United States · United States Congress · 5 January 1995
Medicaid Substance Abuse Treatment Act - Amends title XIX (Medicaid) of the Social Security Act to provide federally reimbursed Medicaid coverage of alcoholism and drug dependency residential treatment services for pregnant women whose family income is below 185 percent of the Federal poverty level and for their Medicaid-eligible children and spouses. Lists the required services included in such coverage. Requires that such coverage continue for at least 12 months, except in certain circumstances, such as where the coverage of pregnant women must continue for one year following the end of pregnancy. Limits the size of a residential treatment facility. Allows a State agency to grant exceptions to such limit. Prohibits the facility from being licensed as a hospital. Caps the number of nationwide beds for which Federal assistance may be provided under such residential treatment programs. Increases such annual bed cap for calendar years 1995 through 1999. Addresses treatment needs of pregnant addicted Indian and Alaska Native women in Indian Health Service areas.
United States · United States Congress · 5 January 1995
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Role in Reform Subtitle D: Expanded Access to Health Plans Subtitle E: Standards for Reform Subtitle F: Federal Responsibilities Subtitle G: Miscellaneous Employer Requirements Subtitle H: General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle A: Home and Community-Based Services Subtitle B: Life Care Subtitle C: Sense of the Committee with Regard to Prescription Drugs Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Health Research Initiatives Subtitle C: Health Services for Medically Underserved Populations Subtitle D: Assistance for State Managed Mental Health and Substance Abuse Programs Subtitle E: Comprehensive School Health Education; School-Related Health Services Subtitle F: Public Health Service Initiative Title IV: Medical Malpractice Subtitle A: Liability Reform Subtitle B: Other Provisions Relating to Medical Malpractice Liability Title V: Fall-Back Premium Limits in Cases of Ineffective Competition; Premium-Based Financing; Assistance to Low Income Individuals and to Businesses Subtitle A: Fall-Back Premium Limits Subtitle B: Premium-Related Financings Subtitle C: Payments to Health Plans and Miscellaneous Provisions Subtitle D: Cost-Sharing Assistance, Application for Assistance and Premium Discounts, and Income Reconciliation Title VI: Aggregate Government Payments Subtitle A: Aggregate Federal Payments to Participating State Subtitle B: Borrowing Authority to Cover Cash-Flow Shortfalls Subtitle C: Miscellaneous Provisions Affordable Health Care for All Americans Act - Title I: Health Care Security - Subtitle A: Universal Coverage and Individual Responsibility - Entitles each U.S. citizen or national, resident alien, and long-term nonimmigrant (except for individuals exempt from paying Social Security taxes and except for individuals eligible under title XVIII (Medicare) of the Social Security Act)) to the benefits required under subtitle B. (Sec. 1004) Declares that: (1) subject to exception, the applicable health plan for a family is a community-rated plan for the community-rating area in which the family resides; and (2) the applicable health plan for a family member eligible to enroll in an experienced-rated (sic) plan is such an experienced-rated (sic) plan. Allows eligible individuals who are permitted to elect coverage under more than one plan to elect which will be the applicable plan. (Sec. 1005) Prohibits aliens who are not eligible individuals from obtaining benefits through enrollment under this Act. Allows benefits to lawful nonimmigrants (who are not long-term nonimmigrants) only in accordance with any reciprocal agreements between the United States and foreign States. (Sec. 1011) Requires, subject to exception, all members of the same family to be enrolled in the same applicable plan. Authorizes national rules regarding who will be treated as children under this Act. (Sec. 1012) Provides for the treatment of certain families that include: (1) Medicare-eligible individuals; (2) recipients under part A (Aid to Families with Dependent Children (AFDC)) of the Social Security Act; and (3) disabled and nondisabled recipients under title XVI (Supplemental Security Income for the Aged, Blind, and Disabled (SSI)) of the Social Security Act. Allows qualifying students to enroll in a community-rate plan for the area in which the school is located. (Sec. 1013) Requires individuals (and their spouses) who are eligible as an employee for more than one plan to elect the applicable plan. Subtitle B: Benefits - Requires a certified health plan to provide benefits actuarially equivalent to the BlueCross-Blue Shield standard option plan provided under the Federal Employees Health Benefits Program (FEHBP) on January 1, 1995. Includes in minimum services: (1) hospital services; (2) health professionals' services; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care, home health care, extended care services, outpatient rehabilitation services, and ambulance services; (8) outpatient laboratory, radiology and diagnostic services; (9) outpatient prescription drugs and biologicals; (10) durable medical equipment; (11) vision care and dental care for children; and (12) patient care costs of qualified investigational treatments. Prohibits scope or duration limits on certain services. Declares that certain services are not medically necessary or appropriate. Prohibits cost-sharing for preventive and prenatal services. Mandates establishment of three model certified plans having cost-sharing and scope and duration limits appropriate for fee-for-service plans, preferred provider plans, and health maintenance organization (HMO) plans. Requires a study on the provision and enrollment patterns of certified plans. (Sec. 1102) Declares that a health professional or a health facility may not be required to provide an item or service under a certified plan if the professional or facility objects on the basis of a religious belief or moral conviction. (Sec. 1103) Prohibits balance billing. Subtitle C: State Role in Reform - Requires each State to establish a State market reform program (SMRP) meeting the requirements of this title. (Sec. 1202) Mandates certain SMRP actions, including regarding certification of insured health plans, establishment of community rating areas, certification of purchasing cooperatives, establishment of purchasing cooperative coordination rules, development of standardized comparative certified plan information and information on accessing plans and cooperatives, providing for risk adjustment programs for community-rated and association health plans, and enrollment periods. (Sec. 1209) Authorizes a SMRP to certify a network plan to operate in a service area different from the borders of a community rating area if certain requirements are met. (Sec. 1210) Allows a State, on approval by the Secretary of Health and Human Services and notwithstanding specified provisions of this Act, to tighten premium rate bands beyond the variation permitted, establish association plan rules more restrictive than provided for, and establish financial solvency requirements exceeding requirements. (Sec. 1211) Mandates establishment (by grant or contract) and oversight of a National Center of Consumer Advocacy to provide technical assistance, training, and support to States and Offices of Consumer Advocacy in each State. (Sec. 1212) Requires each participating State to establish a procedure for exempt employers to elect to be treated as a community- rated employer. (Sec. 1222) Sets forth requirements for single-payer systems, including: (1) operation by the State or a designated agency of the State; (2) enrollment of all individuals in the State, subject to exception; (3) payments made by the State (directly or through fiscal intermediaries) to providers; (4) coverage of all items and services as required by subtitle B of this title (allowing reduced but not increased cost-sharing); (5) limiting the health care spending increase rate; and (6) meeting the requirements applicable to certified plans. Subtitle D: Expanded Access to Health Plans - Requires that each employer make available to each employee the opportunity to enroll in one of at least three certified plans, including either a fee-for-service plan or a point-of-service option. Allows a small employer (defined as having fewer than 100 employees) to meet this requirement through a purchasing cooperative; requires a large employer (defined as having 100 or more employees) to meet this requirement only through offering experience-rated health plans. Provides for payroll withholding of any required employee premiums. (Sec. 1302) Allows small employer employees who are community- rated individuals to elect to enroll in any certified plan in the community rating area in which the employees work or live. (Sec. 1311) Allows a State to establish or charter purchasing cooperatives. Prohibits any individual or entity engaged in the sale of health insurance from forming or underwriting a purchasing cooperative (PC) or holding or controlling any right to vote regarding a PC. (Sec. 1313) Requires PCs to: (1) accept all small employers and individuals eligible for coverage in the community-rated market and residing in the area served by the cooperative; and (2) enter into agreements with at least three certified plans providing the benefits described in subtitle B, including at least one fee-for-service plan or point-of-service plan. Prohibits PCs from: (1) being involved in approval or enforcement of payment rates for providers; (2) being involved in the compliance of certified plans; or (3) assuming financial risk relating to a plan. (Sec. 1321) Requires certified association plans (APs), except as otherwise provided, to meet all requirements of this Act for certified plans offered by large employers. Requires, for APs meeting those requirements, treating: (1) the AP as a plan established and maintained by a large employer; and (2) individuals enrolled in the AP as experience-rated individuals. Requires an AP to cover at least 500 lives. Declares that the certifying authority for APs is: (1) the Secretary of Labor for a certified AP that is a multistate self- insured plan; (2) the State for a certified AP that is a single State self-insured plan. Applies risk adjustment provisions of this Act to APs. Mandates solvency standards for APs. (Sec. 1324) Repeals specified provisions of the Employee Retirement Income Security Act of 1974 (ERISA) relating to multiple employer welfare arrangements. (Sec. 1325) Requires church plans and multiemployer plans, except as otherwise provided, to meet all requirements of this Act for certified plans offered by large employers. Requires, for plans meeting those requirements, treating: (1) the plan as a plan established and maintained by a large employer; and (2) individuals enrolled in the plan as experience-rated individuals. Declares that the certifying authority for such plans is the Secretary of Labor. Sets forth risk adjustment and solvency requirements. (Sec. 1331) Requires any health plan participating under the Federal Employees Health Benefits Program to offer the plan to community-rated individuals and small employers in community rating areas served by the plan at a premium established in accordance with specified provisions of this Act. Subtitle E: Standards for Reform - Sets forth requirements regarding certified health plans. Requires a plan sponsor offering a community-rated plan to offer the plan to any community-rated individual and a plan sponsor offering an experience-rated plan to offer the plan to any experience-rated individual. Declares that a network plan may be made available only in a service area not identical to a community rating area if specified requirements are met. Mandates renewability, subject to exception. (Sec. 1413) Requires standard premiums within each community rating area to be the same for each plan. Requires the premium charged to be the product of the standard premium, an adjustment for the class of enrollment (individual, couple only, single parent, or dual parent), and an age adjustment factor. (Sec. 1414) Prohibits denial, limitation, or conditioning of coverage on any reason, including health status, except as provided in this Act. (Sec. 1416) Allows a plan to offer: (1) additional coverage only if offered and priced separately, if the purchase of the plan is not conditioned on purchase of additional coverage, and if the additional coverage is also offered to individuals not in the plan; and (2) a reduction in cost-sharing only to enrollees for a price that includes any use increase expected to result from the cost-sharing reduction. (Sec. 1417) Requires each community-rated plan to: (1) participate in a risk adjustment program; (2) meet financial solvency requirements; (3) provide information to the State; and (4) provide for quality improvement and quality assurance. Prohibits: (1) utilization management from creating financial incentives for reviewers to reduce or limit medically necessary or appropriate services; and (2) physician incentive plans unless in accordance with specified provisions of title XVIII (Medicare) of the Social Security Act. (Sec. 1421) Applies to each plan Medicare provisions relating to procedures to notify a patient of the patient's right to accept or refuse treatment and to execute an advance directive. Limits plan gatekeepers in complex or chronic health conditions so as to avoid undue enrollee burdens. Mandates procedures to protect confidentiality. Prohibits: (1) selective marketing; (2) patient lability for unpaid plan obligations; and (3) discrimination in selecting providers for a provider network based on the actual or anticipated health status of the provider's patients. Mandates: (1) physician participation in matters affecting patient care; and (2) patient ability to choose any primary care physician from among participating providers. (Sec. 1422) Requires certification of specified types of providers as essential community providers, including: (1) covered entities under provisions of the Public Health Service Act (PHSA); (2) Medicare-dependent small rural hospitals; (3) children's hospitals; (4) mental health and substance abuse providers receiving funds under specified provisions of the PHSA; (5) runaway homeless youth centers or homeless youth transitional living programs; (6) maternal and child health providers receiving funds under specified provisions of the Social Security Act; (7) rural health clinics; (8) school health services centers; and (9) nonprofit hospitals providing a specified percentage of services to individuals entitled to or eligible for benefits under Medicare or under title XIX (Medicaid) of the Social Security Act. Requires each plan, if such providers so elect, to have a written provider participation agreement with such providers or have an agreement to make payment to the provider. (Sec. 1423) Requires each plan to have in its network (or through other arrangements) a sufficient number, distribution, and variety of specialists to assure service availability to adults, infants, children, and persons with disabilities. Directs the Secretary of Health and Human Services to establish criteria for designating, and to designate, centers of specialized care. (Sec. 1424) Requires each plan to: (1) have the capacity, within its network or through arrangements with providers, to deliver the benefits required in subtitle B throughout the community rating area; and (2) provide emergency out-of-area and out-of-plan coverage for enrollees and urgent out-of-area coverage. (Sec. 1431) Specifies which certified health plan requirements apply to certified self-insured health plans. Applies certain fiduciary requirements of the Employee Retirement Income Security Act of 1974 (ERISA) to self-insured plans and imposes financial management and record keeping requirements. (Sec. 1441) Prohibits States from requiring: (1) the offering, as part of a certified plan, of any services different from the benefit categories of this Act; or (2) a right of conversion from a group certified plan to an individual certified plan. (Sec. 1442) Prohibits State limits, regulations, or prohibitions regarding: (1) incentives for certified plan enrollees to use participating providers; (2) limiting coverage to services provided by a participating provider; (3) rate and payment form negotiations; (4) limitations on the number of participating providers; (5) requiring that services be provided or authorized by a participating provider; (6) the corporate practice of medicine; (7) utilization management and review programs; (8) single-source suppliers; and (9) point-of-service options. (Sec. 1451) Sets forth plan standards for the interim period between January 1, 1996, and when the State becomes a participating State. Subtitle F: Federal Responsibilities - Directs the Secretary of Labor to develop and publish standards for certified self-insured plans and to provide for the certification of the plans. (Sec. 1502) Mandates procedures for corrective actions when a self-insured plan has failed to meet requirements. Provides for termination of self-insured plans. (Sec. 1503) Amends the Employee Retirement Income Security Act of 1974 (ERISA) to authorize special rules for the application of portions of ERISA to group health plans. (Sec. 1521) Requires sanctions and corrective action orders if a participating State fails to meet requirements of this Act. Allows the Secretary of Health and Human Services to carry out activities in the same manner as a participating State would. (Sec. 1522) Requires treating related employers as a single employer if a reason for their separation relates to their employees' health risk characteristics. (Sec. 1523) Mandates development of certification criteria for workplace wellness programs. (Sec. 1532) Repeals these provisions relating to collective bargaining dispute resolution on a specified date. Authorizes a health care entity or a labor organization certified or recognized as representing a health care entity's employees to request that the Director of the Federal Mediation and Conciliation Service appoint an impartial Health Care Board of Inquiry to investigate a collective bargaining dispute between the entity and the labor organization. Subtitle G: Miscellaneous Employer Requirements - Prohibits discrimination against employees on the basis of family status or class of family enrollment selected. (Sec. 1603) Makes it unlawful to take adverse action against an employee if a purpose of the action is to interfere with the employee's attainment of status as a qualifying employee, full time employee, or part-time employee, or if a purpose is to evade or avoid any obligation under this Act. (Sec. 1604) Allows a community-rated employer (and an experience- rated employer with respect to employees who are community-rated eligible individuals) to provide benefits to employees that consist of benefits in a cost-sharing policy only through a contribution toward the purchase of a cost-sharing policy that is funded primarily through insurance. Makes the responsibilities of individuals and employers in single payer States supersede their obligations under this subtitle. (Sec. 1605) Authorizes the Secretary of Labor to impose a civil money penalty for violations of this subtitle. Subtitle H: General Definitions; Miscellaneous Provisions - Sets forth definitions for purposes of this Act. (Sec. 1714) Amends the Davis-Bacon Act to modify the definitions of "wages" and related terms by adding references to this Act. Amends the Service Contract Act of 1965 to add references to this Act in provisions relating to required contract provisions. (Sec. 1715) Declares that it is the sense of the Committee on Labor and Human Resources of the Senate that, when this Act is enacted, it should include these sources of financing not within the jurisdiction of the Committee: (1) the net savings and revenues included in the Health Security Act; (2) a specified increase in the cigarette tax; (3) a phased-in premium assessment; (4) other savings or revenues as necessary to provide budget neutrality; and (5) a payroll assessment on exempt employers with specified numbers of workers. Title II: New Benefits - Subtitle A: Home and Community-Based Services - Sets forth requirements in order to approve a State plan for home and community-based services for individuals with disabilities, including: (1) State maintenance of effort (with a base amount set with regard to expenditures under title XIX (Medicaid) of the Social Security Act); (2) eligibility (including initial screenings, restrictions, and continuation of services during transition from Medicaid to the State plan); (3) types of providers and requirements for participation; (4) provider reimbursement; (5) State matching funds; and (6) health care worker redeployment. Mandates annual compliance monitoring. (Sec. 2103) Requires the State plan to specify the services available and any limitations on those services. Mandates a needs assessment, an individualized plan of care, care management services, coverage of personal assistance services. Sets forth a list of other services the plan may cover. Prohibits coverage of room and board or services in institutional settings. Declares that service recipients shall retain the right to independently select, terminate, and direct the work of a home care provider. (Sec. 2104) Prohibits cost-sharing for individuals with an income under a specified level. Mandates coinsurance and an annual deductible in graduated steps above that level. (Sec. 2105) Requires the plan to ensure and monitor service quality. Mandates State plan adherence to federal standards in: (1) case review; (2) mandatory reporting of abuse, neglect, and exploitation; (3) a registry of providers against whom complaints have been sustained; (4) sanctions on States or providers; (5) surveys of client satisfaction; and (6) State optional training programs for informal care givers. Requires client advocacy services. (Sec. 2106) Mandates a Federal advisory group and an advisory group in each State. (Sec. 2107) Sets forth formulas for payments to States. (Sec. 2108) Authorizes appropriations. Subtitle B: Life Care - Life Care Act - Amends the Public Health Service Act to create a new title establishing a voluntary insurance program for individuals 35 years old and over to cover nursing home stays. Covers the nursing facility services to inpatients of: (1) nursing care; (2) physical, occupational, or speech therapy; (3) medical social work; (4) drug, biological, supply, appliance, and equipment; (5) other services as necessary to the functioning of a patient, including personal care and assistance with activities of daily living; and (6) the portion of the first six months of room and board not covered by copayments. Limits the dollar amount of coverage to three levels electable by the individual. Mandates a report on the feasibility of making payments for services delivered in residential care facilities. Declares an individual eligible if the individual is a legal U.S. resident, needs hands-on or standby assistance, supervision, or cueing over at least 90 days, and has elected coverage. Makes individuals in a hospital or nursing home at the time of enrollment ineligible until their next spell of illness. Gives an individual the option to purchase coverage under this title when the individual is within six months of his or her 35th, 45th, 55th, or 65th birthday, with one premium rate for each of the periods between those birthdays or after the 65th birthday. Requires that covered services be provided by nursing homes certified by the State. Sets the monthly reimbursement at 80 percent of the amount reasonable and appropriate to cover costs. Mandates, to extent feasible, a prospective payment mechanism. Makes the benefit recipient responsible for specified percentages of room and board charges. Requires nursing facility services reimbursement, to the extent available, to be made under title XIX (Medicaid) of the Social Security Act, Department of Veterans Affairs' programs, or private insurance policies before reimbursement under this title. Directs the Secretary to contract with entities to act as Long- Term Care Screening Agencies for each designated area of the State to assess the eligibility of individuals for services under this title. Allows Screening Agencies to require payment from individuals only in accordance with standards set by the Secretary. Prohibits requiring payment from individuals with incomes below a specified level. Requires, notwithstanding any other law, that the assets an individual may retain and be eligible for nursing facility benefits under State Medicaid programs be increased by the amount of coverage elected under this title. Prohibits insurers from offering long-term care policies duplicating coverage provided under this title. Directs the Secretary to develop standard long-term care packages insurers may offer that complement this title. Subtitle C: Sense of the Committee with Regard to Prescription Drugs - Declares that it is the sense of the Committee on Labor and Human Resources of the Senate that, when this Act is enacted, it should include coverage of outpatient prescription drugs as included in the Health Security Act (as introduced in the 103d Congress) and providing for a deductible, coinsurance, and out-of-pocket limits not over specified amounts. