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451 records in US in 1991
United States · United States Congress · 9 May 1991
Seniors Helping Seniors Act of 1991 - Amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act to prohibit the income an individual who has attained retirement age earns for providing home health care or respite services in the recipient's home from being applied against such individual's OASDI benefits.
United States · United States Congress · 9 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.
United States · United States Congress · 9 May 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, of research before the Secretary of Health and Human Services may approve the 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. 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 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 by and training scientists 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). 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 National Institute of Child Health and Human Development (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 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 employees 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.
United States · United States Congress · 8 May 1991
Waste Isolation Pilot Plant Land Withdrawal Act - Withdraws from all forms of entry, appropriation, and disposal under the general land laws and from location and patent under the mining laws the public lands in Eddy County, New Mexico, which surround the Waste Isolation Pilot Plant project (WIPP) and transfers jurisdiction and control of the withdrawn lands to the Department of Energy (DOE). Describes the lands to be withdrawn. Revokes specified public land orders made inconsistent by this Act. Makes the Secretary of Energy responsible for the management of WIPP and the withdrawn lands. Requires the Secretary to develop a management plan for the use of the withdrawn lands until WIPP has been decommissioned, requiring any use for activities not associated with WIPP to be subject to conditions and restrictions that may be necessary to permit the conduct of WIPP activities. Requires the management plan to permit domestic livestock grazing, hunting and trapping, maintenance of wildlife habitat, the disposal of salt tailings remaining on the surface, and mining, subject to prescribed guidelines. Authorizes the Secretary to close to the public any part of such withdrawn lands if required for public health and safety. Directs the Secretary to submit the management plan to appropriate congressional committees and the State of New Mexico. Directs the Secretary, in consultation with specified officials and agencies, to develop and update a performance assessment plan that includes experiments needed to assess compliance with Environmental Protection Agency (EPA) standards for disposal of transuranic waste and other experiments which the Secretary considers necessary. Authorizes the Secretary to place transuranic waste in WIPP during the performance assessment phase and to begin permanent disposal of transuranic waste after such phase is completed if he determines, after an EPA review, that WIPP complies with relevant environmental standards and has submitted to the Congress plans for decommissioning WIPP and managing such withdrawn lands afterwards. Directs the EPA Administrator to issue final standards for disposal of transuranic wastes within two years after the enactment of this Act. Requires the Secretary to demonstrate compliance with such standards notwithstanding any court order requiring repromulgation or reissuance of the standards or any injunction preventing their enforcement, unless the court order or injunction relates to health and safety aspects of the standards directly applicable to WIPP. Requires the Secretary to demonstrate compliance with disposal standards in effect on November 18, 1985, if the EPA Administrator fails to issue standards for disposal of transuranic wastes. Subjects WIPP to EPA management and storage standards applicable to transuranic waste. Bans high-level radioactive waste from being placed in WIPP by DOE. Requires the Secretary to continue to encourage WIPP related business and employment opportunities within the State of New Mexico. Provides for payments to the State of New Mexico to assist in the mitigation of the impacts on the State and on local governments resulting from WIPP. Authorizes appropriations. Directs the Secretary to submit to the State of New Mexico, the Secretary of the Interior, the EPA Administrator, and appropriate congressional committees within five years after enactment of this Act a plan for decommissioning WIPP. Directs the Secretary to develop within such period a plan for the management and use of the withdrawn lands following the WIPP decommission.
United States · United States Congress · 8 May 1991
Freedom from Want Act - Title I: Domestic Assistance Programs - Part A: Nutrition, Education, and Health Care - Expresses the sense of the Congress that it should make a commitment to increasing participation in the special supplemental food program for women, infants, and children (the WIC program) by 20 percent in each of FY 1992 through 1996, so that the goal of full participation may be reached by the end of FY 1996. Expresses the sense of the Congress that the Head Start Act should be fully funded so that the goal of participation of all eligible three- and four-year-old children in Head Start programs can be achieved by FY 1994. Amends the Older Americans Act of 1965 to increase the reimbursement provided by the Department of Agriculture for congregate and home-delivered meals for older Americans to 65.66 cents in FY 1992, with adjustments for inflation in FY 1993 and 1994. Amends the Public Health Service Act to direct the Secretary of Health and Human Services (HHS) to undertake a Children's Vaccine Initiative, for research, development, testing, and evaluation of children's vaccines, and for assisting in delivery of such vaccines in the United States and throughout the world. Directs the Secretary of HHS to consult with the World Health Organization and the United Nation's Children's Fund in organizing such Initiative. Requires the Director of the National Vaccine Program to plan and coordinate such Initiative, and ensure that the Public Health Service conducts activities under the Initiative in collaboration with nongovernment institutions and other Federal agencies. Authorizes appropriations. Directs the Secretary of Agriculture to ensure that rules issued under the Federal Meat Inspection Act that impose labeling standards for any meat or meat food product sold or offered for sale in commerce also impose equivalent labeling standards for meat or meat food products distributed by the Department of Agriculture through domestic commodity food assistance programs. Part B: Individual Development Account Demonstration - Amends the Internal Revenue Code to allow a deduction for payments (other than certain assistance from an organization of a demonstration project under this part) made by or on behalf of eligible individuals to an individual development account (IDA) to accumulate funds to pay the following qualified expenses: (1) postsecondary education expenses; (2) first-home purchase; (3) business capitalization; (4) retirement expenses; and (5) transfers to an IDA of the individual's spouse or dependent. Sets forth requirements relating to such IDAs. Establishes five-year IDA demonstration projects to determine: (1) the social, psychological, and economic effects of providing to individuals with limited means an opportunity to accumulate assets; and (2) the extent to which an asset-based welfare policy may be used to enable individuals with low income to achieve economic self-sufficiency. Allows any organization to apply to the Secretary of the Treasury for grants to conduct such a project. Requires each organization authorized to conduct such a project to establish a Reserve Fund drawn from investments, public and private funds, and IDA penalty amounts. Requires the organization to use Reserve Fund amounts to: (1) assist project participants in obtaining skills and information to achieve economic self-sufficiency through activities requiring IDA qualified expenses; (2) provide financial assistance to the IDAs of individuals selected by the organization to participate in the project; (3) administer the project; and (4) provide the organization evaluating the project with necessary information. Directs the organization to invest Reserve Fund amounts that are not immediately needed to carry out such project fund uses. Limits the administrative expenses. Requires that unused Federal grant funds be transferred to the Secretary when the project terminates. Makes eligible for IDA demonstration project assistance any individual who is a member of a household with: (1) a household income for the immediately preceding calendar year of not more th an 200 percent of the poverty threshold; and (2) a household net worth, as of the close of such year, of not more than $20,000. Directs the project organization to select individuals whom the organization deems suited to receive such assistance. Sets forth a table for organization contributions to an individual's IDA, based on: (1) the individual income for the applicable period, as a percentage of the poverty threshold; and (2) matched with the lesser of either a specified percentage of the qualified savings of the individual for the period, or a specified dollar amount. Provides for a greater organization contribution for individuals with lower incomes. Requires local control over demonstration projects by giving the organization sole authority over project administration, and allowing the Secretary of the Treasury to prescribe only regulations that are necessary to ensure compliance with approved applications and this Act. Requires each project organization to prepare ten semiannual progress reports for an oversight panel, the Secretary of the Treasury, and the Treasurer (or equivalent official) of the State in which the project is conducted. Directs the Secretary of the Treasury to establish an oversight panel for such demonstration projects. Authorizes the Secretary of the Treasury to revoke the original authorization for a demonstration project upon receipt of a notice that the project has failed to implement the oversight panel's recommendations. Sets forth required revocation actions and procedures. Requires the oversight panel to enter into a contract with an independent research organization to evaluate the IDA demonstration projects, individually and as a group, addressing specified questions. Authorizes appropriations for IDA demonstration projects. Requires that funds in the IDAs of demonstration project participants to be disregarded for purposes of all means-tested Federal programs. Part C: Microenterprise Programs - Amends the Social Security Act to include microenterprise training programs under the JOBS program under provisions for aid to families with dependent children (AFDC). Requires adjustment of performance standards for microenterprises to take account of the time required for their establishment. Provides for limited exclusions of microenterprise resources and income under the AFDC program. Defines a microenterprise as a commercial enterprise which has five or fewer employees, one or more of whom owns the enterprise; and (2) none of the owners of which has income exceeding 200 percent of the poverty threshold. Authorizes States to waive Federal AFDC requirements with respect to participants in State-approved microenterpise programs. Provides that participation in such State-approved microenterprise programs shall not affect the participants' means-tested Federal benefits. Amends the Consolidated Farm and Rural Development Act to make microenterprises eligible for rural development loans and grants. Expresses the sense of the Congress that one percent of funds for specified types of rural development assistance should be reserved for certain purposes relating to microenterprises. Amends the Housing and Community Development Act to make microenterprises eligible for