Secretary shall establish, under the laws of have at least 11 members, who shall have ferred to in paragraph (1) are— the District of Columbia and in accordance staggered terms. ‘‘(A) for the first fiscal year described in with this title, the Native American Health ‘‘(ii) INITIAL VOTING MEMBERS.—The initial that paragraph, 20 percent; and Wellness Foundation. voting members of the Board— ‘‘(B) for the following fiscal year, 15 per- ‘‘(2) FUNDING DETERMINATIONS.—No funds, ‘‘(I) shall be appointed by the Committee cent; and gift, property, or other item of value (includ- not later than 180 days after the date on ‘‘(C) for each fiscal year thereafter, 10 per- ing any interest accrued on such an item) ac- which the Foundation is established; and cent. quired by the Foundation shall— ‘‘(II) shall have staggered terms. ‘‘(3) APPOINTMENT AND HIRING.—The ap- ‘‘(A) be taken into consideration for pur- ‘‘(iii) QUALIFICATION.—The members of the pointment of officers and employees of the poses of determining Federal appropriations Board shall be United States citizens who Foundation shall be subject to the avail- relating to the provision of health care and are knowledgeable or experienced in Native ability of funds. services to Indians; or American health care and related matters. ‘‘(4) STATUS.—A member of the Board or of- ‘‘(B) otherwise limit, diminish, or affect ‘‘(C) COMPENSATION.—A member of the ficer, employee, or agent of the Foundation the Federal responsibility for the provision Board shall not receive compensation for shall not by reason of association with the of health care and services to Indians. service as a member, but shall be reimbursed Foundation be considered to be an officer, ‘‘(b) PERPETUAL EXISTENCE.—The Founda- for actual and necessary travel and subsist- employee, or agent of the United States. tion shall have perpetual existence. ence expenses incurred in the performance of ‘‘(n) AUDITS.—The Foundation shall com- ‘‘(c) NATURE OF CORPORATION.—The Foun- the duties of the Foundation. ply with section 10101 of title 36, United dation— ‘‘(h) OFFICERS.— States Code, as if the Foundation were a cor- ‘‘(1) shall be a charitable and nonprofit fed- ‘‘(1) IN GENERAL.—The officers of the Foun- poration under part B of subtitle II of that erally chartered corporation; and dation shall be— title. ‘‘(2) shall not be an agency or instrumen- ‘‘(A) a secretary, elected from among the ‘‘(o) FUNDING.— tality of the United States. members of the Board; and ‘‘(1) AUTHORIZATION OF APPROPRIATIONS.— ‘‘(d) PLACE OF INCORPORATION AND DOMI- ‘‘(B) any other officers provided for in the There is authorized to be appropriated to CILE.—The Foundation shall be incorporated constitution and bylaws of the Foundation. carry out subsection (e)(1) $500,000 for each and domiciled in the District of Columbia. ‘‘(2) CHIEF OPERATING OFFICER.—The sec- fiscal year, as adjusted to reflect changes in ‘‘(e) DUTIES.—The Foundation shall— retary of the Foundation may serve, at the the Consumer Price Index for all-urban con- ‘‘(1) encourage, accept, and administer pri- direction of the Board, as the chief operating sumers published by the Department of vate gifts of real and personal property, and officer of the Foundation, or the Board may Labor. any income from or interest in such gifts, for appoint a chief operating officer, who shall ‘‘(2) TRANSFER OF DONATED FUNDS.—The the benefit of, or in support of, the mission serve at the direction of the Board. Secretary shall transfer to the Foundation of the Service; ‘‘(3) ELECTION.—The manner of election, funds held by the Department of Health and ‘‘(2) undertake and conduct such other ac- term of office, and duties of the officers of Human Services under the Act of August 5, tivities as will further the health and the Foundation shall be as provided in the 1954 (42 U.S.C. 2001 et seq.), if the transfer or wellness activities and opportunities of Na- constitution and bylaws of the Foundation. use of the funds is not prohibited by any tive Americans; and ‘‘(i) POWERS.—The Foundation— term under which the funds were donated.

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00093 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1310 CONGRESSIONAL RECORD — SENATE February 27, 2008 ‘‘SEC. 803. ADMINISTRATIVE SERVICES AND SUP- and who meets 1 or more of the 4 criteria in shall conduct, and submit to Congress a re- PORT. subparagraphs (A) through (D) of paragraph port describing the results of, a study of the ‘‘(a) PROVISION OF SUPPORT BY SEC- (12).’’. tribal justice systems of Indian tribes lo- RETARY.—Subject to subsection (b), during SEC. 105. GAO STUDY AND REPORT ON PAYMENTS cated in the States of North Dakota and the 5-year period beginning on the date on FOR CONTRACT HEALTH SERVICES. South Dakota. which the Foundation is established, the (a) STUDY.— (b) INCLUSIONS.—The study under sub- Secretary— (1) IN GENERAL.—The Comptroller General section (a) shall include, with respect to the ‘‘(1) may provide personnel, facilities, and of the United States (in this section referred tribal system of each Indian tribe described other administrative support services to the to as the ‘‘Comptroller General’’) shall con- in subsection (a) and the tribal justice sys- Foundation; duct a study on the utilization of health care tem as a whole— ‘‘(2) may provide funds for initial operating furnished by health care providers under the (1)(A) a description of how the tribal jus- costs and to reimburse the travel expenses of contract health services program funded by tice systems function, or are supposed to the members of the Board; and the Indian Health Service and operated by function; and ‘‘(3) shall require and accept reimburse- the Indian Health Service, an Indian Tribe, (B) a description of the components of the ments from the Foundation for— or a Tribal Organization (as those terms are tribal justice systems, such as tribal trial ‘‘(A) services provided under paragraph (1); defined in section 4 of the Indian Health Care courts, courts of appeal, applicable tribal and Improvement Act). law, judges, qualifications of judges, the se- ‘‘(B) funds provided under paragraph (2). (2) ANALYSIS.—The study conducted under lection and removal of judges, turnover of ‘‘(b) REIMBURSEMENT.—Reimbursements paragraph (1) shall include an analysis of— judges, the creation of precedent, the record- accepted under subsection (a)(3)— (A) the amounts reimbursed under the con- ing of precedent, the jurisdictional authority ‘‘(1) shall be deposited in the Treasury of tract health services program described in of the tribal court system, and the separa- the United States to the credit of the appli- paragraph (1) for health care furnished by en- tion of powers between the tribal court sys- cable appropriations account; and tities, individual providers, and suppliers, in- tem, the tribal council, and the head of the ‘‘(2) shall be chargeable for the cost of pro- cluding a comparison of reimbursement for tribal government; viding services described in subsection (a)(1) such health care through other public pro- (2) a review of the origins of the tribal jus- and travel expenses described in subsection grams and in the private sector; tice systems, such as the development of the (a)(2). (B) barriers to accessing care under such systems pursuant to the Act of June 18, 1934 ‘‘(c) CONTINUATION OF CERTAIN SERVICES.— (25 U.S.C. 461 et seq.) (commonly known as The Secretary may continue to provide fa- contract health services program, including, the ‘‘Indian Reorganization Act’’), which cilities and necessary support services to the but not limited to, barriers relating to travel promoted tribal constitutions and addressed Foundation after the termination of the 5- distances, cultural differences, and public the tribal court system; year period specified in subsection (a) if the and private sector reluctance to furnish care (3) an analysis of the weaknesses of the facilities and services— to patients under such program; tribal justice systems, including the ade- ‘‘(1) are available; and (C) the adequacy of existing Federal fund- quacy of law enforcement personnel and de- ‘‘(2) are provided on reimbursable cost ing for health care under such contract tention facilities, in particular in relation to basis.’’. health services program; and crime rates; and (b) TECHNICAL AMENDMENTS.—The Indian (D) any other items determined appro- Self-Determination and Education Assist- priate by the Comptroller General. (4) an analysis of the measures that tribal ance Act is amended— (b) REPORT.—Not later than 18 months officials suggest could be carried out to im- (1) by redesignating title V (25 U.S.C. after the date of enactment of this Act, the prove the tribal justice systems, including 458bbb et seq.) as title VII; Comptroller General shall submit to Con- an analysis of how Federal law could im- (2) by redesignating sections 501, 502, and gress a report on the study conducted under prove and stabilize the tribal court system. 503 (25 U.S.C. 458bbb, 458bbb–1, 458bbb–2) as subsection (a), together with recommenda- TITLE II—IMPROVEMENT OF INDIAN sections 701, 702, and 703, respectively; and tions regarding— HEALTH CARE PROVIDED UNDER THE (3) in subsection (a)(2) of section 702 and (1) the appropriate level of Federal funding SOCIAL SECURITY ACT paragraph (2) of section 703 (as redesignated that should be established for health care SEC. 201. EXPANSION OF PAYMENTS UNDER by paragraph (2)), by striking ‘‘section 501’’ under the contract health services program MEDICARE, MEDICAID, AND SCHIP and inserting ‘‘section 701’’. described in subsection (a)(1); and FOR ALL COVERED SERVICES FUR- SEC. 104. MODIFICATION OF TERM. (2) how to most efficiently utilize such NISHED BY INDIAN HEALTH PRO- GRAMS. (a) IN GENERAL.—Except as provided in funding. subsection (b), the Indian Health Care Im- (c) CONSULTATION.—In conducting the (a) MEDICAID.— provement Act (as amended by section 101) study under subsection (a) and preparing the (1) EXPANSION TO ALL COVERED SERVICES.— and each provision of the Social Security report under subsection (b), the Comptroller Section 1911 of the Social Security Act (42 Act amended by title II are amended (as ap- General shall consult with the Indian Health U.S.C. 1396j) is amended— plicable)— Service, Indian Tribes, and Tribal Organiza- (A) by amending the heading to read as fol- (1) by striking ‘‘Urban Indian Organiza- tions. lows: tions’’ each place it appears and inserting SEC. 106. GAO STUDY OF MEMBERSHIP CRITERIA ‘‘SEC. 1911. INDIAN HEALTH PROGRAMS.’’; ‘‘urban Indian organizations’’; FOR FEDERALLY RECOGNIZED IN- and (2) by striking ‘‘Urban Indian Organiza- DIAN TRIBES. (B) by amending subsection (a) to read as tion’’ each place it appears and inserting Not later than 1 year after the date of en- follows: ‘‘urban Indian organization’’; actment of this Act, the Comptroller General ‘‘(a) ELIGIBILITY FOR PAYMENT FOR MEDICAL (3) by striking ‘‘Urban Indians’’ each place of the United States shall conduct a study of ASSISTANCE.—The Indian Health Service and it appears and inserting ‘‘urban Indians’’; membership criteria for federally recognized an Indian Tribe, Tribal Organization, or an (4) by striking ‘‘Urban Indian’’ each place Indian tribes, including— Urban Indian Organization shall be eligible it appears and inserting ‘‘urban Indian’’; (1) the number of federally recognized In- for payment for medical assistance provided (5) by striking ‘‘Urban Centers’’ each place dian tribes in existence on the date on which under a State plan or under waiver authority it appears and inserting ‘‘urban centers’’; the study is conducted; with respect to items and services furnished and (2) the number of those Indian tribes that by the Indian Health Service, Indian Tribe, (6) by striking ‘‘Urban Center’’ each place use blood quantum as a criterion for mem- Tribal Organization, or Urban Indian Organi- it appears and inserting ‘‘urban center’’. bership in the Indian tribe and the impor- zation if the furnishing of such services (b) EXCEPTION.—The amendments made by tance assigned to that criterion; meets all the conditions and requirements subsection (a) shall not apply with respect (3) the percentage of members of federally which are applicable generally to the fur- to— recognized Indian tribes that possesses de- nishing of items and services under this title (1) the matter preceding paragraph (1) of grees of Indian blood of— and under such plan or waiver authority.’’. section 510 of the Indian Health Care Im- (A) 1⁄4; (2) COMPLIANCE WITH CONDITIONS AND RE- provement Act (as amended by section 101); (B) 1⁄8; and QUIREMENTS.—Subsection (b) of such section and (C) 1⁄16; and is amended to read as follows: (2) ‘‘Urban Indian’’ the first place it ap- (4) the variance in wait times and ration- ‘‘(b) COMPLIANCE WITH CONDITIONS AND RE- pears in section 513(a) of the Indian Health ing of health care services within the Service QUIREMENTS.—A facility of the Indian Health Care Improvement Act (as amended by sec- between federally recognized Indian Tribes Service or an Indian Tribe, Tribal Organiza- tion 101). that use blood quantum as a criterion for tion, or an Urban Indian Organization which (c) MODIFICATION OF DEFINITION.—Section 4 membership and those Indian Tribes that do is eligible for payment under subsection (a) of the Indian Health Care Improvement Act not use blood quantum as such a criterion. with respect to the furnishing of items and (as amended by section 101) is amended by SEC. 107. GAO STUDY OF TRIBAL JUSTICE SYS- services, but which does not meet all of the striking paragraph (27) and inserting the fol- TEMS. conditions and requirements of this title and lowing: (a) IN GENERAL.—Not later than 1 year under a State plan or waiver authority ‘‘(27) The term ‘urban Indian’ means any after the date of enactment of this Act, the which are applicable generally to such facil- individual who resides in an urban center Comptroller General of the United States ity, shall make such improvements as are

