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Bill· SS. 1266 (102nd)referred
United States · United States Congress · 11 June 1991
Veterans' Research Corporation and Medical Care Extension Act of 1991 - Amends various Federal veterans' benefits provisions to: (1) extend through FY 1994 the authority of the Department of Veterans Affairs to establish independent nonprofit research corporations at Department medical centers; (2) terminate a provision prohibiting the Secretary of Veterans Affairs from furnishing care and treatment and rehabilitative services for alcohol and drug dependence or abuse disabilities beyond FY 1991; (3) terminate a provision requiring an ongoing clinical evaluation of the long-term results of drug and alcohol abuse treatment furnished to veterans in contract residential treatment facilities; (4) extend through FY 1996 the Department's authority to make grants to States for constructing and acquiring State home facilities for furnishing domiciliary and nursing home care and for expanding, altering, or remodeling existing facilities; (5) extend through FY 1995 the authority for the operation of the Veterans Memorial Medical Center in the Philippines; (6) decrease from $1,000,000 to $500,000 the annual authorized grant for replacing and upgrading equipment and facilities at such Medical Center, requiring the first $50,000 of such funds to be used for educating and training medical personnel; and (7) extend through FY 1994 the authority of the Department to operate adult day health care programs.
Bill· SJRESS.J.Res. 158 (102nd)referred
United States · United States Congress · 11 June 1991
Designates the month of November 1991 as National Alzheimer's Disease Month.
Bill· HRH.R. 2612 (102nd)open
United States · United States Congress · 11 June 1991
Family Planning Amendments Act of 1991 - Amends the Public Health Service Act to authorize appropriations relating to family planning: (1) project grants and contracts; (2) training grants and contracts; and (3) informational and educational materials.
Bill· HRH.R. 2618 (102nd)referred
United States · United States Congress · 11 June 1991
Amends title XVIII (Medicare) of the Social Security Act to prohibit the Secretary of Health and Human Services from using claim sampling to deny claims or recover overpayments under the Medicare program without probable cause that fraud exists.
Bill· HRH.R. 2611 (102nd)referred
United States · United States Congress · 11 June 1991
Title X Pregnancy Counseling 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.
Bill· HJRESH.J.Res. 269 (102nd)referred
United States · United States Congress · 11 June 1991
Designates the week beginning May 3, 1992, as National Nurses Week.
Bill· HRH.R. 2586 (102nd)open
United States · United States Congress · 7 June 1991
Allows the General Accounting Office (GAO) to procure the services of additional experts and consultants. Permits the Comptroller General to enter into agreements with other Federal agencies to allow GAO to participate in health care programs for Government employees serving abroad and their dependents. Excludes temporarily certain GAO positions from the Senior level position pay limitation which would otherwise apply.
Bill· HRH.R. 2597 (102nd)open
United States · United States Congress · 7 June 1991
Food, Drug, Cosmetic, and Device Enforcement Amendments of 1991 - Amends the Federal Food, Drug, and Cosmetic Act (FDCA) to authorize any U.S. district court to order the recall of a food, drug, device, or cosmetic which is in violation of the FDCA if the violation involves fraud or presents a significant risk to human or animal health. Authorizes the Secretary of Health and Human Services to order a recall of a food, drug, or cosmetic for the same reasons. Declares a recall order by the Secretary to be a final agency action. Requires manufacturers and distributors of foods, drugs, devices, or cosmetics to report to the Secretary any recall initiated by the manufacturer or distributor or ordered by a district court. Allows the Secretary to issue regulations requiring manufacturers and distributors of food, drugs, and cosmetics to adopt a method of tracking to facilitate recalls. Adds failure to take certain actions required by this Act to the list of prohibited acts. Authorizes seizure and detention of any food, drug, device, or cosmetic that is in violation of the FDCA. (Current law authorizes seizure of any food, drug, or cosmetic for specified reasons and detention of any device for specified reasons.) Modifies certain procedures regarding detention. Grants the Commissioner of the Food and Drug Administration subpoena power with regard to proceedings and investigations under the FDCA. Adds failure or refusal to obey a subpoena to the list of prohibited acts. Provides for civil monetary penalties for various acts, including violating any provision of the FDCA, making false statements, bribes, and obstruction of investigations. Repeals provisions relating to civil monetary penalties for violations relating to devices. Modifies the authority of the Secretary to inspect establishments and vehicles with regard to violations of the FDCA concerning food, drugs, devices, or cosmetics including adding authority to retain samples and to copy records. Declares that an inspection shall extend to all things, including equipment, finished and unfinished materials, containers, labeling, records, files, papers, processes, controls, and facilities, bearing on whether articles are in violation of the FDCA. (Current law declares that an inspection relating to drugs or devices extends to all things bearing on violation of the FDCA.) Removes provisions relating to inspections to enforce provisions concerning infant formulas. Requires each manufacturer, importer, and distributor of products regulated under the FDCA and each owner, operator, or agent in charge of an establishment subject to inspection under certain provisions of the FDCA to maintain records and make reports as the Secretary determines to be necessary. Extends to all officers and employees of the Department of Health and Human Services conducting examinations, investigations, or inspections under the FDCA the enforcement powers currently granted to those involved with counterfeit drug matters. Requires refusal of admission for import of any article which is in violation of the FDCA. (Current law requires refusal of admission if adulterated, misbranded, or in violation of provisions relating to new drugs.) Replaces provisions requiring the destruction or exporting of articles refused admission with provisions requiring refused articles to be marked, before export, as refused entry into the United States. Directs the Secretary of the Treasury to notify the Secretary of Health and Human Services of food, drugs, devices, and cosmetics being imported into the United States. Requires that the bond which is required, pending decision on the admission of an article, in order to release the article to the owner or consignee, be at least three times the invoice value of the article. Requires destruction within 30 days, without option to relabel or export, of any article that presents a significant risk to human or animal health. Directs the Secretary of the Treasury, on request of the Secretary of Health and Human Services, to refuse to authorize delivery of an article to the owner or consignee. Prohibits the owner or consignee of an article, a sample of which was delivered or examined, from making a claim for payment for the sample. Includes in the definition of "interstate commerce," as used in the FDCA, commerce involving an article or activity which affects interstate commerce. Makes a similar inclusion in definitional provisions relating to electronic product radiation control. Presumes the existence of the connection with interstate commerce required for jurisdiction in any action to enforce the FDCA respecting a food, drug, device, or cosmetic. (Current law presumes such existence in an action respecting a device.) Transfers provisions of the Public Health Service Act relating to regulation of biological products to the FDCA and removes from the transferred material provisions relating to recalls and penalties for offenses. Adds violation of the transferred provisions to the FDCA list of prohibited acts.
Bill· HRH.R. 2585 (102nd)open
United States · United States Congress · 7 June 1991
Family Planning Amendments Act of 1991 - Amends the Public Health Service Act to require grant recipients 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. Authorizes appropriations for such grants and contracts. 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. 2595 (102nd)referred
United States · United States Congress · 7 June 1991
Limits the total number of civilian employees of the Federal Government on September 30, 1991, unless there is a national emergency or the United States is at war. Prohibits compliance with such mandate through any involuntary separations. Exempts from such mandate employees within the executive branch who are law enforcement officers, who are involved in the delivery of health care services, or who work in specified intelligence agencies.
Bill· SS. 1241 (102nd)passed
United States · United States Congress · 6 June 1991
Violent Crime Control Act of 1991 - Title I: Safer Streets and Neighborhoods - Safer Streets and Neighborhood Act of 1991 - Amends the Omnibus Crime Control and Safe Streets Act of 1968 (Omnibus Act) to: (1) authorize appropriations ($1,000,000,000 for FY 1992 and such sums as necessary in FY 1993 and 1994) for grants to State and local law enforcement agencies; and (2) continue the Federal-State funding formula for such agencies for FY 1992. Title II: Death Penalty - Federal Death Penalty Act of 1991 - Amends the Federal criminal code to establish criteria for the imposition of the death penalty for Federal crimes. 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, of its intention to seek the death penalty and of 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 information to be excluded where its probative value is substantially outweighed by the danger of unfair prejudice, confusion of 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. Includes as threshold aggravating factors for homicide that the defendant: (1) intentionally killed the victim; (2) intentionally inflicted serious bodily injury which resulted in the death of the victim; (3) intentionally participated in an act, contemplating that the life of a person would be taken, and the victim died as a direct result of the act; (4) attempted to kill the President of the United States; or (5) intentionally engaged in an act constituting reckless disregard for human life, knowing that the act created a grave risk of death to someone other than the participants, and the victim died as a direct result of the act. Sets forth special aggravating factors with respect to the crimes of treason, espionage, homicide, and attempted murder of the President. States that no person who was less than 18 years of age at the time of the offense may be sentenced to death. Prohibits the execution of mentally retarded persons or pregnant women. Directs the court, or the jury by unanimous vote, to impose the death penalty upon a finding that such sentence is justified based on consideration of both the aggravating and mitigating factors. Requires the court to instruct the jury: (1) not to consider the race, color, national origin, creed, or sex of the defendant or any victim in its consideration of the sentence; and (2) that it is not required to return a death sentence. Establishes procedures for appeal from a death sentence. Requires the Court of Appeals to review the record, address all substantive and procedural issues raised on appeal, and consider whether such sentence was imposed under the influence of passion, prejudice, or any other arbitrary factor and whether the evidence supports the special finding of the existence of the required aggravating factor. Specifies that whenever such court finds that the sentence was imposed under such influence, the admissible evidence adduced does not support such special finding, or other legal error requires reversal of the sentence, the court shall remand the case for reconsideration or impose a sentence other than death (and, in any other case, remand for reconsideration.) Requires the court to provide a written explanation of its determination. Prohibits requiring any employee of any State department of corrections, the Federal Bureau of Prisons, or any provider of services under contract to participate in any execution if participation is contrary to his or her moral or religious convictions. Bars the imposition of a death sentence for a death-eligible offense committed in Indian country unless the Indian tribe having criminal jurisdiction over land and persons subject to such jurisdiction has elected to have this title apply in such cases. Limits the circumstances under which the offense of delivering defense information to aid foreign governments is punishable by death. Provides for the imposition of the death penalty for: (1) murders committed by prisoners in Federal correctional institutions; (2) kidnappings which result in the death of any person; (3) attempting to kill the President of the United States (if such attempt results in bodily injury or comes dangerously close to causing the President's death); (4) murder for hire; (5) murder in the aid of a racketeering activity; (6) engaging in a criminal enterprise activity which results in death; and (7) other specified offenses, including civil rights murders and certain murders involving damage to religious property or obstruction of persons in the free exercise of religious beliefs. Racial Justice Act of 1991 - Amends the Federal judicial code to prohibit the imposition or execution of sentences of death under color of State or Federal law in a racially discriminatory pattern. Specifies that to establish such a pattern: (1) ordinary methods of statistical proof shall suffice; and (2) it shall not be necessary to show discriminatory intent on the part of any individual or institution. Specifies that: (1) to establish a prima facie showing of a racially discriminatory pattern it shall suffice that death sentences are being imposed or executed upon persons of one race with a frequency disproportionate to their representation among the number of persons arrested for, charged with, or convicted of death-eligible crimes, or as punishment for crimes against persons of one race with a frequency that is disproportionate to their representation among persons against whom death-eligible crimes have been committed; and (2) to rebut such a showing, a State or Federal entity must establish by clear and convincing evidence that identifiable and pertinent nonracial factors persuasively explain the observable racial disparities comprising the pattern. Requires any State or Federal entity that provides for the death penalty to designate a central agency to collect and maintain pertinent data on the charging, disposition, and sentencing patterns for all cases of death-eligible crimes. Directs each such entity to: (1) monitor compliance by local officials and agencies; (2) devise and distribute to every local official or agency responsible for the investigation or prosecution of death-eligible crimes a standard form to collect pertinent data; (3) maintain, compile, and index such forms and data and make them available to the public; (4) maintain a centralized, alphabetically indexed file of all police and investigative reports transmitted to it by local officials or agencies in every case of death-eligible crime; and (5) allow access to its file of police and investigative reports to the counsel of record for persons charged with death-eligible crimes. Requires each local official responsible for the investigation or prosecution of death-eligible crimes to: (1) complete such form on every case of death-eligible crime; (2) transmit such form to the central agency within three months after disposition of each such case; and (3) transmit to such agency a copy of all police and investigative reports made in connection with each case of death-eligible crime. Requires such data to include, at a minimum: (1) pertinent demographic information on all persons charged with the crime and all victims (including race, sex, age, and national origin); (2) information on the principal features of the crime; (3) information on the aggravating and mitigating factors of the crime, including the background and character of every person charged with the crime; and (4) a narrative summary of the crime. Requires the court to appoint counsel for those financially unable to retain counsel and to furnish investigative, expert, or other services as necessary for the development of the claim of any such person, subject to certain limitations. Specifies that no determination on the merits of a factual issue made by a State court pertinent to any claim under this Act shall be presumed to be correct unless: (1) the State is in compliance with the provisions of this Act; (2) the determination was made in a proceeding in a State court in which the person asserting the claim was afforded rights to counsel and to the furnishing of investigative, expert, and other such services which were substantially equivalent to those provided in this Act; and (3) the determination is one which is otherwise entitled to be presumed correct under the criteria specified under Federal habeas corpus provisions. Title III: Death Penalty for Murder of Law Enforcement Officer Act - Authorizes the death penalty for the murder of: (1) Federal law enforcement officials; and (2) State law enforcement officers working with Federal agents. Title IV: Death Penalty for Drug Criminals Act - Death Penalty for Drug Criminals Act of 1991 - Amends the Controlled Substances Act (CSA) to authorize the death penalty for first degree murders committed in the course of: (1) drug distribution conspiracies; (2) drug import and export conspiracies; (3) drug distribution to minors, near schools, or while employing minors; and (4) export, import, or distribution of major quantities of drugs. Title V: Prevention and Punishment of Terrorist Acts - Subtitle A: Aviation Terrorism - Amends the Federal criminal code to set forth penalties for 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; destroying or seriously damaging the facilities of, or a civil aircraft not in service at, such airport; or 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. Makes the willful violation of certain Federal Aviation Administration regulations relating to airport and airline security punishable by a fine, imprisonment for up to one year, or both. Subtitle B: Maritime Terrorism - Act for the Prevention and Punishment of Violence Against Maritime Navigation and Fixed Platforms - Amends the Federal criminal code to establish 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. Declares that all the territorial sea of the United States, as defined by Presidential Proclamation 5928 of December 27, 1988: (1) is part of the United States, subject to its sovereignty; and (2) for purposes of Federal criminal jurisdiction, is within the special maritime and territorial jurisdiction of the United States. Sets forth additional provisions with respect to U.S. jurisdiction over the territorial sea and over crimes against U.S. nationals on foreign vessels. Subtitle C: Terrorism Offenses and Sanctions - Establishes criminal penalties for: (1) committing, or attempting to commit, torture outside the United States (with jurisdiction over the prohibited activity if the alleged offender is a U.S. national or is present in the United States, irrespective of the nationality of the victim or the alleged offender); (2) using weapons of mass destruction against a U.S. national outside of the United States, any person within the United States, or any property that is owned, leased, or used by the United States or any U.S. department or agency; and (3) committing certain homicides and attempted homicides involving firearms in Federal facilities. Increases penalties for international terrorist acts. Provides for the imposition of the death penalty for terrorist murders. Subtitle D: Preventing Domestic and International Terrorist Acts - Part I: Attacking the Infrastructure of Terrorist Organizations - Makes it a Federal criminal offense for an individual, within the United States and acting as an agent of a foreign power, to provide material support or resources (including currency, securities, communications equipment, facilities, weapons, personnel, and other physical assets), or to conceal or disguise the nature, location, source, or ownership of such support or resources, knowing that such resources or support are intended to be used to commit a terrorist act. Provides for the civil and criminal seizure and forfeiture of any real or personal property used or intended for use for, or constituting or derived from the gross profits or other proceeds obtained from, specified violations related to terrorist acts, or to facilitate the concealment or an escape from the commission of such violations. Part II: Cooperation of Witnesses in Terrorist Investigations - Alien Witness Cooperation Act of 1991 - Authorizes the Attorney General to waive immigration admission, and other legal, requirements and grant permanent resident status for alien witnesses who cooperate with the Government in Federal or State prosecutions. Bars the granting of such status to an alien who would be excluded because of felony convictions unless the Attorney General determines that the granting of such status to such alien is necessary in the interests of justice and comports with the safety of the community. Limits the number of aliens and members of their immediate families entering the United States under such authority to 200 persons in any single fiscal year. Makes the decision to grant or deny permanent resident status under this Act at the discretion of the Attorney General and not subject to judicial review. Subtitle E: Preventing Economic Terrorism - Makes it a Federal criminal offense to counterfeit, or to make, deal, or possess any plate or other item used in the counterfeiting of, U.S. securities abroad. Establishes an Economic Terrorism Task Force to: (1) assess the threat of terrorist actions directed against the U.S. economy and the adequacy of existing policies and procedures designed to prevent such actions; and (2) recommend administrative and legislative responses to prevent such actions. Sets forth provisions: (1) regarding the makeup of such Task Force; (2) making provisions of the Federal Advisory Committee Act inapplicable to such Task Force; and (3) establishing reporting requirements. Specifies that if the report of the Task Force is classified, an unclassified version shall be prepared for public distribution. Subtitle F: Authorizations to Expand Counter-Terrorist Operations by Federal Agencies - Authorizes appropriations for counter-terrorist operations and programs. Title VI: Drive-By-Shooting Act - Drive-By-Shooting Prevention Act of 1991 - Sets penalties for any individual who, in furtherance or to escape detection of a major drug offense, with intent to intimidate, harass, injure, or maim, fires a weapon into a group of two or more people causing: (1) grave risk to human life (a fine and up to 25 years' imprisonment); or (2) death (a fine, life imprisonment, or, in a case of first degree murder, a sentence of death). Title VII: Assault Weapons - Antidrug, Assault Weapons Limitation Act of 1991 - Amends the Federal criminal code to prohibit the transfer, importation, receipt, or possession of any assault weapon, except: (1) by the Federal, State, or local government; and (2) with respect to weapons lawfully possessed before enactment of this Act. Specifies firearms to be included as assault weapons. Authorizes the Secretary of the Treasury to recommend to the Congress the addition or deletion of firearms to be designated as assault weapons. Increases the length of imprisonment for an individual who uses or carries an assault weapon during and in relation to the commission of a crime of violence or a drug trafficking crime. Prohibits the sale, shipment, or delivery (or purchase, possession, or acceptance of delivery) of an assault weapon to (or by) any person who does not fill out a specified form. Establishes recordkeeping requirements. Directs the Secretary to prescribe regulations for the request and delivery of such form. Directs the Attorney General to: (1) investigate and study the effect of this title on violent and drug trafficking crime; and (2) submit to the Senate a report on its findings. Establishes penalties for knowingly failing to acquire the proper form with respect to the lawful transfer, transport, shipping, receipt, or possession of an assault weapon. Specifies the effective period of this title. Title VIII: Police Corps and Law Enforcement Training and Education Act - Police Corps and Law Enforcement Training and Education Act - Establishes within the Department of Justice (DOJ) an Office of the Police Corps and Law Enforcement Education to be headed by a Director. Requires a State that desires to participate in the Police Corps program or the Law Enforcement Scholarship program to designate a lead agency and submit a State plan containing assurances with respect to: (1) lead agency cooperation with other State and local agencies; (2) the State advertising of the assistance available; (3) State screening and selection of law enforcement personnel for participation in the program; and (4) compliance with other specified requirements. Subtitle A: Police Corps Program - Authorizes the Director to award scholarships (including direct payments to institutions and reimbursement of educational costs) to participants who agree to work for four years in a State or local police force after completion of a baccalaureate program and police corps training, subject to specified conditions. Sets forth provisions with respect to: (1) scholarship assistance for dependent children of law enforcement officers; (2) the selection of participants; (3) minority recruitment; and (4) leaves of absence. Requires the Director to establish up to three training centers to provide basic law enforcement training to State Police Corps program participants. Requires participants to attend two eight-week training sessions at such training centers and to meet certain performance standards in order to remain in the Police Corps program. Requires the Director to pay participants a weekly stipend during training. Requires a State, in order to participate in the Police Corps program, to submit a plan for implementing such program to the Director for approval. Requires such plan to: (1) include assurances that participants will receive additional State or local training after completing Federal training which shall count toward the four-year service obligation; and (2) provide that program participants shall be assigned to community and preventive patrol in geographic areas with the greatest need for additional law enforcement personnel. Provides for the swearing in of participants as members of the police force to which they are assigned after completing Federal training and meeting the requirements of that police force. Authorizes appropriations. Subtitle B: Law Enforcement Scholarship Program - Directs each State to pay from funds under this Act the Federal share (not more than 60 percent) of the cost of awarding scholarships to in-service law enforcement personnel for further education. Sets forth State plan requirements, including identifying model curricula and existing programs and providing assurances that the State will promote cooperative agreements to enhance law enforcement personnel recruitment efforts in high schools and community colleges. Sets forth application requirements. Grants priority in awarding scholarships to members of underrepresented groups and to those pursuing an undergraduate degree. Requires each individual awarded a scholarship to work in a law enforcement position in the State which made the award for a period of one month for each credit hour of financial assistance (with a six-month minimum and two-year maximum). Authorizes appropriations. Subtitle C: Reports - Sets forth provisions requiring: (1) annual reports by the Director to the Attorney General, the President, and specified Members of Congress; and (2) a special report by the Attorney General to the Congress on a plan to expand scholarship assistance to eligible Federal law enforcement officers. Title IX: Police Officers' Bill of Rights Act of 1991 - Police Officers' Bill of Rights Act of 1991 - Amends the Omnibus Act to provide that, except when on duty or acting in an official capacity, no law enforcement officer (officer) shall be prohibited from engaging in political activity or be denied the right to refrain from engaging in such activity. Sets forth minimum standards that shall apply when an officer is under investigation or is subjected to questioning under circumstances that could lead to disciplinary action, including that: (1) questioning be conducted at a reasonable hour, and take place at the offices of those conducting the investigation, with exceptions; (2) the officer under investigation be informed in writing of the nature of the investigation prior to questioning; (3) any questioning be for a reasonable period of time, allowing for reasonable periods for rest and personal necessities; (4) such questioning be recorded in full in writing or by electronic device, and a copy of the transcript made available to the officer under investigation; and (5) the officer be entitled to the presence of counsel or other individual at the questioning. Requires the law enforcement agency to notify the officer that such officer is entitled to a hearing by a hearing officer or board, with exceptions for summary punishment or emergency suspension for misconduct. Specifies that an emergency suspension shall not affect the officer's health benefits. Sets forth provisions: (1) with respect to the composition of a disciplinary hearing board and procedures for a disciplinary hearing; and (2) limiting the penalty to that which was recommended by the trial board. Provides for notice of disciplinary action. Bars any penalty or threat of penalty against the officer for the exercise of rights under this Act. Prohibits: (1) a law enforcement agency from inserting any adverse material into the file of an officer unless such officer has had an opportunity to review and comment in writing on the adverse material; (2) requiring or requesting an officer to disclose personal property, income, assets, sources of income, debts, or expenditures (including those of any household member) unless the information is necessary in investigating a violation of law, rules, or regulation with respect to the performance of official duties, or where such disclosure is required by Federal, State, or local law; and (3) a State from having more than two legislative sessions to enact a Law Enforcement Officers' Bill of Rights that provides rights substantially similar to those afforded under this Act. Authorizes a cause of action in State court by the officer for recovery of damages and full reinstatement against a law enforcement agency that materially violates rights afforded under this Act, subject to specified limitations. Specifies that the sovereign immunity of a State shall not apply in the case of such a violation. Specifies that this Act does not preempt State law or collective bargaining agreements or discussions that provide rights for officers that are substantially similar to those afforded by this Act. Title X: Federal Law Enforcement Agencies - Federal Law Enforcement Act of 1991 - Authorizes appropriations for the Drug Enforcement Administration (DEA), the Federal Bureau of Investigation (FBI), the Immigration and Naturalization Service (INS), U.S. attorneys, U.S. marshals, the Bureau of Alcohol, Tobacco, and Firearms, U.S. courts, and defender services. Title XI: Habeas Corpus Reform Act - Habeas Corpus Reform Act of 1991 - Amends the Federal judicial code to set forth special habeas corpus procedures in capital cases. Applies such procedures to Federal habeas corpus cases brought by prisoners in State custody who are subject to a capital sentence. Makes the applicability to such procedures contingent upon a State establishing a mechanism for the appointment, compensation, and payment of reasonable fees and litigation expenses of competent counsel consistent with this Act. Sets forth procedures for the appointment of counsel or for allowing a prisoner to proceed pro se. Provides for a mandatory stay of execution during the post-conviction review initiated pursuant to this Act. Details conditions which will cause such stay to expire. Prohibits a Federal court, if one of such conditions has occurred, from entering a stay of execution or granting relief in a capital case unless: (1) the basis for the stay and request for relief is a claim not previously presented by the prisoner in the State or Federal courts, and the failure to raise the claim is the result of State action in violation of the Constitution or laws of United States, is the result of Supreme Court recognition of a new Federal right that is retroactively applicable, or is based on a factual predicate that could not have been discovered through the exercise of reasonable diligence; (2) the facts underlying the claim would be sufficient, if proven, to undermine the court's confidence in the jury's determination of guilt on the offense for which the death penalty was imposed; or (3) a stay and consideration of the requested relief are necessary to prevent a miscarriage of justice. Imposes time limits on filing for habeas corpus relief. Requires such time limits to be tolled under specified conditions. Requires the district court, upon the development of a complete evidentiary record, to rule on the merits of the claims properly before it. Authorizes a district court to refuse to consider a claim under this Act if: (1) the prisoner previously failed to raise the claim in State court at the time and in the manner prescribed by State law; (2) the State courts, for that reason, refused or would refuse to entertain the claim; and (3) such refusal would constitute an adequate and independent State law ground that would foreclose direct review of the State court judgment in the U.S. Supreme Court. Provides an exception to such authorization. Makes the requirement for a certificate of probable cause inapplicable, with an exception. States that a mechanism for the provision of counsel services to indigents sufficient to invoke the provisions of this Act shall provide for counsel to indigents: (1) charged with offenses for which capital punishment is sought; (2) who have been sentenced to death and who seek appellate or collateral review in State court; and (3) who have been sentenced to death and who seek certiorari review in the U.S. Supreme Court. Prescribes minimum qualifications for appointed counsel. Authorizes payment of fees and expenses for investigative, expert, or other services reasonably necessary for the representation of the defendant. Allows the court to fix the compensation to be paid to an attorney appointed under this Act. Specifies which law is applicable in Federal habeas corpus proceedings. Title XII: Punishment of Gun Criminals - Gun Criminals Punishment Act of 1991 - Subtitle A: Increased Penalties for Gun Offenses - Requires that any individual who, during and in relation to any crime of violence or drug trafficking crime, discharges a firearm that kills another person: (1) if the killing is a first degree murder, be sentenced to death, life imprisonment, or any term of years, fined, or both; and (2) if the killing is other than a first degree murder, be fined, imprisoned for life or any term of years, or both. Increases penalties to be imposed in addition to penalties provided for a crime of violence or drug trafficking crime for discharging, using, carrying, or otherwise possessing a firearm during and in relation to such crime to five to ten years for firearm, ten to 15 years for an assault weapon, short-barreled rifle, or short-barreled shotgun, and 30 years for a machine gun, destructive device, or firearm equipped with a silencer or muffler. Requires an individual to be sentenced to life imprisonment for a second conviction of such an offense if the firearm is an assault weapon. Directs the U.S. Sentencing Commission to promulgate, or amend existing, guidelines to provide for a sentencing enhancement in accord with such provisions. Subtitle B: Firearms and Related Amendments - Establishes penalties for possessing (current law covers only using and carrying) an explosive during the commission of a felony. Provides for 20 years imprisonment for using, carrying, or possessing an explosive, in the case of a second or subsequent conviction. Amends the Federal criminal code to prohibit the transfer of firearms to non-residents of the State in which the transferor resides. Specifies that if a conviction was for a violent felony involving the threatened or actual use of a firearm or explosives, or was for a serious drug offense, such person shall be considered convicted for purposes of this Act irrespective of any pardon, setting aside, expunction, or restoration of civil rights. Permits the judicial officer to consider pretrial detention with respect to certain firearms and explosives offenses. Sets forth penalties for smuggling firearms in aid of drug trafficking and for theft of firearms and explosives. Provides for the mandatory revocation of the supervised release of an individual for possession of a firearm. Increases penalties for making knowingly false, material statements in connection with the acquisition of a firearm from a licensed dealer. 