assistance under community development block grants. Provides that certain assisted activities relating to microenterprises shall be considered to benefit persons of low and moderate income. Expresses the sense of the Congress that each grantee under the community development block grant program should reserve one percent of any grant received to provide assistance to facilitate commercial economic development through microenterprises. Amends the Small Business Act to express the sense of the Congress that: (1) one percent of specified funds for small business loans should be reserved for specified purposes relating to microenterprises; and (2) the Small Business Administrator should take such other necessary actions to maximize participation by microenterprises in programs under such Act and the Small Business Investment Act of 1958. Provides for small business loans for microenterprises. Amends the Job Training Partnership Act (JTPA) to authorize the use of funds for training activities with respect to microenterprises. Directs the State Governor to adjust performance standards relating to microenterprises to reflect the time required to establish and develop a stable income from such an enterprise as participants seek to achieve economic self-sufficiency. Provides for JTPA microenterprise grants. Directs the Secretary of Labor, from specified funds for FY 1992 through 1996, to make grants in limited amounts to not more than ten States per year to implement and enhance community-based microenterprise activities. Requires State matching funds and annual reports. Authorizes appropriations for such microenterprise grants. Part D: Increasing the Food Purchasing Power of Low-Income Households - Authorizes the Secretary of Agriculture to make grants to up to 20 nonprofit community-based organizations to carry out food retailing development projects to: (1) increase the access of individuals residing in communities underserved by supermarkets to more affordable and quality food; and (2) strengthen the operation of existing food retail stores in underserved communities by providing such stores with services that lower costs, improve management, and increase the quality and nutritional value of food inventories. Sets forth priorities in selecting grantees. Sets forth requirements for grant expenditures. Authorizes appropriations for such food retailing development program. Authorizes the Secretary of Agriculture to make grants to up to ten eligible entities to carry out a food stamp and producer direct marketing demonstration project to: (1) increase retail marketing opportunities for local agricultural producers through farmers markets, roadside stands, and other means; (2) increase the access to and consumption of fresh, perishable agricultural commodities by low-income individuals; (3) identify and implement successful strategies to increase the number of agricultural producers certified to redeem food stamp coupons in exchange for commodities sold directly to coupon recipients; and (4) increase the number of food stamp recipients who use such coupons to purchase such commodities from agricultural producers. Sets forth requirements for grant expenditures. Defines an eligible entity as a community-based organization with strong ties to both the farming community and to an anti-hunger organization. Authorizes appropriations for such food stamp and producer direct marketing demonstration program. Amends the Child Nutrition Act of 1966 to revise WIC farmers' market demonstration programs. Increases from ten to 20 the number of States allowed to provide WIC participants with coupons to purchase fresh fruit and vegetables from farmers markets. Sets forth requirements for program reports and review. Authorizes appropriations. Part E: Assessing Food Security within Communities - Amends the National Agricultural Research, Extension, and Teaching Policy Act of 1977 to provide for regional centers for community food security. Directs the Secretary of Agriculture, through the Federal Extension Service, to make competitive grants to seven land grant colleges and universities to establish seven regional centers for community food security, with one of them designated to serve as a coordinating center. Sets forth requirements for selection of recipients, use of grants, prohibited uses, term of grants, performance evaluations, and annual reports. Defines food security as the ability of all people at all times to purchase or receive from usual food sources enough nutritionally adequate food for an active and healthy life. Part F: Findings Regarding Communities Making the Transition to Hunger-Free Status - Expresses the sense of the Congress regarding criteria for communities making the transition to food secure status. Part G: Infant Mortality Reduction - Subpart 1: Low Birthweight and Infant Mortality - Establishes within the Department of Health and Human Services a program to make grants to States, municipalities, and nonprofit organizations to establish demonstration projects to reduce infant mortality by reducing the incidence of low birthweight births in high-risk communities. Sets forth grant application requirements and preferences in awards. Directs the Secretary of HHS to: (1) establish an Infant Mortality Advisory Panel; and (2) evaluate such projects and provide technical assistance to grantees. Requires annual reports from grantees. Limits project duration to three years. Authorizes appropriations. Subpart 2: Breast Feeding and Infant Morbidity and Mortality Study - Directs the Secretary of HHS to establish a program to award grants to conduct studies of the impact of breastfeeding on infant mortality and morbidity in certain high-risk populations. Authorizes appropriations for each fiscal year for conducting such study. Part H: Amendments to the Food Stamp Act of 1977 - Mickey Leland Childhood Hunger Relief Act - Subpart 1: General Provisions - Sets forth general provisions. Subpart 2: Ensuring Adequate Food Assistance - Amends the Food Stamp Act of 1977 to remove the excess shelter deduction cap for purposes of food stamp program (program) eligibility. (Sets forth transitional caps through FY 1995.) Requires the Secretary of Agriculture to adjust the basic benefit level upwards by specified increments at the beginning of each fiscal year until it reaches 105 percent of the cost of the thrifty food plan. Eliminates food stamp reductions for households reapplying for program reinstatement within 30 days. Excludes third party payments for transitional housing for the homeless from consideration as program income. Increases funding for the nutrition assistance program in Puerto Rico. Excludes general assistance vendor payments from consideration as program income. Subpart 3: Promoting Self-Sufficiency - Excludes from consideration as program income: (1) the first $50 a month received as child support; and (2) child support payments to non-household members. Increases annually the fair market value limit of vehicles that program recipients may own. Excludes from financial resources the value of a vehicle a household depends upon to carry heating fuel or water for home use where it has no other access to fuel or water. Increases dependent care deductions and participant and State agency reimbursements in connection with employment and training activities. Subpart 4: Simplifying the Provision of Food Assistance - Permits related adults living in the same household to apply for separate program benefits under specified conditions. Permits a participating family made up of, or including, an elderly or disabled member to own $300 in allowable financial resources. (Current law refers to a family member 60 years of age or older.) Makes program authorization of appropriations permanent. Subpart 5: Implementation and Effective Dates - Sets forth the effective dates for provisions of this Act. Title II: International Programs - Part A: Food as a Human Right - Declares that the United States should: (1) make a major effort toward strengthening the right to food in international law; and (2) propose to the United Nations General Assembly that a Declaration and Convention on the Right to Food be adopted and submitted to countries for ratification. Prohibits the provision of development assistance under the Foreign Assistance Act of 1961 and the provision or financing of agricultural commodities under the Agricultural Trade Development and Assistance Act of 1954 for countries that engage in a consistent pattern of violations of internationally recognized rights to food and medical care. Requires the United States to: (1) make a major effort toward reforming and restructuring the United Nations mechanism for responding to international disasters and humanitarian emergencies; and (2) evaluate the role of the United Nations Disaster Relief Organization and develop a proposal for strengthening the United Nations response to such emergencies. Part B: Democratic Empowerment - Amends the Foreign Assistance Act of 1961 to authorize the President, acting through the administrator of the agency responsible for administering development assistance (administering agency), to provide assistance for eligible emerging democracies. Defines an "eligible emerging democracy" as a least developed country that is making a transition from an undemocratic to a democratic system of government. Lists authorized assistance as development and relief and rehabilitation assistance and assistance for child survival, maternal health, basic nutrition, and basic education. Waives provisions of law that prohibit or restrict assistance to countries in arrears or default on loan or credit payments owed to the United States with respect to assistance for eligible emerging democracies. Establishes a Fund for Democratic Empowerment to carry out such assistance program. Authorizes appropriations. Part C: Children - Authorizes appropriations for FY 1992 and 1993 for U.S. contributions to the United Nations Children's Fund. Amends the Foreign Assistance Act of 1961 to authorize appropriations for the Child Survival Fund for FY 1992 and 1993. Earmarks amounts of foreign assistance for activities that deal directly with the special health needs of children and mothers. Requires the President, with respect to the provision of development assistance, to promote and undertake activities relating to research on, and the treatment and control of, acquired immune deficiency syndrome (AIDS) in developing countries. Designates such assistance as the International AIDS Prevention and Control Program. Earmarks amounts of development assistance for FY 1992 and 1993 for the Vitamin A Deficiency Program and programs to eliminate iodine deficiency. Expresses the sense of the Congress that the United States should join in a comprehensive initiative to reduce micronutrient deficiencies from iron, as well as leading in the elimination of vitamin A and iodine deficiency. Earmarks foreign assistance for basic education programs. Directs the President to report annually to the Congress on U.S. contributions to the goals and strategies of the World Declaration on the Survival, Protection and Development of Children; the Plan of Action for Implementing the Declaration; the World Declaration on Education for All; and the Framework for Action to Meet Basic Learning Needs. Part D: Women in Development - Removes a limitation on, and earmarks an amount of, assistance to promote the participation and integration of women in the development process in developing countries. Requires specified amounts of such assistance to be used to support the integration of women into programs of the administering agency and to support needs of such agency in administering the women in development policy. Part E: Refugees - Authorizes appropriations for FY 1992 and 1993 for migration and refugee assistance, with earmarked funds for programs of refugee assistance overseas. Expresses the sense of the Congress that other international donors should join with the United States in ensuring that refugee relief and rehabilitation efforts are adequately funded and supported. Part F: Agriculture and the Environment - Requires agricultural development programs supported by the United States