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necessary to achieve or maintain compliance ‘‘(b) COMPLIANCE WITH CONDITIONS AND RE- ERVATIONS TO INCREASE THE ENROLLMENT OF with such conditions and requirements in ac- QUIREMENTS.—Subject to subsection (e), a fa- INDIANS IN THOSE PROGRAMS.— cordance with a plan submitted to and ac- cility of the Indian Health Service or an In- ‘‘(1) IN GENERAL.—In order to improve the cepted by the Secretary for achieving or dian Tribe, Tribal Organization, or an Urban access of Indians residing on or near a res- maintaining compliance with such condi- Indian Organization which is eligible for pay- ervation to obtain benefits under the Med- tions and requirements, and shall be deemed ment under subsection (a) with respect to icaid and State children’s health insurance to meet such conditions and requirements the furnishing of items and services, but programs established under titles XIX and (and to be eligible for payment under this which does not meet all of the conditions XXI, the Secretary shall encourage the State title), without regard to the extent of its ac- and requirements of this title which are ap- to take steps to provide for enrollment on or tual compliance with such conditions and re- plicable generally to such facility, shall near the reservation. Such steps may include quirements, during the first 12 months after make such improvements as are necessary to outreach efforts such as the outstationing of the month in which such plan is submitted.’’. achieve or maintain compliance with such eligibility workers, entering into agreements (3) REVISION OF AUTHORITY TO ENTER INTO conditions and requirements in accordance with the Indian Health Service, Indian AGREEMENTS.—Subsection (c) of such section with a plan submitted to and accepted by the Tribes, Tribal Organizations, and Urban In- is amended to read as follows: Secretary for achieving or maintaining com- dian Organizations to provide outreach, edu- ‘‘(c) AUTHORITY TO ENTER INTO AGREE- pliance with such conditions and require- cation regarding eligibility and benefits, en- MENTS.—The Secretary may enter into an ments, and shall be deemed to meet such rollment, and translation services when such agreement with a State for the purpose of re- conditions and requirements (and to be eligi- services are appropriate. imbursing the State for medical assistance ble for payment under this title), without re- ‘‘(2) CONSTRUCTION.—Nothing in subpara- provided by the Indian Health Service, an In- gard to the extent of its actual compliance graph (A) shall be construed as affecting ar- dian Tribe, Tribal Organization, or an Urban with such conditions and requirements, dur- rangements entered into between States and Indian Organization (as so defined), directly, ing the first 12 months after the month in the Indian Health Service, Indian Tribes, through referral, or under contracts or other which such plan is submitted.’’. Tribal Organizations, or Urban Indian Orga- arrangements between the Indian Health (3) CROSS-REFERENCES TO SPECIAL FUND FOR nizations for such Service, Tribes, or Organi- Service, an Indian Tribe, Tribal Organiza- IMPROVEMENT OF IHS FACILITIES; DIRECT BILL- zations to conduct administrative activities tion, or an Urban Indian Organization and ING OPTION; DEFINITIONS.— under such titles. another health care provider to Indians who (A) IN GENERAL.—Such section is further ‘‘(b) REQUIREMENT TO FACILITATE COOPERA- are eligible for medical assistance under the amended by striking subsections (c) and (d) TION.—The Secretary, acting through the State plan or under waiver authority.’’. and inserting the following new subsections: Centers for Medicare & Medicaid Services, (4) CROSS-REFERENCES TO SPECIAL FUND FOR ‘‘(c) SPECIAL FUND FOR IMPROVEMENT OF shall take such steps as are necessary to fa- IMPROVEMENT OF IHS FACILITIES; DIRECT BILL- IHS FACILITIES.—For provisions relating to cilitate cooperation with, and agreements ING OPTION; DEFINITIONS.—Such section is fur- the authority of the Secretary to place pay- between, States and the Indian Health Serv- ther amended by striking subsection (d) and ments to which a facility of the Indian ice, Indian Tribes, Tribal Organizations, or adding at the end the following new sub- Health Service is eligible for payment under Urban Indian Organizations with respect to sections: this title into a special fund established the provision of health care items and serv- ‘‘(d) SPECIAL FUND FOR IMPROVEMENT OF under section 401(c)(1) of the Indian Health ices to Indians under the programs estab- IHS FACILITIES.—For provisions relating to Care Improvement Act, and the requirement lished under title XVIII, XIX, or XXI. the authority of the Secretary to place pay- to use amounts paid from such fund for mak- ‘‘(c) DEFINITION OF INDIAN; INDIAN TRIBE; ments to which a facility of the Indian ing improvements in accordance with sub- INDIAN HEALTH PROGRAM; TRIBAL ORGANIZA- Health Service is eligible for payment under section (b), see subparagraphs (A) and (B) of TION; URBAN INDIAN ORGANIZATION.—In this this title into a special fund established section 401(c)(1) of such Act. section, the terms ‘Indian’, ‘Indian Tribe’, under section 401(c)(1) of the Indian Health ‘‘(d) DIRECT BILLING.—For provisions relat- ‘Indian Health Program’, ‘Tribal Organiza- Care Improvement Act, and the requirement ing to the authority of a Tribal Health Pro- tion’, and ‘Urban Indian Organization’ have to use amounts paid from such fund for mak- gram or an Urban Indian Organization to the meanings given those terms in section 4 ing improvements in accordance with sub- elect to directly bill for, and receive pay- of the Indian Health Care Improvement section (b), see subparagraphs (A) and (B) of ment for, health care items and services pro- Act.’’. vided by such Program or Organization for section 401(c)(1) of such Act. SEC. 203. ADDITIONAL PROVISIONS TO INCREASE ‘‘(e) DIRECT BILLING.—For provisions relat- which payment is made under this title, see OUTREACH TO, AND ENROLLMENT ing to the authority of a Tribal Health Pro- section 401(d) of the Indian Health Care Im- OF, INDIANS IN SCHIP AND MED- gram or an Urban Indian Organization to provement Act.’’. ICAID. elect to directly bill for, and receive pay- (B) CONFORMING AMENDMENT.—Paragraph (a) NONAPPLICATION OF 10 PERCENT LIMIT ON ment for, health care items and services pro- (3) of section 1880(e) of such Act (42 U.S.C. OUTREACH AND CERTAIN OTHER EXPENDI- vided by such Program or Organization for 1395qq(e)) is amended by inserting ‘‘and sec- TURES.—Section 2105(c)(2) of the Social Secu- which payment is made under this title, see tion 401(c)(1) of the Indian Health Care Im- rity Act (42 U.S.C. 1397ee(c)(2)) is amended by section 401(d) of the Indian Health Care Im- provement Act’’ after ‘‘Subsection (c)’’. adding at the end the following new subpara- provement Act. (4) DEFINITIONS.—Such section is further graph: ‘‘(f) DEFINITIONS.—In this section, the amended by amending subsection (f) to read ‘‘(C) NONAPPLICATION TO EXPENDITURES FOR terms ‘Indian Health Program’, ‘Indian as follows: OUTREACH TO INCREASE THE ENROLLMENT OF Tribe’,‘Tribal Health Program’, ‘Tribal Orga- ‘‘(f) DEFINITIONS.—In this section, the INDIAN CHILDREN UNDER THIS TITLE AND TITLE nization’, and ‘Urban Indian Organization’ terms ‘Indian Health Program’, ‘Indian XIX.—The limitation under subparagraph (A) have the meanings given those terms in sec- Tribe’, ‘Service Unit’, ‘Tribal Health Pro- on expenditures for items described in sub- tion 4 of the Indian Health Care Improve- gram’, ‘Tribal Organization’, and ‘Urban In- section (a)(1)(D) shall not apply in the case ment Act.’’. dian Organization’ have the meanings given of expenditures for outreach activities to (b) MEDICARE.— those terms in section 4 of the Indian Health families of Indian children likely to be eligi- (1) EXPANSION TO ALL COVERED SERVICES.— Care Improvement Act.’’. ble for child health assistance under the plan Section 1880 of such Act (42 U.S.C. 1395qq) is (c) APPLICATION TO SCHIP.—Section or medical assistance under the State plan amended— 2107(e)(1) of the Social Security Act (42 under title XIX (or under a waiver of such (A) by amending the heading to read as fol- U.S.C. 1397gg(e)(1)) is amended— plan), to inform such families of the avail- lows: (1) by redesignating subparagraph (D) as ability of, and to assist them in enrolling ‘‘SEC. 1880. INDIAN HEALTH PROGRAMS.’’; subparagraph (E); and their children in, such plans, including such and (2) by inserting after subparagraph (C), the activities conducted under grants, contracts, (B) by amending subsection (a) to read as following new subparagraph: or agreements entered into under section follows: ‘‘(D) Section 1911 (relating to Indian 1139(a).’’. ‘‘(a) ELIGIBILITY FOR PAYMENTS.—Subject Health Programs, other than subsection (d) (b) ASSURANCE OF PAYMENTS TO INDIAN to subsection (e), the Indian Health Service of such section).’’. HEALTH CARE PROVIDERS FOR CHILD HEALTH and an Indian Tribe, Tribal Organization, or SEC. 202. INCREASED OUTREACH TO INDIANS ASSISTANCE.—Section 2102(b)(3)(D) of such an Urban Indian Organization shall be eligi- UNDER MEDICAID AND SCHIP AND Act (42 U.S.C. 1397bb(b)(3)(D)) is amended by ble for payments under this title with re- IMPROVED COOPERATION IN THE striking ‘‘(as defined in section 4(c) of the In- spect to items and services furnished by the PROVISION OF ITEMS AND SERVICES TO INDIANS UNDER SOCIAL SECU- dian Health Care Improvement Act, 25 U.S.C. Indian Health Service, Indian Tribe, Tribal RITY ACT HEALTH BENEFIT PRO- 1603(c))’’ and inserting ‘‘, including how the Organization, or Urban Indian Organization GRAMS. State will ensure that payments are made to if the furnishing of such services meets all Section 1139 of the Social Security Act (42 Indian Health Programs and Urban Indian the conditions and requirements which are U.S.C. 1320b–9) is amended to read as follows: Organizations operating in the State for the applicable generally to the furnishing of ‘‘SEC. 1139. IMPROVED ACCESS TO, AND DELIV- provision of such assistance’’. items and services under this title.’’. ERY OF, HEALTH CARE FOR INDIANS (c) INCLUSION OF OTHER INDIAN FINANCED (2) COMPLIANCE WITH CONDITIONS AND RE- UNDER TITLES XVIII, XIX, AND XXI. HEALTH CARE PROGRAMS IN EXEMPTION FROM QUIREMENTS.—Subsection (b) of such section ‘‘(a) AGREEMENTS WITH STATES FOR MED- PROHIBITION ON CERTAIN PAYMENTS.—Section is amended to read as follows: ICAID AND SCHIP OUTREACH ON OR NEAR RES- 2105(c)(6)(B) of such Act (42 U.S.C.

