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Resolution· HCONRESH.Con.Res. 208 (102nd)referred
United States · United States Congress · 24 September 1991
Expresses the sense of the Congress that it is inappropriate for the Federal Government to take actions that have the effect of preempting the tax decisions of State governments. Protests the decision of the Secretary of Health and Human Services to prohibit Federal payments under the Medicaid program (title XIX of the Social Security Act) relating to State Medicaid expenditures that are made from revenues derived from provider-specific taxes. Urges the Secretary to drop the proposed rule implementing his decision.
Bill· HRH.R. 3371 (102nd)open
United States · United States Congress · 23 September 1991
Violent Crime Prevention Act of 1991 - Title I: Community Policing; Cop on the Beat - Community Policing; Cop on the Beat Act of 1991 - Amends the Omnibus Crime Control and Safe Streets Act of 1968 (Omnibus Act) to authorize the Director of the Bureau of Justice Assistance (BJA) to make grants to units of general local government and community groups to establish or expand cooperative efforts between police and the community to increase the police presence in the community. Requires the Director to develop a written model that informs community members regarding: (1) how to identify the existence of a drug or gang house; (2) what civil remedies are available; and (3) what mediation techniques are available between community members and individuals who have established a drug or gang house in such community. Sets forth application requirements. Requires each application to include a comprehensive plan containing: (1) a description of the crime problems within the areas targeted for assistance, the projects to be developed, community resources and gaps in the plan that cannot be filled with existing resources, and the system the applicant will establish to prevent and reduce crime; (2) an explanation of how the requested grant will be used to fill such gaps; and (3) an evaluation component. Requires the Director to allocate not less than 75 percent of the funds available to units of local government or combinations of such units and not more than 20 percent to community groups. Provides for grant renewal. Limits: (1) costs of administration, technical assistance, and evaluation to five percent of available funds; and (2) the Federal share to 75 percent of total project costs. Requires the Director, in awarding grants, to consider: (1) demonstrated need and ability to provide the services described in the plan; (2) evidence of the ability to coordinate a community-wide response to crime; (3) ability to maintain the program after funding is no longer available; and (4) geographic distribution of grant awards. Sets forth reporting requirements. Authorizes appropriations. Title II: Drug Treatment in Federal Prisons - Drug Treatment in Federal Prisons Act of 1991 - Directs the Bureau of Prisons (Bureau) to provide residential substance abuse treatment for: (1) not less than 50 percent of eligible prisoners by the end of FY 1993; (2) not less than 75 percent of eligible prisoners by the end of FY 1994; and (3) all eligible prisoners by the end of FY 1995. Amends the Federal criminal code to authorize a change in the conditions of confinement, a reduction of up to one year from the prisoner's sentence, or both, with respect to any prisoner who, in the judgment of the Director of the Bureau, has successfully completed a residential substance abuse treatment program. Specifies that, if such conditions are changed, the Bureau shall periodically test the prisoner for drug abuse and discontinue such changes upon determining that drug abuse has recurred. Sets forth reporting requirements. Authorizes appropriations. Title III: Substance Abuse Treatment in State Prisons - Substance Abuse Treatment in State Prisons Act of 1991 - Amends the Omnibus Act to authorize the Director of the BJA to make grants for use by States in developing and implementing residential substance abuse treatment programs within State correctional facilities. Sets forth application requirements, including: (1) assurances that Federal funds received will be used to supplement, not supplant, non-Federal funds; and (2) agreement by the State to implement or continue to require urinalysis or similar testing of individuals in correctional residential substance abuse programs, including testing of individuals released from such programs who remain in State custody. Sets forth requirements with respect to: (1) duties of the designated State office under the Omnibus Act (application preparation and grant administration); (2) the review of State applications by the Bureau; (3) the allocation and distribution of funds; and (4) evaluation. Limits the Federal share to 75 percent of total project costs. Authorizes appropriations. Title IV: Safe Schools - Safe Schools Act of 1991 - Amends the Omnibus Act to: (1) authorize the Director of the BJA to make grants to local educational agencies (LEAs) to provide assistance to such agencies most directly affected by crime and violence; and (2) require the Director to develop a written safe schools model in a timely fashion and make such model available to any LEA that requests such information. Earmarks such grants: (1) to fund anticrime and safety measures, and to develop education and training programs for the prevention of crime, violence, illegal drugs, and alcohol; and (2) for counseling programs for victims of crime within schools, crime prevention equipment, and the prevention and reduction of youth participation in organized crime and drug- and gang-related activities in schools. Sets forth application requirements, provisions with respect to limits on administrative costs and grant renewal, factors in the Director's consideration in awarding grants, and reporting requirements. Authorizes appropriations. Title V: Crime Victims - Victims Justice Act of 1991 - Repeals: (1) the current $150,000,000 cap on the Crime Victims Fund under the Victims of Crime Act of 1984; and (2) sunset provisions under such Act. Modifies the formula for the distribution of sums deposited into the Fund to provide that: (1) the first $10,000,000 of the total funds deposited in a fiscal year shall be available for child abuse prevention and treatment grants; (2) the next sums deposited, up to the reserved portion (specified below), shall be made available to the judicial branch for administration costs; (3) of the sums remaining, four percent shall be available for training and technical services to victim assistance programs and for financial support of services to victims of crime by victim assistance programs, and 96 percent shall be available for crime victim compensation and victim assistance programs. (Current law provides a complex formula for the distribution of funds depending on the amount deposited in the Fund.) Authorizes the Director of the Office for Victims of Crime to retain any amount in excess of 110 percent of the total deposited in the previous fiscal year as a reserve for those years in which there is a shortfall in the Fund, provided that the reserve shall not exceed $20,000,000. Specifies that: (1) the reserved portion shall be $6,200,000 in each of FY 1992 through 1995 and $3,000,000 for each fiscal year thereafter; and (2) sums awarded as part of a grant under this Act that remain unspent at the end of a fiscal year in which such grant is made may be expended for the grant's purpose at any time during the two succeeding fiscal years (under current law, during the succeeding fiscal year). Increases the Federal share of victim compensation programs from 40 to 45 percent of the amounts awarded by each program during the preceding fiscal year. Specifies that if the compensation paid by an eligible crime victim compensation program would cover costs that a Federal program, or a federally financed State or local program, would otherwise pay: (1) such victim compensation program shall not pay such compensation; and (2) the other program shall make its payments without regard to the existence of the crime victim compensation program. Authorizes the Director to use unspent compensation funds for assistance programs in either the year such funds are not spent or in the following year. Requires crime victim assistance chief executives to give particular attention to children who are victims of violent street crime. Authorizes the use of grants under this Act for demonstration projects. Allows the Director to permit up to five percent of a victim assistance program grant to be used by the chief executive of each State for administrative costs. Makes biannual reports under such Act due on May 31 (currently, such reports are due December 31). Requires grantees to certify that no grant funds will be used to supplant State and local funds, but rather will supplement those otherwise available funds. Delays the effective date for specified provisions to make the allocations required by such provisions without reducing the funding levels of programs supported by the Victim Assistance Fund and the Victims Compensation Fund. Title VI: The Certainty of Punishment for Young Offenders - Certainty of Punishment for Young Offenders Act of 1991 - Amends the Omnibus Act to require the Director of the BJA to make grants to States, for use by States and units of local governments, to develop alternatives to incarceration and probation for young offenders which promote reduced recidivism, crime prevention, and victim assistance, including boot camp prison programs, community service programs, and demonstration restitution projects. Sets forth provisions with respect to: (1) State and local applications; (2) application review; (3) the allocation and distribution of funds to State and local governmental units; (4) evaluation; and (5) limitations on administrative costs. Authorizes appropriations. Title VII: Drug-Testing of Arrested Individuals - Authorizes the Director of the BJA to make grants to States, for use by States and units of local government, to develop, implement, or continue drug testing projects when individuals are arrested and during the pretrial period. Sets forth provisions with respect to: (1) State applications, including a requirement that the State agree to develop or maintain programs of urinalysis or similar drug testing of individuals upon arrest and on a regular basis pending trial for the purpose of making pretrial detention decisions; (2) local applications; (3) the allocation and distribution of funds to State and local governmental units; and (4) reporting requirements. Authorizes appropriations. Title VIII: Drug Emergency Areas Act of 1991 - Drug Emergency Areas Act of 1991 - Amends the National Narcotics Leadership Act of 1988 to replace language with respect to the designation of high intensity drug trafficking areas with provisions authorizing the President to declare a State or part of a State to be a drug emergency area. Requires requests for such a declaration to be made, in writing, by the Governor or chief executive officer of any affected State or local government and forwarded to the President through the Director of National Drug Control Policy. Allows cities, counties, or States to submit a joint request. Requires requests to be based on a written finding that the emergency is of such severity and magnitude that Federal assistance is necessary to assure an effective response to save lives and to protect property, public health, and safety. Prohibits the President from limiting declarations made under this Act to highly-populated centers of drug trafficking, drug use, or drug-related violence. Requires the President to consider applications from governments of less populated areas where the magnitude and severity of such activities is beyond the capability of the State or local government to respond. Requires each Governor or chief executive officer, as part of such requests and as a prerequisite to such assistance, to: (1) take appropriate action under State or local law to respond to the crisis and furnish information on the nature and amount of State and local resources which have been or will be committed to alleviating the emergency; (2) certify that State and local government obligations and expenditures will comply with all applicable cost-sharing requirements; and (3) submit a detailed plan outlining that government's short- and long-term plans to respond to the emergency. Requires the Director to review requests submitted and forward the application to the President, along with a recommendation. Authorizes the President to make grants to State or local governments of up to $50,000,000 for any single emergency. Limits the Federal share to 75 percent of the costs necessary to implement the short- and long-term plan. Limits the duration of assistance to a drug disaster area to one year, after which the Governors or chief executive officers may apply for an extension of up to 180 days. Requires any State or local government receiving Federal assistance to balance the allocation of such assistance evenly between drug supply and demand reduction efforts, unless State or local conditions dictate otherwise. Authorizes the President to: (1) direct any Federal agency to utilize its authorities and resources to support State and local efforts; and (2) provide technical and advisory assistance. Makes assistance under this title subject to an annual audit by the Comptroller General. Authorizes appropriations. Title IX: Coerced Confessions - Specifies that the admission into evidence of a coerced confession (i.e., one elicited in violation of the fifth or fourteenth amendments to the Constitution) shall not be considered harmless error. Title X: DNA Records - DNA Identification Act of 1991 - Amends the Omnibus Act to authorize the use of drug control and system improvement grants to develop or improve in a forensic laboratory a capability to analyze DNA for identification purposes. Requires State applications for grant funds to certify, if any part of such grant is to be used to develop or improve a DNA analysis capability in a forensic laboratory, that: (1) DNA analyses performed at such laboratory will satisfy or exceed then current standards for a quality assurance program for DNA analysis issued by the Director of the Federal Bureau of Investigation (FBI); (2) DNA samples obtained by, and DNA analyses performed at, such laboratory will be accessible only to criminal justice agencies for law enforcement identification purposes, to any defendant for criminal defense purposes, and if identifiable information is removed, for a population statistics database, for identification research and protocol development purposes, or for quality control purposes; and (3) such laboratory and each analyst performing DNA analyses at such laboratory will undergo, at regular intervals of not to exceed 180 days, external proficiency testing by a DNA proficiency testing program meeting the standards issued under this Act. Authorizes appropriations. Requires the Director of: (1) the National Research Council to appoint an advisory board on DNA quality assurance methods to develop and periodically monitor recommended standards for quality assurance, including standards for testing the proficiency of forensic analysis in conducting DNA analyses; and (2) the FBI, after taking into consideration such recommended standards, to issue standards for quality assurance including standards for testing the proficiency of forensic laboratories in conducting such analyses. Mandates that such standards: (1) specify criteria for quality assurance and proficiency tests to be applied to each procedure used by forensic laboratories to conduct such analyses; and (2) include a system for grading proficiency testing performance to determine whether a laboratory is performing acceptably. Authorizes the Director of the FBI to establish an index of DNA identification records of persons convicted of crimes punishable by more than one year's imprisonment and analyses of DNA samples recovered from crime scenes. Specifies that such index may include only information on DNA identification records and analyses that are: (1) based on analyses performed in accordance with publicly available standards that satisfy or exceed specified guidelines for the quality assurance program for DNA analysis; (2) prepared by labs and DNA analysts that undergo regular external proficiency testing; and (3) maintained by Federal, State, and local criminal justice agencies pursuant to rules that restrict disclosure of stored DNA samples and analyses. Makes the exchange of DNA identification records subject to cancellation if the quality control and privacy requirements of this Act are not met. Requires: (1) FBI personnel who perform DNA analyses to undergo, at regular intervals of not to exceed 180 days, external proficiency proficiency testing by a DNA proficiency testing program meeting the standards issued pursuant to this Act; and (2) the Director of the FBI to submit an annual report on the results of such tests to the House and Senate Judiciary Committees for five years after enactment of this Act and to arrange for periodic blind external tests to determine the proficiency of DNA analysis performed at the FBI laboratory within one year. Restricts disclosure of DNA tests performed for a Federal law enforcement agency to: (1) criminal justice agencies for law enforcement identification purposes; and (2) any defendant for criminal defense purposes. Authorizes disclosure of test results for a population statistics database, for identification research and protocol development purposes, or for quality control purposes if personally identifiable information is removed. Sets fines of up to $100,000 for individuals: (1) having access to individually identifiable DNA information indexed in a database created or maintained by Federal law enforcement agency by virtue of employment or official position who willfully disclose such information to any person or agency not entitled to receive it; and (2) who, without authorization, willfully obtain DNA samples or such individually identifiable DNA information. Authorizes appropriations. Title XI: Habeas Corpus - Habeas Corpus Reform Act of 1991 - Amends the Federal judicial code to revise provisions governing habeas corpus procedures, particularly in capital cases. Establishes a statute of limitations of one year for the filing of an application for habeas corpus relief from a sentence of death. Prescribes periods during which such time requirement shall be tolled, including any period during which the applicant is not represented by counsel. Provides for dismissal of an application for failure to comply with such time requirement, except where the waiver of such requirement is warranted by exceptional circumstances. Specifies requirements for stays of execution in capital cases. Bars the court from applying a new rule representing a sharp break from precedent announced by the U.S. Supreme Court that could not reasonably have been anticipated at the time the claimant's sentence became final in State court. Requires a State in which capital punishment may be imposed to provide legal services to indigents: (1) charged with offenses for which capital punishment is sought; (2) who have been sentenced to death and who seek appellate, collateral, or unitary review in State court; and (3) who have been sentenced to death and who seek certiorari review of State court judgments in the U.S. Supreme Court. Directs the State to establish an appointing authority which shall be a statewide defender organization, a resource center, or a committee appointed by the highest State court, comprised of bar members with substantial experience in, or commitment to, criminal justice. Requires the appointing authority to: (1) publish a roster of attorneys qualified to be appointed in capital cases, procedures by which attorneys are appointed, and standards governing qualifications and performance of counsel (including knowledge and understanding of pertinent legal authorities regarding issues in capital cases; skills in the conduct of negotiations and litigation in capital cases, the investigation of capital cases and the psychiatric history and current condition of capital clients, and the preparation and writing of legal papers in capital cases; and five years of specified felony trial or other experience); (2) monitor the performance of attorneys appointed and delete from the roster any attorney who fails to meet qualification and performance standards; and (3) appoint a defense team, including at least two attorneys, to represent a client at the relevant stage of proceedings, promptly upon receiving notice of the need for the appointment from the relevant State court. Sets forth additional provisions with respect to the appointment of counsel. Requires that, in the case of an applicant for Federal habeas corpus relief under sentence of death, a claim presented in a second or successive application shall be dismissed unless the applicant shows that: (1) the basis of the claim could not have been discovered by the exercise of reasonable diligence before the applicant filed the prior application, or the failure to raise the claim in the prior application was due to action by State officials in violation of the U.S. Constitution; and (2) the facts underlying the claim would be sufficient, if proven, to undermine the court's confidence in the applicant's guilt of the offense for which the capital sentence was imposed or in the validity of that sentence under Federal law. Grants an applicant under sentence of death the right to appeal without a certification of probable cause, except after denial of a second or successive application. Title XII: Provisions Relating to Police Officers - Subtitle A: Police Accountability - Police Accountability Act of 1991 - Makes it unlawful for any governmental authority to engage in a pattern or practice of conduct by law enforcement officers that deprives persons of their constitutional or statutory rights, privileges, or immunities. Authorizes: (1) civil actions by the Attorney General and by any injured person to obtain equitable and declaratory relief to eliminate any such pattern or practice; and (2) the court to allow the prevailing plaintiff (in the case of an action by an injured person) reasonable attorney's fees and other litigation fees and costs, including expert's fees. Specifies that a governmental body shall be liable for such fees and costs to the same extent as a private individual. Establishes penalties for police brutality (excessive force), including a fine and imprisonment for any term of years or life if death results, for not more than ten years if bodily injury other than death results, and for not to exceed one year in any other case. Directs the Attorney General to acquire and publish an annual summary of data about complaints to criminal justice authorities about the use of excessive force by law enforcement officers. Requires State applications for justice system improvement grants (under the Omnibus Act) to include a certification that the State and its units of local government are providing such data to the Attorney General. Subtitle B: Retired Public Safety Officer Death Benefits - Amends the Omnibus Act to provide death benefits to retired public safety officers who become permanently and totally disabled as the direct result of a catastrophic injury sustained while responding to a fire, rescue, or police emergency. Title XIII: Fraud - Amends the Federal criminal code to include within mail fraud provisions depositing specified matter to be sent by any private or commercial interstate carrier (current law applies only to matter sent by the Postal Service). Establishes penalties for knowingly and with intent to defraud: (1) affecting transactions with one or more access devices (ADs) issued to another person to receive any thing of value aggregating $1,000 or more during any one-year period; (2) without the authorization of the issuer of the AD, soliciting a person for the purpose of offering an AD, or selling information regarding, or an application to obtain, an AD; or (3) without the authorization of the credit card system member or its agent, causing or arranging for another person to present to the member or its agent for payment evidence or records of transactions made by an AD. Establishes penalties for persons engaged in the business of insurance whose activities affect commerce, who: (1) knowingly make a materially false statement or report or willfully overvalue land, property, or security in connection with reports or documents presented to an insurance regulatory official or agency, or to any agent or examiner (official) appointed to examine the affairs of such person for the purpose of influencing in any way the actions of such official; (2) embezzle or willfully misappropriate funds or property while acting as an officer, director, agent, or employee (officer) of such person; (3) knowingly make a false entry of material fact in any book, report, or statement of such person with intent to deceive any person about the financial condition or solvency of such business or to deceive any officer of such person or any insurance regulatory official; and (4) by threats or force, corruptly influences, obstructs, or endeavors corruptly to influence or obstruct the proper administration of the law under which a proceeding (involving the business of insurance whose activities affect interstate commerce) is pending before an insurance regulatory official to examine the affairs of such person. Authorizes the Attorney General to seek civil penalties and injunctions for violations of this title. Sets penalties for obstructing criminal investigations with respect to the prosecution of cases of insurance fraud. Title XIV: Protection of Youth - Subtitle A: Crimes Against Children - Jacob Wetterling Crimes Against Children Registration Act - Directs the Attorney General to establish a State program and guidelines requiring persons convicted of a criminal offense against a minor to register a current address with a designated State law enforcement agency (LEA) for ten years after release from prison or after being placed on parole or supervised release. Sets forth requirements for an approved State registration program, including: (1) requirements that a State prison officer inform a released person of the duty to register and provide a designated State LEA with any new address in writing within ten days, obtain a fingerprint card and photograph if not already obtained, require the person to read and sign a form stating that the duty to register has been explained, and forward such information to a designated State LEA (which shall immediately enter the information into the appropriate State law enforcement record system, notify the appropriate LEA having jurisdiction where the person expects to live, and transmit the conviction data and fingerprints to the Identification Division of the FBI); (2) annual address verification by the designated State LEA; and (3) notification of LEAs having jurisdiction over a released person's new address. Provides that: (1) a person required to register who violates any requirement of a State program established by this Act shall be subject to criminal penalties in such State (recommends at least six months' imprisonment); and (2) the information provided under this Act is private and may be used for law enforcement purposes and confidential background checks conducted with fingerprints for child care services providers. Specifies that the allocation of BJA grant funds (under the Omnibus Act) received by a State not complying with the provisions of this Act three years after the enactment of this Act shall be reduced by 25 percent. Requires such unallocated funds to be reallocated to the States in compliance with this Act. Subtitle B: Parental Kidnapping - International Parental Kidnapping Crime Act of 1991 - Amends the Federal criminal code to establish penalties for removing a child from, or retaining a child outside, the United States with intent to obstruct the lawful exercise of parental rights. Authorizes appropriations to carry out (under the State Justice Institute Act of 1984) national, regional, and in-State training and educational programs dealing with criminal and civil aspects of interstate and international parental child abduction. Subtitle C: Sexual Abuse Amendments - Amends the Federal criminal code to include within the definition of "sexual act" the intentional touching, not through the clothing, of the genitalia of another person who has not attained age 16 with intent to abuse, humiliate, harass, degrade, or arouse or gratify the sexual desire of any person. Title XV: Miscellaneous Drug Control - Amends the Controlled Substances Act (CSA) to establish penalties for any physical trainer or adviser who persuades or induces an individual to possess or use anabolic steroids in violation of such Act. Amends: (1) the CSA to make enhanced penalty provisions with respect to the distribution of a controlled substance within 1,000 feet of specified schools and other facilities applicable to public housing projects; and (2) the Public and Assisted Housing Drug Elimination Act of 1990 to authorize the use of grants in public housing projects for the determination of boundaries and the posting of signs identifying the property of the projects as drug-free zones. Directs the Secretary of Housing and Urban Development to require each public housing agency to post notices regarding the penalty imposed in common areas and at other appropriate locations in public housing projects of the agency. Authorizes the Attorney General, for calendar years 1992, 1993, and 1994, to reserve not more than 70, 60, and 50 percent, respectively, of the total narcotic raw materials imports for materials having Turkey or India as their original source if the Attorney General determines that such materials are in adequate supply and are priced competitively with other authorized suppliers. Provides for enhanced penalties for drug trafficking in prisons. Title XVI: Fairness in Death Sentencing Act of 1991 - Fairness in Death Sentencing Act of 1991 - Amends the Federal judicial code to prohibit the implementation of a sentence of death that was imposed based on race. Specifies that an inference that race was the basis of a death sentence is established if valid evidence is presented demonstrating that, at the time such sentence was imposed, race was a statistically significant factor in decisions to seek or to impose the death sentence in the jurisdiction in question. Provides that evidence relevant to establishing such inference may include evidence that death sentences were, at the pertinent time, being imposed in the jurisdiction in question significantly more frequently upon persons of one race or as punishment for capital offenses against persons of one race. Directs the court to determine the validity of any statistical evidence presented to establish such inference and if it provides a basis for such inference. Specifies that such evidence must take into account, to the extent it is compiled and made publicly available, evidence of the statutory aggravating factors of the crimes involved and must include comparisons of similar cases involving persons of different races. Bars the implementation of the death sentence unless the Government rebuts such inference by a preponderance of the evidence. Requires that the data collected by public officials concerning factors relevant to the imposition of the death sentence be made publicly available. Sets forth provisions with respect to the enforcement of this Act. Specifies that no person shall be barred from raising any claim under this Act on the ground of having failed to raise or prosecute the same or a similar claim before the enactment of this Act, nor by reason of any adjudication rendered before such enactment. Title XVII: Miscellaneous Crime Control - Subtitle A: General - Establishes penalties for receiving the proceeds of: (1) extortion; (2) kidnapping; and (3) postal robbery. Amends the Federal criminal code to establish penalties, in addition to the punishment otherwise provided for a crime, for the commission of a felony crime of violence or specified drug-related felonies in or for any criminal street gang, subject to specified conditions. Specifies that any term of imprisonment imposed under this subtitle shall run consecutively to any other sentence imposed for the underlying crime. Provides that an element of an offense that the defendant knew that property was stolen or counterfeit may be established by proof that the defendant, as a result of an official representation as to the nature of the property, believed the property to be stolen or counterfeit. Amends the CSA to increase penalties for the distribution of controlled substances in or near schools. Amends the Federal criminal code to authorize the Director of the FBI or his designee in a position not lower than Deputy Assistant Director to request: (1) the name, address, length of service, and toll billing records of a person or entity (person) if the Director certifies in writing to the wire or electronic communication service provider that such records are relevant to an authorized foreign counterintelligence investigation and there are specific and articulable facts giving reason to believe that the person to whom the information pertains is a foreign power or a foreign agent; and (2) the name, address, and length of service of a person if the Director certifies in writing to such provider that the information is relevant to such an investigation and there are specific articulable facts giving reason to believe that communication facilities registered in the name of the person have been used in communication with an individual who is or has engaged in international terrorism or clandestine activities that involve or may involve a violation of U.S. criminal statutes or a foreign power or foreign agent concerning international terrorism or such clandestine activities. Requires that the House and Senate Judiciary Committees be informed regarding all such requests for certification. (Current law authorizes the Director or his designee to request telephone toll and transactional records upon written certification to the provider that the information sought is relevant to an authorized foreign counterintelligence investigation and there are specific and articulable facts giving reason to believe that the person is a foreign power