under the Foreign Assistance Act of 1961 and in the multilateral development banks and International Monetary Fund (IMF) to incorporate principles of environmental sustainability. Directs the Administrator of the Agency for International Development (AID) to establish specified environmental sustainability guidelines and standards to be applied to all agricultural development programs supported under the Foreign Assistance Act of 1961, bilateral agricultural projects, and, where appropriate, environmental projects supported under such Act. Requires the U.S. executive directors of the multilateral development banks and the IMF to seek the adoption of requirements comparable to such standards by their respective institutions. Declares that AID should make a long-term commitment to research the ecological and socioeconomic components of sustainable agricultural development. Provides that research topics should include: (1) how traditional systems of agriculture respond to local ecological conditions and how such responses can be incorporated in agricultural development that aims to increase yields without degrading long-term productive potential or the ability to withstand ecological pressures; (2) the role of subsistence agriculture in meeting the nutritional needs of rural populations and the improvement of subsistence food production; and (3) the improvement of crops which comprise a substantial part of the diet of the poorest part of the population. Declares that the United States should encourage the Consultative Group on International Agriculture to incorporate such topics into its research priorities and to promote the application of research findings into project design and implementation. States that AID should increase its support for agricultural research institutions that have demonstrated a capacity to contribute to sustainable agricultural development. Directs the AID Administrator to report to the Congress on AID programs directed toward sustainability as a basis for agricultural assistance efforts. Part G: World Bank and International Monetary Fund - Expresses the sense of the Congress that the Secretary of the Treasury should instruct the U.S. executive directors of the International Bank for Reconstruction and Development (World Bank), the International Development Association (Association), and the IMF to seek the establishment by their institutions of programs and policies to assist in the realization of the right to food. Amends the International Financial Institutions Act to direct the Secretary of the Treasury to instruct: (1) the U.S. executive director of the Association to advocate, in the context of the Association's tenth replenishment, that at least 50 percent of the Association's loans go to countries that have developed a national development and poverty alleviation strategy; and (2) the U.S. executive directors of the World Bank and the IMF to urge such institutions to develop Policy Framework Papers (including sections on environmental goals) for borrowing countries. Expresses the sense of the Congress that the World Bank and the Association should: (1) give greater programmatic and budgetary priority to child survival and development; and (2) commit to devoting at least five percent of the annual lending programs to primary health and five percent to basic education. Directs the Secretary to instruct the U.S. executive directors of the World Bank and the Association to urge such institutions to: (1) promote environmental sustainability as a guiding principle in agricultural development projects; (2) emphasize food-based policies in agriculture by increasing funding for research focusing on improving foods which comprise a substantial portion of the diet of poor people; and (3) ensure that such projects target and integrate women. Amends the Bretton Woods Agreements Act to direct the Secretary of the Treasury to instruct the U.S. executive director of the IMF to urge the IMF to ensure that IMF programs are designed to avoid any deterioration in the provision of social services for basic human needs and to maintain sustainable use of the environment. Part H: Debt Relief - Amends the Foreign Assistance Act of 1961 to authorize the President to make certain debt relief authorities concerning relatively least developed countries with respect to which an IMF standby agreement or a World Bank or Association structural adjustment program or similar IMF program is in effect applicable to least developed countries pursuing specified national economic policy reforms, even if such an arrangement is not in effect. Part I: Private and Voluntary Organizations - Increases the amount of funding for private and voluntary organizations under the Foreign Assistance Act of 1961.
United States · United States Congress · 8 May 1991
Amends title XVIII (Medicare) of the Social Security Act to authorize payment for specified services performed by chiropractors, including x-rays, physical examinations, and related routine laboratory tests.
United States · United States Congress · 8 May 1991
Designates the week beginning July 28, 1991, as National Juvenile Arthritis Awareness Week.
United States · United States Congress · 7 May 1991
Federally Assisted Health Clinics Legal Protection Act of 1991 - Amends the Public Health Service Act to include entities receiving Federal funds under provisions relating to migrant health centers, community health centers, or health services for the homeless, and officers, employees, or contractors of such entities who are licensed health care practitioners, in the coverage of provisions regulating civil actions for injury resulting from medical or related functions against commissioned officers or employees of the Public Health Service. Subrogates to the United States any insurance claim such an entity or person has. Prohibits grants under provisions relating to migrant or community health centers or health services for the homeless unless the applicant has: (1) implemented policies and procedures to assure against malpractice; and (2) no history of claims against it under such provisions relating to officers and employees of the Public Health Service.
United States · United States Congress · 7 May 1991
Rural Physicians' Incentives Act of 1991 - Amends the Internal Revenue Code to allow a deduction on medical education loan interest of a physician which accrues while the physician is living in and providing primary care to residents of a medically underserved rural area. Amends title XVIII (Medicare) of the Social Security Act to exempt services furnished in a rural area from a special fee schedule applicable to new physicians. Amends the Higher Education Act of 1965 to extend beyond the normal two-year limit, for borrowers serving an internship or residency program in preparation for practice in an area of primary care, the deferral of payments on: (1) insured student loans (Stafford Loans), including those eligible for interest subsidies; and (2) low-interest student loans (Perkins Loans). Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify provisions setting forth requirements concerning billing by one physician for services rendered by another physician in specified circumstances.
United States · United States Congress · 7 May 1991
Rural Health Leadership Education Act of 1991 - Amends the Rural Development Act of 1972, as amended by the Food, Agriculture, Conservation, and Trade Act of 1990, to authorize grants for rural health leadership development education programs.
United States · United States Congress · 7 May 1991
Rural Health Statistics Act of 1991 - Amends the Public Health Service Act to require that the geographic area description and analysis in a currently-mandated annual report on the health of the Nation's people include a description and analysis by rural area and urban area.
United States · United States Congress · 7 May 1991
Rural Medical Emergencies Air Transport Act of 1991 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to make grants to at least seven States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. Requires: (1) preference for States with plans to integrate the proposed air medical system into a comprehensive network or plan for regional or statewide emergency medical services; and (2) the grant to be administered by the State agency responsible for medical emergency or trauma services programs. Allows the State to award grant funds to public and private entities. Authorizes appropriations.
United States · United States Congress · 7 May 1991
Rural Mental Health Initiatives Act of 1991 - Amends the Public Health Service Act to establish, in the National Institute of Mental Health, the Office of Rural Mental Health. Mandates grants for demonstration projects to improve the availability of rural mental health services through providing such services in the same facilities as other health or social services, and otherwise integrating mental health, other health, and social services. Requires reports to the Congress. Requires that funds be made available to carry out these provisions from amounts appropriated under the Act for mental health research. Requires State comprehensive mental health services plans to describe how mental health services will be provided to rural residents.
United States · United States Congress · 7 May 1991
Amends the Omnibus Budget Reconciliation Act of 1987 to allow a consortium including one or more rural hospitals (including at least a small rural hospital and/or one or more rural health clinics) to participate in the rural health medical education demonstration project of the Department of Health and Human Services. Authorizes appropriations as necessary to pay costs of such project which are attributable to travel and living expenses of medical residents and travel expenses of supervising physicians, to the extent such costs are not reimbursed under the Medicare program.
United States · United States Congress · 7 May 1991
Rural Access to Obstetrical Care Act of 1991 - Requires the Secretary of Health and Human Services to: (1) provide for demonstration projects to reduce infant mortality by improving access in rural, underserved areas to obstetric services for eligible pregnant women under title XIX (Medicaid) of the Social Security Act; (2) develop and make available to the public each year a compendium of State initiatives to address the obstetric access crisis in rural areas; and (3) provide funding for a study, and report to the Congress on, obstetrical malpractice claims payment by Medicaid and private insurance companies.
United States · United States Congress · 7 May 1991
Amends the Public Health Service Act to require that between 25 and 50 percent (currently, at least 50 percent) of certain block grant funds be used for prevention and treatment with respect to intravenous drug abuse.
United States · United States Congress · 7 May 1991
Primary Care Training Amendments of 1991 - Amends provisions of the Public Health Service Act authorizing grants and contracts for training, traineeships, and fellowships in general internal medicine and general pediatrics to require that a school, hospital, or other entity, in order to receive a grant or contract, provide certain types of training related to family medicine. Adds demonstration of a commitment to family medicine to the criteria for establishing priority in making the grants and contracts.
United States · United States Congress · 7 May 1991
Rural Hospital Medicare Certification Due Process Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to establish due process requirements for State certifications of providers of services under the Medicare program.
United States · United States Congress · 7 May 1991
Improving Access to Health Care Through Telecommunications Act - Mandates grants to rural health care consortia for acquisition and operation of interactive telecommunications systems to improve delivery of health care services. Allows information uses to include consultations, x-ray transfers, professional education programs, patient record transfers, and claims processing. Limits grants to one consortium per State, subject to waiver for consortia serving two or more States. Authorizes appropriations.