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes in the Department of Health and Human Services the National Council on Graduate Medical Education. Repeals provisions of the Health Professions Education Extension Amendments of 1992 establishing the Council on Graduate Medical Education. (Sec. 3011) Allows payments to physician training programs in a medical specialty only if the program will ensure that the number of individuals enrolled in the program in the subsequent academic year is in accordance with these provisions. (Sec. 3012) Requires the National Council to designate, for each medical specialty for each academic year, starting with academic year 2001-2002, the number of individuals nationwide authorized to be enrolled in eligible programs, with at least 55 percent completing programs in primary care. Mandates interim voluntary targets set by the National Council. (Sec. 3013) Requires the National Council, for each academic year and each medical specialty, to make allocations among eligible programs of the number of positions for the year. (Sec. 3031) Mandates payments to qualified entities for the operational costs of an approved physician training program. Requires, in order to be qualified, that entities providing primary care training rotate enrollees to community programs in underserved areas. Specifies the amounts to be available for payments in certain calendar years under these provisions and under provisions relating to transitional payments to institutions. Declares that these amounts constitute the annual health professions workforce account. (Sec. 3041) Mandates payments to medical schools (to be administered as a grant) for the direct costs of academic programs, including the education of medical students, graduate students in biomedical sciences, and otherwise unfunded faculty research. Specifies the amounts to be available for payments in certain academic years. Declares that these amounts constitute the annual medical school fund account. (Sec. 3051) Mandates payments to academic health centers or teaching hospitals (to be administered as a contract, grant, or cooperative agreement) for costs not routinely incurred by other entities providing health services but are incurred by such institutions by virtue of their academic nature, including productivity decreased by teaching responsibilities, uncompensated costs of clinical research, and exceptional costs associated with treatment using the institution's specialized expertise. Specifies the amounts to be available for payments in certain calendar years. Declares that these amounts constitute the annual academic health center account. (Sec. 3061) Requires transitional payments to eligible entities losing specialty positions to assist operational costs. (Sec. 3071) Mandates a program regarding graduate nurse training programs (nurse program) equivalent to the program in previous provisions of this Act relating to physician training programs (physician program). Applies the physician program provisions of this Act to the nurse program provisions of this Act, including calling the council established the National Council on Graduate Nurse Education. (Sec. 3073) Specifies the amounts to be available for payments in certain calendar years. Declares that these amounts constitute the annual graduate nurse training account. (Sec. 3081) Sets forth transitional provisions, terminating them on a specified date and applying them only to health care entities employing more than 25 individuals. Requires hiring preference for displaced employees of those entities and provides for termination of preference eligibility. Requires successor health care entity employers to provide employees of the previous entity continued employment unless their positions no longer exist. Regulates collective bargaining matters during the transition period. Provides for enforcement of these transitional provisions. Subtitle B: Health Research Initiatives - Makes available specified percentages of the premiums required to be paid under this Act. Amends the Public Health Service Act (PHSA) to make those amounts available to: (1) the Office of the Director of the National Institutes of Health (NIH), to be used to carry out the responsibilities of the Office and for construction and acquisition of equipment or facilities; (2) the National Center for Research Resources to carry out provisions of the National Institutes of Health Revitalization Act of 1993 concerning biomedical and behavioral research facilities; (3) carry out PHSA provisions regarding health information communications; and (4) the NIH institutes. (Sec. 3102) Amends provisions of the PHSA to require the Agency for Health Care Policy and Research to conduct and support U.S. health care reform research. Authorizes appropriations. Subtitle C: Health Services for Medically Underserved Populations - Authorizes appropriations to carry out specified provisions of this subtitle. Declares that these authorizations are in addition to any others for the same purposes. (Sec. 3321) Authorizes grants and contracts for: (1) the development of community groups to provide benefits under subtitle B of title I of this Act in health professional shortage areas or to members of a medically underserved population; and (2) the expansion and development of health delivery sites and services. (Sec. 3322) Specifies permitted fund uses, including: (1) recruitment, compensation, and training of professional and administrative staff; (2) purchase and upgrading of equipment, supplies, and information systems; and (3) establishment of reserves for furnishing services on a prepaid or capitated basis. (Sec. 3341) Mandates grants and loans to eligible entities, essential access community hospitals, and rural primary care hospitals for the capital costs of developing community health groups and expanding or developing health delivery sites. (Sec. 3361) Authorizes grants and contracts with eligible entities to provide services to increase the capacity of individuals to use the benefits under title I (including transportation, outreach, patient and family education, translation services, case management, and home visiting) and to provide access to essential supplemental services that are not fully reimbursable under title I before a specified date. Authorizes appropriations in addition to any other authorizations. (Sec. 3371) Authorizes appropriations to carry out provisions of the Public Health Service Act (PHSA) relating to the National Health Service Corps and to carry out these provisions on nurse participation in PHSA scholarship and loan repayment programs. Requires reservation of sufficient funds to ensure that a specified percentage of the participants in those programs are being educated in specified nursing fields. (Sec. 3373) Requires reservation of sufficient funds to ensure that a specified percentage of the participants in those programs are being educated or are serving as psychiatrists, psychologists, and clinical social workers. (Sec. 3381) Directs the Secretary of Health and Human Services to make payments to eligible hospitals. Declares that this: (1) is an entitlement in the Secretary on behalf of the hospitals but not an entitlement in the State in which any hospital is located or in any individual receiving hospital services; and (2) constitutes budget authority in advance of appropriations and the obligation of the Government to provide funding in specified amounts for certain years. (Sec. 3382) Identifies as eligible those hospitals with low income use rates of at least a specified percentage. (Sec. 3383) Regulates the amount of payments. (Sec. 3391) Declares that it is the sense of the Senate Committee on Labor and Human Resources that this Act and later appropriations Acts should recognize the success of community and migrant health centers. Subtitle D: Assistance for State Managed Mental Health and Substance Abuse Programs - Mandates grants to States for the development and operation of comprehensive managed mental health and substance abuse programs integrated with the health delivery system established under this Act. Authorizes appropriations. Subtitle E: Comprehensive School Health Education; School- Related Health Services - Mandates grants to State educational agencies to integrate comprehensive school health education. Authorizes requirements waivers for the Prevention, Treatment, and Rehabilitation Model Projects for High Risk Youth, the State and Local Comprehensive School Health Programs to Prevent Important Health Problems and Improve Educational Outcomes, and programs carried out under certain provisions of the Drug-Free Schools and Communities Act of 1986. Authorizes appropriations. (Sec. 3503) Establishes the Healthy Students-Healthy Schools Interagency Task Force. (Sec. 3504) Directs the Secretary of Health and Human Services to establish and maintain a national clearinghouse and mechanisms for the dissemination of school health education material. (Sec. 3581) Authorizes appropriations for: (1) planning and development grants to local community partnerships (LCPs), both directly and through State health agencies; and (2) operational grants to LCPs, both directly and through States. Requires that LCPs include at least one local health care provider, one local educational agency on behalf of one or more public schools, and one community-based organization. Authorizes the Secretary to make the grants to develop and operate school-based or school-linked health service sites. Limits the Federal share of operational grants. Subtitle F: Public Health Service Initiative - Directs the Secretary of Health and Human Services to pay, under specified provisions of this Act, certain amounts for: (1) health services research activities; (2) the development of community groups to provide benefits in health professional shortage areas or to members of a medically underserved population and the expansion and development of health delivery sites and services; (3) the capital costs of developing community health groups; (4) increasing the capacity of individuals to use benefits; (5) providing access to essential supplemental services not fully reimbursable before a specified date; (6) the National Health Service Corps; (7) comprehensive managed mental health and substance abuse programs; and (8) school-based or school-linked health service sites. Title IV: Medical Malpractice - Subtitle A: Liability Reform - Applies this subtitle to any medical malpractice liability action in State or Federal court except for actions under title XXI (Vaccines) of the Public Health Service Act. (Sec. 4002) Requires parties, before or after beginning a medical malpractice action, to participate in the alternative dispute resolution system (ADR) administered by the State. Requires each State to adopt at least one ADR satisfying specified requirements. (Sec. 4003) Limits attorneys contingent fees. (Sec. 4004) Reduces damages for collateral source recovery. (Sec. 4005) Allows a party to ask the court to award future damages on a periodic basis. Subtitle B: Other Provisions Relating to Medical Malpractice Liability - Mandates grants to States for malpractice reform demonstration projects assessing the fairness and effectiveness of one or more of no-fault liability, enterprise liability, or practice guidelines. Authorizes appropriations. Title V: Fall-Back Premium Limits in Cases of Ineffective Competition; Premium-Based Financing; Assistance to Low Income Individuals and to Businesses - Subtitle A: Fall-Back Premium Limits - Directs the Secretary of Health and Human Services to: (1) compute and publish annually an area inflation factor for each community rating area; (2) determine baseline premium amounts; and (3) annually determine baseline premiums for each community rating area. (Sec. 5004) Regulates the process for community-rated plan's submitting premium rate bids to States and premium bids to cooperatives. Conditions community and cooperative bids on the plan s agreement to accept any payment reduction that may be imposed under these provisions. (Sec. 5005) Allows any State to assume responsibility for containment of health care expenditures. (Sec. 5011) Directs the Secretary to develop and use a method to reduce payments to each noncomplying plan in a noncomplying community rating area. Defines "noncomplying community rating area" as one in which the weighted average accepted bid exceeds the community rating area baseline premium. Defines "noncomplying plan" as a plan in a noncomplying area if the premium rate exceeds the baseline premiums. (Sec. 5012) Requires community-rated plans to include in their contracts with providers a provision reducing provider payments if the plan is noncomplying. (Sec. 5021) Directs the Secretary to develop a method for calculating an annual per capita expenditure equivalent for amounts paid for benefit package coverage by a large employer. (Sec. 5022) Directs the Secretary of Labor to take corrective action if a large employer has two years in which the rate of increase exceeds the national corporate inflation factor. Requires considering the large employer a small employer and requiring it to make premium payments in accordance with specified provisions of this Act. (Sec. 5031) Directs the Secretary of Health and Human Services, for a statewide single-payer State, to compute a statewide per capita premium target in the same manner as the community rating area per capita premium target. Subtitle B: Premium-Related Financings - Makes each family enrolled in a community- or experience-rated plan responsible for payment of the family share of premium. Allows payment of the premium by an employer or another person. (Sec. 5102) Provides for family credits for community- and experience-rated plans. (Sec. 5103) Provides for a premium discount for families that: (1) are AFDC families or SSI; (2) have a family income below a certain level; or (3) have a family obligation that would otherwise exceed specified percentages of family income. (Sec. 5110) Makes families that are provided a family credit liable for repayment of the base employment monthly premium. Reduces that amount by the amount of: (1) any employer payments made based on the net earnings from self-employment; and (2) employer premiums payable. (Sec. 5112) Limits repayment liability for low income families. (Sec. 5113) Regulates the net liability of families with one or more nonqualifying employees and no full-time qualifying employees. (Sec. 5114) Provides for special treatment for certain individuals eligible for Medicare. (Sec. 5116) Exempts small employers (no more than 10 employees and average annual wages under a specified amount) from these requirements on employer premium payments. (Sec. 5118) Allows an exempt employer to elect to be treated as a community-rated employer. Requires treating an exempt employer as a community-rated employer after an election and makes the employer eligible for discounts. (Sec. 5120) Applies Medicare rules relating to Medicare as a second payer to individuals eligible for premium assistance under this title in relation to any non-electing employer. (Sec. 5121) Requires community-rated employers to pay at least a specified amount of the premium payment for each qualifying employee. (Sec. 5122) Requires each State to provide for the annual computation of a base employment premium for each class of family enrollment. (Sec. 5123) Limits the amount of the employer s required premium payment to a specified percentage of the qualifying employee s wages, with different levels for medium employers (eleven to 75 employees) and small employers. Provides for the treatment of certain self- employed individuals. Requires, for employers that make premium payments in more than one community rating area, application of the reduction in a pro-rated manner to the payments in all areas. (Sec. 5124) Adjusts employee payments of large employers if certain average costs and rate increases exceed limits. (Sec. 5125) Considers a self-employed individual to be an employer of himself or herself and to pay wages to himself or herself equal to the amount of net earnings from self-employment. Limits the payment obligation of certain individuals to a specified amount. (Sec. 5131) Requires each experience-rated large employer to contribute to premiums in specified amounts. Increases the share of large employers for low income employees entitled to a premium discount. Subtitle C: Payments to Health Plans and Miscellaneous Provisions - Makes States responsible for assisting plans and cooperatives in premium collection. (Sec. 5202) Makes the payment amount for a community-rated plan equal to a blended payment amount reflecting the final bid for each plan, the number of enrollees in each class, and the proportion of AFDC and SSI beneficiaries in the area. (Sec. 5203) Requires States to develop and implement adjustments (including risk adjustment, reinsurance, premium discounts, and adjustments to reflect AFDC and SSI beneficiaries) necessary to reconcile the amounts collected by plans with the amounts owed to the plans. (Sec. 5204) Requires each State to compute and publish specified components of the general family share of premiums and the general employer premium payment amount. (Sec. 5205) Declares that the obligations of an employer regarding employees that reside in a single-payer State supersede the obligations of an employer to provide for payments under specified provisions of this Act. (Sec. 5207) Requires, if an employer makes available a voluntary payment on behalf of an employee in a community- or experience-rated plan and except as provided under collective bargaining agreements, that the employer make such a voluntary payment in the same dollar amount available to all qualifying employees of the employer in any community- or experience-rated plan in the same class of enrollment and the same area. Prohibits employers from discriminating in the terms or conditions of employment based on the health plan (or the premium of a plan) in which an employee is enrolled. (Sec. 5208) Requires employers to deduct from the wages of qualifying employees the amount of the family share of the premium. Mandates that States require payment for families that do not include a qualifying employee to be made prospectively. Subtitle D: Cost-Sharing Assistance, Application for Assistance and Premium Discounts, and Income Reconciliation - Entitles AFDC, SSI, and low income families to a reduction in cost-sharing, unless: (1) for community-rated families, there are sufficient at- or below- average cost plans with cost-sharing similar to the model certified preferred provider network plans or model certified health maintenance organization plans established under this Act; or (2) for experience- rated families, the employer offers such a plan. (Sec. 5302) Allows a family to apply for a determination of the family adjusted income or wage adjusted income of the family to establish eligibility for cost-sharing reductions, premium discounts, and reductions in liability. Makes each individual who knowingly understates income or otherwise makes a material misrepresentation liable to the State for triple the excess payments and interest. (Sec. 5303) Requires families with premium discounts or reductions in liability to file an income reconciliation statement for the year. Mandates related payment adjustments. (Sec. 5304) Requires States to make eligibility determinations for premium discounts, liability reductions, and cost-sharing reductions in a way that keeps error rates below a level specified by the Secretary of Health and Human Services or the Secretary of Labor. Title VI: Aggregate Government Payments - Subtitle A: Aggregate Federal Payments to Participating State - Directs the Secretary of Health and Human Services to provide for payments to each participating State of the capped Federal payment amount. Declares that this constitutes budget authority in advance of appropriations Acts and represents the obligation of the Government to provide for the payments. Sets forth a formula for determination of amounts, including determination of caps. Provides for the handling of anticipated shortfalls. Subtitle B: Borrowing Authority to Cover Cash-Flow Shortfalls - Authorizes the Secretary of Health and Human Services to make loans available to States to cover temporary cash-flow shortfalls. (Sec. 6102) Provides for the use of funds resulting from estimation discrepancies. Subtitle C: Miscellaneous Provisions - Declares that it is the sense of the Committee on Labor and Human Resources that, when this Act is enacted, it should include requirements that States: (1) pay premiums for AFDC and SSI recipients at a level established as described in the Health Security Act; and (2) make maintenance of effort payments to be included in the amounts receivable under certain provisions at a level established as described in the Health Security Act.