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. Makes it unlawful for felons and others to possess explosives. Authorizes the summary destruction of explosives subject to forfeiture under specified circumstances. Sets forth requirements for reimbursement of the value of destroyed property. Makes it unlawful to knowingly possess stolen firearms, ammunition, or explosives. Adds using a firearm in the commission of counterfeiting or forgery (current law specifies only "whoever, during and in relation to any crime of violence or drug trafficking crime") 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 those 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. Defines "burglary" to mean any crime punishable by a term of imprisonment exceeding one year and consisting of entering or remaining surreptitiously within a building that is the property of another with intent to engage in conduct constituting a Federal or State offense. Prohibits the court from placing on probation or suspending the sentence of any person sentenced pursuant to (currently, convicted of) a provision enhancing penalties for the use of a firearm during and in relation to any crime of violence or drug trafficking crime. Bars the sale of firearms and explosives to, or possession of firearms and explosives by, persons convicted of a violent or serious drug misdemeanor. Subtitle C: Prohibited Gun Clips and Magazines - Includes ammunition feeding devices (AFDs) within the definition of firearms for purposes of Federal firearms laws. Defines an AFD to include any detachable magazine, feed strip, or similar device which has a capacity of, or which can be readily converted to accept, more than 15 rounds of ammunition, with exceptions. Prohibits the importation, manufacture, transfer, receipt, or possession of AFDs, with exceptions. Requires the Secretary of the Treasury to maintain a central registry of all such devices transferred after the effective date of this Act which, after such transfer, are not under the control of the United States or any State or political subdivision. Specifies that such registry shall include: (1) identification of the device; (2) date of registration; (3) identification and address of the person entitled to possess the device; and (4) such other information as may be required by regulations promulgated by the Secretary. Establishes additional registration procedures. Requires all AFDs to be identified by a serial number and such other identification as the Secretary may prescribe. Provides for criminal penalties for violation of provisions of this Act relative to AFDs. Authorizes specified individuals engaged in the manufacture or importation of AFDs requiring a license to continue to engage in such business pending final action on the application. Title XIII: Prison for Violent Drug Offenders - Authorizes appropriations for the construction, and operation for one year, of ten regional prisons. Sets forth provisions with respect to the location and population of such prisons, prisoner eligibility (State and Federal prisoners with release dates of not more than two years from the date of assignment to the prison who have long-term drug abuse problems and serious criminal histories, and who agree to the assignment), State responsibilities, and the powers of the Director of the Bureau of Prisons (e.g., to return any prisoner not complying with program requirements and conditions.) Requires any State seeking to refer a State prisoner to a regional prison to submit to such Director an aftercare plan setting forth the provisions that the State will make for the continued treatment of the prisoner in a therapeutic community following release and providing for vocational job training where appropriate. Title XIV: Boot Camps - Directs the Attorney General, within one year, to establish within the Bureau of Prisons ten military-style boot camp prisons. Sets forth provisions with respect to prison capacity, proportion of State to Federal prisoners, and eligibility requirements. Authorizes appropriations. Title XV: Youth Violence Act - Subtitle A: Increasing Penalties for Employing Children to Distribute Drugs Near Schools and Playgrounds - Amends the CSA to increase the penalty for employing, using, inducing, or coercing individuals under age 18 to violate provisions of such Act, or to assist in avoiding detection or apprehension for certain offenses under such Act by Federal, State, or local law enforcement officials. Subtitle B: Antigang Grants - Amends the Juvenile Justice and Delinquency Prevention Act of 1974 to authorize the Administrator of the Office of Juvenile Justice and Delinquency Prevention to make grants to States and units of general local government to assist them in planning, coordinating, and evaluating projects to reduce the formation or continuation of juvenile gangs and the use and sale of illegal drugs by juveniles. Specifies the allocation (50-50) of funds available to each State for juvenile drug supply and drug demand reduction programs. Directs the Administrator to give priority to programs aimed at juvenile involvement in organized gang- and drug-related activities. Authorizes appropriations. Sets forth provisions with respect to application, and review and approval, procedures. Subtitle C: Juvenile Penalties - Amends the Federal criminal code to: (1) add certain firearms offenses to the offenses over which the United States has juvenile delinquency jurisdiction; and (2) provide for the treatment of violent juveniles who commit firearms offenses as adults under certain circumstances. Specifies factors to be considered in transferring a juvenile to adult status. Classifies as serious drug offenses for purposes of the Armed Career Criminal Act of 1984 serious drug offenses committed by juveniles. Title XVI: Rural Crime and Drug Control Act - Subtitle A: Fighting Drug Trafficking in Rural Areas - Amends the Omnibus Act to authorize appropriations, and increase the base allocation, for rural drug enforcement assistance. Directs the Attorney General to establish a Rural Drug Enforcement Task Force in each of the Federal judicial districts which encompass significant rural lands. Specifies the membership of such task forces. Directs the Attorney General to cross-designate up to 100 Federal officers with jurisdiction to enforce CSA provisions on non-Federal lands to the extent necessary to effect the purposes of this title. Requires the Director of the Federal Law Enforcement Training Center to develop a specialized course of instruction devoted to training law enforcement officers from rural agencies in the investigation of drug trafficking and related crimes. Authorizes appropriations. Subtitle B: Increasing Penalties for Certain Drug Trafficking Offenses - Ice Enforcement Act of 1991 - Amends the CSA to increase penalties for specified offense involving crystalline methamphetamine. Subtitle C: Rural Drug Prevention and Treatment - Amends the Public Health Service Act to require the Director of the Office for Treatment Improvement to establish a program to provide grants to hospitals, community health centers, and other appropriate entities that serve nonmetropolitan areas to assist in developing and implementing projects that provide, or expand the availability of, substance abuse treatment services. Authorizes appropriations. Requires the alcohol and drug abuse information clearinghouse required to be established under the Public Health Service Act to: (1) gather information pertaining to Alcohol, Drug Abuse, and Mental Health Administration and other rural drug abuse treatment and education projects operating throughout the United States; and (2) disseminate information to rural hospitals, community health centers, community mental health centers, treatment facilities, community organizations, and other interested individuals. Subtitle D: Rural Land Recovery Act - Specifies that each of the Rural Drug Enforcement Task Forces shall include one Director of Rural Land Recovery. Directs State and Federal prosecutors, when bringing charges against the operators of such laboratories, to include, in addition to drug-related charges, counts involving infringements of applicable environmental protection laws, including illegal disposal of hazardous waste and knowing endangerment of the environment. Authorizes such prosecutors and private citizens to bring suit against the operators of such laboratories for environmental and health-related damages caused by the operators in their manufacture of illicit substances. Title XVII: 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 ensure an effective response. 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 are beyond the capability of the State or local government to respond. Requires Governors or chief executive officers, 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 the State or local 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. Title XVIII: Drunk Driving Child Protection Act - Drunk Driving Child Protection Act of 1991 - Amends the Assimilative Crimes Statute to require the imposition of a Federal penalty (if not already imposed by a State) of one year imprisonment and a $1,000 fine, or both, in addition to any term of imprisonment under State law for driving under the influence of drugs or alcohol if a minor (other than the offender) was present in the vehicle at the time of the offense. Amends the common carrier provisions of the Federal criminal code to increase the penalty for operating a common carrier under the influence of drugs or alcohol if a minor (other than the offender) is present in the vehicle by up to one year's imprisonment (or if serious bodily injury of a minor is caused, five years; or if death of a minor is caused, ten years) and an additional $1,000 fine, or both. Defines "minor" as a person less than 18 years of age. Expresses the sense of the Congress that, in determining child custody and visitation rights, the courts should take into consideration the history of drunk driving of any person involved in the determination. Title XIX: Commission on Crime and Violence - Establishes the National Commission on Crime and Violence in America to: (1) develop a comprehensive crime control plan to serve as a blueprint for action in the 1990s; (2) bring attention to successful models and programs; (3) reach beyond the traditional criminal justice community for ideas; and (4) recommend improvements in local, State, and Federal coordination. Sets forth the composition of the Commission, its responsibilities, administrative provisions, reporting requirements, and termination date. Title XX: Protection of Crime Victims - Victims' Rights and Restitution Act of 1991 - Amends the Victims of Crime Act of 1984, as amended, to eliminate the cap on the crime victims fund. Requires (current law authorizes) the court to order restitution payments for specified violations of the Federal criminal code and the Federal Aviation Act of 1958. Authorizes the court, in addition to ordering restitution of the victim of the offense of which a defendant is convicted, to order restitution of persons harmed physically, emotionally, or pecuniarily by defendant's unlawful conduct during which the offense occurred or during the course of a scheme, conspiracy, or pattern of unlawful activity related to the offense. Sets forth additional provisions with respect to determination of amounts owed to the victim, set-offs, enforcement of restitution orders, and procedures for issuing such orders. Title XXI: Crack House Eviction Act - Amends the CSA to authorize: (1) the Attorney General to bring a civil action against violators of prohibitions against maintaining places for the manufacture, distribution, or use of controlled substances; and (2) the court to assess a civil penalty of up to $100,000 and grant such other relief, including injunctions and evictions, as appropriate. Directs the Attorney General to: (1) aggressively pursue the use of criminal penalties, civil injunctions, forfeiture sanctions, and other remedies against drug offenders; and (2) report annually to the Congress on the manner and extent to which such remedies are being used and their effect in curtailing drug trafficking. Title XXII: Organized Crime and Dangerous Drugs Division - Subtitle A: Establishment of an Organized Crime and Dangerous Drugs Division in the Department of Justice - Justice Department Organized Crime and Drug Enforcement Enhancement Act of 1991 - Establishes within DOJ the Organized Crime and Dangerous Drugs Division, consisting initially of specified offices within the Criminal Division of DOJ and the Organized Crime Drug Enforcement Task Force Program. Transfers to such Division all functions, personnel, and available funds of such offices and program. Requires such Division to be headed by an Assistant Attorney General for the Organized Crime and Dangerous Drug Division and a Deputy Assistant. Establishes within such Division such sections and offices as the Attorney General deems appropriate to maintain or increase the level of enforcement activities with respect to criminal racketeering, narcotics trafficking, money laundering, asset forfeiture, international crime, and civil enforcement. Directs the Attorney General to establish at least 20 field offices of the Division to be known as Organized Crime and Dangerous Drug Strike Forces. Sets forth additional provisions with respect to coordination of field activities and the transfer of staff assigned to the Task Forces to the Division (designated the Criminal Narcotics Section). Specifies that the agents assigned to the Strike Forces shall be dedicated exclusively to, and located with, the Strike Forces and shall be given credit for the work of the Strike Forces. Requires the Assistant Attorney General for Organized Crime and Dangerous Drugs to report to the Congress on the areas of the United States that may require increased assistance from DOJ through the establishment of additional strike forces. Authorizes appropriations for salaries and expenses of the Division for FY 1992, subject to certain limitations. Subtitle B: International Prosecution Teams - Requires the Division to include at least ten International Drug Enforcement Teams: (1) devoted exclusively to investigating, prosecuting, and supporting the investigation and prosecution of international drug cases; and (2) responsible for developing expertise in handling civil and criminal cases involving extradition, money laundering, drug-related corruption, and other complex cases relating to international drug trafficking. Specifies relationships of team members and goals, including improved coordination and cooperation between the United States and foreign countries in the suppression of international money laundering and narcotics trafficking. Title XXIII: Exclusionary Rule - Amends the Federal criminal code to bar the exclusion of evidence obtained as a result of a search or seizure that was in violation of the fourth amendment to the Constitution if the search or seizure was carried out in reasonable reliance on a warrant that was issued by a detached and neutral magistrate and that was ultimately found to be invalid, unless: (1) the judicial officer in issuing the warrant was materially misled by information in an affidavit that the affiant knew was false or would have known was false except for his reckless disregard of the truth; (2) the judicial officer provided approval of the warrant without exercising a neutral and detached review of the application for the warrant; (3) the warrant was based on an affidavit so lacking in indicia of probable cause as to render official belief in its existence entirely unreasonable; or (4) the warrant is so facially deficient that the executing officers could not reasonably presume it to be valid. Title XXIV: Drug Testing - Federal Prisoner Drug Testing Act of 1991 - Amends the Federal criminal code to require, as a condition of probation, supervised release, or parole, that the defendant pass a drug test prior to the imposition of sentence, refrain from any unlawful use of a controlled substance, and submit to at least two periodic drug tests (as determined by the court, with respect to probation or supervised release, and by the U.S. Parole Commission, with respect to parole) for use of a controlled substance. Specifies that no action may be taken against a defendant pursuant to such a drug test unless the test confirmation is a urine drug test confirmed using gas chromatography/mass spectrometry techniques or one determined to be of equivalent accuracy. Title XXV: Maximum Penalty Increases for Violent Crimes - Increases the maximum penalty for: (1) assaults against specified classes of individuals; (2) manslaughter; (3) certain civil rights violations (including damage to religious property); (4) interstate and foreign travel or transportation in aid of racketeering enterprises; and (5) conspiracy to commit murder for hire. Specifies that, in determining the equitable share of proceeds for a State or local law enforcement agency from a drug-related asset seizure under CSA provisions, the Attorney General shall not retain more than ten percent of the total proceeds to cover the costs of administrative expenses. Title XXVI: Obstruction of Justice - Increases penalties for obstruction of justice offenses against court officers and jurors and for retaliatory killings of witnesses, victims, and informants. Title XXVII: Brady Handgun Violence Prevention Act - Brady Handgun Violence Prevention Act - Makes it unlawful for any licensed importer, manufacturer, or dealer to sell, deliver, or transfer a handgun to an unlicensed individual unless: (1) after the most recent proposal of such transfer by the individual, the transferor has received a statement of eligibility from the individual, has notified the chief law enforcement officer for such individual's place of residence about the proposed transfer, and either has received a response indicating that such transfer is not prohibited by law or has not received a response indicating otherwise within seven days; (2) the individual has presented to the transferor a statement from the officer, issued in the past ten days, that the individual requires a handgun because of a threat to him or his family; (3) the individual has presented to the transferor a permit to possess a handgun that has been issued in the past five years by the State in which the transfer is to take place under a State law which requires law enforcement verification of the individual's legal qualification to possess a handgun; (4) State law either requires a waiting period of at least seven days or requires that an authorized government official verifies that the information available to such official does not indicate that possession of a handgun by the purchaser would be unlawful; or (5) the transferor has received a report from any system of felon identification established by the Attorney General under the Anti-Drug Abuse Act of 1988 that the individual's possession or receipt of the handgun would not violate Federal, State, or local law. Requires the statement of eligibility to include a statement that the individual: (1) is not under indictment for and has not been convicted of a crime punishable by imprisonment for a term exceeding one year; (2) is not a fugitive; (3) is not an unlawful user of, or addicted to, a controlled substance; (4) has not been adjudicated as a mental defective or committed to a mental institution; (5) is not an alien who is illegally in the United States; (6) has not been dishonorably discharged from the armed forces; and (7) is not a person who has renounced U.S. citizenship. Requires any transferor who, after a transfer, receives a report from such officer that receipt or possession of the handgun by the individual violates the law, to: (1) furnish information about the transfer and the individual to the chief law enforcement officer of the transferor's place of business and the individual's place of residence; and (2) keep confidential any information received which is not otherwise available to the public, with exceptions. Requires a transferor to retain a copy of the individual's statement and retain evidence of compliance with the requirement under this Act with respect to the furnishing of a copy of the statement to the chief law enforcement officer of the place of residence of the individual within one day after furnishing such statement. Requires the law enforcement officer to destroy any copy of the individual's sworn statement and any record containing information derived from such statement within 30 days, unless such officer determines that the transaction would violate Federal, State, or local law. Specifies that a chief law enforcement officer shall not be liable to any person for action taken by the officer to ascertain whether a transferee of a handgun has a criminal record or whether there is any other legal impediment to the transferee receiving a handgun under any Federal, State, or local law, except a law that specifically provides for such liability. Directs the Attorney General, subject to appropriations, to make a grant to an eligible State for the direction of a computerized criminal history record system or improvement of an existing system and to defray the cost to State and local law enforcement agencies in conducting background checks on prospective handgun purchasers. Specifies the allocation of grant funds. Authorizes appropriations.
Bill· SS. 1232 (102nd)open
United States · United States Congress · 6 June 1991
Medical Injury Compensation Fairness Act of 1991 - Deems any person accepting or providing health care which is to be paid for, in whole or in part, directly or indirectly, with funds under the Social Security Act, the Public Health Service Act, or any other Federal Act to have agreed to participate in the dispute resolution program established under this Act. Makes such agreement binding and enforceable in court. Requires any claim against health care providers for personal injury arising from care rendered under such Acts that is not settled voluntarily by the parties to be resolved only through a resolution service certified under this Act. Requires liability to be determined under the standard of care prescribed by State law except that, in certain circumstances: (1) particular services must be rendered in accordance with medical practice guidelines certified under this Act; (2) expert witnesses must possess specified qualifications; or (3) an alternative method of compensation which has been certified under this Act is applicable. Limits noneconomic damages. Reduces awards for collateral source payments. Provides for periodic payment of certain amounts for future damages. Prohibits paying punitive damages to the claimant, requiring in certain circumstances that they be paid to the State. Requires, subject to exception, that charges by the resolution service be paid by the party against whom the claim is substantially resolved. Amends provisions of the Internal Revenue Code relating to trade or business expenses to prohibit deductions for employer health plan expenses unless the covered employees agree to mandatory and final dispute resolution through a service certified under this Act. Directs the Secretary of Health and Human Services to develop: (1) a standard notice to persons regarding their option to enter into agreements with health care providers to resolve claims in a manner consistent with this Act; and (2) a standard contract for such purposes. Requires health care providers, as a condition of eligibility for reimbursement under titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act, to make a good faith effort to enter into agreements with persons not subject to certain provisions of this Act to provide for the resolution of medical injury claims in a manner consistent with provisions of this Act. Deems contracts entered into in accordance with this provision to be binding and valid contracts in all courts. Directs the Secretary to promulgate: (1) regulations that establish the criteria and procedures to determine whether to certify an alternative dispute resolution service, allowing waiver of the criteria and procedures in certifying services sponsored by the States; and (2) regulations that establish the criteria for certifying medical practice guidelines and that establish the criteria for certifying alternative methods of compensating personal injuries and other losses without regard to provider fault. Declares that the procedures required by this Act are exclusive and prohibits any action seeking recovery for any personal injury covered by this Act in any State or Federal court, except as expressly provided in this Act. Provides that specified provisions of this Act apply to health care plans approved as part of collective bargaining agreements.
Bill· SS. 1238 (102nd)referred
United States · United States Congress · 6 June 1991
Directs the Secretary of Health and Human Services to report to specified congressional committees on the statutory formula by which funds made available under certain provisions are allocated among the States and territories, including regarding: (1) the needs of the States and territories; (2) a review of epidemiological research on substance abuse and mental illness among various groups and geographic regions; (3) predictors of substance abuse and mental illness not used in the formula; and (4) factors used in the formula. Requires the Comptroller General to review the study after transmittal to the Congress and make recommendations.
Bill· SS. 1229 (102nd)referred
United States · United States Congress · 6 June 1991
Small Employer Health Insurance Incentive Act of 1991 - Exempts small employer purchasing groups organized for the purpose of obtaining health insurance for employer members from State insurance mandates, State taxes on premiums, and State laws relating to managed care. Amends the Internal Revenue Code to allow self-employed individuals participating in small employer purchasing groups an itemized deduction of 100 percent for health insurance costs (25 percent for nonparticipants). Makes such deduction permanent law.
Bill· SS. 1240 (102nd)referred
United States · United States Congress · 6 June 1991
Amends title XIX (Medicaid) of the Social Security Act to revise the process under which the Secretary of Health and Human Services (HHS) may disallow a State's claim for Medicaid matching funds to: (1) give States the opportunity to come into compliance with Medicaid procedural requirements on a prospective basis before the Secretary may disallow the claim involved; (2) allow the HHS Appeals Board, if it upholds a disallowance, to reduce its amount; (3) prohibit disallowances if the State is in compliance with its HHS approved plan; (4) require interest to be paid to States by the Federal Government for disallowances for which they elected to repay, but were later overturned on appeal; and (5) prohibit disallowances three years after the filing of the State's claim.
Bill· SS. 1231 (102nd)referred
United States · United States Congress · 6 June 1991
Medicare Preventive Benefits Act of 1991 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to provide for coverage of fecal-occult blood tests (FOBTs) and screening flexible sigmoidoscopies for the early detection of colorectal cancer. Covers FOBTs on an annual basis for individuals aged 50 or over. Covers screening sigmoidoscopies provided every five years for individuals aged 50 or over. Provides payment for FOBTs under the laboratory fee schedule, subject to a five dollar limit in 1992. Provides payment for screening sigmoidoscopies under the relative value scale in 1992. Permits the Secretary to modify the frequency criteria after 1994. Provides for Medicare coverage of annual influenza vaccinations and for tetanus-diptheria vaccinations administered every ten years. Provides for Medicare coverage up to age seven according to a frequency schedule to be established by the Secretary of Health and Human Services (HHS) in consultation with appropriate entities. Provides for Medicare coverage of annual screening mammography for the early detection of breast cancer for women over age 64. (Currently, such women are covered for such screening performed every other year.) Requires HHS demonstration projects for the coverage of additional specified preventive care services and reports to specified congressional committees on such projects. Authorizes appropriations. Authorizes an Office of Technology Assessment study and report to the Congress on the development of a process evaluating possible Medicare coverage of other preventive care services.
Law· SJRESS.J.Res. 156 (102nd)enacted
United States · United States Congress · 6 June 1991
Designates October 6 through October 12, 1991, as Mental Illness Awareness Week.
Bill· HRH.R. 2565 (102nd)open
United States · United States Congress · 6 June 1991
Medicare Preventive Benefits Act of 1991 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to provide for coverage of fecal-occult blood tests (FOBTs) and screening flexible sigmoidoscopies for the early detection of colorectal cancer. Covers FOBTs on an annual basis for individuals aged 50 or over. Covers screening sigmoidoscopies provided every five years for individuals aged 50 or over. Provides payment for FOBTs under the laboratory fee schedule, subject to a five dollar limit in 1992. Provides payment for screening sigmoidoscopies under the relative value scale in 1992. Permits the Secretary to modify the frequency criteria after 1994. Provides for Medicare coverage of annual influenza vaccinations and for tetanus-diptheria vaccinations administered every ten years. Provides for Medicare coverage up to age seven according to a frequency schedule to be established by the Secretary of Health and Human Services (HHS) in consultation with appropriate entities. Provides for Medicare coverage of annual screening mammography for the early detection of breast cancer for women over age 64. (Currently, such women are covered for such screening performed every other year.) Requires HHS demonstration projects for the coverage of additional specified preventive care services and reports to specified congressional committees on such projects. Authorizes appropriations. Authorizes an Office of Technology Assessment study and report to the Congress on the development of a process evaluating possible Medicare coverage of other preventive care services.
Bill· HRH.R. 2579 (102nd)referred
United States · United States Congress · 6 June 1991
Smith-Wyden Rural Health Care Improvement Act of 1991 - Title I: Tax Provisions - Amends the Internal Revenue Code to allow a tax credit for family practice physicians, nurse practitioners, and certified physicians' assistants who serve in rural and medically underserved areas. Allows such individuals a tax deduction for education loan interest. Title II: Other Provisions - Amends the Public Health Service Act to authorize appropriations for FY 1992 for area health education centers. Deems physicians or other licensed health care practitioners employed in federally-funded migrant health centers, community health centers, and centers to provide health services to the homeless as Public Health Service employees for purposes of liability claims of medical malpractice. Requires such health entities to have implemented appropriate policies and procedures to assure against malpractice.
Bill· HRH.R. 2567 (102nd)referred
United States · United States Congress · 6 June 1991
Federal Council on Women Act - Establishes the Federal Council on Women to: (1) collect and evaluate information on a wide range of issues relating to U.S. women (including poverty, health care, violence, employment, education, and aging); (2) review current and proposed Federal policy relating to those issues and the impact of those issues on women; (3) coordinate Council activities with other public and private organizations; and (4) make recommendations to the Congress. Authorizes appropriations.