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1397ee(c)(6)(B)) is amended by striking ‘‘in- ‘‘(j) NO PREMIUMS OR COST SHARING FOR IN- ‘‘(B) For any federally recognized Tribe not surance program, other than an insurance DIANS FURNISHED ITEMS OR SERVICES DI- described in subparagraph (A), property lo- program operated or financed by the Indian RECTLY BY INDIAN HEALTH PROGRAMS OR cated within the most recent boundaries of a Health Service’’ and inserting ‘‘program, THROUGH REFERRAL UNDER THE CONTRACT prior Federal reservation. other than a health care program operated HEALTH SERVICE.— ‘‘(C) Ownership interests in rents, leases, or financed by the Indian Health Service or ‘‘(1) NO COST SHARING FOR INDIANS FUR- royalties, or usage rights related to natural by an Indian Tribe, Tribal Organization, or NISHED ITEMS OR SERVICES DIRECTLY BY OR resources (including extraction of natural re- Urban Indian Organization’’. THROUGH INDIAN HEALTH PROGRAMS.— sources or harvesting of timber, other plants (d) SATISFACTION OF MEDICAID DOCUMENTA- ‘‘(A) NO ENROLLMENT FEES, PREMIUMS, OR and plant products, animals, fish, and shell- TION REQUIREMENTS.—Section 1903(x)(3)(B) of COPAYMENTS.— fish) resulting from the exercise of federally the Social Security Act (42 U.S.C. ‘‘(i) IN GENERAL.—No enrollment fee, pre- protected rights. 1396b(x)(3)(B)) is amended— mium, or similar charge, and no deduction, ‘‘(D) Ownership interests in or usage rights (1) by redesignating clause (v) as clause copayment, cost sharing, or similar charge to items not covered by subparagraphs (A) (vii); and shall be imposed against an Indian who is through (C) that have unique religious, spir- (2) by inserting after clause (iv), the fol- furnished an item or service directly by the itual, traditional, or cultural significance or lowing new clauses: Indian Health Service, an Indian Tribe, a rights that support subsistence or a tradi- ‘‘(v) Except as provided in clause (vi), a Tribal Organization, or an urban Indian or- tional lifestyle according to applicable tribal document issued by a federally recognized ganization, or by a health care provider law or custom.’’. Indian tribe evidencing membership or en- through referral under the contract health (2) APPLICATION TO SCHIP.—Section rollment in, or affiliation with, such tribe service for which payment may be made 2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)) (such as a tribal enrollment card or certifi- under this title. is amended— cate of degree of Indian blood). ‘‘(ii) EXCEPTION.—Clause (i) shall not apply (A) by redesignating subparagraphs (B) ‘‘(vi)(I) With respect to those federally rec- to an individual only eligible for the pro- through (E), as subparagraphs (C) through ognized Indian tribes located within States grams or services under sections 102 and 103 (F), respectively; and having an international border whose mem- or title V of the Indian Health Care Improve- (B) by inserting after subparagraph (A), bership includes individuals who are not citi- ment Act. the following new subparagraph: zens of the United States documentation (in- ‘‘(B) NO REDUCTION IN AMOUNT OF PAYMENT ‘‘(B) Section 1902(e)(13) (relating to dis- cluding tribal documentation, if appropriate) TO INDIAN HEALTH PROVIDERS.—Payment due regard of certain property for purposes of that the Secretary determines to be satisfac- under this title to the Indian Health Service, making eligibility determinations).’’. tory documentary evidence of United States an Indian Tribe, Tribal Organization, or (c) CONTINUATION OF CURRENT LAW PROTEC- citizenship or nationality under the regula- Urban Indian Organization, or a health care TIONS OF CERTAIN INDIAN PROPERTY FROM tions adopted pursuant to subclause (II). provider through referral under the contract MEDICAID ESTATE RECOVERY.—Section ‘‘(II) Not later than 90 days after the date health service for the furnishing of an item 1917(b)(3) of the Social Security Act (42 of enactment of this subclause, the Sec- or service to an Indian who is eligible for as- U.S.C. 1396p(b)(3)) is amended— retary, in consultation with the tribes re- sistance under such title, may not be re- (1) by inserting ‘‘(A)’’ after ‘‘(3)’’; and ferred to in subclause (I), shall promulgate duced by the amount of any enrollment fee, (2) by adding at the end the following new premium, or similar charge, or any deduc- interim final regulations specifying the subparagraph: tion, copayment, cost sharing, or similar forms of documentation (including tribal ‘‘(B) The standards specified by the Sec- charge that would be due from the Indian documentation, if appropriate) deemed to be retary under subparagraph (A) shall require but for the operation of subparagraph (A). satisfactory evidence of the United States that the procedures established by the State ‘‘(2) RULE OF CONSTRUCTION.—Nothing in citizenship or nationality of a member of agency under subparagraph (A) exempt in- this subsection shall be construed as re- any such Indian tribe for purposes of satis- come, resources, and property that are ex- stricting the application of any other limita- fying the requirements of this subsection. empt from the application of this subsection tions on the imposition of premiums or cost ‘‘(III) During the period that begins on the as of April 1, 2003, under manual instructions sharing that may apply to an individual re- date of enactment of this clause and ends on issued to carry out this subsection (as in ef- ceiving medical assistance under this title fect on such date) because of the Federal re- the effective date of the interim final regula- who is an Indian. tions promulgated under subclause (II), a sponsibility for Indian Tribes and Alaska Na- ‘‘(3) DEFINITIONS.—In this subsection, the tive Villages. Nothing in this subparagraph document issued by a federally recognized terms ‘contract health service’, ‘Indian’, ‘In- Indian tribe referred to in subclause (I) evi- shall be construed as preventing the Sec- dian Tribe’, ‘Tribal Organization’, and retary from providing additional estate re- dencing membership or enrollment in, or af- ‘Urban Indian Organization’ have the mean- filiation with, such tribe (such as a tribal en- covery exemptions under this title for Indi- ings given those terms in section 4 of the In- ans.’’. rollment card or certificate of degree of In- dian Health Care Improvement Act.’’. dian blood) accompanied by a signed attesta- SEC. 205. NONDISCRIMINATION IN QUALIFICA- (2) CONFORMING AMENDMENT.—Section tion that the individual is a citizen of the TIONS FOR PAYMENT FOR SERVICES 1916A(a)(1) of such Act (42 U.S.C. 1396o– UNDER FEDERAL HEALTH CARE United States and a certification by the ap- 1(a)(1)) is amended by striking ‘‘section propriate officer or agent of the Indian tribe PROGRAMS. 1916(g)’’ and inserting ‘‘subsections (g), (i), or Section 1139 of the Social Security Act (42 that the membership or other records main- (j) of section 1916’’. U.S.C. 1320b–9), as amended by section 202, is tained by the Indian tribe indicate that the (3) EFFECTIVE DATE.—The amendments amended by redesignating subsection (c) as individual was born in the United States is made by this subsection take effect on Octo- subsection (d), and inserting after subsection deemed to be a document described in this ber 1, 2009. (b) the following new subsection: subparagraph for purposes of satisfying the (b) TREATMENT OF CERTAIN PROPERTY FOR ‘‘(c) NONDISCRIMINATION IN QUALIFICATIONS requirements of this subsection.’’. MEDICAID AND SCHIP ELIGIBILITY.— FOR PAYMENT FOR SERVICES UNDER FEDERAL (e) DEFINITIONS.—Section 2110(c) of such (1) MEDICAID.—Section 1902(e) of the Social HEALTH CARE PROGRAMS.— Act (42 U.S.C. 1397jj(c)) is amended by adding Security Act (42 U.S.C. 1396a) is amended by ‘‘(1) REQUIREMENT TO SATISFY GENERALLY at the end the following new paragraph: adding at the end the following new para- APPLICABLE PARTICIPATION REQUIREMENTS.— ‘‘(9) INDIAN; INDIAN HEALTH PROGRAM; IN- graph: ‘‘(A) IN GENERAL.—A Federal health care DIAN TRIBE; ETC.—The terms ‘Indian’, ‘Indian ‘‘(13) Notwithstanding any other require- program must accept an entity that is oper- Health Program’, ‘Indian Tribe’, ‘Tribal Or- ment of this title or any other provision of ated by the Indian Health Service, an Indian ganization’, and ‘Urban Indian Organization’ Federal or State law, a State shall disregard Tribe, Tribal Organization, or Urban Indian have the meanings given those terms in sec- the following property for purposes of deter- Organization as a provider eligible to receive tion 4 of the Indian Health Care Improve- mining the eligibility of an individual who is payment under the program for health care ment Act.’’. an Indian (as defined in section 4 of the In- services furnished to an Indian on the same SEC. 204. PREMIUMS AND COST SHARING PRO- dian Health Care Improvement Act) for med- basis as any other provider qualified to par- TECTIONS UNDER MEDICAID, ELIGI- ical assistance under this title: ticipate as a provider of health care services BILITY DETERMINATIONS UNDER MEDICAID AND SCHIP, AND PROTEC- ‘‘(A) Property, including real property and under the program if the entity meets gen- TION OF CERTAIN INDIAN PROP- improvements, that is held in trust, subject erally applicable State or other require- ERTY FROM MEDICAID ESTATE RE- to Federal restrictions, or otherwise under ments for participation as a provider of COVERY. the supervision of the Secretary of the Inte- health care services under the program. (a) PREMIUMS AND COST SHARING PROTEC- rior, located on a reservation, including any ‘‘(B) SATISFACTION OF STATE OR LOCAL LI- TION UNDER MEDICAID.— federally recognized Indian Tribe’s reserva- CENSURE OR RECOGNITION REQUIREMENTS.— (1) IN GENERAL.—Section 1916 of the Social tion, pueblo, or colony, including former res- Any requirement for participation as a pro- Security Act (42 U.S.C. 1396o) is amended— ervations in Oklahoma, Alaska Native re- vider of health care services under a Federal (A) in subsection (a), in the matter pre- gions established by the Alaska Native health care program that an entity be li- ceding paragraph (1), by striking ‘‘and (i)’’ Claims Settlement Act, and Indian allot- censed or recognized under the State or local and inserting ‘‘, (i), and (j)’’; and ments on or near a reservation as designated law where the entity is located to furnish (B) by adding at the end the following new and approved by the Bureau of Indian Affairs health care services shall be deemed to have subsection: of the Department of the Interior. been met in the case of an entity operated by

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00096 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1313 the Indian Health Service, an Indian Tribe, Indian Health Programs or Urban Indian Or- among an Indian Health Program, Indian Tribal Organization, or Urban Indian Organi- ganizations (as such terms are defined in sec- Tribe, Tribal Organization, or Urban Indian zation if the entity meets all the applicable tion 4 of the Indian Health Care Improve- Organization, that are made for the purpose standards for such licensure or recognition, ment Act) provide health care in the State of providing necessary health care items and regardless of whether the entity obtains a li- for which medical assistance is available services to any patient served by such Pro- cense or other documentation under such under such title, provide for a process under gram, Tribe, or Organization and that con- State or local law. In accordance with sec- which the State seeks advice on a regular, sist of— tion 221 of the Indian Health Care Improve- ongoing basis from designees of such Indian ‘‘(i) services in connection with the collec- ment Act, the absence of the licensure of a Health Programs and Urban Indian Organiza- tion, transport, analysis, or interpretation of health care professional employed by such an tions on matters relating to the application diagnostic specimens or test data; entity under the State or local law where the of this title that are likely to have a direct ‘‘(ii) inventory or supplies; entity is located shall not be taken into ac- effect on such Indian Health Programs and ‘‘(iii) staff; or count for purposes of determining whether Urban Indian Organizations and that— ‘‘(iv) a waiver of all or part of premiums or the entity meets such standards, if the pro- ‘‘(A) shall include solicitation of advice cost sharing. fessional is licensed in another State. prior to submission of any plan amendments, ‘‘(B) TRANSFERS BETWEEN INDIAN HEALTH ‘‘(2) PROHIBITION ON FEDERAL PAYMENTS TO waiver requests, and proposals for dem- PROGRAMS, INDIAN TRIBES, TRIBAL ORGANIZA- ENTITIES OR INDIVIDUALS EXCLUDED FROM PAR- onstration projects likely to have a direct ef- TIONS, OR URBAN INDIAN ORGANIZATIONS AND TICIPATION IN FEDERAL HEALTH CARE PRO- fect on Indians, Indian Health Programs, or PATIENTS.—Transfers of anything of value GRAMS OR WHOSE STATE LICENSES ARE UNDER Urban Indian Organizations; and between an Indian Health Program, Indian SUSPENSION OR HAVE BEEN REVOKED.— ‘‘(B) may include appointment of an advi- Tribe, Tribal Organization, or Urban Indian ‘‘(A) EXCLUDED ENTITIES.—No entity oper- sory committee and of a designee of such In- Organization and any patient served or eligi- ated by the Indian Health Service, an Indian dian Health Programs and Urban Indian Or- ble for service from an Indian Health Pro- Tribe, Tribal Organization, or Urban Indian ganizations to the medical care advisory gram, Indian Tribe, Tribal Organization, or Organization that has been excluded from committee advising the State on its State Urban Indian Organization, including any participation in any Federal health care pro- plan under this title.’’. patient served or eligible for service pursu- gram or for which a license is under suspen- (2) APPLICATION TO SCHIP.—Section ant to section 807 of the Indian Health Care sion or has been revoked by the State where 2107(e)(1) of such Act (42 U.S.C. 1397gg(e)(1)), Improvement Act, but only if such trans- the entity is located shall be eligible to re- as amended by section 204(b)(2), is amended— fers— ceive payment under any such program for (A) by redesignating subparagraphs (B) ‘‘(i) consist of expenditures related to pro- health care services furnished to an Indian. through (F) as subparagraphs (C) through viding transportation for the patient for the ‘‘(B) EXCLUDED INDIVIDUALS.—No individual (G), respectively; and provision of necessary health care items or who has been excluded from participation in (B) by inserting after subparagraph (A), services, provided that the provision of such any Federal health care program or whose the following new subparagraph: transportation is not advertised, nor an in- State license is under suspension or has been ‘‘(B) Section 1902(a)(71) (relating to the op- centive of which the value is disproportion- revoked shall be eligible to receive payment tion of certain States to seek advice from ately large in relationship to the value of the under any such program for health care serv- designees of Indian Health Programs and health care item or service (with respect to ices furnished by that individual, directly or Urban Indian Organizations).’’. the value of the item or service itself or, for through an entity that is otherwise eligible (c) RULE OF CONSTRUCTION.—Nothing in the preventative items or services, the future to receive payment for health care services, amendments made by this section shall be health care costs reasonably expected to be to an Indian. construed as superseding existing advisory avoided); ‘‘(C) FEDERAL HEALTH CARE PROGRAM DE- committees, working groups, guidance, or ‘‘(ii) consist of expenditures related to pro- FINED.