or foreign agent.) Extends the protection under civil rights statutes with respect to conspiracy against rights and deprivation of rights under color of law to any person in (currently, any inhabitant of) any State territory, or district. Increases penalties under the Travel Act for crime involving violence. Eliminates the $10,000 cap on fines under such Act. Provides penalties for misuse of the words "Drug Enforcement Administration" or the initials "DEA." Defines: (1) "savings and loan association" for purposes of the bank robbery statute to mean any Federal or State savings association having accounts insured by the Federal Deposit Insurance Corporation and any corporation described in the Federal Deposit Insurance Act which is operating under U.S. law; and (2) "livestock" to mean any domestic animals raised for home use, consumption, or profit. Subtitle B: Motor Vehicle Theft Prevention - Motor Vehicle Theft Prevention Act - Directs the Attorney General to develop a national voluntary motor vehicle theft prevention program under which: (1) the owner of a motor vehicle may voluntarily sign a consent form with a participating State or locality in which the motor vehicle owner states that the vehicle is not normally operated under specified conditions and agrees to display program decals or devices on the owner's vehicle and permit law enforcement officials in any State to stop the vehicle and take reasonable steps to determine whether such vehicle is being operated by the owner or with the owner's permission, if the vehicle is being operated under such conditions; (2) participating States and localities authorize law enforcement officials in the State or locality to stop motor vehicles displaying program decals or devices under such conditions and take reasonable steps to determine whether the vehicle is being operated by or with the permission of the owner; and (3) Federal law enforcement officials are authorized to stop such vehicles under such conditions and make such determination. Requires such program to include a uniform design or designs for decals or other devices to be displayed by motor vehicles participating in the program which shall: (1) be highly visible; and (2) explicitly state that the motor vehicle to which it is affixed may be stopped under the specified conditions without additional grounds for establishing a reasonable suspicion that the vehicle is being operated unlawfully. Sets forth requirements with respect to the voluntary consent form. Directs the Attorney General to promulgate rules establishing the conditions under which participating motor vehicles may be authorized to be stopped under this Act, such as the operation of the vehicle during certain hours of the day or under circumstances that would provide a sufficient basis for establishing a reasonable suspicion that the vehicle was not being operated by, or with the consent of, the owner. Sets forth provisions with respect to the establishment of more than one set of conditions under which participating motor vehicles may be stopped. Requires the notification of lessees of motor vehicles for hire of participation in the program, as specified. Sets penalties for failure to comply with such notice provisions. Authorizes a State or locality to participate in the program by filing an agreement to comply with the terms and conditions of the program with the Attorney General. Specifies that, as a condition of participation, a State or locality must agree to take reasonable steps to ensure that law enforcement officials throughout the State or locality are familiar with the program and with the conditions under which motor vehicles may be stopped under the program. Authorizes appropriations. Includes within the scope of a provision setting penalties for the removal of or tampering with an identification number for a motor vehicle or motor vehicle part, removal of or tampering with a decal or device affixed pursuant to this Act with intent to further the theft of a vehicle, with exceptions. Sets forth penalties for the unauthorized application of a theft prevention decal or device, or a replica thereof. Title XVIII: Miscellaneous Funding Provisions - Authorizes appropriations for: (1) the Drug Enforcement Agency; and (2) the justice system improvement program under the Omnibus Act. Amends: (1) the Federal judicial code to make available sums from the Department of Justice (DOJ) Assets Forfeiture fund for alcohol and drug abuse and mental health services block grants under the Public Health Service Act, subject to specified limitations; and (2) the Omnibus Act to authorize the Director of the BJA to make grants to, or enter into contracts with, specified non-Federal public or private entities (current law does not specify non-Federal). Title XIX: Miscellaneous Criminal Procedure and Correction - Subtitle A: Revocation of Probation and Supervised Release - Amends the Federal criminal code to: (1) require the court, in sentencing a defendant for a violation of probation or supervised release, to consider applicable guidelines or policy statements issued by the U.S. Sentencing Commission; and (2) permit the court, if a defendant violates a condition of probation, to resentence the defendant (under current law, the court may impose any other sentence that was available at the time of the initial sentencing). Provides for the mandatory revocation of probation for possession of a controlled substance or firearm (currently, applies only to actual possession of a firearm). Requires the court, under such circumstances, to resentence the defendant to a sentence that includes a term of imprisonment (current law directs the court to impose any other sentence that was available at the time of the initial sentencing). Directs the court to require, as an explicit condition of probation or supervised release, that the defendant not unlawfully possess a controlled substance. (Current law specifies that the defendant not possess illegal controlled substances.) Specifies that a defendant whose term of supervised release is revoked may not be required to serve more than five years in prison if the offense that resulted in the term of release is a class A felony, more than three years if such offense is a class B felony, more than two years for a class C or D felony, or more than one year in any other case. (Current law specifies only no more than three years for a class B felony or more than two years for a class C or D felony.) Requires the court to revoke the term of supervised release and require the defendant to serve a term of imprisonment not to exceed the maximum authorized if the defendant possesses a controlled substance in violation of a condition of supervised release or possesses a firearm in violation of Federal law or otherwise violates a condition of supervised release prohibiting the defendant from possessing a firearm. (Current law states that if the defendant is found to be in possession of a controlled substance, the court shall terminate the term of supervised release and require the defendant to serve in prison not less than one-third of the term of release.) Provides that: (1) when a term of supervised release is revoked and the defendant is required to serve a term of imprisonment less than the maximum authorized, the court may require that the defendant be placed on a term of supervised release after imprisonment (for a length of time not to exceed the term of release authorized by statute for the offense that resulted in the original term of supervised release, less any term of imprisonment imposed upon revocation of such release); and (2) the power of the court to revoke a term of supervised release for violation of a condition of such release and to order the defendant to serve a term of imprisonment and a further term of such release extends beyond the expiration of the term of such release for any period reasonably necessary for the adjudication of matters arising before its expiration, subject to specified conditions. Subtitle B: List of Veniremen - Provides that a person charged with treason or another capital offense shall, a reasonable time (currently, at least three days) before trial, be furnished with: (1) a copy of the indictment (as under current law); (2) a list of veniremen and witnesses to be produced at trial (as under current law) and at the sentencing hearing; (3) the relevant written or recorded statements of such witnesses, relevant portions of memoranda containing reports of their statements, and copies of documents and the opportunity to examine tangible objects that the Government intends to use in the trial or sentencing hearing; and (4) such other reports, statements, or information as the court may order. Provides that the list of veniremen and the name, address, and other information identifying a witness need not be furnished if the court finds by a preponderance of the evidence that providing the list or the name or address may jeopardize the life or safety of any person. Subtitle C: Immunity - Permits a U.S. attorney to request an order requiring an individual to give testimony or provide other information which such individual refuses to give or provide based on the privilege against self-incrimination under specified circumstances with the approval of an officer or employee of the Criminal Division of DOJ designated by the Attorney General (currently, only with the approval of specified officials). Subtitle D: Clarification of 18 U.S.C. 5032's Requirement That Any Record of a Juvenile be Produced Before the Commencement of Juvenile Proceedings - Specifies that a juvenile shall not be transferred to adult prosecution nor shall a hearing be held under section 5037 (disposition after a finding of juvenile delinquency) until any prior juvenile court records have been received by the court or other specified conditions are met. (Current law states that "any proceedings against a juvenile under this chapter or as an adult shall not be commenced" until such conditions are met.) Subtitle E: Petty Offenses - Authorizes probation for a petty offense if the defendant has been sentenced to a term of imprisonment at the same time for another such offense. Provides for trial by a magistrate in petty offense cases. Grants a magistrate judge who has sentenced a person to a term of supervised release the power to revoke or modify the terms or conditions of such release. Subtitle F: Optional Venue for Espionage and Related Offenses - Provides for venue in the District of Columbia or in any other district authorized by law for the trial of specified espionage and related offenses. Title XX: Firearms and Related Amendments - Subtitle A: Firearms and Related Amendments - Amends the Federal criminal code to prohibit the transfer of firearms to non-residents of the State in which the transferor resides. Provides for enhanced penalties for: (1) the use of a semiautomatic firearm during a crime of violence or drug trafficking offense, with exceptions; and (2) possession of a firearm or explosive during the commission of such offenses. Sets forth penalties for smuggling firearms in aid of drug trafficking and for theft of firearms and explosives. Increases penalties for: (1) making knowingly false, material statements in connection with the acquisition of a firearm from a licensed dealer; and (2) a second offense of using an explosive to commit a Federal felony. Amends the Internal Revenue Code of 1986 to: (1) change from six to five years the statute of limitations for certain firearms offenses; and (2) provide for the summary forfeiture of unregistered National Firearms Act weapons, with provision for reimbursement for innocent owners. Authorizes the summary destruction of explosives subject to forfeiture under specified circumstances. Sets forth requirements for reimbursement of the value of destroyed property. Adds using a firearm in the commission of counterfeiting or forgery among offenses which, if the offender uses or carries a firearm, will subject such person to an enhanced sentence. Provides for a mandatory five-year penalty for firearms possession by violent felons and serious drug offenders. Modifies provisions regarding the reporting of multiple firearms sales to: (1) cover sales during any 30 consecutive days (currently, during any five consecutive business days); and (2) require each licensee to forward a copy of the report to the chief law enforcement officer of the place of residence of the unlicensed person not later than the close of business on the date that the multiple sale or disposition occurs. Subjects individuals who conspire to commit a firearms or explosives offense to the same penalties as prescribed for the underlying offense. Provides for a fine or up to ten years' imprisonment, or both, for stealing a firearm or explosive from specified individuals, such as a licensed importer, manufacturer, or dealer. Makes it unlawful for any person (current law specifies licensee) to distribute explosive materials to specified classes of individuals. Subtitle B: Assault Weapons - Prohibits the possession or transfer of assault weapons, with exceptions. Defines "assault weapon" to mean all firearms so designated under this Act, including Kalashnikov, Uzi, and AR-15 semiautomatic firearms. Authorizes the Secretary of the Treasury to recommend modifications to the list of designated assault weapons. Repeals a provision setting penalties (a fine of up to $5,000, up to five years' imprisonment, or both) for knowingly possessing a firearm in a school zone. Applies such penalties to persons who: (1) assemble from imported parts any semiautomatic rifle or shotgun which is identical to any rifle or shotgun prohibited from importation as not being particularly suitable for or readily adaptable to sporting purposes, with exceptions; and (2) possess or transfer an assault weapon in violation of this subtitle. Provides for an enhanced penalty for possession or use of an assault weapon during a crime of violence or drug trafficking crime. Directs the Secretary to prescribe regulations governing the transfer of assault weapons. Establishes a fine of up to $500 for the transfer in violation of any such regulation of an assault weapon that has been lawfully and continuously possessed by the person since before the date the weapon was included in the list under this subtitle. Subtitle C: Large Capacity Ammunition Feeding Devices - Prohibits the possession or transfer of large capacity ammunition feeding devices, with exceptions. Defines "large capacity ammunition feeding device" to mean: (1) a detachable magazine or similar device which has, or which can be readily converted to have, a capacity of more than seven rounds of ammunition; and (2) any part or combination of parts designed or intended to convert a detachable magazine or similar device. Excludes from such definition any attached tubular device designed to accept and capable of operating with, only .22 rimfire caliber ammunition. Sets penalties for the possession or transfer of large capacity ammunition feeding devices in violation of this subtitle. Directs the Secretary to promulgate regulations requiring manufacturers of large capacity ammunition feeding devices to stamp each such device manufactured after the date of the enactment of this Act with a permanent distinguishing mark selected in accordance with such regulations. Subtitle D: Possession of Stolen Firearms, Etc. - Prohibits the possession of: (1) stolen firearms or ammunition; and (2) explosives by felons and specified other individuals. Title XXI: Sports Lotteries - Professional and Amateur Sports Protection Act - Amends the Federal judicial code to prohibit a government entity from sponsoring, operating, advertising, promoting, licensing, or authorizing by law, or a person from sponsoring, operating, advertising, or promoting, pursuant to the law of a governmental entity, a lottery, sweepstakes, or other gambling scheme based on competitive games in which amateur or professional athletes participate, with exceptions. Authorizes the Attorney General, or a professional or amateur sports organization whose competitive game is alleged to be the basis of the violation, to enjoin a violation of this title. Title XXII: Technical Corrections - Makes technical corrections to the Omnibus Act, CSA, Federal criminal code, and other statutes. Requires the Director of the National Institute of Corrections to give priority, in making correction options grants, to public agencies (currently, States) that demonstrate that the capacity of their correctional facilities is inadequate to accommodate the number of individuals who are convicted of offenses punishable by a term of imprisonment exceeding one year. Modifies the definition of "firefighter" to include an officially recognized or designated public employee member of a rescue squad or ambulance crew (currently, who was responding to a fire, rescue, or police emergency). Title XXIII: Death Penalty Procedures - Amends the Federal criminal code to establish criteria for the imposition of the death penalty for specified Federal crimes, including: (1) delivering defense information to aid a foreign government; (2) treason; (3) specified CSA offenses committed as part of a continuing criminal enterprise; (4) felony violations of the CSA, the Controlled Substances Import and Export Act, or the Maritime Drug Law Enforcement Act where the defendant knowingly or intentionally causes the death of another individual in the course of the violation or from the use of the controlled substance involved in the violation; (5) certain offenses relating to drive-by shooting; (6) specified offenses under the Federal Aviation Act of 1958; and (7) any other offense for which a death sentence is provided by law and in which the defendant, as determined beyond a reasonable doubt at a sentencing proceeding under this title, intentionally or knowingly caused the death of another individual. Requires the Government, for any offense punishable by death, to serve notice upon the defendant a reasonable time before trial or acceptance of a plea, that it intends to seek the death penalty and the aggravating factors upon which it will rely. Requires a separate sentencing hearing before a jury, or the court upon motion by the defendant, when the defendant is found guilty or pleads guilty to an offense punishable by death. Allows the defendant and the Government to present any information relevant to sentencing, without regard to the rules of evidence, but permits evidence to be excluded where its probative value is substantially outweighed by the danger of creating unfair prejudice, confusing the issues, or misleading the jury. Specifies mitigating factors which the defendant must establish by a preponderance of the information and aggravating factors which the Government must prove beyond a reasonable doubt. Sets forth special aggravating factors for: (1) espionage, treason, homicide, and the attempted murder of the President; and (2) drug offenses punishable by the death penalty (such factors include previous serious drug felony convictions, use of a firearm in committing or furthering certain continuing criminal enterprises, use of minors in trafficking, and lethal adulteration of controlled substances). Directs the court, or the jury by unanimous vote, to impose the death penalty upon a finding of at least one aggravating and no mitigating factor, or one or more aggravating factors which outweigh any mitigating factors. States that no person who was under 18 years of age at the time of the offense may be sentenced to death. Requires the court to instruct the jury not to consider the race, color, religion, national origin, or sex of the defendant or victim in its consideration of the sentence. Establishes procedures for appeal from a death sentence. Requires the court of appeals, upon consideration of the record and the information and procedures of the sentencing hearing, to affirm the decision if: (1) the sentence was not imposed under the influence of passion, prejudice, or any other arbitrary factor; (2) the information supports the finding of aggravating factors; and (3) the proceedings did not involve any other prejudicial error requiring reversal of the sentence that was properly preserved for and raised on appeal. Specifies that if any reviewing court determines that an aggravating factor was not supported by the evidence or is not a proper aggravating factor, the sentence shall be affirmed if the court finds that a remaining aggravating factor found to exist is one allowed under this title and that the remaining aggravating factors substantially outweigh any mitigating factors. Requires the court to provide a written explanation of its determination. Sets forth procedures for the implementation of the sentence of death. Limits the circumstances under which a person subject to the criminal jurisdiction of an Indian tribal government may be executed under this Act. Prohibits a sentence of death from being carried out upon: (1) a woman while she is pregnant; (2) a person who is mentally retarded; (3) a person who, as a result of mental disability, cannot understand the nature of the proceedings, what such person was tried for, or the reason for or nature of the punishment; or (4) a person who lacks the capacity to recognize or understand facts which would make the punishment unjust or unlawful or the ability to convey such information to counsel or to the court. Provides for appointment of counsel in Federal cases for a defendant or applicant (defendant) charged with a crime with respect to which a sentence of death may be sought or on whom a sentence of death has been imposed, for an offense against the United States, and for any defendant seeking to vacate or set aside a death sentence in a State or Federal habeas corpus proceeding, where the defendant is or becomes financially unable to obtain adequate representation or investigative, expert, or other reasonably necessary services. Entitles such defendant to such other services. Sets forth additional provisions with respect to: (1) representation before and after review of judgment; (2) standards for competence of counsel; (3) ancillary services; (4) rates of compensation; and (5) claims of ineffectiveness of counsel. Sets forth provisions with respect to: (1) deadlines for collateral attacks on judgements imposing a sentence of death; and (2) stays of execution. Amends the Federal Rules of Criminal Procedure to require the court, in death penalty cases, to permit the defendant or his attorney and the attorney for the Government to conduct direct, oral examination of any of the prospective jurors. Title XXIV: Death Penalty - Federal Death Penalty Act of 1991 - Provides for the imposition of the death penalty for: (1) murder committed by prisoners in Federal prisons; (2) kidnappings which result in the death of any person; (3) hostage takings which result in the death of any person; (4) attempting to kill the President of the United States (if such attempt results in serious bodily injury or comes dangerously close to causing the President's death); (5) murder for hire; (6) murder in the aid of a racketeering activity; (7) international terrorism (where a death is the result of first-degree murder or conduct that constitutes a reckless disregard of human life); (8) genocide; (9) murder of Federal law enforcement officials; (10) murder of specified persons aiding such officials; (11) torture; (12) using, or attempting or conspiring to use, a weapon of mass destruction, if death results; (13) first-degree murders involving the use of a firearm or other dangerous weapon in a Federal facility; (14) civil rights murders; (15) intentionally killing a Federal witness in the Witness Protection Program; and (16) drive-by-shootings that result in death. Increases penalties for obstruction of justice offenses against court officers and jurors and for retaliatory killings of witnesses, victims, and informants. Sets forth penalties for: (1) performing or attempting an act of violence against a person at an airport serving international civil aviation which causes or is likely to cause serious injury or death; (2) destroying or seriously damaging the facilities of, or a civil aircraft not in service at, such airport; or (3) disrupting the services of such airport, if such an act endangers or is likely to endanger safety. Amends the Federal Aviation Act to delete a limitation on the applicability of aircraft piracy provisions to situations where the place of takeoff or of actual landing of the aircraft on board which the offense is committed is situated outside the territory of the State of registration of such aircraft. Establishes penalties for acts of violence against maritime navigation, such as seizing control of a ship by force, threat, or intimidation, performing acts of violence against persons on board a ship that are likely to endanger safe navigation, and destroying or seriously damaging maritime navigational facilities that are likely to endanger safe navigation. Sets forth analogous provisions with respect to maritime fixed platforms. Sets forth provisions with respect to U.S. jurisdiction over the territorial sea and over crimes against U.S. nationals on foreign vessels.
Bill· SS. 1736 (102nd)referred
United States · United States Congress · 20 September 1991
Medicare Durable Medical Equipment Patient Protection Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to designate no more than five regional carriers nationwide to process all claims for durable medical equipment and prosthetics and orthotics. Requires the carrier designated to process the claims in a particular region to process all claims for such items furnished to an individual residing in that region unless the Secretary decides otherwise for reasons of administrative efficiency. Requires the development of a national fee schedule for ostomy supplies, urologicals, surgical, and other medical supplies. Directs the Secretary to develop recommendations for national uniform reimbursement rates and coverage and utilization policies for all the items mentioned above. Require an interim and final report to the Congress with recommendations on national uniform reimbursement rates and utilization parameters for such items. Directs the Secretary to group the procedure codes contained in any HCFA Common Procedure Coding System for payment purposes to minimize inappropriate increases in the volume of medical items and supplies provided as a result of coding distinctions which do not reflect substantial differences in the items supplied. Directs the Secretary, in grouping such codes, to ensure that no more is paid for an item that is billed separately than would be paid if the item were billed as part of a grouping of items. Amends title XI of the Social Security Act to set forth additional information disclosure requirements which suppliers of the items mentioned above who receive payment for such items under Medicare part B (Supplementary Medical Insurance) must meet. Requires such supplier to resubmit and renew an application for a provider number every two years in order to participate in Medicare and Medicaid (title XIX of the Social Security Act). Includes within provisions providing criminal penalties for kickbacks certain employment situations involving the processing of paperwork and warehousing or stock inventory functions. Authorizes user fees for provider numbers. Amends the Medicare program to require the Secretary to: (1) develop a list of suppliers and billing agents for the items mentioned above who the Secretary determines may be engaged in fraud or sales or billing practices which serve to maximize reimbursement or promote unnecessary utilization; and (2) develop an administrative mechanism to provide due process to suppliers or other entities placed on such list for removal from the list. Authorizes carriers to require prior approval of billings submitted by entities on the Secretary's list. Relieves Medicare beneficiaries from responsibility for payment of items or services furnished by a supplier on an unassigned basis in cases where the supplier is excluded from participation in any program under Medicare or is denied payment by the carrier for the item or service in advance. Authorizes the Comptroller General to study and report to the Congress on: (1) the types, volume, and utilization of services and supplies furnished under contract or under arrangement with suppliers to individuals eligible for benefits under Medicare part B and residing in nursing facilities; and (2) the appropriateness of utilization controls applied to the use of durable medical equipment by Medicare beneficiaries. Directs the Secretary to study and report to the Congress on the application of certain payment limits under Medicare to parenteral and enteral nutrition nutrients, supplies, and equipment.
Bill· SS. 1729 (102nd)open
United States · United States Congress · 19 September 1991
Public Health Clinic Prudent Pharmaceutical Purchasing Act - Amends title XXI (Vaccines and Certain Drug Purchases) of the Public Health Service Act to provide for rebates from drug manufacturers to entities receiving financial assistance under the Act in an amount determined under a specified formula. Defines "drug" to include a drug as defined under the Social Security Act and any over-the-counter drug or birth control device. Prohibits reducing grants to such entities as a result of the rebates. Prohibits such an entity from reselling a drug or biological for which it has received a rebate.
Bill· SS. 1719 (102nd)referred
United States · United States Congress · 17 September 1991
Prerecorded Telephone Solicitation Consumer Rights Act - Amends the Communications Act of 1934 to make it unlawful for any person to make any call using any automatic dialing recorded message program system or an artificial or prerecorded voice: (1) to any emergency telephone line or pager line or pager of any hospital, medical physician or services office, health care facility, or fire protection or law enforcement agency; (2) to any telephone number assigned to paging or cellular telephone service; or (3) to any restricted telephone number on the national database list. Directs the Federal Communications Commission to: (1) initiate a rulemaking proceeding to develop proposed regulations to implement methods and procedures for protecting the privacy rights of residential telephone subscribers to avoid receiving unsolicited prerecorded telephone solicitations to which they object; and (2) prescribe technical and procedural standards for systems that are used to transmit any artificial or prerecorded voice message via telephone. Makes it unlawful for any person to initiate any telephone call using any automatic telephone dialing system that does not comply with such standards, or to use any such system to transmit prerecorded telephone solicitations in a manner that does not comply with such standards. Lets stand any State law that imposes more restrictive intrastate requirements or regulations on, or which prohibits: (1) the use of automatic telephone dialing systems to transmit prerecorded telephone solicitations; and (2) the use of artificial voice or recorded messages. Preempts any provisions of State law concerning interstate communications that are inconsistent with the provisions of this Act.
Bill· HRH.R. 3349 (102nd)referred
United States · United States Congress · 17 September 1991
Revises provisions concerning health care for members and certain former members of the armed forces to entitle members or former members who are eligible for retired or retainer pay and for Medicare to medical and dental care in any uniformed service medical facility. Provides that such facilities will recover the costs of such care from Medicare Subvention funding. Provides that the costs of care for members or former members who are not eligible for Medicare will be recovered from the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) Subvention funding. Revises provisions concerning health care for military dependents to provide that the uniformed services facilities providing such care will recover costs from Medicare or CHAMPUS, as appropriate. Prohibits medical or dental care from being provided to an otherwise eligible person at a military treatment facility only if the senior or commanding officer of such facility determines that such facility cannot provide the particular care required because of lack of space or facilities or because such type of care is not provided at such facility. Requires the administering Secretary to be advised immediately when a determination to deny treatment is made, with a verifiable date as to when the restriction will be removed. Amends title XVIII (Medicare) of the Social Security Act to make Department of Defense and Department of Veterans Affairs treatment facilities eligible for Medicare payments as long as they meet requirements applicable to hospitals and skilled nursing facilities under such title.
Bill· SS. 1712 (102nd)referred
United States · United States Congress · 16 September 1991
Directs the Secretary of the military department concerned, the Secretary of Commerce with respect to the National Oceanic and Atmospheric Administration, and the Secretary of Health and Human Services with respect to the Public Health Service to pay an annuity to any individual who is the surviving spouse or a dependent child of a reserve member of the armed forces who: (1) died during the period between September 21, 1972, and September 30, 1978; and (2) at the time of death, would have been entitled to retired pay but for the fact that such individual was under 60 years of age. Requires such annuity to be paid in the same manner as if the individual had made a designation to provide an annuity as a veteran under the Survivor Benefit Plan. Requires an individual who is entitled to an annuity under Federal armed forces provisions and an annuity under Federal veterans' benefits provisions by reason of a subsequent marriage to choose one annuity to receive.
Bill· HRH.R. 3346 (102nd)referred
United States · United States Congress · 16 September 1991
Medicare EKG Payment Equity Act of 1991 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to: (1) reestablish separate payment for the interpretation of electrocardiograms (EKGs) that are ordered or performed during an office visit to or consultation with a physician; and (2) set forth special rules governing the payment for EKG interpretation services in order to ensure budget-neutrality. Makes this Act effective as of the enactment of the Omnibus Budget Reconciliation Act of 1990.