Bill· SS. 1227 (102nd)open
United States · United States Congress · 5 June 1991
HealthAmerica: Affordable Health Care for All Americans Act - HealthAmerica Act - Title I: Amendments to Public Health Service Act - Amends the Public Health Service Act to create a new title on basic health benefits for employees and their families. Requires each employer, with regard to each of its full-time employees and their families, and allows an employer, with regard to all of its part-time employees and their families, to: (1) enroll them in a health benefit plan under provisions of this Act; or (2) make a contribution for coverage of the employees and their families under the public health insurance plan added by this Act to the Social Security Act. Requires employers making a contribution to follow prescribed procedures to facilitate enrollment of its employees, including distributing and submitting enrollment forms and withholding and submitting payroll deductions. Requires, beginning seven years after enactment of this Act, that an individual seeking benefits under a Federal program certify possession of health insurance meeting minimum standards under this Act. Conditions claiming of a personal exemption deduction under the Internal Revenue Code on the individual filer certifying coverage meeting such standards. Title II: Requirements for Health Benefit Plans - Allows, except for provisions of title III of this Act relating to small and medium-sized business insurance, an employer to meet the requirements of this title through any health benefit plan. Exempts, in certain circumstances, employers in the State of Hawaii from the requirements of this title so long as the Hawaii Prepaid Health Care Act remains in effect. Requires that enrollment of an employee include enrollment of the employee's family and prohibits waiver of enrollment of the employee or the employee's family, subject to exception to avoid duplicate enrollment. Permits variations in premiums, deductibles, copayments, and coinsurance which are actuarially equivalent to the requirements in certain provisions of this title. Establishes an Advisory Board to develop actuarial equivalency standards and to deal with other matters concerning the administration of this title. Sets forth general requirements for plan coverage, including, subject to certain limitations, inpatient and outpatient hospital care, inpatient and outpatient physician services, diagnostic tests, prenatal and well-baby care, preventive services (limited to well child care, pap smears, and mammograms), and inpatient and outpatient mental disorder care. Prohibits limitations on the amount, scope, and duration of certain benefits. Allows such limitations on specified other benefits. Allows a plan to: (1) provide benefits through managed care systems; (2) select particular providers or types, classes, or categories of providers; and (3) establish different levels of payment for different providers. Allows an employer to establish a fee schedule or other basis for payment different from charges, provided the payment is sufficient to achieve adequate access to plan services without additional out-of-pocket expenses, but for permitted copayments and deductibles. Requires inpatient mental health care to include payment for professional services by a physician or a licensed or certified clinical psychologist. Requires plan coverage to include outpatient services by a licensed or certified clinical psychologist or a provider with training and education equivalent to a licensed clinical social worker. Mandates reports to the Congress regarding: (1) possible changes to the preventive services covered; and (2) the cost-effectiveness and desirability of coverage of colorectal cancer, prostate cancer, and osteoporosis screening and of coverage of outpatient prescription drugs. Specifies when plan coverage must begin in various circumstances. Prohibits preexisting condition limitations or exclusions. Allows a part-time employee who is charged an increased premium under specified provisions of this Act to waive enrollment. Requires the employer, in such case, to pay, under title V of this Act, the minimum amount the employer would have paid toward coverage if the employee had not waived enrollment. Requires continuation of employee or family coverage during a period of hospitalization. Permits a plan to require an enrollee to pay premiums, deductibles, copayments, and coinsurance amounts, subject in each case to certain limits. Limits out-of-pocket expenses. Mandates administration of certain requirements and standards of this title by the State agency designated by the State's chief executive officer. Requires certain notice to the employee, including plan contents, the availability of premium and cost-sharing subsidies, and employer failure to make premium payments. Provides for establishment of model plan language. Requires each plan to designate an individual to answer questions on the plan. Requires the State administering authority to assist employees regarding their rights under the plans. Provides for review of denied claims. Allows an employer to offer a nonmanaged care plan as well as a managed care plan. Allows an employee, if no unmanaged plan is offered, to use nonparticipating providers. Allows a plan to provide for cost-sharing of up to 200 percent of the normal or minimum plan if nonparticipating providers are used. Provides for a civil monetary penalty on an employer, up to a specified percentage of all wages paid by the employer for the year, for failure to comply with specified provisions of this Act. Requires penalties collected to be credited to the public health insurance plan established by this Act. Makes an employer that knowingly does not comply with specified provisions of this Act liable for damages, including health care costs, to the employee or the family of the employee. Allows the employee or family to bring a civil action to recover damages. Title III: Special Assistance for Small and Medium Sized Businesses - 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 title II of this Act. Includes benefit plans under that title in the ERISA definitions of "employee welfare benefit plan" and "welfare plan." Subtitle A: Reform of Small Group Insurance - Amends the Public Health Service Act to create a new part, and amends (using similar language) the Social Security Act to create a new title, on group health insurance standards. Prohibits 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 of this subtitle; (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. (Provides, in the amendments to the Social Security Act, but not in the amendments to the Public Health Service Act, for imposition on a carrier that is not in compliance with provisions of this subtitle of an excise tax, as provided in subtitle B of this title.) Directs the Secretary to request the National Association of Insurance Commissioners (NAIC) to develop a model Act and model regulations to implement requirements of this subtitle. 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 provisions of this subtitle. Sets forth transitional provisions applicable only to plans offered to small employers during the first four years after the effective date of these provisions, including: (1) allowing, in certain circumstances, preexisting condition exclusion; and (2) requiring making available equivalent coverage during any waiting period before the individual may be covered by the plan. Requires carriers offering a plan to small employers to: (1) register with State regulatory authorities; and (2) 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 status 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 title XVIII (Medicare) of the Social Security Act. 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 title II of this Act; and (2) not impose cost-sharing in excess of that permitted by title II (with regard to the amendments to the Public Health Service Act) or in excess of that permitted by the Social Security Act, as amended by title VI of this Act (with regard to the amendments to the Social Security Act.) 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 NAIC to develop a model to standardize benefits offered to small employers to promote consumer understanding and comparison among plans. Requires each carrier offering a plan to small employers under subtitle E (relating to payment for services at Medicare rates) of this title to offer the employer the option of having payment at rates no higher than the rates established by title II of this Act (with regard to the amendments to the Public Health Service Act) or by title XVIII (Medicare) of the Social Security Act (with regard to the amendments to the Social Security Act). Applies, with regard to an employer who elects such option, the limits on charges that may be made under Medicare to individuals receiving benefits under the plan. (Applies, with regard to the amendments to the Social Security Act, the sanctions imposed under Medicare and title XI (general provisions and peer review) of the Social Security Act to violations of these limits.) Requires the NAIC to develop models of legislation for the enactment of health insurance policy reinsurance systems for use by States, including plans offered to small employers. Specifies three models which must be included. Requires any system enacted to provide for an adjustment in reinsurance premiums charged to HMOs that takes into account specified factors. Subtitle B: Tax Equity for Small and Medium-Sized Business - Amends the Internal Revenue Code to allow self-employed individuals to take a deduction for 100 percent of the cost of health insurance coverage for the individual and the individual's family under subtitle A of this title or under AmeriCare. (Current law allows a deduction of 25 percent of the cost of health insurance coverage.) Provides for a deduction for certain group health plan contributions for the benefit of self-employed individuals. Imposes an excise tax on an entity's violation of the Social Security Act, as amended by subtitle A of this title. Subtitle C: Opportunity for Voluntary Provision of Coverage - Prohibits requiring a medium-sized employer (defined as having between 25 and 100 employees) to provide a health benefit plan under title II of this Act or make a contribution under title V of this Act until the fifth calendar year after enactment of this Act. Ties application to medium-sized employers of the requirement to provide coverage or make a contribution to the number of uninsured employees of all such employers, during or after those four years, as compared to the number of such employees when this Act is enacted. Delays application to small employers of the requirement to provide coverage or make a contribution until the sixth calendar year after enactment of this Act. Ties application of the requirement to the change in the number of uninsured employees of small employers in the first five years. Subtitle D: Small Business Tax Credit - Amends the Internal Revenue Code to allow an eligible small business (defined as having no more than 60 employees) a tax credit for a percentage of health plan expenses. Reduces the percentage as the number of employees increases and as the expanded profit ratio increases. Subtitle E: Additional Assistance to Small and Medium-Sized Businesses - Makes businesses with fewer than 100 employees that did not provide coverage in the year before enactment of this Act eligible to buy private coverage from a small or medium-sized business insurer under which health service providers are paid at rules based on Medicare rates. Allows a small employer that employs fewer than 25 employees and that has been an employer for not more than three years to: (1) not provide coverage or make a contribution for the first two years of being an employer; and (2) make a contribution at one-half the normal rate. Establishes a small and medium-sized business advisory committee. Authorizes appropriations. Title IV: Reducing Health Care Cost Inflation - Subtitle A: Outcomes Research and Practice Guideline Development and Dissemination - Amends the Public Health Service Act to require the Administrator for Health Care Policy and Research to: (1) develop an initial set of guidelines for at least three clinical treatments or conditions that account for a significant portion of national health expenditures, have a significant variation in treatment, or otherwise meet specified needs and priorities; and (2) develop outcomes research and practice parameters for mental health services, including regarding childhood attention deficit disorders and manic depression. Amends the Social Security Act to increase the authorization of appropriations to carry out provisions relating to research on outcomes of health care services and procedures. Modifies the percentages which are, during FY 1993 and 1994, to be appropriated from the Federal Supplementary Medical Insurance Trust Fund. Subtitle B: 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 recommended payment levels and other recommended measures; (4) developing State and regional goals; (5) establishing uniform billing and claim forms and mandatory reporting requirements; and (6) recommending rates, budgets, and other measures. Mandates that the Board require negotiations regarding physician and hospital care. 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 matters to achieve the goals. Allows, with regard to the amendments to the Public Health Service Act, purchasers and providers to combine for the purpose of agreeing to pay or charge at the recommended rates. Allows, with regard to the amendments to the Social Security Act, purchasers to combine for such purpose. Makes a provider assessing or a purchaser paying rates other than those required: (1) ineligible for any assistance under the Public Health Service Act (with regard to the amendments to the Public Health Service Act) or for any assistance under the Social Security Act (with regard to the amendments to the Social Security Act); and (2) liable to the United States for a civil monetary penalty. Provides for temporary injunctive relief. Requires the Board to promulgate regulations recommending nonbinding 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. Prohibits, through the fifth fiscal year after enactment of these provisions, Federal payments from rising as a result of such rates. 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, including modifications of the prospective payment system and the physician payment system. Prohibits, through the fifth fiscal year after enactment of these provisions, the recommendations from increasing Federal payments. Subtitle C: 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 set 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 B of this title; and (4) attempting to reduce administrative costs and burdens on enrollees and providers through specified measures. Lists optional consortium functions, including: (1) permitting 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. 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 provisions of that Act, as amended by title VI of this Act. Amends the Public Health Service Act to authorize appropriations to carry out provisions relating to the consortia. Subtitle D: Cost Control Grant Program - Amends the Public Health Service Act to authorize grants and contracts for the development, demonstration, and evaluation of innovative methods for reducing health care costs. Provides for the establishment of a clearinghouse and other activities to disseminate information on successful health care cost control methods. Authorizes appropriations. Subtitle E: Malpractice Reform - Authorizes grants to States for programs for medical malpractice reforms. Requires programs receiving grants to include alternative dispute resolution methods. Allows the programs to include medical practice guidelines. Requires a grant to be either: (1) a planning grant, for up to two years; or (2) an operational grant, for up to five years. Authorizes appropriations. Provides for the collection and analysis of data and issues related to: (1) ineffective or unnecessary testing; (2) the occurrence of malpractice and malpractice awards; (3) licensing and disciplining; and (4) malpractice insurance. Authorizes appropriations. Subtitle F: Reducing the Administrative Cost of Assuring Appropriate Utilization of Health Care Services and Improving the Quality of Health Care Services - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to contract with the quality improvement board in each State to review the quality of health care provided by professionals and institutions in the State and to establish mechanisms to encourage continuous quality improvement. Amends the Public Health Service Act and, using similar language, the Social Security Act to set forth board duties, including: (1) adopting practice guidelines and quality improvement guidelines; (2) recommending continuous quality improvement measures; (3) reviewing provider performance, with the board allowed to certify a provider as an outstanding provider; and (4) data collection. Prohibits a plan from: (1) denying payment for any service performed or ordered by a provider certified as outstanding; and (2) denying coverage on the basis that the service is not medically necessary. Authorizes planning grants to facilitate the establishment of a board in each State. Authorizes appropriations. Subtitle G: Use of Practice Guidelines in Federal Health Insurance and Service Programs - Requires that clinical guidelines developed under existing provisions of the Public Health Service Act relating to the Forum for Quality and Effectiveness in Health Care be used in Federal health insurance programs as utilization review screens and as practice guidelines in Federal programs providing health care services. Subtitle H: National Standards for the Promotion of Managed Care - Amends the Public Health Service Act to prohibit any State law or regulation from: (1) prohibiting a managed care plan from selecting providers, or the type of providers, as the participating providers; or (2) limiting the ability of a managed care entity to negotiate, make contracts or establish alternative rates or forms of payment for participating providers, or require or provide incentives to promote the use of participating providers. Allows, notwithstanding any State law, an entity to offer utilization review services, provided certain procedures are established. Makes the applicable State regulatory authority (or, in certain circumstances, the Secretary of Health and Human Services) responsible for certifying, for the Public Health Service Act and the Social Security Act, whether a plan is a managed care plan. Prohibits making amounts available to a State under the Public Health Service Act unless the State is in compliance with this requirement. Deems a State, unless the State's chief executive officer otherwise indicates, to have elected to comply. Limits State regulation of certain actions by managed care plans. Provides for the establishment of Federal standards for utilization review programs of health benefit plans. Preempts inconsistent State laws or regulations. Subtitle I: Expansion of Technology Assessment - Requires the Administrator for Health Care Policy and Research to focus on expanding and applying assessments of existing health care technologies, to be achieved in part through an evaluation of services provided to individuals through publicly and privately funded sources. Mandates a program of contracts and cooperative agreements for the establishment of public-private partnerships to undertake technology assessment and related activities in the private sector. Title V: Contribution by Employers Not Providing Private Health Coverage - Amends the Internal Revenue Code to provide for the percentage of wages which must be paid by employers who elect, under provisions of this Act, to pay a contribution rather than provide a health benefit plan covering their employees. Provides for setting, by the Secretary of Health and Human Services, of that percentage at a level that reflects the cost of coverage of no more than 65 percent of those employees under provisions of the Social Security Act (as amended by this Act) and at least 35 percent covered under provisions of the Public Health Service (as amended by this Act). Title VI: Assuring Provision of Health Benefits to All Americans - Amends the Social Security Act to create a new title on "AmeriCare," under which a State is required to provide basic health benefits described in this title to: (1) any child or pregnant woman without other nongovernmental health coverage by the second year after enactment of this title; (2) any employee or family member for whom an employer makes a contribution under title V of this Act by the second year after enactment of this title; and (3) any individual not covered by a plan under title II of this Act by the seventh year after enactment of this title. Sets forth other requirements on States for participation in AmeriCare. Entitles each individual not otherwise covered under a health benefit plan under title II of this Act to basic health benefits under AmeriCare. Allows each State to require that employers collect AmeriCare premiums on behalf of the employer's employees. Requires basic benefits to include inpatient and outpatient hospital care, inpatient and outpatient physician services, diagnostic tests, prenatal and well-baby care, preventive services (limited to well child care, pap smears, and mammograms), inpatient and outpatient mental disorder care, and certain items and services described under existing provisions of title XIX (Medicaid) of the Social Security Act relating to early and periodic screening, diagnosis, and treatment for children under the age of 21. Requires, subject to exception, the basic health benefits with respect to special eligibility individuals to include medical assistance in the State's plan under Medicaid. Allows a State to provide, but prohibits Federal payment for, coverage beyond basic benefits. Prohibits imposing premiums, deductibles, or other cost-sharing on an individual in an under-poverty family. Sets varying limits on premiums, deductibles, and other cost sharing for individuals in families whose income is specified percentages over the poverty line. Provides for the premium levels of employees whose employer elects, in lieu of providing a health benefit plan, to make a contribution under title V of this Act. Allows States to compute premiums separately for four specified combinations of individual, spouse, and child coverage. Limits deductibles, copayments, coinsurance, and out-of-pocket expenses. Declares ineligible for AmeriCare benefits an individual who is enrolled in a health plan under title II of this Act, except that AmeriCare is required to pay, with respect to an individual covered by a plan or whose employer makes a contribution under title V of this Act, for: (1) premiums, deductibles, and other cost-sharing for an individual in an under-poverty family; and (2) a specified percentage of premiums, deductibles, and other cost-sharing for an individual in a near-poverty family. Requires that an individual receive advanced payment of supplemental premium payments for the calendar year from AmeriCare. Disqualifies all family members from the supplemental payments if a required family income statement is not filed by a specified deadline. Requires payment under AmeriCare to be: (1) on the same basis as under title XVIII (Medicare) of the Social Security Act, adjusted by the Secretary of Health and Human Services to take into account differences between the population served under Medicare and the population served by AmeriCare or title II of this Act; (2) according to an alternative payment system provided for by a State, if the State meets in the aggregate for all health care providers in the State the requirements for national reimbursement levels described in these provisions; or (3) under Medicare rates phased-in over specified periods. Prohibits administrative or judicial review of the payment rates or rules, including adjustments, under these provisions. Allows a State to contract for the design and implementation of innovative systems of health care delivery and administrative systems that meet the standards of the AmeriCare title. Requires each State, as part of AmeriCare, to offer managed care plans, selected competitively, in which an individual eligible under AmeriCare may enroll. Directs the Secretary of Health and Human Services to establish demonstration projects to enable States that submit an approved application to implement cost management initiatives that promote the effective furnishing of care. Specifies initiatives required to be included. Allows the Secretary to provide that a State plan for AmeriCare may include payment for services described in existing provisions of title XIX (Medicaid) of the Social Security Act relating to home or community-based services. Provides for the administration of AmeriCare in each State, directly or by contract: (1) by that State; (2) at the election of the State and with the approval of the Secretary, by the Secretary; or (3) by a regional administration with other States approved by the Secretary. Provides for review of denied claims and other administrative matters. Mandates a quarterly Federal payment to each State with an approved AmeriCare plan for the Federal share of the expenditures for benefits, supplemental payments, and administrative expenses. Sets the State share of expenses at 80 percent of the State percentage under title XIX (Medicaid) of the Social Security Act during the second year after enactment of this Act and increases that percentage until 100 percent of the State medicaid percentage is reached in the seventh year after enactment. Establishes in the Treasury the AmeriCare Trust Fund consisting of such gifts and bequests as may be made and amounts credited to the Fund. Appropriates to the Fund the amounts received from: (1) contributions by employers under title V of this Act in lieu of health plan coverage; (2) AmeriCare premiums collected by employers on behalf of employees; (3) penalties collected for employment discrimination based on family status and the requirement to enroll a spouse or child; and (4) penalties collected for failure of an employer to either provide coverage or make a title V contribution. Authorizes appropriations to the Fund as required to make certain expenditures from the Fund. Authorizes and appropriates from the Fund each fiscal year a sum sufficient to carry out the purpose of the AmeriCare title, to be used for making payments to States with approved plans for benefits, supplemental payments, and administrative expenses. Requires amounts received in the Fund to be allotted to each State on the basis of amounts received in the Fund with respect to employees residing in the State. Make amounts in the Fund available, as provided in appropriations Acts, for the expenses of administering the AmeriCare title. Provides for review of AmeriCare programs by utilization and quality control peer review organizations in a similar manner as provided under title XVIII (Medicare) of the Social Security Act. Directs the Secretary of Health and Human Services to develop: (1) recommendations for the calculation of a specific Federal insurance assistance percentage applicable to coverage furnished under AmeriCare; and (2) recommendations for the creation of an emergency fund to fund certain benefits under AmeriCare in the event a State experiences changes in economic conditions or other conditions necessitating emergency funding. Mandates a reduction (by one quarter after the second year after enactment of this Act and by one half after the seventh year after enactment of this Act) in the Medicare disproportionate share adjustment percentage, subject to exception for hospitals receiving, under title VI of this Act, less that 200 percent of the reduction. Amends title XIX (Medicaid) of the Social Security Act to prohibit the provision of medical assistance under Medicaid to any individual eligible for AmeriCare. Provides for an annual increase in the Medicaid cap on payments to territories based on the percentage increase in the total Federal program costs of AmeriCare over such costs of Medicaid in the year preceding the effective date of this Act. Title VII: Development of Health Service Capacity - Amends the Public Health Service Act to mandate grants to entities that do or will meet requirements relating to migrant or community health centers to expand the availability of comprehensive primary health services in medically underserved or high impact areas. Sets forth priorities in making the grants, including that the amounts be used to provide services in areas with the greatest need and in which demand can be expected to increase after implementation of this Act. Authorizes appropriations. Title VIII: Effective Date - Sets forth the effective dates of specified provisions of this Act. Declares that, after enactment of this Act, no employer shall be required under title II of this Act to provide any health benefit in addition to the benefits required under specified provisions of title II, as in effect on the date of enactment, unless: (1) the additional benefit is for a service that AmeriCare plans are required to cover; and (2) before enactment of such requirement, the benefits and costs have been analyzed and considered by the Congress.
Bill· HRH.R. 2546 (102nd)open
United States · United States Congress · 5 June 1991
Communications Competitiveness and Infrastructure Modernization Act of 1991 - Title I: Communications Infrastructure Modernization Policy - Amends the Communications Act of 1934 (the Act) to establish a new national goal that by 2015 the United States will have established an advanced, interactive, interoperable broadband communications system nationwide. Requires local telephone companies to submit a plan to achieve such goal for approval by the appropriate agency in each State in which they operate. Requires disapproval only when the plan is not in the public interest. Requires such plan to give priority consideration to accelerated deployment of such a system for educational institutions, health care facilities, and small businesses. Requires such plan to provide for deployment to less densely populated and economically disadvantaged areas at a rate reasonably related to the rate of deployment in more populous and affluent areas. Requires the FCC, after final State action, to review the plan to certify compliance with the goals and objectives of this Act. Requires FCC procedures for local telephone companies to ensure coordinated communications network planning in the development of a nationwide communications infrastructure and to assure broad availability of information services. Title II: Regulatory Changes to Promote Efficient Multiple Uses of Communications Technologies - Amends the Act to establish a policy to permit multiple uses of communications technologies and to eliminate restrictions on communications technologies to single lines of services in order to promote communications technology deployment in a manner which secures communication services for the public at reasonable costs. Title III: Modification of Impediments to Convergence of Telephone and Video Technologies - Amends the Act to modify ownership restrictions to permit local telephone companies to provide video programming subject to specified regulatory safeguards to prevent anti-competitive activities only after the FCC makes the certification described under title I and certifies that the company has filed a plan pledging it to comply with such safeguards. Outlines safeguards against telephone company monopolization of the cable service industry, including those: (1) requiring separate video programming subsidiaries for telephone companies; (2) allowing competitors attachment rights to telephone poles and conduits and rights-of-way within telephone company service areas; (3) prohibiting cross-subsidization between local telephone companies and affiliated video programming subsidiaries and marketing by a local telephone company of its subsidiary's video programming; and (4) subjecting local telephone companies to local cable franchise requirements. Requires local telephone companies which distribute affiliated video programming over a broadband communications system to provide video gateway services to facilitate user access to video programming. Exempts from the safeguards outlined above a carrier which provides video programming in rural areas with a population of 10,000 or below in which it also provides local exchange service. Requires periodic FCC evaluation of the effect of the provision of video programming by telephone companies on the video marketplace and recommendations to the Congress concerning any modifications needed as a result of such evaluation. Requires FCC and State rules and regulations to prevent consumers from paying more for telephone services as a result of their local telephone company's provision of video programming. Revises multiple cable franchise provisions. Requires an FCC report to the Congress regarding competition and consumer choice in the delivery of video programming and telephone services. Requires an FCC review of the rural exemption described above to determine how to expedite access to broadband multichannel video programming for all parts of the United States. Sets forth penalties for violations of the safeguards outlined above to prevent telephone company monopolization of the cable service industry.
Bill· HRH.R. 2551 (102nd)referred
United States · United States Congress · 5 June 1991
National Board and Care Reform Act of 1991 - Amends title XVI (Supplemental Security Income) (SSI) of the Social Security Act to define a "board and care facility" as a facility providing food, shelter, and personal assistance to more than one SSI or Old Age, Survivors and Disability Insurance (title II of the Social Security Act) (OASDI) beneficiary who is unrelated to the owner or operator of such facility. Lists the rights of facility residents, including the right to control his or her receipt of health-related services and the right to examine the most recent survey of the facility and any plan of correction in effect with respect to the facility. Requires that facility residents be given oral and written notice of such rights, including a written statement that a resident may file a complaint with a State survey and certification agency respecting resident abuse and neglect and misappropriation of resident property. Prohibits facilities from admitting or retaining residents who are bedbound, require skilled nursing care, or a level or type of care the facility is not equipped to provide. Requires that each board and care facility: (1) employ at least one full-time administrator who has successfully completed a basic initial and ongoing training program approved by the Secretary of Health and Human Services and has not been convicted of any felony or defrauding the Federal Government; (2) be sufficiently staffed, with at least one staff member present at the facility at all times; (3) adopt certain measures to preserve facility safety and sanitation; (4) develop and implement a written medication policy and procedure that outlines in detail the procedures to be followed regarding the handling of medications at the facility; (5) fully meet each resident's dietary and nutritional needs, including those prescribed by a physician; (6) assure residents prompt and efficient access to health care; and (7) provide and actively promote resident participation in a program of daily activities which do not consist solely of television viewing. Makes the States responsible for certifying that board and care facilities comply with this Act's requirements. Requires each State to: (1) conduct periodic educational programs for facility staff and residents regarding the requirements imposed on such facilities; (2) provide for the receipt, review, and on-site investigation of allegations of resident neglect and abuse and of misappropriation of resident property; (3) conduct an unannounced inspection of each facility at least once every 15 months (though the statewide average interval may not exceed 12 months) for compliance with this Act's requirements; and (4) maintain procedures and adequate staff to monitor, on-site, on a regular, as needed basis, the compliance of a facility with this Act's requirements if the facility was previously found out of compliance or the State has reason to question its compliance. Directs the Secretary to: (1) provide for the comprehensive training of State inspectors; and (2) conduct sample onsite inspections of facilities within two months of State inspections to test the adequacy of State inspections. Requires that: (1) certain information regarding facilities and their compliance with this Act's requirements be made available to the public; (2) the State long-term ombudsman be notified of a facility's noncompliance with any of this Act's requirements; and (3) State Medicaid fraud and abuse control units be given access to facility survey and certification information. Requires that when a State determines that a facility's deficiencies immediately jeopardize residents' health and safety: (1) temporary management be appointed to oversee the closure of the facility or correction of its deficiencies; or (2) it be prohibited from keeping or admitting OASDI or SSI beneficiaries. Directs the Secretary to appoint temporary management for such a facility when the Secretary finds that its deficiencies immediately jeopardize residents' health and safety. Sets forth other remedies to be applied when the health and safety of facility residents is not immediately jeopardized. Authorizes the imposition of civil monetary penalties against facilities found to be in compliance with this Act's requirements but to have been out of compliance previously. Reimburses States for 90 percent of their inspection and enforcement activities. Directs each State to maintain a program to aggressively seek out and identify unlicensed board and care facilities. Permits States to establish a program rewarding facilities providing the highest quality of care to residents who are OASDI or SSI beneficiaries. Directs the Secretary to: (1) maintain a toll-free hotline to collect, maintain, and update information on board and care facilities and to receive complaints and answer questions regarding such facilities; and (2) maintain a Department unit to investigate such complaints. Increases, by ten percent, the SSI benefit available to beneficiaries who reside in certified board and care facilities. Requires States to make supplementary payments to eligible facility residents whose income does not exceed the Federal poverty level. Directs the Secretary to establish a system of monitoring and periodic review of a statistically significant number of all payments made under the OASDI and SSI programs to ensure that payments are being made to the proper parties. Sets forth reporting requirements. Amends title XVIII (Medicare) of the Social Security Act to prohibit hospitals from discharging patients to board and care facilities which fail to satisfy this Act's requirements. Requires such hospitals to report facility noncompliance to the State. Amends title XIX (Medicaid) of the Social Security Act to require State Medicaid fraud control units to monitor for, investigate, and prosecute illegalities and fraud in the provision of medical assistance to residents of board and care facilities. Sets the Federal matching rate for such activities at 90 percent. Directs the Secretary to: (1) provide grants to States and localities to train operators and staff of board and care facilities and advocates of facility residents; (2) develop model training methods and supporting training material within one year after this Act's enactment; (3) provide grants to States, localities, and private nonprofit organizations to establish temporary emergency shelters for the abused elderly and disabled; and (4) arrange for the establishment of a National Commission on Board and Care Facility Quality to examine enforcement of requirements for board and care facilities for adequacy and effectiveness and to make appropriate recommendations to the Congress and the Secretary. Authorizes appropriations for such grant programs.
Bill· SS. 1200 (102nd)open
United States · United States Congress · 4 June 1991
Communications Competitiveness and Infrastructure Modernization Act of 1991 - Title I: Communications Infrastructure Modernization Policy Findings - Sets forth congressional findings. Amends the Communications Act of 1934 (the Act) to establish a new national goal that by 2015 the United States has established an advanced, interactive, interoperable, broadband communications system nationwide. Requires local telephone companies to submit for approval or disapproval a plan prepared in accordance with Federal Communications Commission (FCC) rules and regulations issued under this Act to achieve such goal to the appropriate State agency in each State in which they operate. Requires disapproval only when the plan is not in the public interest. Requires such plan to give priority consideration to accelerated deployment of such a system for educational institutions, health care facilities, and small businesses. Requires such plan to provide for deployment to less densely populated and economically disadvantaged areas at a rate reasonably related to the rate of deployment in more populous and affluent areas. Requires the FCC, after final State action, to review the plan to certify compliance with the goals and objectives of this Act. Requires FCC procedures for local telephone companies to ensure coordinated communications network planning in the development of a nationwide communications infrastructure and to assure broad availability of information services. Title II: Regulatory Changes to Promote Efficient Multiple Uses of Communications Technologies - Sets forth congressional findings. Amends the Act to establish a policy to permit multiple uses of communications technologies and to eliminate restrictions on communications technologies to single lines of services in order to promote communications technology deployment in such a way as to secure communication services for the public at reasonable costs. Title III: Modification of Impediments to Convergence of Telephone and Video Technologies - Sets forth congressional findings. Amends the Act to modify ownership restrictions to permit local telephone companies to provide video programming subject to specified regulatory safeguards to prevent anti-competitive activities only after the FCC makes the certification described under title I and certifies that the company has filed a plan pledging it to comply with such safeguards. Outlines safeguards against telephone company monopolization of the cable service industry, including those: (1) requiring separate video programming subsidiaries for telephone companies; (2) allowing competitors attachment rights to telephone poles and conduits and rights-of-way within telephone company service areas; (3) prohibiting cross-subsidization between local telephone companies and affiliated video programming subsidiaries and marketing by a local telephone company of its subsidiary's video programming; and (4) subjecting local telephone companies to local cable franchise requirements. Requires local telephone companies which distribute affiliated video programming over a broadband communications system to provide video gateway services to facilitate user access to video programming. Exempts from the safeguards outlined above a carrier which provides video programming in rural areas with a population of 10,000 or below in which it also provides local exchange service. Requires periodic FCC evaluation of the effect of the provision of video programming by telephone companies on the video market place and recommendations to the Congress concerning any modifications needed as a result of such evaluation. Requires FCC and State rules and regulations to prevent consumers from paying more for telephone services as a result of their local telephone company's provision of video programming. Revises multiple cable franchise provisions. Requires an FCC report to the Congress regarding competition and consumer choice in the delivery of video programming and telephone services. Requires an FCC review of the rural exemption described above to determine how to expedite access to broadband multichannel video programming for all parts of the United States. Sets forth penalties for violations of the safeguards outlined above.