United States · United States Congress · 2 May 1991
Child Health Program Act of 1991 - Amends title XIX (Medicaid) of the Social Security Act to require State plans for medical assistance to make available through a mail application process preventive care services and outpatient and physicians' services for children whose parents do not have health insurance but have incomes between 133 and 185 percent of the Federal poverty line and choose, via an annual enrollment fee, to participate in such child health program. Finances such program entirely through Federal funding. Amends the Internal Revenue Code to finance such program by removing the cap on the maximum amount of income subject to the Medicare hospital insurance (part A of title XVIII of the Social Security Act) payroll tax.
United States · United States Congress · 2 May 1991
Breast Cancer Research Act of 1991 - Authorizes to be appropriated, in addition to sums already authorized, a certain amount to the National Cancer Institute for breast cancer research.
United States · United States Congress · 1 May 1991
Partnership for Long-Term Care Act of 1991 - Title I: Medicaid Program Improvements - Amends title XIX (Medicaid) of the Social Security Act to require States to cover certain primary care for pregnant women and children, and nursing facility services for other individuals, whose incomes are below the Federal poverty level. Requires States to establish a subsidy program to assist individuals whose incomes are no less than the Federal poverty level and no more than twice such level in paying long-term care insurance premiums. Provides larger subsidies as individuals' incomes approach the Federal poverty level. Prohibits States from establishing a subsidy resource eligibility limit at less than twice the resource limit under title XVI (Supplemental Security Income) of the Act. Title II: Medicaid Amendments Relating to Treatment of Payments Under Qualified Long-Term Care Insurance Policies - Subtracts long-term care insurance payments from an individual's assets in determining his or her Medicaid eligibility. Title III: Tax Treatment of Long-Term Care Insurance - Requires that, for the purpose of determining the income tax liability of life insurance companies, qualified long-term care insurance be treated as accident or health insurance. Applies this provision to policies which provide coverage for at least 12 consecutive months of diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services provided in a setting other than the acute care unit of a hospital and for an individual's loss of functional capacity. Provides that for the purpose of determining whether a tax exclusion applies to employer contributions to, or an employee's receipt of benefits from, qualified long-term care insurance, such contributions and benefits shall be considered to be for coverage under an accident or health plan. Makes the penalty tax on early distributions from qualified retirement plans inapplicable when such distributions are used to pay for qualified long-term care insurance. Treats an individual's qualified long-term care expenses as deductible medical care expenditures. Provides for the deduction of employer contributions to a reserve fund providing employees with post-retirement qualified long-term care benefits. Permits the inclusion of qualified long-term care insurance in cafeteria plans. Excludes such insurance from a cafeteria plan participant's gross income.
United States · United States Congress · 1 May 1991
Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 to make specified contract notice requirements currently applicable to property transferred by Federal agencies on which a hazardous substance was stored, released, or disposed applicable to leases of, or granting of easements on, such property. Considers remedial action to have been taken on transferred Federal property on which a hazardous substance was stored, released, or disposed if one of the following conditions exists: (1) remedial action has been completed on the property or no action was required; or (2) remedial action has been commenced on the property with respect to any remaining hazardous substance, the deed for the transfer of such property assures access so that such action can be taken, and the United States agrees to carry out actions until remedial action has been completed. Authorizes the President, acting through a Federal agency, to arrange for the removal of any hazardous substance on real property, regardless of whether a danger to the public health or welfare or the environment exists. Permits Federal agencies to subdivide property subject to this Act for purposes of sale, lease, grant of easement, or other transfer. Requires the Secretary of Defense to report to the Congress on the manner in which the Department of Defense plans to carry out environmental restoration activities on military installations to be closed.
United States · United States Congress · 1 May 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).
United States · United States Congress · 1 May 1991
Department of Defense Lyme Disease Research and Education Act of 1991 - Directs the Secretary of the Army, acting through the Army Environmental Hygiene Agency, to carry out a research and education (R&E) program regarding Lyme disease. Specifies actions to be taken by the Secretary as part of such R&E program, including: (1) assessing the risk of Lyme disease at military installations; (2) providing lab support for identifying and assaying deer ticks for Lyme disease; (3) providing information regarding Lyme disease to military personnel at installations at which there are sizable populations of deer ticks, as well as to dependents of such personnel; (4) establishing and maintaining a data repository on information collected by the Department of Defense regarding the disease; (5) conducting operational testing; and (6) testing candidate deer tick repellent compounds for effectiveness and toxicity to humans. Authorizes appropriations to the Secretary for conducting the R&E program. Earmarks specified amounts of such appropriations for each of the R&E activities undertaken. Directs the Secretary to print and distribute to appropriate military personnel wallet-sized cards that identify the ticks that transmit Lyme disease and Rocky Mountain spotted fever, listing symptoms and methods of prevention. Allows the Secretary to make 25 percent of such cards available to Federal health agencies and the public. Authorizes appropriations. Directs the Walter Reed Army Institute of Research to conduct research to develop a ribosomal RNA probe to detect Borrella burgdorferi in arthropods, animal reservoirs, and laboratory samples. Authorizes appropriations to the Secretary of Defense for such research.
United States · United States Congress · 1 May 1991
Amends the Internal Revenue Code, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act to prohibit any qualified beneficiary who is convicted of or pleads guilty to murder from being entitled, as a result of that death, to elect continuation coverage under a group health plan.
United States · United States Congress · 30 April 1991
Repeals provisions of the Public Health Service Act prohibiting appointing to the Regular Corps of the Public Health Service or calling to active duty for over one year in the Reserve Corps an individual over 44 years old.
United States · United States Congress · 30 April 1991
Expands the definition of "child," for purposes of eligibility for military health care as dependents of members or former members of the armed forces, to include a person who is under the legal custody of the member or former member and who otherwise satisfies the definition of a military dependent.
United States · United States Congress · 29 April 1991
Amends title XVIII (Medicare) of the Social Security Act to require the Director of the Office of Technology Assessment to annually review changes affecting the cost of surgical procedures for the implantation of artificial devices and organs for which Medicare makes payments: (1) in medical technology, skill, and procedures; and (2) in the costs of artificial devices and organs. Requires the Director to recommend to the Secretary of Health and Human Services changes in the amounts that should be recognized as reasonable for purposes of Medicare payments.
United States · United States Congress · 25 April 1991
Heinz Elder Life Program Act - Amends the Older Americans Act of 1965 to modify the definition of "information and referral" to include services for older individuals that: (1) assess their problems and capacities; (2) link older individuals to available opportunities and needed services; and (3) benefit the entire older community. Elevates the status of the Commissioner on Aging to Assistant Secretary. Directs the Assistant Secretary to establish a Commission to study existing reporting requirements and related programs and make legislative and regulatory recommendations to achieve specified objectives. Includes as functions of the Assistant Secretary the: (1) establishment of information and assistance services as priority services for the aged and aging; and (2) development of guidelines for choosing legal assistance providers and developers. Requires area agencies on aging: (1) to establish an informal grievance procedure for older individuals who are dissatisfied with, or denied, services with further appeal to the appropriate area agency on aging; and (2) in providing legal assistance, to give priority to legal problems related to income, health care, long-term care, nutrition, housing and utilities, defense of guardianship, abuse and neglect, and age discrimination. Requires State plans to also provide priority legal assistance in such areas. Requires technical assistance and training to State long-term care ombudsman programs to include assistance in recruiting and retaining volunteers for ombudsman programs by establishing a national program for recruitment efforts. Requires State agencies on aging to encourage adoption of memoranda of understanding between legal assistance providers and long-term care ombudsman providers that will ensure that the providers will coordinate services to the greatest extent possible. Requires the program for the prevention of abuse, neglect, and exploitation of older individuals to require that State agencies make all reasonable efforts to resolve any conflicts with other public agencies with respect to the confidentiality of information in complaints and other reports of abuse, neglect, or exploitation of older individuals by entering into memoranda of understanding that limit information disclosure according to current guidelines. Establishes a program to provide transportation services to older individuals. Authorizes appropriations. Makes legal assistance agencies eligible to participate in demonstration projects for developmental disabilities and mental illness established under the Developmental Disabilities Assistance and Bill of Rights Act and under the Protection and Advocacy for Mentally Ill Individuals Act of 1986. Reauthorizes and extends such demonstration projects through FY 1993. Adds a new section to provide for demonstration projects to determine the feasibility of using the aging network as the infrastructure for a comprehensive long-term care system. Authorizes appropriations. Directs the Assistant Secretary to establish a program of grants to State agencies to support and assist older individuals by providing legal assistance in areas such as living wills, durable powers of attorney, and other life planning areas. Authorizes appropriations.