—In this subsection, the term, ‘Fed- other advisory procedures established by the viding housing to the patient (including a eral health care program’ has the meaning Secretary of Health and Human Services or pregnant patient) and immediate family given that term in section 1128B(f), except by any State with respect to the provision of members or an escort necessary to assuring that, for purposes of this subsection, such health care to Indians. the timely provision of health care items and term shall include the health insurance pro- (d) EFFECTIVE DATE.—This section and the services to the patient, provided that the gram under chapter 89 of title 5, United amendments made by this section take ef- provision of such housing is not advertised States Code.’’. fect on October 1, 2009. nor an incentive of which the value is dis- SEC. 206. CONSULTATION ON MEDICAID, SCHIP, SEC. 207. EXCLUSION WAIVER AUTHORITY FOR proportionately large in relationship to the AND OTHER HEALTH CARE PRO- AFFECTED INDIAN HEALTH PRO- value of the health care item or service (with GRAMS AND SAFE HARBOR TRANS- GRAMS FUNDED UNDER THE SOCIAL respect to the value of the item or service SECURITY ACT INVOLVING INDIAN ACTIONS UNDER THE SOCIAL SECU- HEALTH PROGRAMS AND URBAN IN- RITY ACT. itself or, for preventative items or services, DIAN ORGANIZATIONS. (a) EXCLUSION WAIVER AUTHORITY.—Sec- the future health care costs reasonably ex- (a) IN GENERAL.—Section 1139 of the Social tion 1128 of the Social Security Act (42 pected to be avoided); or Security Act (42 U.S.C. 1320b–9), as amended U.S.C. 1320a–7) is amended by adding at the ‘‘(iii) are for the purpose of paying pre- by sections 202 and 205, is amended by redes- end the following new subsection: miums or cost sharing on behalf of such a pa- ignating subsection (d) as subsection (e), and ‘‘(k) ADDITIONAL EXCLUSION WAIVER AU- tient, provided that the making of such pay- inserting after subsection (c) the following THORITY FOR AFFECTED INDIAN HEALTH PRO- ment is not subject to conditions other than new subsection: GRAMS.—In addition to the authority granted conditions agreed to under a contract for the ‘‘(d) CONSULTATION WITH TRIBAL TECHNICAL the Secretary under subsections (c)(3)(B) and delivery of contract health services. ADVISORY GROUP (TTAG).—The Secretary (d)(3)(B) to waive an exclusion under sub- ‘‘(C) CONTRACT HEALTH SERVICES.—A trans- shall maintain within the Centers for Med- section (a)(1), (a)(3), (a)(4), or (b), the Sec- fer of anything of value negotiated as part of icaid & Medicare Services (CMS) a Tribal retary may, in the case of an Indian Health a contract entered into between an Indian Technical Advisory Group, established in ac- Program, waive such an exclusion upon the Health Program, Indian Tribe, Tribal Orga- cordance with requirements of the charter request of the administrator of an affected nization, Urban Indian Organization, or the dated September 30, 2003, and in such group Indian Health Program (as defined in section Indian Health Service and a contract care shall include a representative of the Urban 4 of the Indian Health Care Improvement provider for the delivery of contract health Indian Organizations and the Service. The Act) who determines that the exclusion services authorized by the Indian Health representative of the Urban Indian Organiza- would impose a hardship on individuals enti- Service, provided that— tion shall be deemed to be an elected officer tled to benefits under or enrolled in a Fed- ‘‘(i) such a transfer is not tied to volume or of a tribal government for purposes of apply- eral health care program.’’. value of referrals or other business generated ing section 204(b) of the Unfunded Mandates (b) CERTAIN TRANSACTIONS INVOLVING IN- by the parties; and Reform Act of 1995 (2 U.S.C. 1534(b)).’’. DIAN HEALTH CARE PROGRAMS DEEMED TO BE ‘‘(ii) any such transfer is limited to the fair (b) SOLICITATION OF ADVICE UNDER MED- IN SAFE HARBORS.—Section 1128B(b) of the market value of the health care items or ICAID AND SCHIP.— Social Security Act (42 U.S.C. 1320a–7b(b)) is services provided or, in the case of a transfer (1) MEDICAID STATE PLAN AMENDMENT.—Sec- amended by adding at the end the following of items or services related to preventative tion 1902(a) of the Social Security Act (42 new paragraph: care, the value of the future health care U.S.C. 1396a(a)) is amended— ‘‘(4) Subject to such conditions as the Sec- costs reasonably expected to be avoided. (A) in paragraph (69), by striking ‘‘and’’ at retary may promulgate from time to time as ‘‘(D) OTHER TRANSFERS.—Any other trans- the end; necessary to prevent fraud and abuse, for fer of anything of value involving an Indian (B) in paragraph (70)(B)(iv), by striking the purposes of paragraphs (1) and (2) and section Health Program, Indian Tribe, Tribal Orga- period at the end and inserting ‘‘; and’’; and 1128A(a), the following transfers shall not be nization, or Urban Indian Organization, or a (C) by inserting after paragraph (70)(B)(iv), treated as remuneration: patient served or eligible for service from an the following new paragraph: ‘‘(A) TRANSFERS BETWEEN INDIAN HEALTH Indian Health Program, Indian Tribe, Tribal ‘‘(71) in the case of any State in which the PROGRAMS, INDIAN TRIBES, TRIBAL ORGANIZA- Organization, or Urban Indian Organization, Indian Health Service operates or funds TIONS, AND URBAN INDIAN ORGANIZATIONS.— that the Secretary, in consultation with the health care programs, or in which 1 or more Transfers of anything of value between or Attorney General, determines is appropriate,

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00097 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1314 CONGRESSIONAL RECORD — SENATE February 27, 2008 taking into account the special cir- the submission of a claim or other docu- vider of the difference between the applica- cumstances of such Indian Health Programs, mentation by an Indian health care provider ble encounter rate under such memorandum Indian Tribes, Tribal Organizations, and that is consistent with section 403(h) of the and the amount paid by the managed care Urban Indian Organizations, and of patients Indian Health Care Improvement Act. entity to the provider for such services. served by such Programs, Tribes, and Orga- ‘‘(D) COMPLIANCE WITH GENERALLY APPLICA- ‘‘(F) CONSTRUCTION.—Nothing in this para- nizations.’’. BLE REQUIREMENTS.— graph shall be construed as waiving the ap- SEC. 208. RULES APPLICABLE UNDER MEDICAID ‘‘(i) IN GENERAL.—Subject to clause (ii), as plication of section 1902(a)(30)(A) (relating to AND SCHIP TO MANAGED CARE EN- a condition of payment under subparagraph application of standards to assure that pay- TITIES WITH RESPECT TO INDIAN (A), an Indian health care provider shall ments are consistent with efficiency, econ- ENROLLEES AND INDIAN HEALTH comply with the generally applicable re- omy, and quality of care). CARE PROVIDERS AND INDIAN MAN- quirements of this title, the State plan, and ‘‘(3) OFFERING OF MANAGED CARE THROUGH AGED CARE ENTITIES. such entity with respect to covered Medicaid (a) IN GENERAL.—Section 1932 of the Social INDIAN MEDICAID MANAGED CARE ENTITIES.— managed care services provided by the In- If— Security Act (42 U.S.C. 1396u–2) is amended dian health care provider to the same extent by adding at the end the following new sub- ‘‘(A) a State elects to provide services that non-Indian providers participating with through Medicaid managed care entities section: the entity must comply with such require- ‘‘(h) SPECIAL RULES WITH RESPECT TO IN- under its Medicaid managed care program; ments. DIAN ENROLLEES, INDIAN HEALTH CARE PRO- and ‘‘(ii) LIMITATIONS ON COMPLIANCE WITH MAN- VIDERS, AND INDIAN MANAGED CARE ENTI- ‘‘(B) an Indian health care provider that is AGED CARE ENTITY GENERALLY APPLICABLE RE- TIES.— funded in whole or in part by the Indian QUIREMENTS.—An Indian health care pro- ‘‘(1) ENROLLEE OPTION TO SELECT AN INDIAN Health Service, or a consortium composed of vider— HEALTH CARE PROVIDER AS PRIMARY CARE PRO- 1 or more Tribes, Tribal Organizations, or ‘‘(I) shall not be required to comply with a VIDER.—In the case of a non-Indian Medicaid Urban Indian Organizations, and which also generally applicable requirement of a man- managed care entity that— may include the Indian Health Service, has aged care entity described in clause (i) as a ‘‘(A) has an Indian enrolled with the enti- established an Indian Medicaid managed care condition of payment under subparagraph ty; and entity in the State that meets generally ap- (A) if such compliance would conflict with ‘‘(B) has an Indian health care provider any other statutory or regulatory require- plicable standards required of such an entity that is participating as a primary care pro- ments applicable to the Indian health care under such Medicaid managed care program, vider within the network of the entity, provider; and the State shall offer to enter into an agree- insofar as the Indian is otherwise eligible to ‘‘(II) shall only need to comply with those ment with the entity to serve as a Medicaid receive services from such Indian health care generally applicable requirements of a man- managed care entity with respect to eligible provider and the Indian health care provider aged care entity described in clause (i) as a Indians served by such entity under such has the capacity to provide primary care condition of payment under subparagraph program. services to such Indian, the contract with (A) that are necessary for the entity’s com- ‘‘(4) SPECIAL RULES FOR INDIAN MANAGED the entity under section 1903(m) or under pliance with the State plan, such as those re- CARE ENTITIES.—The following are special section 1905(t)(3) shall require, as a condition lated to care management, quality assur- rules regarding the application of a Medicaid of receiving payment under such contract, ance, and utilization management. managed care program to Indian Medicaid that the Indian shall be allowed to choose ‘‘(E) APPLICATION OF SPECIAL PAYMENT RE- managed care entities: such Indian health care provider as the Indi- QUIREMENTS FOR FEDERALLY-QUALIFIED ‘‘(A) ENROLLMENT.— an’s primary care provider under the entity. HEALTH CENTERS AND ENCOUNTER RATE FOR ‘‘(i) LIMITATION TO INDIANS.—An Indian ‘‘(2) ASSURANCE OF PAYMENT TO INDIAN SERVICES PROVIDED BY CERTAIN INDIAN HEALTH Medicaid managed care entity may restrict HEALTH CARE PROVIDERS FOR PROVISION OF CARE PROVIDERS.— enrollment under such program to Indians COVERED SERVICES.—Each contract with a ‘‘(i) FEDERALLY-QUALIFIED HEALTH CEN- and to members of specific Tribes in the managed care entity under section 1903(m) or TERS.— same manner as Indian Health Programs under section 1905(t)(3) shall require any ‘‘(I) MANAGED CARE ENTITY PAYMENT RE- may restrict the delivery of services to such such entity that has a significant percentage QUIREMENT.—To agree to pay any Indian Indians and tribal members. of Indian enrollees (as determined by the health care provider that is a Federally- ‘‘(ii) NO LESS CHOICE OF PLANS.—Under such Secretary), as a condition of receiving pay- qualified health center but not a partici- program the State may not limit the choice ment under such contract to satisfy the fol- pating provider with respect to the entity, of an Indian among Medicaid managed care lowing requirements: for the provision of covered Medicaid man- entities only to Indian Medicaid managed ‘‘(A) DEMONSTRATION OF PARTICIPATING IN- aged care services by such provider to an In- care entities or to be more restrictive than DIAN HEALTH CARE PROVIDERS OR APPLICATION dian enrollee of the entity at a rate equal to the choice of managed care entities offered OF ALTERNATIVE PAYMENT ARRANGEMENTS.— the amount of payment that the entity to individuals who are not Indians. Subject to subparagraph (E), to— would pay a Federally-qualified health cen- ‘‘(iii) DEFAULT ENROLLMENT.— ‘‘(i) demonstrate that the number of Indian ter that is a participating provider with re- ‘‘(I) IN GENERAL.—If such program of a health care providers that are participating spect to the entity but is not an Indian State requires the enrollment of Indians in a providers with respect to such entity are suf- health care provider for such services. Medicaid managed care entity in order to re- ficient to ensure timely access to covered ‘‘(II) CONTINUED APPLICATION OF STATE RE- ceive benefits, the State, taking into consid- Medicaid managed care services for those en- QUIREMENT TO MAKE SUPPLEMENTAL PAY- eration the criteria specified in subsection rollees who are eligible to receive services MENT.—Nothing in subclause (I) or subpara- (a)(4)(D)(ii)(I), shall provide for the enroll- from such providers; or graph (A) or (B) shall be construed as ment of Indians described in subclause (II) ‘‘(ii) agree to pay Indian health care pro- waiving the application of section 1902(bb)(5) who are not otherwise enrolled with such an viders who are not participating providers regarding the State plan requirement to entity in an Indian Medicaid managed care with the entity for covered Medicaid man- make any supplemental payment due under entity described in such clause. aged care services provided to those enroll- such section to a Federally-qualified health ‘‘(II) INDIAN DESCRIBED.—An Indian de- ees who are eligible to receive services from center for services furnished by such center scribed in this subclause, with respect to an such providers at a rate equal to the rate ne- to an enrollee of a managed care entity (re- Indian Medicaid managed care entity, is an gotiated between such entity and the pro- gardless of whether the Federally-qualified Indian who, based upon the service area and vider involved or, if such a rate has not been health center is or is not a participating pro- capacity of the entity, is eligible to be en- negotiated, at a rate that is not less than the vider with the entity). rolled with the entity consistent with sub- level and amount of payment which the enti- ‘‘(ii) CONTINUED APPLICATION OF ENCOUNTER paragraph (A). ty would make for the services if the services RATE FOR SERVICES PROVIDED BY CERTAIN IN- ‘‘(iv) EXCEPTION TO STATE LOCK-IN.—A re- were furnished by a participating provider DIAN HEALTH CARE PROVIDERS.—If the amount quest by an Indian who is enrolled under which is not an Indian health care provider. paid by a managed care entity to an Indian such program with a non-Indian Medicaid ‘‘(B) PROMPT PAYMENT.—To agree to make health care provider that is not a Federally- managed care entity to change enrollment prompt payment (in accordance with rules qualified health center and that has elected with that entity to enrollment with an In- applicable to managed care entities) to In- to receive payment under this title as an In- dian Medicaid managed care entity shall be dian health care providers that are partici- dian Health Service provider under the July considered cause for granting such request pating providers with respect to such entity 11, 1996, Memorandum of Agreement between under procedures specified by the Secretary. or, in the case of an entity to which subpara- the Health Care Financing Administration ‘‘(B) FLEXIBILITY IN APPLICATION OF SOL- graph (A)(ii) or (E) applies, that the entity is (now the Centers for Medicare & Medicaid VENCY.—In applying section 1903(m)(1) to an required to pay in accordance with that sub- Services) and the Indian Health Service for Indian Medicaid managed care entity— paragraph. services provided by such provider to an In- ‘‘(i) any reference to a ‘State’ in subpara- ‘‘(C) SATISFACTION OF CLAIM REQUIRE- dian enrollee with the managed care entity graph (A)(ii) of that section shall be deemed MENT.—To deem any requirement for the is less than the encounter rate that applies to be a reference to the ‘Secretary’; and submission of a claim or other documenta- to the provision of such services under such ‘‘(ii) the entity shall be deemed to be a tion for services covered under subparagraph memorandum, the State plan shall provide public entity described in subparagraph (A) by the enrollee to be satisfied through for payment to the Indian health care pro- (C)(ii) of that section.