Bill· HRH.R. 3323 (102nd)referred
United States · United States Congress · 12 September 1991
Amends the Public Health Service Act to make students in occupational therapy eligible for Federal student loan insurance.
Bill· HRH.R. 3315 (102nd)referred
United States · United States Congress · 12 September 1991
Depository Institution Employee Benefits Protection Act - Amends the Federal Deposit Insurance Act (the Act) to direct the Federal Deposit Insurance Corporation (FDIC) to require an acquiring institution or company to take FDIC-determined appropriate action to retain or give future hiring preference to employees of any insured depository institution for which the FDIC has been appointed conservator or receiver (as a condition for providing any assistance to the acquiring insured depository institution or depository institution holding company). Authorizes the FDIC to apply such requirement in a manner which it determines appropriate in the case of more than one acquirer. Prohibits the FDIC, notwithstanding specified provisions of the Act relating to contracts, from disaffirming or repudiating any collective bargaining agreement with any insured depository institution which was in effect at the time of the FDIC's appointment as conservator or receiver, but allows the FDIC to renegotiate the terms of any such collective bargaining agreement. Directs the FDIC and the Resolution Trust Corporation (RTC) to ensure that they (as conservator or receiver) and any successor institution honor the obligations and policies of any depository institution placed in such receivership with respect to such institution's employees (including retired or former employees) who are not covered by a collective bargaining agreement on the date of such appointment. Includes among such obligations and policies: (1) health care coverage, including continuation coverage for group plans, and other medical benefits; (2) severance pay; (3) accrued sick and vacation leave; and (4) pension rights and benefits, including any liability for any unfunded or underfunded pension plan or deferred compensation plan. Directs FDIC and RTC to implement procedures to provide for assumption of such employee benefit obligations and continuation of such policies by successor institutions to the greatest extent practicable. Directs the FDIC, within the 120-day period beginning on the date of enactment of this Act, to report to the Congress with recommendations for such additional legislative action as the FDIC determines appropriate to carry out the purposes of this Act.
Bill· HRH.R. 3312 (102nd)referred
United States · United States Congress · 11 September 1991
Area Health Education Centers Reauthorization Act of 1991 - Amends the Public Health Service Act to specify a term of six years for agreements establishing area health education centers (AHECs). Modifies the purposes of AHECs, including serving high-impact areas and States as well as border areas close to Mexico. Mandates, if available in the area, participation of a school of public health. Authorizes agreements for the planning, development, and operation of State-supported AHECs. Authorizes appropriations.
Bill· HRH.R. 3309 (102nd)referred
United States · United States Congress · 11 September 1991
Amends title XVIII (Medicare) of the Social Security Act to provide that: (1) notwithstanding budget neutrality requirements, in the case of an urban area with a wage index below the rural wage index applicable in the State, any decision rendered by the Medicare Geographic Classification Review Board or by the Secretary of Health and Human Services on an application by a hospital for a change in geographic classification may result in a reduction of that urban area's wage index; and (2) no urban wage index in a State may be below the rural wage index applicable in the State.
Law· SS. 1671 (102nd)enacted
United States · United States Congress · 2 August 1991
Waste Isolation Pilot Plant Land Withdrawal Act of 1991 - Withdraws from all forms of entry, sale, and disposal under the public land laws and from all forms of appropriation and operation under mining and mineral leasing laws the public lands in Eddy County, New Mexico, which surround the Waste Isolation Pilot Plant (WIPP) (a Department of Energy (DOE) research and development facility authorized to demonstrate the safe disposal of defense radioactive waste). Describes the lands to be withdrawn. Revokes specified public land orders made inconsistent by this Act. Makes the Secretary of Energy responsible for management of the withdrawn lands. Requires the Secretary to develop a management plan for the withdrawn lands requiring any use of such lands for activities not associated with WIPP to be subject to conditions and restrictions that may be necessary to permit the conduct of WIPP activities. Requires the management plan to permit domestic livestock grazing, hunting and trapping, maintenance of wildlife habitat, the disposal of salt tailings remaining on the surface, and mining, subject to prescribed guidelines. Authorizes the Secretary to close to the public any part of such withdrawn lands if required for public health and safety. Directs the Secretary to submit the management plan to appropriate congressional committees and the State of New Mexico. Provides for ongoing review by the National Academy of Sciences (NAOS), the State, the WIPP Environmental Evaluation Group (EEG), and the Administrator of the Environmental Protection Agency (EPA) of a proposal to be developed by the Secretary for an experimental program at the WIPP site to demonstrate compliance with EPA standards issued below for the disposal of transuranic radioactive waste. Outlines requirements applicable to such demonstration, including those prohibiting radioactive wastes from being received at WIPP until after the EPA Administrator certifies to the Congress and the State that the Secretary has demonstrated compliance with the disposal standards issued below for transuranic radioactive waste. Requires the EPA Administrator to publish proposed environmental standards for the disposal of transuranic radioactive waste, which will be made final one year after this Act is enacted. Requires the Secretary, with respect to WIPP, to comply in all respects with the environmental standards for management and storage issued by the EPA Administrator, beginning on the date of enactment of this Act. Requires the Secretary to comply fully with the final environmental standards for the disposal of transuranic radioactive waste. Requires the EPA Administrator, with respect to the transuranic radioactive waste at WIPP, to certify to the Congress whether the Secretary has complied with the environmental standards for disposal issued by the EPA Administrator. Requires the Secretary to comply with the environmental standards for the disposal of transuranic radioactive waste as in effect on November 18, 1985, if the Administrator fails to publish the proposed or final environmental standards for such a disposal. Requires WIPP to use engineered barriers as well as natural barriers to isolate the radioactive waste after disposal in compliance with applicable EPA standards. Outlines minimum specifications for such barriers. Requires the Secretary to also include waste from modifications in WIPP, if appropriate under certain circumstances. Provides that if WIPP fails to meet final EPA disposal standards by six years after enactment of this Act, the Secretary shall ensure that the waste is removed from the site within one year and WIPP will be decommissioned and the land withdrawl provided by this Act will be terminated. Allows such deadline to be extended by one year. Places restrictions on the amount of transauranic radioactive waste that may be received at WIPP during and after the experimental program. Prohibits spent fuel or high-level radioactive waste from being received at WIPP. Requires all waste emplaced in WIPP under the experimental program to be retrievable during the course of that program and for the period of time subsequent to the program needed to provide for its retrieval in the event that facility does not comply with the environmental standards issued for the disposal of transuranic radiactive waste. Directs the Secretary to provide the EPA Administrator and the State with a retrieval plan for the removal of all wastes from WIPP and the return of all waste to its point of origin, as indicated on the waste shipping manifest, or any other interim storage facility designated by the Secretary other than the WIPP facilities. Directs the Secretary to implement the plan or take corrective actions to assure the retrievability of waste in the event that a finding is made below that the waste is not retrievable. Requires the Secretary to make an annual determination, taking into account the evaluation discussed below, of whether all radioactive waste is presently retrievable and can remain retrievable if: (1) WIPP fails to meet the final environmental standards for the disposal of transuranic radioactive waste; or (2) the waste needs to be retrieved for engineering modification or for repackaging for permanent disposal. Directs the Secretary to demonstrate, on an annual basis, in conjunction with the determination required above, that a sample of transuranic waste is retrievable. Directs the Bureau of Mines to prepare an annual evaluation of the safety of the WIPP mine. Provides that upon a determination by the EPA Administrator that the waste will not be retrievable, the EPA Administrator shall, pursuant to the authorities provided in the Resource Conservation and Recovery Act, revoke any applicable permits and take such action as provided in such Act to assure the retrievability or removal of all WIPP waste. Requires that transuranic radioactive waste transported to or from WIPP must be transported in special containers certified by the Nuclear Regulatory Commission. Requires advance notification to State and local officials and Indian tribes before such waste may be so transported. Requires the Secretary to provide technical assistance and funds for training public safety officials for emergency preparedness. Prohibits the transport of radioactive waste to or from WIPP until the training has been provided. Requires the Secretary to provide to State and local governments the equipment to respond to an incident involving waste being transported. Prevents radioactive waste from being transported by or for the Secretary to or from WIPP until after the designation of the WIPP routes by the Highway Commission of the State. Disallows the transport of transuranic radioactive waste from the Los Alamos National Laboratory to WIPP until the Santa Fe bypass is built. Requires the Secretary to continue to encourage WIPP related business and employment opportunities within New Mexico. Provides for payments to New Mexico to mitigate the impacts on the State and local governments resulting from WIPP. Requires the Secretary to make annual payments to the State for an appropriate group to undertake annual reviews of the economic impact of WIPP activities. Directs the Secretary to submit to New Mexico, EEG, and appropriate congressional committees within three years after the enactment of this Act a plan for environmental controls for managing WIPP after decommissioning. Directs the Secretary to develop within two years a plan for the management and use of the withdrawn lands following decommission. Authorizes appropriations to the Secretary to acquire the Federal Oil and Gas leases No. NMNM 02953 and 02953C. Authorizes appropriations to carry out this Act. Requires any waste introduced at the WIPP site prior to the enactment of this Act to be subject to the provisions of this Act and to be removed from such site in the event the conditions of this Act have not been complied with.
Bill· SS. 1669 (102nd)open
United States · United States Congress · 2 August 1991
Improvements to the HealthAmerica Act of 1991 - Title I: Cost Containment - Subtitle A: Federal Health Expenditure Board - Amends the Public Health Service Act to establish as an independent agency in the executive branch the Federal Health Expenditure Board. Amends the Public Health Service Act and, using similar language, the Social Security Act to require the Board to take specified actions, including: (1) developing national health care expenditure, access, and quality goals; (2) convening and overseeing negotiations between providers and purchasers to develop payment rates regarding those expenditure goals; (3) establishing payment levels and other measures to achieve the goals; (4) establishing measures for the allocation of capital; (5) developing State and regional goals; (6) establishing uniform billing and claim forms and mandatory reporting requirements; and (7) recommending rates, budgets, and other measures. Mandates that the Board require negotiations regarding physician, hospital care, and pharmaceutical products. Allows the Board to require negotiations concerning other health care sectors. Declares that the Board shall determine which individuals, organizations, and institutions are eligible for representation by negotiators. Sets forth procedures and requirements regarding approval of an organization or individual as a negotiator. Sets forth requirements regarding payment systems adopted for hospitals or physicians. Requires the Board, when negotiators for a sector fail to reach an agreement, to promulgate regulations recommending advisory rates and other measures to achieve the goals. Imposes a civil monetary penalty on a provider assessing or a purchaser paying rates other than those required. Provides for temporary injunctive relief. Requires the Board to recommend rates for all Federal programs that reimburse providers on a fee, charge, or cost basis or charge third-party providers on such basis. Exempts from that requirement: (1) with regard to the amendments to the Public Health Service Act, programs under titles XVIII (Medicare), XIX, (Medicaid), or XXI (AmeriCare) of the Social Security Act; and (2) with regard to the amendments to the Social Security Act, programs under such title XVIII. Allows a State consortium, with the approval of the Board, to establish an alternative payment system, rates, and methods for achieving Board goals. Requires the Board to establish a system of uniform billing and reporting to enable the Board to determine the progress in meeting the goals, enable providers and purchasers to provide and obtain efficiently provided care, and reduce administrative costs of the health care system. Directs the Secretary to develop and implement methodologies that will measure the effectiveness of the health care service provided by health care providers. Amends Federal law to add members of the Board to the list of positions paid at levels III and IV of the Executive Schedule. Amends the Social Security Act to require the Board to make recommendations regarding hospital and physician services. Subtitle B: State Purchasing Consortia - Amends the Public Health Service Act to mandate establishment in each State of a consortium open to all providers and purchasers of health insurance and health care in the State. Directs the Secretary of Health and Human Services to make a grant to each State for establishment and initial operation of the consortium. Amends the Public Health Service Act and, using similar language, the Social Security Act to list optional consortium functions, including: (1) permitting or requiring insurers with a large market share in a State to participate in the consortium; and (2) convening negotiations with providers, purchasers, and others on service availability, coverage and reimbursement levels, and claim submission and payment procedures. Exempts such negotiations, if authorized by the State, from Federal anti-trust laws. Sets forth the mandatory consortium functions, including: (1) enrolling all small share health insurance companies in the State as consortium members; (2) establishing a claim payment fund and payment procedures, with the fund to be capitalized through public and private contributions and assessments by the consortium on such enrollees; (3) developing and using uniform billing and claim forms and procedures consistent with subtitle A of this title; and (4) attempting to reduce administrative costs and burdens on enrollees and providers through specified measures. Declares that the Consumer Product Safety Act and other Federal consumer protection laws apply to the mandatory consortium functions. Allows States to enter into an agreement for the establishment of a regional consortium. Declares that a State that fails to comply with the requirements regarding consortia shall be ineligible: (1) with regard to the amendments to the Public Health Service Act, to receive assistance under that Act; and (2) with regard to the amendments to the Social Security Act, to receive payments to States under specified provisions of that Act. Amends the Public Health Service Act to authorize appropriations to carry out provisions relating to the consortia. Title II: State Single Payer Option - Authorizes a State to establish a universal health care system for its residents, supported by revenues generated from State tax assessments, if the system provides for universal health care coverage for all State residents at least as comprehensive as the coverage required by this Act and its amendments. Provides for matching Federal contributions in an amount equal to what the Federal contributions would have been had the State established an AmeriCare program under the HealthAmerica Act. Requires a State establishing a State system to establish a cost containment program approved by the Board. Authorizes the Secretary of Health and Human Services such sums as necessary to make three-year grants to two States establishing such a system. Title III: Coverage of Early Retirees, Strikers and Individuals Whose Employers' Businesses Have Failed - Directs the Secretary of Health and Human Services, subject to changes to finance this provision, to promulgate regulations to expand coverage under Medicare to provide full coverage to retired individuals at a younger age than currently covered. Requires that early retirees who are not eligible for Medicare, individuals on strike, and individuals who are unemployed as a result of the failure of their previous employer's business be eligible for coverage under the AmeriCare program in the State of their residence. Provides for premiums and cost sharing. Title IV: Accelerated Implementation of Certain Provisions - Requires that the requirements of specified provisions of the HealthAmerica Act and their amendments apply to all employers on January 1 of the second full year after enactment of this Act. Title V: Insurance Reform - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to declare that certain provisions of ERISA supersede any State law relating to benefits under provisions of the Public Health Service Act added by title I of this Act. Includes benefit plans under that title in the ERISA definitions of "employee welfare benefit plan" and "welfare plan." Amends the Public Health Service Act to prohibit issuing a health benefit plan in a State, or offering a new contract under such a plan with respect to a small employer (defined as having fewer than 100 employees), unless the plan meets certain standards under this Act. Provides for: (1) complaints by individuals and entities respecting potential violations of certain requirements; (2) investigations and related procedures; and (3) enforcement, including cease and desist orders, civil monetary penalties, and orders to take other corrective action. Requires penalties collected to be credited to the AmeriCare Trust Fund. Directs the Secretary to develop standards to implement requirements of these provisions. Requires establishment of a toll-free telephone number to: (1) handle consumer complaints or inquiries; and (2) provide information to small employers and consumers about carriers that offer plans in the area. Mandates periodic audits of State regulatory programs by the Comptroller General to determine compliance with these provisions. Requires carriers offering a plan to small employers to offer the same plan to any other small employer in the community. Allows: (1) health maintenance organizations (HMOs) to have geographic and size limitations; and (2) carriers to require participation by a minimum percentage of employees. Requires, at the option of the business, plan renewability under the same terms as for issuance, except for rates and administrative changes. Regulates rate changes. Requires premiums for plans offered to small employers to be based on a single cohesive rating system applied consistently for all small employer groups and designed not to treat groups, after the fourth year after enactment of this Act, differently based on health or risk status. Requires the lowest rate for plans with similar benefits within a block of business to be the same for all small employers. Limits the percentage by which the premium rate for the most expensive block of business may exceed the rate for the least expensive block of business. Allows limited variation in premium rates for: (1) different age and gender groups; and (2) employers who elect, under provisions of this Act, reimbursement under Medicare. Requires plans offered to small employers to permit enrollment and compute premiums based on four specified beneficiary classes. Requires plans offered to small employers to: (1) cover all basic health services specified in certain provisions; and (2) not impose cost-sharing in excess of that permitted by those provisions. Requires the carrier, except HMOs, to offer to the small employer a plan that only provides basic services and maximum cost-sharing. Requires a carrier (other than an HMO or a reinsurance carrier) which offers a managed care plan to an employer that is not a small employer to make a managed care plan available to small employers in the same community. Requires the Secretary to develop a model to standardize benefits offered to small employers to promote consumer understanding and comparison among plans. Sets forth miscellaneous disclosure and recordkeeping requirements for health benefit plans offered to small employers. Requires each small business insurer to offer certain types of plans. Allows each such insurer to offer additional types. Directs the Secretary to publish a description of the plans offered in each State to facilitate comparison. Requires: (1) the description to include an enrollment form; and (2) insurers to enroll eligible persons submitting that form.
Bill· SS. 1677 (102nd)referred
United States · United States Congress · 2 August 1991
Medicaid Substance Abuse Treatment Act of 1991 - 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 as: (1) individual, group, and family counseling and addiction education and treatment provided pursuant to individualized treatment plans; (2) room and board in a structured environment with on-site supervision 24 hours a day; (3) therapeutic child care or counseling for children of individuals in treatment; (4) parental assistance in obtaining developmental assistance for their preschool children and public education for themselves and their school-age children; (5) easier access to prenatal, postpartum, pediatric, and other appropriate health, social, and child care services; (6) planning and assistance in reentering society; and (7) continuing specialized training of residential treatment facility staff members in the most recent and effective treatment techniques. Requires that such coverage continue for at least 12 months, except that the coverage of pregnant women must continue for one year following the end of pregnancy. Limits the size of a residential treatment facility to no more than 40 beds beginning in calendar year 1994. Allows a State agency to grant exceptions to such limit for one or more facilities subject to review by the Secretary of Health and Human Services. Prescribes the conditions for granting such exceptions. Caps the number of nationwide beds for which Federal assistance may be provided under such residential treatment programs. Increases such annual bed cap from 1,080 to 6,000 beds nationwide for calendar years 1992 through 1996. Addresses treatment needs of pregnant addicted Indian and Alaska Native women in the Indian Health Service areas by: (1) allocating additional beds nationwide for such areas; (2) providing 100 percent Federal matching funds to States to create residential treatment programs in such areas; and (3) requiring the Secretary to conduct training in such areas for appropriate parties regarding the availability and nature of residential treatment services in such areas under this Act.
Bill· SS. 1645 (102nd)referred
United States · United States Congress · 2 August 1991
Income-Dependent Education Assistance Act of 1991 - Establishes the income-dependent education assistance (IDEA) program of supplemental direct higher education student loans in which a borrower's annual repayment obligation is dependent upon both postschool income level and borrowing history. Title I: System for Making Income-Dependent Education Assistance Loans - Directs the Secretary of the Treasury to: (1) make IDEA loans to eligible students in accordance with this title; and (2) establish an account for each IDEA loan borrower and collect repayments on such loans using the income tax collection system under specified Internal Revenue Code provisions added by title II of this Act. Sets forth provisions for the terms and enforcement of IDEA program agreements between the Secretary of Education and eligible institutions. Sets forth provisions for the amounts and terms of IDEA loans. Sets annual limits on the amounts of such loans to various categories of students. Sets a limitation on individual borrowing capacity, with adjustments for inflation and with consideration of any outstanding student loan obligations. Limits the duration of individual eligibility for such loans. Sets forth requirements for: (1) agreements to the terms of such loans; and (2) disbursement of the proceeds of such loans. Sets forth the responsibilities of eligible institutions and of the Secretary of the Treasury for certain information requirements relating to the IDEA loan program. Sets forth provisions for interest charges on such loans. Requires such charges to be added to the recipient's obligation account at the end of each calendar year. Bases such charges on an interest rate equal to the lesser of: (1) ten percent; or (2) the sum of the average bond equivalent rates of 91-day Treasury bills auctioned for the previous year, plus two percentage points, rounded to the next higher one-eighth of one percent. Provides for conversion and consolidation of certain other types of student loans as IDEA loans. Authorizes the Secretary of the Treasury, upon request of borrowers who have received federally insured or guaranteed loans under specified provisions of the Higher Education Act of 1965 (HEA) (Stafford loans) or of the Public Health Service Act (PHSA) (HEAL loans), to make new IDEA loans to such borrowers which are equal to the sum of the unpaid principal of those other loans and which discharge the liability on those other loans. Provides for mandatory conversion of certain defaulted student loans to IDEA loans. Requires IDEA collection treatment of any loan made, insured, or guaranteed under specified provisions of HEA or PHSA after enactment of this Act which is assigned after default for collection by the Secretary of Education or the Secretary of Health and Human Services. Directs such Secretaries to notify: (1) the Secretary of the Treasury of the need to establish or adjust an IDEA account for such loan's borrower; and (2) the borrower of the conversion of the defaulted loan to an IDEA loan and the procedures for collection under the income tax system. Terminates the authority to make additional loans under the HEA programs of supplemental loans for students (SLS) and direct loans to students in institutions of higher education, for any academic year beginning after the date regulations are prescribed by the Secretaries of Education and the Treasury to carry out this title. Directs the Secretary of Education to study and report to the Congress on the effects of the IDEA program on participating institutions' tuition rates and accrediting and licensure standards. Authorizes appropriations to: (1) make distributions of IDEA loan funds to eligible institutions; and (2) administer and carry out this title. Bases student eligibility for IDEA loans on their eligibility for student assistance under specified HEA provisions and their carrying at least one-half the normal full-time academic workload. Title II: Collection of Income-Dependent Education Assistance Loans - Amends the Internal Code to add provisions for the collection of IDEA loans. Directs the Secretary of the Treasury to notify each IDEA loan borrower of their yearly repayment obligation. Sets forth formulas for computation of the annual IDEA loan repayment amount. Makes such amount equal to the lesser of: (1) 20 percent of the excess of the modified adjusted income of the taxpayer for such taxable year over the standard deduction and exemption (twice for joint returns); or (2) the product of a base amortization amount and a progressivity factor based on the taxpayer's modified adjusted gross income. Defines "base amortization amount" as the amount which, if paid at the close of each year for 12 consecutive years, would fully repay (with an eight-percent annual interest rate) the maximum account balance of the borrower. Sets forth progressivity factor tables for various types of taxpayers. Provides that, in general, the repayment obligation of an IDEA loan borrower shall terminate only if there is repaid: (1) in the case of any repayment during the first 12 years for which the borrower is in repayment status, the principal plus interest at an annual rate equal to the otherwise applicable rate plus two and one-half percent; and (2) in the case of any repayment during any subsequent year (or in the case of loans under $3,000 repaid during the first 12 years), the principal plus interest at applicable rates. Requires no repayment after 25 years in repayment status. Sets forth provisions for the determination of years in repayment status. Sets forth the requirements for payment of the amount owing. Directs the Secretary of the Treasury to assess and collect any unpaid amount in the same manner as for any delay in the payment of income tax. Provides for discharge, by the Secretary of Education, of the IDEA loan liability of any borrower who dies or becomes permanently and totally disabled. Provides for crediting of amounts paid on a joint return. Sets forth formulas for computation of an alternative annual payment for individuals who have attained age 55. Provides for inflation adjustment in the computation of the progressivity factor. Provides that, in general, an IDEA loan shall not be dischargeable in a case of bankruptcy, but authorizes the Secretary of the Treasury to postpone certain portions of the loan liability in such cases. Makes specified provisions relating to finality of assessment and collection applicable to such loans. Includes the amount required to be repaid for IDEA loan under amounts listed under requirements relating to failure by an individual to pay estimated income tax. Requires individuals who are obligated to make IDEA loan repayments to file income tax returns for the applicable years.