Bill· SS. 1214 (102nd)referred
United States · United States Congress · 4 June 1991
Directs the Secretary of Health and Human Services to treat physicians' services furnished in Lancaster County, Pennsylvania, as services furnished in a number II locality for purposes of determining the amount of payment for such services under part B (Supplementary Medical Insurance) of the Medicare program (title XVIII of the Social Security Act).
Bill· SS. 1213 (102nd)referred
United States · United States Congress · 4 June 1991
Amends the Public Health Service Act to authorize competitive grants to evaluate which preventive health screenings and health promotion activities achieve the highest cost-benefit and health improvement in order to monitor practices and trends in preventive medical care and technology. Establishes a clearinghouse to collect, store, analyze, and make available data provided through the evaluations. Requires the clearinghouse to: (1) rank health prevention and promotion activities; (2) establish practice guidelines for appropriate care; and (3) prepare model prevention insurance packages. Authorizes appropriations.
Bill· SS. 1212 (102nd)referred
United States · United States Congress · 4 June 1991
Amends title XVIII (Medicare) of the Social Security Act to allow Medicare part B (Supplementary Medical Insurance) beneficiaries to elect to receive specified preventive care items and services provided by a primary care physician during an annual periodic health examination if they pay an additional monthly premium for such coverage. Authorizes Medicare part B coverage of certain immunizations for individuals who are at high risk of contracting infectious diseases presenting a public health problem. Waives copayments for the preventive care items and services and immunizations described above. Provides for a discount in the additional monthly premium described above if the beneficiary is certified by a physician for that year as maintaining a healthy lifestyle.
Bill· SS. 1215 (102nd)referred
United States · United States Congress · 4 June 1991
Adoption Assistance and Maternal Certificates Act - Amends the Public Health Service Act to mandate grants to ten States to establish demonstration programs to provide maternal health certificates to low-income pregnant females residing or awaiting residence in, or receiving outpatient services from, a maternity home. Requires eligible maternity homes to provide a range of services in accordance with standards promulgated under this Act, including regarding room and board, medical care, and counseling and services concerning health, adoption, education, vocation, or employment. Limits the time period covered and the dollar amounts paid per day. Requires matching funds from a State agency, the home, or both. Prohibits requiring a woman, in order to be eligible for this program, to participate in the Aid to Families with Dependent Children program under title IV of the Social Security Act. Authorizes appropriations. Requires that adoption data from private agencies that receive Federal assistance (and voluntarily-released data from private agencies that receive no Federal assistance) be included in an existing system of data collection, under the Social Security Act, relating to adoption and foster care Requires an adoption or foster care agency that receives Federal assistance to disclose, to prospective adoptive and foster parents, information about the history of the child, including: (1) medical history; (2) social background; (3) information about the placement of the child; and (4) any record of abuse or neglect. Makes it unlawful to discriminate against an individual in the making, performance, modification, or termination of an insurance contract (defined as a health or life insurance contract which provides family coverage) on the basis of the fact that a son or daughter of the individual is not a biological child of the individual. Declares it an unlawful employment practice to discriminate against an employee with respect to a term or condition of any leave benefit on the basis of the fact that a son or daughter is not a biological child of the employee. Defines "son or daughter," for both such insurance and such employment discrimination, to mean a biological, adopted, or foster child, a stepchild, a legal ward, a child placed for adoption, or a child of a person standing in loco parentis, who is: (1) under 18 years old; or (2) 18 years old or older and incapable of self care. Allows any person to bring a civil action for equitable relief, damages and interest, and attorney's fees. Amends the Social Security Act to add to the formula, used for determining the amount of payments to States for foster care and adoption assistance, provisions relating to expenditures for recruitment of adoptive parents for a child with special needs. Amends the National Defense Authorization Act for Fiscal Years 1988 and 1989 to remove provisions terminating, on a specified date, a program for reimbursement for adoption expenses incurred by a member of the armed forces.
Bill· SS. 1211 (102nd)referred
United States · United States Congress · 4 June 1991
Medicaid Glideslope Act of 1991 - Amends title XIX (Medicaid) of the Social Security Act to allow States to: (1) expand Medicaid coverage to individuals whose family incomes do not exceed 300 percent of the Federal poverty level; and (2) require Medicaid beneficiaries to contribute toward the cost of their Medicaid premiums and copayments on the basis of their ability to pay.
Bill· HRH.R. 2535 (102nd)referred
United States · United States Congress · 4 June 1991
Pepper Commission Health Care Access and Reform Act of 1991 - Title I: Access To Private or Public Health Insurance For Basic Health Services Through Employment - Amends the Social Security Act to add a new title XXI entitled "Access to Private or Public Health Insurance For Basic Health Services Through Employment." Requires, under the new title, that employers enroll their employees and family members in a qualified employer health plan or in the public health insurance plan discussed in title II of this Act. Sets forth requirements relating to employee premiums and cost-sharing. Title II: Access to Health Insurance for Basic Health Services Through a Public Health Insurance Plan - Amends the Social Security Act to add a new title XXII entitled "Access to Health Insurance for Basic Health Services Through a Public Health Insurance Plan." Provides, under title XXII, for a new public health insurance program to be administered by the Health Care Financing Administration through the use of fiscal agents in the same manner as under Medicare (title XVIII of the Social Security Act) to process claims. Requires program coverage of basic health services, including preventive services, subject, except with respect to preventive services, to specified deductible and coinsurance requirements, with an overall annual limit on cost-sharing of $3,000. Makes U.S. residents and citizens who are not Medicare beneficiaries or enrolled under the qualified employer health plan described under title I or any other qualified health insurance plan eligible to enroll in the public health insurance program. Makes low-income individuals enrolling in the program eligible for assistance to limit or eliminate their financial obligations under the program. Requires the program to provide early and periodic screening, diagnosis, and treatment services (EPSDT) services for children. Allows Medicare beneficiaries to obtain Medicare supplemental (Medigap) coverage under the public health insurance program. Prohibits payment under title XXII for services furnished which are not reasonable and medically necessary. Allows provision of covered services without limitation, except as specified under prescribed guidelines. Provides for the use of Medicare payment rules for purposes of benefit payments under title XXII. Sets forth provisions for: (1) determining the amount of premiums to be charged individuals and employers for enrollment under title XXII; and (2) collecting premiums. Creates in the Treasury the Public Health Insurance Trust Fund to support the public health insurance program through the premiums charged under this Act. Authorizes appropriations each fiscal year to cover the Government's share of program costs. Outlines requirements established under part F (Qualified Health Plans) of title XXII respecting basic benefits, limits on pre-existing condition exclusions and on cost-sharing, and other protections which private health insurance plans must afford consumers in order to be certified by the Secretary of Health and Human Services as qualified for issuance or sale. Outlines administrative provisions. Directs the Secretary to provide information via a toll-free telephone number on low-income assistance and other information concerning the public health insurance program. Authorizes the Secretary to conduct demonstration projects under this title. Title III: Quality Assurance and Cost Containment - Authorizes the Secretary to waive the requirements of titles XVIII and XXII of the Social Security Act insofar as they prevent the use of State uniform payment rates, under prescribed conditions. Requires the Administrator for Health Care Policy and Research to design, implement, and evaluate studies on medical malpractice issues and demonstration projects related to medical malpractice reform for the purpose of making recommendations to the Congress respecting: (1) incentives to improve the quality of care; and (2) cost-effective methods of providing efficient and appropriate compensation to individuals injured in adverse medical occurrences. Authorizes appropriations. Title IV: Group Health Insurance Reform - Subtitle A: General Reforms - Amends the Public Health Service Act to add a new title XXVII entitled "Group Health Insurance Standards." Requires States to enforce the minimum Federal standards required to be established under the new title for employment-related health plans. Requires the Secretary to certify such plans as meeting such requirements if the applicable State has not established a regulatory program to enforce the standards. Prohibits employment-related health plans from denying or limiting coverage of basic health services on the basis of an individual's health status or lack of insurability. Sets forth additional requirements applicable to all employment-related health plans. Requires small employer health plans to offer a basic benefit package, use community rating, guarantee issue and renewal of policies, and meet certain information disclosure and recordkeeping requirements. Subtitle B: Encouraging Establishment of Managed Care - Preempts State law restricting the use of network plans and utilization review programs that meet Federal standards. Subtitle C: Repeal of COBRA Continuation Requirements under the Public Health Service Act - Repeals title XXII of the Public Health Service Act. Title V: Expansion of Primary Care and Public Health Delivery Capacity in Meeting Health Objectives - Amends the Public Health Service Act to extend the authorization of appropriations for programs related to immunization, tuberculosis, lead poisoning, sexually transmitted diseases, migrant health centers, community health centers, health services for the homeless, health services for residents of public housing, family planning, and HIV disease. Amends title XXII (Access to Health Insurance for Basic Health Services Through a Public Health Insurance Plan) of the Social Security Act, as added by title II of this Act, to direct the Secretary of Health and Human Services, from amounts in the Public Health Insurance Trust Fund established by this Act, to make grants to plan and develop primary care centers and public health clinics, defined as migrant or community health centers or other entities qualified to receive a grant under specified provisions of the Public Health Service Act. Directs the Secretary to report to the Congress every five years on the impact of this Act in meeting the goals in the report "Healthy People, 2000." Requires each report to include recommendations regarding changes in qualified health plan benefits and payment policies to promote achievement of national health promotion and disease prevention goals and objectives. Title VI: Financing and Tax-Related Provisions - Amends the Internal Revenue Code to: (1) provide a full deduction for qualified health plan insurance costs of self-employed individuals; (2) make such deduction permanent; (3) repeal provisions imposing an excise tax for the failure of group health plans to satisfy coverage requirements; and (4) impose a surtax on individual and corporate income tax liability. Title VII: Medicare and Medicaid Amendments - Subtitle A: Medicare - Amends the Medicare program to assure coordination of enrollment with qualified health plans and to provide coverage of colon rectal cancer screening services. Subtitle B: Medicaid - Amends the Medicaid program (title XIX of the Social Security Act) to continue Medicaid benefits not covered under such public health insurance program and to discontinue those benefits covered under the program. Title VIII: Conforming Changes to ERISA - Amends the Employee Retirement Income Security Act of 1974 to repeal provisions regarding continuation coverage under group health plans and to make other conforming changes to assure coordination with the amendments made by this Act.
Law· HRH.R. 2521 (102nd)enacted
United States · United States Congress · 4 June 1991
Department of Defense Appropriations Act, 1992 - Title I: Military Personnel - Appropriates funds for FY 1992 for military and reserve personnel in the Army, Navy, Marine Corps, and Air Force and for National Guard personnel in the Army and Air Force. Title II: Operation and Maintenance - Appropriates funds for FY 1992 for the operation and maintenance of the Army, (including a transfer of funds) Navy, Marine Corps, Air Force, the defense agencies (including a transfer of funds), the respective reserve components, and the Army and Air National Guards. Appropriates funds for the Army's National Board for the Promotion of Rifle Practice, the Court of Military Appeals, environmental restoration (including a transfer of funds), humanitarian assistance, and for support and services for the World University Games. Title III: Procurement - Appropriates funds for FY 1992 for the procurement by the Army of aircraft, missiles, weapons, tracked combat vehicles, and ammunition and for other procurement. Appropriates funds to the Navy for the procurement of aircraft, (including a transfer of funds) weapons, and shipbuilding and conversion and for other procurement. Appropriates funds for Marine Corps procurement. Appropriates funds for procurement by the Air Force of aircraft and missiles and for other procurement. Appropriates funds for: (1) National Guard and Reserve equipment; (2) procurement by the defense agencies; (3) Defense Production Act purchases; and (4) procurement of prepositioning equipment. Title IV: Research, Development, Test, and Evaluation - Appropriates funds for FY 1992 for research, development, test, and evaluation by the Army, Navy, Air Force, and defense agencies (including a transfer of funds). Appropriates funds for the expenses of the Deputy Director of Defense Research and Engineering (Test and Evaluation) and the Director, Operational Test and Evaluation. Title V: Defense Business Operations Fund - Establishes in the Treasury the Defense Business Operations Fund and appropriates specified amounts to such fund. Title VI: Other Department of Defense Programs - Appropriates funds for: (1) the destruction of lethal chemical agents and munitions; (2) drug interdiction and counter-drug activities, defense (including a transfer of funds); and (3) expenses and activities of the Office of the Inspector General for carrying out the Inspector General Act of 1978. Title VII: Related Agencies - Appropriates funds for: (1) the Central Intelligence Agency Retirement and Disability System Fund; and (2) the Intelligence Community Staff. Title VIII: General Provisions - Prohibits the use of appropriations for unauthorized publicity or propaganda. Exempts during FY 1992 Department of Defense (DOD) personnel from provisions of law prohibiting the employment of non-U.S. citizens. Provides that no part of any appropriation contained in this Act may remain available for obligation beyond the current fiscal year, unless expressly so provided. Prohibits the obligation of more than 20 percent of the funds appropriated by this Act during the last two months of the fiscal year, except as specified. Prohibits the use of appropriations for the procurement of any food, clothing, specified cloth (including cotton, silk, and wool) or synthetic fabrics, or specified metals not grown, produced, or processed within the United States, with specified exceptions. Authorizes the Secretary of Defense, in the national interest and with the approval of the Office of Management and Budget (OMB), to transfer and merge specified working capital funds. Directs the Secretary to notify the Congress of all such transfers. Limits the cash balances which may be maintained in such funds. Prohibits the use of appropriated funds for: (1) the purchase of coal or coke from foreign nations for use at U.S. defense facilities when U.S. coal is available; (2) heating plant fuel conversion at defense facilities in Europe; (3) the conversion of any heating facility at military installations in the Kaiserslautern Military Community in Germany, except as provided under Federal law and after a certain notification from the Secretary to the Senate and House Committees on Appropriations; (4) the initiation of a special access program without prior notification to the appropriations and armed services committees; (5) the preparation of a request to the appropriations committees for a reprogramming of funds, except as specified; (6) certain claims for physician or provider reimbursement for medical services provided under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) in excess of those allowed for FY 1991; (7) programs of the Central Intelligence Agency (CIA) beyond FY 1992, with a specified exception; (8) initiating a multiyear contract that employs economic order quantity procurement in excess of specified amounts, unless proper congressional notification is given; (9) any intelligence or special activity different from an activity previously justified to the Congress unless the Secretary has notified the appropriations committees of the intent to make such funds available for such activity; or (10) converting certain military technician positions to positions to be held by persons in active Guard or Reserve status if such conversion would reduce the number of military technicians below a specified amount. Prohibits the use of funds appropriated by this Act to include civilian military technicians in any administratively imposed freeze on civilian positions. Eliminates during FY 1992 the requirement that the Congress must authorize by law the end-strengths for civilian personnel in DOD. Prohibits setting any end-strength limitations for such personnel during FY 1992. Prohibits the use of appropriated funds for: (1) congressional lobbying; (2) the pay of certain nonmilitary Army Reserve technicians; (3) purchasing of dogs or cats to study the medical treatment of wounds; and (4) floating storage for petroleum products in non-U.S. vessels. Permits the appropriation of funds for humanitarian and civic assistance costs incident to authorized operations of the armed forces. Authorizes the Secretaries of the Army and the Air Force to retain in active status until age 60 certain officers who need such status in order to maintain employment as a National Guard or Reserve technician. Permits the use of operation and maintenance funds provided under this Act for studies and demonstration projects relating to the delivery of military health and medical care. Prohibits the use of funds appropriated by this Act to make contributions to the Department of Defense Education Benefits Fund for educational assistance for a member of the armed forces who enlists for less than three years or receives an enlistment bonus. Prohibits the use of funds appropriated by this Act for the basic pay and allowances of a member of the Army participating as a full-time student and receiving benefits through the Secretary of Veterans Affairs when time spent as a full-time student is credited toward completion of a service commitment. Limits the availability of appropriations to specified percentages of postsecondary educational costs for off-duty training of military personnel. Prohibits the use of appropriated funds for conversion to contractor performance of an activity or function of DOD that is currently performed by more than ten civilian DOD employees until a cost-analysis on such performance is completed and certified to the appropriations committees. Prohibits the use of funds for the procurement of 120mm mortars or ammunition for such mortars if manufactured outside the United States. Prohibits the use of appropriated funds for the payment of salaries of any persons who authorize the transfer of unobligated or deobligated funds into the Reserve for Contingencies of the CIA. Requires funds appropriated under this Act for CIA construction projects to remain available until expended. Authorizes the Secretary of the Navy to use specified funds to charter ships for use as auxiliary minesweepers, under specified conditions. Limits the amount of funds available from this Act for the execution of a contract for the CHAMPUS Reform Initiative. Permits the use of appropriated funds to fully utilize the facilities at the U.S. Army Engineer's Waterways Experiment Station, with a specified exception. Prohibits this Act's funds from being used by a military department to modify an aircraft, weapon, ship, or other item of equipment if such item is to be retired or otherwise disposed of within five years after completion of the modification, with specified exceptions. Specifies the definition of "program, project, and activity" for appropriations contained in this Act for purposes of the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Earmarks specified funds appropriated to the Army under this Act for the Reserve Component Automation System (RCAS), with certain expenditure limitations. Prohibits the use of appropriated funds for fixed-price contracts exceeding $10,000,000 for the development of a major defense system or subsystem, unless the Under Secretary of Defense for Acquisition and the Secretary of Defense take certain action. Provides that monetary limitations on the purchase price of passenger motor vehicles shall not apply to vehicles purchased for certain intelligence activities. Earmarks specified funds for the construction of classified military projects within the continental United States. Prohibits the use of appropriated funds for the procurement of welded shipboard anchor and mooring changes manufactured outside the United States. Authorizes DOD to transfer prior-year unobligated balances to the operations and maintenance appropriations of the reserve components in order to provide military technician and DOD medical personnel pay and medical programs the same exemption from the Gramm-Rudman-Hollings Act as is currently granted to other military personnel accounts, with specified exceptions. Prohibits any funds available to the Department of the Navy from being used to enter into any contract for the overhaul, repair, or maintenance of any naval vessel on the west coast which includes interport differential charges as a factor for the award of such contract. Prohibits funds appropriated by this Act for CHAMPUS programs from being used to reimburse any health care provider for inpatient mental health services in excess of specified periods (depending on one's age), or for care received when a patient is referred to a provider of such care by a medical or health care professional having an economic interest in the facility to which the patient is referred, with specified exceptions. Requires the designs of specified military aircraft to incorporate certain standard avionics specifications by no later than 1998. Provides for the accounting treatment of expenses incurred by the United States in monitoring Soviet implementation of the INF Treaty. Reduces the total amount appropriated to DOD by this Act to reflect savings resulting from the decreased use of consulting services by DOD. Provides funds from this Act for transportation to annual meeting in the United States. of individuals who have been prisoners of war or missing in action from the Vietnam era. Requires limited funds to be available to the Air Force to execute the cleanup of uncontrolled hazardous waste contamination affecting a sale parcel of land at Hamilton Air Force Base, California. Provides for the return of deposit if the purchaser of such parcel exercises the option to withdraw from its sale. Provides reimbursement to the Air Force after a sale is completed for cleanup expenditures in excess of a specified amount. Prohibits funds available to the Department of the Navy from being used to implement certain automated data processing or information technology facility consolidation plans or to make reductions or transfers of personnel in connection with such plans until a congressional notification requirement has been met by the Secretary. Prohibits funds from this Act from being obligated or expended to prepare, or to assist any defense contractor in preparing, any material with respect to economic or employment impact in a State of an acquisition program for which all research, development, testing and evaluation has not been completed. Prohibits funds appropriated by this Act from being available for a contract for studies, analyses, or consulting services entered into without competition on the basis of an unsolicited proposal unless the head of the activity responsible for the procurement makes certain determinations with respect to such contract. Prohibits the use of DOD funds under this Act to dispose of specified unserviceable M1 rifles and carbines. Prohibits this Act's funds from being used to pay more than 50 percent of a lump-sum reenlistment bonus. Prohibits this Act's funds from being used to assign a supervisor's title or grade when the number of people he or she supervises is considered as a basis for such determination. Prohibits funds appropriated in this Act for the CHAMPUS program from being used for the payment of certain deductible charges required for medical care authorized for spouses and children of members of the armed forces on active duty for 30 days or more and received on an outpatient basis after April 1, 1991, with specified exceptions and limitations. Prohibits Navy funds appropriated by this or any other Act from being used to carry out an electromagnetic pulse program in the Chesapeake Bay area in connection with the Electromagnetic Pulse Radiation Environment Simulator for Ships (EMPRESS) program until the Secretary has made certain certifications to the Congress concerning the importance of such program. Limits the funds available for a health care demonstration project regarding chiropractic care required by the Department of Defense Authorization Act, 1985. Prohibits this Act's funds from being used to pay health care providers under CHAMPUS for services determined to be not medically or psychologically necessary. Requires sums for FY 1992 pay raises for programs funded by this Act to be absorbed within the levels appropriated in this Act. Prohibits funds available in this Act from being used for: (1) payments under a DOD contract with the Louisiana State University Medical Center involving the use of cats for wound research; or (2) conducting bone trauma research at the Letterman Army Institute of Research until the Secretary of the Army makes certain certifications. Requires the Secretary to include in any base closure and realignment plan submitted to the Congress a complete review for FY 1991 through 1995, which includes specified information relating to force structures and cost savings after such closure or realignment. Prohibits funds appropriated by this Act from being used to reduce the FY 1992 two and a half or five-ton truck maintenance workload at letterkenny Army Depot as a result of the consolidation of truck maintenance activities or an increase of such maintenance at any other depot. Prohibits funds from being used to transfer towed and self-propelled artillery maintenance from such Depot. Limits the amount of funds to be used for any single relocation of an organization, unit, activity, or function of DOD into or within the National Capital Region. Provides for the waiver of such limitation in certain cases. Prohibits this Act's funds from being used for: (1) producing more than two-thirds of the liquid gas requirements in-house at Andersen Air Force Base, Guam; (2) reducing the end strength and force structure of DOD reserve components below the levels funded in this Act; or (3) reducing or disestablishing the operation of reserve units below those in existence on April 15, 1991. Allows appropriated funds to be used for the pay, allowances, and benefits of Federal or District of Columbia employees who are members of the reserve or National Guard, who perform Federal or military service to enforce the law or provide assistance to civil authorities in the protection or saving of life or property, and who request and are granted leave. Prohibits funds appropriated by this Act from being used to: (1) initiate or continue any cost study pursuant to Office of Management and Budget Circular A-76; or (2) begin closing a military treatment facility unless the Secretary notifies the appropriations committees. Prohibits funds appropriated by this Act for the American Forces Information Service from being used for any national or international political or psychological activities. Prohibits this Act's funds from being used for the recruitment or enrollment of new students at the Uniformed Services University of the Health Sciences for any class commencing after September 30, 1991. Requires all DOD software to be written in the programming language Ada after June 1, 1991, in the absence of a special exemption. Authorizes the Secretary of Defense to adjust the wage rates of certain civilian employees hired for certain health care occupations as authorized for the Secretary of Veterans Affairs for the direct care of veterans in the Department of Veterans Affairs. Prohibits funds available to DOD from being used for the training or utilization of psychologists in the prescription of drugs, except upon the findings and recommendations of a specified Army Blue Ribbon Panel. Prohibits funds appropriated by this Act from being used for reducing the military and civilian work force at any military medical facility or medical support facility below the level maintained or authorized for FY 1990. Rescinds specified funds as provided in DOD appropriation Acts. Amends the Department of Defense Appropriations Act, 1991 to terminate the National Commission on Defense and National Security 30 days after submission of its final report. Removes the requirement that such Commission submit five annual reports, instead requiring only an initial and final report. Authorizes the Chairman of the Commission to obtain necessary information from Federal departments or agencies. Earmarks funds made available in this Act for the Civil Air Patrol. Prohibits funds appropriated or made available in this Act from being used to reduce or disestablish the operation of the 815th Tactical Airlift Squadron of the Air Force Reserve if such action would reduce the WC-130 weather reconnaisance mission below the levels funded in this Act. Earmarks DOD operation and maintenance funds made available in this Act for transporting beef for resale in DOD commissaries in foreign countries. Requires, in the use of funds for the procurement of supplies or services appropriated by this Act, that qualified nonprofit agencies for the blind or other severly handicapped be afforded the maximum opportunity to participate as subcontractors and suppliers in the performance of DOD contracts. Earmarks specified funds for the National Drug Intelligence Center. Provides that certain numerical restrictions on the number of flag or general officers serving on active duty shall not apply in the case of such officers serving as full-time practicing physicians. Authorizes any CHAMPUS medical provider to voluntarily waive the patient copayment required for medical services provided to dependents of active-duty personnel from August 2, 1990, until the return of the troops from the Persian Gulf theater, as long as the Government's share of such services is not increased during such period. Limits the sources of funding for the Mitchell Field Health Care Facility in New York. Authorizes the Navy, during FY 1992, to provide notice to exercise options under the LEASAT program for the next fiscal year. Establishes the Foreign National Employees Separation Pay Account, Defense, to provide separation pay to foreign national employees of DOD. Places certain spending limitations on intelligence program funds which are transferred from DOD to another Federal agency for execution. Earmarks specified Navy R&D funds for the V-22 aircraft program. Specifies the manner in which prior-year appropriations for the V-22 program shall be expended. Directs the Secretary to provide the Congress with the total funding plan and schedule to complete the Phase II V-22 full-scale engineering development program. Provides that, during FY 1992, third party payments for health care provided in a military medical facility shall be available for the use of such facility and shall be over and above its direct budget amount. Directs the Secretary to transfer specified funds within DOD accounts. Authorizes the President, during FY 1992 through 1994, to acquire not less than 50,000 kilograms of germanium from current domestic sources to be held in the National Defense Stockpile. Prohibits funds appropriated in this Act from being used to: (1) procure a Multibeam Sonar Mapping System not manufactured in the United States; (2) implement more than 15 catchment area management demonstration sites; or (3) fill the commander's position at any military medical facility with a medical doctor unless such person is a trained professional administrator. Earmarks specified funds to CHAMPUS for the payment of expenses of former members of the armed forces who are 100 percent disabled as well as their dependents notwithstanding their coverage for health insurance benefits under Parts A and B of Title XVII (Medicare) of the Social Security Act. Authorizes certain prior-year funds to be used for the purchase of passenger motor vehicles. Authorizes the Secretary, during FY 1992, to accept burdensharing contributions from the Republic of Korea for the cost of local national employees, supplies, and services of DOD. Exempts the Coast Guard from the assessment of surcharges against stock and industrial fund customers with respect to transactions between the stock and industrial funds of the Coast Guard and DOD. Repeals a provision of the National Defense Authorization Act for Fiscal Year 1991 which requires a 20 percent reduction in the defense acquisition workforce by the end of FY 1995. Prohibits during FY 1992 the incurring of obligations against DOD stock funds in excess of 90 percent of sales from such funds during such fiscal year. Prohibits funds appropriated in this Act from being used for: (1) the compensation of military and civilian personnel assigned to specified naval systems and engineering commands in excess of 75 percent of the number assigned to such commands as of the end of FY 1991; and (2) reducing or disestablishing the operation of the P-3 squadrons of the Navy Reserve below the levels funded in this Act. Directs the Secretary of the Navy to obligate and expend funds appropriated during FY 1991 and 1992 for the modernization of P-3B aircraft of the Navy Reserve. Prohibits funds made available to the Army for FY 1990 through 1992 for C-23 aircraft which remain available for obligation from being used except to maintain commonality with C-23 Sherpa aircraft already in the Army National Guard. Prohibits funds appropriated in this Act from being used for: (1) any contract or grant with a university or other institution of higher learning unless such contract undergoes certain audit procedures and the institution responds fully to all requests for financial information; (2) costs associated with a federally funded research and development center if a member of the Board of Directors of such center simultaneously serves on the Board of Directors of a company under contract to DOD; (3) paying the salaries of more than four senior executives within the Navy Comptroller organization, or for compensation to such individuals at more than a specified rate; (4) paying the salaries of debarment/suspension officials unless such officials are assigned to a consolidated office of debarment and suspension within the Office of the Inspector General; and (5) procuring for use in any Government-owned facility or property under DOD control carbon, alloy, or armor steel plate which were not melted and rolled in the United States or Canada. Provides for the (waiver of such rule on a case-by-case basis). Repeals a provision of the National Defense Authorization Act for Fiscal Year 1991 which authorizes the Secretary of the Army to lease aircraft for helicopter pilot training and to determine if such leasing arrangement is more cost-effective than operating and maintaining Army aircraft for such purpose. Makes funds appropriated under such Act available during FY 1992 to establish an Executive Committee under the auspices of the Critical Technologies Institute. Makes the Secretaries of Defense and Commerce co-chairmen of the Committee. Requires the Committee to prepare and deliver to specified congressional committees: (1) a listing of those products determined to be a critical technology; (2) summaries of general economic conditions of domestic industries producing a product used in a critical technology, as well as current and prospective trends in such industries; (3) reviews of domestic and foreign policies, programs, and activities affecting the economic health of domestic industries using or producing critical technologies; and (4) appropriate recommendations regarding future actions to minimize adverse effects of policies, programs, and activities of domestic and foreign industries on critical technologies. Prohibits any funds available to the Secretary from being used to purchase bridge or machinery control systems or interior communications equipment for the Sealift Program, unless certain Buy American requirements are met with respect to such systems or equipment. Authorizes the waiver of such requirements on a case-by-case basis. Transfers specified operation and maintenance funds to the Radiation Exposure Compensation Trust Fund established under prior law to be available for the Fund's purposes. Earmarks specified funds for a grant to the Naval Undersea Museum Foundation for the completion of an undersea museum at Keyport, Washington. Prohibits the use of appropriated funds for: (1) procuring SQQ-89 systems which do not have the enhanced modular signal processor; (2) procuring vessels which were constructed in foreign shipyards; (3) the Army's acquisition of four-ton dolly jacks if such equipment is or would be manufactured outside the United States; or (4) implementing the U.S. Army Corps of Engineers Reorganization Study until the reorganization proposed is specifically authorized by law after the enactment of this Act. Authorizes the Secretary to acquire the modification, depot maintenance, and repair of aircraft, vehicles and vessels, as well as the production of components and other defense-related articles, through competition between DOD depot maintenance activities and private firms. Prohibits funds appropriated by this Act from being used to implement provisions of the Chief Financial Officers Act of 1990 (providing for the establishment of chief financial officers to oversee the financial management of the Federal Government). Requires funds appropriated by this Act to be made available for the Overseas Workload Program. Allows a contract awarded to a firm under such Program during FY 1992 to be performed in the country where the equipment or firm is located. Requires the Secretary to report to the appropriations committees on the nature of the maintenance, repair, and overhaul work of DOD performed under the Program. States that, for purposes of this provision, Israel shall be considered to be in the European Theater in every respect, with its firms fully eligible for non-restrictive, non-discriminatory competition under the Program. Directs the Secretary to work with Israel to identify new specialized capabilities in depot maintenance and repair for which it is uniquely suited. Prohibits FY 1992 funds under the Program from being used for contracts awarded during such fiscal year unless such contracts have been awarded under open competition conditions as described under these provisions. Entitles a member of the armed forces on duty at a foreign station (as well as any dependents of such member) to the provision of any reproductive health service in a military medical facility of the United States serving that duty station in the same manner as any other type of medical care. Requires the member to pay the full cost of such services in the case of any such reproductive health service for which appropriated funds may not be used.