United States · United States Congress · 4 January 1995
TABLE OF CONTENTS: Title I: Health Insurance Market Reform Subtitle A: Insurance Market Standards Subtitle B: Establishment and Application of Standards Subtitle C: Health Care Cost and Access Advisory Commission Subtitle D: Definitions Title II: Improving Access to Health Care Coverage Subtitle A: Coverage Under Qualified Health Plans and Premium Assistance Subtitle B: Self-Employed Health Insurance Deduction Title III: Improving Access in Rural Areas Subtitle A: Offfice of Rural Health Policy Subtitle B: Development of Telemedicine in Rural Underserved Areas Subtitle C: Rural Health Plan Demonstration Projects Subtitle D: Antitrust Safe Harbors for Rural Health Providers Title IV: Quality and Consumer Protection Subtitle A: Administrative Simplification Subtitle B: Privacy of Health Information Subtitle C: Enhanced Penalties for Health Care Fraud Subtitle D: Health Care Malpractice Reform Title V: Budget Neutrality Family Health Insurance Protection Act - Title I: Health Insurance Market Reform - Subtitle A: Insurance Market Standards - Prohibits a health plan, with specified exceptions, from denying, limiting, or conditioning its coverage (or benefits), or varying its premium, for an individual based on the health status, medical condition, claims experience, receipt of health care, medical history, anticipated need for health care services, disability, or lack of evidence of insurability. (Sec. 1002) Requires each health plan that offers coverage in the small group market or large employer market to guarantee enrollment in and renewal of (at the option of the individual or employer) such plan to each individual purchaser and employer. (Sec. 1003) Requires a health plan offering coverage in the small group market to comply with certain rating (premium rates) standards to be developed by the National Association of Insurance Commissioners (NAIC). (Sec. 1004) Requires the Secretary of Health and Human Services to establish minimum guidelines for the issuance by each State of delivery system quality standards. Sets forth such guidelines, including: (1) establishing health plan quality assurance; (2) providing consumer protection for health plan enrollees; and (3) ensuring reasonable access for vulnerable populations in underserved areas. (Sec. 1005) Requires a sponsor of a health plan to offer a benchmark benefits package which covers specified health care items and services and provides for a cost-sharing schedule. Authorizes a sponsor to offer any other health benefits package. (Sec. 1006) Requires each health plan offering coverage in the small group market in a State to participate in a risk adjustment program. Subtitle B: Establishment and Application of Standards - Prohibits any requirement or standard imposed on a health plan under this Act from preempting any State consumer protection laws unless such laws conflict with such requirement or standard. (Sec. 1012) Declares that nothing in this Act shall be construed as prohibiting States from enacting health care reform measures that exceed the measures established under this Act, including reforms that expand access to health care services, control health care costs, and enhance quality of care. (Sec. 1013) Requires the Secretary to make grants to States that submit applications that meet certain requirements for the establishment and operation of small group health insurance purchasing arrangements. Requires the Secretary in awarding such grants to consider the potential impact of the State's proposal on the cost of health insurance for the small group market and on the number of uninsured, and the need for regional variation in the award of such grants. Authorizes the use of grant funds to finance administrative costs associated with developing such arrangements. Authorizes appropriations. (Sec. 1014) Directs States to require that each health plan issued, sold, offered for sale, or operated in such State meets the insurance reform standards established under this title pursuant to an enforcement plan filed by it with, and approved by, the Secretary. Subtitle C: Health Care Cost and Access Advisory Commission - Establishes the Health Care Cost and Advisory Commission to monitor and respond to trends in national health care spending and health insurance coverage. Requires the Commission to report annually to the Congress and the President on the status of health care spending and health insurance coverage in the nation. Sec. 1023) Authorizes appropriations. Subtitle D: Definitions - Sets forth definitions. Title II: Improving Access to Health Care Coverage - Subtitle A: Coverage Under Qualified Health Plans and Premium Assistance - Part 1: Access to Qualified Health Plans - Requires States, in order to qualify for certain Federal payments, to establish a program under which a State: (1) makes available at least one qualifed health plan to each premium subsidy eligible individual residing there; and (2) furnishes premium assistance to such individual. (Sec. 2002) Requires the Secretary to issue regulations specifying requirements for State programs with respect to determining eligibility for premium assistance, including measures to prevent individuals from knowingly making material misrepresentations of information or providing false information in applications for assistance under the program. Requires a premium subsidy eligible individual who receives premium assistance to use such assistance only for payments toward the premium under a qualified State health plan. (Sec. 2011) Sets forth a formula for: (1) the amount of premium assistance for a month that a premium subsidy eligible individual shall receive; and (2) the maximum subsidy amount for a State. (Sec. 2012) Sets forth eligibility requirements for children and temporarily unemployed individuals to receive premium assistance. Part 2: Aggregate Federal Payments - Sets forth a formula for determining the amount of Federal payments to States for the payment of premium assistance under a qualified State health plan. Part 3: Definitions and Determinations of Income - Sets forth definitions. Subtitle B: Self-Employed Health Insurance Deduction - Amends the Internal Revenue Code to increase the deduction for health insurance costs of self-employed individuals from 25 percent through 1996 to 50 percent in 1997 to 75 percent in 1998 and to 100 percent in 1999 and thereafter. Title III: Improving Access in Rural Areas - Subtitle A: Office of Rural Health Policy - Amends the Social Security Act (SSA) to mandate that the Office of Rural Health Policy of the Department of Health and Human Services (HHS) be headed by an Assistant Secretary for Rural Health, who shall report directly to the Secretary. Adds as one of the duties of the Assistant Secretary that he or she advise the Secretary on reforms to the health care system and their implications for rural areas. Transfers the functions, powers, duties, and authority of the Office of Rural Health Policy to the Office of the Assistant Secretary for Rural Health. Subtitle B: Development of Telemedicine in Rural Underserved Areas - Directs the Secretary to award grants to eligible entities to expand access to health care services for individuals in rural areas through the use of telemedicine. (Sec. 3102) Directs the White House Information Infrastructure Task Force to report to the Congress an evaluation of the cost effectiveness of telemedicine, including recommendations for a coordinated Federal strategy to increase access to health care through telemedicine. (Sec. 3103) Directs the Secretary to issue regulations regarding reimbursement for telemedicine services provided under title XVIII (Medicare) of the SSA. (Sec. 3104) Authorizes appropriations. Subtitle C: Rural Health Plan Demonstration Projects - Directs the Secretary to establish not more than three demonstration projects for the designation of rural health plan areas. Subtitle D: Antitrust Safe Harbors for Rural Health Providers - Directs the Attorney General to establish, and publish in the Federal Register, policy guidelines to assist rural health care providers in complying with safe harbor requirements with respect to the provision of health care services in rural areas. Title IV: Quality and Consumer Protection - Subtitle A: Administrative Simplification - Part 1: Purpose and Definitions - Establishes a national framework for health information whose goal, through standardization of data elements, code sets, and electronic transactions, and by assuring a secure environment for the transmission and exchange of health information, is to reduce the burden of administrative complexity, paper work, and cost on the health care system, including Medicare under title XVIII and Medicaid under title XIX the SSA. Part 2: Standards for Data Elements and Information Transactions - Directs the Secretary to adopt standards for health information transactions and data elements. (Sec. 4012) Directs the Secretary to promulgate regulations specifying procedures for the electronic transmission and authentication of signatures on medical records and prescriptions. Part 3: Requirements with Respect to Certain Transactions and Information - Sets forth specified requirements with respect to certain transactions conducted by a health plan or health care provider. Part 4: Accessing Health Information - Requires the Secretary to adopt technical standards for persons to locate and access health information that is available through the health information network. Part 5: Penalties - Sets forth penalties for violations committed under this subtitle. Part 6: Miscellaneous Provisions - Mandates that any provision, requirement, or standard under this subtitle supercede any contrary provision of State law (except State provisions governing the reporting of disease or injury, child abuse, birth, or death, public serveillance, or public health investigation or intervention). (Sec. 4052) Authorizes appropriations. Subtitle B: Privacy of Health Information - Part 1: Defintions - Set forth definitions. Part 2: Authorized Disclosures - Subpart A: General Provisions - Sets forth requirements for the disclosure of protected health information by a health information trustee, or by a health care provider and person receiving such information, including a health information protection organization. Subpart B: Specific Disclosures Relating to Patient - Authorizes a health care provider, health plan, employer, or person who receives protected health information to disclose it to a health care provider for the purpose of providing health care (including emergency situations) to, or providing for the payment of such care for, an individual. Subpart C: Disclosure for Oversight, Public Health, and Research Purposes - Authorizes a health information trustee to disclose protected health information to a health oversight agency or to a health researcher. (Sec. 4117) Authorizes a health care provider, health plan, public health authority, employer, or person who receives protected health information to disclose it to a public health authority or other person authorized by law for use in: (1) disease or injury reporting; (2) public health surveillance; or (3) public health investigation or intervention. Subpart D: Disclosure for Judicial, Administrative, and Law Enforcement Purposes - Authorizes a health care provider, health plan, health oversight agency, employer, or person who receives protected health information to disclose it, (subject to a court's rules of procedure): (1) in connection with litigation where an individual's physical or mental condition is at issue; (2) in response to a court- ordered physical or mental examination; or (3) pursuant to a law requiring the reporting of specific medical information to law enforcement authorities. (Sec. 4122) Authorizes such entities or persons to disclose such information to law enforcement agencies. Subpart E: Disclosure Pursuant to Government Subpoena or Warrant - Authorizes a health care provider, health plan, health oversight agency, employer, or person who receives protected health information to disclose it pursuant to an administrative or judicial subpoena or warrant. Subpart F: Disclosure Pursuant to Party Subpoena - Authorizes a health care provider, health plan, employer, or person who receives protected health information to disclose it pursuant to a party subpoena. Part 3: Procedures for Ensuring Security of Protected Health Information - Subpart A: Establishment of Safeguards - Directs a health information trustee to establish administrative, technical, and physical safeguards to ensure the confidentiality of protected health information created or received by such trustee. Subpart B: Review of Protected Health Information By Subjects of the Information - Requires a health care provider or health plan to allow an individual who is the subject of protected health information to inspect any such information, with specified exceptions, that the provider or plan maintains. (Sec. 4142) Requires a health care provider or health plan, upon the written request of the subject individual, to correct or amend his or her protected health information. (Sec. 4143) Requires a health care provider or health plan to provide written notice of its information practices, including notice of individual rights with respect to protected health information. Part 4: Sanctions - Subpart A: Civil Sanctions - Sets forth civil penalties for violations of this subtitle. (Sec. 4152) Authorizes an individual who is aggrieved by the negligent conduct of a health information trustee to bring a civil action in court. Subpart B: Criminal Sanctions - Subjects to civil and criminal penalties any person who, in violation of this subtitle, knowingly: (1) obtains protected health information relating to an individual; or (2) discloses such information to another person. Part 5: Administrative Provisions - Sets forth provisions regarding: (1) preemption of State law with respect to the disclosure of protected health information; and (2) the rights of incompetents with respect to such information. Subtitle C: Enhanced Penalties for Health Care Fraud - Directs the Secretary to establish a program to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of and payment for health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for such health care; (3) facilitate the enforcement of specified sections of the SSA and other applicable statutes with respect to health care fraud and abuse; and (4) provide for the modification and establishment of safe harbors, and to issue interpretative rulings and special fraud alerts. (Sec. 4201) Establishes a Health Care Fraud and Abuse Control Account which shall comprise all criminal and administrative fines imposed in cases involving a Federal health care offense. (Sec. 4202) Amends SSA title XI to provide for the application of sanctions under the Medicare and Medicaid Fraud and abuse programs for all fraud and abuse against any health plan. Subjects any person (including any organization, agency, or other entity, but excluding a beneficiary) who violates a provision of this section to a civil monetary penalty. (Sec. 4203) Directs the Secretary to establish a national health care fraud and abuse data collection program for the reporting of final adverse actions (not including settlements in which no findings of liability have been made) against health care providers, suppliers, or practitioners. (Sec. 4204) Amends Federal criminal law to subject to civil and criminal penalties any person who knowingly executes, or attempts to execute, a scheme to: (1) defraud any health plan or other person, in connection with the delivery of or payment for health care benefits or services; or (2) obtain, by false pretenses, any money or property owned by, or under the control of, any health plan, or person in connection with the delivery of or payment for such health care or services. Subtitle D: Health Care Malpractice Reform - Declares that these provisions apply to any health care liability action (except damages for vaccine-related injury or death) brought in any Federal or State court. (Sec. 4302) Requires each State to adopt an alternative dispute resolution method for the resolution of health care malpractice claims and consumer grievances. (Sec. 4303) Limits attorney contingency fees and award amounts for noneconomic damages. (Sec. 4304) Authorizes a party to a medical malpractice liability action to petition the court to instruct the trier of fact to award any future damages on an appropriate periodic basis. (Sec. 4305) Requires 50 percent of any punitive damages awarded in a medical liability action to be paid to the State in which such action is brought to carry out: (1) licensing or cretifying health care professionals and providers; (2) implementing health care quality assurance and improvement programs; (3) reducing malpractice-related costs for providers volunteering to provide services in medically underserved sreas; and (4) providing resources for additional investigation and disciplinary activites. Title V: Budget Neutrality - Prohibits any provision of this Act from taking effect until legislation is enacted which provides for its Federal budget neutrality.