Bill· SS. 1668 (102nd)referred
United States · United States Congress · 2 August 1991
Secure Choice - Title I: Long - Term Care Provisions - Amends the Social Security Act to establish a new Federal program to provide grants to States for making long-term care assistance to low-income functionally impaired elderly individuals under a State plan approved under a new title XXI entitled "Long-Term Care Assistance Programs For The Elderly." Outlines: (1) requirements for State plans for long-term care assistance; and (2) conditions for the approval of such plans by the Secretary of Health and Human Services. Allows States to impose sanctions on service providers who overcharge such individuals. Disregards payments under title XVI (Supplemental Security Income) to an individual who is eligible for long-term care assistance under the plan and is in a nursing facility at the time such benefits are paid for purposes of determining the amount of any post-eligibility contribution by the individual toward the cost of the care and services provided by the nursing facility. Allows States to exclude any individual or entity for participation under the State plan for any reason for which the Secretary could exclude the individual or entity from participation in Medicare (title XVIII of the Social Security Act) and State health care programs. Requires States to provide for making long-term care assistance available, including at least the services described below in items 2 and 3, to all individuals aged 55 or older: (1) who are impaired because they are limited in performing specified activities of daily living or have Alzheimer's disease or a similar dementia; (2) whose income and resources do not exceed the minimum prescribed levels the State is required by this Act to establish; and (3) who are likely to receive the care and services described below for at least 45 consecutive days. Defines "long-term care assistance" as payment of part or all of the cost of the following care and services (if provided in or after the third month before the month in which the recipient makes application for assistance) for the individuals described above: (1) nursing facility services (other than services in an institution for mental diseases); (2) home and community-based services that include homemaker/home health aide services, personal care services, adult day care, nursing services, physical therapy, and respite care; (3) case management services provided by a qualified community-care case manager; (4) respiratory care services; (5) prescription drugs; and (6) any other long-term care and any other type of remedial care (other than room and board) recognized under State law and specified by the Secretary. Gives States the option to cover individuals with incomes up to 240 percent of the Federal poverty level. Outlines provisions for determining the amount of funds the Secretary must pay to a State for expenditures for long-term care assistance provided under its approved plan. Prohibits State plans from imposing enrollment fees, premiums, or similar charges for services furnished to severely functionally impaired individuals who, as a condition for receiving services under the plan, must spend for the costs of long-term care all but a minimal amount of their income required for personal needs. Requires any deductible, cost sharing, or similar charge imposed under the plan with respect to other such individuals or other care and services to be nominal in amount. Requires State plans to require that no provider participating under the State plan may deny care or services to an individual eligible for such care or services under the plan on account of such individual's inability to pay a deduction, cost sharing, or similar charge. Makes an individual to whom such care or services were furnished liable for applicable charges. Sets forth provisions regarding: (1) liens, adjustments, and recoveries with respect to debts incurred for long-term care; and (2) transfers of assets and eligibility for long-term care assistance. Sets forth special rules for the treatment of income and resources of impaired spouses. Establishes the Secure Choice Insurance Option program under part B of new title XXI under which a State, if it chooses to participate, will subsidize long-term care insurance for individuals aged 55 or older who have incomes between 240 and 400 percent of the Federal poverty level and who are provided with care and services under a qualified long-term care insurance policy. Specifies the requirements an insurance policy must meet in order to qualify as a long-term care insurance policy. Requires that an individual, in order to be eligible to purchase a qualified long-term care insurance policy under the program, must, at the time such individual elects to purchase such policy: (1) be a resident of the State; and (2) meet the standard underwriting requirements of an insurer which has been certified by the State's Standards and Performance Organization as having met specified requirements set forth in this Act in order to be able to provide qualified long-term care insurance policies under the State plan. Requires States, in order to be eligible to participate in the new program, to establish a Standards and Performance Organization to: (1) ensure that qualified long-term care insurance policies cover the required care and services; (2) determine that insurers desiring to become qualified insurers comply with applicable State standards; (3) ensure that information concerning the program is made available to qualified participants within the State; (4) assess the quality and appropriateness of the case management services provided to qualified participants; (5) determine whether qualified insurers are using appropriate managed care techniques in the provision of program services; (6) determine whether long-term care is being provided under the program in settings that meet State standards; (7) establish standards applicable to qualified issuers regarding rejection rates for underwriting, and provide for consumer protection; (8) determine and verify on an annual basis the income of qualified participants and their compliance with income and resource requirements; (9) notify qualified insurers of any changes in the income and resources of participants; (10) carry out the educational program discussed below; (11) hear appeals of certain denials and establish appropriate appeals procedures; (12) establish a sliding scale for determining the amount of the benefit subsidy a State is required to pay under a long-term care insurance policy; and (13) carry out such other functions as the Secretary may require. Outlines provisions applicable to qualified participants who change their State of residence. Requires the amount of the premium to be charged by a qualified insurer for a qualified long-term care insurance policy to be determined by each qualified insurer, subject to State insurance regulations, on the basis of the minimum benefits that must be provided under the policy. Requires the State insurance commission to ensure that the premium rate structure applicable to a qualified long-term care insurance policy remains level throughout the policy's life. Sets forth procedures for the periodic review of premium rates in order to determine if qualified insurers may make adjustments. Establishes maximum daily and lifetime benefit amounts for nursing facility services and home- and community-based care under a qualified long-term care insurance policy for which the qualified insurer is liable for payment to the service provider. Outlines additional requirements a State plan must meet applicable to the Secure Choice Insurance Option program. Requires the Secretary to reimburse each participating State for program costs, according to a specified formula. States that to be eligible as a qualified provider an entity must agree to accept the payment rate specified under the program as payment in full for services provided to qualified participants. Requires the Standards and Performance Organization of the State that elects to participate in the program to implement a comprehensive public information and education program that shall be directed to individuals age 55 and above but which shall attempt to educate the general public as whole concerning the need for long-term care insurance. Specifies the requirements for such education program. Requires States participating in the programs under new title XXI to ensure that any long-term care insurance policy offered within the State meets specified: (1) requirements of the long-term care insurance model regulation, and the long-term care insurance model Act, respectively, promulgated by the National Association of Insurance Commissioners (NAIC); (2) tax disclosure requirements; and (3) requirements relating to nonforfeitability. Outlines additional responsibilities of participating States with respect to any individual or entity selling or offering for sale in the State a long-term care insurance policy, including responsibilities of participating States for ensuring that such individuals or entities comply with specified NAIC model regulations and Act provisions. Directs NAIC to promulgate standards for the use of uniform language and definitions in long-term care insurance policies. Directs the Secretary to provide that individuals eligible for services under title XIX (Medicaid) of the Social Security Act which, effective upon the enactment of this Act, are provided under new title XXI shall continue to be eligible to receive such services in the same manner as previously provided. Amends the Medicaid program to repeal provisions concerning home and community care for functionally disabled elderly individuals. Directs the Comptroller General to study and report to the Congress on the appropriateness and adequacy of using the Federal medical assistance percentage utilized under Medicaid for payment of services provided under new title XXI. Directs the Secretary to conduct studies to: (1) develop appropriate criteria for determining eligibility for long-term care services under a program similar to the Secure Choice program for mentally retarded or developmentally disabled individuals; and (2) determine the feasibility of establishing a data collection system for public and private long-term care services. Directs the Secretary to establish a new organizational unit within the Health Care Financing Administration to administer the new long-term care assistance program under title XXI. Title II: Long-Term Care Tax Provisions - Subtitle A: Tax Treatment of Long-Term Care - Private Long-Term Care Insurance Act of 1991 - Amends the Internal Revenue Code to allow an individual an itemized deduction for qualified long-term care services. Defines such services as necessary diagnostic, preventive, therapeutic, and rehabilitative services, and maintenance and personal care services which: (1) are required by a chronically ill individual; (2) have as their primary purpose the provision of needed assistance with daily living activities which the individual is certified as being unable to perform; and (3) are provided pursuant to a continuing plan of care prescribed by a licensed health practitioner. Provides for: (1) long-term care insurance contracts to be treated as accident or health insurance contracts; (2) amounts received under such contracts with respect to qualified long-term care services to be treated as amounts received for personal injuries or sickness; (3) employer plans providing such services to be treated as an accident or health plan; and (4) per diem and other periodic payments to be treated as payments made with respect to qualified long-term care services, with specified limitations. Declares that a qualified long-term care insurance contract is one in which the only insurance protection provided is coverage of qualified long-term care services. Prohibits borrowing under such a contract and its assignment or pledging as collateral for a loan. Prohibits it from covering expenses to the extent that such expenses are reimbursable under Medicare. Provides for the tax treatment of policyholders based on dollar limitations on per diem and other periodic payments. Makes the continuation coverage excise tax inapplicable to qualified long-term care insurance contracts or plans of employers that provide such coverage. Sets forth specified consumer protection provisions to be satisfied by qualified long-term care insurance contracts, including the NAIC model Act. Imposes an excise tax of $5,000 on any person who fails to meet specified requirements for such contracts with respect to: (1) regulation of sales practices; (2) model Act provisions; and (3) disclosure. Requires NAIC to promulgate standards for the use of uniform language and definitions in long-term care insurance policies by January 1, 1993. Subtitle B: Treatment of Accelerated Death Benefits - Provides for the treatment of amounts paid to a terminally ill individual as death benefits. Allows insurance companies to issue such accelerated death benefit riders on life insurance contracts and requires spousal consent for such treatment and riders. Amends title XI of the Social Security Act to prohibit applicants or recipients under public assistance programs from being required to make an election respecting accelerated death benefits under life insurance policies.
Bill· SS. 1655 (102nd)open
United States · United States Congress · 2 August 1991
Environmental Research, Development, and Demonstration Authorization Act of 1991 - Authorizes appropriations to the Environmental Protection Agency (EPA) for FY 1992 through 1994 for specified environmental research, development, and demonstration activities and for program management and support of the Office of Research and Development. Requires the EPA Administrator to inform the appropriate congressional committees prior to the issuance of notice to close any field station, regional office, laboratory, or research center, or for a reduction-in-force. Directs the Administrator to establish a separately identified core research program consisting of fundamental ecological, health, and risk reduction research to support efforts to identify, assess, and mitigate serious environmental risks. Requires the Administrator to establish an intra-agency task group to define, review, and ensure adequate funding of the core research program. Provides that such research shall give emphasis to the effects of exposure to environmental contaminants on human immune and neurological systems. Authorizes the Administrator to award grants to eligible organizations for purposes of conducting such research. Requires the Science Advisory Board to review and make recommendations on core research program activities. Makes amounts earmarked for multimedia activities available for such research. Directs the Administrator to: (1) establish a modernization program to identify, acquire, and maintain modern buildings, facilities, supplies, and equipment needed to conduct high quality research; and (2) conduct studies and make assessments of the adequacy of the equipment and facilities to meet the needs of EPA and to attract well-qualified scientists, engineers, and other appropriate personnel. Requires the Administrator to carry out a program of environmental technology transfer and exchange of scientific information to make full use of EPA's research, development, and demonstration efforts. Directs the Science Advisory Board to submit annual reports to the Congress and the Administrator on the proposed research program described in the President's budget request for research, development, and demonstration activities of the EPA. Requires the Board to conduct periodic evaluations of selected areas of the current and planned activities. Requires concurrent submission to the Congress of any report required from the Board to the Administrator. Requires the Administrator, in reviewing research, development, and demonstration grant, contract, and cooperative agreement applications, to enter into cooperative agreements to conduct scientific and professional review of such applications. Authorizes the Administrator to use research funds authorized by this Act for such agreements. Repeals a required annual report from the Administrator of a five-year plan for environmental research, development, and demonstration. Directs the Administrator to report to the Senate Committee on Environment and Public Works and the House Committee on Science, Space, and Technology on the accomplishments of programs authorized under this Act as they relate to EPA's mission to protect public health and the environment. Authorizes the Administrator to: (1) conduct research on the nature and impacts of international environmental problems and how to respond to such problems; and (2) provide assistance to foreign countries and international bodies to improve the quality of the environment. Directs the Administrator to: (1) implement monitoring methodologies for measuring the level of pesticides in ambient and indoor air, groundwater, soil, and food; (2) assess routes of exposure to pesticides; (3) implement monitoring methodologies to assess the extent and effects of exposure to pesticides by agricultural workers and the level of human exposure to lawn and garden pesticides; (4) conduct a demonstration project to implement methodologies for assessing pesticide residues in food and assess the feasibility of establishing an EPA program for the routine monitoring of pesticide residues in food ready for marketing; (5) determine the extent of pesticide contamination in air and groundwater; (6) study the acute and chronic health effects of exposure to pesticides and the effects resulting from exposure to cholinesterase inhibitors; (7) implement methodologies for assessing the potential health effects on agricultural workers and consumers of agricultural products from exposure to chemical pesticides; (8) conduct field studies to assess the effects of exposure to pesticides introduced in the environment through long-term use; and (9) assess and monitor the impact of biological pesticides and the impact of pesticides on air quality. Makes specified amounts available for such activities. Requires the Administrator to develop methods for chemical storage and disposal and for remediating chemical contamination in soil, groundwater, and other environmental media. Directs the Administrator to: (1) establish a program to award grants to institutions of higher education for training graduate students in the field of environmental toxicology; and (2) sponsor internships for grant recipients at EPA laboratories and administrative offices and encourage EPA staff members to hold seminars and lecture at such institutions. Limits grants to three-year periods and authorizes grant renewals. Requires the Administrator to implement a research program to increase understanding of the health effects of exposure to electric and magnetic fields. Makes specified amounts available for such program. National Arid Climate Groundwater Research Center Act - Requires the Administrator to establish the National Arid Climate Groundwater Research Center in the State of Nevada. Directs the Center to: (1) study and evaluate the availability, usage, and management of groundwater in arid regions; (2) study and evaluate means of monitoring and regulating contaminants in groundwater; (3) coordinate groundwater research with Federal, State, and private agencies; (4) encourage graduate and undergraduate education in disciplines and professions related to groundwater; (5) provide a forum for consideration of issues involving the management and protection of groundwater; and (6) make its work accessible to the public. Authorizes appropriations. Requires the annual EPA appropriations request to identify funding for source reduction research, development, and demonstration activities as a separate account. Authorizes the Administrator to conduct, and makes funds available for, such activities. Requires the Administrator to conduct a research program on the use of indoor foliage for reducing indoor air pollution. Authorizes appropriations. Directs the Administrator to study and report to the Congress on the health risks, including the physiological and psychological effects on humans, associated with volcanic haze in the State of Hawaii. Authorizes appropriations.
Bill· SS. 1648 (102nd)referred
United States · United States Congress · 2 August 1991
Area Health Education Centers Reauthorization Act of 1991 - Amends the Public Health Service Act to specify a term of six years for agreements establishing area health education centers (AHECs). Modifies the purposes of AHECs, including serving high-impact areas and States as well as border areas close to Mexico. Mandates, if available in the area, participation of a school of public health. Authorizes agreements for the planning, development, and operation of State-supported AHECs. Authorizes appropriations.
Bill· SS. 1627 (102nd)referred
United States · United States Congress · 2 August 1991
Veterans Dignity in Health Care Act of 1991 - Directs the Secretary of Veterans Affairs to ensure that any veteran who is furnished hospital, nursing home, or domiciliary care in a Department of Veterans Affairs (Department) facility shall be entitled to purchase and consume tobacco products there. Requires the Department to maintain, and veterans being treated to have access to: (1) a commissary or canteen for the purchase of such products; and (2) a suitable indoor area for consumption of the products.
Law· SJRESS.J.Res. 188 (102nd)enacted
United States · United States Congress · 2 August 1991
Designates November 1991 as National Red Ribbon Month.
Bill· HRH.R. 3229 (102nd)referred
United States · United States Congress · 2 August 1991
U.S. Health Service Act - Title I: Establishment and Operation of the United States Health Service - Part A: Initial Organization - Establishes, as an independent entity within the executive branch, the United States Health Service (Service). Vests authority of the Service in the appropriate National Health Board and area health boards. Grants the Service the power of eminent domain. Directs the President to: (1) appoint 21 individuals to serve as members of the Interim National Health Board of the Service; and (2) designate two nominees as chairperson and vice chairperson of the Interim National Board. Declares that the members of the Interim National Board shall serve until the National Health Board holds its initial meeting in accordance with certain provisions of this Act. Sets forth the duties of the Interim National Board. Authorizes appropriations. Part B: Organization of Area Health Boards - Requires the Interim National Board to establish health care delivery regions throughout the United States which meet specified requirements. Sets forth procedures regarding election and appointment of members and certain officers of: (1) interim national, interim regional, and interim district health boards; and (2) initial and subsequent national, regional, district, and community health boards. Requires the National Health Board (National Board) to modify the boundaries of each health care delivery region after each census and at such other times as it deems necessary, provided such modification is approved in a referendum of registered users residing in an area whose regional identification would be changed by such modification. Requires each regional board, in certain circumstances, to review the appropriateness of district and community boundaries. Allows regional boards to modify such boundaries in certain circumstances, provided modification is approved in a referendum. Part C: General Provisions Regarding Health Boards - Sets forth the membership and terms of office of health boards. Provides for recall of board members for specified reasons and for filling vacancies on health boards. Provides for the manner of conducting meetings of health boards and for the compensation of members of the National Board and compensation of and payment of expenses for members of other health boards. Sets forth procedures for the establishment by the National Board of guidelines and standards required by or in furtherance of the objectives of this Act. Requires each regional board to provide orientation, education, and technical assistance to district and community boards. Requires the appropriate national board to provide such assistance to regional boards. Title II: Delivery of Health Care and Supplemental Services - Part A: Patients' Rights in Health Care Delivery - Requires the Service to ensure that every user is given the right to receive high quality care and supplemental services without charge and without discrimination. Sets forth a list of other basic health rights. Amends the Fair Labor Standards Act of 1973 to entitle certain employees to health leave compensation, subject to specified exceptions which exist in current law as exceptions to minimum wage and maximum hours provisions. Part B: Eligibility for, Nature of, and Scope of Services Provided by the Service - Declares all individuals, while within the United States, to be eligible to receive health care and supplemental services under this Act. Excludes personal comfort or cosmetic services unless they are necessary for health-related reasons. Requires the Service to provide in the United States specified services in or through facilities established by the Service. Prohibits the Service from providing such services in a region, district, or community other than under the auspices of a regional, district, or community board established in accordance with this Act. Requires the Service to provide specified supplemental services in or through health care facilities established by the Service. Provides for reimbursement by the Service of the cost of emergency health care services under certain circumstances. Part C: Health Care Facilities and Delivery of Health Care Services - Requires each community board to establish and maintain such health care facilities as are necessary for efficient and effective delivery of comprehensive primary health care services, specialized health care services, special services, and community-oriented health measures which are provided, as much as possible, through a single comprehensive health center. Requires each district board to establish and maintain in its district a general hospital, such other health care facilities as are necessary, and such health care services of a specialized nature as may be provided most effectively and efficiently at the district level. Requires each regional board to establish and maintain: (1) a regional medical facility for highly specialized health care services; (2) health care and supplemental services for individuals whose needs cannot be met by community or district boards; and (3) such other facilities as are necessary. Requires each area health board to: (1) hire health workers; (2) purchase or lease necessary premises; and (3) seek to minimize fragmentation and duplication in delivery of health care. Requires each regional board to provide for affiliation and coordination within its region and with adjacent regions. Requires the National Board to establish guidelines for distribution and coordination of the delivery of health care services and plan and transition to the new facilities for affected workers. Requires regional boards, if a community or district board fails to provide health services, to provide the services. Requires each health board to establish policies and organizational plans consistent with provisions of this Act. Requires such boards, in establishing, implementing, and modifying such policies and plans, to seek participation of affected workers and users. Provides for a health board, if it determines that it cannot itself effectively manage the operation of all facilities, to establish a health care facility board or boards. Specifies elements to be provided for in the policies and organizational plans established by health boards. Prohibits a health board, on and after three years after the effective date of health services, from permitting its health care facilities to be used for the private delivery of health services. Prohibits individuals employed by a health board from engaging in the private delivery of health services. Requires each health board to ensure that health facilities it operates which provide outpatient services are open during hours which permit all users to make use of such services. Sets forth requirements for facilities providing inpatient services for 30 continuous days or longer. Requires each health board to provide that, at least once each year, the inpatients of facilities providing inpatient services for 30 continuous days or longer shall elect, from among themselves and representatives of certain user associations, a review committee of not less than three members. Provides for recall and proxies with respect to such committees. Requires various health boards to conduct regular inspections of specified facilities. Requires area health boards to provide: (1) contraception information and materials; (2) evaluation and treatment for venereal diseases and diseases of the reproductive organs; (3) information and counseling regarding pregnancy, child bearing, and possible genetically induced anomalies; (4) pregnancy testing; (5) prenatal services; (6) abortion services; and (7) counseling by women for specified services and counseling by men for specified services. Requires all such services to be delivered without coercion or harassment, with confidentiality, and without prior approval of individuals other than the individual receiving the services. Requires that individuals be permitted to be accompanied by a person of their choice during the provision of such services, subject to exception. Sets forth restrictions and requirements for informed consent regarding: (1) treatments or procedures which could affect an individual's reproductive capacity; and (2) mastectomy or other breast cancer treatment. Requires that women giving birth have the right to choose from a complete range of childbirth options. Title III: Health Labor Force - Part A: Job Categories and Certification - Declares that, notwithstanding State laws to the contrary, the Service shall be the sole judge of the qualifications of its employees. Requires each area health board to insure that work is performed by certified health workers. Mandates health boards to provide for periodic review and assessment of competency. States that area health boards shall provide opportunities for assessment and certification of skills required for advancement. Requires the National Board to establish guidelines for classification, certification, and employment of health workers. Requires that such guidelines: (1) permit alternative approaches to healing, when such approaches have not been shown to be injurious to health; (2) have both flexibility and uniformity to meet stated objectives; and (3) require that each health worker employed by a community board work part of the time in a facility operated by a district or regional board and each health worker employed by a district or regional board work part of the time in a health care facility operated by a community board. Mandates that the National Board periodically evaluate job categories and certification practices established by area health boards and assist regional boards in applying certain guidelines. States that each regional board, for job categories requiring advanced specialty training, shall establish certification standards which contain certain specifications made by the National Board. Requires recognition of training, experience, and performance undertaken or demonstrated before the establishment of health team schools under part B of this title. Requires each board to periodically review, supplement, modify, or eliminate such standards. Part B: Education of Health Workers - Requires each regional board, in consultation with community and district boards, to establish a health team school (school) to provide initial and continuing basic education in health care delivery and initial and continuing advanced education in health care specialties and health science specialty fields. Allows for collaboration between adjacent regions conducting joint educational programs. Requires that the schools be funded exclusively by the Service, prohibits them from charging or accepting tuition or fees, and requires them to provide each student with an allowance for living expenses, educational supplies, and any child care. Sets forth the principles under which the schools are required to be operated and maintained. Requires the National Board to establish guidelines for the application of such principles and for the phased integration of existing health worker education programs into the schools. Requires each regional board to establish and implement for the school: (1) admissions policies with certain required elements; (2) curriculum policies with stated elements; (3) faculty hiring procedures which will create a faculty which approximates the population of the region by race, sex, and language; and (4) a governance plan for the management of its school which gives significant decision making powers to staff and students. Prohibits enrolling any individual unless the individual agrees to perform health care services as an employee of the Service, in a job category for which training is being provided, for a period of time equal to the period of enrollment, but not less than two years, and subject to other terms and conditions. Entitles the Service, if an individual fails to start or fails to complete such service, to recover damages. Cancels payment of damages upon the death of the individual. Allows waiver or suspension of the obligation of service or payment if compliance is impossible or would involve extreme hardship and if enforcement would be unconscionable. Limits discharge of such obligation under bankruptcy. Mandates that each area board periodically assess the ratio of the health workers employed by the board in each job category to the number of residents in the area. Gives priority in hiring individuals obligated to perform service to health worker shortage areas and, as a second level of priority, to the regional, district, or community board for the region, district, or community in which the program was completed. States that the National Board shall establish a program to match the preferences graduates have for locations with the needs and preferences of various boards. Requires the National Board to make payments of principal and interest on certain loans incurred by individuals for an educational program in health care delivery, health care specialties, or health science fields which is outstanding on the day that individual begins to work for the Service. Establishes a schedule for such payments. Part C: Employment and Labor-Management Relations Within the Service - Requires health boards to employ, classify, and fix the salaries and benefits of all employees of the Service. Mandates that the appropriate National Board provide for: (1) employment and promotion in the Service in the same manner as under the Federal civil service system; (2) opportunities for advancement; (3) use of work time for continuing education without loss of pay or other rights; and (4) hearings on adverse actions. States that health boards shall give hiring preference to individuals employed as health workers before enactment of this Act. Requires the National Board to ensure that all such individuals desiring employment in the Service find appropriate employment in the Service. Declares employees of the Service eligible for promotion or transfer to any position in the Service for which they are qualified. Mandates that each regional board establish and maintain a job placement service. Places restrictions on hiring relating to the: (1) ratio of health workers to residents; and (2) existence of a health worker shortage area in the same region. Declares that employees of the Service are covered by specified Federal laws relating to adverse actions, compensation for work injuries, civil service retirement, and withholding of pay for the Civil Service Retirement and Disability Fund, subject to exceptions relating to collective bargaining agreements and conditioned on approval by the Office of Personnel Management. Declares sick and annual leave and compensatory time of employees of the Service, whether accrued prior to or after the commencement of operations of the Service, to be obligations of the Service. Requires compensation, benefits, and other terms and conditions of employment to be the same on the effective date of health services as for Federal Government employees until changed by the Service. Makes specified provisions of Federal law relating to unemployment compensation and life insurance apply to employees of the Service unless modified. Prohibits changes in fringe benefits which result in a program which is less favorable to employees of the Service than fringe benefits for employees of the Federal Government on the effective date of health services. Declares that the provisions of the National Labor Relations Act shall apply to the Service and its employees, subject to specified exceptions. Declares that provisions of Federal law relating to participation in a strike shall not apply to employees of the Service. Authorizes provisions in collective bargaining agreements between the Service and its employees regarding procedures for the resolution of grievances and adverse actions, including binding third-party arbitration. Amends the Labor-Management Reporting and Disclosure Act of 1959 to include the Service in the definition of the term "employer" under that Act. Provides that the remedies provided by stated Federal laws regarding jurisdiction and tort claims shall be exclusive of any other civil action or proceeding. Directs the Attorney General to defend any such action or proceeding. Provides, in certain circumstances, for removal and remanding of cases between State and Federal courts and for suspensions of specified limitations of time. Authorizes the