Bill· HRH.R. 2531 (102nd)referred
United States · United States Congress · 4 June 1991
Amends the Higher Education Act of 1965 to revise and retitle title XI as Urban Community Service. Establishes an Urban Community Service program to provide incentives to urban institutions (including academic, private, and civic bodies) to work together to devise and implement solutions to the most pressing and severe problems in their communities. Requires applications for such urban community service program grants to contain a plan agreed to by the members of a consortium that includes a public or private four-year institution of higher education (and, where possible and appropriate, a community college) in partnership with an urban school system, a local government, a private business, or a nonprofit institution. Allows the Secretary of Education (the Secretary) to waive this consortium requirement for applicants with an appropriate integrated and coordinated plan. Gives priority to applications that: (1) include plans agreed to by a consortium of several members of the specified categories; and (2) propose to conduct joint projects supported by other local, State, and Federal programs. Requires grant funds to be used for planning, applied research, training, resource exchanges, technology transfers, delivery of services, or other activities to design and implement programs to assist urban communities to meet and address their most pressing problems. Includes the following problem areas among those for which such activities are authorized: (1) urban poverty and its alleviation; (2) health care including delivery and access; (3) under-performing school systems and students; (4) problems faced by the elderly in urban settings; (5) crime prevention and alternative interventions; (6) urban housing; (7) urban infrastructure; (8) economic development; and (9) other problem areas which the participants agree are of high priority for that urban area. Establishes an Urban College, University, and School Partnerships program to encourage partnerships of urban institutions of higher education (or consortia of such institutions) and secondary schools and school systems serving low-income and disadvantaged urban students to support programs to improve school retention and graduation rates, student academic skills, opportunities to continue education beyond high school, and prospects for productive employment. Requires an urban institution of higher education (or consortium), to be eligible for such a university-school partnership grant, to enter a written partnership agreement with a local education agency (LEA). Allows such partnership to include businesses, labor organizations, professional associations, community-based organizations, or other public or private agencies or organizations. Authorizes the Secretary to make grants to university-school partnerships to support the authorized program activities. Requires that grant preference be given to: (1) programs to serve predominantly low-income neighborhoods; (2) partnerships to run programs during the regular school year and during the summer; and (3) programs to serve educationally disadvantaged students, potential dropouts, pregnant adolescents, and teen-aged parents. Requires maintenance of fiscal effort by LEAs participating in such partnership agreements. Requires such grant applications to assure: (1) establishment of a partnership governing body including one representative from each participant; (2) a gradually declining specified Federal share of project costs; and (3) use of such Federal grant funds to supplement and not supplant non-Federal funds. Provides for: (1) peer review panels for title XI grant applications; and (2) multiyear disbursement of Urban Community Service program grant funds, under specified conditions. Authorizes appropriations.
Bill· HRH.R. 2534 (102nd)referred
United States · United States Congress · 4 June 1991
Ethics and Treatment of Home Medical Equipment Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services to establish certification standards for suppliers of durable medical equipment, ostomy bags, and supplies related to ostomy care under part B (Supplementary Medical Insurance) to assure patient safety and the availability of high-quality covered items. Requires such suppliers to meet such standards in order to be eligible for reimbursement from Medicare. Deems such suppliers accredited by the Joint Commission on the Accreditation of Healthcare Organizations or other appropriate accrediting entities to have met those standards. Prohibits carrier forum shopping. Modifies the prohibition against suppliers filling out certificates of medical necessity to make such prohibition applicable to items on the Secretary's list of potentially overused items. Prohibits physician referrals to durable medical equipment companies in which the referring physician has a financial relationship. Waives mandatory submission of claims provisions for nonparticipating suppliers of inexpensive items of durable medical equipment. Sets limits on the Medicare reimbursement cuts mandated under the Omnibus Budget Reconciliation Act of 1990 for covered items. Restores Medicare's monthly payment for rental cap items to ten percent per month for up to 12 months. Provides an up-front purchase option for rental cap items in instances where the item is needed for longer than 12 months at least 75 percent of the time or where the patient is in a severe condition recognized by the Secretary.
Bill· HRH.R. 2530 (102nd)referred
United States · United States Congress · 4 June 1991
National Health Care and Cost Containment Act - Title I: Federal Contributions and Payments - Requires an annual Federal payment comprising payments under the Medicare and Medicaid programs (titles XVIII and XIX respectively of the Social Security Act) and a payment in the form of a block grant to States which have been certified by the Secretary of Health and Human Services as having established a universal, comprehensive health plan which meets the terms and conditions set forth in title II of this Act. Title II: State Health Care Insurance Plans - Outlines criteria concerning administration, comprehensiveness, universality, portability, and accessibility that the State's health care insurance plan must satisfy in order to receive the Federal payment under title I of this Act. Title III: Budget-Neutral Financing of the Federal Block Grant - Amends the Internal Revenue Code to impose a surtax, on both the regular income tax and the minimum tax, to replace revenues used for block grants under this Act. Creates in the Treasury the National Health Care Block Grant Trust Fund to finance the block grants made available under title I of this Act.
Resolution· HRESH.Res. 164 (102nd)referred
United States · United States Congress · 4 June 1991
Declares that it is the sense of the House of Representatives that the Congress should: (1) act now to end the AIDS (acquired immune deficiency syndrome) epidemic by any means possible; and (2) reaffirm its commitment to ensuring compassionate and comprehensive care for Americans with AIDS.
Bill· SS. 1197 (102nd)referred
United States · United States Congress · 3 June 1991
Family Planning Amendments of 1991 - Amends the Public Health Service Act to require family planning projects under existing provisions to offer adoption referral services. Removes provisions authorizing a reduction in grant amounts by the value of supplies or equipment furnished. Authorizes appropriations for the projects. Repeals provisions authorizing formula grants to States for family planning services. Replaces provisions authorizing grants and contracts for training personnel to carry out the family planning projects with provisions authorizing grants and contracts for technical assistance, clinical training for personnel, training for educators and counselors, and training of other personnel to carry out the family planning projects and information and education programs. Authorizes appropriations. Allows grants and contracts for research on contraceptive development to be used: (1) for contraceptive evaluation; and (2) to improve the clinical management and direct delivery of family planning services. Authorizes the Secretary of Health and Human Services to conduct, and make grants and contracts for the conduct of: (1) applied research into the development of new or improved contraceptive devices, drugs, and methods; and (2) evaluations of the acceptance, convenience, safety, efficacy, and cost of contraceptive devices, drugs, and methods. Authorizes appropriations. Replaces provisions authorizing grants and contracts for developing and making available family planning and population growth information to all persons desiring such information with provisions authorizing grants or contracts to establish community-based information and education programs to assist individuals in making responsible choices concerning human sexuality, pregnancy, and parenthood, and to enable individuals to prevent unintended pregnancies and sexually transmitted diseases. Directs the Secretary to: (1) conduct, or make grants and contracts for the conduct of, training and technical assistance activities to assist in carrying out the information and education programs; and (2) make grants and contracts for the development, evaluation, and dissemination of educational and informational materials. Authorizes appropriations. Directs the Secretary to annually collect data on: (1) the numbers of low- and moderate-income individuals and adolescents at risk of unintended pregnancies; (2) the sources of funding for family planning services; and (3) the number of individuals who receive family planning services from grantees and contractees under certain provisions amended by this Act and the types of services chosen by those individuals. Authorizes grants and contracts for the collection of the data. Requires the data to be: (1) made public; and (2) included in an annual report to the Congress, mandated by current law, on family planning and population research. Requires that all grantees under the title of the Public Health Service Act relating to population research and family planning provide education to patients concerning self breast examinations. Requires that projects receiving assistance under such title offer pregnant women information and counseling concerning all legal and medical options regarding their pregnancies. Requires that women requesting such information be provided with nondirective counseling, and referral on request, concerning alternative courses of action, including: (1) prenatal care and delivery; (2) infant care, foster care, or adoption services; and (3) pregnancy termination.
Bill· HRH.R. 2507 (102nd)open
United States · United States Congress · 3 June 1991
National Institutes of Health Revitalization Amendments of 1991 - Title I: General Provisions Regarding Title IV of Public Health Service Act - Subtitle A: Research Freedom - Part I: Review of Proposals for Biomedical and Behavioral Research - Amends the Public Health Service Act to require review and approval, by an Institutional Review Board, a peer review group, or other entity, before the Secretary of Health and Human Services may approve research or fund applications. Prohibits the Secretary from withholding funding, on ethical grounds, from research which has been so approved unless an ethics advisory board recommends withholding. Part II: Research on Transplantation of Fetal Tissue - Allows the Secretary to conduct or support research on the transplantation of human fetal tissue for therapeutic purposes, regardless of whether the tissue is obtained from a spontaneous abortion, an induced abortion, or a stillbirth, in accordance with State and local law. Establishes criminal penalties for knowingly acquiring, receiving, or otherwise transferring any human fetal tissue for valuable consideration. Excludes from the term "valuable consideration" reasonable payments associated with the transportation, implantation, processing, preservation, quality control, or storage of human fetal tissue. Prohibits any official of the executive branch from imposing a policy that prohibits the Department of Health and Human Services from conducting or supporting any research on the transplantation of human fetal tissue for therapeutic purposes. Prohibits the Secretary from withholding funds for research which meets requirements of this subtitle. Deems a specified report of the Human Fetal Tissue Transplantation Research Panel to: (1) be issued by an ethics advisory board under provisions of this subtitle; and (2) find that there are no ethical grounds for withholding funds for research on transplantation of human fetal tissue for therapeutic purposes. Part III: Technical and Conforming Amendments - Removes provisions requiring a study of the nature, advisability, and biomedical and ethical implications of exercising any waiver of a specified risk standard relating to fetal research. Subtitle B: Clinical Research Equity Regarding Women and Minorities - Part I: Women and Minorities as Subjects in Clinical Research - Requires the Director of the National Institutes of Health (NIH) and the Administrator of the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) in conducting and supporting research, to ensure that: (1) women and minorities are included as subjects in each project; and (2) research is conducted so as to provide for a valid analysis of whether the variables being tested affect women or minorities differently than other research subjects. Requires technical and scientific peer review to include an evaluation of compliance with these requirements. Part II: Offices of Research on Women's Health - Establishes within each of the Office of the Director of NIH and the Office of the ADAMHA Administrator an Office of Research on Women's Health to identify projects of women's health (and, for ADAMHA, mental health) research and promote sufficient resource allocation for the conduct or support of the projects by NIH and ADAMHA. Requires the Directors of each Office to establish a Coordinating Committee on Research on Women's Health and an Advisory Committee on Research on Women's Health. Includes in the Coordinating Committee's duties determining the extent women are represented among senior physicians and scientists of NIH and ADAMHA and among physicians and scientists conducting research with NIH or ADAMHA funding and carrying out activities to increase such representation. Requires the Director of NIH to: (1) establish a single data system regarding research on women's health conducted or supported by NIH or ADAMHA; and (2) establish and operate a program to provide information on research and prevention activities of NIH and ADAMHA relating to research on women's health (and, for ADAMHA, mental health) and gender differences. Mandates a biennial report by each Director with specified contents, including analyzing the professional status of women physicians and scientists at NIH and ADAMHA and identifying advancement barriers. Directs the Secretary: (1) through the Directors of the Offices of Research on Women's Health, to contract for a study of how research on women's health can be facilitated by the NIH Director and the ADAMHA Administrator; and (2) to request the Institute of Medicine of the National Academy of Sciences to enter into the contract. Subtitle C: Scientific Integrity - Amends provisions relating to scientific fraud or scientific misconduct to establish within the Office of the Director of NIH the Office on Scientific Integrity. Provides for termination and recovery of financial assistance, provided for certain biomedical or behavioral research, if there is retaliation against a scientific misconduct whistleblower. Prohibits grants to or cooperative agreements or contracts with entities that fail to follow procedures to prevent or respond to such retaliation. Directs the Secretary, with regard to any entity receiving assistance for research to evaluate the safety or effectiveness of a drug, medical device, or treatment, to establish criteria for preventing or responding to any financial interests which will or may create a conflict of interest. Requires the criteria to be uniformly applicable to each entity. Allows individual variation in implementation. Prohibits allowing each entity to develop individual criteria. Allows the Secretary, where such a conflict of interest exists, to take certain actions, including disapproving an application, terminating assistance, and recovering assistance obligated while the conflict exists. Directs the Secretary to require the entity to disclose the conflict in each public presentation of the research results. Prohibits the Secretary, in fiscal years after regulations establishing the criteria are issued, from making a grant, cooperative agreement, or contract for biomedical or behavioral research unless the entity seeking assistance agrees to be subject to the regulations. Mandates a study by the Comptroller General on the extent to which the activities of the Director of the Office of Scientific Integrity have been effective in investigating and preventing scientific fraud and other misconduct. Directs the Secretary, through the National Library of medicine, to develop guidelines for use by scientific and medical journals to protect against publication of manuscripts involving scientific misconduct. Subtitle D: Indirect Costs - Allows the Secretary, in providing financial assistance through NIH for a research project, to authorize an entity to make expenditures from the assistance for administrative and nonadministrative indirect costs. Limits indirect cost expenditures to a percentage of direct costs. Requires a separate approval for certain building and equipment expenditures. Requires the NIH Director to establish a program of supporting biomedical or behavioral research projects whose principal researchers have not previously been principal researchers in such projects supported by the Director. Title II: Protection of Health Facilities - Prohibits stealing or otherwise converting personal property or damaging real property of a health facility assisted under the Public Health Service Act, or deterring, through physical restraint, any individual from entering or exiting the facility. Includes in the prohibitions various acts interfering with the use of animals for research. Provides for fines, imprisonment, restitution, and private civil actions. Title III: National Institutes of Health in General - Directs the Secretary to establish in the Office of the Director of NIH the Advisory Committee on Health Sciences to periodically review the missions of each of the agencies of NIH for the purpose of advising the NIH Director, the Secretary, and the Congress on any modifications in the organizational structure of NIH. Requires the approval of the Committee in order for the Secretary to establish, reorganize, or abolish a national research institute. Mandates preparation and implementation of a plan, regarding biomedical research and experimentation conducted or supported by NIH, for methods that: (1) do not require the use of animals; (2) reduce the number of animals used; and (3) produce less pain and distress in animals. Requires measures to encourage acceptance and training in such methods. Establishes the Interagency Coordinating Committee on the Use of Animals in Research. Repeals similar provisions, relating to a plan on animal research and a coordinating committee, of the Health Research Extension Act of 1985. Removes provisions of the Public Health Service Act allowing members of advisory councils to serve after the expiration of their terms until successors have taken office. Title IV: General Provisions Respecting National Research Institutes - Requires that the Secretary, through the director of each of the national research institutes, receive directly all funds appropriated for the institute. Removes provisions allowing the Director of the National Cancer Institute (NCI) to directly receive NCI funds. Excludes peer review groups under specified provisions from the application of the Federal Advisory Committee Act. Requires the Director of NIH to: (1) carry out a program to expand and intensify research on osteoporosis, Paget's disease, and related bone disorders in addition to research authorized under other Federal law; (2) establish the Advisory Board on Osteoporosis, Paget's Disease, and Related Bone Disorders; and (3) enter into a grant, cooperative agreement, or contract to establish an information clearinghouse on osteoporosis and related bone disorders. Authorizes appropriations. Title V: National Cancer Institute - Authorizes appropriations for the National Cancer Institute. Title VI: National Heart, Lung, and Blood Institute - Authorizes the National Heart, Lung, and Blood Institute (NHLBI) to conduct programs of training and education, including continuing education and laboratory and clinical research training. Title VII: National Institute on Aging - Transfers provisions of the Health Research Extension Act of 1985 establishing an Alzheimer's disease registry to provisions of the Public Health Service Act relating to the National Institute on Aging (NIA). Transfers provisions of the Health Research Extension Act of 1985 establishing an Alzheimer's disease registry to provisions of the Public Health Service Act relating to the National Institute on Aging (NIA). Authorizes appropriations for the NIA. Title VIII: National Institute of Allergy and Infectious Diseases - Authorizes the Director of the National Institute of Allergy and Infectious Diseases to make grants or enter into contracts for the development and operation of centers to conduct basic and clinical research on chronic fatigue syndrome. Title IX: National Institute of Child Health and Human Development - Subtitle A: Research Centers With Respect to Contraception and Research Centers With Respect to Infertility - Requires the Director of the NICHHD to make grants and enter into contracts for the development and operation of centers to conduct contraception research and centers to conduct infertility research. Directs the Secretary to establish a program of educational loan repayments for health professionals who agree to conduct research on contraception or on infertility. Subtitle B: Program Regarding Obstetrics and Gynecology - Requires the Director of the NICHHD to establish and maintain an intramural laboratory and clinical research program in obstetrics and gynecology. Subtitle C: Child Health Research Centers - Requires the Director of the NICHHD to develop and support centers for conducting research on child health, giving priority to clinical applications of basic research findings. Title X: National Institute of Neurological Disorders and Stroke - Requires the Director of the National Institute of Neurological Disorders and Stroke to conduct and support research on multiple sclerosis. Title XI: National Institute of Environmental Health Sciences - Establishes in the National Institute of Environmental Health Science the Applied Toxicological Research and Testing Program. Title XII: National Library of Medicine - Subtitle A: General Provisions - Adds to the list of functions of the National Library of Medicine (NLM) that of publicizing NLM products and services and promoting the use of computers and telecommunications by health professionals. Authorizes appropriations to carry out provisions relating to: (1) the NLM and to other medical libraries, including regional medical libraries; (2) training in medical library sciences; and (3) biomedical publications. Subtitle B: Financial Assistance - Directs the Secretary to make grants for research on, and development and demonstration of, new education technologies. Subtitle C: National Center for Biotechnology Information - Authorizes appropriations for the National Center for Biotechnology Information. Subtitle D: National Information Center on Health Services Research and Health Care Technology - Establishes in the NLM the National Information Center on Health Services Research and Health Care Technology. Removes similar provisions from provisions relating to the Agency for Health Care Policy and Research. Title XIII: Other Agencies of National Institutes of Health - Subtitle A: Division of Research Resources - Redesignates the Division of Research Resources as the National Center for Research Resources. Authorizes the Director of NIH to reserve up to a specified sum to improve regional centers for research on primates. Subtitle B: National Center for Human Genome Research - Adds the National Center for Human Genome Research to the list of agencies of NIH. Declares that the purpose of the Center is to characterize the structure and function of the human genome, including the mapping and sequencing of individual genes. Requires the Director of the Center to make available a minimum percentage of funds for carrying out provisions relating to ethical issues associated with the genome project. Title XIV: Awards and Training - Subtitle A: National Research Service Awards - Directs the Secretary to make grants for comprehensive programs to recruit women and individuals from disadvantaged backgrounds into fields of biomedical or behavioral research and to provide research training to women and such individuals. Authorizes appropriations for payments and grants under National Research Service Awards. Subtitle B: Acquired Immune Deficiency Syndrome - Allows the Secretary, under a loan repayment program for research with respect to acquired immune deficiency syndrome (AIDS) established by existing provisions, to enter into a repayment agreement with a health professional who agrees to conduct AIDS research at NIH for at least three years, provided other conditions are met. Authorizes appropriations. Authorizes the Commissioner of Food and Drugs to carry out for the Food and Drug Administration a similar loan repayment program with respect to the review of applications concerning AIDS that are submitted to the Commissioner. Subtitle C: Scholarship and Loan Repayment Programs Regarding Professional Skills Needed by Certain Agencies - Directs the Secretary, through the Director of NIH and the Administrator of ADAMHA, to establish programs of scholarships for undergraduate education for individuals from disadvantaged backgrounds who are underrepresented in professions needed by NIH and ADAMHA in return for the scholarship recipients agreeing to serve as an employee of NIH or ADAMHA for a prescribed period. Requires that the Director and the Administrator: (1) carry out activities to facilitate the interest of the individuals in pursuing careers as employees of NIH and ADAMHA; and (2) approve the academic program of each individual. Directs the Secretary, through the Director and the Administrator, to establish programs of repaying educational loans for individuals from disadvantaged backgrounds who have a substantial amount of education loans relative to income in return for the repayment recipients agreeing to conduct clinical research as employees of NIH or ADAMHA. Limits the NIH scholarship and loan programs to an aggregate of 40 contracts and the ADAMHA programs to an aggregate of 10 contracts. Title XV: Research with Respect to Acquired Immune Deficiency Syndrome - Modifies the duties of the AIDS Clinical Research Review Committee, including requiring the Committee to give advice to other agencies of NIH as well as to the National Institute of Allergy and Infectious Diseases (NIAID). States that the requirement that the clinical evaluation units at the National Cancer Institute and NIAID conduct evaluations of treatments for acquired immune deficiency syndrome (AIDS) includes evaluations of treatments for opportunistic cancers and infectious diseases. Authorizes appropriations for model protocols for the clinical care of individuals infected with the etiologic agent for AIDS. Requires the Director of NIH to develop and implement a comprehensive plan for the conduct and support of AIDS research by NIH agencies. Title XVI: Miscellaneous Provisions - Directs the Secretary to report to specified congressional committees on the appropriateness and impact of NIH assuming responsibility for all Federal research, development, testing, and evaluation functions relating to the medical aspects of biological agents in the development of defenses against biological warfare. Renames the Senior Biomedical Research Service as the Silvio Conte Senior Biomedical Research Service. Increases the maximum number of members of the Service. Declares that the authority regarding the number of members in the Service is in addition to the numbers authorized for the Regular Corps, the Reserve Corps, and the Senior Executive Service. Renames the AIDS clinical Research Review Committee as the AIDS Research Advisory Committee. Title XVII: Effective Date - Sets forth the effective date of this Act.