United States · United States Congress · 4 January 1995
Amends the Public Health Service Act to authorize the Secretary of Health and Human Services to carry out projects to reduce the incidence of traumatic brain injury through grants or contracts to public or nonprofit entities. Authorizes the following activities: (1) the conduct of research into identifying effective strategies for the prevention of traumatic brain injury; and (2) the implementation of public information and education programs for the prevention of such injury and for broadening the awareness of the public concerning the public health consequences of such injury. (Sec. 2) Requires the National Institutes of Health research program on trauma to include the authority to award grants or contracts to public or nonprofit entities for the conduct of basic and applied research regarding traumatic brain injury. (Sec. 3) Authorizes the Secretary to make grants to States for the purpose of carrying out demonstration projects to improve access to health and other services regarding traumatic brain injury. Permits the Secretary to make a grant only if the State agrees to establish an advisory board within the appropriate health department or another department of the State. Authorizes appropriations. (Sec. 4) Directs the Secretary to conduct: (1) a study concerning traumatic brain injuries; and (2) a national consensus conference on managing traumatic brain injury and related rehabilitation concerns. Authorizes appropriations.
United States · United States Congress · 4 January 1995
Firefighters Pay Fairness Act of 1995 - Amends Federal law to extend existing biweekly pay period and pay computation requirements to Federal fire fighters. Repeals the current exception from such requirements for employees on the Isthmus of Panama in the service of the Panama Canal Commission. States that, for fire fighters, the annual rate of basic pay shall be calculated on the basis of 26 administrative biweekly work periods of up to 106 hours each. Prescribes a formula for computing the basic biweekly pay of Federal employees who are not fire fighters but perform fire fighting duties. Requires compensation at time-and-a-half per hour for any hours worked in excess of 106 during a biweekly pay period by fire fighters subject to the Fair Labor Standards Act of 1938. Specifies limits on the payment of other premium pay to such fire fighters. Prescribes basic rates of pay for fire fighters: (1) promoted to a supervisory position; and (2) selected and assigned for training. Authorizes a Federal agency to pay cash awards of up to five percent of basic pay to fire fighters or other employees performing fire fighting duties who possess and make substantial use of special skills or certifications, including handling hazardous materials or certification as an emergency medical technician.
United States · United States Congress · 4 January 1995
TABLE OF CONTENTS: Title I: Job Training Account System Title II: Elimination of Federal Job Training Programs Title III: Information for Better Choices Title IV: Reports and Plans Working Americans Opportunity Act - Title I: Job Training Account System - Directs the Secretaries of Labor and of Education to establish a job training account system that provides vouchers to individuals for job training and employment related services. (Sec. 102) Allows an individual to: (1) receive such a voucher of $3,000 for two years beginning on the date of application approval; and (2) use such voucher to purchase authorized job training or employment-related services. (Sec. 103) Makes individuals eligible for such vouchers if they are dislocated workers or economically disadvantaged adults. (Sec. 104) Requires each State to establish or designate easily accessible voucher application offices to assist in administering the training account system. Allows such offices to be administered by private for-profit or nonprofit or public entities. Requires such offices to provide: (1) performance-based information on service providers; and (2) information on local economy,employment, industries, and labor market demand. Requires conflict of interest standards for such offices that are concurrently eligible service providers. Expresses the sense of the Congress that, as States become more experienced in such voucher administration, such offices should be converted to one-stop assistance centers. (Sec. 105) Requires the Secretaries to issue oversight and accountability regulations relating to such vouchers. (Secs. 106 and 107) Sets forth eligibility requirements for providers of job training or employment-related services, including requirements for submission of performance-based information. (Sec. 108) Directs the Secretaries to evaluate annually the training account system and the one-stop assistance centers under title III, and report to the appropriate congressional committees. (Sec. 109) Provides for apportionment of system funds to States based on relative numbers of: (1) unemployed individuals; (2) excess unemployed individuals; (3) individuals who have been unemployed for 15 weeks or more; and (4) economically disadvantaged adults. Requires at least 75 percent of such funds to be made available as vouchers; but waives this requirement if a State provides non-voucher job training and employment-related services which the Secretary of Labor considers more beneficial in meeting the self-determined training needs of individuals. Requires the remaining balance of such funds to be used for certain authorized employment-related services provided through means other than voucher. Directs the Secretaries to determine the equitable distribution of such voucher and non-voucher assistance between dislocated workers and economically disadvantaged adults. Title II: Elimination of Federal Job Training Programs - Expresses the sense of the Congress that the elimination and streamlining of Federal job training programs should not reduce Federal commitment and effort to improve education, employment, and earnings of all workers and jobseekers, particularly those in hard-to- serve communities. Repeals specified employment training program provisions under the Job Training Partnership Act, Food Stamp Act of 1977, Stewart B. McKinney Homeless Assistance Act, Displaced Homemakers Self- Sufficiency Assistance Act, Airline Deregulation Act of 1978, and other specified Federal law relating to certain workers affected by an expansion of Redwood National Park in California. (Sec. 202) Authorizes appropriations. Title III: Information for Better Choices - Allows a State to use funds for non-voucher employment services under this Act to make arrangements with private or public entities to establish assistance centers to provide employment and training information and employment- related services to voucher recipients, job seekers, employers, and workers. Allows such an assistance center to serve as a voucher assistance application location, which may be within an existing unemployment office. (Sec. 302) Authorizes the Secretaries to make arrangements with public or private entities to develop and provide relevant regional labor market information to interested individuals. (Sec. 303) Directs the Department of Education to try to make known the value and availability of direct loans through the Federal Direct Student Loan Program under the Higher Education Act of 1965, through cooperative arrangements with training and educational training programs, assistance centers, State agencies, and other Federal agencies. Title IV: Reports and Plans - Directs the Secretaries to report annually to the Congress on how additional Federal job training programs not covered by this Act can be consolidated into a more integrated, accountable, and effective workforce development system. Directs the Secretaries to develop a plan that, wherever practicable, requires all Federal job training programs not covered by this Act to use common definitions, outcome measures, eligibility standards, and funding cycles. (Sec. 402) Directs the Secretary of Labor to report to the Congress on the need for income support, and options for providing it, to enable dislocated workers and economically disadvantaged adults to participate in long-term job training.
United States · United States Congress · 6 October 1994
TABLE OF CONTENTS: Title I: Federal Responsibilities Title II: State Responsibilities Title III: Local Responsibilities Title IV: Consolidation Title V: Integrated Labor Market Information System Job Training Consolidation and Reform Act - Consolidates and revises Federal job training programs to create a workforce development system. (Sec. 3) Authorizes appropriations. Title I: Federal Responsibilities - Establishes the National Workforce Development Board (the Board). (Sec. 101) Amends the Job Training Partnership Act (JTPA) to repeal the establishment of the National Commission for Employment Policy. Replaces references to such Commission with references to the Board. Requires the Board to issue a biennial National Workforce Strategic Plan (Federal Blueprint). Directs the Board also to: (1) provide congressional testimony; (2) make recommendations on measures (including tax code changes) to encourage employers and workers to invest in training and skills upgrading and employers to hire and train hard-to-serve individuals; (3) review implementation and incentive grant proposals; (4) coordinate with the National Skill Standards Board; and (5) make final recommendations in the form of a joint resolution to the President and the Congress. (Sec. 102) Requires the Board to prepare an annual report to be known as the Nation's Workforce Development Report Card (National Report Card) which shall assess the U.S. workforce development system performance and evaluate all workforce development programs that receive Federal funding. (Sec. 103) Authorizes the Secretary of Labor to make grants to applicant States to: (1) develop strategic plans for development of comprehensive statewide integrated workforce development systems; and (2) if they are leading edge States, implement such systems. Directs the Secretary to use specified information clearinghouses and other entities to: (1) collect and disseminate information to help States and localities to streamline and reform their job training systems; and (2) facilitate exchange of information and ideas among States and localities carrying out job training reform initiatives. Requires the Board to determine whether any proposed Federal job training legislation complies with data reporting, common definitions, and common funding cycles provisions under this Act. Makes it out of order for the Senate or House of Representatives to consider any bill or resolution concerning workforce development that would not comply with the national workforce development system, as determined by the Board. Requires a three-fifths affirmative vote to waive or suspend such requirement in the Senate or House. (Sec. 104) Directs the President to establish an expedited process to consider and act on requests by States for waivers of laws and regulations for specified programs for: (1) two years to facilitate provision of assistance for workforce development, for States not receiving implementation grants; or (2) the duration of the implementation grant, for States receiving such grants. (Sec. 105) Establishes a quality assurance system. Directs the Secretaries of Labor, of Education, and of Health and Human Services to jointly develop common terms and definitions and a placement accountability system and adjust existing program performance standards. Directs the Board to recommend a system of performance standards in its joint resolution to the Congress that includes standard outcome measures relating to employment, job retention, earnings, and nonemployment outcome measures (such as learning and competency gains). Requires each workforce development program that receives Federal funds to collect, and report to the Governor and State Council, specified information relating to each participant's: (1) quarterly employment status and earnings for one year after no longer receiving program assistance; (2) economic and demographic characteristics; (3) services received and spending for them; (4) program outcomes; and (5) other data that may be added as the Board develops other standard definitions. Requires that program monitoring under these provisions supplant existing monitoring and reporting requirements for program participants. Directs each Federal department and agency with responsibility for a workforce development program to report to the Board on its progress in adopting common terms and definitions for program participants, service activities, and outcomes by program operators and grant recipients. Requires each workforce development program receiving Federal funds to use the common terms and definitions. Directs the Board to make recommendations to: (1) the Secretaries and heads of other agencies operating workforce development programs, on common definitions for other terms; and (2) the Congress, on legislative action if any of the proposed common definitions require amendment to existing laws. Establishes a placement accountability system for all federally funded workforce development programs. Requires each such program to: (1) monitor its own performance by measuring quarterly employment status and earnings of each participant for one year after he or she no longer receives program assistance; and (2) provide required information on participants, to be matched by information from the State agency for labor market information which shall be reimbursed by the requesting program with Federal funds. Directs the State agency to submit the results of the matching to the State Council. Requires the Governor to ensure submission of matched data to the State Council, the Board, the Secretary (of Labor), and other Federal entities. Requires that such program quality assurance information be made available to the State Council, local workforce development boards in the State, and consumers of labor market information. Requires all federally funded workforce development programs to be funded on a consistent funding cycle basis. Directs the Board to make recommendations to the Congress on the appropriate funding cycle. Title II: State Responsibilities - Requires each State desiring to participate in development of an integrated and accountable workforce development system to: (1) establish a State Workforce Development Council (State Council); or (2) have an existing entity similar to a State Council that includes representatives of employers and workers. Directs each State Council to: (1) serve as principal advisory board to the Governor for all programs in the State's integrated workforce development system; and (2) assume the functions and responsibilities of councils and commissions required under Federal law that are part of such system. (Sec. 204) Directs the State Council to assist the Governor in: (1) preparing a biennial State Workforce Development Policy Blueprint and an annual State Workforce Development Report Card; and (2) certifying each local workforce development board, as well as recommending criteria to judge such local boards' effectiveness. (Sec. 205) Requires the State Council to develop a quality assurance system to complement and expand upon the one established under title I, in order to provide customers of job training services with consumer reprts on the supply, demand, price, and quality of job training services in each unified service delivery area in the State. Directs each State to select tools and measures appropriate to its needs, including: (1) collecting and organizing service provider performance data; and (2) conducting surveys to ascertain customer satisfaction. Directs the State Council, with the local workforce development boards, to establish mechanisms for collecting and disseminating the quality assurance information to individuals seeking employment, employers, Federal, State, and local policymakers, and training and education providers. Requires each public and private education, training, and career development service provider receiving Federal funds under a program in a State integrated system to collect and provide the quality assurance information. (Sec. 206) Sets forth State Council authorities, including funding and operating special projects for research or improvement of system performance. (Sec. 207) Directs State Councils to make recommendations to Governors for establishment of unified service delivery areas (SDAs). Requires States receiving implementation grants to establish unified SDAs to provide community-wide workforce development assistance in one-stop career centers. Requires consideration of existing labor market areas, local governments, and SDAs under JTPA, as well as distance traveled by individuals to receive services. Allows merger of existing SDAs. Prohibits approval of a total number of such unified SDAs greater than that of the existing SDAs in the State. (Sec. 208) Requires each State to use a portion of its development grant to design a unified financial and management information system. Directs each State receiving an implementation grant to require all programs in the integrated system to use such unified financial and management information system. Sets forth requirements for such systems. (Sec. 209) Requires each State, from its development or implementation grant, to develop a strategy to enhance capacity of institutions, organizations, and staff involved in State and local workforce development activities by providing certain types of services. (Sec. 210) Provides that the Governor of each State implementing an integrated workforce development system: (1) may adjust existing performance standards for programs in such system, using criteria including specified factors; and (2) shall, within parameters established by the Board, prescribe adjustments to such performance criteria for unified SDAs based on specified factors. Requires such developed performance criteria to be used in lieu of similar criteria for programs receiving Federal funding included in the State's integrated system, to the extent determined by the State Council subject to Board approval. Title III: Local Responsibilities - Requires the local elected officials of each unified SDA, in each State receiving an implementation grant (except any with a single unified SDA with contiguous borders), to establish a workforce development board (local board) to administer the workforce development provided by all programs in the integrated workforce development system in such area. (Sec. 302) Requires each local board to report to the State Council a biennial workforce development board policy blueprint. (Sec. 303) Requires each local board to submit to the State Council an annual unified SDA report card. (Sec. 304) Requires each local board receiving funds under an implementation grant to develop and implement a network of one-stop career centers in its unified SDA to provide jobseekers, workers, and businesses universal access to a comprehensive array of quality employment, education, and training services. Requires selection of a method for such establishment consistent with specified criteria. Makes eligible for selection as a one-stop career center each entity within the unified SDA that performs specified brokerage services for individuals and employers. Prohibits any entity that performs one-stop career center functions from making an education and training referral to itself, but allows waivers of this prohibition under certain conditions. Allows each one-stop career center to charge fees for certain brokerage services to employers, subject to local board approval. Requires each such center to: (1) adopt core data elements and common definitions; and (2) enter into an operating agreement with the local board. (Sec. 305) Directs each local board to submit annual progress reports to the State Council. (Sec. 306) Requires each local board to identify capacity building actions to be taken for the workforce development system in its unified SDA. Directs the State Council to make funds available to each local board for capacity building building activities from implementation grant funds and other funds within the State's integrated workforce development budget. Lists types of capacity building activities. (Sec. 307) Establishes a program of incentive grants for incumbent worker training, consisting of competitive matching grants to local boards to respond to the training needs of front-line workers in their communities. Sets forth provisions for applications, selection of grantees by the Secretary according to certain criteria, authorized uses of funds, and Federal and local matching shares of funding. Title IV: Consolidation - Provides for consolidation of the system of federally funded employment training services available to jobseekers, workers, and businesses. (Sec. 401) Expresses the sense of the Congress that: (1) any budget savings realized through elimination or consolidation or sunsetting of such programs should be reinvested in the national job training (or workforce development) system; and (2) elimination or merging of programs should be done without reducing the Federal commitment or level of effort to improve education, employment, and earnings of all workers, particularly hard-to-serve individuals, including those with limited-English proficiency and others with special needs. (Sec. 402) Directs the Board to study and report to the President and the Congress on how best to integrate specified programs for in-school-and out-of-school youth under various Federal laws with those under the School-to-Work Opportunities Act of 1994. (Sec. 403) Directs the board to advise on consolidation of workforce development progrms through: (1) recommendations to the President and the Congress for the elimination of Federal workforce development programs, or programs whose functions should be subsumed under other Federal programs; (2) a report and recommendations for proposed reforms to specified congressional committees based on its analysis of the experience of leading edge States and the progress toward establishing an integrated workforce development system; and (3) a draft of a joint resolution to the Congress with provisions to develop a streamlined, integrated, federally supported workforce development system, from listed programs and any other appropriate Federal program (including recommendations for standard program measures and a description of how the new system will maintain services to hard-to-serve populations). (Sec. 404) Requires any State receiving an implementation grant to include specified programs under various Federal laws (mandatory integrated programs) in its reformed delivery system. Allows any such State to include specified additional programs (optional integrated programs) under various Federal laws in its reformed delivery system. (Sec. 405) Repeals the provisons of various Federal laws for the listed mandatory integrated programs. Title V: Integrated Labor Market Information System - Directs the Secretary to oversee and ensure development, maintenance, and continued improvement of: (1) a nationwide integrated system of labor market information that will serve specified functions, include certain information, use common standards, and make certain data and information available to the Board and to consumers in automated delivery systems; and (2) certain mechanisms and programs for dissemination, technical assistance, and research. (Sec. 502) Directs the Board to plan, review, and evaluate the national integrated labor market information system. (Sec. 503) Requires the Secretary to: (1) manage the investment in an integrated labor market information on system in a specified manner; and (2) submit an annual plan for improving such system to the Board for review and recommendations, and to the President and the Congress. (Sec. 504) Directs each Governor and State Council to designate one State agency to be responsible for: (1) managing and overseeing a statewide integrated labor market information system; and (2) developing an annual State unified labor market information budget. Conditions Federal financial assistance under this title on the Governor or State Council carrying out other specified functions with respect to labor market information. Provides that the State agency is not limited by this Act from conducting additional data collection, analysis, and dissemination activities with funds derived from sources other than this Act.