Attorney General to compromise or settle such cases as provided in specified Federal law. Declares that assault or battery arising out of negligence in various health care functions is not an exception under specified Federal law to tort claims and jurisdiction provisions of Federal law. Authorizes the National Board to hold harmless or provide liability insurance for any employee of the Service under certain circumstances. Title IV: Other Functions of Health Boards - Part A: Advocacy, Grievance Procedures, and Trusteeships - Requires each area health board to establish a program of health advocacy with specified elements. Requires the National Board to establish a health rights legal services program, for users and health workers, providing specified elements. Requires each appropriate regional board to provide that any user, health worker, user association, or specified health board may commence grievance proceedings before specified health boards with respect to alleged violations of this Act. Provides for review of adverse decisions. Prohibits commencement or continuation of such review when suit is filed. Provides procedures for handling such grievances. Authorizes, in certain circumstances, the entity before which a grievance proceeding is commenced or reviewed to: (1) set aside an election of a community board and require a new election; and (2) if not involving a community board, require that a new election be conducted or a new appointment be made. Requires such entity to transfer such functions as necessary to the appropriate higher health board until a new election is conducted or a new appointment is made. Authorizes a health board which receives functions under such a transfer to appoint a trustee or trustee committee to carry out transferred functions. Part B: Occupational Safety and Health Programs - Requires the National Board to oversee occupational safety and health programs conducted at the regional level and to participate in the establishment and administration of occupational safety and health standards under the Occupational Safety and Health Act of 1970, with the advice and comments of regional occupational safety and health action councils established under this Act. Amends the Occupational Safety and Health Act of 1970 to substitute references to the National Health Board for references to the Secretary of Health and Human Services throughout such Act, with one specified exception. Adds references to the National Health Board to existing provisions in such Act regarding promulgation, modification, and revocation of safety and health standards. Ends responsibility of the Secretary of Health and Human Services for prescribing rules and regulations to carry out such Secretary's responsibilities under that Act. Adds a reference to consultation with the National Board to existing provisions relating to: (1) exemptions from required provisions on account of national defense; (2) conditions for approval of State safety and health plans; and (3) access to safety and health records and reports required of Federal agencies. Ends the authorization under a specified provision of such Act for the Secretary of Health and Human Services to prescribe regulations requiring employers to measure, record, and make reports on employees' exposure to certain substances or agents. Requires the National Board to establish guidelines for: (1) its participation in the establishment and administration of safety and health standards; (2) the election of community occupational safety and health action councils; (3) the establishment of regional occupational safety and health programs; (4) the establishment and operation of work place health facilities; and (5) the provision of assistance by various health boards to various safety and health councils, and to work place safety and health committees. Requires each community board to provide for the operation of a community occupational safety and health action council (COSHAC). Gives a formula for election of the members of COSHACs. Specifies the duties of each COSHAC. Requires each regional board to establish an occupational health and safety program for its region with specified elements, including staffing and supporting the operation of the regional occupational safety and health action council (ROSHAC). Specifies the responsibilities of each ROSHAC. Requires the employer in each work place to establish and maintain a health facility in or near the work place to meet occupational and emergency health care needs of employees, to be operated either by the community board or by the employer, and the cost, in either case, to be borne by the employer. Grants employees in each work place having 25 or more employees the right to establish work place occupational safety and health committees. Grants the members of such committees rights to engage in certain activities relating to inspections without loss of pay or other job rights. Authorizes employees to monitor conditions and to remove themselves from the site of any hazard without loss of pay or other job rights. Requires employers to minimize hazards and furnish employees with or reimburse employees for needed equipment or clothing. Specifies rights of employees regarding: (1) inspection of medical records maintained by their employers; (2) provision to employees of copies of all reports, studies, and data concerning health and safety in that work place; and (3) the seeking, through collective bargaining, of standards more restrictive than those established under the Occupational Safety and Health Act of 1970. Part C: Health and Health Care Delivery Research - Requires the Service to conduct a program of research concerning health and health care delivery. Transfers the National Institutes of Health from the Department of Health and Human Services to the National Health Board. States that the National Board shall establish five new national institutes: Epidemiology, Evaluative Clinical Research, Health Care Services, Pharmacy and Medical Supply, and Sociology of Health and Health Care. Specifies the duties of each such institute. Part D: Health Planning, Distribution of Drugs and Other Medical Supplies, and Miscellaneous Functions - Requires each area board to collect data on supply and demand regarding health workers and health care delivery. Requires each regional board to coordinate the planning and administration of health care delivery, health worker education, and health research in its region. Requires the National Board to formulate one-year and five-year national plans and budgets. Requires the National Board, after consultation with regional boards, to publish, and regularly update, a National Pharmacy and Medical Supply Formulary. Specifies the contents of the Formulary. Requires each regional board to establish a program for the purchase and distribution of drugs and other medical supplies. Authorizes the National Board to establish and operate drug and medical supply manufacturing facilities in certain circumstances. Requires the National Board to publish an annual report and a comprehensive dictionary of terms used in health care records and services maintained or provided by the Service. Title V: Financing of the Service - Part A: Health Service Taxes - Amends the Internal Revenue Code to add a new part imposing on individuals and corporations an additional tax of specified percentages of the normal tax and surtax imposed by a specified section of such code. Ends the income tax exclusion from gross income of amounts paid by third parties for medical care. Excludes from gross income employer contributions to accident or health plans to the extent that such contributions do not provide for health care available to such employees under the Health Service Act. Prohibits income tax deductions for: (1) health care expenses as a trade or business expense; and (2) contributions to certain medical and hospital facilities. Repeals provisions of the Internal Revenue Code relating to: (1) medical and dental expenses; (2) hospital insurance tax imposed on employment and self-employment income; and (3) receipts for railroad employees. Declares that no contractual or other nonstatutory obligation of any employer to pay or provide for health care for present or former employees and their dependents and survivors shall apply on or after the effective date of health services under this Act to the extent such individuals are eligible to receive such services under this Act. Prohibits Federal, State, or private worker compensation programs from paying for or providing any health care on or after the effective date of health services under this Act to the extent such care is available under this Act. Part B: Health Service Trust Fund - Creates in the Treasury the Health Service Trust Fund (Trust Fund). Appropriates to the Trust Fund amounts equal to 100 percent of the expected net receipts from specified provisions of the Internal Revenue Code. Appropriates to the Trust Fund a Government contribution equal to 40 percent of the amount appropriated under such 100 percent provision. Transfers to the Trust Fund all assets and liabilities of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Creates the Board of Trustees of the Trust Fund. Requires the investment of specified portions of the Trust Fund. Extends the purposes for which obligations of the United States may be issued under the Second Liberty Bond Act, to authorize the issuance at par of public debt obligations for purchase by the Trust Fund. Part C: Preparation of Plans and Budgets - Requires the National Board to annually fix the maximum amount of funds which may be expended from the Trust Fund during the fiscal year. Specifies criteria to be considered in determining such amount's maximum value. Authorizes the National Board to refix such maximum amount in certain circumstances. Authorizes the National Board to exceed such maximum amount as necessary because of epidemic, disaster, or other occurrence which was not and could not have been planned for. Authorizes the National Board to allocate, in addition to such maximum amount, funds borrowed under specified provisions of this Act. Requires each community, district, and regional board to annually submit fiscal year and five-year plans and budgets to the next higher level health board. Requires plans and budgets to be prepared in consultation with appropriate users, health workers, and health boards. Part D: Allocation and Distribution of Funds - Requires the National Board to annually transmit to regional boards a national health budget dividing the total funds available into funds for ordinary operating expenses, preventive health measures, capital expenses, research expenses, and special operating expenses. Requires funds for ordinary operating expenses, preventive health measures, and research expenses to be allocated to the regional boards on the basis of population. Requires funds for capital expenses to be allocated according to stated criteria. Declares the budget submitted to the regional boards by the National Board to be adopted upon the approval by a majority of the regional boards. Sets forth requirements, similar to those for the national health budget, for preparation and adoption of regional and district budgets. Defines "special operating expenses" to mean operating expenses associated with: (1) care and treatment for users 65 years of age and older; (2) care and treatment of persons confined to full-time residential institutions, including nursing homes and facilities for the treatment of mental illness; (3) the special health care needs of low-income users; (4) the special health care needs of rural users; (5) special health care needs arising from environmental or occupational health conditions; (6) special health care needs arising from unexpected occurrences, including epidemics and natural disasters; and (7) the conduct of environmental health inspection and monitoring services. Sets forth rules for allocation of special operating expenses. Requires funds allocated under the national health budget to be distributed by the National Board from the Trust Fund. Prohibits health boards from requesting or receiving funds from any other source. Sets forth rules regarding: (1) distribution of funds in the absence of an adopted budget; (2) maintenance of separate accounts by area boards; (3) payment of area health boards; and (4) allocation of supplementary funds required by events occurring or information acquired after initial allocations. Authorizes area boards to retain unused funds for two years following receipt. Requires any funds unexpended after such time to be returned to the Trust Fund. Mandates annual financial statements by area health boards. Grants the National Board and the Comptroller General of the United States, for the purpose of audits, access to any books, documents, papers, and records related to the operation of the Service. Part E: General Provisions - Authorizes the National Board to borrow money and to issue and sell obligations as necessary for this Act, but only in amounts specified in appropriations Acts. Limits the aggregate amount of such obligations outstanding at any one time. Authorizes the National Board to pledge the assets of the Trust Fund and pledge its revenues and receipts for various purposes related to such obligations. Authorizes the National Board to enter into a variety of covenants as necessary or desirable to enhance the marketability of such obligations. Declares that such obligations: (1) shall be negotiable or nonnegotiable, bearer or registered; (2) shall contain a recital that they are issued under a specified provision of this Act; (3) shall be lawful investments; (4) shall be exempt from State taxes; and (5) shall not, subject to exception, be obligations of the U.S. Government. Requires the National Board to advise the Secretary of the Treasury of the proposed sale of obligations. Authorizes such Secretary to elect to purchase the obligations. Authorizes the National Board, if the Secretary elects not to buy such obligations, to issue and sell them to a party or parties other than the Secretary, upon notice to the Secretary and consultation regarding various terms and conditions. Empowers the National Board to require the Secretary of the Treasury to purchase obligations of the Service. Prohibits any required purchase which would result in a holding by the Secretary in excess of a specified amount. Makes obligations issued by the Service obligations of the U.S. Government under certain circumstances. Authorizes the Secretary of the Treasury, for the purpose of any purchase of the obligations of the Service, to use as a public debt transaction the proceeds from the sale of any securities issued under the Second Liberty Bond Act. Extends the purposes of such Act to include any purchases of the obligations of the Service under this part. Title VI: Miscellaneous Provisions - Repeals, on the effective date of health services, the Public Health Service Act, except for specified provisions relating to: (1) its short title and definitions; (2) licensing, quarantine, and inspections authority; and (3) safety of public water systems. Delays, until four years after the effective date of health services, repeal of portions of the Public Health Service Act regarding provision of assistance to educational institutions and their students, in areas which have not established health team schools under part A of title III of this Act. Repeals specified provisions of the Social Security Act relating to maternal and child health, Medicare, Medicaid, professional standards review, entitlement to hospital insurance benefits, uniform health reporting systems, limitation on Federal participation for capital expenditures, the program for determining qualification for certain health care personnel, disclosure of ownership and related information, disclosure of certain convictions, and payments to States for health care and supplemental services. Repeals specified provisions of Federal law relating to health insurance for Federal employees, medical benefits and programs relating to veterans, and the civilian health and medical program of the uniformed services. Repeals the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970, the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act Amendments of 1974, and a specified provision of the Comprehensive Drug Abuse Prevention and Control Act of 1970 relating to medical treatment of narcotic addiction. Repeals Federal law relating to hospitals, community hospitals, and other health facilities for Indians. Repeals the District of Columbia Medical Facilities Construction Act of 1968 and the District of Columbia Medical and Dental Manpower Act of 1970. Repeals specified provisions of the National Housing Act relating to mortgage insurance for nursing homes, hospitals, and group practice facilities. Repeals the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963, the Family Planning Services and Population Research Act of 1970, the National Arthritis Act of 1974, and the National Diabetes Mellitus Research and Education Act. Repeals specified provisions of the Lead-Based Paint Poisoning Prevention Act relating to grant, demonstration, and research programs for lead-based paint poisoning prevention. Repeals the Act of March 2, 1897, relating to tea importation. Repeals specified provisions of the Occupational Safety and Health Act of 1970 relating to the National Institute for Occupational Safety and Health. Requires the President to prepare and submit to the Congress legislation to repeal or amend provisions of laws which are inconsistent with this Act, including the transfers of authority of the Secretary of Health and Human Services, under specified provisions of Federal law, to the Service. Sets forth various requirements regarding review and reporting to the President and the Congress concerning how the Service is carrying out the purposes of the various programs authorized to be conducted by provisions repealed by this Act. Transfers to the Health Service Trust Fund amounts appropriated to carry out the purposes of any law repealed by this Act. Provides transition rules regarding contracts entered into or rights or obligations arising before the effective date of such repeals. Amends the Budget and Accounting Act, 1921 to require that each budget submitted by the President set forth items relating to the Health Service Trust Fund separately from other operations of the Government. Declares that, if any provisions of this Act are declared invalid, the remainder of the Act shall not be affected.
Bill· HRH.R. 3205 (102nd)referred
United States · United States Congress · 2 August 1991
Health Insurance Coverage and Cost Containment Act of 1991 - Title I: Requiring Employers to Provide Health Insurance Coverage for Employees and Dependents or to Pay for Coverage Through the Public Health Plan - Amends the Social Security Act and the Internal Revenue Code to, respectively: (1) add a new title XXI under which employers are required to either enroll their employees and family members under a qualified employer health plan or provide information to the Secretary of Health and Human Services for enrollment instead in the public health plan created under a new title XXII of the Social Security Act and discussed under title II of this Act; and (2) impose a premium tax (set at nine percent of the employment wage base for 1993 and indexed to the rate of growth in public health plan benefits) on employers who fail to enroll their employees and family members under a qualified employer health plan and on such employers' employees, with employers paying 80 percent of the tax and employees paying the remaining 20 percent in order to pay for the basic health insurance coverage provided under the public health plan, impose an excise tax (set at $100 per day) on those employers who fail to provide the information necessary for enrollment under the public health plan, and set forth special rules and exceptions applicable in the imposition of such premium and excise taxes. Sets forth, under new title XXI of the Social Security Act, the rules for the enrollment of full- and part-time, seasonal, and temporary employees, including rules applicable in cases of families with more than one worker and where both employers offer enrollment under a qualified employer health plan. Phases in implementation of enrollment and tax payment requirements beginning on January 1, 1993 for employers with more than 100 employees. Requires that as of January 1, 1996 all employers must provide coverage or pay the premium tax for coverage under the public health plan. Allows the qualified employer health plan under which the employer must provide such benefit package to be either a private health plan or a self-insured plan, depending upon the size of the employer. Allows employers to charge employees up to 20 percent of the premium for such basic coverage. Outlines additional requirements for qualified employer health plan premiums and cost-sharing. Sets forth requirements for which the Secretary is to develop standards to certify a health plan as a qualified employer health plan. Requires the Secretary to: (1) establish procedures for the periodic review and recertification of plans as qualified employer health plans; and (2) terminate the certification of any such plan that no longer meets such standards. Requires employers to provide their employees and family members with a basic health benefit package that at least mirrors the benefits provided under the public health plan. Amends the Internal Revenue Code, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act to repeal certain health insurance continuation requirements. Title II: Provision of Health Insurance Through a Public Health Plan - Amends the Social Security Act to add a new title XXII under which is created a public health plan similar to Medicare (title XVIII of the Social Security Act) under which those U.S. citizens who are not Medicare beneficiaries or enrolled under a qualified employer health plan under title I of this Act or under a Federal health plan are eligible to enroll for the basic health insurance benefits outlined below. Makes low-income individuals who enroll in the plan eligible for assistance to limit or eliminate their financial obligations for premiums, deductibles, and co-payments under the plan. Sets forth provisions detailing the application process for enrollment under the public health plan. Requires individuals who are eligible to enroll under the public health plan but have not applied for enrollment by January 1, 1996 to be automatically enrolled on a retroactive basis and subjected to a penalty of twice any premiums otherwise due. Provides that the benefits under the public health plan will generally be the same as those currently covered under Medicare, except that: (1) plan benefits will include the preventive services added to the Medicare program under title V of this Act, without co-payments or limits on days of care per spell of illness; (2) plan benefits will include hospital care for children, without co-payments or limits on days of care per spell of illness; (3) plan benefits will include specified pregnancy-related services, subject to a required periodicity schedule and prior authorization for certain services; and (4) there will be a single annual deductible of $250 per individual/$500 per family with an overall annual limit on deductibles and co-payments of $2,500 per individual/$3,000 per family indexed to the annual increases in the contribution and benefit base. Requires payments for services under the public health plan to be based on rates established by the Secretary, and approved by the Health Care Cost Containment Commission, under title III of this Act. Directs the Secretary to establish a global fee schedule for payment of obstetrical services with a disincentive for cesarean sections. Sets forth provisions for: (1) determining the amount of premiums to be charged individuals not connected to the work force and individuals who are employed on a part-time, seasonal, or temporary basis; and (2) collecting current and delinquent premium payments. Creates in the Treasury the Public Health Trust Fund to receive the funds generated from the premium and excise taxes imposed under this Act as well as from other specified revenues dedicated to the support of the plan. Directs the Secretary to provide for the: (1) submission of claims under new titles XXII and XVIII using uniform forms developed by the Health Care Cost Containment Commission established under title III of this Act; and (2) reporting to the Commission of information on required health services provided under such new titles pursuant to standards to be developed by the Commission. Sets forth administrative provisions applicable to the public health plan. Requires that the Secretary establish a toll-free telephone number for information on the public health plan. Authorizes the Secretary to conduct demonstration projects to: (1) improve the delivery and quality of health care services under new title XXII; and (2) increase the efficiency and effectiveness of the methods for paying for such services. Title III: Cost Containment - Sets a national limit on the health expenditures of the public health plan and qualified employer health plans for the services required to be covered for each year beginning in 1993. Indexes the limit each year to the rate of growth in the gross national product plus: (1) four percent for 1993 and 1994; (2) three percent for 1995 and 1996; (3) two percent for 1997 and 1998; (4) 1 percent for 1999 and 2000; and (5) zero percent for each year after 2000. Establishes the Health Care Cost Containment Commission to: (1) negotiate with health care providers to allocate national expenditures under the limit among the different classes of health care providers; (2) report annually to the Secretary on negotiation results and on the specific dollar amounts to be allocated to each class of providers; (3) review and approve or disapprove the ceilings for provider payment rates established below; (4) develop uniform reporting standards with respect to information involving the services required to be covered under the public health plan and under qualified employer health plans; (5) develop uniform claims forms for use under the public health plan, qualified employer health plans, and Medicare; (6) report periodically to the Congress and the public on the effect of this title on the delivery of such services; and (7) develop a national capital budget for health care facilities and equipment needed for the provision of such services. Authorizes appropriations. Directs the Secretary to establish maximum payment rates that may be charged by providers under the public health plan or under qualified employer health plans for the services such plans are required to cover. Allows the use of State uniform payment rates for services under the public health plan, qualified employer health plans, and Medicare, under certain conditions. Title IV: Group Health Insurance Reform - Amends the Social Security Act and the Internal Revenue Code to, respectively: (1) add a new title XXIII under which the Secretary is required to develop specific standards to implement requirements which group health insurance plans provided by employers must be certified as meeting in order to be issued, and to maintain, their qualified status; and (2) impose an excise tax (set at 50 percent of the gross premiums received during the taxable year) on the issuer of such a group plan which fails to meet such standards, with specified exceptions. Requires that no such group plans discriminate on the basis of health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability. Requires the same treatment for pre-existing condition exclusions as is required for qualified employer health plans. Requires any health insurance carrier which offers small employer health plans to register with the Secretary. Requires such carriers to offer such plans to all small employers within their community on a continuous, year-round basis. Allows a carrier to refuse to issue or renew or terminate a plan only for nonpayment of premiums and fraud or misrepresentation. Disallows a carrier from offering to, or issuing with respect to, a small employer a small employer health plan with a term of less than 12 months. Requires such carriers to offer a benefit package which contains only the basic benefits all other employers are required to provide to their employees and dependents. Prohibits a small employer carrier from varying the remuneration paid a broker for the sale or renewal of any small employer health plan based on the claims experience associated with the group to which the plan was sold. Details notice and other requirements applicable to renewals. Requires that premiums and age-sex adjustments for all small employer plans of the same entity must be: (1) established based on a single cohesive rating system which is applied consistently for all employer groups and is not designed to treat groups differently based on health or risk status; and (2) actuarially certified each year. Prescribes beneficiary classes for enrollment. Requires premiums to be community-rated for a particular geographic area. Details disclosure and recordkeeping requirements for small employer plans. Sets forth requirements for health maintenance organizations. Directs the Secretary to provide for the establishment of a toll-free telephone information and complaint system which provides for: (1) a system for the receipt and disposition of consumer complaints or inquiries regarding the compliance of health plans with the requirements of this title; and (2) information to small employers about carriers that offer small employer health plans in the area covered by the regulatory authority. Directs the Secretary to periodically publish the names of issuers of insured employment-related small employer health plans that have been found to meet the applicable requirements of this title. Title V: Changes in Medicare Program - Amends the Medicare program to: (1) reduce the age of eligibility for Medicare by one year in each year beginning on January 1, 1993 until the age for eligibility reaches 60 on January 1, 1997; (2) add annual screenings for colorectal cancer for individuals over age 50 and for breast cancer for women over age 64, vaccinations for influenza and tetanus-diphtheria, and well-child care services as program benefits; and (3) make technical and conforming changes in provisions with respect to Medicare enrollment and participation agreements that reflect the additions of new titles XXI and XXII and to ensure the coordination of low-income assistance for Medicare beneficiaries. Directs the Secretary to establish and provide for ongoing demonstration projects providing for the coverage of other specified preventive services under Medicare to determine whether to include the coverage of such services for all individuals enrolled under Medicare part B (Supplementary Medical Insurance). Requires reports to specified congressional committees describing the findings made under such demonstration projects and the Secretary's plans for future such demonstration projects. Authorizes appropriations. Directs the Director of the Office of Technology Assessment (OTA) to conduct a study to develop a process for the regular review of Medicare coverage of preventive services. Requires an OTA report to specified congressional committees on such study. Title VI: Financing Provisions - Amends the Internal Revenue Code to provide additional funding for universal health insurance coverage through the imposition of: (1) a surtax applicable to the regular income tax or alternative minimum tax owed by individuals, corporations, and estates and trusts beginning in taxable year 1993 at six percent of such taxpayer's tax liability and reaching nine percent after taxable year 1995; (2) an increase in the hospital insurance taxable wage base from $125,000 to $200,000; (3) an increase in the hospital insurance payroll tax imposed on both employers and employees from 1.45 percent to 1.55 percent in 1993 and to 1.65 percent in 1966 and thereafter; and (4) an increase in the self-employment tax from 2.90 percent to 3.10 percent in 1993 and to 3.30 percent in 1996 and thereafter. Sets forth special rules applicable to estate and trust and corporate liability for the health surtax. Extends the current deduction for health insurance costs of self-employed individuals for 1992 and modifies such deduction for subsequent years to entitle self-employed individuals and owners of personal service corporations to deduct 100 percent of their health insurance costs if they provide to all their employees who work 17 1/2 hours or more per week health coverage under a plan that would qualify as a qualified employer health plan under new title XXI of the Social Security Act. Provides that if such coverage is not provided, then the deduction for health insurance expenses of such individuals is limited to 25 percent, until after 1996 when the deduction is set unconditionally at 100 percent of the costs of health insurance coverage. Title VII: Medicaid Provisions - Amends title XIX (Medicaid) of the Social Security Act to: (1) limit Federal financial participation for services covered under the public health plan; (2) provide for the continuation of Medicaid benefits not covered under the public health plan and the nonduplication of benefits with the public health plan; and (3) require payments under State Medicaid programs to hospitals and physicians to be increased during the transition period to full implementation of universal health insurance coverage.
Bill· HRH.R. 3238 (102nd)referred
United States · United States Congress · 2 August 1991
Amends the Anti-Drug Abuse Act of 1988 to extend through FY 1995 the authorization of appropriations for specified programs for drug abuse education and prevention: (1) relating to youth gangs; and (2) for runaway and homeless youth. Amends the Drug-Free Schools and Communities Act Amendments of 1989 to replace a reference to the National Narcotics Leadership Act of 1988 with a reference to the Anti-Drug Abuse Act of 1988.
Bill· HRH.R. 3241 (102nd)referred
United States · United States Congress · 2 August 1991
Nontraditional Student Opportunity Act - Amends the Higher Education Act of 1965 (HEA) to revise student assistance programs with respect to access by nontraditional students. Revises the campus-based programs of supplemental educational opportunity grants (SEOG), college work-study (CWS), and Perkins Loans to require that a reasonable proportion of the higher education institution's SEOG allocation, CWC grant, and Perkings Loans be made to nontraditional students, if the institutions's allocation, grant, or loans under such programs are based directly or indirectly in part on the financial need demonstrated by nontraditional students. Defines nontraditional students, for such purposes, as those who are: (1) attending the institution less than full time; (2) age 24 or older; (3) single parents; or (4) independent students. Provides for access to the Robert T. Stafford Student Loan Program by less-than-half-time students who are enrolled for the equivalent of at least three credit hours. Provides for access to Pell Grants by less-than-half-time students. Revises need analysis requirements for Pell Grants and for student assistance in general to exclude from consideration as assets the net value of: (1) the family's principal place of residence; (2) a family farm on which the family resides; or (3) a small business substantially owned and managed by a member or members of the family. Increases the maximum of the child care allowance for purposes of determining cost of attendance in calculating the amount of an individual Pell Grant. Requires higher education institutions to assure that they provide human resources supportive services designed to solve particular problems related to the nontraditional student's need, including, but not limited to, counseling, child care services, financial aid services, campus health care services, and library services at times and places to accommodate nontraditional students. Provides that failure to comply with this requirement will result in the institution's forfeiting a portion of its funds under the programs of supplemental educational opportunity grants (SEOG), college work-study (CWS), and Perkins Loans. Revises postsecondary programs for nontraditional students to require the Secretary of Education (the Secretary) to conduct, through the Office of Educational Research and Improvement, a two-year study of the types of programs available for increasing the accessibility for nontraditional students of postsecondary education, and determine the success or failure of such programs. Directs the Secretary to make interim and final reports to specified congressional committees. Directs the Secretary to establish information and counseling services within the Department of Education to: (1) collect information on effective existing programs providing financial aid information and dissemination, and on existing exemplary guidance and counseling and college admission counseling programs targeted to adult students; and (2) offer assistance to businesses and institutions that wish to implement such programs. Directs the Secretary to make grants or contracts to develop model guidance and counseling and college admission counseling programs for use in various types of businesses and institutions, including tools and resources for dissemination to nontraditional students. Requires preference to be given applicants that have the ability to recruit nontraditional students. Includes among those eligible for such grants and contracts public and nonprofit private entities concerned with the availability of higher education assistance. Provides for disregard of student financial assistance received under HEA in determining need or eligibility for, or amount of, benefits or assistance under any Federal (or federally-assisted State or local) program providing food stamps, welfare assistance, medicaid, or social security income.