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‘‘(C) EXCEPTIONS TO ADVANCE DIRECTIVES.— vidual under the contract between the entity under such programs and who, because of The Secretary may modify or waive the re- and the State involved. educational needs, migration of families, quirements of section 1902(w) (relating to ‘‘(F) MEDICAID MANAGED CARE PROGRAM.— emergency evacuations, or otherwise, fre- provision of written materials on advance di- The term ‘Medicaid managed care program’ quently change their State of residency or rectives) insofar as the Secretary finds that means a program under sections 1903(m) and otherwise are temporarily present outside of the requirements otherwise imposed are not 1932 and includes a managed care program the State of their residency. Such study an appropriate or effective way of commu- operating under a waiver under section shall include an examination of the enroll- nicating the information to Indians. 1915(b) or 1115 or otherwise.’’. ment and coverage coordination issues faced ‘‘(D) FLEXIBILITY IN INFORMATION AND MAR- (b) APPLICATION TO SCHIP.—Section by Indian children who are eligible for med- KETING.— 2107(e)(1) of such Act (42 U.S.C. 1397gg(1)), as ical assistance or child health assistance ‘‘(i) MATERIALS.—The Secretary may mod- amended by section 206(b)(2), is amended by under such programs in their State of resi- ify requirements under subsection (a)(5) to adding at the end the following new subpara- dence and who temporarily reside in an out- ensure that information described in that graph: of-State boarding school or peripheral dor- subsection is provided to enrollees and po- ‘‘(H) Subsections (a)(2)(C) and (h) of section mitory funded by the Bureau of Indian Af- tential enrollees of Indian Medicaid managed 1932.’’. fairs. care entities in a culturally appropriate and (c) EFFECTIVE DATE.—This section and the (b) REPORT.—Not later than 18 months understandable manner that clearly commu- amendments made by this section take ef- after the date of enactment of this Act, the nicates to such enrollees and potential en- fect on October 1, 2009. Secretary, in consultation with directors of rollees their rights, protections, and bene- SEC. 209. ANNUAL REPORT ON INDIANS SERVED State Medicaid programs under title XIX of fits. BY SOCIAL SECURITY ACT HEALTH the Social Security Act and directors of BENEFIT PROGRAMS. ‘‘(ii) DISTRIBUTION OF MARKETING MATE- State Children’s Health Insurance Programs RIALS.—The provisions of subsection (d)(2)(B) Section 1139 of the Social Security Act (42 under title XXI of such Act, shall submit a requiring the distribution of marketing ma- U.S.C. 1320b–9), as amended by the sections report to Congress that contains rec- terials to an entire service area shall be 202, 205, and 206, is amended by redesignating ommendations for such legislative and ad- deemed satisfied in the case of an Indian subsection (e) as subsection (f), and inserting ministrative actions as the Secretary deter- Medicaid managed care entity that distrib- after subsection (d) the following new sub- mines appropriate to address the enrollment utes appropriate materials only to those In- section: and coverage coordination barriers identified dians who are potentially eligible to enroll ‘‘(e) ANNUAL REPORT ON INDIANS SERVED BY through the study required under subsection with the entity in the service area. HEALTH BENEFIT PROGRAMS FUNDED UNDER (a). ‘‘(5) MALPRACTICE INSURANCE.—Insofar as, THIS ACT.—Beginning January 1, 2008, and SEC. 211. ESTABLISHMENT OF NATIONAL CHILD under a Medicaid managed care program, a annually thereafter, the Secretary, acting WELFARE RESOURCE CENTER FOR TRIBES. health care provider is required to have med- through the Administrator of the Centers for (a) ESTABLISHMENT.—The Secretary of ical malpractice insurance coverage as a Medicare & Medicaid Services and the Direc- Health and Human Services shall establish a condition of contracting as a provider with a tor of the Indian Health Service, shall sub- National Child Welfare Resource Center for Medicaid managed care entity, an Indian mit a report to Congress regarding the en- Tribes that is— health care provider that is— rollment and health status of Indians receiv- (1) specifically and exclusively dedicated to ‘‘(A) a Federally-qualified health center ing items or services under health benefit meeting the needs of Indian tribes and tribal that is covered under the Federal Tort programs funded under this Act during the organizations through the provision of as- Claims Act (28 U.S.C. 1346(b), 2671 et seq.); preceding year. Each such report shall in- sistance described in subsection (b); and ‘‘(B) providing health care services pursu- clude the following: (2) not part of any existing national child ant to a contract or compact under the In- ‘‘(1) The total number of Indians enrolled welfare resource center. dian Self-Determination and Education As- in, or receiving items or services under, such (b) ASSISTANCE PROVIDED.— sistance Act (25 U.S.C. 450 et seq.) that are programs, disaggregated with respect to each (1) IN GENERAL.—The National Child Wel- covered under the Federal Tort Claims Act such program. fare Resource Center for Tribes shall provide (28 U.S.C. 1346(b), 2671 et seq.); or ‘‘(2) The number of Indians described in information, advice, educational materials, ‘‘(C) the Indian Health Service providing paragraph (1) that also received health bene- and technical assistance to Indian tribes and health care services that are covered under fits under programs funded by the Indian tribal organizations with respect to the the Federal Tort Claims Act (28 U.S.C. Health Service. types of services, administrative functions, 1346(b), 2671 et seq.); ‘‘(3) General information regarding the data collection, program management, and are deemed to satisfy such requirement. health status of the Indians described in reporting that are provided for under State ‘‘(6) DEFINITIONS.—For purposes of this subparagraph (1), disaggregated with respect to plans under parts B and E of title IV of the section: specific diseases or conditions and presented Social Security Act. ‘‘(A) INDIAN HEALTH CARE PROVIDER.—The in a manner that is consistent with protec- (2) IMPLEMENTATION AUTHORITY.—The Sec- term ‘Indian health care provider’ means an tions for privacy of individually identifiable retary may provide the assistance described Indian Health Program or an Urban Indian health information under section 264(c) of in paragraph (1) either directly or through Organization. the Health Insurance Portability and Ac- grant or contract with public or private or- ‘‘(B) INDIAN; INDIAN HEALTH PROGRAM; SERV- countability Act of 1996. ganizations knowledgeable and experienced ICE; TRIBE; TRIBAL ORGANIZATION; URBAN IN- ‘‘(4) A detailed statement of the status of in the field of Indian tribal affairs and child DIAN ORGANIZATION.—The terms ‘Indian’, ‘In- facilities of the Indian Health Service or an welfare. dian Health Program’, ‘Service’, ‘Tribe’, Indian Tribe, Tribal Organization, or an Urban Indian Organization with respect to (c) APPROPRIATIONS.—There is appropriated ‘tribal organization’, ‘Urban Indian Organi- to the Secretary of Health and Human Serv- zation’ have the meanings given such terms such facilities’ compliance with the applicable conditions and requirements of titles ices, out of any money in the Treasury of the in section 4 of the Indian Health Care Im- United States not otherwise appropriated, provement Act. XVIII, XIX, and XXI, and, in the case of title XIX or XXI, under a State plan under such $1,000,000 for each of fiscal years 2009 through ‘‘(C) INDIAN MEDICAID MANAGED CARE ENTI- 2013 to carry out the purposes of this section. TY.—The term ‘Indian Medicaid managed title or under waiver authority, and of the SEC. 212. ADJUSTMENT TO THE MEDICARE AD- care entity’ means a managed care entity progress being made by such facilities (under plans submitted under section 1880(b), 1911(b) VANTAGE STABILIZATION FUND. that is controlled (within the meaning of the Section 1858(e)(2)(A)(i) of the Social Secu- last sentence of section 1903(m)(1)(C)) by the or otherwise) toward the achievement and maintenance of such compliance. rity Act (42 U.S.C. 1395w–27a(e)(2)(A)(i)), as Indian Health Service, a Tribe, Tribal Orga- amended by section 110 of the Medicare, nization, or Urban Indian Organization, or a ‘‘(5) Such other information as the Sec- retary determines is appropriate.’’. Medicaid, and SCHIP Extension Act of 2007 consortium, which may be composed of 1 or (Public Law 110–173), is amended by striking SEC. 210. DEVELOPMENT OF RECOMMENDATIONS more Tribes, Tribal Organizations, or Urban ‘‘$1,790,000,000’’ and inserting ‘‘$1,657,000,000’’. Indian Organizations, and which also may in- TO IMPROVE INTERSTATE COORDI- SEC. 213. MORATORIUM ON IMPLEMENTATION OF clude the Service. NATION OF MEDICAID AND SCHIP COVERAGE OF INDIAN CHILDREN CHANGES TO CASE MANAGEMENT ‘‘(D) NON-INDIAN MEDICAID MANAGED CARE AND OTHER CHILDREN WHO ARE AND TARGETED CASE MANAGEMENT ENTITY.—The term ‘non-Indian Medicaid OUTSIDE OF THEIR STATE OF RESI- PAYMENT REQUIREMENTS UNDER managed care entity’ means a managed care DENCY BECAUSE OF EDUCATIONAL MEDICAID. entity that is not an Indian Medicaid man- OR OTHER NEEDS. (a) MORATORIUM.— aged care entity. (a) STUDY.—The Secretary shall conduct a (1) DELAYED IMPLEMENTATION OF DECEMBER ‘‘(E) COVERED MEDICAID MANAGED CARE study to identify barriers to interstate co- 4, 2007, INTERIM FINAL RULE.—The interim SERVICES.—The term ‘covered Medicaid man- ordination of enrollment and coverage under final rule published on December 4, 2007, at aged care services’ means, with respect to an the Medicaid program under title XIX of the pages 68,077 through 68,093 of volume 72 of individual enrolled with a managed care en- Social Security Act and the State Children’s the Federal Register (relating to parts 431, tity, items and services that are within the Health Insurance Program under title XXI of 440, and 441 of title 42 of the Code of Federal scope of items and services for which bene- such Act of children who are eligible for Regulations) shall not take effect before fits are available with respect to the indi- medical assistance or child health assistance April 1, 2009.

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(2) CONTINUATION OF 2007 PAYMENT POLICIES (1) in subsection (a), in the flush matter States since time immemorial and for thou- AND PRACTICES.—Notwithstanding any other following paragraph (7)— sands of years before the arrival of people of provision of law, the Secretary of Health and (A) by striking ‘‘$10,000’’ each place it ap- European descent; Human Services shall not, prior to April 1, pears and inserting ‘‘$20,000’’; (2) for millennia, Native Peoples have hon- 2009, take any action (through promulgation (B) by striking ‘‘$15,000’’ and inserting ored, protected, and stewarded this land we of regulation, issuance of regulatory guid- ‘‘$30,000’’; and cherish; ance, use of Federal payment audit proce- (C) by striking ‘‘$50,000’’ and inserting (3) Native Peoples are spiritual people with dures, or other administrative action, policy ‘‘$100,000’’; and a deep and abiding belief in the Creator, and or practice, including a Medical Assistance (2) in subsection (b)— for millennia Native Peoples have main- Manual transmittal or issuance of a letter to (A) in paragraph (1), in the flush matter tained a powerful spiritual connection to State Medicaid directors) to restrict cov- following subparagraph (B), by striking this land, as evidenced by their customs and erage or payment under title XIX of the So- ‘‘$2,000’’ and inserting ‘‘$4,000’’; legends; cial Security Act for case management and (B) in paragraph (2), by striking ‘‘$2,000’’ (4) the arrival of Europeans in North Amer- targeted case management services if such and inserting ‘‘$4,000’’; and ica opened a new chapter in the history of action is more restrictive than the adminis- (C) in paragraph (3)(A)(i), by striking Native Peoples; trative action, policy, or practice that ap- ‘‘$5,000’’ and inserting ‘‘$10,000’’. (5) while establishment of permanent Euro- plies to coverage of, or payment for, such (b) INCREASED CRIMINAL FINES.—Section pean settlements in North America did stir services under title XIX of the Social Secu- 1128B of the Social Security Act (42 U.S.C. conflict with nearby Indian tribes, peaceful rity Act on December 3, 2007. Any such ac- 1320a–7b) is amended— and mutually beneficial interactions also tion taken by the Secretary of Health and (1) in subsection (a), in the flush matter took place; Human Services during the period that be- following paragraph (6)— (6) the foundational English settlements in gins on December 4, 2007, and ends on March (A) by striking ‘‘$25,000’’ and inserting Jamestown, Virginia, and Plymouth, Massa- 31, 2009, that is based in whole or in part on ‘‘$100,000’’; and chusetts, owed their survival in large meas- the interim final rule described in subsection (B) by striking ‘‘$10,000’’ and inserting ure to the compassion and aid of Native Peo- (a) is null and void. ‘‘$20,000’’; ples in the vicinities of the settlements; (7) in the infancy of the United States, the (b) INCLUSION OF MEDICARE PROVIDERS AND (2) in subsection (b)— founders of the Republic expressed their de- SUPPLIERS IN FEDERAL PAYMENT LEVY AND (A) in paragraph (1), in the flush matter sire for a just relationship with the Indian ADMINISTRATIVE OFFSET PROGRAM.— following subparagraph (B), by striking tribes, as evidenced by the Northwest Ordi- (1) IN GENERAL.—Section 1874 of the Social ‘‘$25,000’’ and inserting ‘‘$100,000’’; and Security Act (42 U.S.C. 1395kk) is amended (B) in paragraph (2), in the flush matter nance enacted by Congress in 1787, which be- by adding at the end the following new sub- following subparagraph (B), by striking gins with the phrase, ‘‘The utmost good faith shall always be observed toward the Indi- section: ‘‘$25,000’’ and inserting ‘‘$100,000’’; ans’’; ‘‘(d) INCLUSION OF MEDICARE PROVIDER AND (3) in subsection (c), by striking ‘‘$25,000’’ (8) Indian tribes provided great assistance SUPPLIER PAYMENTS IN FEDERAL PAYMENT and inserting ‘‘$100,000’’; to the fledgling Republic as it strengthened LEVY PROGRAM.— (4) in subsection (d), in the second flush matter following subparagraph (B), by strik- and grew, including invaluable help to ‘‘(1) IN GENERAL.