Bill· HRH.R. 2508 (102nd)failed
United States · United States Congress · 3 June 1991
International Cooperation Act of 1991 - Title I: Economic Assistance - Amends the Foreign Assistance Act of 1961 to revise policy provisions concerning economic assistance. Sets forth the objectives of U.S. development cooperation policy and economic assistance programs as the: (1) promotion of broad based economic growth; (2) improvement of resource management to bring about environmentally and economically sustainable patterns of development; (3) alleviation of poverty through the development of human resources; and (4) promotion of democracy, respect for human rights, and social and economic pluralism. Requires the President to use the authorities of this Act to provide assistance to meet long-term development needs in developing countries. Authorizes the President to provide such assistance to promote specified activities contributing to broad based, sustainable, and participatory development and economic growth. Authorizes appropriations for FY 1992 and 1993 for development assistance. Earmarks specified amounts for health improvement, child survival activities, prevention and control of acquired immune deficiency syndrome (AIDS), and reducing vitamin A deficiency. Authorizes appropriations for FY 1992 and 1993 for population planning assistance. Earmarks a specified amount for the United Nations Population Fund if: (1) the Fund maintains such funds in a separate account, without commingling; (2) none of the funds are made available for China; and (3) any agreement to obligate such funds expressly states that funds will be refunded to the United States if used for family planning in China or abortions in any country. Prohibits the denial of funds for population activities to nongovernmental or multilateral organizations on the basis of any criterion that is not applicable to foreign governments. Authorizes the President to use development and economic support assistance and assistance from the Development Fund for Africa to support human rights and activities to improve the performance of democratic institutions and to promote democracy. Requires a substantial portion of such assistance to be provided to nongovernmental organizations. Prohibits such assistance from being used to influence the outcome of an election in any country. Permits Development Fund for Africa assistance to be used only for countries in Subsaharan Africa. Authorizes the use of such assistance for: (1) development education programs to educate U.S. citizens about developing countries; and (2) nongovernmental organizations to carry out programs concerned with the economic and social development of such countries. Authorizes the President, acting through the administrator of the agency responsible for administering this title (administering agency), to provide assistance for microenterprises in developing countries. Directs the agency to establish specified criteria for determining the financial intermediaries that will receive such assistance. Requires a significant portion of such assistance to be used to support direct credit assistance by, and the institutional development of, financial intermediaries with a primary emphasis on assisting people living in absolute poverty, especially women. Outlines funding sources for such assistance. Permits the President, in order to generate local currencies for providing such assistance, to use development and economic support assistance or assistance from the Development Fund for Africa to provide assistance to developing countries on a loan basis repayable in local currencies. Sets forth minimum levels of assistance to be provided under this Act. Requires the administrator to develop a monitoring system to evaluate the administering agency's microenterprise development activities. Earmarks amounts out of funds for development assistance and assistance for the Development Fund for Africa for private voluntary organizations for FY 1992 and 1993. Requires agencies responsible for environmental programs in developing countries to prepare initial examinations to ensure that such programs are environmentally sustainable. Declares that beneficiary countries should bear a share of the costs of development assistance programs under this Act. Prohibits funds made available under this title from being used for military or paramilitary purposes. Authorizes the President to furnish economic support assistance to countries and organizations to promote economic or political stability. Authorizes appropriations for FY 1992 and 1993 for such assistance. Declares that economic support assistance should be provided through commodity import programs, project assistance, sector programs, or the provision of U.S. goods and services. Permits such assistance to be provided as a cash transfer only pursuant to an agreement requiring that the country spend an amount equal to such transfer to purchase U.S. goods and services. Requires such agreements to include provisions to ensure that representatives of the U.S. Comptroller General have access to necessary records and personnel for monitoring and auditing purposes. Exempts from such requirements countries which: (1) receive less than $25,000,000 cash transfer assistance annually; or (2) have certain agreements with the United States. Authorizes the President to waive the requirements of this section when it is in the national interest. Authorizes appropriations for FY 1992 and 1993 for contributions to international organizations. Earmarks specified amounts of such funds for: (1) the United Nations Development Program; (2) the United Nations Children's Fund; (3) the United Nations Environmental Program; (4) the International Fund for Agricultural Development; (5) the Special Program for Africa of the International Fund for Agricultural Development; (6) the United Nations University; and (7) the Organization of American States (OAS) for purposes of establishing an electronic network for the exchange of science and technology information among universities in OAS member countries. Authorizes funds to be earmarked for the International Atomic Energy Agency only if the Secretary of State reports to the appropriate congressional committees that Israel is not being denied the right to participate in the Agency. Applies evaluation and auditing procedures for the International Bank for Reconstruction and Development and the Asian Development Bank to the International Development Association, the International Finance Corporation, the Multilateral Investment Guarantee Agency, the Inter-American Development Bank, the Inter-American Investment Corporation, the African Development Bank, the African Development Fund, and the Asian Development Fund. Revises provisions concerning the housing and urban development guarantee program. Raises the limit on: (1) the face value of guarantees with respect to any country; (2) the average face value of guarantees; and (3) the total principal amount of guarantees issued. Authorizes appropriations for the program for FY 1992 and 1993. Terminates authorities with respect to housing guarantees after FY 1993. Authorizes assistance to be provided to developing countries to support private sector activities meeting specified criteria. Permits the President to issue guarantees assuring against losses incurred in connection with loans made for such activities. Sets forth terms and conditions for such guarantees. Authorizes the President to make direct loans for such activities, subject to certain conditions. Establishes ceilings for direct loans and for contingent liability for guarantees. Authorizes appropriations for FY 1992 and 1993. Authorizes appropriations for FY 1992 and 1993 for: (1) international disaster assistance; and (2) American schools, libraries, and hospital centers abroad. Permits the President to use development or economic support assistance or assistance from the Development Fund for Africa for grants to, or contracts with, nongovernmental organizations to enable such organizations to: (1) purchase debt obligations owned by developing countries to commercial lending institutions or other private parties; and (2) cancel such obligations subject to the President's approval, to the extent that such countries make available assets or policy commitments to promote the objectives of this title. Authorizes grantees or contractees to retain interest earned on the proceeds of debt-for-development or debt-for-environment purchases or exchanges pending the disbursement of such proceeds and interest for the purposes for which assistance was provided. Authorizes appropriations for FY 1992 and 1993 for operating expenses of the administering agency and of the Office of the Inspector General of such agency. Permits development or economic support assistance or assistance from the Development Fund for Africa to be used for such expenses, subject to a specified limitation. Requires the President to establish a program performance evaluation capacity to: (1) develop a program performance information system to afford the administering agency's managers a means for monitoring achievement of impact and interim performance of the agency's major programs; (2) prepare and disseminate reports on the agency's progress in meeting development objectives for major assistance categories and recipient countries; (3) strengthen the implementation of foreign assistance projects; and (4) coordinate with the Inspector General of such agency to ensure complementarity of efforts. Directs the President to report annually to the Congress on: (1) progress toward achieving the four basic objectives set forth under this title; and (2) a country-by-country analysis of the impact on economic development in each country during the preceding three to five years of U.S. economic assistance programs, with a discussion of U.S. interests that were served by such assistance. Requires the President to maintain within the administering agency a Center for University Cooperation in Development and a Center for Voluntary Cooperation in Development. Provides that the respective purposes of such centers shall be to strengthen the partnership for development between the U.S. Government and: (1) U.S. and developing country institutions of higher education engaged in education, research, and public service programs relevant to developing countries; and (2) U.S. private voluntary organizations, cooperatives, and credit unions engaged in activities relevant to such countries. Authorizes funds from development assistance and assistance from the Development Fund for Africa to be made available for the Centers. Requires the agency administrator to establish a permanent Advisory Committee on Voluntary Cooperation in Development. Title II: Military Assistance, Related Assistance, and Military Sales Programs - Chapter 1: Consolidation and Revision of Assistance Authorities - Revises policy provisions concerning military assistance. Revises the President's authority to furnish military assistance to friendly countries to permit the President to: (1) finance the sale of defense articles or services; or (2) finance the procurement of such articles (under certain circumstances) by any member country of the North Atlantic Treaty Organization (NATO) or any major non-NATO ally through leases from U.S. commercial suppliers. Requires sales under the Defense Trade and Export Control Act (formerly, the Arms Export Control Act) which are wholly paid from funds made available on a grant basis under this Act or were transferred or made available under former authorities prior to this Act's enactment to be priced to exclude the costs of salaries of members of the U.S. armed forces (other than members of the Coast Guard) and unfunded estimated costs of civilian retirement and other benefits. Prohibits assistance from being furnished under this chapter in any case involving coproduction or licensed production outside the United States of any defense article of U.S. origin unless the President furnishes full information on the proposed transaction to the appropriate congressional committees. Prohibits the obligation of certain assistance for the procurement of: (1) any vessel of war built pursuant to a prime contract awarded to a foreign shipyard; or (2) any weapons system or other major system for a vessel of war built pursuant to such a contract awarded to a foreign rather than a U.S. shipyard because of unfair foreign competition. Exempts from such prohibition vessels of war built in the foreign country which is the recipient of such assistance or built pursuant to a prime contract signed before the effective date of this Act. Permits military assistance to be provided for civic action in Africa. Authorizes assistance provided under this chapter to be on a grant, credit, or guarantee basis. Outlines criteria to be considered by the President in determining the terms of assistance. Requires repayment in U.S. dollars within 12 years of the signature of a loan agreement for credit assistance. Provides that the interest rate on such loans shall be at least five percent annually. Outlines disbursement procedures for funds used to finance the procurement of defense articles and services. Makes such assistance available to a foreign country to make payments to the United States for credits or loans for defense articles or services granted under predecessor military sales or assistance legislation. Revises provisions concerning eligibility for the receipt of defense articles or services and makes them applicable to the financing of such articles or services. Makes defense articles sold or leased under the Defense Trade and Export Control Act or furnished under predecessor foreign assistance or military sales legislation subject to the eligibility provisions of this title. Directs the President to establish controls to make financed commercial arms sales subject to monitoring and auditing requirements no less stringent in accountability than requirements of Federal Acquisition Regulation applicable to sales under the Defense Trade and Export Control Act relating to improper business practices and personal conflict of interest. Incorporates provisions of the Arms Export Control Act concerning the opinion of the U.S. Arms Control and Disarmament Agency with respect to furnishing assistance. Authorizes appropriations for military assistance and sales for FY 1992 and 1993. Sets aside two percent of appropriations for military financing for assistance to eligible countries for which the Congress has not specified an amount of assistance. Revises provisions concerning transfers of excess defense articles for the modernization of defense capabilities. Requires excess defense articles to be made available to maintain the military balance in the Eastern Mediterranean. Requires the President to ensure, over a three-year period beginning in FY 1992, that the ratio of the value of such articles made available for Turkey to those made available for Greece closely approximates the ratio of the amount of foreign military financing provided for Turkey to the amount provided for Greece. Revises provisions concerning the transfer of excess defense articles to: (1) eligible major drug producing or transit countries (currently, major drug producing countries in Latin America and the Caribbean); and (2) eligible countries, international organizations, or private voluntary organizations for natural resources and wildlife management. Makes provisions concerning transportation and related costs of such articles under provisions governing transfers for the modernization of military capabilities applicable to transfers for counternarcotics or natural resource and wildlife management purposes. Adds to the list of conditions for such transfers that the transfer of articles is preferable to selling them. Sets forth congressional notification requirements. Permits transfers for natural resource and wildlife management purposes to be made available without cost to the recipient. Excludes certain excess defense articles from the annual ceiling on transfers. Revises provisions concerning military personnel detailed overseas for management of military assistance programs. Requires at least one person assigned to each country to be responsible for monitoring international security assistance. Authorizes appropriations for FY 1992 and 1993 for: (1) international military education and training; and (2) peacekeeping operations. Revises provisions concerning the location of stockpiles. Places a ceiling on the value of additions to stockpiles during FY 1992 and 1993. Authorizes appropriations for FY 1992 and 1993 for antiterrorism assistance. Revises provisions concerning special drawdown authorities. Authorizes the President to direct the drawdown of Department of Defense commodities or services for: (1) international narcotics control assistance; (2) international disaster assistance; or (3) assistance under the Migration and Refugee Assistance Act of 1962. Places a ceiling on articles and services provided for such assistance. Raises the ceiling on the value of defense articles and services authorized to be provided under existing emergency authorities. Makes the Secretary of Defense responsible for establishing priorities in the procurement, delivery, and allocation of defense articles and services. Requires the President to appoint one officer to coordinate security assistance programs. Prohibits personnel overseeing the management of assistance programs or providing defense services or military education and training overseas from performing combatant duties. Makes technical and conforming amendments to the Arms Export Control Act. Revises a provision regarding the Guaranty Reserve Fund and redesignates the Fund as the Foreign Military Loan Liquidating Account. Repeals a provision concerning the availability of funds for procurement of defense articles and services outside the United States. Permits the President to waive requirements under the Foreign Assistance Act of 1961 concerning the disposition of defense articles and services furnished before the effective date of this title. Chapter 2: Foreign Military Sales Program - Amends the Arms Export Control Act to rename such Act as the Defense Trade and Export Control Act. Repeals a provision concerning purposes for military sales or leases. Deems references to the Arms Export Control Act to be references to the Defense Trade and Export Control Act. Requires the President to take the following steps to address financial management problems with respect to payments on account of foreign military sales: (1) establish a new account for the deposit of funds for sales entered into after September 30, 1992, to isolate such financial transactions from previous sales; (2) establish a centralized accounting system; (3) improve coordination and conformity among the accounting and billing systems of each of the military services; and (4) reconcile the discrepancies between reported disbursements and reported performance with respect to such sales. Directs the President to notify the Congress before: (1) designating a country as a major non-NATO ally; or (2) terminating such a designation. Deems Australia, Egypt, Israel, Japan, and the Republic of Korea to have been so designated by the President. Raises the threshold on the dollar amount of defense equipment or services on which the President is required to submit specified certifications. Revises provisions concerning presidential certifications and congressional procedures for certain arms transfers. Sets forth conditions under which New Zealand is eligible for shorter congressional review procedures. Adds to the list of information required in the President's quarterly report on military exports information on all concluded defense coproduction agreements. Imposes sanctions on foreign parties to coproduction agreements that violate restrictions concerning unauthorized third party transfers or unauthorized dispositions of defense articles or services or technical data if the President so notifies the Congress or the Congress so determines by joint resolution. Lists such sanctions as: (1) the suspension of authority to produce defense articles abroad pursuant to such agreements; and (2) a prohibition on the issuance and approval of licenses with respect to the foreign party. Disqualifies for financing under the Foreign Assistance Act of 1961 for 12 months any contracts of a person convicted or debarred for a violation of international traffic in arms regulations under the Defense Trade and Export Control Act. Exempts international organizations from a prohibition on the issuance of export licenses for items on the U.S. Munitions List to foreign persons. Requires the President to review biennially and revise, as necessary, international traffic in arms regulations. Provides that charges for defense articles that are not major defense equipment sold or licensed for export under the Defense Trade and Export Control Act shall exclude nonrecurring costs of research on or development or production of such articles. Repeals provisions concerning: (1) discrimination; (2) restraint in arms sales to Subsaharan Africa; (3) foreign military sales credit standards; (4) foreign military sales to less developed countries; and (5) the crediting of registration fees. Chapter 3: Other Provisions - Prohibits funds authorized by any Act from being made available to facilitate the sale of M-833 antitank shells or comparable shells containing a depleted uranium penetrating component to any country other than a NATO member or major non-NATO ally. Sets forth U.S. policy with respect to arms transfers to the Middle East and Persian Gulf region. Requires the President to seek negotiations among, and undertake efforts to convene a conference of, the five members of the United Nations Security Council and other nations, as appropriate, to establish a multilateral arms transfer and control regime with respect to the Middle East and Persian Gulf region. Declares that the purpose of such regime should be to: (1) limit the proliferation of conventional weapons and ballistic missile technologies and systems and halt the proliferation of unconventional weapons; (2) maintain the military balance in the region through the reduction of conventional weapons and the elimination of unconventional weapons; and (3) promote regional arms control in such region. Directs the President to submit to the Senate Foreign Relations Committee and the House Committee on Foreign Affairs: (1) a U.S. plan for establishing a multilateral regime to restrict transfers of arms to the Middle East; and (2) an analysis of the feasibility and potential elements of such regime. Prohibits the United States from agreeing to any transfers of major military equipment to the Middle East and Persian Gulf region unless the President submits such plan and analysis and reports that there has been agreement by another major arms supplier on or after May 21, 1991, to transfer such equipment to any nation in the region. Exempts from such prohibition emergency or replacement transfers or transfers pursuant to agreements entered into before May 21, 1991. Requires the President to report to the Senate Foreign Relations Committee and the House Foreign Affairs Committee on: (1) all transfers of conventional and unconventional arms to the Middle East; (2) the current military balance in the region; (3) the operation of any agreements comprising the arms transfer and control regime; and (4) supplier nations that have refused to participate in such a regime or that have engaged in conduct that violates or undermines the regime. Title III: Trade and Development Agency and Overseas Private Investment Corporation - Amends the Foreign Assistance Act of 1961 to revise the authorities of the Director of the Trade and Development Agency (replaces the Trade and Development Program). Requires the Agency to disseminate information about its activities to the private sector. Sets forth the duties of the Inspector General of the Agency for International Development (AID) with respect to the Agency. Authorizes appropriations for FY 1992 and 1993. Revises provisions concerning the Overseas Private Investment Corporation (OPIC). Requires OPIC, in determining whether to provide insurance, reinsurance, guarantees, or financing for a project, to ensure that the project is consistent with objectives concerning resource sustainable development. Prohibits OPIC payments from being issued in connection with losses resulting from violations of foreign trade practices under the Securities Exchange Act of 1934. Raises the ceiling on the maximum contingent liability for outstanding OPIC guarantees. Authorizes OPIC to draw specified amounts from a noncredit account revolving fund to pay estimated subsidy costs of program levels for the loan guarantee and direct loan programs. Permits OPIC to: (1) establish a revolving fund to be available solely for the equity finance program; and (2) make a one-time transfer to such fund from the noncredit account revolving fund. Revises provisions concerning OPIC's insurance reserves. Authorizes OPIC to draw a specified amount from the noncredit account revolving fund for administrative expenses of the direct loan and loan guarantee programs. Makes provisions concerning income and revenues applicable to income and revenues from OPIC's noncredit activities (currently, revenues and income from any source). Authorizes (currently, requires) OPIC to charge fees for its services. Provides for annual (currently, triennial) audits of OPIC. Removes OPIC's exemption from Federal taxation. Title IV: International Narcotics Control - Revises provisions concerning international narcotics control. Authorizes appropriations for FY 1992 and 1993 for international narcotics control. Makes a prohibition on the use of narcotics control funds for the procurement of weapons or ammunition inapplicable (subject to congressional notification requirements) to: (1) weapons or ammunition for the defensive arming of aircraft used for narcotics control purposes; or (2) firearms and related ammunition provided to Department of State employees for narcotics control activities. Requires the President (currently, the Secretary of State) to maintain records on aircraft use under this title. Authorizes foreign military financing assistance under the Defense Trade and Export Control Act to be made available to finance the leasing of aircraft. Removes a prohibition on the use of narcotics control funds by foreign countries to acquire real property for military or law enforcement forces if the President notifies the appropriate congressional committees. Permits funds for economic support assistance, foreign military financing, or international military education and training to be transferred and consolidated with funds for international narcotics control if: (1) such assistance is withheld from the country for which it was allocated because of laws that require the withholding of assistance from countries that have not cooperated with the United States or taken steps to halt illicit drug production and trafficking; and (2) such funds are used for assistance to countries that have taken significant steps to halt illicit drug production or trafficking. Makes provisions of law that restrict assistance to countries inapplicable with respect to narcotics-related assistance, provided that the President notifies the appropriate congressional committees. Revises congressional reporting and certification requirements with respect to international narcotics control. Requires the President to notify the appropriate congressional committees annually of countries determined to be major drug transit or illicit drug producing countries. Makes prohibitions on the provision of assistance to foreign law enforcement agencies inapplicable, during FY 1992 and 1993, to: (1) transfers of defense articles and services for counternarcotics purposes; and (2) foreign military financing and international military education and training for narcotics-related purposes. Title V: Special Assistance Initiatives and Other Region or Country Specific Provisions - Authorizes the President to provide project and program assistance for long-term development in Subsaharan Africa. Designates such assistance as the Development Fund for Africa. Requires the purpose of such assistance to be to help the poor majority of men and women in Subsaharan Africa to participate in a process of long-term development through economic growth that is equitable, participatory, environmentally sustainable, and self-reliant. Provides that such assistance should also promote sustained economic growth, encourage private sector development, promote individual initiatives, and help to reduce the role of central governments in areas more appropriate for the private sector. Requires the local-level perspective of the rural and urban poor in Subsaharan Africa to be taken into account during the planning process for project assistance. Declares that consultations should be undertaken with private and voluntary organizations which have demonstrated effectiveness in or commitment to the promotion of local grassroots activities on behalf of development in Subsaharan Africa. Requires: (1) local people to be consulted and involved in projects that have a local focus; and (2) development activities to expand the participation and integration of African women in certain critical sectors. Requires assistance provided by this Act to emphasize projects to address critical sectoral priorities for development. Authorizes assistance to promote economic policy reforms. Requires such reforms to include provisions to protect vulnerable groups from possible negative consequences of such reforms. Designates as the critical sectoral priorities for long-term development: (1) increased agricultural production and the maintenance and restoration of renewable natural resources; (2) improved health conditions and the prevention and control of AIDS; (3) voluntary family planning services; (4) improved relevance, equity, and efficiency of education; and (5) development of income generating opportunities for the unemployed and underemployed. Imposes minimum levels of assistance for certain critical sectors. Requires assistance provided under this Act to be concentrated in countries that will make the most effective use of such assistance. Allows assistance to be made available to: (1) assist Subsaharan African countries to increase their capacity to participate in donor coordination mechanisms at the country, regional, and sector levels; and (2) assist sector projects supported by the Southern African Development Coordination Conference (SADCC). Expresses the sense of the Congress that: (1) there should be periodic evaluations of the progress of the administering agency in achieving assistance goals in Subsaharan Africa; and (2) the period of availability of funds appropriated for such assistance should be extended whenever appropriate. Authorizes appropriations. Expresses the sense of the Congress that: (1) the United States should participate with multilateral financial institutions and other bilateral donors in an economic reform and development program in the Philippines; and (2) a commitment of resources by the United States, donors, and such institutions and a reform effort and leadership role by the Government of the Philippines will be necessary to ensure economic growth in the Philippines and enhanced participation of the Filipino people in the democratic process. Authorizes the President to provide assistance to promote the goals of this Act. Links such assistance to progress by the Government of the Philippines in implementing its economic, structural, judicial, and administrative reform program. Authorizes appropriations. Limits the amount of appropriations for FY 1992. Expresses the sense of the Congress that prior to requesting additional amounts to carry out this Act, the President should take into account: (1) the progress being made by the Philippines toward achieving reform objectives; (2) the extent of participation by the bilateral donors and multilateral financial institutions; and (3) the efforts to coordinate the assistance program. Expresses the sense of the Congress that: (1) the coordination of objectives and programs by donors, institutions, and the Government of the Philippines is critical to the success of the multilateral assistance program; (2) all donors should simplify procurement and disbursement procedures to ensure that conditions on the provision or use of assistance are complementary; and (3) the Philippines should establish internal procedures that will ensure the most effective use of such assistance. Sets forth the Caribbean Regional Development Act of 1991. Sets forth U.S. policy with respect to development and economic assistance for the Caribbean. Provides that priority in providing development assistance should be given to supporting indigenous democratic Caribbean institutions that represent and benefit the poor. Requires priority in the allocation of assistance to the Caribbean to be given to: (1) increased food production; (2) rural development; (3) community-based agro-industries; (4) small- and medium-sized farm and manufacturing enterprises; (5) the expansion of tourism; (6) regional integration; (7) the upgrading of technical and managerial skills; (8) support for renewable natural resources; (9) private sector development; (10) democratic development and the administration of justice; and (11) human services and human resources development. Directs the President, in providing assistance to a Caribbean country, to take into account whether the government of such country has failed to protect worker rights and is taking steps to implement laws that demonstrate advancement in providing such rights. Prohibits the administering agency from providing assistance for the use of any substance in a Caribbean country if such use is prohibited under the country's or U.S. public health laws. Declares that the agency should: (1) ensure the active participation of women in the development process; and (2) take into account the perspectives of the poor in the development process. Establishes in the Department of the Treasury the Enterprise for the Americas Facility to support improvement in the lives of the people of Latin America and the Caribbean through market-oriented reforms and economic growth with actions to promote debt reduction, investment reforms, and community based conservation and sustainable use of the environment. Makes eligible for Facility benefits Latin American or Caribbean countries that: (1) have in effect, received approval for, or are making progress toward, specified International Monetary Fund arrangements and structural or sectoral adjustment loans from the International Bank for Reconstruction and Development or the International Development Association; (2) have put in place major investment reforms in conjunction with an Inter-American Development Bank loan or are implementing or making progress toward an open investment regime; and (3) have agreed with commercial bank lenders on a financing program for debt or debt service reduction. Authorizes the President to reduce the amount owed to the United States (as a result of concessional loans made pursuant to the Foreign Assistance Act of 1961 or predecessor foreign economic assistance legislation) by any country eligible for Facility benefits. Sets forth requirements with respect to the exchange of obligations, repayment of principal, and interest on new obligations issued by beneficiary countries. Requires beneficiary countries that enter into Environmental Framework Agreements to establish Enterprise for the Americas Environmental Funds. Authorizes the Secretary of State to enter into Environmental Framework Agreements concerning the operation and use of Environmental Funds with countries eligible for Facility benefits. Directs administering bodies in each beneficiary country to administer the Environmental Funds and to make grants for environmental activities. Requires grants from the Funds to be used for activities that link the conservation and sustainable use of natural resources with local community development. Subjects grants of more than $100,000 to veto by the U.S. Government or the government of the beneficiary country. Establishes an Environment for the Americas Board to: (1) advise the Secretary on the negotiations of Environmental Framework Agreements; (2) ensure that a suitable administering body is identified for each Environmental Fund; and (3) review the programs, operations, and fiscal audits of administering bodies. Declares that the President should encourage other official creditors of beneficiary countries whose debt is reduced under this Act to provide debt reduction to such countries. Requires the President to ensure that Environmental Funds are able to receive donations from private and public entities and private creditors of beneficiary countries. Permits military assistance and sales to be delivered to the armed forces of any Latin American or Caribbean country only with the prior approval of such a country's civilian government. Earmarks a specified amount of funds from economic support and development assistance and assistance from the Development Fund for Africa for assistance for disadvantaged South Africans. Prohibits support to organizations financed or controlled by the Government of South Africa. Requires priority in providing such assistance to be given to South African nongovernmental organizations whose staff are selected on a nonracial basis and which have the support of the disadvantaged communities being served. Extends a certain waiver of a prohibition on assistance to Pakistan if the President certifies that Pakistan does not possess a nuclear explosive device and that the proposed U.S. assistance program will reduce the risk that Pakistan will possess such device. Prohibits the allocation of assistance or the sale or transfer of defense articles or services for Pakistan for FY 1992 and 1993 unless such certification is made. Amends the Agricultural Trade Development and Assistance Act of 1954 to increase the number of representatives on the Environment for the Americas Board. Title VI: Special Authorities, Restrictions, Reports, General Provisions, and Technical and Conforming Amendments - Chapter 1: Special Authorities, Restrictions, and Reports - Amends the Foreign Assistance Act of 1961 to revise provisions concerning the transfer of funds between accounts. Prohibits: (1) transfers to increase amounts for foreign military financing; and (2) the transfer of funds for the housing and urban development guarantee program and funds for development assistance or assistance under the Development Fund for Africa. Raises the ceilings on the amounts of assistance provided under the Foreign Assistance Act of 1961 that may be provided to any one country. Exempts from such limitation assistance for countries that are the victims of active (currently, Communist or Communist-supported) aggression. Revises provisions concerning assistance for unanticipated contingencies. Prohibits such assistance from being provided for foreign military financing or international military education and training. Raises the annual ceiling on such assistance. Authorizes the President to transfer unobligated funds (without regard to the 20 percent increase limitation) to provide assistance to a country that has recently emerged or is in the process of emerging: (1) as a democracy; or (2) from civil strife and has a democratically elected government or is making progress toward a democratic form of government. Authorizes the President to adopt as a U.S. contract or obligation any contract with a U.S. or third-country contractor that had been funded with assistance prior to the termination of such assistance. Applies assistance termination provisions to any provision of law concerning such terminations. Exempts from restrictions on foreign assistance (except for countries that support terrorism) assistance for: (1) child survival activities; (2) the prevention and control of AIDS; (3) the needs of displaced children; (4) environmentally sound, sustainable resource management; and (5) efficient energy systems. Revises prohibitions concerning restrictions on assistance. Adds to the list of restrictions prohibitions on assistance for: (1) a country whose government engages in a consistent pattern of human rights violations; (2) a country whose elected head of government is deposed by a military coup; (3) projects designed to increase exports of agricultural, textile, or apparel commodities from developing countries if such exports would be in competition with U.S. exports or be expected to cause injury to U.S. exporters of the same or a similar commodity; and (4) a country that provides lethal military equipment to a terrorist government. Exempts from such prohibition assistance: (1) that is important to U.S. national interests, provided that such assistance will further U.S. nonproliferation objectives; (2) for the alleviation of suffering resulting from a natural or manmade disaster; (3) that benefits poor people; and (4) that will be furnished through nongovernmental organizations to promote respect for human rights and democracy. Prohibits the provision of such assistance until the President reports to the appropriate congressional committees. Requires the President to maintain a list of Communist countries for purposes of restricting assistance. Authorizes the President to remove or exempt a country from the list or prohibitions on assistance, provided that such removal or exemption is reported to the appropriate congressional committees. Prohibits assistance to any country which is more than one year in arrears to the U.S. Government on loan payments under the Foreign Assistance Act of 1961 or former authorities of the Arms Export Control Act. Applies prohibitions on the use of development assistance for abortions or involuntary sterilizations to the use of assistance for Subsaharan Africa or the Philippines for such purposes. Requires funds for voluntary family planning services to be available only for projects which offer a broad range of family planning methods and services. Consolidates and revises provisions concerning prohibitions on assistance to countries engaged in transfers of nuclear materials. Outlines required elements of annual congressional presentation documents on foreign assistance. Revises provisions regarding: (1) U.S. assistance policies and human rights; and (2) congressional notification for program changes. Requires the President to submit quarterly reports to the appropriate congressional committees on the funds obligated for development and economic support assistance. Directs the President to report triennially to the Speaker of the House and the chairman of the Senate Foreign Relations Committee on: (1) the percentage of the budget of each country receiving development or economic assistance that is devoted to military purposes; and (2) the degree to which such country is using its foreign exchange or other resources to acquire military equipment. Chapter 2: Administrative and General Provisions - Revises provisions regarding presidential authorities under this Act. Authorizes the President to designate an agency to administer foreign assistance programs. Revises provisions concerning the allocation of funds and reimbursement among agencies. Permits funds to be used for programs under the Agricultural Act of 1949 and the Food for Progress Act of 1985. Removes funding limitations on assistance for the construction of living quarters, offices, schools, and hospitals abroad and for assistance to schools educating dependents of personnel abroad. Permits economic and development assistance funds to be used to reimburse Federal or State agencies or institutions of higher education that detail employees for economic or development assistance programs that require special technical skills. Excludes such employees from applicable personnel ceilings during the detail period. Provides that if an amount appropriated for any fiscal year pursuant to this Act is less than the authorization amount and the provision calls for earmarked funds, such funds shall be deemed to be reduced to an amount bearing the same ratio to such funds as the amount appropriated bears to the authorization amount. Exempts funds for Israel and Egypt from such reduction. Sets forth provisions concerning the generation and use of local currencies. Revises provisions concerning the use of local currencies owned by the United States. Authorizes nongovernmental organizations to invest local currencies accrued as a result of economic assistance provided by this Act and other specified Acts and to use interest earned on investments for assistance purposes. Revises provisions concerning the use of private enterprise for the procurement of commodities and defense articles. Authorizes the use of Federal facilities for technical assistance purposes when such facilities are not competitive with private enterprise. Revises provisions concerning procurement standards and procedures. Allows (currently, requires) the use of excess personal property or property already owned by a Federal agency (if a substantial savings would occur) in lieu of, or supplementary to, the procurement of new items for U.S.