Law· HRH.R. 3259 (102nd)enacted
United States · United States Congress · 2 August 1991
Amends the Anti-Drug Abuse Act of 1988 to extend through FY 1994 the authorization of appropriations for specified programs for drug abuse education and prevention: (1) relating to youth gangs; and (2) for runaway and homeless youth. Directs the Secretary of Health and Human Services to report annually to specified congressional officials on the program of drug education and prevention relating to youth gangs. Includes, as grant and contract recipient under such program, consortia of local education, juvenile justice, employment and social service agencies.
Bill· HRH.R. 3277 (102nd)referred
United States · United States Congress · 2 August 1991
Amends title XVIII (Medicare) of the Social Security Act to eliminate the annual cap on the amount of payment for outpatient physical therapy and occupational therapy services under part B (Supplementary Medical Insurance).
Bill· HRH.R. 3256 (102nd)referred
United States · United States Congress · 2 August 1991
National Drug Treatment Goals Act of 1991 - Amends the National Narcotics Leadership Act of 1988 to establish as a part of the National Drug Control Strategy (NDCS) a goal for expanding the availability of treatment for drug addiction. Expresses the sense of the Congress that the long-term goals of the NDCS should include the availability of drug treatment to all who are in need of such treatment.
Bill· HRH.R. 3251 (102nd)referred
United States · United States Congress · 2 August 1991
Low-Income Medicare Beneficiary Notification Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services' annual notice to Medicare beneficiaries to: (1) notify such beneficiaries of the availability of and the requirements to qualify for Medicaid (title XIX of the Act) payment of their premiums, deductibles, and copayments under Medicare; and (2) contain an initial application for such assistance. Requires participating physicians and hospitals to post conspicuously a notice of the availability of such assistance. Amends the Medicaid program to State plans to provide for the establishment and operation of a toll-free hotline to provide information on such assistance.
Bill· HRH.R. 3220 (102nd)referred
United States · United States Congress · 2 August 1991
Medicare Occupational Therapy Amendments of 1991 - Amends title XVIII (Medicare) of the Social Security Act to provide for eligibility for home health services on the basis of a need for occupational therapy.
Bill· HRH.R. 3216 (102nd)referred
United States · United States Congress · 2 August 1991
Food Quality Protection Act of 1991 - Title I: Cancellation and Suspension - Amends provisions of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) relating to cancellation and changes in classification or other terms or conditions of registration with respect to the authority of the Administrator of the Environmental Protection Agency. Requires that a rulemaking under such provisions be based on a validated test or other significant evidence raising prudent concerns of unreasonable adverse effects to man or to the environment. Sets forth procedural requirements for such a rulemaking. Provides for amendment of a rule and for judicial review. Allows the Administrator, in the case of a suspension, to waive certain requirements. Allows the Administrator to elect to proceed with a special review proceeding or a public interim administrative review proceeding, if published before a specified date, under the law in effect before enactment of this Act. Requires the Administrator to reassess each tolerance and exemption from the requirement for a tolerance at certain times in connection with reregistration of pesticides. Establishes the Science Review Board to assist the Scientific Advisory Panel in reviews conducted by the Panel. Revises procedures applicable after denial of an application for registration. Allows the Administrator to deny an application for registration because it does not comply with the requirements of a rule issued under provisions of this Act. Repeals provisions regulating the authority of the Administrator to initiate a public interim administrative review process. Declares a decision made after a hearing in certain circumstances during phase three of reregistration to be final. Amends provisions regulating: (1) review by district courts of suspension of registrations; and (2) public hearings. Title II: Data Collection - Directs the Secretary of Agriculture to collect pesticide use data of Statewide or regional significance for all the major crops and crops of dietary significance. Mandates research, development, and dissemination of integrated pest management techniques and other pest control methods that enable producers to reduce or eliminate application of pesticides which pose a greater than negligible dietary risk to humans. Title III: Amendments to the Federal Food, Drug, and Cosmetic Act - Amends the Federal Food, Drug, and Cosmetic Act (FDCA) to define, subject to exception, "pesticide chemical" as it is defined in the FIFRA. Adds to the list of prohibited acts under the FDCA violation of provisions relating to confidentiality of data, as amended by this Act. Deems a food adulterated if it bears or contains: (1) a pesticide chemical residue that is unsafe; or (2) a new animal drug, or conversion product thereof, that is unsafe. Sets forth requirements relating to tolerances and exemptions from the requirement of a tolerance for pesticide chemical residues in food, including residues of degradation products. Prohibits establishment of a tolerance higher than a level the Administrator of the Environmental Protection Agency determines is adequate to protect the public health. Sets forth the factors the Administrator must consider. Allows a greater than negligible dietary risk if: (1) use protects from greater adverse health effects to humans or the environment; (2) use avoids greater risks from another pesticide; or (3) the unavailability of the pesticide would reduce the availability of an adequate, wholesome, and economical domestic supply of the food, and the adverse effects from the reduction would outweigh the risk posed by the residue. Allows the Administrator to issue an exemption from the requirement for a tolerance only if the Administrator determines that a tolerance is not needed to protect the public health, in view of the levels of dietary exposure that could reasonably be expected to occur. Sets forth the factors the Administrator must consider. Sets forth procedures and requirements in connection with: (1) petitions for tolerances or exemptions; (2) certain actions authorized on the Administrator's own initiative; (3) the required submission of additional data to support the continuation of a tolerance or exemption; and (4) confidentiality of data submitted to the Administrator. Provides for continuation of previously issued regulations. Sets forth transitional provisions. Prohibits a final rule that revokes, modifies, or suspends a tolerance or exemption until the Administrator has taken any necessary action under the FIFRA with respect to the registration of the pesticide involved. Requires the Administrator, if the Administrator takes certain actions with respect to the registration of a pesticide, to revoke any tolerance or exemption that allows the presence of the chemical or chemical residue. Requires the suspension of any tolerance or exemption upon the suspension of the use of an associated registered pesticide. Provides for: (1) tolerances for unavoidable residues in the case of a residue of a canceled or suspended pesticide chemical that will unavoidably persist in the environment and thereby be present in or on a food; and (2) residues resulting from an application which was lawful at the time of the application. Directs the Administrator to require the payment of fees sufficient for the Administrator's functions under these provisions. Prohibits, subject to exception, a State from establishing or enforcing any limit on a qualifying pesticide chemical residue in or on any food which is not identical to Federal requirements. Prohibits a State from enforcing a residue limit which was lawful at the time of application. Authorizes appropriations for increased monitoring by the Secretary of Health and Human Services of pesticide residues in imported and domestic food.
Bill· HRH.R. 3253 (102nd)referred
United States · United States Congress · 2 August 1991
Pollution Prevention, Community Recycling, and Incinerator Control Act - Amends the Solid Waste Disposal Act to prohibit the issuance of permits for construction or expansion to municipal solid waste incinerators. Prohibits Federal agencies, State or local governments, or other waste management jurisdictions from issuing permits to such incinerators after December 31, 1999, unless the applicant demonstrates and the State finds that: (1) an annual waste composition analysis of the solid waste generated within the area to be served by the facility is conducted by the applicant and by entities from which the facility accepts waste; (2) such entities divert specified percentages of glass, paper, metals, plastics, and yard and food waste to waste management methods other than incineration; (3) the facility will not interfere with diversion rates; (4) it is not feasible to manage the remaining solid waste through source reduction, reuse, or recycling; (5) the facility will not adversely affect the environment or human health and is not situated in a nonattainment area identified under the Clean Air Act; (6) the facility will not harm the local economy; (7) the full cost of the facility over its entire life will be less costly than reducing, recycling, or composting waste; (8) the waste management jurisdiction conducts a public participation process (including a technical assistance grant to local community groups concerned about the project); (9) the proposed construction or expansion is approved by the unit of local government in whose boundaries the facility would be sited; (10) firms operating the facility are in compliance with environmental and public health statutes, have paid outstanding fines for violations of such statutes, and make disclosure statements available; and (11) an approved environmental impact statement is completed. Directs the Administrator of the Environmental Protection Agency to: (1) promulgate standards for waste composition analyses; and (2) review diversion rates triennially and require higher rates, if feasible. Treats ash from municipal solid waste incinerators as a hazardous waste under the Solid Waste Disposal Act. Requires such ash to be managed in a monofill containing only such ash and designed to: (1) prevent the migration of constituents during the operation of the facility; and (2) prevent the infiltration of precipitation during any closure or postclosure monitoring period. Provides for compliance with such requirement by existing incinerators within three years of the enactment of this Act. Prohibits the use of such ash for any purpose. Prohibits the incineration of household hazardous waste, batteries, chlorinated plastics, consumer electronics, and yard waste in such incinerators. Prohibits the issuance of permits or prior approval for the construction or expansion of hazardous waste incinerators unless: (1) waste composition analyses are conducted by the applicant and generators of waste to be incinerated at the facility; (2) specified toxics use reduction requirements have been met and the facility will not interfere with the implementation of such requirements; (3) the facility will not adversely affect the environment or human health; (4) the facility will not harm the local economy; (5) there is no safer disposal or treatment technology available for any of the wastes; (6) the waste management jurisdiction conducts a public participation process (including a technical assistance grant to local community groups concerned about the project); (7) the proposed construction or expansion is approved by the unit of local government in whose boundaries the facility would be sited; (8) firms operating the facility are in compliance with environmental and public health statutes, have paid outstanding fines for violations of such statutes, and make disclosure statements available; and (9) an approved environmental impact statement is completed. Requires hazardous waste generators, as part of the permit process, to report annually on the use, and reduction of the use, of toxic or hazardous substances at their facilities. Directs permit applicants to demonstrate that the State in which the incinerator is located, and each State in which generators of hazardous waste to be incinerated at the facility are located, are implementing toxics use reduction programs. Applies this Act's requirements to any facility that burns hazardous waste.
Bill· HRH.R. 3234 (102nd)referred
United States · United States Congress · 2 August 1991
Makes members and former members of the armed forces and their dependents who are entitled to Medicare benefits eligible for Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) benefits for health care outside the United States for which payment under Medicare is prohibited. (Currently, individuals entitled to Medicare benefits are not eligible for CHAMPUS benefits.)
Bill· HRH.R. 3230 (102nd)referred
United States · United States Congress · 2 August 1991
Amends the Internal Revenue Code (with respect to the excise tax on failure to satisfy continuation coverage requirements of group health plans) to provide for continuation of health plan coverage in cases where failed financial institutions are taken over by Federal entities or other financial institutions.
Bill· SS. 1622 (102nd)open
United States · United States Congress · 1 August 1991
Comprehensive Occupational Safety and Health Reform Act - Amends the Occupational Safety and Health Act of 1970 (OSHA) with respect to occupational safety and health programs, committees, employee representatives, coverage, standards, enforcement, antidiscrimination, training and education, hazard and illness evaluation, State plans, and victims' rights. Title I: Safety and Health Programs - Amends OSHA to establish requirements for each employer to set up and carry out a written occupational safety and health program that includes methods and procedures for: (1) identifying, evaluating, and documenting hazards; (2) correcting them; (3) investigating work-related illnesses, injuries, and deaths; (4) providing occupational safety and health services, including emergency response and first aid procedures; (5) employee participation in implementing such program, including, where applicable, a safety and health committee; (6) responding to such committee's recommendations; (7) providing safety and health training and education to employees and committee members; (8) designating an employer representative qualified to and responsible for identifying hazards and initiating corrective action; and (9) at a worksite where employees of two or more employers work, protecting employees from hazards under the other employers' control. Authorizes the Secretary of Labor (the Secretary) to modify the application of such requirements to classes of employers where, in light of the risks faced by the employer's employees, such a modification would not reduce their safety and health protection. Directs the Secretary to issue final regulations on the required employer occupational safety and health programs, covering employee training and education as well, including annual refresher courses. Title II: Safety and Health Committees and Employee Safety and Health Representatives - Amends OSHA to require each employer of 11 or more employees to provide for: (1) safety and health committees; and (2) employee safety and health representatives. Requires, in general, such employers to establish such a committee at each worksite, but authorizes the Secretary to modify application of this requirement to: (1) an employer whose employees do not primarily report to or work at a fixed location; (2) covered employers at worksites where less than 11 of their employees are employed; and (3) worksites where employees of more than one employer are employed. Requires committee membership to consist of elected or appointed employee representatives and up to an equal number of employer representatives. Requires the committee to be cochaired by an employer representative and an employee representative. Grants each committee the reasonable right to: (1) review occupational safety and health related employer programs, incidents of death, injury, or illness, complaints of hazards, the employer's work injury and illness records (other than personally identifiable medical information), and other related reports and documents; (2) conduct worksite inspections (and related employee interviews) at least once every three months and in response to complaints; (3) conduct meetings at least once every three months; (4) observe the measurement of employee exposure to toxic materials and harmful physical agents; (5) establish procedures for exercising committee rights; (6) make advisory recommendations for improvements and corrections; and (7) accompany the Secretary's representative during certain physical inspections of the worksite. Requires the employer to permit committee members to take such time from work as is reasonably necessary to exercise committee rights, without any loss of pay or benefits for such time. Directs the Secretary to issue final regulations for the establishment and functioning of such committees. Sets forth procedures for selection of employee representatives by and from nonmanagerial employees. Directs the Secretary to issue regulations on safety and health representatives, including specified numbers and selection procedures. Title III: Coverage - Revises the OSHA definition of employer to include the Federal Government (except certain congressional employees) and State and local governments, thus extending OSHA coverage to public employees. (Includes under such OSHA coverage the executive and judicial branches and the following agencies of the legislative branch: the Botanic Garden, the General Accounting Office, the Government Printing Office, the Library of Congress, the Office of Technology Assessment, the Congressional Budget Office, and the Copyright Royalty Tribunal.) Authorizes the Secretary to cede OSHA jurisdiction to a Federal agency with respect to specified standards or regulations affecting occupational safety and health of some or all employees within that agency's regulatory jurisdiction, if the agency has promulgated and is enforcing standards and regulations so that its employees are being protected at least as effectively as they would be by the Secretary. Declares that nothing in OSHA shall apply to working conditions covered by the Federal Mine Safety and Health Act of 1977. Applies OSHA to employment performed in the Federal nuclear facilities under the control or jurisdiction of the Department of Energy. Extends an employer's duties under OSHA to all employees working at the place of employment (even if they are not the employer's employees). Title IV: Occupational Safety and Health Standards - Revises provisions for OSHA standards. Requires specified timeframes for setting such standards after the Secretary has received: (1) a recommendation of an advisory committee, the Secretary of Health and Human Services (HHS), or the Administrator of the Environmental Protection Agency; or (2) a petition from an interested person setting forth with reasonable particularity the facts claimed to establish that a standard should be promulgated, modified, or revoked. Directs the Secretary, within 90 days after such receipt, to publish a response stating whether the Secretary intends to publish a proposed rule with respect to such standard, or if not, the reasons for the decision not to publish such a rule. Directs the Secretary, if such rule is intended to be published, to do so within 12 months after the receipt of the recommendation or petition. Directs the Secretary to: (1) afford interested persons a period of at least 30 days to submit written data or comments after publication of a proposed rule promulgating, modifying, or revoking an OSHA standard; and (2) issue a final rule within 180 days after the public comment period (or within 180 days after a required public hearing on objections to such rule). Allows any adversely affected person to petition for judicial review, in the U.S. court of appeals for the appropriate circuit, of the Secretary's refusal or failure to issue such rules or standards. Requires that such petition be filed within 60 days after publication of such determination. Requires set-aside of the Secretary's determination if it is found to be arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law. Allows a petition to appeal the Secretary's failure to publish a proposed rule within the required 12-month time frame to be filed at any time after such time period has elapsed. Directs the reviewing court to compel the Secretary to take any such action that is found to have been unlawfully withheld or unreasonably delayed. Provides that the withholding or delaying of action shall not be justified by the Secretary's desire to consult with, or receive approval from any other Federal agency or executive official, except where required by applicable law and pursued in timely fashion. Revises the definition of "occupational safety and health standard" to mean a standard which addresses a significant risk to the safety or health of employees by requiring conditions, or the adoption or use of one or more practices, means, methods, operations, or processes that most adequately assure, to the extent feasible, safe and healthful employment and places of employment. Requires each OSHA standard also to prescribe requirements for recording or reporting a work-related illness determined as a result of a medical examination or test conducted under the standard. Directs the Secretary to place in the public record all written comments and communications and a summary of all verbal communications with parties outside the Department of Labor (DOL) (including communications with executive branch officials) regarding promulgation, modification, or revocation of an OSHA standard. Directs the Secretary, in cooperation with the Secretary of HHS and in addition to other OSHA standards, to modify and establish exposure limits for toxic materials and harmful physical agents on a regular basis in a specified manner. Directs the Secretary of HHS, acting through the National Institute for Occupational Safety and Health (NIOSH), to: (1) regularly evaluate available scientific evidence, data, and information to determine if such exposure limits should be modified or established to protect exposed employees from material impairment of health or functional capacity; and (2) at least every three years, on the basis of such evaluation, develop and transmit to the Secretary recommendations identifying materials and agents for which exposure limits should be modified or established to protect employees from such impairment. Directs the Secretary: (1) within 30 days of receipt of such recommendations, to publish them and provide a 30-day public comment period; (2) within six months of their receipt, evaluate them and the public comments and publish a proposed rule for the exposure limits of each material and agent for which the Secretary of HHS has made a recommendation (explaining why any proposed limit is not the same as a recommended limit); (3) within one year of publication of the proposed limits, issue a final standard (explaining why any final limit is not the same as the recommended limit); and (4) establish or modify such limits whenever warranted, in addition to a periodic review. Directs the Secretary, within two years after the effective date of this Act, to promulgate final standards on exposure monitoring and medical surveillance programs, including specified requirements. Directs the Secretary to issue a final standard on ergonomic hazards to protect employees from work-related musculoskeletal disorders, including specified requirements. Sets forth timetables for the Secretary to issue various OSHA final standards. Title V: Enforcement - Revises OSHA enforcement provisions. Provides that time spent by an employee in accompanying the Secretary's representative on an OSHA inspection shall be deemed to be hours worked, with no loss of pay, benefits, or seniority. Requires the Secretary to notify employees or their representative within 30 days after receipt of their request for inspection that there are no reasonable grounds to believe a violation or danger exists. Directs the Secretary also to make a special inspection after determining that there are reasonable grounds to believe that an imminent danger or serious violation exists in a place of employment, upon notification from any other source (as well as upon notification by an employee or employee representative as in current law). Directs the Secretary to establish and carry out a special emphasis inspection program for conducting inspections of industries or operations where existing hazards or newly recognized or new hazards introduced into work sites warrant more intensive inspections. Requires annual designation of the industries and operations for such program and the number of inspections planned and enforcement personnel required. Requires that special emphasis inspections be in addition to other programmed and complaint inspections conducted under OSHA before the effective date of this Act. Requires a report on such program in the Secretary's annual OSHA report to the Congress. Requires the Secretary to investigate any work-related death or serious incident (i.e. one resulting in hospitalization of two or more employees). Requires the employer to: (1) notify the Secretary of any death or serious incident occurring in a place of employment covered by OSHA; and (2) prevent the destruction or alteration of evidence that would assist in investigating such death or incident. Requires OSHA citations to state if the Secretary or the Secretary's representative believes that an alleged violation is serious and presents such a substantial risk to the safety or health of employees that initiation of review proceedings should not suspend the running of the period for correction of the violation. Revises the correction period to make it begin to run from the date of receipt of the citation, with specified exceptions. Requires employers to verify the abatement of a serious, willful, or repeated violation in writing to the Secretary within 30 days after the correction period has expired. Requires employers, within ten days after verification of abatement, to prominently post notice of such abatement at or near each place the violation occurred and to make a copy of the verification available to employers and employee representatives. Directs the Secretary to issue regulations implementing such abatement verification and notice requirements. Grants employees the right to contest: (1) citations' designations of the character of the violation or of the OSHA provision, standard, rule, regulation, or order violated (in addition to contesting the abatement period, as in current law); and (2) proposed penalties as inadequate. Grants employee representatives the right to participate in other proceedings (as well as hearings) conducted under specified OSHA enforcement procedures. Requires, if the Secretary intends to withdraw or modify a citation as a result of any agreement with the employer, the Occupational Safety and Health Review Commission (Commission) rules of procedure to provide for prompt notice to affected employees or their representatives. Grants employees or their representative, regardless of whether they have previously elected to participate in the proceedings, the right to file a notice alleging that the proposed agreement fails to effectuate the purposes of OSHA within 15 days after receipt of notice of the agreement. Directs the Secretary to consider the matter and, upon determination to proceed with the agreement, respond with particularity to the objections. Grants employees or their representative, within 15 days after the Secretary's response, the right to a hearing upon request to the Commission. Provides that if the Commission determines the proposed agreement fails to effectuate the purposes of OSHA, the proposed agreement shall not be entered as a Commission order and the citation shall not be withdrawn or modified in accordance with the proposed agreement. Revises OSHA provisions for restraining imminent dangers. Directs the Secretary to inform the employer and the affected employees and request that a condition or practice that poses an imminent danger be corrected immediately or that employees be immediately removed from exposure to such danger. Requires such actions if the Secretary determines, on the basis of an inspection or investigation, that a condition or practice in the place of employment is such that an imminent danger to safety or health exists which could reasonably be expected to cause death, serious physical harm, or permanent impairment of health or functional capacity of employees if not corrected immediately. Directs the Secretary to determine whether to post a notice in the workplace if the employer refuses to comply with the Secretary's request. Requires that such notice identify the source of the imminent danger. Grants employees the right to refuse to perform a duty that has been identified as the source of an imminent danger by such a notice, and prohibits discrimination against them for such refusal. Subjects an employer to a civil penalty of from $10,000 to $50,000 for each day during which an employee continues to be exposed if the employer does not immediately correct the hazard referred to in the posted notice or remove all employees from exposure to it, unless the Commission determines that the condition or practice is not covered by such imminent danger provisions. Revises OSHA criminal penalties to increase the maximum amount of fines and the length of prison terms for specified violations, including those for a willful violation causing death, an improper advance notice of an inspection, or a false statement. Establishes criminal penalties for a willful violation that causes serious bodily injury. Prohibits a penalty or fine which is imposed on a director, officer, or agent of an employer from being paid out of the employer's assets on behalf of that individual. Provides that nothing in OSHA shall preclude State and local law enforcement agencies from conducting criminal prosecutions in accordance with State or local laws. Title VI: Protection of Employees from Discrimination - Revises OSHA antidiscrimination provisions to extend coverage to an employee's: (1) reporting any injury, illness, or unsafe condition to the employer, employer's agent, safety and health committee, or employee safety and health representative; and (2) refusing to perform duties when reasonably apprehensive that doing so would result in serious injury to himself/herself or other employees, after having sought and been unable to obtain from the employer corrections of the circumstances causing such refusal. Revises procedures for consideration of complaints of discrimination. Increases the period for filing such complaints from 30 to 180 days after the alleged discrimination. Requires the Secretary, within 60 days after receipt of the complaint, to investigate and notify the complainant and the alleged violator of the findings. Requires such findings to be accompanied by a preliminary order providing relief, if the Secretary has concluded that there is reasonable cause to believe a violation has occurred. Allows the alleged violator or the complainant to file, within 30 days, objections to the findings and/or the preliminary order, and to request a hearing on the record. Provides that such filing of objections shall not operate to stay any reinstatement remedy in the preliminary order. Requires such hearings to be conducted expeditiously. Deems the preliminary order a final order not subject to judicial review if a hearing is not timely requested. Directs the Secretary to issue a final order within 120 days after the conclusion of such hearing. Allows such proceedings to be terminated at any time in the interim on the basis of a settlement agreement by the Secretary, the complainant, and the alleged violator. Requires the Secretary, upon determination that a violation of antidiscrimination provisions has occurred, to order: (1) correction of the violation; (2) reinstatement to the former position with all compensation (including back pay), terms, conditions, and privileges of such employment; and (3) compensatory damages. Authorizes the Secretary, upon request of the complainant, to assess against the person against whom such order is issued all costs and expenses (including attorney's fees) incurred by the complainant in connection with bringing the complaint. Allows adversely affected or aggrieved persons to petition within 60 days to obtain review of such orders in the U.S. Court of Appeals for the appropriate circuit. Directs the Secretary to file a civil action in the appropriate U.S. district court to enforce such orders against persons who fail to comply. Authorizes such court to grant appropriate relief. Provides that the legal burdens of proof that prevail under the Whistleblower Protection Act of 1989 shall govern adjudication of protected activities under OSHA antidiscrimination provisions. Title VII: OSHA and NIOSH Training and Education - Revises OSHA provisions for training and education. Includes education programs for employees and members of safety and health committees, as appropriate, among those programs which the Secretary of HHS is to conduct through NIOSH. Requires the Secretary (of Labor) to develop training materials, model curricula, and programs to assist employers in: (1) providing the training and education required under the new provisions for employer occupational safety and health programs; and (2) complying with OSHA standards. Title VIII: Recordkeeping and Reporting - Revises OSHA provisions relating to statistics to require the Secretary to collect information and conduct analyses that identify: (1) industries, employers, processes, operations, and occupations that have a high rate of injury or illness; (2) factors that cause or contribute to injuries and illnesses; and (3) workers' compensation costs associated with the injuries and illnesses. Requires such data to be publicly available in a form suitable for further statistical analysis, and to be used in setting safety and health standards, targeting inspections of individual establishments, and evaluating standard setting and enforcement programs. Directs the Secretary to require each employer covered by OSHA to report: (1) each work-related death of an employee immediately upon knowledge; and (2) each serious incident resulting in hospitalization of two or more employees within 24 hours of the incident. Revises OSHA requirements for employer records and reports to include (in addition to work-related deaths, injuries, and illnesses) suspected work-related illnesses, including a work-related illness reported by an employee or an employee's physician, unless the employer makes a reasonable determination that the illness is not work-related. Provides that all such employer records and reports shall be made available to the Secretary, the Secretary of HHS, employees, and employee representatives. Title IX: NIOSH - Revises OSHA provisions relating to duties of the Secretary of HHS acting through NIOSH. Includes under hazard evaluation reports an evaluation of whether any hazardous condition or harmful physical agent found in the place of employment poses a risk to exposed employees. Directs the Secretary of HHS, if a final determination of hazard is not made within six months of a request, to provide to the employer and employees an interim report on the known or suspected hazards, a recommendation for control, and an estimate of the time in which a final determination will be made. Directs the Secretary of HHS to identify major factors contributing to occupational injuries and deaths through accident investigations and epidemiological research. Directs the Secretary of HHS to carry out a program to identify and notify employees at increased risk of occupational illnesses, injuries, and deaths, including public information and education programs, and recommendations for appropriate medical surveillance. Requires notification, if they are found to be at increased risk, of subjects of studies funded or conducted by the Secretary of HHS under such program. Specifies that the authority of the Secretary of HHS, and of NIOSH, to inspect records extends to the Secretary's designees and contractors. Directs the Secretary of HHS, through NIOSH (and in cooperation with other HHS agencies and the Secretary of Labor), to establish a national surveillance program to identify cases of occupational illnesses, deaths, and serious injuries. Requires coordination with State health agencies and Federal and State workers' compensation agencies under such program. Directs the Secretary of HHS to collect data each year on the number and characteristics of all occupational deaths and selected occupational illnesses and injuries. Requires, in making such selections, consideration of known frequency and severity of the disorder and of the size of the population at risk. Directs the Secretary of HHS to report on and analyze the occupational deaths, illnesses, and injuries collected under such program, and transmit such information to the Secretary of Labor, State health agencies, employers, employees, and other interested parties. Authorizes the Secretary of HHS to require an employer, through a physician or health professional employed by or under contract to the employer, to report information on occupational deaths, illnesses, and injuries. Establishes NIOSH as a separate agency within the U.S. Public Health Service in the Department of HHS. Title X: State Plans - Revises OSHA requirements for State plans to provide for: (1) development of safety and health programs and safety and health committees and training programs that are at least as effective as those under the new OSHA requirements; and (2) reporting requirements, protection of employee rights, and access to information that are at least as effective as those under OSHA or other Federal laws governing access to information related to OSHA. Requires the State to enforce the Federal standard until a State standard at least as effective is in effect, if a State fails to adopt or promulgate such a standard within six months after the Federal standard is promulgated. Requires the Secretary (of Labor) to: (1) promptly investigate complaints against a State plan if there are reasonable grounds to believe a deficiency exists; (2) investigate complaints alleging a deficiency in a State enforcement action within 30 days of receipt; and (3) within 30 days of completion of the investigation, transmit findings and recommendations for correction to the State and complainant (or notify the complainant if there are no reasonable grounds to believe a deficiency exists). Requires a State to respond as to what action it has taken on the Secretary's findings and recommendations within 30 days of their receipt. Directs the Secretary to issue a citation with reasonable promptness if, after receipt of the State's response, the Secretary believes a serious violation of OSHA exists for which the State has failed to issue a citation. Requires the Secretary, upon determination that there are reasonable grounds to conclude there is a failure to comply substantially with any provision or assurance of the State plan, to: (1) notify the State and allow six months for correction of deficiencies; (2) institute proceedings for withdrawal of approval of the State plan, if the State has not corrected the deficiencies within six months (unless there are exceptional circumstances); and (3) during the pendency of such proceedings, exercise concurrent jurisdiction with the State over the safety and health issues that are subject to the State plan. Requires States operating State safety and health plans to modify them to conform to this Act. Title XI: Victim's Rights - Sets forth provisions for victims' rights under OSHA. Defines a victim as: (1) an employee who has sustained a work-related injury or illness which is the subject of an OSHA inspection or investigation; or (2) the family member of an employee who either is killed or cannot reasonably exercise victim's rights as a result of such an injury or illness. Grants victims the right, on request, to: (1) meet with the Secretary or a representative respecting the inspection or investigation before the Secretary's decision to issue a citation or to take no action; (2) receive a free copy of any citation or report issued as a result of the inspection or investigation; (3) be informed of any notice of contest filed; (4) be provided an explanation of the rights of employees and employee representatives to participate in OSHA enforcement proceedings; and (5) be provided an opportunity to appear and make a statement before the parties conducting any settlement negotiations before the Secretary agrees to withdraw or modify the citation. Provides that a victim shall have the same rights as an employee under OSHA enforcement procedures. Entitles a victim, if such victims' rights are violated, to declaratory relief, injunctive relief, recovery of costs of securing specified documents, and reasonable attorney's fees and costs. Directs the Secretary to take reasonable actions to inform victims of these rights. Title XII: Effective Date - Sets forth the effective date of this Act.