—The Centers for Medicare Meriwether Lewis and William Clark on & Medicaid Services shall take all necessary ing ‘‘$25,000’’ and inserting ‘‘$100,000’’; and (5) in subsection (e), by striking ‘‘$2,000’’ their epic journey from St. Louis, Missouri, steps to participate in the Federal Payment to the Pacific Coast; and inserting ‘‘$4,000’’. Levy Program under section 6331(h) of the (9) Native Peoples and non-Native settlers (c) EFFECTIVE DATE.—The amendments Internal Revenue Code of 1986 as soon as pos- engaged in numerous armed conflicts in made by this section shall apply to civil sible and shall ensure that— which unfortunately, both took innocent money penalties and fines imposed for ac- ‘‘(A) at least 50 percent of all payments lives, including those of women and children; tions taken on or after the date of enact- under parts A and B are processed through (10) the Federal Government violated many ment of this Act. such program beginning within 1 year after of the treaties ratified by Congress and other the date of the enactment of this section; SEC. 215. INCREASED SENTENCES FOR FELONIES diplomatic agreements with Indian tribes; ‘‘(B) at least 75 percent of all payments INVOLVING MEDICARE FRAUD AND (11) the United States forced Indian tribes ABUSE. under parts A and B are processed through and their citizens to move away from their (a) FALSE STATEMENTS AND REPRESENTA- such program beginning within 2 years after traditional homelands and onto federally es- TIONS.—Section 1128B(a) of the Social Secu- such date; and tablished and controlled reservations, in ac- rity Act (42 U.S.C. 1320a–7b(a)) is amended, in ‘‘(C) all payments under parts A and B are cordance with such Acts as the Act of May clause (i) of the flush matter following para- processed through such program beginning 28, 1830 (4 Stat. 411, chapter 148) (commonly graph (6), by striking ‘‘not more than 5 not later than September 30, 2011. known as the ‘‘Indian Removal Act’’); years’’ and inserting ‘‘not more than 10 ‘‘(2) ASSISTANCE.—The Financial Manage- (12) many Native Peoples suffered and per- ment Service and the Internal Revenue Serv- years’’. ished— (b) ANTI-KICKBACK.—Section 1128B(b) of the ice shall provide assistance to the Centers (A) during the execution of the official for Medicare & Medicaid Services to ensure Social Security Act (42 U.S.C. 1320a–7b(b)) is Federal Government policy of forced re- that all payments described in paragraph (1) amended— moval, including the infamous Trail of Tears are included in the Federal Payment Levy (1) in paragraph (1), in the flush matter fol- and Long Walk; Program by the deadlines specified in that lowing subparagraph (B), by striking ‘‘not (B) during bloody armed confrontations subsection.’’. more than 5 years’’ and inserting ‘‘not more and massacres, such as the Sand Creek Mas- (2) APPLICATION OF ADMINISTRATIVE OFFSET than 10 years’’; and sacre in 1864 and the Wounded Knee Massacre PROVISIONS TO MEDICARE PROVIDER OR SUP- (2) in paragraph (2), in the flush matter fol- in 1890; and PLIER PAYMENTS.—Section 3716 of title 31, lowing subparagraph (B), by striking ‘‘not (C) on numerous Indian reservations; United States Code, is amended— more than 5 years’’ and inserting ‘‘not more (13) the Federal Government condemned (A) by inserting ‘‘the Department of than 10 years’’. the traditions, beliefs, and customs of Native Health and Human Services,’’ after ‘‘United (c) FALSE STATEMENT OR REPRESENTATION Peoples and endeavored to assimilate them States Postal Service,’’ in subsection WITH RESPECT TO CONDITIONS OR OPERATIONS by such policies as the redistribution of land (c)(1)(A); and OF FACILITIES.—Section 1128B(c) of the Social under the Act of February 8, 1887 (25 U.S.C. (B) by adding at the end of subsection (c)(3) Security Act (42 U.S.C. 1320a–7b(c)) is amend- 331; 24 Stat. 388, chapter 119) (commonly the following new subparagraph: ed by striking ‘‘not more than 5 years’’ and known as the ‘‘General Allotment Act’’), and ‘‘(D) This section shall apply to payments inserting ‘‘not more than 10 years’’. the forcible removal of Native children from made after the date which is 90 days after (d) EXCESS CHARGES.—Section 1128B(d) of their families to faraway boarding schools the enactment of this subparagraph (or such the Social Security Act (42 U.S.C. 1320a– where their Native practices and languages earlier date as designated by the Secretary 7b(d)) is amended, in the second flush matter were degraded and forbidden; of Health and Human Services) with respect following subparagraph (B), by striking ‘‘not (14) officials of the Federal Government to claims or debts, and to amounts payable, more than 5 years’’ and inserting ‘‘not more and private United States citizens harmed under title XVIII of the Social Security than 10 years’’. Native Peoples by the unlawful acquisition (e) EFFECTIVE DATE.—The amendments Act.’’. of recognized tribal land and the theft of made by this section shall apply to criminal (3) EFFECTIVE DATE.—The amendments tribal resources and assets from recognized penalties imposed for actions taken on or made by this subsection shall take effect on tribal land; after the date of enactment of this Act. the date of the enactment of this Act. (15) the policies of the Federal Government SEC. 214. INCREASED CIVIL MONEY PENALTIES TITLE III—MISCELLANEOUS toward Indian tribes and the breaking of cov- AND CRIMINAL FINES FOR MEDI- SEC. 301. RESOLUTION OF APOLOGY TO NATIVE enants with Indian tribes have contributed CARE FRAUD AND ABUSE. PEOPLES OF UNITED STATES. to the severe social ills and economic trou- (a) INCREASED CIVIL MONEY PENALTIES.— (a) FINDINGS.—Congress finds that— bles in many Native communities today; Section 1128A of the Social Security Act (42 (1) the ancestors of today’s Native Peoples (16) despite the wrongs committed against U.S.C. 1320a–7a) is amended— inhabited the land of the present-day United Native Peoples by the United States, Native

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00100 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1317 Peoples have remained committed to the There being no objection, the Senate formation or work product. See, e.g., Nguyen protection of this great land, as evidenced by proceeded to consider the bill. v. Excel Corp., 197 F.3d 200 (5th Cir. 1999) (re- the fact that, on a per capita basis, more Na- Mr. LEAHY. Mr. President, today I liance on an advice of counsel defense waives tive Peoples have served in the United States hope we pass a bipartisan bill that will the privilege with respect to attorney-client Armed Forces and placed themselves in communications pertinent to that defense); harm’s way in defense of the United States go a long way in reducing the costs of Ryers v. Burleson, 100 F.R.D. 436 (D.D.C. 1983) in every major military conflict than any litigating disputes in our civil justice (allegation of lawyer malpractice con- other ethnic group; system. This bill creates a new Federal stituted a waiver of confidential communica- (17) Indian tribes have actively influenced Rule of Evidence regarding electronic tions under the circumstances). The rule is the public life of the United States by con- disclosure of privileged material that not intended to displace or modify federal tinued cooperation with Congress and the would limit the consequences of inad- common law concerning waiver of privilege Department of the Interior, through the in- vertent disclosure. The new rule would or work product where no disclosure has volvement of Native individuals in official been made. Federal Government positions, and by lead- provide predictability and uniformity Subdivision (a). The rule provides that a ership of their own sovereign Indian tribes; in a discovery process that has been voluntary disclosure in a federal proceeding (18) Indian tribes are resilient and deter- made increasingly difficult with the or to a federal office or agency, if a waiver, mined to preserve, develop, and transmit to growing use of e-mail and other elec- generally results in a waiver only of the future generations their unique cultural tronic media. This legislation contains communication or information disclosed; a identities; the full text of Judicial Conference rec- subject matter waiver (of either privilege or (19) the National Museum of the American ommendations and is supported by all work product) is reserved for those unusual Indian was established within the Smithso- situations in which fairness requires a fur- nian Institution as a living memorial to Na- sectors of the legal community. ther disclosure of related, protected informa- tive Peoples and their traditions; and I ask unanimous consent to have tion, in order to prevent a selective and mis- (20) Native Peoples are endowed by their printed in the RECORD the Judicial leading presentation of evidence to the dis- Creator with certain unalienable rights, and Conference’s Committee Note to illu- advantage of the adversary. See, e.g., In re among those are life, liberty, and the pursuit minate the purpose of the new Federal United Mine Workers of America Employee of happiness. Rule of Evidence and how it should be Benefit Plans Litig., 159 F.R.D. 307, 312 (b) ACKNOWLEDGMENT AND APOLOGY.—The applied. (D.D.C. 1994) (waiver of work product limited United States, acting through Congress— There being no objection, the mate- to materials actually disclosed, because the (1) recognizes the special legal and polit- party did not deliberately disclose docu- ical relationship Indian tribes have with the rial was ordered to be printed in the ments in an attempt to gain a tactical ad- United States and the solemn covenant with RECORD, as follows: vantage). Thus, subject matter waiver is lim- the land we share; EXPLANATORY NOTE ON EVIDENCE RULE 502 ited to situations in which a party inten- (2) commends and honors Native Peoples tionally puts protected information into the This new rule has two major purposes: for the thousands of years that they have litigation in a selective, misleading and un- (1) It resolves some longstanding disputes stewarded and protected this land; fair manner. It follows that an inadvertent in the courts about the effect of certain dis- (3) recognizes that there have been years of disclosure of protected information can closures of communications or information official depredations, ill-conceived policies, never result in a subject matter waiver. See protected by the attorney-client privilege or and the breaking of covenants by the Federal Rule 502(b). The rule rejects the result in In Government regarding Indian tribes; as work product—specifically those disputes re Sealed Case, 877 F.2d 976 (D.C.Cir. 1989), (4) apologizes on behalf of the people of the involving inadvertent disclosure and subject which held that inadvertent disclosure of United States to all Native Peoples for the matter waiver. documents during discovery automatically many instances of violence, maltreatment, (2) It responds to the widespread complaint constituted a subject matter waiver. and neglect inflicted on Native Peoples by that litigation costs necessary to protect The language concerning subject matter citizens of the United States; against waiver of attorney-client privilege or waiver—‘‘ought in fairness’’—is taken from (5) expresses its regret for the ramifica- work product have become prohibitive due to Rule 106, because the animating principle is tions of former wrongs and its commitment the concern that any disclosure (however in- the same. Under both Rules, a party that to build on the positive relationships of the nocent or minimal) will operate as a subject makes a selective, misleading presentation past and present to move toward a brighter matter waiver of all protected communica- that is unfair to the adversary opens itself to future where all the people of this land live tions or information. This concern is espe- a more complete and accurate presentation. reconciled as brothers and sisters, and har- cially troubling in cases involving electronic To assure protection and predictability, moniously steward and protect this land to- discovery. See, e.g., Hopson v. City of Balti- the rule provides that if a disclosure is made gether; more, 232 F.R.D. 228, 244 (D.Md. 2005) (elec- at the federal level, the federal rule on sub- (6) urges the President to acknowledge the tronic discovery may encompass ‘‘millions of ject matter waiver governs subsequent state wrongs of the United States against Indian documents’’ and to insist upon ‘‘record-by- court determinations on the scope of the tribes in the history of the United States in record pre-production privilege review, on waiver by that disclosure. order to bring healing to this land; and pain of subject matter waiver, would impose Subdivision (b). Courts are in conflict over (7) commends the State governments that upon parties costs of production that bear no whether an inadvertent disclosure of a com- have begun reconciliation efforts with recog- proportionality to what is at stake in the munication or information protected as priv- nized Indian tribes located in their bound- litigation’’). ileged or work product constitutes a waiver. aries and encourages all State governments The rule seeks to provide a predictable, A few courts find that a disclosure must be similarly to work toward reconciling rela- uniform set of standards under which parties intentional to be a waiver. Most courts find tionships with Indian tribes within their can determine the consequences of a disclo- a waiver only if the disclosing party acted boundaries. sure of a communication or information cov- carelessly in disclosing the communication (c) DISCLAIMER.—Nothing in this section— ered by the attorney-client privilege or or information and failed to request its re- (1) authorizes or supports any claim work-product protection. Parties to litiga- turn in a timely manner. And a few courts against the United States; or tion need to know, for example, that if they hold that any inadvertent disclosure of a (2) serves as a settlement of any claim exchange privileged information pursuant to communication or information protected against the United States. a confidentiality order, the court’s order will under the attorney-client privilege or as be enforceable. Moreover, if a federal court’s work product constitutes a waiver without f confidentiality order is not enforceable in a regard to the protections taken to avoid TO AMEND THE FEDERAL RULES state court then the burdensome costs of such a disclosure. See generally Hopson v. OF EVIDENCE privilege review and retention are unlikely City of Baltimore, 232 F.R.D. 228 (D.Md. 2005), to be reduced. for a discussion of this case law. Mr. SALAZAR. Mr. President, I ask The rule makes no attempt to alter federal The rule opts for the middle ground: inad- unanimous consent that the Senate or state law on whether a communication or vertent disclosure of protected communica- proceed to the immediate consider- information is protected under the attorney- tions or information in connection with a ation of Calendar No. 580, S. 2450. client privilege or work-product immunity federal proceeding or to a federal office or The PRESIDING OFFICER. The as an initial matter. Moreover, while estab- agency does not constitute a waiver if the lishing some exceptions to waiver, the rule holder took reasonable steps to prevent dis- clerk will report the bill by title. does not purport to supplant applicable waiv- closure and also promptly took reasonable The legislative clerk read as follows: er doctrine generally. steps to rectify the error. This position is in A bill (S. 2450) to amend the Federal Rules The rule governs only certain waivers by accord with the majority view on whether of Evidence to address the waiver of the at- disclosure. Other common-law waiver doc- inadvertent disclosure is a waiver. torney-client privilege in the work product trines may result in a finding of waiver even Cases such as Lois Sportswear, U.S.A., Inc. doctrine. where there is no disclosure of privileged in- v. Levi Strauss & Co., 104 F.R.D. 103, 105