United States · United States Congress · 4 October 1994
Expresses the sense of the Congress that the U.S. delegation to the Spring 1995 meeting of the Facilitation Division of the International Civil Aviation Organization: (1) seek to amend the Convention on International Civil Aviation, done on December 7, 1944, at Chicago, to end aircraft disinsection practices that threaten the health of aircraft passengers and crew; and (2) make every effort to gain the support of other member nations of the organization in that amendment.
United States · United States Congress · 30 September 1994
Ryan White CARE Reauthorization Act of 1994 - Amends the Ryan White Comprehensive AIDS Resources Emergency Act of 1990 (title XXVI of the Public Health Service Act) to limit the grant program for emergency relief for areas with substantial need for services to eligible areas with a population of at least 500,000 individuals. Requires an HIV health services planning council (which advises on the distribution of such grants) to be reflective of the demographics of the human immunodeficiency virus (HIV) epidemic in an eligible area, with particular consideration given to disproportionately affected and historically underserved groups. Revises the method of distributing such grants and extends authorized appropriations for them until FY 2000. Revises the care grant program that makes funds available for individuals and families with the HIV disease. Authorizes the award of supplemental grants to eligible entities to enhance community-based care, treatment, and supportive services through the development and operation of consortia and innovative approaches. Extends authorized appropriations for such grant program through FY 2000. Requires the establishment of grievance procedures to address allegations of egregious violations of title XXVI of the Public Health Service Act. Directs the Secretary of Health and Human Services to coordinate the planning and implementation of Federal HIV programs to facilitate the development of a complete continuum of HIV-related services for individuals with HIV disease and those at risk of such disease. Extends authorized appropriations for early intervention services until FY 2000. Extends authorized appropriations until FY 2000 for grants for coordinated services and access to research for children, youth, women, and families (formerly known as demonstration grants for research and services for pediatric patients regarding acquired immune deficiency syndrome). Makes appropriations available for special projects of national significance program to award direct grants to public and nonprofit private entities to fund special programs for the care and treatment of individuals with HIV disease.
United States · United States Congress · 26 September 1994
Amends the Omnibus Budget Reconciliation Act of 1990 to extend from three years to five years the period during which Medicare select policies may be issued.
United States · United States Congress · 13 September 1994
Nursing Education Consolidation and Reauthorization Act of 1994 - Amends the Public Health Service Act to revise provisions regarding the general student loan program for nursing education. Makes individuals who breach agreements for obligated service by failing to maintain an acceptable level of academic standing, by being dismissed for disciplinary reasons, by voluntarily terminating the program, or by failing to provide health services under the program for the applicable period liable for the amount of the award, including amounts provided for expenses related to such attendance and interest at the maximum legal prevailing rate. Waives or suspends such liability under specified circumstances. Sets forth provisions regarding: (1) application requirements, including a plan for carrying out a project, performance standards, and linkages with relevant educational and health care entities; (2) use of funds; (3) matching requirements; (4) preferences; (5) grant and contract awards; (6) information requirements; (7) training program requirements; (8) duration of assistance; and (9) peer review. Establishes a National Advisory Council on Nurse Education and Practice. Permits funds appropriated under the Act to be used by the Secretary to provide technical assistance. Provides for the recovery of construction assistance by the Secretary if specified conditions are not met. Specifies that the right of recovery of the United States shall not, prior to judgment, constitute a lien on any facility. Authorizes the Secretary to award grants to, and enter into contracts with, eligible entities to meet the costs of: (1) projects that support the enhancement of advanced practice nursing education; and (2) traineeships for individuals in advanced practice nursing programs. Specifies that nurse practitioner and nurse midwifery programs eligible for support are educational programs for registered nurses that meet specified guidelines and that have as their objective the education of nurses who will upon completion of their studies be qualified to effectively provide primary health care. Authorizes appropriations. Authorizes the Secretary to award grants to, and enter into contracts with, eligible entities to meet the costs of special projects to increase nursing education opportunities for individuals who are from disadvantaged racial and ethnic backgrounds underrepresented among registered nurses by providing student scholarships or stipends, pre-entry preparation, and retention activities. Authorizes appropriations. Authorizes the Secretary to award grants to, and enter into contracts with, eligible entities for projects to strengthen capacity for basic nurse education and practice. Authorizes appropriations.
United States · United States Congress · 19 August 1994
Missing Service Personnel Act of 1994 - Requires the military commander of the unit, facility, or area to which the following persons are assigned to conduct an investigation as to their whereabouts after receiving factual information that their status is uncertain: (1) military personnel who disappear during a period of war, national emergency, or hostilities; and (2) any civilian Federal employee (including an employee of a Federal contractor) who serves with or accompanies an armed force in the field during such a period. Requires such persons to be placed in a missing status and requires notification of such status to either the officer having general court-martial authority over the person (for military personnel) or the Secretary of the military department employing such person (for civilian and contractor employees). Requires such officials to be kept informed (specifies deadlines) as to all information and inquiries concerning efforts to locate such missing personnel. Requires such officials to appoint a board to conduct an inquiry into the whereabouts and status of such persons. Provides for: (1) board composition, activities, and access to information; (2) inquiry proceedings (requiring the appointment of counsel, with specified duties, to represent the missing person); (3) a board recommendation as to the official status of a person following such an inquiry; (4) board reports to the officials involved as to board conclusions (prohibiting public availability of such reports for a one-year period); (5) report review by the official; (6) a report from such official to interested persons; and (7) an additional investigation and inquiry by an additional board upon receipt of new information within one year after the date of the first official notice of a person's disappearance. Allows interested persons (family members, dependents, next of kin) to participate at the proceedings of the board during such additional inquiry. Provides for the availability of appropriate information to board personnel conducting investigations and inquiries. Provides similar procedures for the second board with respect to meetings (open to the public, with exceptions), recommendations, reports, review by the Secretary of the military department concerned, and reports to interested persons. Requires a board to be reconvened when information becomes available that would directly lead to a determination of a person's status. Requires the Secretary concerned to appoint a board to conduct an inquiry as to the status of a missing person: (1) on or about three years after the first official notice of the disappearance of such person; and (2) not later than every three years thereafter until a total of 12 years after the first official notice. Provides for: (1) the release to a board by the Secretary concerned of all personnel file information concerning missing persons; (2) the treatment of classified information; (3) penalties for the wrongful withholding of information; (4) limited circumstances under which a board may recommend that a missing person be declared officially dead; (5) the submission by the board of appropriate information if such recommendation occurs; and (6) judicial review for interested persons of a board decision to declare a person officially dead. Provides for the appointment of a board to review the status of a person previously declared dead, with board procedures similar to those described above. Requires a person previously declared dead or in a missing status who is subsequently found alive to be paid for the full time of their absence.
United States · United States Congress · 10 August 1994
Humanitarian Aid Corridor Act - Prohibits funds for foreign assistance from being made available for any country whose government prohibits or restricts the transport or delivery of U.S. humanitarian assistance. Waives such prohibition if the President notifies the Congress that providing such assistance is in the national security interest. Provides for a resumption of assistance when the President certifies to the Speaker of the House and the Senate Foreign Relations Committee that such country is no longer prohibiting or restricting such transports or deliveries.
United States · United States Congress · 2 August 1994
Mental Health and Substance Abuse Programs Reauthorization Act of 1994 - Amends the Public Health Service Act to reauthorize appropriations for specified programs relating to the Substance Abuse and Mental Health Services Administration. Repeals the block grant program that provides funds to States with insufficient capacity for treatment facilities.
United States · United States Congress · 1 August 1994
TABLE OF CONTENTS: Title I: National Science Foundation Authorization Title II: Research and Education in Strategic Areas Title III: General Provisions National Science Foundation Authorization Act of 1994 - Title I: National Science Foundation Authorization - Authorizes appropriations to the National Science Foundation (NSF) for FY 1995 through 1999. (Sec. 103) Amends the National Science Foundation Act of 1950 to direct the NSF to include in its annual report to the President a strategic plan defining its goals, criteria, and procedures. Title II: Research and Education in Strategic Areas - National Science Foundation Strategic Research and Education Authorization Act of 1994 - Authorizes the Director of the NSF to establish the following cross-directorate initiatives: (1) advanced manufacturing technology; (2) advanced materials and processing; (3) biotechnology; (4) civil infrastructure systems; (5) global change research; (6) environmental research; (7) high performance computing and communications; and (8) science, mathematics, engineering, and technology education. Title III: General Provisions - Amends the Academic Research Facilities Modernization Act of 1988 to require the NSF Director, when making awards for academic facilities maintenance, to include projects for the acquisition of research instrumentation. (Sec. 302) Amends the Science and Engineering Equal Opportunities Act to authorize the Director to make awards to institutions of higher education and local educational agencies to develop science, computer science, technology, and mathematics curricula in accord with traditional cultural values of Native Hawaiian students, Pacific Islander students, and Native American students. Includes individuals with disabilities as an underrepresented group for which the Committee on Equal Opportunities in Science and Engineering should encourage full participation in scientific, engineering, and professional fields. (Sec. 303) Authorizes appropriations for the Director to: (1) make grants to organizations, including colleges and universities, to promote cooperative research projects between scientists in the United States and scientists in Latin America; and (2) establish a cross-directorate program between the United States and the Newly Independent States to make awards to individuals, small groups, and research centers to support collaborative research efforts between scientists and engineers from both countries. (Sec. 304) Requires the Director to continue to carry out the Experimental Program to Stimulate Competitive Research in certain States. (Sec. 305) Authorizes appropriations for FY 1995 and 1996 for the National Undergraduate Teaching Fellows program. (Sec. 306) Amends the National Science Foundation Act of 1950 and the National Science Foundation Authorization Act of 1988 to modify certain administrative procedures.
United States · United States Congress · 27 July 1994
Defines the term "disease," for purposes of determining the relationship between undiagnosed illness and disease for purposes of entitlement to veterans' disability compensation, as any deviation from or interruption of the normal structure or function of any part, organ, or system of the body that is manifested by a symptom or sign the etiology, pathology, and prognosis for which is known or unknown. Requires due consideration to be given to the common or shared experiences, medical symptoms, or signs of other veterans who were engaged in similar service and who exhibit similar medical symptoms or signs.
United States · United States Congress · 26 July 1994
Rape and Assault Victims Counseling Protection Act - Expresses the sense of the Senate regarding the confidentiality of communications between victims of sexual assault or domestic violence and their therapists or trained counselors. Directs the Attorney General to: (1) evaluate State measures to protect such confidentiality and disseminate the findings to State authorities; (2) develop model legislation that will adequately protect such confidentiality; and (3) report to the Congress. Directs the Judicial Conference of the United States to complete and submit to the Congress a study evaluating whether and how the Federal Rules of Evidence should be amended to guarantee that such confidentiality will be adequately protected in Federal court proceedings.
United States · United States Congress · 19 July 1994
International Antitrust Enforcement Assistance Act of 1994 - Authorizes the Attorney General and the Federal Trade Commission (FTC) to provide, in accordance with an antitrust mutual assistance agreement in effect with a foreign antitrust authority, antitrust evidence to assist such authority to: (1) determine whether a person has violated, or is about to violate, any of the foreign antitrust laws administered or enforced by the authority; and (2) enforce any of such laws. Authorizes the Attorney General to conduct investigations to obtain evidence relating to a violation of such foreign antitrust laws and provide such evidence to the authority, regardless of whether the conduct investigated violates any of the Federal antitrust laws. Authorizes the U.S. district court for the district in which a person resides, is found, or transacts business, upon application of the Attorney General made in accordance with such an agreement, to order such person to give testimony or a statement to, or to produce a document or other thing for, the Attorney General to assist the authority to make its determination or enforce any of such laws. Sets forth provisions regarding the contents of the order, the preservation of rights and privileges, and voluntary conduct. Makes this Act inapplicable with respect to antitrust evidence that is: (1) received by the Attorney General or the FTC under provisions of the Clayton Act regarding a premerger notification and waiting period; (2) a matter occurring before a grand jury with respect to which disclosure is prevented by Federal law, with exceptions; (3) specifically authorized to be kept secret in the interest of national defense or foreign policy under criteria established by executive order; and (4) classified under specified provisions of the Atomic Energy Act of 1954. Permits disclosure of antitrust evidence obtained under the Antitrust Civil Process Act in accordance with such an agreement under, and the other requirements of, this Act. Sets forth provisions regarding: (1) publication requirements; (2) implementation of such agreements; (3) limitations on judicial review; (4) supplementation and preservation of authority; and (5) reporting requirements. Authorizes the Attorney General and the FTC to receive from a foreign state or a regional economic integration organization reimbursement for costs incurred to conduct investigations or provide evidence.