United States · United States Congress · 25 April 1991
Contraceptive and Infertility Research Centers Act of 1991 - Amends the Public Health Service Act to require the Director of the Institute of Child Health and Human Development to make grants or enter into contracts for centers for improving methods of contraception and centers for diagnosing and treating infertility. Requires the Director, subject to appropriations, to provide for three centers with respect to contraception and two centers with respect to infertility. Requires each center to: (1) conduct clinical and other applied research; (2) develop training protocols for and conduct training of physicians, scientists, nurses, and other health and allied health professionals; (3) develop model continuing education programs; and (4) disseminate information to professionals. Allows a center to use the funds to provide: (1) stipends for health and allied health professionals enrolled in the training programs; and (2) fees to individuals serving as subjects in the clinical trials. Requires each center to use the facilities of a single institution, or be formed from a consortium of cooperating institutions, meeting requirements as prescribed by the Secretary of Health and Human Services. Allows support for a center to be for a period of up to five years, with extensions of one or more periods of up to five years if the center's operations have been reviewed by a peer review group and the group has so recommended. Authorizes appropriations. Amends the Public Health Service Act to direct the Secretary to establish a program of entering into agreements with health professionals, including graduate students, under which the professionals agree to conduct research with respect to contraception or infertility in consideration of the Government agreeing to repay, for each year of such service, not more than a specified amount of the principal and interest of their educational loans. Applies provisions of the National Health Service Corps Loan Repayment Program to this program, except as inconsistent. Authorizes appropriations. Requires amounts appropriated to remain available until the end of the second fiscal year after they are appropriated.
United States · United States Congress · 25 April 1991
Amends Federal provisions relating to the National Guard to add a new chapter concerning the formation of State defense forces. Defines a "State defense force" as a military force organized by a State to become operational when the State National Guard forces are federalized or otherwise unavailable or inadequate for the defense needs of such State. Provides that, as general policy, State defense forces are in the national interest as a military reserve force ready to supplement National Guard forces and State and local government agencies for the performance of specified functions. Provides that membership in a State defense force shall be determined by the individual States, but that a member of the U.S. armed forces shall not also be a member of a State defense force, unless specifically authorized to do so. Provides further that membership in a State defense force does not exempt a person from any required duty under the Military Selective Service Act, nor does such membership limit a person from enlistment or appointment in an armed force. Authorizes the Secretary of a military department to issue or loan military equipment, supplies, or uniforms to a State for use in connection with its State defense force. Directs the Secretary of Defense to prescribe policies and procedures to be followed in the issuing and loaning of such equipment. Authorizes the sale (by the Secretary of the military department concerned) and the wearing of military uniforms by members of a State defense force, as long as such uniforms have been approved by such Secretary. Authorizes the Secretary of a military department to provide a member of a State defense force and States with defense forces training and training assistance for such forces. Authorizes such training, in the alternative, to be provided by an executive department and an independent agency of the Federal Government in the interest of national security and when not detrimental to the primary operational requirements of the department or agency concerned. Authorizes the Secretary of a military department to require reimbursement from a State for the cost of providing training or training assistance to the State defense force of such State. Declares that reimbursement normally should be required in the case of training provided a member of a State defense force for a period exceeding 14 days. Directs that the chief executive officer of a State sponsoring a State defense force is the responsible official for that force. Provides that the Chief of the National Guard Bureau shall serve as the means of communication between a State and the Federal Government on matters involving the State defense forces. Provides that a member of a State defense force is not to be considered a member of the U.S. armed forces for any reason, including eligibility for federally-sponsored health care or disability benefits. Authorizes the Secretary of a military department to conduct such background investigations for potential members of State defense forces as considered necessary and appropriate by such Secretary for the granting of appropriate security clearances for such personnel. Encourages a State sponsoring a State defense force to make available to officials of the State defense force all appropriate criminal history information, and to maintain a record of criminal history information pertaining to a member in order that security clearances may be expedited in time of mobilization or national emergency.
United States · United States Congress · 25 April 1991
Comprehensive Adolescent Health Care Promotion and Education Act - Directs the Secretary of Agriculture to establish as part of the Cooperative Extension Service a National Health Promotion and Education Center for Youth Development. Directs the Center to establish: (1) rural adolescent health promotion and education programs through the collaborative efforts by Federal, State, and local entities; and (2) a related health care internship program. Authorizes appropriations.
United States · United States Congress · 25 April 1991
Reaffirms the commitment of the Congress embodied in the National Cancer Act of 1971, specifically that: (1) cancer research should be a national priority to address the scope of the cancer epidemic; (2) the public and private sectors should join forces to provide the necessary fiscal and human resources to establish, maintain, and strengthen the National Cancer Program; and (3) this public-private partnership should strive to provide effective treatment to every American with cancer.
United States · United States Congress · 25 April 1991
Designates October 1991 as National Down Syndrome Awareness Month.
United States · United States Congress · 25 April 1991
Comprehensive Health Care Improvement Act of 1991 - Title I: Qualified Health Insurance Plans - Part A: Definitions and Standards for Qualified Plans - Defines a "plan of health coverage" as any plan or combination of plans, including combinations of self-insurance, individual accident and health insurance policies, group accident and health insurance policies, coverage under a nonprofit health service plan, or coverage under a health maintenance organization (HMO) subscriber contract. Directs the Secretary of Health and Human Services to establish standards for qualified plans and procedures for the review and certification of plans of health coverage as qualified plans. Provides that a plan shall be certified as an "A" qualified plan if it meets State requirements and meets the following minimum standards: (1) the minimum benefits for a covered individual equal at least 80 percent of the covered expenses in excess of an annual deductible not exceeding $250 per person or $250 for each of two members of a covered family; (2) the coverage includes a limitation of $3,000 per person and $6,000 for a covered family on total annual out-of-pocket expenses for covered expenses; (3) the coverage is subject to a $1,000,000 maximum life-time benefit; and (4) the $3,000, $6,000, and $1,000,000 limitations are not subject to change or substitution by use of an actuarially equivalent benefit. States that covered expenses are the usual and customary charges of a physician or chiropractor. Lists covered and excluded services. Deems HMOs providing certain services to be providing an "A" qualified plan. Certifies as a "B" qualified plan a plan which meets the requirements of an "A" plan, except that the annual deductible does not exceed $1,000 per person. Directs the Secretary, to the extent feasible, to provide for the review and certification by the insurance commissioner of each State of qualified plans to be offered in the State. States that the sale of plans is in and affects interstate commerce and that, in order to properly regulate such sales, it is necessary to regulate such sales in intrastate, as well as interstate, commerce. Requires every plan of health coverage sold to be labelled as "qualified" or "nonqualified" on the front of the policy. Requires each advertisement or promotion for a plan to specify whether the plan is "qualified" or "nonqualified." Part B: Requiring Offering of Certain Qualified Plans - Requires each employer employing an average of ten or more employees annually to make available a plan or combination of plans of health coverage which: (1) has been certified as an "A" or supplemental plan; (2) is a qualified convertible plan; and (3) permits either coverage of an employee's spouse and children or coverage of an employee's children. Defines a "qualified convertible plan" as a plan of health coverage which: (1) permits each enrolled individual to continue coverage for 36 months and then to convert the plan to any individual qualified plan without the addition of underwriting restrictions if, for any reason, the individual leaves the group; and (2) permits, in the case of the death of the individual in whose name the contract was issued, other individuals covered under the plan to continue coverage without the addition of underwriting restrictions. Sets forth civil penalties for noncompliance. Excludes from the term "employee," for purposes of this provision, certain new, part-time, part-year, young, bargaining unit, and nonresident alien employees. Part C: Offering of Comprehensive Health Insurance by States - Amends title XIX (Medicaid) of the Social Security Act to require the establishment and creation of a health insurance pool available to uninsured and uninsurable individuals and businesses in each State and a comprehensive health plan in each State, in accordance with this part of this Act. Defines a "comprehensive health insurance plan" to mean policies of insurance and contracts of HMO coverage offered by the State through the contractee in the State. Defines the "contractee" as the insurers and HMOs in the State selected by the State to administer the comprehensive health insurance plan. Provides for the authorities and responsibilities of each State commissioner of insurance. Requires each State to provide for the establishment of a comprehensive health insurance plan. Requires each State, through its comprehensive health insurance plan, to offer: (1) policies which provide the benefits of "A" and "B" qualified plans; and (2) HMO contracts in those areas of the State where an HMO has agreed to make the coverage available. Provides that upon certification the individual can enroll in a State's comprehensive health insurance plan by payment of the State plan premium to the contractee. Requires that the premium schedule be set by the State. Allows the State to subsidize the premium with all or part of its Federal payment to be self-supporting. Limits agent referral fees. Requires any surplus to be held at interest and used to offset losses or reduce premiums. Exempts premiums received by the contractee from State taxation. Requires the comprehensive health insurance plan for a State to be open for enrollment by individuals residing in the State, who can enroll by submitting a certificate of eligibility to the State which certifies the applicant's name, address, age, length of residence, dependents to be insured, and type of coverage desired. Requires each State to disseminate information to State residents regarding the existence of the comprehensive health insurance plan and the means of enrollment. Requires each contractee to pay an agent's referral fee, in an amount to be determined by the State, to each insurance agent referring an applicant to the State comprehensive health insurance plan, if the application is accepted. Requires each State to adopt a method for judging the quality of health care provided by providers who are eligible for reimbursement under the plan. Title II: Program of Assistance to States for Assisting Low-Income Individuals to Purchase Comprehensive Health Insurance - Comprehensive Health Insurance Assistance Act of 1991 - Adds a new title XXI to the Social Security Act entitled "Grants to States for Assistance to Low-Income Individuals in the Purchase of Comprehensive Health Insurance." Authorizes appropriations under title XXI to enable each State to provide assistance to low-income individuals in the purchase of comprehensive health insurance under title XXI. Requires the sums made available under this title to be used to make payments to States which have submitted, and have had approved by the Secretary, State plans for comprehensive health insurance assistance to low-income individuals. Directs the Secretary to pay each State with an approved plan, from the Low-Income Health Insurance Assistance Account, an amount determined under a specified formula. Title III: Medicare Tax Fairness - Amends the Internal Revenue Code to make unlimited the amount of the applicable contribution base for hospital insurance taxes imposed by specified provisions. Amends the Social Security Act to establish within the Federal Hospital Insurance Trust Fund the Catastrophic Health Insurance Reserve Account. Requires that the account be credited for all receipts of the Fund attributable to amendments made by this Act. Prohibits amounts credited or appropriated to the account from being expended, transferred, or appropriated. Requires that such amounts be reserved to carry out catastrophic health insurance programs for elderly individuals which are established by law after enactment of this Act. Amends the Internal Revenue Code to impose a tax (the health insurance enhancement tax) on a specified percentage of an individual's health insurance enhancement unearned income, defined as adjusted gross income minus wages or self-employment income taxable under provisions relating to hospital insurance. Establishes in the Treasury the Low-Income Health Insurance Enhancement Trust Fund and appropriates to it all taxes received under the health insurance enhancement tax imposed by this Act. Makes amounts in the Fund available for payments to States under the new title of the Social Security Act added by this Act.