Bill· HRH.R. 3174 (102nd)referred
United States · United States Congress · 1 August 1991
Amends title XIX (Medicaid) to exclude facilities with less than 30 beds from treatment as institutions for mental diseases under Medicaid.
Bill· HRH.R. 3198 (102nd)referred
United States · United States Congress · 1 August 1991
Veterans Dignity in Health Care Act of 1991 - Grants veterans who are patients or residents in Department of Veterans Affairs (VA) medical centers, nursing homes, and domiciliaries the right to purchase and use tobacco products. Directs the Secretary of Veterans Affairs to ensure that: (1) each VA facility that maintains a commissary or canteen makes tobacco products available through, and provides patients or residents access to, the commissary or canteen; and (2) each VA facility maintains and provides patients or residents access to an indoor patient smoking area.
Bill· HRH.R. 3160 (102nd)reported
United States · United States Congress · 1 August 1991
Comprehensive Occupational Safety and Health Reform Act - Amends the Occupational Safety and Health Act of 1970 (OSHA) with respect to occupational safety and health programs, committees, employee representatives, coverage, standards, enforcement, antidiscrimination, training and education, hazard and illness evaluation, State plans, and victims' rights. Title I: Safety and Health Programs - Amends OSHA to establish requirements for each employer to set up and carry out a written occupational safety and health program that includes methods and procedures for: (1) identifying, evaluating, and documenting hazards; (2) correcting them; (3) investigating work-related illnesses, injuries, and deaths; (4) providing occupational safety and health services, including emergency response and first aid procedures; (5) employee participation in implementing such program, including, where applicable, a safety and health committee; (6) responding to such committee's recommendations; (7) providing safety and health training and education to employees and committee members; (8) designating an employer representative qualified to and responsible for identifying hazards and initiating corrective action; and (9) at a worksite where employees of two or more employers work, protecting employees from hazards under the other employers' control. Authorizes the Secretary of Labor (the Secretary) to modify the application of such requirements to classes of employers where, in light of the risks faced by the employer's employees, such a modification would not reduce their safety and health protection. Directs the Secretary to issue final regulations on the required employer occupational safety and health programs, covering employee training and education as well, including annual refresher courses. Title II: Safety and Health Committees and Employee Safety and Health Representatives - Amends OSHA to require each employer of 11 or more employees to provide for: (1) safety and health committees; and (2) employee safety and health representatives. Requires, in general, such employers to establish such a committee at each worksite, but authorizes the Secretary to modify application of this requirement to: (1) an employer whose employees do not primarily report to or work at a fixed location; (2) covered employers at worksites where less than 11 of their employees are employed; and (3) worksites where employees of more than one employer are employed. Requires committee membership to consist of elected or appointed employee representatives and up to an equal number of employer representatives. Requires the committee to be cochaired by an employer representative and an employee representative. Grants each committee the reasonable right to: (1) review occupational safety and health related employer programs, incidents of death, injury, or illness, complaints of hazards, the employer's work injury and illness records (other than personally identifiable medical information), and other related reports and documents; (2) conduct worksite inspections (and related employee interviews) at least once every three months and in response to complaints; (3) conduct meetings at least once every three months; (4) observe the measurement of employee exposure to toxic materials and harmful physical agents; (5) establish procedures for exercising committee rights; (6) make advisory recommendations for improvements and corrections; and (7) accompany the Secretary's representative during certain physical inspections of the worksite. Requires the employer to permit committee members to take such time from work as is reasonably necessary to exercise committee rights, without any loss of pay or benefits for such time. Directs the Secretary to issue final regulations for the establishment and functioning of such committees. Sets forth procedures for selection of employee representatives by and from nonmanagerial employees. Directs the Secretary to issue regulations on safety and health representatives, including specified numbers and selection procedures. Title III: Coverage - Revises the OSHA definition of employer to include the Federal Government (except certain congressional employees) and State and local governments, thus extending OSHA coverage to public employees. (Includes under such OSHA coverage the executive and judicial branches and the following agencies of the legislative branch: the Botanic Garden, the General Accounting Office, the Government Printing Office, the Library of Congress, the Office of Technology Assessment, the Congressional Budget Office, and the Copyright Royalty Tribunal.) Authorizes the Secretary to cede OSHA jurisdiction to a Federal agency with respect to specified standards or regulations affecting occupational safety and health of some or all employees within that agency's regulatory jurisdiction, if the agency has promulgated and is enforcing standards and regulations so that its employees are being protected at least as effectively as they would be by the Secretary. Declares that nothing in OSHA shall apply to working conditions covered by the Federal Mine Safety and Health Act of 1977. Applies OSHA to employment performed in the Federal nuclear facilities under the control or jurisdiction of the Department of Energy. Extends an employer's duties under OSHA to all employees working at the place of employment (even if they are not the employer's employees). Title IV: Occupational Safety and Health Standards - Revises provisions for OSHA standards. Requires specified timeframes for setting such standards after the Secretary has received: (1) a recommendation of an advisory committee, the Secretary of Health and Human Services (HHS), or the Administrator of the Environmental Protection Agency; or (2) a petition from an interested person setting forth with reasonable particularity the facts claimed to establish that a standard should be promulgated, modified, or revoked. Directs the Secretary, within 90 days after such receipt, to publish a response stating whether the Secretary intends to publish a proposed rule with respect to such standard, or if not, the reasons for the decision not to publish such a rule. Directs the Secretary, if such rule is intended to be published, to do so within 12 months after the receipt of the recommendation or petition. Directs the Secretary to: (1) afford interested persons a period of at least 30 days to submit written data or comments after publication of a proposed rule promulgating, modifying, or revoking an OSHA standard; and (2) issue a final rule within 180 days after the public comment period (or within 180 days after a required public hearing on objections to such rule). Allows any adversely affected person to petition for judicial review, in the U.S. court of appeals for the appropriate circuit, of the Secretary's refusal or failure to issue such rules or standards. Requires that such a petition to appeal the Secretary's determination not to propose a rule with respect to a standard be filed within 60 days after publication of such determination. Requires set-aside of the Secretary's determination if it is found to be arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law. Allows a petition to appeal the Secretary's failure to publish a proposed rule within the required 12-month time frame to be filed at any time after such time period has elapsed. Directs the reviewing court to compel the Secretary to take any such action that is found to have been unlawfully withheld or unreasonably delayed. Provides that the withholding or delaying of action shall not be justified by the Secretary's desire to consult with, or receive approval from any other Federal agency or executive official, except where this is required by applicable law and pursued in timely fashion. Revises the definition of "occupational safety and health standard" to mean a standard which addresses a significant risk to the safety or health of employees by requiring conditions, or the adoption or use of one or more practices, means, methods, operations, or processes that most adequately assure, to the extent feasible, safe and healthful employment and places of employment. Requires each OSHA standard also to prescribe requirements for recording or reporting a work-related illness determined as a result of a medical examination or test conducted under the standard. Directs the Secretary to place in the public record all written comments and communications and a summary of all verbal communications with parties outside the Department of Labor (DOL) (including communications with executive branch officials) regarding promulgation, modification, or revocation of an OSHA standard. Directs the Secretary, in cooperation with the Secretary of HHS and in addition to other OSHA standards, to modify and establish exposure limits for toxic materials and harmful physical agents on a regular basis in a specified manner. Directs the Secretary of HHS, acting through the National Institute for Occupational Safety and Health (NIOSH), to: (1) regularly evaluate available scientific evidence, data, and information to determine if such exposure limits should be modified or be established to protect exposed employees from material impairment of health or functional capacity; and (2) at least every three years, on the basis of such evaluation, develop and transmit to the Secretary recommendations identifying materials and agents for which exposure limits should be modified or established to protect employees from such impairment. Directs the Secretary: (1) within 30 days of receipt of such recommendations, to publish them and provide a 30-day public comment period; (2) within six months of their receipt evaluate them and the public comments and publish a proposed rule for the exposure limits of each material and agent for which the Secretary of HHS has made a recommendation (explaining why any proposed limit is not the same as a recommended limit); (3) within one year of publication of the proposed limits, issue a final standard (explaining why any final limit is not the same as the recommended limit); and (4) establish or modify such limits whenever warranted, in addition to a periodic review. Directs the Secretary, within two years after the effective date of this Act, to promulgate final standards on exposure monitoring and medical surveillance programs, including specified requirements. Directs the Secretary to issue a final standard on ergonomic hazards to protect employees from work-related musculoskeletal disorders, including specified requirements. Sets forth timetables for the Secretary to issue various OSHA final standards. Title V: Enforcement - Revises OSHA enforcement provisions. Provides that time spent by an employee in accompanying the Secretary's representative on an OSHA inspection shall be deemed to be hours worked, with no loss of pay, benefits, or seniority. Requires the Secretary to notify employees or their representative within 30 days after receipt of their request for inspection that there are no reasonable grounds to believe a violation or danger exists. Directs the Secretary also to make a special inspection after determining that there are reasonable grounds to believe that an imminent danger or serious violation exists in a place of employment, upon notification from any other source (as well as upon notification by an employee or employee representative as in current law). Directs the Secretary to establish and carry out a special emphasis inspection program for conducting inspections of industries or operations where existing hazards or newly recognized or new hazards introduced into work sites warrant more intensive than normal inspections. Requires annual designation of the industries and operations for such program and the number of inspections planned and number of enforcement personnel required. Requires that special emphasis inspections be in addition to other programmed and complaint inspections conducted under OSHA before the effective date of this Act. Requires a report on such program in the Secretary's annual OSHA report to the Congress. Requires the Secretary to investigate any work-related death or serious incident (i.e. one resulting in hospitalization of two or more employees). Requires the employer to: (1) notify the Secretary of any death or serious incident occurring in a place of employment covered by OSHA; and (2) prevent the destruction or alteration of evidence that would assist in investigating such death or incident. Requires OSHA citations to state if the Secretary or the Secretary's representative believes that an alleged violation is serious and presents such a substantial risk to the safety or health of employees that initiation of review proceedings should not suspend the running of the period for correction of the violation. Revises the correction period to make it begin to run from the date of receipt of the citation, with specified exceptions. Requires employers to verify the abatement of a serious, willful, or repeated violation in writing to the Secretary within 30 days after the correction period has expired. Requires employers, within ten days after verification of abatement, to prominently post notice of such abatement at or near each place the violation occurred and to make a copy of the verification available to employers and employee representatives. Directs the Secretary to issue regulations implementing such abatement verification and notice requirements. Grants employees the right to contest: (1) citations' designations of the character of the violation or of the OSHA provision, standard, rule, regulation, or order violated (in addition to contesting the abatement period, as in current law); and (2) proposed penalties as inadequate. Grants employee representatives the right to participate in other proceedings (as well as hearings) conducted under specified OSHA enforcement procedures. Requires, if the Secretary intends to withdraw or modify a citation as a result of any agreement with the employer, the Commission's rules of procedure to provide for prompt notice to affected employees or their representatives. Grants employees or their representative, regardless of whether they have previously elected to participate in the proceedings, the right to file a notice alleging that the proposed agreement fails to effectuate the purposes of OSHA within 15 days after receipt of notice of the agreement. Directs the Secretary to consider the matter and, upon determination to proceed with the agreement, respond with particularity to the objections. Grants employees or their representative, within 15 days after the Secretary's response, the right to a hearing upon request to the Commission. Provides that if the Commission determines the proposed agreement fails to effectuate the purposes of OSHA, the proposed agreement shall not be entered as a Commission order and the citation shall not be withdrawn or modified in accordance with the proposed agreement. Revises OSHA provisions for restraining imminent dangers. Directs the Secretary to inform the employer and the affected employees and request that a condition or practice that poses an imminent danger be corrected immediately or that employees be immediately removed from exposure to such danger. Requires such actions if the Secretary determines, on the basis of an inspection or investigation, that a condition or practice in the place of employment is such that an imminent danger to safety or health exists which could reasonably be expected to cause death, serious physical harm, or permanent impairment of health or functional capacity of employees if not corrected immediately. Directs the Secretary to determine whether to post a notice in the workplace if the employer refuses to comply with the Secretary's request. Requires that such notice identify the source of the imminent danger. Grants employees the right to refuse to perform a duty that has been identified as the source of an imminent danger by such a notice, and prohibits discrimination against them for such refusal. Subjects an employer to a civil penalty of from $10,000 to $50,000 for each day during which an employee continues to be exposed if the employer does not immediately correct the hazard referred to in the posted notice or remove all employees from exposure to it, unless the Commission determines that the condition or practice is not covered by such imminent danger provisions. Revises OSHA criminal penalties to increase the maximum amount of fines and the length of prison terms for specified violations, including those for a willful violation causing death, an improper advance notice of an inspection, or a false statement. Establishes criminal penalties for a willful violation that causes serious bodily injury. Prohibits a penalty or fine which is imposed on a director, officer, or agent of an employer from being paid out of the employer's assets on behalf of that individual. Provides that nothing in OSHA shall preclude State and local law enforcement agencies from conducting criminal prosecutions in accordance with State or local laws. Title VI: Protection of Employees from Discrimination - Revises OSHA antidiscrimination provisions to extend coverage to an employee's: (1) reporting any injury, illness, or unsafe condition to the employer, employer's agent, safety and health committee, or employee safety and health representative; and (2) refusing to perform duties when reasonably apprehensive that doing so would result in serious injury to himself/herself or other employees, after having sought and been unable to obtain from the employer corrections of the circumstances causing such refusal. Revises procedures for consideration of complaints of discrimination. Increases the period for filing such complaints from 30 to 180 days after the alleged discrimination. Requires the Secretary, within 60 days after receipt of the complaint, to investigate and notify the complainant and the alleged violator of the findings. Requires such findings to be accompanied by a preliminary order providing relief, if the Secretary has concluded that there is reasonable cause to believe a violation has occurred. Allows the alleged violator or the complainant to file, within 30 days, objections to the findings and/or the preliminary order, and to request a hearing on the record. Provides that such filing of objections shall not operate to stay any reinstatement remedy in the preliminary order. Requires such hearings to be conducted expeditiously. Deems the preliminary order a final order not subject to judicial review if a hearing is not timely requested. Directs the Secretary to issue a final order within 120 days after the conclusion of such hearing. Allows such proceedings to be terminated at any time in the interim on the basis of a settlement agreement by the Secretary, the complainant, and the alleged violator. Requires the Secretary, upon determination that a violation of antidiscrimination provisions has occurred, to order: (1) correction of the violation; (2) reinstatement to the former position with all compensation (including back pay), terms, conditions, and privileges of such employment; and (3) compensatory damages. Authorizes the Secretary, upon request of the complainant, to assess against the person against whom such order is issued all costs and expenses (including attorney's fees) incurred by the complainant in connection with bringing the complaint. Allows adversely affected or aggrieved persons to petition within 60 days to obtain review of such orders in the U.S. Court of Appeals for the appropriate circuit. Directs the Secretary to file a civil action in the appropriate U.S. district court to enforce such orders against persons who fail to comply. Authorizes such court to grant appropriate relief. Provides that the legal burdens of proof that prevail under the Whistleblower Protection Act of 1989 shall govern adjudication of protected activities under OSHA antidiscrimination provisions. Title VII: OSHA and NIOSH Training and Education - Revises OSHA provisions for training and education. Includes education programs for employees and members of safety and health committees, as appropriate, among those programs which the Secretary of HHS is to conduct through NIOSH. Requires the Secretary (of Labor) to develop training materials, model curricula, and programs to assist employers in: (1) providing the training and education required under the new provisions for employer occupational safety and health programs; and (2) complying with OSHA standards. Title VIII: Recordkeeping and Reporting - Revises OSHA provisions relating to statistics to require the Secretary to collect information and conduct analyses that identify: (1) industries, employers, processes, operations, and occupations that have a high rate of injury or illness; (2) factors that cause or contribute to injuries and illnesses; and (3) workers' compensation costs associated with the injuries and illnesses. Requires such data to be publicly available in a form suitable for further statistical analysis, and to be used in setting safety and health standards, targeting inspections of individual establishments, and evaluating standard setting and enforcement programs. Directs the Secretary to require each employer covered by OSHA to report: (1) each work-related death of an employee immediately upon knowledge; and (2) each serious incident resulting in hospitalization of two or more employees within 24 hours of the incident. Revises OSHA requirements for employer records and reports to include (in addition to work-related deaths, injuries, and illnesses) suspected work-related illnesses, including a work-related illness reported by an employee or an employee's physician, unless the employer makes a reasonable determination that the illness is not work-related. Provides that all such employer records and reports shall be made available to the Secretary, the Secretary of HHS, employees, and employee representatives. Title IX: NIOSH - Revises OSHA provisions relating to duties of the Secretary of HHS acting through NIOSH. Includes under hazard evaluation reports an evaluation of whether any hazardous condition or harmful physical agent found in the place of employment poses a risk to exposed employees. Directs the Secretary of HHS, if a final determination of hazard is not made within six months of a request, to provide to the employer and employees an interim report on the known or suspected hazards, a recommendation for control, and an estimate of the time in which a final determination will be made. Directs the Secretary of HHS to identify major factors contributing to occupational injuries and deaths through accident investigations and epidemiological research. Directs the Secretary of HHS to carry out a program to identify and notify employees at increased risk of occupational illnesses, injuries, and deaths, including public information and education programs, and recommendations for appropriate medical surveillance. Requires notification, if they are found to be at increased risk, of subjects of studies funded or conducted by the Secretary of HHS under such program. Specifies that the authority of the Secretary of HHS, and of NIOSH, to inspect records extends to the Secretary's designees and contractors. Directs the Secretary of HHS, through NIOSH (and in cooperation with other HHS agencies and the Secretary of Labor), to establish a national surveillance program to identify cases of occupational illnesses, deaths, and serious injuries. Requires coordination with State health agencies and Federal and State workers' compensation agencies under such program. Directs the Secretary of HHS to collect data each year on the number and characteristics of all occupational deaths and selected occupational illnesses and injuries. Requires, in making such selections, consideration of known frequency and severity of the disorder and of the size of the population at risk. Directs the Secretary of HHS to report on and analyze the occupational deaths, illnesses, and injuries collected under such program, and transmit such information to the Secretary of Labor, State health agencies, employers, employees, and other interested parties. Authorizes the Secretary of HHS to require an employer, through a physician or health professional employed by or under contract to the employer, to report information on occupational deaths, illnesses, and injuries. Establishes NIOSH as a separate agency within the U.S. Public Health Service in the Department of HHS. Title X: State Plans - Revises OSHA requirements for State plans to provide for: (1) development of safety and health programs and safety and health committees and training programs that are at least as effective as those under the new OSHA requirements; and (2) reporting requirements, protection of employee rights, and access to information that are at least as effective as those under OSHA or other Federal laws governing access to information related to OSHA. Requires a State to enforce a Federal OSHA standard until a State standard at least as effective is in effect, if a State fails to adopt or promulgate such a standard within six months after the Federal standard is promulgated. Requires the Secretary (of Labor) to: (1) promptly investigate complaints against a State plan if there are reasonable grounds to believe a deficiency exists; (2) investigate complaints alleging a deficiency in a State enforcement action within 30 days of receipt; and (3) within 30 days of completion of the investigation, transmit findings and recommendations for correction to the State and complainant (or notify the complainant if there are no reasonable grounds to believe a deficiency exists). Requires a State to respond as to what action it has taken on the Secretary's findings and recommendations within 30 days of their receipt. Directs the Secretary to issue a citation with reasonable promptness if, after receipt of the State's response, the Secretary believes a serious violation of OSHA exists for which the State has failed to issue a citation. Requires the Secretary, upon determination that there are reasonable grounds to conclude there is a failure to comply substantially with any provision or assurance of the State plan, to: (1) notify the State and allow six months for correction of deficiencies; (2) institute proceedings for withdrawal of approval of the State plan, if the State has not corrected the deficiencies within six months (unless there are exceptional circumstances); and (3) during the pendency of such proceedings, exercise concurrent jurisdiction with the State over the safety and health issues that are subject to the State plan. Requires States which are operating State safety and health plans to modify them to conform to this Act. Title XI: Victim's Rights - Sets forth provisions for victims' rights under OSHA. Defines a victim as: (1) an employee who has sustained a work-related injury or illness which is the subject of an OSHA inspection or investigation; or (2) the family member of an employee who either is killed or cannot reasonably exercise victim's rights as a result of such an injury or illness. Grants victims the right, on request, to: (1) meet with the Secretary or a representative respecting the inspection or investigation before the Secretary's decision to issue a citation or to take no action; (2) receive a free copy of any citation or report issued as a result of the inspection or investigation; (3) be informed of any notice of contest filed; (4) be provided an explanation of the rights of employees and employee representatives to participate in OSHA enforcement proceedings; and (5) be provided an opportunity to appear and make a statement before the parties conducting any settlement negotiations, before the Secretary agrees to withdraw or modify the citation. Provides that a victim shall have the same rights as an employee under OSHA enforcement procedures. Entitles a victim, if such victims' rights are violated, to declaratory relief, injunctive relief, recovery of costs of securing specified documents, and reasonable attorney's fees and costs. Directs the Secretary to take reasonable actions to inform victims of these rights. Title XII: Worker's Compensation Study - Establishes the Federal Worker's Compensation Commission. Directs the Commission to study worker's compensation laws and system with respect to: (1) the recommendations of the National Commission on State Workmen's Compensation Laws; (2) the feasibility of using workers' compensation data to target loss prevention activities on high risk occupations; (3) the laws' adequacy in providing for needs of injured workers, occupational illnesses and diseases, quality control and medical and rehabilitation costs with cost control, and time for recuperation and counseling before return to full-time work; (4) the administrative system's adequacy and the appropriateness of such laws as the exclusive remedy; (5) the relationship between workers' compensation, safety and health programs, and insurance rates and services; (6) the feasibility and appropriateness of transferring the branch of the Department of Labor involved in workers' compensation studies from the Employment Standards Administration to the Occupational Safety and Health Administration; and (7) the feasibility of preempting State workers' compensation laws with a national program. Requires such Commission to report the results of such study to the President and the Congress. Title XIII: Effective Date - Sets forth the effective date of this Act.