-assisted programs. Revises provisions concerning the use of excess property. Removes a ceiling on the amount of domestic excess property that may be held. Prohibits excess property from being used for economic assistance purposes unless approval is given and the President makes specified determinations regarding such property. Authorizes the use of economic assistance funds to pay transportation charges on shipments by the American National Red Cross and by registered U.S. private voluntary organizations. Revises provisions concerning personnel. Permits personnel detailed to foreign governments or international organizations to be assigned on a leave without pay status. Authorizes the detailing of Department of Defense personnel to any civil office to carry out this Act. Revises provisions concerning discrimination against U.S. personnel. Chapter 3: Technical and Conforming Provisions - Incorporates provisions of the Foreign Assistance Act of 1961 concerning the Assistant Secretary of State for Human Rights and Humanitarian Affairs into another Act. Prohibits U.S. courts from declining on the ground of the Federal Act of State Doctrine to make a determination on the merits of international law in any case in which claim of title or right to property is asserted by any party, based upon a confiscation after January 1, 1959, by a state in violation of international law. Exempts from such prohibition cases in which: (1) an act of a foreign state is not contrary to international law or cases with respect to a right to property acquired pursuant to an irrevocable letter of credit issued in good faith prior to the time of taking; or (2) the President determines that application of such doctrine is required by U.S. foreign policy interests. Amends Federal provisions governing coins and currency to grant the Secretary of the Treasury: (1) responsibility with respect to foreign credits owed to or by the United States; and (2) sole authority to establish for all foreign currencies or credits the exchange rates at which such currencies are to be reported by Federal agencies. Authorizes the Foreign Claims Settlement Commission, at the request of the President, to report on the value of any property of any U.S. person expropriated by a foreign government. Redesignates the Trade and Development Program as the Trade and Development Agency. Makes technical and conforming amendments to specified Acts. Repeals specified Acts. Title VII: Latin America and the Caribbean - Chapter 1: El Salvador - Reserves this portion of the bill for provisions relating to El Salvador. Chapter 2: Other Provisions Pertaining to Central America - Declares that it shall be U.S. policy to: (1) support Central American countries in efforts to build democracy, restore peace, establish respect for human rights, expand economic opportunities, and improve living conditions; (2) support dialogue as the proper means of resolving armed conflicts in Central America; (3) assist in the implementation of, and secure international cooperation and support for, recommendations of the International Commission on Central American Recovery and Development; (4) support the United Nations Development Program for its Special Plan of Economic Cooperation for Central America; (5) organize a partnership among donor countries and Central American countries to mobilize resources and promote a forum for dialogue on issues of development, democracy, social justice, and human rights; and (6) support and promote the Enterprise for the Americas Initiative to assist Central American countries in opening their economies and managing their foreign debt. Prohibits the provision of military aircraft to Central American countries during FY 1992 and 1993 unless the appropriate congressional committees are notified in advance. Requires the Secretary of State to notify such committees whenever any helicopters or other military aircraft are provided to such countries by any foreign country. Prohibits the provision of foreign military financing to Guatemala during FY 1992 and 1993 except as provided by this Act. Establishes the Demobilization and Transition Fund for Guatemala. Authorizes the President to transfer amounts made available for foreign military financing to the Fund. Makes funds available only upon notification to the appropriate congressional committees that the Guatemalan Government and the Guatemalan National Revolutionary Unit have agreed to a ceasefire. Permits such funds to be available only for: (1) costs of demobilization, retraining, relocation, and reemployment in civilian pursuits of former combatants; and (2) costs of monitoring the ceasefire and permanent settlement. Prohibits the authorities of the Defense Trade and Export Control Act from being used to sell to the Guatemalan Government, or issue licenses for the export to Guatemala of: (1) weapons or ammunition; or (2) aircraft, unless the aircraft are unarmed and the Guatemalan Government has agreed that they will not be armed. Permits FY 1992 and 1993 development and economic support assistance and assistance under the Agricultural Trade Development and Assistance Act of 1954 for Guatemala to be used only by civilian agencies and nongovernmental organizations. Requires such assistance to be targeted for: (1) programs that address poverty, basic human needs, and environmental concerns; (2) the improvement of democratic institutions and the promotion of political pluralism; (3) the National Reconciliation Commission; (4) fiscal reform and administration; or (5) programs that promote trade and investment. Prohibits such assistance from being used for partisan political purposes or as an instrument of counterinsurgency. Waives assistance target requirements if the President notifies the appropriate congressional committees that Guatemala has made progress in eliminating human rights violations and in bringing to trial those responsible for major human rights cases. Declares that the President should: (1) take into account the extent to which the Nicaraguan Government has brought the armed forces under civilian control and undertaken investigations into, and prosecution of those responsible for, human rights violations prior to providing assistance for FY 1992 and 1993; and (2) consider the extent to which foreign military financing for Nicaragua will further the goals of strengthening civilian control over the military, ending human rights abuses, and stemming the export of lethal military equipment prior to providing such financing for such fiscal years. Prohibits foreign assistance for any member of the Nicaraguan resistance who has not disarmed or is not abiding by the terms of the cease-fire agreement and the addenda to the Toncontin Agreement. Expresses the sense of the Congress that the Nicaraguan Government should expedite the processing of claims by private citizens based on expropriation of property by the Sandinista government. Earmarks a specified amount of FY 1992 and 1993 economic support assistance for Central America for the Concerted Plan of Action in Favor of Central American Refugees, Returnees and Displaced Persons. Expresses the sense of the Congress with respect to strengthening democratic legislatures in Central America. Chapter 3: The Caribbean - Congratulates Haiti on its transition to democracy. Expresses the sense of the Congress that the United States should: (1) provide significant and sustained assistance to the Haitian Government so long as it abides by the Haitian Constitution and respects freedom of expression and human rights; (2) continue to provide substantial assistance to Haitian private voluntary organizations to institutionalize democracy and promote economic development; and (3) provide a specified amount of economic assistance to Haiti during FY 1992 and 1993. Encourages the Government of the Dominican Republic to improve respect for the human rights of Haitian laborers engaged in the sugar cane harvesting industry in the Dominican Republic. Withholds a specified amount of economic support assistance from the Dominican Republic until the President notifies the appropriate congressional committees of the steps taken by the Government of the Dominican Republic to improve such human rights. Permits assistance under the Foreign Assistance Act of 1961 and the Agricultural Trade Development and Assistance Act of 1954 to be provided to the Government of Guyana only if the President reports to the appropriate congressional committees that such government is in power as a result of free and fair elections. Exempts from such restriction international narcotics control assistance or assistance for the holding of free and fair elections. Expresses the sense of the Congress that following the submission of the report regarding Guyana, the United States should provide significant and sustained assistance for Guyana under such Acts. Earmarks a specified amount of such assistance for basic human needs. Condemns the armed forces of Suriname for the December 1990 coup and for disregard for civilian authority. Urges the armed forces to permit a peaceful transfer of power to the elected civilian government. Calls upon the President to withhold assistance from Suriname until a peaceful transfer of power has taken place and to use assistance to bolster civilian rule. Chapter 4: Andean Initiative - Authorizes appropriations for development and economic support assistance for FY 1992 and 1993 for Andean countries. Requires priority in the use of funds for Bolivia and Peru to be given to support programs that focus on providing coca farmers with alternative sources of income. Declares that specified amounts of such assistance should be used for law enforcement assistance, protection against narco-terrorist attacks, and assistance for human rights offices in Bolivia, Colombia, and Peru. Authorizes appropriations for FY 1992 and 1993 for foreign military financing assistance for Andean countries. Requires such assistance to be designed to: (1) enhance the ability of the recipient government to control illicit narcotics production and trafficking; (2) strengthen respect for human rights and the rule of law to control narcotics production and trafficking; and (3) assist the armed forces of the Andean countries in their support roles for such countries' law enforcement agencies. Permits the provision of such assistance only if: (1) such country has a democratic government; and (2) the government of such country does not engage in a consistent pattern of human rights violations. Permits such assistance to be used for certain law enforcement training and equipment for purposes of narcotics control efforts. Limits the amount of military and law enforcement assistance for Bolivia, Colombia, and Peru. Prohibits Peru's Sinchi Police from being considered as a law enforcement unit. Permits assistance or the transfer of excess defense articles under this Act to an Andean country only if the President determines that: (1) such country is implementing programs to reduce the flow of cocaine to the United States; and (2) the armed forces and law enforcement agencies of such country are not engaged in a consistent pattern of human rights violations and the government of such country has made progress in protecting human rights. Exempts from the human rights condition assistance for programs providing coca farmers with alternative sources of income. Waives provisions of law that prohibit assistance to countries in arrears on loan payments to the United States with respect to narcotics-related assistance to Andean countries. Chapter 5: Other Provisions Pertaining to the Region - Makes assistance available for countries with democratically-elected governments in Latin America and the Caribbean. Prohibits the use of such funds for: (1) lethal equipment; and (2) the participation of Department of Defense personnel and members of the U.S. armed forces in law enforcement training. Permits law enforcement training in the Caribbean to be provided only by the Department of Justice International Criminal Investigative Training Assistance Program. Makes specified amounts available for such assistance. Amends the Foreign Assistance Act of 1969 to authorize appropriations for the Inter-American Foundation for FY 1992 and 1993. Revises provisions concerning the composition of the Foundation's Board of Directors and the principal office. Prohibits foreign military financing or sales to Chile under the Defense Trade and Export Control Act during FY 1992 and 1993 unless the appropriate congressional committees are notified in advance. Earmarks development and economic support assistance for the Central American Journalism Program and Regional Administration of Justice Program's Center for the Administration of Justice to support democracy building activities in the region. Title VIII: Europe and the Middle East - Chapter 1: Middle East - Earmarks funds for economic support assistance, foreign military financing grants, and assistance for stockpiles for Israel for FY 1992 and 1993. Makes certain amounts of military financing available for advanced weapon systems research and development and the procurement of defense articles and services. Permits the drawdown of a specified amount of defense articles and services from the Department of Defense and military education and training for Israel. Reduces such amount by the value of articles, services, and education and training provided to Israel under the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1991. Requires such drawdowns, to the maximum extent feasible, to be made from units withdrawn from Europe. Earmarks funds for economic support assistance and foreign military financing for Egypt for FY 1992 and 1993. Permits such assistance to include support for law enforcement training. Requires specified amounts of amounts allocated by the Agency for International Development (AID) during FY 1992 and 1993 for democratic initiatives and human rights to be made available for the growth of indigenous nongovernmental organizations that contribute to pluralism, democracy, and respect for human rights and the rule of law in the Middle East. Earmarks specified amounts of FY 1992 and 1993 economic support assistance for the West Bank and Gaza Program and for regional cooperative projects in the Middle East. Earmarks specified amounts of FY 1992 and 1993 development assistance to finance projects under the Cooperative Development Program and cooperative development research among the United States, Israel, and developing countries. Expresses the sense of the Congress that the United States should support educational, cultural, and humanitarian activities that bring Israelis together with Palestinians living in the West Bank and Gaza. Sets forth U.S. policy with respect to Lebanon. Earmarks funds for economic support and development assistance for Lebanon for FY 1992 and 1993. Prohibits the sale of defense articles and services under the Defense Trade and Export Control Act and suspends the delivery of such articles and services to Lebanon unless the President submits to the appropriate congressional committees a report that: (1) sets forth the purpose and value of the articles and services to be provided; (2) identifies the intended end-user within the Lebanese Government of such articles and services; and (3) states that such articles and services will assist the Lebanese Government in establishing effective control of Lebanese territory and that sufficient safeguards exist to ensure that such articles and services will not benefit the Government of Syria. Prohibits assistance to Syria until the President reports to the House Foreign Affairs Committee and the Senate Foreign Relations Committee that the Goverment of Syria: (1) has demonstrated willingness to enter into negotiations with Israel; (2) does not deny its citizens the right to emigrate and does not impose taxes with respect to emigration; (3) is assisting the U.S. Government in obtaining the release of American hostages in Lebanon; (4) no longer supports international terrorist groups; (5) is withdrawing its armed forces from Lebanon; (6) is no longer acquiring chemical, biological, or nuclear weapons and will not use weapons currently in its arsenal to threaten its neighbors; (7) is cooperating with U.S. antinarcotics efforts and taking steps to remove members of the government who are involved in the drug trade; (8) has made progress in improving human rights; and (9) has extradited the Nazi war criminal Alois Brunner. Requires the President to report to the House Foreign Affairs Committee and the Senate Foreign Relations Committee on third country transfers of weapons and military equipment to Syria. Permits the transfer of equipment, supplies, or material captured from Iraq by U.S forces in Operation Desert Storm to the government of any Middle Eastern country only if specified congressional committees are notified in advance. Expresses the sense of the Congress that under international law and the terms of specified United Nations resolutions: (1) Iraq is liable for loss, damage, or injury to foreign governments, nationals, and corporations as a result of its invasion and occupation of Kuwait; and (2) Israel suffered damage as a result of Iraq's aggression and should be able to receive compensation from Iraq commensurate with damage suffered. Expresses the sense of the Congress that the United States should work with its Arab coalition partners to: (1) encourage their support for efforts to achieve peace and stability in the Middle East and to settle the Arab-Israeli conflict; and (2) take specific steps with respect to Israel and terrorism. Requires the President to submit to the appropriate congressional committees an analysis of: (1) the Middle East arms balance based upon the cumulative impact of transfers of defense articles and services to the region by all countries; (2) how U.S. policy goals are advanced by U.S. transfers; (3) what type of military or economic compensation is required to countries whose qualitative edge the United States is committed to maintaining, how such compensation is to be funded, and the steps taken to preserve such qualitative edge and areas requiring attention due to a decline in comparative advantage; and (4) defense articles and services obtained by Middle East countries from sources other than the United States. Expresses the sense of the Congress that the United States should obtain rescission by the United Nations General Assembly of Resolution 3379 (maintains that Zionism is a form of racism) and calls upon the General Assembly to rescind such resolution. Expresses the sense of the Congress that: (1) the 1981 Israeli preemptive strike against the Iraqi nuclear reactor at Osirak was a legitimate and justifiable exercise of self-defense which also reduced the threat of Iraqi nuclear aggression against countries bordering Iraq; and (2) the United States should seek the repeal of United Nations Security Council Resolution 487 which condemned the strike. Prohibits sales from being made to Kuwait under the Defense Trade and Export Control Act and licenses from being issued for the export to Kuwait of any item on the U.S. Munitions List unless the President certifies to the appropriate congressional committees that the Kuwaiti Government has: (1) put an end to arbitrary arrest, torture, and extrajudicial killing by Kuwaiti armed forces and is making an effort to stop such acts by nongovernmental resistance groups; (2) clarified the legal basis for arrest and detention; (3) ensured that those detained have access to legal counsel and to human rights groups; (4) ensured the rights to a speedy trial, due process, and an appeal of any sentence to detainees; (5) the intention to extend the right to vote to all citizens irrespective of sex or literacy; and (6) established a date for parliamentary elections. Chapter 2: Eastern Mediterranean - Earmarks funds for economic support assistance for Cyprus for FY 1992 and 1993. Permits such assistance to be used only for scholarships or bicommunal projects. Earmarks funds for foreign military financing assistance for Greece and Turkey for FY 1992 and 1993. Expresses the sense of the Congress that the President should support Turkey's inclusion in the full range of political, economic, and military institutions in Europe. Supports the United Nations Secretary General's peace initiatives regarding Cyprus and encourages both parties on Cyprus to cooperate with the Secretary General. Chapter 3: Support for East Europe Democracy - Amends the Support for East European Democracy (SEED) Act of 1989 to make eligible for SEED benefits any Eastern European country taking steps toward: (1) political pluralism and economic reform; (2) respect for human rights; and (3) a willingness to build a friendly relationship with the United States. (Currently, most SEED programs target Hungary and Poland.) Extends specified structural adjustment, debt reduction, and stabilization assistance to such countries. Authorizes AID to provide assistance to support private sector development in Eastern Europe and U.S. participation in capital projects. Permits the President, acting through the AID Administrator, to use funds for labor market transition assistance to eligible Eastern European countries. Extends technical assistance and training for labor market transition assistance to eligible Eastern European countries. Removes a provision authorizing appropriations for Peace Corps programs in Poland and Hungary. Extends assistance for the development of Peace Corps and credit unions to eligible Eastern European countries. Applies provisions governing the use of Polish currency generated by agricultural assistance to local Eastern European currencies generated by such assistance. Repeals provisions concerning: (1) OPIC support for Poland and Hungary; (2) Trade and Development Program activities in Poland and Hungary; (3) tax treatment of loans with below market interest rates for Poland and Israel; and (4) the trade credit insurance program for Poland. Extends Export-Import Bank programs to Czechoslovakia. Urges the President to seek bilateral investment treaties with eligible Eastern European countries to establish a legal framework for U.S. investment in such countries. Extends educational and cultural exchange programs and the scholarship partnership program to eligible Eastern European countries. Removes funding provisions concerning the scholarship partnership program. Authorizes the AID Administrator to use funds available for the scholarship partnership program for scholarships to enable Eastern European students to study at American institutions of higher education in Europe. Extends assistance for the support of democratic institutions and environmental protection and energy efficiency activities to eligible Eastern European countries. Authorizes the President, acting through the AID Administrator and the Administrator of the Environmental Protection Agency, to provide assistance for environmental and energy activities in eligible Eastern European countries, with emphasis on assistance for policies encouraging and providing incentives for end-use energy efficiency and conservation and reliance on renewable energy resources. Requires the President to work with officials of the Government of Czechoslovakia to establish a regional program to facilitate cooperative activities to address the public health aspects of environmental degradation. Earmarks funds for such program. Revises provisions concerning medical assistance to Poland. Authorizes the President, acting through the AID Administrator, to: (1) provide medical training, health care planning assistance, and other assistance to improve health care to eligible Eastern European countries; and (2) provide assistance to support the infrastructure for a housing sector in such countries. Redesignates the SEED Information Center System as the Eastern European Business Information Center System. States that the System should develop special information on business opportunities in the communications, broadcasting, and information field for use by U.S. industry and the SEED Program coordinator. Repeals a provision concerning economic and commercial officers at U.S. embassies and missions in Hungary and Poland. Authorizes and allocates appropriations for SEED programs for FY 1992 and 1993. Sets forth provisions concerning the reallocation or reduction of such funds. Chapter 4: Other Provisions Relating to Europe - Amends the Anglo-Irish Agreement Support Act of 1986 to make economic support funds available for U.S. contributions to the International Fund. Removes a certification requirement under such Act and revises reporting requirements. Earmarks economic support assistance for FY 1992 and 1993 for assistance to Estonia, Latvia, and Lithuania and to eligible recipients in the Soviet Union that request U.S. technical assistance in support of democratic or market-oriented reforms. Permits such assistance to be provided only through the government of such state or republic or through nongovernmental organizations. Defines an "eligible recipient in the Soviet Union" as the government of any republic or local government that was elected through free and fair elections or any indigenous nongovernmental organization that promotes democratic and market-oriented reforms. Authorizes additional appropriations for FY 1992 and 1993 for disaster assistance to Armenia and to carry out the Soviet-East European Research and Training Act of 1983. Revises reporting requirements under such Act. Expresses the sense of the Congress with respect to U.S. policy toward Yugoslavia and the situation in Kosovo province. Expresses the sense of the Congress that regulations issued pursuant to the Defense Trade and Export Control Act should be amended to allow the importation into the United States of sporting and hunting rifles and shotguns manufactured in Poland, Hungary, or Czechoslovakia. Expresses the sense of the Congress that: (1) President Bush should place Soviet cessation of aid to Cuba high on the list of objectives of the upcoming U.S.-Soviet summit; (2) a Soviet cutoff of aid to Cuba should remain a high priority in U.S.-Soviet relations until the Soviet Union ends its economic and military support for the Castro regime; and (3) a democratically-elected government in Cuba should remain a goal of American foreign policy. Title IX: Asia and the Pacific - Chapter 1: East Asia and the Pacific - Requires the President, in determining whether to furnish assistance or make sales of defense articles or services to Burma (Myanmar) during FY 1992 and 1993, to make a specified certification with respect to international narcotics control in Burma and to take into account whether the Burmese Government has: (1) ceded legal authority to a civilian government as mandated by the 1990 elections; (2) released persons arrested for the peaceful expression of their political views; and (3) ceased harassment of persons and political parties attempting to exercise freedoms of expression, association, and assembly. Sets forth notification requirements with respect to certain assistance for Burma. Declares that the Congress would welcome decisions by the President to: (1) impose economic sanctions on Burma under the Customs and Trade Act of 1990; and (2) call upon industrialized countries to impose similar sanctions upon Burma. Expresses the sense of the Congress with respect to the settlement of the Cambodian conflict and genocide. Makes available FY 1992 and 1993 economic support assistance for humanitarian and development assistance for Cambodians along the Thai-Cambodia border and throughout Cambodia. Sets forth conditions on the disbursement of such assistance. Prohibits any funds from being used to promote or augment the capacity of the Khmer Rouge to conduct military or paramilitary operations in Cambodia or Indochina. Earmarks funds for FY 1992 and 1993 for humanitarian assistance to children and war victims in Cambodia. Authorizes the President to use funds under the Foreign Assistance Act of 1961 for: (1) nonmilitary training of noncommunist Cambodians in the United States; and (2) an international relief and reconstruction program in Cambodia. Prohibits the provision of FY 1992 and 1993 foreign military financing assistance and assistance for international military education and training to Fiji unless the President certifies to the Congress that Fiji has held elections in which there has been broad participation by all communities. Sets forth provisions concerning Malaysia's policy of denying first asylum to Indochinese asylum-seekers. Requires the President to allocate the amount of funds requested in the congressional presentation materials for the South Pacific regional program for FY 1992 unless he notifies the appropriate congressional committees in accordance with reprogramming procedures. Makes available specified amounts of economic support, development, and international disaster assistance for such program. Earmarks development assistance funds for scholarships for study at postsecondary institutions in the United States. Commends Taiwan for sharing in the responsibilities associated with Operation Desert Shield and Desert Storm. Calls on the President to accept future contributions from Taiwan for multinational operations regardless of the positions of China. Expresses the sense of the Congress that: (1) the United States should give the highest priority to accounting for Americans missing in Southeast Asia and to negotiating the return of any Americans still held captive in Southeast Asia; (2) the United States should heighten public awareness of the missing Americans through dissemination of factual data; (3) progress on accounting for missing Americans and other humanitarian issues will affect the process of normalizing relations between the United States and Vietnam; and (4) the President should provide specified amounts to support humanitarian projects in Laos for efforts to resolve questions concerning Vietnam prisoners of war or those missing in action. Expresses the sense of the Congress that the President should encourage the Organization for Economic Cooperation and Development (OECD) to consider for OECD membership the Governments of South Korea, Taiwan, Hong Kong, and Singapore. Makes available specified amounts of economic support, development, and international disaster assistance for humanitarian assistance for displaced Burmese nationals in Thailand and Burma. Prohibits the sale, and the issuance of licenses for export, to China of any item on the U.S. Munitions List for military end-users if the President determines that: (1) any U.S. defense article or technology was used in certain missiles or aircraft transferred to Iran, Iraq, Libya, Pakistan, or Syria by China in contravention of the Defense Trade and Export Control Act; and (2) any chemical weapon or nuclear equipment or materials were transferred to such countries by China. Makes such prohibition inapplicable to the sale or export of systems or components designed for inclusion in civil products and controlled as defense articles only for purposes of export to a controlled country, unless the President determines that the intended recipient is the Chinese military or security forces. Chapter 2: South Asia - Authorizes the President to make available development and economic support assistance for humanitarian assistance to the Afghan people and for reconstruction efforts in Afghanistan and the establishment of a broad-based freely-elected Afghan Government. Sets forth provisions regarding: (1) land mines in Afghanistan; and (2) the termination of military assistance to, and a political settlement in, Afghanistan. Congratulates Bangladesh on the transition to a democratically-elected government and welcomes the economic adjustment program being implemented in coordination with the International Monetary Fund. Urges the President to provide debt relief under the Agricultural Trade Development and Assistance Act of 1954 to Bangladesh. Requires the President to allocate the amount of funds requested in the congressional presentation materials for Nepal for FY 1992 unless he notifies the appropriate congressional committees in accordance with reprogramming procedures. Makes available specified amounts of economic support, development, and international disaster assistance for Nepal if a democratically-elected government assumes office pursuant to free and fair elections. Sets forth provisions concerning human rights abuses in Sri Lanka. Requires the President, in determining whether to provide assistance or make sales of defense articles or services to Sri Lanka during FY 1992 and 1993, to take into account whether the Government of Sri Lanka has: (1) established a public register of detainees and ensured that detainees have access to lawyers and family members; (2) taken steps to deter disappearances and killings of civilians by persons under control of government forces; (3) taken measures to minimize civilian casualties in combat operations in the north and the east; and (4) made serious efforts to investigate and prosecute those involved in the murder of journalist Richard DeZoysa. Encourages the Government of Sri Lanka to provide human rights education and training. Chapter 3: Industrial Cooperation Projects in China and Tibet - Expresses the sense of the Congress that U.S. nationals conducting industrial cooperation projects in China or Tibet should adhere to specified principles, including to: (1) suspend the use of merchandise manufactured by convict or forced labor; (2) seek to ensure political and religious freedom without fear of one's employment status; (3) ensure that methods of production do not pose