United States · United States Congress · 25 April 1991
Family Caregiver Support Act of 1991 - Amends the Social Security Act to add a new title XXI entitled "Grants to States for Family Caregiver Support Programs" to establish a program to enable States to furnish services to support informal caregivers of individuals with functional disabilities. Outlines State plan requirements for such caregiver support services, including requirements that: (1) States must support 50 percent of program administration costs; (2) services may not supplant Medicare or Medicaid (titles XVIII and XIX of the Social Security Act) or private insurance otherwise available to eligible recipients of services; and (3) persons with incomes exceeding 200 percent of the Federal poverty level must pay on a sliding fee scale established by the State, up to a maximum annual income of $75,000. Caps total annual Federal expenditures at $2,400 per eligible recipient. Authorizes appropriations to carry out the new title.
United States · United States Congress · 25 April 1991
Prohibits any individual from obtaining a position as a graduate medical student or a physician in any federally funded hospital or medical facility if such individual's license to practice medicine was procured through an intentional misrepresentation of a material fact (including cheating on an examination required for licensing).
United States · United States Congress · 24 April 1991
State Health Service Corps Demonstration Act - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to establish a State Health Service Corps Demonstration Project. Directs the Secretary to make grants under the Project to up to ten States for the Federal share of training and employment of physician and nonphysician providers serving health professional shortage areas. Requires a recipient State to enter into an agreement with an area health education center for the planning, development, and operation of a program of training and recruiting such providers. Sets forth the responsibilities of a center. Authorizes appropriations. Requires each State carrying out a Project to establish a State Health Service Corps Scholarship Program involving a period of service in the service area or on the clinical staff of an area health education center or a medical school in return for a scholarship. Authorizes the official heading the State agency administering the Program to contract with an educational institution for the payment of scholarship or loan amounts.
United States · United States Congress · 24 April 1991
Children's and Communities' Mental Health Systems Improvement Act of 1991 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services, through the Administrator of the Alcohol, Drug Abuse, and Mental Health Administration, to make grants to States for comprehensive community mental health services to children with serious emotional disturbances. Prohibits the Secretary from making a grant to a State unless the State is receiving payments under alcohol and drug abuse and mental health services block grant provisions. Requires non-Federal contributions in specified percentages. Requires State grantees to: (1) establish and operate one or more systems, through grants or contracts, to provide specified types of mental health services to children under 22 years of age; (2) enter into a memorandum of understanding with providers of medical, educational, and vocational counseling, vocational rehabilitation, and protection and advocacy services to facilitate the provision of such services without use of grant funds or non-Federal contributions made with respect to the grant; (3) provide case management; (4) provide services in the cultural context that is most appropriate for the child and effectively communicate, either directly or through interpreters; and (5) establish, for each child, a multidisciplinary team providing services and ensuring the development and implementation of an Individualized Services Plan and either an Individualized Education Program, an Individualized Family Services Plan, or both. Describes additional services for which a State system may provide. Requires that parents of children with serious emotional disturbances be included as members of the mental health planning council established under existing provisions. Requires that, if a charge is imposed for services under a grant, the charge be made according to a public schedule, adjusted to reflect the income of the family of the child, and not imposed on any child whose family has income and resources at or below the poverty line. Limits grants to States to five years. Requires that a State, in order to receive grants for the third, fourth, and fifth years: (1) have a plan for achieving long-term financial support for systems for comprehensive care; and (2) be making satisfactory progress in expanding access to such systems in all areas of the State. Directs the Secretary to provide to a State, on request: (1) technical assistance regarding grant applications; and (2) training and technical assistance on the planning, development, and operation of the systems under this Act. Authorizes the Secretary to provide the technical assistance directly or through grants or contracts. Authorizes appropriations, earmarking a specified sum for the technical assistance and training. Limits the number of grants to ten in FY 1992.
United States · United States Congress · 24 April 1991
School Readiness Act of 1991 - Title I: Public Health Service Act Provisions - Subtitle A: Comprehensive Primary and Preventive Care for Pregnant Women, Infants and Children - Comprehensive Maternal and Early Childhood Health Care Act - Replaces Public Health Service Act provisions authorizing appropriations for migrant health centers (MHCs) and community health centers (CHCs) with provisions requiring the use of funds appropriated under other provisions to develop, operate, and expand Comprehensive Perinatal and Early Childhood Health Programs in medically underserved areas. Mandates grants to MHCs and CHCs for such programs. Requires the use of funds appropriated under other provisions for planning and developing CHCs to serve medically underserved populations. Amends provisions relating to health services for the homeless to require use of funds appropriated under other provisions to develop, operate, and expand such programs. Mandates grants to grantees under the provisions relating to the homeless for such programs. Directs the Secretary of Health and Human Services, through the Centers for Disease Control (CDC), to provide vaccines to the health department of each State or large city that is operating an immunization project for distribution to grantees under specified provisions, federally qualified health centers, and public health professionals. Requires, in determining the quantity of vaccine needed, that the Administrator of the Health Resources and Services Administration make available to the CDC Director data from annual reports from such grantees and federally qualified health centers. Requires the CDC Director to direct the State or city health department to provide the recipients with an adequate supply of vaccine from the allotment provided to the grantee. Amends the Vaccine and Immunization Amendments of 1990 to replace provisions authorizing grants for vaccine outreach programs with provisions authorizing the Secretary, through the CDC Director, to make grants to States for demonstration projects related to immunization. Authorizes appropriations. Amends the Public Health Service Act to add substance abuse treatment and prevention services to the list of supplemental health services provided by MHCs and CHCs. Replaces provisions mandating grants for prevention, education, and treatment projects regarding drug and alcohol abuse relating to pregnant and postpartum women and their infants with provisions mandating demonstration grants for substance abuse prevention, education, and treatment projects serving such individuals. Requires that services under the grants be provided at locations accessible to low-income pregnant and postpartum women and in the most appropriate language and cultural context. Requires that services eligible for Medicaid payment be provided by an entity qualified to receive Medicaid payments. Limits fees for services. Requires non-Federal contributions in a specified ratio. Limits grants to five years but allows renewal. Makes grant payments subject to annual approval by the Secretary and to the availability of appropriations. Authorizes appropriations. Directs the Secretary, through the CDC Director, to assist the prenatal clinics in the United States in implementing smoking cessation programs to decrease rates of smoking during pregnancy. Authorizes grants to or contracts with State or local health departments and other public entities to assist in implementing programs and policies to prevent and encourage cessation of tobacco use during pregnancy. Authorizes appropriations. Subtitle B: Grants for Home-visiting Services for At-Risk Families - Mandates competitive grants for the Federal share of the costs of home visiting services. Requires that the grants be for at least three years. Requires that the services include case management, with a registered nurse or social worker assigned as the case manager for individual cases. Requires that the case manager develop a family service plan for the client. Sets the Federal share of the grants at a specified percentage. Authorizes appropriations. Title II: Head Start Act - Amends the Head Start Act to direct (currently, authorize) the Secretary, on application by an agency designated (currently, an agency eligible for designation) as a Head Start agency, to provide, subject to appropriations, financial assistance for Head Start programs. Entitles all eligible children to receive services through a Head Start program. Authorizes appropriations to carry out the Act. Declares that provisions of the Omnibus Budget Reconciliation Act of 1990 (excluding receipts and expenditures of the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund from being counted as new budget authority, outlays, receipts, or deficit or surplus for purposes of the U.S. budget, the congressional budget, or the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act)) shall apply with respect to amounts appropriated under this authorization. Directs the Secretary to make a minimum amount available to carry out the Head Start Transition Project Act.
United States · United States Congress · 24 April 1991
Designates the week of June 9, 1991, as National Scleroderma Awareness Week.