Bill· HRH.R. 3180 (102nd)referred
United States · United States Congress · 1 August 1991
Long-Term Home Care Act of 1991 - Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act to provide part A coverage of long-term home care furnished to chronically ill beneficiaries. Provides such coverage to otherwise uncovered chronically ill or disabled individuals who are age 65 or older and unable to perform at least two daily living activities. Amends title II (Old Age, Survivors and Disability Insurance) of such Act to cover, under part A of the Medicare program, long-term home care provided to children under age 19 who: (1) are chronically ill or disabled and unable to perform at least two daily living activities; or (2) require a medical device to compensate for the loss of a vital body function and substantial and ongoing nursing care to avert death or further disability. Holds monthly payments for the latter category of children to the amount which would be payable under the Medicaid program (title XIX of the Act) if such children were institutionalized. Limits monthly payments for other individuals to 65 percent of the average monthly Medicaid payment for full-time skilled nursing facility services if such individuals have a severe impairment and to 50 percent if they have a moderate impairment. Requires that long-term home care be provided pursuant to a written plan of care established, on the basis of an in-person assessment of the individual, and periodically reviewed by a trained case management team of a public or nonprofit private long-term care management agency and approved by the individual and the individual's physician. Lists the services which comprise long-term home care. Defines a "chronically ill individual" as an individual who requires assistance with at least two daily living activities or has a similar level of dependency due to cognitive impairment. Directs the Secretary of Health and Human Services to establish a prospective payment methodology and uniform national payment rates for long-term home care services. Provides that when expenditures for this Act's benefits exceed revenues raised pursuant to this Act, a copayment shall be imposed on long-term care, payment limits for such care shall be reduced, and prior surpluses shall be used to eliminate such deficit. Directs the Secretary to promulgate a long-term home care consumers' bill of rights which includes rights: (1) facilitating consumer participation in the planning and delivery of services; (2) requiring consumer notification regarding services, charges for services, and the termination or reduction of services; (3) protecting consumer dignity, privacy, and property; and (4) ensuring service from properly trained and competent individuals. Requires home health agencies to: (1) comply with the home care consumers' bill of rights and provide consumers with copies of such bill of rights; (2) implement prompt grievance review procedures and provide copies of such procedures to consumers; (3) ensure that each long-term home care provider whom they employ or have under contract receives training; and (4) evaluate annually and supervise each long-term home care provider whom they employ or have under contract. Conditions coverage of durable medical equipment services on providers: (1) issuing written instructions to and training the long-term home care consumer and staff in the operation of such equipment; and (2) formulating an emergency plan for providing services to the consumer. Requires long-term care management agencies to: (1) comply with the home care consumers' bill of rights and provide consumers with copies of such bill of rights; (2) implement prompt grievance review procedures and provide copies of such procedures to consumers; (3) provide consumers with schedules of the services to be provided; (4) provide consumers with statements on how to appeal agency benefit decisions; (5) maintain procedures assuring prompt access to long-term home care services; (6) ensure that case management personnel receive adequate training; and (7) establish and implement care management processes which include methods for measuring the progress of care and a statement of the criteria and procedures for the transfer or discharge of a consumer to another agency, program, or service. Directs the Secretary to establish procedures for conducting unannounced surveys of long-term care management agencies' compliance with Medicare participation conditions, with more frequent surveys required for agencies with poor compliance records. Authorizes the Secretary to contract with States having survey and enforcement procedures equivalent to those the Secretary would otherwise apply to conduct such compliance surveys and transmit their results to the Secretary annually. Directs the Secretary to develop procedures for reviewing State surveys. Directs the Secretary to promulgate regulations pursuant to which peer review organizations (PROs) shall monitor the provision of home health services and long-term home care, devoting at least 75 percent of their efforts to quality assurance. Requires the inclusion of: (1) both documentary review and personal interviews of home care consumers and providers in the PRO review process; and (2) representatives of home care providers and consumers in PRO membership. Requires the Secretary to establish a Consumer Board to oversee the review activities of PROs. Directs the Board to report to the Secretary and the State's chief executive on October 1 of each year regarding such review activities. Requires the Secretary to develop methods for monitoring continuity in the provision of home health care and outcome-oriented criteria for monitoring the quality of such care. Requires that PROs: (1) establish and operate statewide toll-free hotlines for receiving home care questions and complaints; and (2) assist consumers in resolving problems related to home care quality and case management services. Directs Consumer Boards and PROs to cooperate with State and local officials in educating consumers regarding quality assurance programs and the assistance available for consumers with quality assurance programs. Requires States to establish community advisory boards to monitor the activities of long-term care management agencies and annually report their findings to the Secretary. Requires the Secretary to: (1) develop a range of sanctions for, and procedures to implement such sanctions against, long-term care management agencies that fail to comply with this Act's requirements; and (2) report to the Congress on January 1 of each year regarding the availability, adequacy, and use of sanctions. Directs the Secretary to: (1) encourage States to develop home care provider licensing and certification policies; and (2) issue a biennial report on State implementation of such policies. Requires the Director of the Office of Technology Assessment to appoint a Long-Term Care Advisory Council with which the Secretary must consult in implementing and administering this Act. Directs the Secretary to award grants for home health agency, long-term care management agency, and long-term home care provider training programs and to furnish States and such agencies and providers with training materials. Directs the Secretary to: (1) conduct, and issue a report regarding, studies on long-term home care quality assurance measures; and (2) report to the Congress on January 1 of each year regarding the nature and performance during the preceding fiscal year of the home care quality assurance system. Authorizes appropriations from the Federal Hospital Insurance Trust Fund to carry out the long-term home care quality assurance program. Directs the Secretary to issue regulations, within six months of this Act's enactment, for implementing the long-term home care quality assurance program. Directs the Secretary to conduct demonstration projects to: (1) determine the relative effectiveness, cost, and impact on the quality of long-term home care of using different models of providing and reimbursing Medicare case management services; (2) determine the relative effectiveness, cost, and impact on quality of long-term home care of using different models of providing and reimbursing long-term home care services for seriously mentally ill individuals and family caregivers; (3) determine the feasibility of providing Medicare long-term care benefits for working-age individuals with severe functional limitations; and (4) test the feasibility of including adult day care within Medicare long-term home care coverage. Provides for the inclusion of adult day care within Medicare long-term home care coverage if the Secretary finds that its inclusion will not result in expenditures for adult day care exceeding savings in other long-term health care and will maintain the quality of Medicare long-term home care. Permits disabled individuals to purchase part A Medicare coverage during the 24-month waiting period preceding their entitlement to such coverage. Gives such individuals the option of enrolling for long-term home care benefits, for part A benefits other than long-term home care benefits, or for both. Amends the Internal Revenue Code to subject all of an individual's wages and self-employment income to the Hospital Insurance tax and the Disability Insurance tax.
Bill· SS. 1597 (102nd)referred
United States · United States Congress · 31 July 1991
Rural Health Innovation Demonstration Act of 1991 - Amends the Public Health Service Act to authorize competitive grants for the development of networks among rural and urban health care providers to preserve and share health care resources and enhance the quality and availability of health care in rural areas. Allows the networks to be statewide or regional. Specifies the services for which grant amounts must be used. Authorizes appropriations. Authorizes competitive grants to develop and administer cooperatives in rural areas that will establish an effective case management and reimbursement system designed to support the economic viability of essential public or private health services, facilities, health care systems, and health care resources. Involves the cooperative in matters such as third party reimbursement, employee health insurance, malpractice insurance, and managed care and practice standards. Authorizes appropriations. Authorizes competitive grants to develop and implement a plan for mental health outreach programs in rural areas. Authorizes appropriations. Authorizes grants to enable rural communities to provide stipends to physicians, nurses, or other health professional trainees to encourage such individuals to continue to provide health care services in such communities. Authorizes appropriations to carry out provisions relating to area health education centers.
Bill· SS. 1603 (102nd)referred
United States · United States Congress · 31 July 1991
Economic Growth Act of 1991 - Title I: Investment and Job Creation Incentives - Subtitle A: Reduction in Capital Gains Tax for Individuals - Amends the Internal Revenue Code to allow a capital gains deduction for individuals for assets held from one to three years. Provides special rules for the gain or loss from the sale or exchange of collectibles and sales of interests in partnerships. Disallows such deduction in computing the alternative minimum tax. Revises the formula for determining gain from the dispositions of certain depreciable realty to take into account depreciation adjustments (adjustments allowed or allowable for exhaustion, wear and tear, obsolescence, or certain amortization). Subtitle B: Inflation Adjustment for Investments - Requires indexing, based on the consumer price index, of the adjusted basis of certain assets (corporate stock and tangible property that is a capital asset of property used in a trade or business after April 15, 1991) that have been held for more than one year at the time of sale or other transfer, solely for the purpose of determining gain or loss. Provides for the inflation adjustment treatment of: (1) short sales; (2) regulated investment companies and real estate investment trusts; and (3) partnerships, S corporations, and common trust funds. Prohibits gain from the sale or other disposition of an indexed asset from being taken into account under the limitation on investment interest. Subtitle C: Enterprise Zones - Part I: Designation - Authorizes the Secretary of Housing and Urban Development (Secretary) to designate enterprise zones for purposes of providing tax and regulatory relief and improving local services. Limits choices to areas nominated by States and local governments. Limits the total number of areas that may be designated, and the time period of the designation. Authorizes the Secretary to designate a zone only if the area meets certain locational, demographic, unemployment, and poverty criteria. Requires nominating local governments, as a condition of the Secretary's designation, to agree in writing to follow a course of action that may include reducing tax rates, improving local services, simplifying or streamlining regulation of business, and providing job training to area residents. Describes areas to which the Secretary must give preference in selecting areas for designation. Requires the Secretary to report to the Congress every two years on the effects of such enterprise zones' designation in accomplishing the purposes of this Act. Part II: Federal Income Tax Incentives - Allows a nonrefundable income tax credit to enterprise zone employees for five percent of any wages earned that do not exceed a specified amount. Phases out such credit. Provides for the nonrecognition of capital gain on the sale of enterprise zone property. Allows a taxpayer a deduction on the aggregate amount paid for the purchase of enterprise stock on its original issue by a qualified issuer. Requires any gain from the disposition of the stock to be treated as ordinary income. Excludes enterprise zone capital gains from income computation of alternative minimum taxes. Part III: Regulatory Flexibility - Amends Federal law to revise the definition of "small entity" for purposes of the analysis of regulatory functions to include qualified business, government, and nonprofit enterprises operating within enterprise zones. Authorizes Federal agencies, upon request by a designating government, to waive or modify rules and regulations pertaining to the implementation of projects or activities within an enterprise zone. Requires agencies to approve the request if the resulting benefits of job creation, community development, or economic revitalization outweigh the public interest in retaining the rule unchanged. Disallows waiver or modification of a rule that would directly violate a statutory requirement or present a danger to the public health and safety. Part IV: Establishment of Foreign-Trade Zones in Enterprise Zones - Requires the Foreign-Trade Zone Board to consider on a priority basis and to expedite the processing of applications for the establishment of foreign-trade zones within enterprise zones. Requires the Secretary of the Treasury to give priority to, and expedite applications for, the establishment of ports of entry necessary to establish such zones. Part V: Repeal of Title VII of the Housing and Community Development Act of 1987 - Repeals title VII (enterprise zone development) of the Housing and Community Development Act of 1987. Subtitle D: Research and Experimentation Credit Made Permanent - Makes permanent the tax credit for increasing research activities and the tax credit for clinical testing expenses. Title II: Savings Incentives - Allows individuals to establish individual retirement plus accounts with tax treatment similar to that for individual retirement plans. Makes contributions to such accounts nondeductible. Allows existing individual retirement accounts (IRA) to be rolled over into individual retirement plus accounts with payment of tax on the amount rolled over for which a deduction was once allowable, but no tax when withdrawn. Title III: Homeownership Incentives - Subtitle A: First-Time Homebuyers - Allows a tax credit for the first-time purchase of a principal residence by individuals with incomes of $31,000 or less (phased-out to incomes of up to $41,000). Limits such credit to $1,000. Subtitle B: Penalty-Free IRA Plus Withdrawal for Home Purchase, Higher Education, and Health Costs - Allows penalty-free distributions from IRA Plus accounts of up to 25 percent of the account limit for: (1) first-time homebuyers; (2) medical expenses; and (3) higher education expenses. Title IV: Work Incentives - Subtitle A: Reduction in Social Security Penalty on Working Elderly - Amends title II of the Social Security Act (Federal Old-Age, Survivors, and Disability Insurance Benefits) to raise the earnings limit for retirees. Appropriates to each payor fund amounts equivalent to the aggregate increase in social security benefits payable from such fund which is attributable to such amendment. Directs the Secretary of Health and Human Services to study during 1997 whether further amendments relating to deductions on account of work and the exempt amount under the earnings limit are necessary or appropriate. Subtitle B: Economic Growth Dividend - Requires any economic growth dividend (as determined by the Secretary of the Treasury) to be used to increase the personal exemption amount. Requires, after 1995, all revenues resulting from real growth in the gross national product greater than three percent to fund an increased personal exemption. Requires, for fiscal years beginning on or after October 1, 1992, and before October 1, 1995, that 50 percent of such dividend be used to increase the personal exemption amount and the other 50 percent be used to make a downward adjustment in the maximum deficit amount.
Bill· HRH.R. 3142 (102nd)referred
United States · United States Congress · 31 July 1991
Amends title XVIII (Medicare) of the Social Security Act to limit Medicare coverage of chiropractic services to certain spinal manipulations and physical examinations and X-rays furnished to an individual to determine if spinal manipulations are appropriate therapy, conducted by State-licensed chiropractors who are legally authorized by the State to provide such services.
Bill· HRH.R. 3130 (102nd)referred
United States · United States Congress · 31 July 1991
Economic Growth Act of 1991 - Title I: Investment and Job Creation Incentives - Subtitle A: Reduction in Capital Gains Tax for Individuals - Amends the Internal Revenue Code to allow a capital gains deduction for individuals for assets held from one to three years. Provides special rules for the gain or loss from the sale or exchange of collectibles and sales of interest in partnerships. Disallows such deduction in computing the alternative minimum tax. Revises the formula for determining gain from the dispositions of certain depreciable realty to take into account depreciation adjustments (adjustments allowed or allowable for exhaustion, wear and tear, obsolescence, or certain amortization). Subtitle B: Inflation Adjustment for Investments - Requires indexing, based on the consumer price index, of the adjusted basis of certain assets (corporate stock and tangible property that is a capital asset of property used in a trade or business after April 15, 1991) that have been held for more than one year at the time of sale or other transfer, solely for the purpose of determining gain or loss. Provides for the inflation adjustment treatment of: (1) short sales; (2) regulated investment companies and real estate investment trusts; and (3) partnerships, S corporations, and common trust funds. Prohibits gain from the sale or other disposition of an indexed asset from being taken into account under the limitation on investment interest. Subtitle C: Enterprise Zones - Part I: Designation - Authorizes the Secretary of Housing and Urban Development (Secretary) to designate enterprise zones for purposes of providing tax and regulatory relief and improving local services. Limits choices to areas nominated by States and local governments. Limits the total number of areas that may be designated, and the time period of the designation. Authorizes the Secretary to designate a zone only if the area meets certain locational, demographic, unemployment, and poverty criteria. Requires nominating local governments, as a condition of the Secretary's designation, to agree in writing to follow a course of action that may include reducing tax rates, improving local services, simplifying or streamlining regulation of business, and providing job training to area residents. Describes areas to which the Secretary must give preference in selecting areas for designation. Requires the Secretary to report to the Congress every two years on the effects of such enterprise zones' designation in accomplishing the purposes of this Act. Part II: Federal Income Tax Incentives - Allows a nonrefundable income tax credit to enterprise zone employees for five percent of any wages earned as do not exceed a specified amount. Phases out such credit. Provides for the nonrecognition of capital gain on the sale of enterprise zone property. Allows a taxpayer a deduction on the aggregate amount paid for the purchase of enterprise stock on its original issue by a qualified issuer. Requires any gain from the disposition of the stock to be treated as ordinary income. Excludes enterprise zone capital gains from income computation of alternative minimum taxes. Part III: Regulatory Flexibility - Amends Federal law to revise the definition of "small entity" for purposes of the analysis of regulatory functions to include qualified business, government, and nonprofit enterprises operating within enterprise zones. Authorizes Federal agencies, upon request by a designating government, to waive or modify rules and regulations pertaining to the implementation of projects or activities within an enterprise zone. Requires agencies to approve the request if the resulting benefits of job creation, community development, or economic revitalization outweigh the public interest in retaining the rule unchanged. Disallows waiver or modification of a rule that would directly violate a statutory requirement or present a danger to the public health and safety. Part IV: Establishment of Foreign-Trade Zones in Enterprise Zones - Requires the Foreign-Trade Zone Board to consider on a priority basis and to expedite the processing of applications for the establishment of foreign-trade zones within enterprise zones. Requires the Secretary of the Treasury to give priority to, and expedite applications for, the establishment of ports of entry necessary to establish such zones. Part V: Repeal of Title VII of the Housing and Community Development Act of 1987 - Repeals title VII (enterprise zone development) of the Housing and Community Development Act of 1987. Subtitle D: Research and Experimentation Credit Made Permanent - Makes permanent the tax credit for increasing research activities and the tax credit for clinical testing expenses. Title II: Savings Incentives - Allows individuals to establish individual retirement plus accounts with tax treatment similar to that for individual retirement plans. Makes contributions to such accounts nondeductible. Allows existing individual retirement accounts (IRA) to be rolled over into individual retirement plus accounts with payment of tax on the amount rolled over for which a deduction was once allowable, but no tax when withdrawn. Title III: Homeownership Incentives - Subtitle A: First-Time Homebuyers - Allows a tax credit for the first-time purchase of a principal residence by individuals with incomes of $31,000 or less (phased-out to incomes of up to $41,000). Limits such credit to $1,000. Subtitle B: Penalty-Free IRA Plus Withdrawal for Home Purchase, Higher Education, and Health Costs - Allows penalty-free distributions from IRA Plus accounts of up to 25 percent of the account limit for: (1) first-time homebuyers; (2) medical expenses; and (3) higher education expenses. Title IV: Work Incentives - Subtitle A: Reduction in Social Security Penalty on Working Elderly - Amends title II of the Social Security Act (Federal Old-Age, Survivors, and Disability Insurance Benefits) to raise the earnings limit for retirees. Appropriates to each payor fund amounts equivalent to the aggregate increase in social security benefits payable from such fund which is attributable to such amendment. Directs the Secretary of Health and Human Services to study during 1997 whether further amendments relating to deductions on account of work and the exempt amount under the earnings limit are necessary or appropriate. Subtitle B: Economic Growth Dividend - Requires any economic growth dividend (as determined by the Secretary of the Treasury) to be used to increase the personal exemption amount. Requires, after 1995, all revenues resulting from real growth in the gross national product greater than three percent to fund an increased personal exemption. Requires, for fiscal years beginning on or after October 1, 1992, and before October 1, 1995, that 50 percent of such dividend be used to increase the personal exemption amount and the other 50 percent be used to make a downward adjustment in the maximum deficit amount.
Bill· HRH.R. 3145 (102nd)referred
United States · United States Congress · 31 July 1991
Defense Coordinated Health Care Act of 1991 - Requires the medical health care system of the Departments of the Army, Navy, and Air Force to be administered solely by the Coordinated Health Care Agency (CHCA). Directs the Office of the Assistant Secretary of Defense of Health Affairs to organize the CHCA and requires the CHCA to be established by January 15, 1992. Requires the Assistant Secretary to develop and implement policy over: (1) all functions necessary to operation of the military health care system; (2) readiness of combat medical support in operating and field forces; (3) delivery of health care services in field facilities; (4) training and development of health services personnel; (5) service unique operational medical support; and (6) preparation for wartime medical mobilization (to be developed jointly by the three Surgeons General). Directs the Surgeons General to advise and provide technical information to assist the Assistant Secretary.
Bill· HRH.R. 3147 (102nd)referred
United States · United States Congress · 31 July 1991
Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide that for FY 1992 through 1995 the costs of the Head Start Act, child immunizations under the Public Health Service Act, and the special supplemental food program under the Child Nutrition Act of 1966 are to be treated as emergency funding requirements not subject to discretionary spending limits. Requires funding for such activities to be provided through the normal legislative process.
Bill· HJRESH.J.Res. 318 (102nd)referred
United States · United States Congress · 31 July 1991
Designates May 1992 as National Amyotrophic Lateral Sclerosis Awareness Month.
Law· SS. 1594 (102nd)enacted
United States · United States Congress · 30 July 1991
Terry Beirn Community Based AIDS Research Initiative Act of 1991 - Declares that it is the sense of the Congress that the community-based clinical trials program should be renamed as the Terry Beirn Community-Based AIDS Research Initiative. Amends the Public Health Service Act to require clinical trials under the Initiative to be designed to encourage existing consortia of primary care providers to participate. Authorizes appropriations.
Bill· SS. 1592 (102nd)referred
United States · United States Congress · 30 July 1991
Prescription Drug Purchasing Assistance for Older Americans Act - Amends title XIX (Medicaid) of the Social Security Act to give States the option of extending their Medicaid prescription drug program to certain low-income Medicare (title XVIII of the Social Security Act) beneficiaries. Permits States which elect to make such an extension to charge a premium or co-payment to those beneficiaries with incomes exceeding that of a qualified Medicare beneficiary. Limits such charge to five percent of the individual's gross income.
Bill· HRH.R. 3090 (102nd)open
United States · United States Congress · 30 July 1991
Family Planning Amendments Act of 1991 - Amends the Public Health Service Act to require recipients of financial assistance under provisions relating to project grants and contracts for family planning services to offer women information on pregnancy management options, defined as nondirective counseling and referrals regarding: (1) prenatal care and delivery; (2) infant care, foster care, and adoption; and (3) termination of pregnancy. Prohibits such assistance unless the recipient is in compliance with State law regarding parental notification of or consent for the performance of an abortion on a minor. Authorizes appropriations for such assistance. Authorizes appropriations to carry out provisions relating to family planning and: (1) training grants and contracts; and (2) informational and educational materials.
Bill· HRH.R. 3089 (102nd)referred
United States · United States Congress · 30 July 1991
Access to Obstetrical Care Act of 1991 - Requires the Secretary of Health and Human Services to provide for demonstration projects to reduce infant mortality by improving access in underserved areas to obstetric services for eligible pregnant women under title XIX (Medicaid) of the Social Security Act. Amends the Public Health Service Act to: (1) deem any officer, employee, or contractor of an entity receiving Federal funds, under provisions relating to migrant and community health centers and health services for the homeless, and who is a licensed health care practitioner to be an employee of the Public Health Service; and (2) subrogate to the United States any medical malpractice claim of such employee. Requires such entities to take certain actions regarding malpractice. Directs the Secretary of Health and Human Services to: (1) develop and make available to the public each year a compendium of State initiatives to address the obstetric access crisis; and (2) provide funding for a study, and report to the Congress on, obstetrical malpractice claims payment by Medicaid and private insurance companies.