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00101 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB S1318 CONGRESSIONAL RECORD — SENATE February 27, 2008 (S.D.N.Y. 1985) and Hartford Fire Ins. Co. v. and . . . federalism’’). Thus, a state court yers, could not rely on the protections pro- Garvey, 109 F.R.D. 323, 332 (N.D.Cal. 1985), set order finding no waiver in connection with a vided by the Rule, and the goal of limiting out a multi-factor test for determining disclosure made in a state court proceeding costs in discovery would be substantially un- whether inadvertent disclosure is a waiver. is enforceable under existing law in subse- dermined. Rule 502(f) is intended to resolve The stated factors (none of which is disposi- quent federal proceedings. any potential tension between the provisions tive) are the reasonableness of precautions Subdivision (d). Confidentiality orders are of Rule 502 that apply to state proceedings taken, the time taken to rectify the error, becoming increasingly important in limiting and the possible limitations on the applica- the scope of discovery, the extent of disclo- the costs of privilege review and retention, bility of the Federal Rules of Evidence oth- sure and the overriding issue of fairness. The especially in cases involving electronic dis- erwise provided by Rules 101 and 1101. rule does not explicitly codify that test, be- covery. But the utility of a confidentiality The rule is intended to apply in all federal cause it is really a set of non-determinative order in reducing discovery costs is substan- court proceedings, including court-annexed guidelines that vary from case to case. The tially diminished if it provides no protection and court-ordered arbitrations, without re- rule is flexible enough to accommodate any outside the particular litigation in which the gard to any possible limitations of Rules 101 of those listed factors. Other considerations order is entered. Parties are unlikely to be and 1101. This provision is not intended to bearing on the reasonableness of a producing able to reduce the costs of pre-production re- raise an inference about the applicability of party’s efforts include the number of docu- view for privilege and work product if the any other rule of evidence in arbitration pro- ments to be reviewed and the time con- consequence of disclosure is that the com- ceedings more generally. straints for production. Depending on the munications or information could be used by The costs of discovery can be equally high circumstances, a party that uses advanced non-parties to the litigation. for state and federal causes of action, and analytical software applications and lin- There is some dispute on whether a con- the rule seeks to limit those costs in all fed- guistic tools in screening for privilege and fidentiality order entered in one case is en- eral proceedings, regardless of whether the work product may be found to have taken forceable in other proceedings. See generally claim arises under state or federal law. Ac- ‘‘reasonable steps’’ to prevent inadvertent Hopson v. City of Baltimore, 232 F.R.D. 228 cordingly, the rule applies to state law disclosure. The implementation of an effi- (D.Md. 2005), for a discussion of this case law. causes of action brought in federal court. cient system of records management before The rule provides that when a confiden- Subdivision (g). The rule’s coverage is lim- litigation may also be relevant. tiality order governing the consequences of ited to attorney-client privilege and work The rule does not require the producing disclosure in that case is entered in a federal product. The operation of waiver by disclo- party to engage in a post-production review proceeding, its terms are enforceable against sure, as applied to other evidentiary privi- to determine whether any protected commu- non-parties in any federal or state pro- leges, remains a question of federal common nication or information has been produced ceeding. For example, the court order may law. Nor does the rule purport to apply to by mistake. But the rule does require the provide for return of documents without the Fifth Amendment privilege against com- producing party to follow up on any obvious waiver irrespective of the care taken by the pelled self-incrimination. indications that a protected communication disclosing party; the rule contemplates en- The definition of work product ‘‘mate- or information has been produced inadvert- forcement of ‘‘claw-back’’ and ‘‘quick peek’’ rials’’ is intended to include both tangible ently. arrangements as a way to avoid the exces- and intangible information. See In re The rule applies to inadvertent disclosures sive costs of pre-production review for privi- Cendant Corp. Sec. Litig., 343 F.3d 658, 662 (3d made to a federal office or agency, including lege and work product. See Zubulake v. UBS Cir. 2003) (‘‘work product protection extends but not limited to an office or agency that is Warburg LLC, 216 F.R.D. 280, 290 (S.D.N.Y. to both tangible and intangible work prod- acting in the course of its regulatory, inves- 2003) (noting that parties may enter into ‘‘so- uct’’). tigative or enforcement authority. The con- called ‘claw-back’ agreements that allow the sequences of waiver, and the concomitant parties to forego privilege review altogether Mr. LEAHY. Mr. President, I thank costs of pre-production privilege review, can in favor of an agreement to return inadvert- Senator SPECTER for joining me in in- be as great with respect to disclosures to of- ently produced privilege documents’’). The troducing this bill last December, as fices and agencies as they are in litigation. rule provides a party with a predictable pro- the first session of this Congress drew Subdivision (c). Difficult questions can tection from a court order—predictability to a close. The Judiciary Committee arise when 1) a disclosure of a communica- that is needed to allow the party to plan in took up and unanimously approved the tion or information protected by the attor- advance to limit the prohibitive costs of ney-client privilege or as work product is bill during our first business meeting privilege and work product review and reten- after returning from the holiday re- made in a state proceeding, 2) the commu- tion. nication or information is offered in a subse- Under the rule, a confidentiality order is cess. I urge all Senators to join Sen- quent federal proceeding on the ground that enforceable whether or not it memorializes ator SPECTER and me to pass this pro- the disclosure waived the privilege or protec- an agreement among the parties to the liti- posal and take a positive step toward tion, and 3) the state and federal laws are in gation. Party agreement should not be a con- modernizing and improving the Federal conflict on the question of waiver. The Com- dition of enforceability of a federal court’s Rules of Evidence. mittee determined that the proper solution order. Mr. SALAZAR. Mr. President, I ask for the federal court is to apply the law that Under subdivision (d), a federal court may is most protective of privilege and work order that disclosure of privileged or pro- unanimous consent that the bill be product. If the state law is more protective tected information ‘‘in connection with’’ a read a third time and passed, the mo- (such as where the state law is that an inad- federal proceeding does not result in waiver. tion to reconsider be laid upon the vertent disclosure can never be a waiver), But subdivision (d) does not allow the federal table, with no intervening action or de- the holder of the privilege or protection may court to enter an order determining the bate, and that any statements relating well have relied on that law when making waiver effects of a separate disclosure of the to the bill be printed in the RECORD. the disclosure in the state proceeding. More- same information in other proceedings, state The PRESIDING OFFICER. Without over, applying a more restrictive federal law or federal. If a disclosure has been made in a objection, it is so ordered. of waiver could impair the state objective of state proceeding (and is not the subject of a preserving the privilege or work-product pro- state-court order on waiver), then subdivi- The bill (S. 2450) was ordered to be tection for disclosures made in state pro- sion (d) is inapplicable. Subdivision (c) would engrossed for a third reading, was read ceedings. On the other hand, if the federal govern the federal court’s determination the third time, and passed, as follows: law is more protective, applying the state whether the state-court disclosure waived S. 2450 law of waiver to determine admissibility in the privilege or protection in the federal pro- Be it enacted by the Senate and House of Rep- federal court is likely to undermine the fed- ceeding. resentatives of the United States of America in eral objective of limiting the costs of produc- Subdivision (e). Subdivision (e) codifies the Congress assembled, tion. well-established proposition that parties can The rule does not address the enforce- enter an agreement to limit the effect of SECTION 1. ATTORNEY-CLIENT PRIVILEGE AND ability of a state court confidentiality order WORK PRODUCT; LIMITATIONS ON waiver by disclosure between or among WAIVER. in a federal proceeding, as that question is them. Of course such an agreement can bind (a) IN GENERAL.—Article V of the Federal covered both by statutory law and principles only the parties to the agreement. The rule Rules of Evidence is amended by adding at of federalism and comity. See 28 U.S.C. 1738 makes clear that if parties want protection the end the following: (providing that state judicial proceedings against non-parties from a finding of waiver ‘‘shall have the same full faith and credit in by disclosure, the agreement must be made ‘‘Rule 502. Attorney-Client Privilege and every court within the United States . . . as part of a court order. Work Product; Limitations on Waiver they have by law or usage in the courts of Subdivision (f). The protections against ‘‘The following provisions apply, in the cir- such State . . . from which they are taken’’). waiver provided by Rule 502 must be applica- cumstances set out, to disclosure of a com- See also Tucker v. Ohtsu Tire & Rubber Co., ble when protected communications or infor- munication or information covered by the 191 F.R.D. 495, 499 (D.Md. 2000) (noting that a mation disclosed in federal proceedings are attorney-client privilege or work-product federal court considering the enforceability subsequently offered in state proceedings. protection. of a state confidentiality order is ‘‘con- Otherwise the holders of protected commu- ‘‘(a) DISCLOSURE MADE IN A FEDERAL PRO- strained by principles of comity, courtesy, nications and information, and their law- CEEDING OR TO A FEDERAL OFFICE OR AGENCY;