United States · United States Congress · 24 April 1991
Circle of Poison Prevention Act of 1991 - Title I: Exported Pesticides - Amends the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) to require pesticide producers operating registered establishments to inform the Administrator of the Environmental Protection Agency of: (1) the types and quantities of pesticides and active ingredients used in producing pesticides for export to a foreign country; and (2) the date of export and quantity of such materials exported to each foreign country to which the producer has exported during the past 365-day period. Provides that specified information on exported pesticides shall not be entitled to confidential trade secret treatment. Makes it unlawful to export a pesticide or device in violation of FIFRA export requirements. Prohibits the exportation of a pesticide or device unless: (1) such materials are prepared and packaged according to the specifications of the foreign purchaser and the legal requirements of the country of use; and (2) the label of the pesticide is written in the official language of the country of use and contains all information required to be included in the labeling for such pesticide in the United States. Prohibits the exportation of a pesticide to a country of use if: (1) the registrations for pesticides containing an active ingredient that is included in such pesticide that account for nearly all of the uses of such ingredient have been canceled; (2) the tolerances for an active ingredient in such pesticide that account for nearly all the uses of such ingredient have been revoked; or (3) an active ingredient of the pesticide is ineligible for reregistration. Prohibits such exports (including pesticides used for agricultural production) unless: (1) the pesticide is registered; or (2) all of the active ingredients in the pesticide are the subject of a food tolerance. Requires exporters, prior to the shipment of certain pesticides, to provide specified information to the Administrator. Prohibits the exportation of any pesticide to a country of use that: (1) has refused consent; or (2) has given conditional consent unless the conditions on which the consent was given are met. Prohibits refusals to consent unless the country certifies that it is not producing or importing and will not produce or import the pesticide or a similar product with the same active ingredient. Waives certain requirements, upon the request of a country of use and subject to certain determinations by the Administrator, to permit the export of pesticides not meeting FIFRA requirements to: (1) prevent or arrest the spread of a communicable disease; or (2) stop or prevent the spread of a pest that is destroying or will destroy quantities of the country's food supply so as to result in widespread famine. Permits the export of pesticides for experimental use in foreign countries if specified conditions are met. Directs the Administrator to submit information to the Secretary of Health and Human Services concerning inspections for pesticide residues in imported foods conducted by the Department of Health and Human Services. Requires the Administrator to notify foreign countries and the International Register of Potentially Toxic Chemicals whenever regulatory action is taken with respect to a pesticide. Directs the Administrator to: (1) convene meetings with foreign governments and other interested parties to promote the implementation of improved research and regulatory programs for pest management and strategies for sustainable agriculture and to encourage the adoption of a multilateral convention requiring standard notice and pesticide export control measures; and (2) provide foreign countries with technical assistance to develop pesticide regulatory programs. Permits persons to bring civil actions to secure the imposition of penalties on persons who violate pesticide export requirements. Prohibits civil actions from being initiated on the basis of the same unlawful acts that form the basis of existing proceedings for criminal violations. Requires the Comptroller General to report to the Congress every four years on: (1) the operation and effect of this Act; and (2) how exported pesticides and their containers are used and disposed of and on their impact on the public health and the environment of countries of use. Title II: Pesticide Residue Monitoring - Amends the Omnibus Trade and Competitiveness Act of 1988 to direct the Food and Drug Administration to summarize the volume of each food product subject to the requirements of the Federal Food, Drug, and Cosmetic Act imported into the United States in quantities determined by the Secretary of Health and Human Services to be commercial quantities (currently, products having an entry value exceeding an amount established by the Secretary). Requires the summary to: (1) be made by food product, country of origin, port of entry, pesticides monitored by the Secretary, pesticide residues detected, and the quantity of each pesticide exported from the United States for agricultural use; and (2) indicate the volume of each type of food tested for pesticide residues, arranged by pesticide, food, and country of origin. Title III: Pesticide Tolerances - Amends the Federal Food, Drug, and Cosmetic Act to require the Administrator, if a registration under FIFRA for a pesticide to be used on food is canceled or modified to prohibit its use in connection with food, to revoke any tolerance or exemption that permits the presence of the pesticide on the food. Suspends tolerances or exemptions for pesticides used on food if such use is suspended under FIFRA. Authorizes the Administrator, if a residue of a canceled or suspended pesticide will persist in the environment and be present on a food, to establish a tolerance for the pesticide at a level that permits the residue to remain and will protect public health. Requires the Administrator to reduce the tolerance for any suspended or canceled pesticide annually if any decrease in the pesticide's residual environmental contamination or residues on food has occurred. Prohibits the Administrator from establishing or continuing a tolerance for a pesticide chemical residue unless the best available, practical method for detecting and measuring the levels of the residue on a food exists. Title IV: Pesticide Information - Prohibits the importation of a raw agricultural commodity into U.S. customs territory unless the commodity importer files with the Secretary and the Secretary of the Treasury a document identifying each pesticide chemical used in connection with the commodity. Requires such importers, if unreported pesticides are detected in such commodities, to submit residue analyses for such pesticides. Waives reporting requirements for unreported pesticides if the presence of such pesticides is attributable to long-term environmental persistence and does not pose a health risk. Amends the Federal Meat Inspection Act, the Poultry Products Inspection Act, and the Egg Products Inspection Act to apply such requirements to importers of meat, poultry, and eggs. Amends the Agricultural Act of 1954 to add to the list of annual reporting requirements of agricultural attaches a report on the customary use of pesticides in the production of agricultural commodities in foreign countries. Title V: Effective Dates - Sets forth the effective dates for provisions of this Act.
United States · United States Congress · 24 April 1991
Amends Federal provisions relating to the National Guard to add a new chapter concerning the formation of State defense forces. Defines a "State defense force" as a military force organized by a State to become operational when the State National Guard forces are federalized or otherwise unavailable or inadequate for the defense needs of such State. Provides that, as general policy, State defense forces are in the national interest as a military reserve force ready to supplement National Guard forces and State and local government agencies for the performance of specified functions. Provides that membership in a State defense force shall be determined by the individual States, but that a member of the U.S. armed forces shall not also be a member of a State defense force, unless specifically authorized to do so. Provides further that membership in a State defense force does not exempt a person from any required duty under the Military Selective Service Act, nor does such membership limit a person from enlistment or appointment in an armed force. Authorizes the Secretary of a military department to issue or loan military equipment, supplies, or uniforms to a State for use in connection with its State defense force. Directs the Secretary of Defense to prescribe policies and procedures to be followed in the issuing and loaning of such equipment. Authorizes the sale (by the Secretary of the military department concerned) and the wearing of military uniforms by members of a State defense force, as long as such uniforms have been approved by such Secretary. Authorizes the Secretary of a military department to provide a member of a State defense force and States with defense forces training and training assistance for such forces. Authorizes such training, in the alternative, to be provided by an executive department and an independent agency of the Federal Government in the interest of national security and when not detrimental to the primary operational requirements of the department or agency concerned. Authorizes the Secretary of a military department to require reimbursement from a State for the cost of providing training or training assistance to the State defense force of such State. Declares that reimbursement normally should be required in the case of training provided a member of a State defense force for a period exceeding 14 days. Directs that the chief executive officer of a State sponsoring a State defense force is the responsible official for that force. Provides that the Chief of the National Guard Bureau shall serve as the means of communication between a State and the Federal Government on matters involving the State defense forces. Provides that a member of a State defense force is not to be considered a member of the U.S. armed forces for any reason, including eligibility for federally-sponsored health care or disability benefits. Authorizes the Secretary of a military department to conduct such background investigations for potential members of State defense forces as considered necessary and appropriate by such Secretary for the granting of appropriate security clearances for such personnel. Encourages a State sponsoring a State defense force to make available to officials of the State defense force all appropriate criminal history information, and to maintain a record of such information pertaining to a member in order that security clearances may be expedited in time of mobilization or national emergency.
United States · United States Congress · 24 April 1991
Amends title XIX (Medicaid) of the Social Security Act to prohibit the Secretary of Health and Human Services from approving or renewing a waiver under a State Medicaid program of Medicaid's home health care exclusion if such program requires a patient to be or have been an inpatient of a hospital or a resident of a nursing facility in order to be eligible for home health care services.
United States · United States Congress · 24 April 1991
Adoption Amendments of 1991 - Replaces Public Health Service Act provisions authorizing appropriations for adolescent family life demonstration projects with provisions requiring set-aside, for such projects, of a specified amount appropriated for the Health Resources and Services Administration. Amends the Internal Revenue Code to allow a tax credit for a limited amount of adoption expenses. Amends the National Defense Authorization Act for Fiscal Years 1988 and 1989 to extend to October 1, 1993, the termination date of a test program for reimbursement of adoption expenses of members of the armed forces. Amends Part E (Foster Care and Adoption Assistance Program) of title IV of the Social Security Act to prohibit payments to a State under provisions relating to foster care and adoption assistance if any public agency responsible for adoption placement has failed to fully disclose to prospective adoptive parents all information regarding the child's health. Amends the Public Health Service Act to mandate grants to two States to establish demonstration programs to provide maternal health certificates to low-income pregnant females residing or awaiting residence in a maternity home. Requires eligible maternity homes to provide specified services, including room and board, medical care, and counseling and services concerning health, adoption, education, vocation, or employment. Requires that such homes accept the certificates as full payment. Directs the Secretary of Education to develop a model curriculum for educating individuals on issues of adoption that are relevant to the field of social work. Requires the curriculum to be appropriate for secondary, postsecondary, and continuing education settings. Authorizes appropriations.