United States · United States Congress · 19 July 1994
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Responsibilities Subtitle D: Consumer Purchasing Cooperatives Subtitle E: Employer Purchasers Subtitle F: Health Plans Subtitle G: Federal Responsibilities Subtitle H: Miscellaneous Employer Responsibilities Subtitle I: General Definitions; Miscellaneous Provisions Title II: Long-Term Care Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Academic Health Centers Subtitle C: Health Research Initiatives Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health Subtitle E: Health Services for Medically Underserved Populations Subtitle F: Mental Health; Substance Abuse Subtitle G: Comprehensive School Health Education; School-Related Health Services Subtitle H: Public Health Service Initiative Subtitle I: Additional Provisions Regarding Public Health Subtitle J: Occupational Safety and Health Subtitle K: Full Funding for WIC Subtitle L: Border Health Improvement Title V (sic): Quality and Consumer Protection Subtitle A: Quality Management and Improvement Subtitle B: Information Systems, Privacy, and Administrative Simplification Subtitle C: Remedies and Enforcement Subtitle D: Medical Malpractice Subtitle E: Expanded Efforts to Combat Health Care Fraud and Abuse Subtitle F: Repeal of Exemption Title VI: Premium Caps; Premium-Based Financing; and Plan Payments Subtitle A: Premium Caps Subtitle B: Premium-Related Financings Subtitle C: Payments to Health Plans and Miscellaneous Provisions Title VIII (sic): Health and Health-Related Programs of the Federal Government Subtitle E (sic): Amendments to the Employee Retirement Income Security Act of 1974 Title IX: Aggregate Government Payments Subtitle B (sic): Aggregate Federal Payments to Participating State Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls Title X: Workers Compensation Medical Services Title XI: Transitional Insurance Reform Health Security Act - Title I: Health Care Security - Subtitle A: Universal Coverage and Individual Responsibility - Entitles each eligible individual to: (1) the benefit provided under subtitle B through the applicable health plan in which the individual is enrolled; and (2) a health security card to be issued by the alliance or other entity that offers the applicable health plan in which the individual is enrolled. Entitles a Medicare-eligible individual to benefits under Medicare instead of the provisions of this Act. (Sec. 1002) Requires each eligible individual to enroll in an applicable health plan and pay any required premium. Prohibits disenrollment of an eligible individual until the individual is either enrolled in another plan or becomes Medicare-eligible. (Sec. 1003) States that nothing in this Act shall be construed as prohibiting: (1) an individual from purchasing any health services; (2) an individual from purchasing supplemental insurance; (3) an individual who is not an eligible individual from purchasing health insurance; or (4) employers from providing additional coverage. (Sec. 1004) Prescribes principles applicable to all health plans, including: (1) nondiscrimination based on medical history, pre- existing medical conditions, or genetic predisposition to medical conditions; (2) open enrollment periods; and (3) the provision of services as defined in the benefits package. (Sec. 1005) States that a community-rated health plan is the applicable plan for a family, unless a family member is eligible for an experienced-rated health plan. (Sec. 1006) Prohibits an ineligible alien from enrolling in a health plan under this Act. Subtitle B: Benefits - Includes the following terms and services in the comprehensive benefit package: (1) hospital services; (2) services of health professionals; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care; (8) home health care; (9) extended care services; (10) ambulance services; (11) outpatient laboratory, radiology, and diagnostic services; (12) outpatient prescription drugs and biologicals; (13) outpatient rehabilitation services; (14) durable medical equipment and prosthetic and orthotic devices; (15) vision care; (16) hearing aids for children; (17) dental care; (18) investigational treatments; and (19) optional services. (Sec. 1131) Requires each health plan to offer to its enrollees only one of the following cost sharing schedules: (1) lower cost sharing; (2) higher cost sharing; or (3) combination cost sharing. Provides that the annual maximum out-of-pocket expenses for an individual in any of the plans shall be $2500 and for a family the annual maximum shall be $3000. (Sec. 1141) Excludes the following items and services: (1) an item or service that is not medically necessary or appropriate; (2) an item or service that the National Health Board may determine is not medically necessary or appropriate; (3) custodial care, except hospice care; (4) surgery performed solely for cosmetic purposes, unless required to correct a congenital anomaly or performed to correct a part of the body altered by either disease or accident; (5) hearing aids; (6) eyeglasses and contact lenses for individuals at least 18 years of age; (7) in vitro fertilization; (8) sex change surgery and related services; (9) private duty nursing; (10) personal comfort items, except in the case of hospice care; and (11) any dental procedures involving orthodontic care, inlays, gold or platinum fillings, bridges, crowns, pin-post retention, dental implants, surgical periodontal procedures, or the preparation of the mouth for the fitting or continued use of dentures, except as specified. (Sec. 1151) Gives the National Health Board the authority to promulgate such regulations or establish such guidelines as necessary to assure uniformity in the application of the comprehensive benefit package across all health plans. Permits the Board to expand the benefit package. (Sec. 1162) Permits a health professional or facility to refuse to provide a benefit if the professional or facility objects on the basis of a religious belief or moral conviction. (Sec. 1163) Requires facilities to promptly report incorrect test results to the provider who ordered the test. Subtitle C: State Responsibilities - Requires a State, in order to be approved as a participating State, to submit a document describing the State's health care system. (Sec. 1201) Sets forth general responsibilities for participating States. (Sec. 1207) Requires the establishment of a National Center of Consumer Advocacy to provide technical assistance, adequate training, and support to States and Offices of Consumer Advocacy in each State. (Sec. 1209) Requires a State to designate an agency to coordinate the delivery of medical and social services to children with special health care needs. (Sec. 1221) Permits a State, with the Board's approval, to operate a single-payer system if specified requirements are met. (Sec. 1281) Provides for reductions in cost sharing for certain low-income families enrolled in community-rated health plans. Subtitle D: Consumer Purchasing Cooperatives - Requires a State to certify consumer purchasing cooperatives to: (1) enter into agreements with health plans; (2) enter into agreements with community-rated employers; (3) enroll eligible individuals in health plans; (4) make payments to health plans on behalf of community-rated employers and eligible individuals; (5) provide for coordination with other cooperatives; (6) provide information on health plans; and (7) carry out other functions as provided in this title. (Sec. 1321) Provides for the Federal Employees Health Benefits Program (FEHBP) to serve as a consumer purchasing cooperative in each health care coverage area designated by a State. Subtitle E: Employer Purchasers - Sets forth the responsibilities of employer purchasers of health plans. (Sec. 1411) Directs the Secretary of Labor to develop and publish standards applicable to employer sponsored plans offered by large group purchasers. Subtitle F: Health Plans - Sets forth requirements for the certification of health plans by a State. (Sec. 1531) Sets forth requirements relating to essential community providers. Subtitle G: Federal Responsibilities - Establishes the National Health Board in the Executive Branch. (Sec. 1603) Sets forth the general duties and responsibilities of the Board, including an annual report to the President and the Congress. (Sec. 1611) Requires the Board to approve a State health care system if the system meets the applicable requirements of this Act. Prohibits approval of a State health care system prior to 1996. (Sec. 1621) Provides for the Federal assumption of responsibilities in the absence of a State system. (Sec. 1641) Directs the Board to develop a risk adjustment and reinsurance methodology. Sets forth guidelines for developing such methodology. (Sec. 1651) Directs the Board to establish minimum capital requirements for community-rated health plans. (Sec. 1660) Requires the Board to establish a national annual open enrollment period. (Sec. 1671) Sets forth the responsibilities of the Secretary of Health and Human Services. Directs the Secretary to administer and implement all provisions of this Act, except those duties delegated to the Board, any other executive agency, or to any State. (Sec. 1672) Directs the Secretary to undertake an interdisciplinary medical technology impact study to assess the overall effect on patient outcomes of medical technologies used in treating a list of target diseases and conditions. (Sec. 1681) Provides for the certification of essential community providers. Sets forth the categories of providers automatically certified. (Sec. 1687) Directs the Secretary to perform responsibilities with respect to the development of workplace wellness programs. (Sec. 1691) Sets forth the responsibilities of the Secretary of Labor in administering provisions of this Act and related Acts. (Sec. 1695) Provides for collective bargaining dispute resolution for the transition period to a restructured health care delivery system. Subtitle H: Miscellaneous Employer Responsibilities - Sets forth employer responsibilities including: (1) auditing of records; (2) prohibitions on discrimination based on family status; (3) evasion of obligations; (4) prohibitions on self-funding of cost sharing benefits; and (5) obligations to retirees. Subtitle I: General Definitions; Miscellaneous Provisions - Sets forth the definitions and rules used in this Act. (Sec. 1911) Grants the National Health Board, the Secretary of Health and Human Services, and the Secretary of Labor authority to issue regulations as necessary to permit the timely implementation of this Act. (Sec. 1917) Expresses the sense of the Senate Committee on Labor and Human Resources that when the Health Security Act is enacted it should include specified sources of financing not within the jurisdiction of the Committee. Expresses the sense of such Committee that when health reform legislation is enacted it should include the permanent extension of the research and development tax credit. (Sec. 1918) Expresses the sense of such Committee that provisions encouraging the establishment of medical savings accounts be included in any health reform bill passed by the Senate, in conjunction with a comprehensive benefit package described in subtitle B of this title. Title II: Long-Term Care - Establishes requirements for State programs for home and community-based services to individuals with disabilities. Requires a State to consult with individuals and groups of individuals with disabilities when developing the plan in order to have the plan approved. (Sec. 2103) Defines individuals with disabilities to mean any individual within one or more of the following four categories: (1) individuals requiring help with the activities of daily living; (2) individuals with severe cognitive or mental impairment; (3) individuals with severe or profound mental retardation; and (4) severely disabled children. (Sec. 2107) Directs the Secretary to establish an advisory group to advise on all aspects of such State programs. (Sec. 2111) Provides financial assistance to States to assist in developing and implementing, or expanding and enhancing, a family- centered, culturally competent, community-centered, comprehensive statewide system of extended services and benefits for children with special health care needs. (Sec. 2201) Long-Term Care Insurance Improvement and Accountability Act - Amends the Public Health Service Act to mandate the establishment of model Federal standards for long-term care insurance. (Sec. 2301) Life Care Act - Amends the Public Health Service Act to establish a voluntary long-term care insurance program for individuals 35 years of age and over to cover the nursing home stays of such individuals. (Sec. 2303) Expresses the sense of the Senate Committee on Labor and Human Services concerning the success of PACE (Program of All- inclusive Care for the Elderly) in providing integrated service delivery. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes within the Department of Health and Human Services the National Council on Graduate Medical Education. Directs the National Council to designate for each academic year the number of individuals nationwide who are authorized to be enrolled in each specified approved physician training program for each medical specialty. (Sec. 3031) Makes funds available for: (1) qualified entities for the operation of approved physician training programs; (2) eligible medical schools for the direct costs of academic programs; and (3) qualified academic health centers or teaching hospitals. (Sec. 3071) Directs the Secretary to carry out a program with respect to graduate nurse training programs that is equivalent to the program for approved physician training programs. Establishes a National Council on Graduate Nurse Education. (Sec. 3081) Authorizes appropriations to the Secretary of Health and Human Services for the following programs: (1) primary care physician and physician assistant training; (2) training of underrepresented minorities and disadvantaged persons; (3) expanding rural health career opportunities and retention efforts; and (4) nurse training. Directs the Secretary to establish a National Advisory Board on Health Care Workforce Development to make recommendations on health care worker matters. Amends the Public Health Service Act to authorize appropriations for grants to improve the training of health care workers in assisting the needs of mentally retarded individuals and others with developmental disabilities. (Sec. 3082) Authorizes appropriations to the Secretary of Labor for a retraining program, a demonstration program for advanced career positions, and a workforce adjustment program. Subtitle B: Academic Health Centers - Authorizes appropriations for grants for: (1) rural information and referral systems; and (2) community- and provider-based health plans to provide services of eligible centers to residents of rural or urban communities. Subtitle C: Health Research Initiatives - Amends the Public Health Service Act to ensure that the National Institutes of Health conducts and supports biomedical and behavioral research on promoting health and preventing diseases, disorders, and other health conditions. Provides for health services research. Authorizes appropriations for such research. Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health - Authorizes appropriations for the core functions of public health programs and national initiatives regarding health promotion and disease prevention. Subtitle E: Health Services for Medically Underserved Populations - Authorizes appropriations for: (1) grants and contracts for the development of qualified community health plans and networks; (2) loans and grants for the capital costs of developing qualified community health groups; and (3) grants and contracts for enabling and supplemental services. (Sec. 3471) Authorizes appropriations for: (1) the National Health Service Corps; and (2) such amounts as are necessary to ensure that a specified percentage of participants in the Scholarship Program or the Loan Repayment Program of the Corps are nurses. (Sec. 3481) Entitles a hospital with a low-income utilization rate to specified payments. (Sec. 3491) Expresses the sense of the Senate Committee on Labor and Human Resources on the appropriate recognition of the success of community and migrant health centers. Subtitle F: Mental Health; Substance Abuse - Authorizes appropriations for grants to States for the development and operation of comprehensive managed mental health and substance abuse programs that are integrated with the health delivery system established under this Act. Subtitle G: Comprehensive School Health Education; School- Related Health Services - Authorizes appropriations for: (1) the development and implementation of comprehensive age appropriate health education programs in public schools for children and youth kindergarten through grade 12; and (2) increase access to preventive and primary health care services for children and youth through school-based or school-linked health service sites. Subtitle H: Public Health Service Initiative - Specifies the initiatives under this Act to be funded through funds not otherwise appropriated. Subtitle I: Additional Provisions Regarding Public Health - Requires the Secretary to reserve allocated appropriations for curriculum development and implementation regarding domestic violence and women's health needs. Subtitle J: Occupational Safety and Health - Directs the Secretary of Health and Human Services and the Secretary of Labor to work together to develop and implement a comprehensive program to expand and coordinate initiatives to prevent occupational injuries and illnesses. Subtitle K: Full Funding for WIC - Amends the Child Nutrition Act of 1966 to authorize appropriations for the special supplemental food program. Subtitle L: Border Health Improvement - Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission. Title V (sic): Quality and Consumer Protection - Subtitle A: Quality Management and Improvement - Requires the National Health Board to establish and oversee a performance-based program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of health care services and access to such services which will be called the National Quality Council. (Sec. 5002) Specifies the duties of such Council. Subtitle B: Information Systems, Privacy, and Administrative Simplification - Directs the National Health Board to develop standards under which health care providers and health plans collect information for a national health care data network. (Sec. 5135) Authorizes the Board to make grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. (Sec. 5160) Health Care Privacy Protection Act - Amends Federal criminal law to prescribe penalties for the wrongful disclosure of protected health information and the misuse of health security cards. (Sec. 5163) Provides limitations on the disclosure of protected health information. (Sec. 5195) Requires the Board to publish standard benefit forms. Subtitle C: Remedies and Enforcement - Sets forth provisions with respect to the review of benefit determinations for enrolled individuals, including provisions: (1) regulating the time limits for notice of disposition of a claim; (2) governing a plan's duty to review claim denials; (3) concerning urgent requests for preauthorization; and (4) concerning other time limits with respect to time limits and notice. (Sec. 5202) Requires each State to establish a complaint review office to permit aggrieved individuals to file complaints. (Sec. 5205) Provides for a Federal Health Plan Review Board to review the decisions of complaint review office hearing officers. (Sec. 5206) Sets monetary penalties for a plan which unreasonably denies or delays payment or provision of benefits. (Sec. 5211) Directs each State to establish and maintain an Early Resolution Program in each complaint review office. Requires a program to include: (1) forums for mediation of disputes; and (2) other forums of alternative dispute resolution as may be prescribed. (Sec. 5231) Sets forth additional remedies and enforcement provisions. Subtitle D: Medical Malpractice - Requires States to adopt an alternative dispute resolution system mechanism under which the parties must participate prior to the commencement of a medical malpractice action. Subtitle E: Expanded Efforts to Combat Health Care Fraud and Abuse - Requires the Secretary of Health and Human Services and the Attorney General to establish a joint program for health care fraud and abuse control. (Sec. 5421) Amends Federal criminal law to impose penalties for health care fraud, theft or embezzlement in connection with health care, false statements relating to health care matters, and bribery and graft relating to health care. Subtitle F: Repeal of Exemption - Amends specified Acts to repeal the exemption for health insurance. Title VI: Premium Caps; Premium-Based Financing; and Plan Payments - Subtitle A: Premium Caps - Sets forth provisions which provide for the computation of factors that limit the growth of premiums for the comprehensive benefit package in community-rated health plans. (Sec. 6002) Directs the Board to determine: (1) a national per capita baseline premium target; and (2) the health care coverage area per capita premium target. (Sec. 6006) Directs the chair of the Board to establish an advisory commission on regional variations in health expenditures. Requires the commission to examine methods of eliminating variation in health care coverage area per capita premium targets due to variation in practice patterns. (Sec. 6011) Subjects each noncomplying community-rated health plan for a year to a reduction in plan payment as specified, in order to assure that payments to community-rated health plans are consistent. (Sec. 6021) Directs the Board to develop a methodology for calculating an annual per capita expenditure equivalent for amounts paid for coverage for the comprehensive benefit package within a large group purchaser. (Sec. 6031) Sets forth special rules for a single-payer State. (Sec. 6041) Directs the Secretary to establish a program to monitor prices and expenditures in the U.S. health care system. Subtitle B: Premium-Related Financings - Makes each family enrolled in a community-rated health plan or an experienced-rated health plan in a class of family enrollment responsible for payment of the family share of premium. Provides for income-related discounts and specified credits. (Sec. 6116) Exempts certain employers from coverage obligations. (Sec. 6121) Specifies premium payments for community-rated employers, including premium discounts. (Sec. 6131) Specifies premium payments for large group purchasers. Subtitle C: Payments to Health Plans and Miscellaneous Provisions - Makes States responsible for assisting health plans and cooperatives in the collection of premium payments. Sets forth other duties and responsibilities of States and health plans with respect to payments and other administrative matters. Title VIII (sic): Health and Health-Related Programs of the Federal Government - Subtitle E (sic): Amendments to the Employee Retirement Income Security Act of 1974 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to define group health plan. (Sec. 8402) Sets limitations on coverage of group health plans under title I (Protection of Employee Benefit Rights) of ERISA. Authorizes the Secretary of Labor to provide special rules for group health plan reporting and disclosure. Makes provisions relating to interference with protected rights and coercive interference applicable to enrollees in large group purchaser health plans. (Sec. 8403) Revises certain continuation coverage requirements (from COBRA - the Consolidated Omnibus Budget Reconciliation Act) under ERISA with respect to group health plans. Repeals ERISA provisions for continuation coverage under group health plans upon full implementation of universal coverage under this Act. Amends the Public Health Service Act with respect to period of coverage under a qualified health plan. Repeals such coverage provisions upon full implementation of universal coverage under this Act. (Sec. 8404) Ends certain ERISA provisions' applicability with respect to: (1) cases of adoption, to the extent otherwise provided in regulations of the National Health Board under this Act; and (2) coverage of pediatric vaccines under group health plans, upon the plan's becoming a large group purchaser health plan under this Act. (Sec. 8405) Requires group health plans covered by specified ERISA provisions to comply with the requirements of this Act for health plan claims procedures. (Sec. 8406) Exempts the Hawaii Prepaid Health care Act from certain ERISA preemption provisions, under specified conditions. Title IX: Aggregate Government Payments - Subtitle B (sic): Aggregate Federal Payments to Participating State - Directs the Secretary of Health and Human Services (HHS) to pay a capped Federal entitlement payment amount to each participating State in each calendar quarter. Sets forth formulas and rules for capped entitlement payments. Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls - Directs the Secretary of HHS to make available loans to States to cover any period of temporary cash-flow shortfall attributable to an estimation discrepancy, an administrative error, or relative timing during the year in which amounts are received and payments are required to be made. (Sec. 9201) Requires each State to provide that any surplus of funds resulting from an estimation discrepancy, up to a reasonable amount specified by the Secretary of HHS, shall be held in a State contingency fund for any future shortfalls from such a discrepancy. Title X: Workers Compensation Medical Services - Makes specified provisions under this Act (HSA) relating to use of standard forms and health care information applicable to a health plan or health care provider's provision of workers compensation medical services. Requires plans and providers that render such services to: (1) provide relevant health care information necessary to assist the worker in the safe and timely return to work; and (2) comply with legal duties and reporting requirements under State workers compensation laws and other Federal and State laws, including those regarding reporting of occupational injuries and diseases. Directs the Secretary of Labor to promulgate rules to clarify such plan and provider information responsibilities. (Sec. 10001) Requires health plans to provide care in disputed workers compensation cases, until an adjudicated determination is made that the claim is compensable as workers compensation. Requires the workers compensation carrier (or the self-insured employer) to reimburse the health plan and the worker if such determination is made. (Sec. 10002) Directs the Secretaries of HHS and Labor to conduct demonstration projects in one or more States with respect to treatment of work-related injuries and illnesses. Requires project development of: (1) protocols for treatment of work-related conditions; and (2) model methods of workers compensation carriers capitated payment on a per case basis to health plans for treatment of specified work-related injuries and illnesses. (Sec. 10003) Establishes a Commission on Workers Compensation Medical Services. Directs the Commission to study the relationship of workers compensation medical services to the new health system under this Act in terms of impact on the cost of such services, access to appropriate care for injured workers, and quality of medical care and its impact on functional and vocational outcomes for injured workers, considering specified issues. Requires the Commission's final report to the President and specified congressional committees to include a recommendation as to whether a transfer of financial responsibility for some or all medical benefits to health plans should be effected, along with a detailed implementation plan if such transfer is recommended. Title XI: Transitional Insurance Reform - Sets forth transitional provisions concerning: (1) enforcement; (2) preservation of current coverage; (3) restrictions on premium increases during transition; (4)portability requirements; (5) restrictions limiting benefit reductions; and (6) the establishment of the National Transitional Health Insurance Risk Pool.