VerDate Aug 31 2005 03:58 Mar 01, 2008 Jkt 069060 PO 00000 Frm 00102 Fmt 4624 Sfmt 0634 E:\MIKE\TEMP\S27FE8.REC S27FE8 mmaher on PROD1PC70 with $$_JOB February 27, 2008 CONGRESSIONAL RECORD — SENATE S1319 SCOPE OF A WAIVER.—When the disclosure is ate completes its business today, it To be major made in a Federal proceeding or to a Federal stand adjourned until 9:30 a.m., Thurs- DANIEL E. BATES office or agency and waives the attorney-cli- day, February 28; that following the THE FOLLOWING NAMED OFFICERS FOR APPOINTMENT ent privilege or work-product protection, the prayer and pledge, the morning hour be TO THE GRADE INDICATED IN THE UNITED STATES AIR waiver extends to an undisclosed commu- FORCE UNDER TITLE 10, U.S.C., SECTION 624: nication or information in a Federal or State deemed expired, the Journal of pro- To be major ceedings be approved to date, the time proceeding only if: JEFFREY D. LEWIS ‘‘(1) the waiver is intentional; for the two leaders be reserved for their ROBERT J. LOVE ‘‘(2) the disclosed and undisclosed commu- use later in the day, and that the Sen- THE FOLLOWING NAMED OFFICERS FOR APPOINTMENT nications or information concern the same ate then proceed to a period for the TO THE GRADE INDICATED IN THE UNITED STATES AIR subject matter; and transaction of morning business for up FORCE UNDER TITLE 10, U.S.C., SECTION 624: ‘‘(3) they ought in fairness to be considered to 1 hour, with the time equally di- To be major together. vided and controlled between the two AUSTIN B. DOSH CURRAN L. JONES ‘‘(b) INADVERTENT DISCLOSURE.—When leaders or their designees, with the ma- made in a Federal proceeding or to a Federal JOSHUA M. SILL office or agency, the disclosure does not op- jority controlling the first half and the THE FOLLOWING NAMED INDIVIDUALS FOR APPOINT- Republicans controlling the final half; MENT IN THE GRADES INDICATED IN THE REGULAR AIR erate as a waiver in a Federal or State pro- FORCE UNDER TITLE 10, U.S.C., SECTION 531(A): ceeding if: further, that the Senate then resume To be lieutenant colonel ‘‘(1) the disclosure is inadvertent; consideration of the motion to proceed ‘‘(2) the holder of the privilege or protec- to S. 2634 and that all time during any GERALD B. WHISLER III tion took reasonable steps to prevent disclo- adjournment or morning business To be major sure; and count postcloture. LUTHER P. MARTIN ‘‘(3) the holder promptly took reasonable The PRESIDING OFFICER. Without SAMUEL R. WETHERILL steps to rectify the error, including (if appli- objection, it is so ordered. IN THE ARMY cable) following Federal Rule of Civil Proce- THE FOLLOWING NAMED INDIVIDUAL FOR REGULAR dure 26(b)(5)(B). f APPOINTMENT TO THE GRADE INDICATED IN THE ‘‘(c) DISCLOSURE MADE IN A STATE PRO- UNITED STATES ARMY DENTAL CORPS UNDER TITLE 10, ADJOURNMENT UNTIL 9:30 A.M. U.S.C., SECTIONS 531 AND 3064: CEEDING.—When the disclosure is made in a TOMORROW State proceeding and is not the subject of a To be major State-court order concerning waiver, the dis- Mr. SALAZAR. Mr. President, if LLENA C. CALDWELL closure does not operate as a waiver in a there is no further business to come be- THE FOLLOWING NAMED INDIVIDUAL FOR REGULAR Federal proceeding if the disclosure: fore the Senate, I ask unanimous con- APPOINTMENT TO THE GRADE INDICATED IN THE ‘‘(1) would not be a waiver under this rule sent that it stand adjourned under the UNITED STATES ARMY VETERINARY CORPS UNDER if it had been made in a Federal proceeding; TITLE 10, U.S.C., SECTION 531 AND 3064: previous order. To be major or There being no objection, the Senate, ‘‘(2) is not a waiver under the law of the DEANNA L. REIBER at 7:46 p.m., adjourned until Thursday, State where the disclosure occurred. THE FOLLOWING NAMED OFFICER FOR APPOINTMENT ‘‘(d) CONTROLLING EFFECT OF A COURT February 28, 2008, at 9:30 a.m. TO THE GRADE INDICATED IN THE UNITED STATES ARMY ORDER.—A Federal court may order that the f MEDICAL CORPS UNDER TITLE 10, U.S.C., SECTIONS 624 AND 3064: privilege or protection is not waived by dis- NOMINATIONS closure connected with the litigation pend- To be major ing before the court—in which event the dis- Executive nominations received by CHRISTOPHER D. YAO closure is also not a waiver in any other Fed- the Senate: THE FOLLOWING NAMED OFFICER FOR APPOINTMENT eral or State proceeding. POSTAL REGULATORY COMMISSION TO THE GRADE INDICATED IN THE UNITED STATES ARMY ‘‘(e) CONTROLLING EFFECT OF A PARTY UNDER TITLE 10, U.S.C., SECTIONS 624: NANCI E. LANGLEY, OF VIRGINIA, TO BE A COMMIS- To be lieutenant colonel AGREEMENT.—An agreement on the effect of SIONER OF THE POSTAL REGULATORY COMMISSION FOR disclosure in a Federal proceeding is binding A TERM EXPIRING NOVEMBER 22, 2012, VICE DAWN A. TIS- MICHAEL L. MANSI DALE, TERM EXPIRED. only on the parties to the agreement, unless THE FOLLOWING NAMED ARMY NATIONAL GUARD OF it is incorporated into a court order. PRIVACY AND CIVIL LIBERTIES OVERSIGHT THE UNITED STATES OFFICER FOR APPOINTMENT TO ‘‘(f) CONTROLLING EFFECT OF THIS RULE.— BOARD THE GRADE INDICATED IN THE RESERVE OF THE ARMY UNDER TITLE 10, U.S.C., SECTIONS 12203 AND 12211: Notwithstanding Rules 101 and 1101, this rule RONALD D. ROTUNDA, OF VIRGINIA, TO BE A MEMBER applies to State proceedings and to Federal OF THE PRIVACY AND CIVIL LIBERTIES OVERSIGHT To be colonel BOARD FOR A TERM OF FOUR YEARS EXPIRING JANUARY MARC FERRARO court-annexed and Federal court-mandated 29, 2012. (NEW POSITION) arbitration proceedings, in the cir- DANIEL W. SUTHERLAND, OF VIRGINIA, TO BE CHAIR- THE FOLLOWING NAMED OFFICER FOR APPOINTMENT cumstances set out in the rule. And notwith- MAN OF THE PRIVACY AND CIVIL LIBERTIES OVERSIGHT TO THE GRADE INDICATED IN THE RESERVE OF THE BOARD FOR A TERM OF SIX YEARS EXPIRING JANUARY ARMY UNDER TITLE 10, U.S.C., SECTION 12203: standing Rule 501, this rule applies even if 29, 2014. (NEW POSITION) State law provides the rule of decision. FRANCIS X. TAYLOR, OF MARYLAND, TO BE A MEMBER To be colonel OF THE PRIVACY AND CIVIL LIBERTIES OVERSIGHT ‘‘(g) DEFINITIONS.—In this rule: WENDELL L. KING ‘‘(1) ‘attorney-client privilege’ means the BOARD FOR A TERM OF TWO YEARS EXPIRING JANUARY 29, 2010. (NEW POSITION) THE FOLLOWING NAMED INDIVIDUALS FOR REGULAR protection that applicable law provides for IN THE COAST GUARD APPOINTMENT TO THE GRADES INDICATED IN THE confidential attorney-client communica- UNITED STATES ARMY MEDICAL CORPS UNDER TITLE 10, tions; and THE FOLLOWING NAMED INDIVIDUAL FOR APPOINT- U.S.C., SECTIONS 531 AND 3064: MENT AS A PERMANENT COMMISSIONED REGULAR OFFI- To be lieutenant colonel ‘‘(2) ‘work-product protection’ means the CER IN THE UNITED STATES COAST GUARD IN THE protection that applicable law provides for GRADE INDICATED UNDER TITLE 14, U.S.C., SECTION 211: PAUL C. PERLIK tangible material (or its intangible equiva- To be lieutenant commander To be major lent) prepared in anticipation of litigation or KIMBERLY J. AVSEC for trial.’’. KEITH MOORE (b) TECHNICAL AND CONFORMING CHANGES.— THE FOLLOWING NAMED OFFICERS FOR APPOINTMENT THE FOLLOWING NAMED INDIVIDUALS FOR REGULAR TO THE GRADE INDICATED IN THE UNITED STATES APPOINTMENT TO THE GRADES INDICATED IN THE The table of contents for the Federal Rules COAST GUARD UNDER TITLE 14, U.S.C., SECTION 211: UNITED STATES ARMY DENTAL CORPS UNDER TITLE 10, of Evidence is amended by inserting after the To be lieutenant commander U.S.C., SECTIONS 531 AND 3064: item relating to rule 501 the following: ANTHONY K. PALMER To be colonel ‘‘502. Attorney-client privilege and work- PATRICK J. ST. JOHN MARC C. HENDLER product doctrine; limitations IN THE AIR FORCE To be lieutenant colonel on waiver.’’. THE FOLLOWING NAMED OFFICER FOR REGULAR AP- LEE A. KNOX (c) EFFECTIVE DATE.—The amendments POINTMENT IN THE GRADE INDICATED IN THE UNITED made by this Act shall apply in all pro- STATES AIR FORCE UNDER TITLE 10, U.S.C., SECTIONS 531 To be major AND 1211: ceedings commenced after the date of enact- THOMAS J. THRASHER ment of this Act and, insofar as is just and To be major JAMES D. TOWNSEND practicable, in all proceedings pending on ANDRE G. SARMIENTO THE FOLLOWING NAMED INDIVIDUALS FOR REGULAR such date of enactment. APPOINTMENT TO THE GRADES INDICATED IN THE THE FOLLOWING NAMED INDIVIDUAL FOR APPOINT- UNITED STATES ARMY MEDICAL CORPS UNDER TITLE 10, MENT IN THE GRADE INDICATED IN THE REGULAR AIR U.S.C., SECTIONS 531 AND 3064: f FORCE UNDER TITLE 10, U.S.C., SECTION 531(A): To be lieutenant colonel ORDERS FOR THURSDAY, To be major JAMES H. KELLY RICKEY J. REYNOLDS FEBRUARY 28, 2008 GREGORY PARK Mr. SALAZAR. Mr. President, I ask THE FOLLOWING NAMED OFFICER FOR APPOINTMENT To be major TO THE GRADE INDICATED IN THE UNITED STATES AIR unanimous consent that when the Sen- FORCE UNDER TITLE 10, U.S.C., SECTION 624: LUIS RAMOS

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KRISTINE R. SAUNDERS ISAAC C. SPRAGG THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR ALLEN D. STEWART APPOINTMENT TO THE GRADE INDICATED IN THE THE FOLLOWING NAMED INDIVIDUALS FOR REGULAR JAY L. THOMAN UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., APPOINTMENT TO THE GRADES INDICATED IN THE CASEY Z. THOMAS SECTION 624: UNITED STATES ARMY NURSE CORPS UNDER TITLE 10, JACQUELINE TUBBS To be major U.S.C., SECTIONS 531 AND 3064: KENNETH A. TYNDAL To be lieutenant colonel JOCELYN S. URGESE SAL L. LEBLANC MATTHEW C. VINTON RAUL TORRES ALLYSON A. PETERSON MASON S. WEISS KEVIN R. WILLIAMS JACOB G. WOLF To be major DANIEL A. WOOLVERTON THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR CORY J. YOUNG APPOINTMENT TO THE GRADE INDICATED IN THE AMELIA S. JACKSON UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., BRIAN E. PREHN IN THE MARINE CORPS SECTION 624: THE FOLLOWING NAMED INDIVIDUALS FOR REGULAR THE FOLLOWING NAMED LIMITED DUTY OFFICER FOR To be major APPOINTMENT TO THE GRADE INDICATED IN THE APPOINTMENT TO THE GRADE INDICATED IN THE ROBERT F. EMMINGER UNITED STATES ARMY MEDICAL SPECIALIST CORPS UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., ARMAND J. FRAPPIER UNDER TITLE 10, U.S.C., SECTIONS 531 AND 3064: SECTION 624: MICHAEL G. MARCHAND To be major To be major THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR LARRY W. AKE PATRICK T. GROSSO APPOINTMENT TO THE GRADE INDICATED IN THE PATRICK S. CARSON UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., THE FOLLOWING NAMED LIMITED DUTY OFFICER FOR SECTION 624: THE FOLLOWING NAMED INDIVIDUALS TO THE GRADE APPOINTMENT TO THE GRADE INDICATED IN THE INDICATED IN THE RESERVE OF THE ARMY UNDER TITLE UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., To be major 10, U.S.C., SECTION 12203: SECTION 624: CHRISTOPHER F. BERGERON To be colonel To be lieutenant colonel DARREN R. DEMYER LLOYD E. EDWARDS, JR. GARY L. GROSS JAMES D. MCCOY SEAN P. HEICHLINGER ANTONIO MARTINEZ-LUENGO KELLY M. JONES PETER M. TAN THE FOLLOWING NAMED LIMITED DUTY OFFICER FOR DAVID A. MCCOVERY APPOINTMENT TO THE GRADE INDICATED IN THE KENNETHE R. MCMILLAN THE FOLLOWING NAMED OFFICERS FOR APPOINTMENT UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., MARK B. WINDHAM TO THE GRADE INDICATED IN THE RESERVE OF THE SECTION 624: ARMY UNDER TITLE 10, U.S.C., SECTION 12203: IN THE NAVY To be lieutenant colonel To be colonel THE FOLLOWING NAMED INDIVIDUALS FOR APPOINT- WALTER C. MURPHY, JR. HAROLD L. CAMPBELL, JR. MENT IN THE GRADES INDICATED IN THE UNITED WILLIAM A. CARROLL THE FOLLOWING NAMED LIMITED DUTY OFFICER FOR STATES NAVY UNDER TITLE 10, U.S.C., SECTION 531: SCOTT E. CLODFELTER APPOINTMENT TO THE GRADE INDICATED IN THE To be commander DARWIN F. CONCON UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., STEVEN W. LAYTON SECTION 624: JEFFREY H. NARD ROBERT M. MARCHI To be lieutenant colonel To be lieutenant commander BRENDAN J. OSHEA SANDRA J. RAVELING DONALD L. BOHANNON PETER PRESSMAN RICHARD W. SELLNER ROBERT G. SHEU DAVID O. SMITH THE FOLLOWING NAMED LIMITED DUTY OFFICER FOR TODD A. TRITCH KENNETH P. STORZ APPOINTMENT TO THE GRADE INDICATED IN THE DANIEL J. TRUEBA, JR. UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., THE FOLLOWING NAMED OFFICERS FOR APPOINTMENT SECTION 624: THE FOLLOWING NAMED OFFICERS FOR REGULAR AP- TO THE GRADE INDICATED IN THE UNITED STATES ARMY POINTMENT IN THE GRADES INDICATED IN THE UNITED JUDGE ADVOCATE GENERAL’S CORPS UNDER TITLE 10, To be lieutenant colonel STATES NAVY UNDER TITLE 10, U.S.C., SECTION 531: U.S.C., SECTIONS 624 AND 3064: CHARLES B. SPENCER To be commander To be major THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR ANDREW S. LOMAX MAGDALENA A. ACEVEDO APPOINTMENT TO THE GRADE INDICATED IN THE NOLAN D. VILLARIN ALAN APPLE UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., To be lieutenant commander KENNETH J. BACSO SECTION 624: GREGORY B. BATDORFF To be lieutenant colonel ERLINA A. HAUN JOHN C. BENSON RUPERT L. HUSSEY JOSHUA A. BERGER JOHN G. OLIVER THE FOLLOWING NAMED OFFICERS FOR REGULAR AP- ADAM J. BERLIN ROGER W. SCAMBLER POINTMENT IN THE GRADES INDICATED IN THE UNITED STEVE D. BERLIN STATES NAVY UNDER TITLE 10, U.S.C., SECTION 531: LISA R. BLOOM THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR JEFFREY T. BRELOSKI APPOINTMENT TO THE GRADE INDICATED IN THE To be captain ANN B. CHING UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., JENNIFER C. CLARK SECTION 624: DAVID R. COUGHLIN MATTHEW A. MCQUEEN ELISABETH A. CLAUS To be lieutenant colonel CHRISTOPHER R. CLEMENTS To be commander STEPHEN R. COUTANT MARK F. BIRK TOBY N. CURTO KENNETH L. KELSAY JOYCE F. RICHARDSON LARRY W. DOWNEND, JR. STEWART B. WHARTON CHE P. DUNGAN THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR WILLIAM A. WIMMER DANIEL J. EVERETT APPOINTMENT TO THE GRADE INDICATED IN THE To be lieutenant commander ANDREW D. FLOR UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., MICHAEL C. FRIESS SECTION 624: RONALD W. NEWHOUSE MICHAEL A. GOBA To be lieutenant colonel TIMOTHY S. STYLES DAVID J. GOSCHA PATRICK D. GREGORY, SR. CHRISTOPHER J. AMBS THE FOLLOWING NAMED OFFICERS FOR REGULAR AP- PHILLIP B. GRIFFITH TODD E. KUNST POINTMENT IN THE GRADES INDICATED IN THE UNITED SEAN G. GYSEN STATES NAVY UNDER TITLE 10, U.S.C., SECTION 531: LAKEYSIA R. HARVIN THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR To be captain PATRICIA K. HINSHAW APPOINTMENT TO THE GRADE INDICATED IN THE SARA F. HOLLAND UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., MICHAEL D. T. EDWARDS NATE G. HUMMEL SECTION 624: DOUGLAS W. FENSKE SCOTT E. HUTMACHER To be lieutenant colonel JENNITH E. HOYT ROBERT C. INSANI MICHAEL J. KAUTZ STEVEN B. JANKO TIM J. SCHROEDER KEVIN S. LERETTE WILLIAM J. JOHNSON JOSEPH G. SINESE KATHLEEN M. LINDENMAYER MICHAEL D. JONES STEVEN F. MOMANO MICHAEL L. KANABROCKI THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR AGUSTIN L. OTERO MATTHEW J. KEMKES APPOINTMENT TO THE GRADE INDICATED IN THE NORMAN W. PORTER SUSAN L. KIM UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., ROBERT A. WOOD FREDERICK K. KRANZ SECTION 624: To be commander KATHERINE A. KRUL To be lieutenant colonel WILLIAM T. KUCHENTHAL RUSSELL P. ASHFORD CHANDRA L. LAGRONE RICHARD D. HARDIN JAMES E. AULL JEREMY M. LARCHICK GEORGE M. SEXTON CRISTOBAL S. BENAVIDES SCOTT E. LINGER LAURANCE C. BOYD HOWARD T. MATTHEWS, JR. THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR TODD A. BROWN MARVIN J. MCBURROWS APPOINTMENT TO THE GRADE INDICATED IN THE ALEXANDER M. CAVAZOS KEVIN P. MCCART UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., ROBERT A. FARLEY KEVIN A. MCCARTHY SECTION 624: JOHN A. FEDOROWICZ ANDREW M. MCKEE To be lieutenant colonel LAURA R. HATCHER MICHAEL J. MEKETEN PATRICK L. LEONHARDT WENDY N. MELLO ROY E. LAWRENCE MICHAEL R. MURRAY ANDREAS G. MILLER DANIEL R. WESTPHAL TUAN A. NGUYEN DOUGLAS W. MOORE RENEE R. RICHARDSON JAMES W. NELSON THE FOLLOWING NAMED LIMITED DUTY OFFICERS FOR DALE C. SCHULMAN ROBERT B. NELSON APPOINTMENT TO THE GRADE INDICATED IN THE CHRISTINA L. SIMINGTON JAMES L. OCONNELL UNITED STATES MARINE CORPS UNDER TITLE 10, U.S.C., KENNETH R. SMITH TERESA T. PHELPS SECTION 624: JOSE TORRES, JR. RYAN W. ROSAUER To be lieutenant colonel DOUGLAS B. UPCHURCH III KAREN L. SHEA To be lieutenant commander ANDREW J. SLITT PETER D. CHARBONEAU DAVID W. SMITH STEVEN R. FREDEEN TED W. BOYD

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FELIPE R. DE VEGA DAVID R. HARRIS JAMES F. SCARCELLI EDWIN D. EXUM JOHN R. HENDERSON JOHN M. SMAHA, JR. CLAUDIA D. FLORES CHARLES G. LONGLEY HIRAM J. WEEDON JOHN FRIEDENREICH PAMELA Y. MCKENZIE CHAD D. WEST RICHARD K. GOUGER ANDREW F. MOORE DAVID H. GRAY KIM H. RIGAZZI

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