United States · United States Congress · 24 April 1991
Hearing Loss Testing Act of 1991 - Directs the Secretary of Health and Human Services to: (1) require that every child born in the United States be tested for hearing loss at the time of birth; and (2) establish uniform standards for such testing. Requires each health insurance policy, including contracts for coverage by health maintenance organizations, which provides for any benefits with respect to a newborn to include coverage for newborn hearing loss testing. Amends title XIX (Medicaid) of the Social Security Act to add newborn hearing loss testing to the definition of screening services. Directs the Secretary to provide for such a grant or other program as necessary to assure that all newborns in the United States are tested for hearing loss at the time of birth. Authorizes appropriations.
United States · United States Congress · 24 April 1991
Requires water quality criteria for dioxin published pursuant to the Federal Water Pollution Control Act to ensure that the application of such criteria to a State's waters will limit the probability to not more than 1 in 1,000,000 that an individual with high exposure to dioxins in such waters will be diagnosed with cancer as a result of lifetime exposure. Directs the Administrator of the Environmental Protection Agency to revise such criteria if they do not meet such requirement. Requires States to submit to the Administrator for approval a chemical-specific numeric water quality standard for dioxin that is at least as stringent as the criteria established by this Act. Sets forth standard approval and modification procedures. Provides that the criteria established for dioxin by this Act shall take effect for any State without an approved standard. Requires the Director of the Fish and Wildlife Service to conduct a study to: (1) assess the impact of discharges of dioxin on wildlife and the aquatic environment; (2) evaluate the potential effects of uptake and accumulation of dioxin in wildlife and aquatic life on the food chain and public health; and (3) evaluate the effectiveness of public health-oriented criteria to protect wildlife and aquatic life from the effects of dioxin discharges.
United States · United States Congress · 23 April 1991
Circle of Poison Prevention Act of 1991 - Title I: Exported Pesticides - Amends the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) to require pesticide producers operating registered establishments to inform the Administrator of the Environmental Protection Agency of: (1) the types and quantities of pesticides and active ingredients used in producing pesticides for export to a foreign country; and (2) the date of export and quantity of such materials exported to each foreign country to which the producer has exported during the past 365-day period. Provides that specified information on exported pesticides shall not be entitled to confidential trade secret treatment. Makes it unlawful to export a pesticide or device in violation of FIFRA export requirements. Prohibits the exportation of a pesticide or device unless: (1) such materials are prepared and packaged according to the specifications of the foreign purchaser and the legal requirements of the country of use; and (2) the label of the pesticide is written in the official language of the country of use and contains all information required to be included in the labeling for such pesticide in the United States. Prohibits the exportation of a pesticide to a country of use if: (1) the registrations for pesticides containing an active ingredient that is included in such pesticide that account for nearly all of the uses of such ingredient have been canceled; (2) the tolerances for an active ingredient in such pesticide that account for nearly all the uses of such ingredient have been revoked; or (3) an active ingredient of the pesticide is ineligible for reregistration. Prohibits such exports (including pesticides used for agricultural production) unless: (1) the pesticide is registered; or (2) all of the active ingredients in the pesticide are the subject of a food tolerance. Requires exporters, prior to the shipment of certain pesticides, to provide specified information to the Administrator. Prohibits the exportation of any pesticide to a country of use that: (1) has refused consent; or (2) has given conditional consent unless the conditions on which the consent was given are met. Prohibits refusals to consent unless the country certifies that it is not producing or importing and will not produce or import the pesticide or a similar product with the same active ingredient. Waives certain requirements, upon the request of a country of use and subject to certain determinations by the Administrator, to permit the export of pesticides not meeting FIFRA requirements to: (1) prevent or arrest the spread of a communicable disease; or (2) stop or prevent the spread of a pest that is destroying or will destroy quantities of the country's food supply so as to result in widespread famine. Permits the export of pesticides for experimental use in foreign countries if specified conditions are met. Directs the Administrator to submit information to the Secretary of Health and Human Services concerning inspection for pesticide residues in imported foods conducted by the Department of Health and Human Services. Requires the Administrator to notify foreign countries and the International Register of Potentially Toxic Chemicals whenever regulatory action is taken with respect to a pesticide. Directs the Administrator to: (1) convene meetings with foreign governments and other interested parties to promote the implementation of improved research and regulatory programs for pest management and strategies for sustainable agriculture and to encourage the adoption of a multilateral convention requiring standard notice and pesticide export control measures; and (2) provide foreign countries with technical assistance to develop pesticide regulatory programs. Permits persons to bring civil actions to secure the imposition of penalties on persons who violate pesticide export requirements. Prohibits civil actions from being initiated on the basis of existing proceedings for criminal violations. Requires the Comptroller General to report to the Congress every four years on: (1) the operation and effect of this Act; and (2) how exported pesticides and their containers are used and disposed of and on their impact on the public health and the environment of countries of use. Title II: Pesticides Residue Monitoring - Amends the Omnibus Trade and Competitiveness Act of 1988 to direct the Food and Drug Administration to summarize the volume of each food product subject to the requirements of the Federal Food, Drug, and Cosmetic Act imported into the United States in quantities determined by the Secretary of Health and Human Services to be commercial quantities (currently, products having an entry value exceeding an amount established by the Secretary). Requires the summary to: (1) be made by food product, country of origin, port of entry, pesticides monitored by the Secretary, pesticide residues detected, and the quantity of each pesticide exported from the United States for agricultural use; and (2) indicate the volume of each type of food tested for pesticide residues, arranged by pesticide, food, and country of origin. Title III: Pesticide Tolerances - Amends the Federal Food, Drug, and Cosmetic Act to require the Administrator, if a registration under FIFRA for a pesticide to be used on food is canceled or modified to prohibit its use in connection with food, to revoke any tolerance or exemption that permits the presence of the pesticide on the food. Suspends tolerances or exemptions for pesticides used on food if such use is suspended under FIFRA. Authorizes the Administrator, if a residue of a canceled or suspended pesticide will persist in the environment and be present on a food, to establish a tolerance for the pesticide at a level that permits the residue to remain and will protect public health. Requires the Administrator to reduce the tolerance for any suspended or canceled pesticide annually if any decrease in the pesticide's residual environmental contamination or residues on food has occurred. Prohibits the Administrator from establishing or continuing a tolerance for a pesticide chemical residue unless the best available, practical method for detecting and measuring the levels of the residue on a food exists. Title IV: Pesticide Information - Prohibits the importation of a raw agricultural commodity into U.S. customs territory unless the commodity importer files with the Secretary and the Secretary of the Treasury a document identifying each pesticide chemical used in connection with the commodity. Requires such importers, if unreported pesticides are detected in such commodities, to submit residue analyses for such pesticides. Waives reporting requirements for unreported pesticides if the presence of such pesticides is attributable to long-term environmental persistence and does not pose a health risk. Amends the Federal Meat Inspection Act, the Poultry Products Inspection Act, and the Egg Products Inspection Act to apply such requirements to importers of meat, poultry, and eggs. Amends the Agricultural Act of 1954 to add to the list of annual reporting requirements of agricultural attaches a report on the customary use of pesticides in the production of agricultural commodities in foreign countries. Title V: Effective Dates - Sets forth the effective dates for provisions of this Act.
United States · United States Congress · 23 April 1991
Social Work Support Act of 1991 - Amends the Public Health Service Act to add references to graduate programs in social work or references to social workers to provisions relating to: (1) the composition of the National Advisory Council on Education for Health Professionals; (2) discrimination on the basis of sex in admission to training programs; (3) a health professions data reporting system; (4) assistance for construction of teaching facilities for health personnel, including in connection with a regional health professions program; (5) federally insured loans to graduate students in health professions schools; (6) student loan funds; (7) scholarships for first-year students of exceptional financial need; (8) grants for scholarships for students from disadvantaged backgrounds; (9) a loan repayment program regarding service on the faculties of certain health professions schools; (10) grants and contracts for educational assistance for students from disadvantaged backgrounds; (11) grants to schools with sufficient graduation of students from disadvantaged backgrounds; (12) grants to schools that offer the first or last two years of education for such graduate degrees; (13) grants and contracts for faculty and curriculum development and development of clinical training sites; (14) residency training programs in preventive medicine; (15) training of physician assistants; and (16) training with respect to acquired immune deficiency syndrome. Amends the Public Health Service Act to add references to graduate programs in social work to provisions relating to: (1) an advisory council on health professions education; (2) sex discrimination in training programs; (3) a health professions data reporting system; (4) construction of educational facilities; and (5) financial assistance to students.