United States · United States Congress · 12 July 1994
Medical Device User Fee Act of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to authorize the assessment and collection of fees from applicants for medical device approval. Provides for the use of such fees to defray cost increases in the resources allocated for the process of device application review and related activities. Authorizes appropriations for FY 1995 through 1999.
United States · United States Congress · 1 July 1994
Worker Rights and Labor Standards Trade Act of 1994 - Directs the President to seek the establishment of: (1) a working party within the General Agreement on Tariffs and Trade (GATT) to examine the relationship of fundamental internationally recognized worker rights to the articles of the GATT; and (2) a standing committee on worker rights within the World Trade Organization to which the functions of the working group shall be transferred.
United States · United States Congress · 1 July 1994
United States-China Act of 1994 - Declares that if nondiscriminatory treatment (most-favored-nation treatment) is not granted to China by reason of the enactment of a congressional disapproval resolution, such treatment shall continue to apply to goods that are produced by a person that is not a state-owned Chinese enterprise, but not apply to any goods that are produced by a state-owned Chinese enterprise. Provides that if nondiscriminatory treatment is granted to China for a 12-month period on July 3, 1994, such treatment shall not apply to: (1) any good that is produced by the People's Liberation Army or Chinese defense industrial trading company; or (2) any nonqualified good that is produced by a state-owned Chinese enterprise. Urges the Secretary of the Treasury to consult with American businesses that have significant trade with or investment in China, to encourage them to adopt a voluntary code of conduct that: (1) follows internationally recognized human rights principles; (2) ensures the employment of Chinese citizens is not discriminatory in terms of sex, ethnic origin, or political belief; (3) ensures that no convict, forced, or indentured labor is knowingly used; (4) recognizes the rights of workers to freely organize and bargain collectively; and (5) discourages mandatory political indoctrination on business premises. Requires the Secretary to determine, and publish in the Federal Register, which persons are state-owned Chinese enterprises and Chinese defense industrial trading companies. Authorizes the President to waive any condition or prohibition imposed under this Act if he determines and reports to the Congress that its continued imposition would have a serious adverse effect on the vital U.S. national security. Declares that if the President recommends in 1995 that the waiver of human rights and emigration requirements for nondiscriminatory treatment for China be continued, he shall state in a specified report to the Congress the extent to which China has made progress with respect to: (1) adhering to the provisions of the Universal Declaration of Human Rights; (2) ceasing the exportation to the United States of products made with convict, forced, or indentured labor; (3) ceasing unfair and discriminatory trade practices which restrict and unreasonably burden American businesses; and (4) adhering to the guidelines of the Missile Technology Control Regime and the controls adopted by the Nuclear Suppliers Group and the Australia Group.
United States · United States Congress · 28 June 1994
Expresses the sense of the Senate that the U.S. Government should: (1) enunciate a policy to promote democracy in Burma; (2) encourage members of the Association of Southeast Asian Nations (ASEAN) at the July meetings in Bangkok to join U.S. efforts to seek the immediate release of Daw Aung San Suu Kyi and other political prisoners, achieve the transfer of power to the winners of the 1990 democratic election, join the U.S. arms embargo against Burma, and end human rights abuses perpetrated by the State Law and Order Restoration Council (SLORC); (3) indicate continued U.S. opposition to SLORC participation in ASEAN; (4) work to implement United Nations (UN) General Assembly resolution 48/150 and pledge to seek international sanctions through the UN and the appointment of a special envoy; (5) oppose commercial arrangements and foreign aid and financial assistance from international finance institutions that only provide financial support for the SLORC; (6) encourage the Government of Thailand to allow Burmese political leaders and refugees to continue their efforts to bring democratic change to Burma without fear of harassment or other pressure; (7) continue the current policy of not sending an ambassador to Rangoon until the SLORC has taken steps to end human rights abuses and transfer power to the democratically elected leaders of Burma; and (8) investigate claims of forced repatriation of Rohingya refugees.
United States · United States Congress · 23 June 1994
Employment Non-Discrimination Act of 1994 - Prohibits employment discrimination on the basis of sexual orientation by covered entities, including employing authorities of the House of Representatives, employing offices of the Senate, and instrumentalities of the Congress. Declares that: (1) this Act does not apply to the provision of employee benefits for the benefit of an employee's partner; and (2) a disparate impact does not establish a prima facie violation of this Act. Prohibits quotas and preferential treatment. Declares that this Act does not apply to: (1) religious organizations (except in their for-profit activities); (2) the armed forces; or (3) laws creating special rights or preferences for veterans. Provides for enforcement. Disallows State and Federal immunity. Allows recovery of attorney's fees. Prohibits retaliation and coercion. Requires posting notices for employees and applicants.
United States · United States Congress · 21 June 1994
Expresses the sense of the Congress that the President should actively seek: (1) an international agreement prohibiting the production, possession, transfer, and use of antipersonnel landmines; and (2) in the interim, international agreements to further limit the production, possession, transfer, and use of such landmines. Expresses the sense of the Congress that a U.S. moratorium on the purchase and production of such landmines would encourage other nations to adopt similar measures. Establishes such moratorium for a one-year period beginning 90 days after enactment of this Act. Calls for the President to urge other nations to adopt such a moratorium. Allows the moratorium to be extended. Earmarks funds authorized under the current Department of Defense Authorization Act for improving landmine detection and neutralization. Directs the Administrator of the Agency for International Development and the Secretary of State to jointly submit to the Congress a report containing an analysis of the social, economic, and environmental costs and effects of the use of antipersonnel landmines. Directs the Secretary of Defense to report to the Congress on the total number of U.S. military personnel killed or wounded by such landmines during World War II, the Korean conflict, the Vietnam era, and the Persian Gulf War.
United States · United States Congress · 21 June 1994
TABLE OF CONTENTS: Title I: JOBS Title II: WORK Title III: Child Care Title IV: Provisions with Multi-Program Applicability Title V: Prevention of Dependency Title VI: Child Support Enforcement Title VII: Improving Government Assistance and Preventing Fraud Title VIII: Self Employment/Microenterprise Demonstrations Title IX: Financing Title X: Effective Dates Work and Responsibility Act of 1994 - Title I: JOBS - Amends parts A (Aid to Families with Dependent Children) (AFDC) and F (Job Opportunities and Basic Skills Training Program) (JOBS) of title IV of the Social Security Act (SSA) to revise the Federal welfare system for the purpose of making AFDC a transitional program with the goal of enabling participants to achieve maximum economic independence and self-sufficiency by, among other changes, imposing time-limited AFDC benefits and requiring participation in modified and new State-administered job training and subsidized employment programs that have been designed to eventually move them into the permanent work force and prepare them for a life without welfare by enabling them to get work experience and by requiring them to perform job searches for suitable nonsubsidized employment. (Sec. 101) Modifies current AFDC and JOBS participation requirements. Requires all AFDC recipients (including minor custodial parents not attending school full time) who are able to participate in the JOBS program to so participate, starting in FY 1996 or 1997 on a phased-in basis with custodial parents (including such minor parents) born in 1972 or later, and continuing thereafter with any such additional classes of parents of dependent children or other AFDC applicants or recipients. Requires a recipient unable to participate in the JOBS program because of a third trimester pregnancy, temporary incapacity, or other specified reason, to participate in related preparatory activities the State in appropriate cases may require pursuant to the recipient's employability plan, in order to prepare the recipient for full JOBS participation. Requires suspension for up to six months of the AFDC benefits of a family with a member who is required to participate in JOBS but refuses without good cause to accept the required number of weekly hours of employment offered by a public or private sector employer under the program. Grants States the option of continuing AFDC to the dependent children of any family with a parent who is required to participate in JOBS but fails without good cause to do so and is cut off AFDC for the period specified under current law, while preserving their eligibility under SSA title XIX (Medicaid). Directs the applicable State agency to provide appropriate counseling and other supportive services to assist the parent in addressing such failure. Requires custodial parents below age 20 who do not have a high school diploma (or its equivalent), and are required to participate in JOBS, to participate in an educational activity, regardless of State resource availability as currently conditioned under law. Allows States to apply AFDC sanctions to any individual required to get substance abuse treatment as a condition of JOBS participation who fails to get such treatment. (Sec. 102) Requires the States to implement statewide within two years of initial implementation in FY 1996 or 1997 modified JOBS programs that, with respect to the AFDC recipients required to participate in JOBS, provide for an assessment of such recipient's literacy skills and for expanded education, optional free substance abuse treatment, mandatory job search, and self-employment (including microenterprise) preparation services, in addition to the currently authorized child care and other supportive services. Requires such State JOBS programs to provide any other appropriate services or activities detailed in the recipient's individualized employability plan which the State agrees to provide and the recipient agrees to participate in by signing a personal responsibility agreement, in order to prepare the recipient for either permanent unsubsidized employment or temporary subsidized employment through the new WORK program. Requires such JOBS programs to address participant training for child care providers and nontraditional employment positions. Requires such JOBS programs to require employability plans to: (1) indicate the overall time for achieving their employment goals; and (2) be extended whenever the 24 month limit on AFDC benefits is extended. Subjects them to periodic review and revision to reflect the recipient's progress towards meeting such goals. (Continues with further modifications in the JOBS program as provided below under title II of this Act.) (Sec. 103) Revises JOBS program provisions on dispute resolution and service provision, with changes in the latter provisions: (1) extending their applicability (although modified, and along with additional specified wage, benefit, and working condition requirements) to the WORK program; (2) specifying the components of grievance procedures for resolving regular employee complaints alleging violations of worker displacement prohibitions or other specified work-related requirements; (3) requiring written notification of labor organizations when JOBS program participants are assigned to regular employment positions; (4) establishing an alternative expedited grievance procedure for complaints involving such an assignment; and (5) providing for binding arbitration for adverse grievance decisions. Changes earned income disregards and the limit on Federal reimbursement for State expenditures under work supplementation program provisions. (Sec. 104) Requires the States to generally limit AFDC benefits to 24 months, subject to extension for certain educational purposes, unless they have opted to participate in a limited number of demonstrations using alternative limits. (Sec. 105) Places administrative jurisdiction of the WORK program under the Assistant Secretary for Family Support in the Department of Health and Human Services. Title II: WORK - Adds to SSA title IV part G the WORK program. Requires States to have new programs requiring former JOBS participants who have been cut off AFDC after 24 months without receiving an extension or finding suitable employment to: (1) register with the applicable State agency for an approprate Work assignment of up to one year in the local area, involving placement in a temporary position in a subsidized private or public sector job (including ones as community service and child care providers) that gives them the experience for eventually finding a nonsubsidized job; and (2) conduct job searches for suitable nonsubsidized employment after completing an assignment while awaiting assignment to the next WORK job. (Sec. 201) Allows registrants to receive supplemental AFDC benefits in addition to their WORK earnings, as well as have their Medicaid-eligibility preserved while participating in WORK. Prohibits the upward adjustment of the amount of such supplemental benefits because of any failure to work the required hours for each assignment. Requires the aplicable State agency to conduct a comprehensive assessment at periodic intervals and either reassign the WORK participant to JOBS for additional training or to another assignment if he or she cannot find unsubsidized employment. Details other program provisions, chief among them provisions for: (1) local WORK advisory boards for advising administering agencies; (2) child care and other supportive services; (3) sanctions, hearings, and evaluations following WORK violations; and (4) optional joint JOBS and WORK administration and provision of program services through one-stop career centers. (Sec. 202) Revises current JOBS funding provisions, among other changes: (1) increasing the capped JOBS entitlement beginning in FY 1996, with the level of such entitlement specified for FY 2005 and each fiscal year thereafter adjusted for inflation; (2) limiting entitlement payments under JOBS to a State according to the average monthly number of adult recipients in the State for the preceding fiscal year relative to the number in all States (no longer factoring in the amount allotted to the State for FY 1987); (3) including enhanced Federal matching in the formulae for determining Federal payment with respect to a State's JOBS, WORK, and associated child care support expenditures; (4) establishing similar separate funding for the WORK program and specified set-asides under both programs for Indian tribes and Alaska Native organizations; and (5) earmarking specified funds for use by the Secretary of Health and Human Services (Secretary) to provide to States requesting additional funding for JOBS or WORK in the following fiscal year beyond that which was originally allocated and subsequently reallocated. (Sec. 204) Requires the States to implement modified JOBS programs as described above that, additionally, provide: (1) at the State's option, for a separate program for job training and employment opportunities for non-custodial parents without requiring their participation in JOBS or WORK in order to participate in the separate program; (2) for revised components for Indian tribes and Alaska Native organizations, among other changes, making such components applicable to such entities applying to conduct WORK programs, and to provide funding for Indian and Alaska Native child care under the AFDC, JOBS, and WORK programs; and (3) for special rules for territories regarding applicability of the 24 month limit on AFDC benefits and the WORK program. (Sec. 205) Amends SSA title XI to remove WORK and "at-risk" family child care from the territorial cap. (Sec. 207) Amends the Internal Revenue Code (IRC) to exempt earnings from WORK employment from being: (1) subject to Federal income and unemployment taxes; and (2) treated as earned income or qualified wages for purposes of the earned income and targeted jobs tax credits. Title III: Child Care - Makes various specified changes with regard to AFDC's child care support programs, including those largely conforming to the provisions of this Act concerning child care support for JOBS and WORK participants. Provides, in addition, for transitional child care for individuals leaving the WORK program. Provides also, with respect to AFDC recipients, JOBS and WORK participants, transitional child care recipients, and "at-risk" families, for parental rights and child care health and safety standards consistent with those under the Child Care and Development Block Grant Act of 1990 (Child Care Block Grant Act), including requirements for proper child immunizations and protection against toxic substances and weapons at sites where child care is provided. (Sec. 302) Provides for: (1) family cost-sharing for transitional and "at-risk" family child care consistent with the methodology used under the Child Care Block Grant Act; (2) "at-risk" family child care only in cases where the family involved is not eligible for other SSA title IV part A child care support programs, and regardless of whether they need child care in order to work; and (3) modified State payment and Federal reimbursement rules, among other changes making State licensing and monitoring activities with respect to child care providers reimbursable as an administrative cost. (Sec. 304) Provides for: (1) optional administration of AFDC's child care support programs by the lead State agency designated under the Child Care Block Grant Act; (2) establishment of a set-aside in the "at-risk" family child care support program for improving the quality and increasing the supply of appropriate child care for low-income communities; (3) increased Federal funding for the "at-risk" family child care support program as well as a new enhanced Federal match for that program consistent with that for other SSA title IV part A services; and (4) reallotment of unused "at-risk" funds to States with expenditures exceeding applicable limits. (Sec. 307) Provides for offering working AFDC families a supplement if certain earned income disregard provisions are applied in order to guarantee child care. Title IV: Provisions with Multi-Program Applicability - Revises current JOBS performance standards and AFDC quality control and management information system provisions. Provides for: (1) an outcome-based performance standards system for measuring the extent to which JOBS and WORK help participants and their families move towards self-sufficiency and economic well-being and away from welfare; and (2) an expanded quality control system, as well as new State automated systems, for use in assessing the State's performance in administering its AFDC, JOBS, WORK and child care support programs, by applying such standards and in assisting the States in monitoring participants, processing payments, providing services, managing information, and performing the other operations involved in administering such programs. Authorizes appropriations. (Sec. 403) Amends AFDC to require the Secretary to establish and maintain an automated National Welfare Receipt