a danger to project employees and the surrounding environment; (4) strive to use business enterprises that are not controlled by China; (5) promote human rights in China; and (6) prohibit compulsory population control activities on the premises of such projects. Requires the Secretary of State to forward a copy of such principles to member nations of the OECD and encourage them to promote such principles. Requires each U.S. national to register with the Secretary and indicate whether they agree to implement such principles. Sets forth specified reporting requirements. Title X: Africa - Chapter 1: Authorizations of Assistance for Africa - Amends the African Development Foundation Act to authorize appropriations for the African Development Foundation for FY 1992 and 1993. Requires funds from the Development Fund for Africa to be used to assist sector projects supported by the SADCC. Urges the President to use diplomatic means to protect the security of SADCC projects and urges the Government of South Africa to respect the territorial integrity of SADCC states and to refrain from military aggression across its borders. Earmarks funds for FY 1992 and 1993 for economic support assistance for Subsaharan Africa. Welcomes the commitment of several governments in Subsaharan Africa to move toward democratic and multiparty systems of government. Urges the President to increase assistance to promote the development of democratic institutions in Africa. Directs the admninistrator of the administering agency to provide for the establishment of an African Center for Conflict Resolution to analyze, research, and resolve conflicts in Africa. Requires funds from the Development Fund for Africa to be made available for the Center. Chapter 2: Provisions Relating to Specific Countries - Expresses the sense of the Congress that: (1) the Government of Angola and the Union for the Total Independence of Angola (UNITA) should be commended for their willingness to enter into negotiations to reach a ceasefire agreement in the Angolan conflict and to reach agreement on a date for national elections; and (2) the United States should continue to support negotiations between the leaders of the Angolan Government and UNITA to achieve an agreement for a process of reconciliation among Angolans. Requires the President, in determining whether to provide assistance to Burundi during FY 1992 and 1993, to take into account that the Government of Burundi has: (1) made progress in reforming its military by engaging in a massive Hutu recruitment program; (2) taken steps to reverse discrimination against the Hutu; and (3) embarked on a major repatriation to accommodate the return of Hutu. Sets forth U.S. policy with respect to Ethiopia. Urges the President to impose diplomatic and economic pressures upon the Ethiopian Government if such Government fails to act in good faith to resolve its internal wars peacefully and to improve respect for human rights. Requires the President to report to the appropriate congressional committees every 90 days on Ethiopia's actions with respect to internal wars, human rights, and economic reform. Sets forth U.S. policy with respect to Kenya. Suspends economic and military assistance and sales to Kenya. Waives such suspension if the President reports to the appropriate congressional committees that the Government of Kenya is taking steps to: (1) charge and try or release all prisoners; (2) cease physical abuse or mistreatment of prisoners; (3) respect the independence of the judiciary; and (4) respect freedom of expression. Declares that it is U.S. policy to commit heightened diplomatic resources to resolving the fundamental political conflicts in Liberia. Makes available international disaster assistance funds for civil strife, rehabilitation, and general recovery in Liberia. Permits the President to transfer funds obligated for economic support assistance for Liberia to fund peacekeeping efforts in Liberia by the Economic Community of West Africa Monitoring Group. Authorizes assistance to Liberia under the Foreign Assistance Act of 1961 only if the President reports to the appropriate congressional committees that the Government of Liberia has achieved progress toward reconciliation among parties to the conflict in Liberia. Commends the Malawi Government's response to the influx of refugees from Mozambique. Condemns the abuse of human rights of Malawian citizens. Urges President Banda to release prisoners of conscience, end incommunicado detention and torture of prisoners, and permit freedom of speech and association in Malawi. Prohibits foreign military financing for the Malawi Young Pioneers and permits such assistance only for the Malawian military's effort to secure the Nacala Railroad and for activities to assist in the Mozambique peace process. Sets forth U.S. policy with respect to Mozambique. Conditions the provision of economic support assistance and foreign military financing for FY 1992 and 1993 for Mozambique on steps by the Government of Mozambique to increase respect for human rights and promote a political settlement to the conflict in such country. Encourages a peaceful and democratic solution to the problems in Somalia. Declares that it is U.S. policy to commit heightened diplomatic resources to resolving the fundamental political conflicts in Somalia. Permits foreign military financing, international military education and training, and economic support assistance for FY 1992 and 1993 to be provided to Somalia only if the President reports to the appropriate congressional committees that the Government of Somalia has made progress toward democratization and respect for human rights. Declares that the President, in providing assistance for refugees in Somalia under the Agricultural Trade Development and Assistance Act of 1954, should ensure that: (1) an impartial counting of eligible beneficiaries of food assistance by donors has been completed; (2) none of the beneficiaries belong to military or paramilitary units; and (3) the amount of such assistance does not significantly exceed the number of beneficiaries of such assistance. Permits international disaster assistance for Somalia to be used for civil strife relief, rehabilitation, and general recovery in Somalia. Sets forth U.S. policy toward South Africa. Expresses the sense of the Congress that: (1) the United States should support the elimination of apartheid and the establishment of democratic majority rule in South Africa through a policy to bring about a nonracial democracy; (2) U.S. firms and the Government should provide specified assistance to disadvantaged South Africans; and (3) the President should seek the cooperation of U.S. allies in Western Europe and Japan to join in multilateral initiatives to aid disadvantaged South Africans. Requires funds to be made available from the Development Fund for Africa for assistance for the development and financing of low-cost housing in South Africa. Declares that it is U.S. policy to encourage negotiations between the Government of Sudan and the Sudanese People's Liberation Army to end the conflict between these factions. Prohibits economic support assistance (except for basic human needs) and foreign military financing and for Sudan during FY 1992 and 1993. Makes such prohibition inapplicable if the President reports to the appropriate congressional committees that the Government of Sudan is making progress toward respect for human rights and democratization. Prohibits the provision of foreign military financing, international military education and training, and economic support and development assistance to Zaire during FY 1992 and 1993 unless the President reports to the appropriate congressional committees that free and fair elections have been held in Zaire. Chapter 3: United States Commission on Southern Africa - United States Commission on Southern Africa Act - Establishes the United States Commission on Southern Africa to solicit private sector funds to develop skilled personnel in South Africa and Namibia, particularly in middle management business and government positions, by providing for the training of disadvantaged South Africans and Namibians in the fields of education, health care, law, and housing. Authorizes the Commission to establish and provide funds for human resource development programs and to provide scholarships and internships for appropriate study and training. Prohibits the use of such funds for programs conducted by or through South African organizations which are financed or controlled by the Government of South Africa. Authorizes the use of such funds only for programs which clearly reflect the objective of an end to apartheid. Provides for the annual audit of the Commission by certified public accountants. Authorizes the U.S. Comptroller General to carry out an annual audit of the Commission. Directs the Commission to ensure that: (1) recipients of Commission assistance keep separate accounts of such assistance and records to facilitate effective audits; and (2) the Commission has access to such records. Makes Development Fund for Africa assistance available for a grant to the Commission. Chapter 4: Other Provisions - Expresses the sense of the Congress that: (1) special efforts should be undertaken to reduce trade barriers and to promote economic interchange between the United States and developing countries in Subsaharan Africa; and (2) the countries of Subsaharan Africa are to be applauded for their stance during the Persian Gulf conflict and commended for their support of the United States. Permits international military education and training to be provided to a Subsaharan African country only if the President considers whether: (1) that country has a government that was democratically-elected as the result of free and fair elections or is committed to respecting human rights and permitting freedom of expression and has achieved progress in a process of democratization; (2) the armed forces of such country are involved in human rights violations or the government of the country fails to respect human rights; and (3) the armed forces of such country or other elements of the government of that country are engaged in destabilization efforts aimed at any other country. Requires the President, when obligating funds for countries that do not meet such conditions, to report to the appropriate congressional committees on the reasons for providing such assistance. Provides for the transfer of a specified amount of funds from the Development Fund for Africa for contributions to the International Fund for Agricultural Development and the United Nations Educational and Training Program for Southern Africa. Exempts international narcotics control assistance or assistance provided through nongovernmental organizations for the holding of free and fair elections from the restrictions on assistance under this title. Provides that any sanction imposed by any State or governmental subdivision that is directed at South Africa or persons engaging in commercial or financial transactions in or with South Africa and that also applies to Namibia shall be null and void with respect to Namibia unless such sanction is consistent with Federal law. Title XI: Other Provisions - Amends the Peace Corps Act to extend the authorization of appropriations for the Peace Corps through FY 1993. United States Environmental Security and Foreign Policy Act of 1991 - Sets forth U.S. policy with respect to global environmental security. Gives the Secretary of State primary responsibility for overseeing environmental agreements and activities between the United States and foreign countries and international organizations and commissions. Requires the Secretary to report biennially to the Congress on: (1) multilateral environmental initiatives and negotiations concluded or in process; (2) bilateral agreements on the environment; (3) U.S. participation in, and support of, environment programs in international organizations and multilateral development banks; (4) international cooperation activities with respect to research and monitoring of environmental and natural resource conditions; and (5) environmental policies and activities of the United States in providing foreign assistance. Expresses the sense of the Congress with respect to the United Nations Conference on Environment and Development. Expresses the sense of the Congress that a major effort should be made to strengthen the right to food in international law to assure the access of all persons to adequate food supplies. Declares that the Secretary, through the U.S. representative to the United Nations, should propose to the United Nations General Assembly that a Declaration and a Convention concerning the right to food be adopted and submitted to countries for ratification. Expresses the sense of the Congress that a major effort should be made to reform and restructure the United Nations mechanism for responding to international disasters and other humanitarian emergencies. Requires the Secretary, through the U.S. representative to the United Nations, to develop a proposal for strengthening the United Nations response to such emergencies. Directs the AID Administrator to release the Institute Centroamericano de Administration de Empresas from its obligation to make payments to the U.S. Government on a loan made pursuant to a specified Alliance for Progress Loan Agreement.
Law· HRH.R. 2519 (102nd)enacted
United States · United States Congress · 3 June 1991
Departments of Veterans Affairs and Housing and Urban Development, and Independent Agencies Appropriations Act, 1992 - Title I: Department of Veterans Affairs - Makes appropriations for FY 1991 to the Department of Veterans Affairs for: (1) the Veterans Benefits Administration; (2) the Veterans Health Administration; and (3) departmental administration, including the Office of the Inspector General. Authorizes the transfer of funds among specified appropriations. Authorizes the use of appropriations to procure consultant services. Authorizes the use of certain appropriations to pay prior year accrued obligations for certain benefits. Title II: Department of Housing and Urban Development - Makes appropriations for FY 1992 for the Department of Housing and Urban Development (HUD) for: (1) housing programs; (2) community planning and development; (3) research and technology; (4) fair housing activities; and (5) management and administration, including the Office of the Inspector General and personal services and travel of departmental headquarters. Limits the amounts of specified loan obligations, including guarantee commitments of the Government National Mortgage Association. Makes funds available for the renewal of expiring low-income subsidy contracts. Makes funds available for grants to public housing agencies for use in eliminating drug-related crime in public housing projects. Makes funds available for the low-income moderate rehabilitation program to be used to assist homeless individuals. Transfers assets and liabilities of the revolving fund for rehabilitation loans to the revolving fund for liquidating programs under the Independent Offices Appropriation Act, 1955. Allows the following municipalities to retain land disposition proceeds from certain financially closed-out projects not paid to HUD: (1) the city of Vallejo, California; (2) the city of New London, Connecticut; and (3) the Housing Authority of the city of Jefferson, Missouri. Allows the cities of Newburyport and Malden, Massachusetts, to retain categorical settlement grant funds or urban renewal grant funds after the financial closeout of specified projects. Cancels the indebtedness of Calhoun Falls, South Carolina, relating to a public facilities loan. Limits the number of Senior Executive Service positions other than career-appointees in HUD. Amends the United States Housing Act of 1937 to establish a separate fair market rental rate for Monroe County, Pennsylvania. Amends the Cranston-Gonzalez National Affordable Housing Act and the Housing Act of 1959 to allow service coordinators in housing for the elderly projects. Amends the United States Housing Act of 1937 to give priority to public housing applications for new construction, acquisition, or acquisition and rehabilitation in areas with an adequate supply of housing for low-income families. Title III: Independent Agencies - Makes appropriations for FY 1992 to the: (1) American Battle Monuments Commission; (2) Consumer Product Safety Commission; (3) Court of Veterans Appeals; (4) Department of Defense-Civil for cemeterial expenses, Army; (5) Environmental Protection Agency (EPA); (6) Executive Office of the President for the Council on Environmental Quality and the Office of Environmental Quality, the National Space Council, and the Office of Science and Technology Policy; (7) Federal Emergency Management Agency; (8) General Services Administration for the Consumer Information Center; (9) Department of Health and Human Services for the Office of Consumer Affairs; (10) National Aeronautics and Space Administration (NASA); (11) National Credit Union Administration for the obligations of the Central Liquidity Facility; (12) National Institute of Building Sciences; (13) National Science Foundation; (14) Neighborhood Reinvestment Corporation; and (15) Selective Service System. Sets forth limitations on average employment in EPA headquarters. Makes funds available to the Interagency Council on the Homeless as authorized under the Stewart B. McKinney Homeless Assistance Act. Prohibits the use of funds by NASA to fund grants, contracts, or other agreements with an expected duration of more than one year when a primary effect of such grant, contract, or agreement is to provide a guaranteed customer base for or establish an anchor tenancy in new commercial space hardware or services unless an appropriations Act approves such new hardware or services. Authorizes the use of income derived from the National Aeronautics and Space Administration Endeavor Teacher Fellowship Trust Fund to award fellowships to U.S. nationals who are undergraduate students pursuing teaching degrees in elementary and secondary education in mathematics, science or technology disciplines. Prohibits the use of funds by NASA to administer, execute, or implement specified Federal regulations with respect to the liability of aerospace contractors in connection with poor workmanship. Title IV: Corporations - Authorizes certain corporations and agencies of HUD to make commitments without regard to fiscal year limitations as necessary to carry out provisions under the Government Corporation Control Act. Allows any collections by such corporations and agencies to be used for new loan or mortgage purchase commitments to the extent provided under this Act, with specified exceptions. Makes funds available for payment of expenditures of the Federal Savings and Loan Insurance Corporation (FSLIC) Resolution Fund and for the Office of Inspector General of the Resolution Trust Corporation. Title V: General Provisions - Specifies certain uses, limitations, and prohibitions on uses of funds appropriated by this Act. Requires FY 1992 pay raises to be absorbed within the levels appropriated in this Act. Prohibits the use of funds by HUD for first class travel of officials or employees unless required by medical necessity or on airplane flights longer than seven hours. Prohibits the use of funds by the Department of Veterans Affairs for any new lease of real property above a specified amount unless a report is submitted to the congressional Committees on Appropriations and a period of 30 days expires after submission of such report. Directs the Resolution Trust Corporation to report to the Congress at least once a month on its review of certain insolvent institution cases resolved by the FSLIC. Prohibits the use of funds to implement the Chief Financial Officers Act of 1990 (Public Law 101-576). Amends Federal law with respect to veterans medical care to extend from September 30, 1991 to September 30, 1992, the requirement for veterans to make copayments for medications. Amends the Omnibus Reconciliation Act of 1990 to extend through FY 1992 the amendments made to modify health care categories and copayments for veterans. Increases the amount made available for veterans medical care for use only for procurement of medical equipment. Provides that such veterans medical care provisions shall not take effect if the amount provided for medical care to the Department of Veterans Affairs is less than a specified amount plus reimbursements.
Bill· HRH.R. 2517 (102nd)referred
United States · United States Congress · 3 June 1991
Trauma Research Act of 1991 - Amends the Public Health Service Act to require the Director of the National Institutes of Health to establish a comprehensive program of conducting basic and clinical research on trauma, including research on diagnosis, treatment, rehabilitation, and general management of trauma. Requires the Director to submit a plan and an estimate of funding needs to the Congress. Requires the program to include: (1) studies regarding all phases of trauma care; and (2) research regarding trauma care for pediatric and geriatric patients. Authorizes grants to carry out the program. Establishes the Trauma Research Interagency Coordinating Committee to make recommendations regarding program activities carried out by various agencies and the funds needed by each agency.
Bill· HRH.R. 2513 (102nd)referred
United States · United States Congress · 3 June 1991
Directs the Secretary of Health and Human Services to establish and operate a demonstration project under which participating suppliers may sell to Medicare (title XVIII of the Social Security Act) beneficiaries certain items of durable medical equipment other than the standard versions for which payment may be made under part B (Supplementary Medical Insurance) of Medicare provided that the beneficiary agrees to pay the difference between the amount charged for the item and the amount Medicare will pay for its standard version.
Bill· HRH.R. 2500 (102nd)referred
United States · United States Congress · 30 May 1991
Medicare Prescription Drug Benefit Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to provide coverage under part B (Supplementary Medical Insurance) of outpatient prescription drugs and insulin (outpatient drugs). Excludes from such coverage any drug that is intraveneously administered in a home setting. Sets the annual deductible for such coverage at $650 in 1993, increased by $50 for each succeeding year. Prohibits application of such deductible to immunosuppressive drugs provided in the first year after an organ transplant. Sets program payments at 80 percent of the lesser of the actual charge for the drug or the applicable payment limit established under this Act. Outlines provisions for determining payment limits. Directs the Secretary to establish a program to identify and to educate physicians and pharmacies concerning: (1) instances and patterns of unnecessary or inappropriate prescribing or dispensing practices; (2) instances or patterns of substandard care; and (3) potential adverse drug reactions. Requires the Secretary to develop and update annually an information guide concerning the comparative average wholesale prices of at least 500 of the most commonly prescribed outpatient drugs and to mail such guide to Medicare hospitals, physicians, social security offices, senior citizen centers, and other appropriate places by January of each year. Sets forth outpatient drug cost reporting and control provisions. Authorizes a pharmacy to enter into an agreement with the Secretary to accept payment under part B of the Medicare program on an assigned basis for outpatient drugs furnished to part B enrollees. Sets forth the obligations of participating pharmacies. Requires the Secretary to establish a point-of-sale electronic system for use by carriers and participating pharmacies in submitting information respecting outpatient drugs dispensed to Medicare beneficiaries. Prohibits part B coverage of an outpatient drug which is dispensed in a quantity exceeding a 30-day supply or such longer supply, not exceeding 90 days, as the Secretary authorizes. Waives the requirement that a Medicare carrier be an insurer of health care services, authorizing the Secretary to contract with other entities for implementation and operation of the electronic point-of-sale claims processing system and for related functions. Requires Medicare carriers which make determinations or payments with respect to outpatient drugs to offer to receive requests from participating pharmacies for payments for such drugs through electronic communications and to respond to requests by such pharmacies as to whether or not an individual has paid the deductible for such drugs. Requires the Director of the Office of Technology Assessment to appoint individuals with expertise in the provision and financing of covered outpatient drugs to a Prescription Drug Payment Review Commission which shall make recommendations to the Congress each year concerning methods of paying for covered outpatient drugs under part B of the Medicare program. Sets forth miscellaneous outpatient drug study and reporting requirements. Increases the part B premium to $42.40 in 1993, $47.70 in 1994, and $53.60 in 1995.
Bill· HRH.R. 2497 (102nd)referred
United States · United States Congress · 30 May 1991
Health Care Workers Information Act - Requires the Director of the National Center for Health Statistics to collect information and prepare a report containing demographic information on home health care aides and nursing home aides and the locations in which they are employed. Requires the Commissioner of the Bureau of Labor Statistics to collect information and prepare a report on both kinds of aides containing specified types of information relating to conditions of employment and employment benefits. Requires the Commissioner to include an occupational code for each kind of aide in each wage survey conducted by the Bureau.
Bill· HRH.R. 2489 (102nd)referred
United States · United States Congress · 29 May 1991
Medicaid Family Care 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; (2) room and board in a structured environment with on-site supervision 24 hours a day; (3) child day health services; (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 apppropriate health, social, and child care services; and (6) planning and assistance in reentering society. Requires that such coverage continue for at least 12 months (unless such coverage is found to be no longer therapeutically necessary, 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, except under prescribed conditions.
Bill· HRH.R. 2488 (102nd)referred
United States · United States Congress · 29 May 1991
International Medical Graduate Equity Act of 1991 - Directs the Secretary of Health and Human Services (the Secretary) to establish: (1) a National Repository of International Physician Credentials (the Repository); and (2) an Advisory Council on the Repository (the Council). Authorizes appropriations for such purposes for FY 1992 through 1994. Requires the Secretary to obtain information on a periodic basis from the physician licensing authority of at least ten States with respect to license applications and periodically report on such information to the Congress. Prohibits any State from discriminating against an individual on the basis of their being an international medical graduate (i.e. a graduate of a medical school located outside the United States) by denying their application for a license to practice medicine, if the individual: (1) has received such a license from another State and has practiced medicine in the United States for five years after receiving such license; and (2) meets the State's criteria for issuance of such license to graduates of U.S. medical schools. Prohibits any entity that operates a residency program for medical school graduates to discriminate against an international medical graduate by denying such individual an available residency in the program in any case in which: (1) the residency cannot be filled by a U.S. medical school graduate; and (2) the international medical graduate meets the criteria for program admission for U.S. medical school graduates. Allows individuals aggrieved by such discrimination by a State or a residency program operator to obtain relief through civil action. Sets a five-year statute of limitations on such actions.
Bill· HRH.R. 2483 (102nd)referred
United States · United States Congress · 29 May 1991
Health Professions Training Improvement Act of 1991 - Amends the Public Health Service Act to require that, in making competitive grants under provisions relating to health research and teaching facilities and training of professional health personnel or provisions relating to nurse education, priority be given to applicants providing certain services or having certain interactions with medically underserved communities. Requires that, after FY 1994, at least 50 percent of the amounts appropriated for such grants be awarded to institutions which meet requirements regarding the percentage of their graduates practicing in such communities. Mandates grants to health professions institutions to expand training programs targeted at individuals desiring to serve the needs of such communities. Authorizes appropriations. Mandates grants to regional consortia (comprised of at least one medical school and at least one health professions school that is not a medical school) to enhance and expand coordination among various health professions programs, particularly in medically underserved rural areas. Authorizes appropriations.
Bill· HRH.R. 2484 (102nd)referred
United States · United States Congress · 29 May 1991
Amends title XVIII (Medicare) of the Social Security Act to increase payments for direct graduate medical education (DME) costs of primary care residents in the initial residency period. Provides an overall cap on approved Full Time Equivalent resident amounts. Requires hospitals to provide more compensation to primary care residents than to non-primary care residents in order to receive DME funding.
Bill· SS. 1186 (102nd)open
United States · United States Congress · 24 May 1991
Substance Abuse Treatment Corps Act - Amends the Public Health Service Act to establish within the Public Health Service the Substance Abuse Treatment Corps to increase the availability of treatment for alcohol and drug abuse in geographic areas with a significant incidence of abuse and an inadequate availability of services. Allows the Secretary of Health and Human Services to carry out such purpose only through assigning Corps members to provide services for such areas. Allows the Secretary to assign a Corps member to an entity only if the entity, among other requirements, enters into an agreement with the Secretary regarding the allocation, between the Secretary and the entity, of costs relating to the assignment. Directs the Secretary to establish a program of entering into contracts with students in specified fields under which the students agree to serve in the Corps upon obtaining their degree in consideration of the Federal Government agreeing to pay tuition, other expenses, and a stipend. Applies, except as inconsistent, provisions relating to the National Health Service Corps Loan Repayment Program to this program. Directs the Secretary to establish a program of entering into contracts with individuals who have been licensed or certified in certain fields, or who are students in such fields, under which the individuals agree to serve in the Corps in consideration of the Federal Government agreeing to repay up to a specified sum of educational loans of the individuals. Applies, except as inconsistent, provisions relating to the National Health Service Corps Loan Repayment Program to this program. Authorizes appropriations for the scholarship and loan repayment programs established by this Act.
Bill· SS. 1192 (102nd)referred
United States · United States Congress · 24 May 1991
International Population Stabilization and Reproductive Choice Act of 1991 - Title I: United States Population Assistance - Sets forth congressional findings with respect to population assistance. Declares that it shall be a principal objective of U.S. foreign policy to achieve universal availability of high quality fertility control services. Requires all family planning activities receiving support under the Foreign Assistance Act of 1961 to provide a broad range of fertility control methods, including abortion where permitted by individual country policy. Prohibits funds from being used to coerce any person to undergo sterilization or involuntary abortion or to accept any method of fertility control. Requires the U.S. Government to support the expansion of reproductive rights in countries receiving foreign assistance. Prohibits the denial of foreign assistance to any foreign government, international organization, or nongovernmental organization based on such entity's provision of abortion-related information or conduct of advocacy efforts on behalf of reproductive choice. Requires population assistance to provide increased support for special programs to reach young adults before they begin childbearing. Provides that funds shall be allocated to countries meeting at least one of the following criteria: (1) countries accounting for a substantial proportion of the world's annual population increment; (2) having significant unmet needs for fertility control and that require foreign assistance to implement, expand, or sustain family planning services; and (3) countries which demonstrate a strong policy commitment to population stabilization through the expansion of reproductive choice. Makes funds available for: (1) the United Nations Population Fund; and (2) the Special Programme of Research, Development and Research Training in Human Reproduction managed by the World Health Organization. Requires the Administrator of the Agency for International Development (AID) to establish simplified procedures for the development and approval of programs to be carried out by nongovernmental organizations that have demonstrated a capacity to undertake effective population and family planning activities and a commitment to quality reproductive health care for women. Makes 50 percent of all U.S. population assistance available for nongovernmental organizations. Requires AID to encourage greater involvement in the delivery of family planning services by private health practitioners, employer-based health services, unions, and cooperative health organizations. Sets forth targets for global expenditures in developing countries for core population programs and for U.S. population assistance. Authorizes appropriations for U.S. population assistance. Prohibits individuals in programs assisted by the United States from being denied family planning services because of an inability to pay the cost of such services. Lists research programs to be supported by U.S. assistance. Requires the U.S. Government to support communications strategies to create public awareness about reproductive health needs and the problems associated with world population growth. Directs the AID Administrator to report annually to the Congress on world progress toward population stabilization and universal reproductive choice. Title II: Population Assistance Policy and Development - Declares that it is U.S. policy to achieve universal access to basic education. Earmarks amounts from funds for development and economic assistance programs for education activities for adult literacy and basic primary education. Declares that it is U.S. foreign policy to: (1) reduce the infant mortality rate in all countries by the lower of one-third of the 1990 level or to 50 deaths per 1,000 live births; and (2) reduce the mortality rate of children under five years of age by the lower of 30 percent or 70 deaths per 1,000 live births. Authorizes appropriations from the Child Survival Fund for child survival activities. Sets forth as an objective of U.S. foreign policy during the 1990's the reduction of deaths to women from problems associated with pregnancy, childbirth, and unsafe abortions by one-half. Authorizes appropriations for the AIDS Prevention and Control Fund. Requires the Secretary of State to include information on discrimination against women in each annual country human rights assessment. Directs the U.S. representatives to the United Nations Commission on the Status of Women to ensure the rapid implementation of the United Nations Forward Looking Strategies for the Advancement of Women. Requires the Secretary to submit the five-year review of the status of U.S. women and annual reports requested by the Commission. Provides that U.S. foreign assistance programs shall emphasize activities which increase women's productivity through improved access to labor saving technology, vocational training, extension services, access to credit, and child care facilities. Requires the AID Administrator to report to the Congress (by country) on the legal, social, economic, and cultural barriers to women's self-determination and improvements in the productivity of women's labor in the traditional and modern sectors. Title III: Organizational Provisions - Establishes within the Department of State an Under Secretary of State for Global Population, Environment, and Natural Resources to provide a focus for dialogue on global population growth, environmental degradation, and natural resources management. Declares that the multilateral development banks should increase their support for core protection population activities. Requires the U.S. executive directors of the International Bank for Reconstruction and Development, the Asian Development Bank, the Inter-American Development Bank, and the African Development Bank to submit annual reports to the Congress on allocations to core population activities and, if such allocations total less than $1,000,000, to report on actions taken to encourage increases in such allocations. Requires the President to establish a National Bipartisan Commission on World Population Stabilization and Reproductive Health to oversee U.S. preparations for, and participation in, the 1994 International Population Meeting. Directs the Commission to report on population trends and their impact on efforts to alleviate poverty and protect the environment. Authorizes appropriations.
Bill· SS. 1188 (102nd)referred
United States · United States Congress · 24 May 1991
Social Security and SSI AIDS Disability Act of 1991 - Directs the Secretary of Health and Human Services to establish an AIDS Disability Advisory Panel to conduct a study and report to the Secretary and the Congress on the disability criteria needed for individuals who are HIV positive to determine eligibility for benefits under titles II (Old Age, Survivors and Disability Insurance) (OASDI) and XVI (Supplemental Security Income) (SSI) of the Social Security Act, with special concern focused on women, children, and intravenous (IV) drug users with AIDS or who test HIV-positive. Terminates the Panel five years after submission of its initial report. Provides for interim disability criteria, inclusive of medical conditions specific to women, children, and IV-drug users, for determining cases until Panel recommendations become law. Requires the Secretary, during the Panel's tenure, to establish and maintain a database on OASDI and SSI applicants with AIDS. Requires annual reports to the Congress containing such information. Authorizes appropriations.