Registry of information on current and past AFDC and WORK participants for assisting States in administering their AFDC, JOBS, and WORK plans. Authorizes appropriations. (Sec. 404) Earmarks funding out of the capped JOBS and WORK entitlements above for specified demonstration projects, studies, and other activities related to the programs created and modified by this Act and involving, for instance: (1) JOBS placements in positions with significant retention rates; (2) WORK programs conducted outside the State's AFDC program; (3) State Work Support Agencies for assisting former AFDC recipients in retaining unsubsidized employment; and (4) parenting skills for noncustodial parents. (Sec. 405) Requires the Secretary and the Director of the Office of Management and Budget, beginning in FY 1998, to make certain certifications over a six-year period regarding the use of the component databases of the National Welfare Reform Information Clearinghouse (established under title VI of this Act) by State and Federal agencies. Requires the Director to determine whether Federal agencies have used such databases for reducing waste, fraud, and abuse in their programs in order to achieve the mandatory spending reductions assumed in the cost estimates accompanying this Act. Specifies required reductions in mandatory spending for the succeeding fiscal year if the Director certifies before the close of the current fiscal year that despite the full use of such databases mandatory spending was not reduced by the projected amount. Title V: Prevention of Dependency - Amends AFDC and JOBS to make various specified changes designed to prevent welfare dependency, including changes relating to: (1) supervised living arrangements for unmarried minor parents with dependent children and pregnant women; (2) State options to limit AFDC benefit increases for families on AFDC who have additional children, and to conduct a program of montary incentives and penalties to encourage teen custodial parents and pregnant women to complete high school and participate in parenting activities; and (3) case management for teen custodial parents on AFDC. (Sec. 505) Amends SSA title XX (Block Grants to States for Social Services) to provide for: (1) grants for development of school-based programs in high risk areas for promoting adolescent personal responsibility and character development with emphasis on drug use and pregnancy prevention; (2) grants for carrying out similar demonstration projects providing comprehensive services for promoting educational advancement, improving community stability, and developing employment opportunities in addition to focusing on personal responsibility and drug use and pregnancy prevention; and (3) establishment by appropriate Federal officials of the National Clearinghouse on Adolescent Pregnancy Prevention Programs for disseminating information on and performing other specified functions, including sponsoring training institutes, with regard to adolescent pregnancy prevention programs. Title VI: Child Support Enforcement - Amends SSA title IV part D (Child Support and Establishment of Paternity) to revise the Federal child support and paternity establishment system and related IRC and other provisions to mandate among other things: (1) centralized collection and disbursement (including interstate collection and disbursement) of child support payments through a new single statewide automated system linked to a central registry of all child support orders established or modified in the State involved subject to wage withholding; and (2) a National Welfare Reform Information Clearinghouse composed of specified automated registries and directories (including an expanded Federal Parent Locator Service) containing employment, locate, and other specified types of information for assisting the Internal Revenue Service (IRS) in verifying employment and States in administering their AFDC, JOBS, WORK, and child support and paternity establishment programs, verifying the income and eligibility of Medicaid, food stamp, and SSI (Supplemental Security Income) (SSA title XVI) program participants, and ruling on unemployment and worker compensation claims. (Sec. 601) Mandates: (1) outreach for voluntarily establishing paternity and facilitating access to child support enforcement services; (2) annual State reviews of and reports on child support and paternity establishment programs for use by Federal auditors in assessing program performance using new Government standards; and (3) increased Federal matching payments for such programs. Includes among such changes new State plan requirements regarding: (1) AFDC recipient cooperation in State efforts to establish paternity and secure support; (2) distribution of support payments; (3) due process rights; (4) privacy safeguards; and (5) State and local agency program staff and contractor training. (Sec. 612) Revises provisions on: (1) State incentive payments, providing for performance-based incentive adjustments to the Federal matching rate for payments to a particular State; and (2) reductions in State AFDC payments for certain failures, adding specific failures to achieve appropriate levels of performance in paternity establishment and child support enforcement or to submit complete or reliable data, and conditioning the effectiveness of such reductions on the State's failure to take sufficient corrective action in the succeeding fiscal year to achieve compliance. (Sec. 615) Requires the Secretary to conduct staffing studies for a report to the Congress. (Sec. 616) Earmarks specified funding for Federal technical assistance, training, research, demonstrations, and other activities assisting State child support and paternity establishment programs. (Sec. 617) Makes specified changes with regard to: (1) annual congressional reports on all SSA title IV part D activities; and (2) data collection and reporting. (Sec. 623) Revises State law requirements regarding: (1) income withholding; (2) locate networks; (3) labor union cooperation in such State efforts; (4) use of social security numbers on child support and paternity orders and other specified party records; (5) modification of child support orders (including uniform interstate enforcement and modification of such orders); (6) expedited administrative and judicial procedures for establishing paternity (including before the child is born) and establishing, modifying, and enforcing support obligations; (7) imposition of motor vehicle title liens and other specified actions for support arrearages (including mandatory credit bureau reporting of all arrearages); (8) arrearage statute of limitations and interest and penalties; and (9) visitation rights. (Sec. 625) Directs the Secretary to establish a National Welfare Reform Information Clearinghouse and an automated National Directory of New Hires. (Sec. 627) Directs the Secretary to conduct studies on: (1) (and make grants to States for demonstrations involving) certain locate activities; and (2) the use of tax return information for modifying child support orders. (Sec. 642) Provides for: (1) a reduction in State AFDC payments for failure to establish paternity promptly; and (2) State options to provide for incentive payments to families to encourage paternity establishment. Directs the Secretary to authorize certain State demonstrations involving financial incentives for paternity establishment. (Sec. 651) Authorizes the Secretary to establish: (1) a revolving loan fund for program improvements to increase child support collections; and (2) the National Commission on Child Support Guidelines to determine whether a national child support guideline is advisable and develop one for congressional consideration if it is. Authorizes appropriations. (Sec. 662) Amends IRC to make specified changes with regard to the IRS tax refund offset program and collection of arrearages, among other changes: (1) eliminating the disparities between AFDC and non-AFDC cases; and (2) prohibiting additional fees for updating open case arrearages. (Sec. 664) Consolidates and revises provisions for collecting support from Federal employees and members of the armed forces. (Sec. 672) Modifies support obligation treatment under the Federal bankruptcy code. (Sec. 673) Provides for passport denial in cases involving child support arrearages exceeding $5,000. (Sec. 681) Directs the Secretary to make grants for State demonstrations to determine the effectiveness of programs to provide assured levels of child support to custodial parents of children whose paternity and support obligations have been established. Authorizes appropriations. (Sec. 691) Authorizes appropriations for State absent parent access and visitation programs. Title VII: Improving Government Assistance and Preventing Fraud - Amends AFDC, the Family Support Act of 1988, the Food Stamp Act of 1977 (Food Stamp Act), SSA title XI, and the IRC to make various specified changes in income disregard, resource exclusion, and other provisions under the Federal welfare system that are designed to: (1) simplify administration, for example, by changing the policy of obtaining citizenship declarations from each family member in cases where a single family is applying for AFDC, and by conforming program rules between AFDC and the food stamp program on the treatment of educational assistance; and (2) prevent fraud by allowing State agencies to use the IRS to collect AFDC overpayments from Federal tax refunds. (Sec. 731) Individual Development Account Demonstration Act of 1994 - States that it is U.S. policy to: (1) eliminate barriers that prevent AFDC recipients from becoming self-sufficient through self-employment and asset accumulation; (2) identify and implement cost-effective strategies to encourage saving and entrepreneurship among low-income families that have the potential to reduce Federal spending on transfers and services to them; (3) enhance private-sector opportunities for such families by enabling them to use their own resources through expanded business investment, job creation, home ownership, and human capital investment; and (4) expand the capacity of local organizations to provide asset-related services, such as savings mechanisms and loan funds, that help people to help themselves. (Sec. 732) Provides for the establishment of State and local demonstration projects designed to determine: (1) the social, psychological, and economic effects of providing low-income individuals with the opportunity to accumulate assets and develop and use entrepreneurial skills; and (2) the extent to which an asset-based assistance policy may be used to enable such individuals to achieve economic self-sufficiency. Authorizes appropriations. (Sec. 734) Amends the IRC to allow the establishment of individual development accounts (IDAs) by or on behalf of an eligible individual for the purpose of accumulating funds to pay his or her qualified expenses. Establishes an annual limit on such contributions (except contributions to IDAs established under the demonstration projects above), and a limit on total contributions for all years of $10,000. Defines qualified expenses as those for: (1) post-secondary education expenses; (2) a first-home purchase; and (3) business capitalization. Declares that contributions to IDAs are not subject to the gift tax or the tax on prohibited transactions. (Sec. 741) Provides for State demonstrations under which participating residents will receive advanced earned income payments from a responsible State agency in lieu of receiving them from an employer. Authorizes appropriations. Title VIII: Self-Employment/Microenterprise Demonstrations - Directs the Secretary and the Administrator of the Small Business Administration, subject to available funding, to jointly develop a self-employment/microenterprise demonstration program for welfare recipients and low-income individuals. Authorizes appropriations. Title IX: Financing - Caps AFDC's emergency assistance program. (Sec. 902) Establishes uniform eligibility criteria under AFDC, SSI, and Medicaid for all categories of aliens, including those lawfully admitted for permanent residence. (Sec. 903) Makes the current five-year period of sponsor responsibility permanent law under SSI and increases sponsor periods under AFDC and food stamps to five years, among other changes in AFDC, SSI, and food stamp alien eligibility rules, which include changes disqualifying after five years certain aliens with sponsors having income in excess of applicable limits. (Sec. 904) Amends the National School Lunch Act, among other things, to: (1) establish a two-tiered reimbursement structure for family or group day care homes; (2) provide family or group day care home sponsoring organizations with additional funding for administrative expenses for each home located in a low-income area; and (3) require the Secretary of Agriculture to provide State assistance grants. (Sec. 905) Amends the Food Stamp Act to extend expiring provisions reducing the percentage of recovered food stamp overpayments retainable by State agencies. (Sec. 906) Make persons receiving in excess of $100,000 in off-farm adjusted gross income ineligible for Commodity Credit Corporation crop subsidies. (Sec. 907) Amends the IRC to: (1)extend the expiring corporate environmental income tax used to finance the Hazardous Substance Superfund; (2) extend the earned income tax credit to military personnel on extended active duty abroad; and (3) deny such credit for non-resident aliens. (Sec. 908) Amends the Federal Railroad Safety Act of 1970 to extend railroad safety inspection fees permanently. (Sec. 911) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to extend certain customs fees. Title X: Effective Dates - Specifies the effective dates of this Act.
United States · United States Congress · 15 June 1994
Unlisted Trading Privileges Act of 1994 - Amends the Securities Exchange Act of 1934 to modify the guidelines under which a national securities exchange may extend unlisted trading privileges for corporate securities. Directs the Securities and Exchange Commission to prescribe, as necessary, the time period after commencement of an initial public offering during which a national securities exchange is prohibited from extending unlisted trading privileges. Subjects the extension of unlisted trading privileges by a national securities exchange to Commission rules and/or approval. Provides for suspension and reinstatement of such privileges.
United States · United States Congress · 14 June 1994
World War II Peace Accords Commemorative Coin Act - Expresses the sense of the Congress that: (1) the 50th anniversary of the signing of the World War II peace accords on the U.S.S. Missouri should not go unrecognized at the national level; and (2) the United States should recognize such anniversary by minting and issuing a commemorative coin. Sets forth specifications for half dollar clad coins. Mandates that the surcharges received from the sale of such coins be paid by the Secretary of the Treasury to the Admiral Nimitz Foundation for the purpose of preserving the Pacific War heritage of the United States.
United States · United States Congress · 10 June 1994
Persian Gulf War Veterans' Compensation Act of 1994 - Directs the Secretary of Veterans Affairs to: (1) develop and implement a uniform case assessment protocol to ensure thorough assessment, diagnosis, and treatment of all Persian Gulf War (War) veterans suffering from illnesses the origins of which are currently unkown but which may be attributable to service in the Southwest Asia theater of operations during such War; (2) develop case definitions or diagnoses for such illnesses; and (3) implement a comprehensive outreach program, including a newsletter and a toll-free telephone number, to inform War veterans and their families of the medical care and other benefits that may be provided by the Department of Veterans Affairs as a result of service in such War. Directs the Secretary to pay compensation to a War veteran suffering from a disability resulting from an undiagnosed illness if such disability becomes manifest to a degree of ten percent or more within three years of separation from active military service. Provides exceptions to the payment of such compensation (i.e., when there is a preponderance of evidence to show that the disability was not incurred during such service or occurred after such service). Allows the Secretary to cease such payments after providing specified congressional committees with a scientific report showing that such disabilities are not connected to service in the War. Directs the Secretary to enter into: (1) an agreement with the Secretary of Defense for access to all clinical data on War veterans who remain on active duty, and to continually compile such data (with a required annual report); and (2) a contract for the conduct of an epidemiological study designed to assess the short- and long-term health consequences of service in such War (with appropriate oversight, a status report, and annual and final reports). Authorizes appropriations for FY 1995 through 2000 for such study. Authorizes appropriations to the Department for FY 1995 through 1998 for the conduct of research to advance the understanding of health risks and effects of service in the Gulf during such War and the means of treating such health effects.
United States · United States Congress · 25 May 1994
Designates September 16, 1994, as National POW/MIA Recognition Day. Requires the display of the National League of Families POW/MIA flag at: (1) all national cemeteries and the National Vietnam Veterans Memorial on May 30, 1994 (Memorial Day), September 16, 1994 (National POW/MIA Recognition Day), and November 11, 1994 (Veterans Day); and (2) the White House, the Capitol Building, and the buildings containing the primary offices of the Secretaries of State, Defense, and Veterans Affairs and the Director of the Selective Service System on September 16, 1994 (National POW/MIA Recognition Day).
United States · United States Congress · 23 May 1994
Support for Families with Children with Disabilities Act of 1994 - Amends the Individuals with Disabilities Education Act to add a new part I, Family Support, which may be cited as the Families of Children with Disabilities Support Act of 1994. Directs the Secretary of Education to make three-year grants to States for systems change and advocacy activities for statewide systems of support for families with children with disabilities. Sets forth priorities and application requirements. Requires States desiring such assistance to designate lead entities and establish State Family Support Policy Councils. Includes among authorized activities training and technical assistance, interagency coordination, local or regional councils, outreach, advocacy services, policy studies, hearings and forums, public awareness and education, needs assessment, program data, and pilot demonstration projects. Requires State strategic plans, progress criteria, and reports. Requires panels of experts to evaluate grant applications. Directs the Secretary to make grants to or contracts with appropriate public or private agencies and organizations, including institutions of higher education, for: (1) providing technical assistance and information on statewide systems of family support; and (2) conducting a national evaluation of the program of grants to States. Directs the Secretary to: (1) review Federal programs with respect to their impact on such family support, consistent with specified policies; and (2) make grants or contracts for projects of national significance for developing national and State policies and practices for family-centered and family-directed systems of support for families of children with disabilities. Authorizes appropriations.
United States · United States Congress · 19 May 1994
Designates August 1, 1994, as Helsinki Human Rights Day. Authorizes the President to reassert America's commitment to the Helsinki Accords and requests him to: (1) convey to all signatories of the Accords that respect for human rights and fundamental freedoms is a vital element of further progress in the ongoing Helsinki process; and (2) develop new proposals to advance the human rights objectives of such process to address the major problems that remain.
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