[Pages S9876-S9882]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

By Mr. CRAPO (for himself and Mr. Craig):
S. 1466. A bill to amend the Consolidated Farm and Rural Development
Act to provide grants for special environmental assistance for the
regulation of communities and habitat (``SEARCH grants'') to small
communities; to the Committee on Agriculture, Nutrition, and Forestry.
Mr. CRAPO. Mr. President, I rise today to introduce legislation to
authorize a national environmental grants program called Project
SEARCH. Project SEARCH is a simplified, flexible program that targets
small communities most in need of assistance in meeting environmental
goals.
I am particularly excited about the proposal. I have heard from
partners interested in helping with the legislation and from colleagues
who recognize the unique challenges small communities face achieving
environmental goals. Because of our mutual interest in helping small
communities respond to environmental problems, I invite my colleagues
to join me in supporting this measure.
The national Project SEARCH, Special Environmental Assistance for the
Regulation of Communities and Habitat, concept is based on a pilot
program that operated with great success in Idaho in 1999 and 2000. In
short, the bill establishes a simplified application process for
communities with populations under 2,500 to receive assistance grants
for meeting a broad array of Federal, State, or local environmental
regulations. Grants would be available for initial feasibility studies,
to address unanticipated costs arising during the course of a project,
or when a community demonstrates that other sources of funding are
unavailable or insufficient.
Some of the major highlights of the program are: a simplified
application process--no special grants coordinators required;
communities must first have attempted to receive funds from traditional
sources; it is open to studies or projects involving any environmental
regulation; applications are reviewed and approved by citizens panel of
volunteers; the panel chooses the number of recipients and size of
grants; the panel consists of volunteers representing all regions of
the state; and no local match is required to receive the SEARCH funds.
Over the past several years, it has become increasingly apparent that
small communities are having problems complying with environmental
rules and regulations due primarily to lack of funding, not a
willingness to do so. They, like all of us, want clean water and air
and a healthy natural environment. Sometimes, they simply cannot
shoulder the financial burden with their limited resources.
In addition, small communities wishing to pursue unique collaborative
efforts might be discouraged by grant administrators who prefer
conformity. Some run into unexpected costs during a project and have
borrowed and bonded to the maximum. Others are in critical habitat
locations and any project may have additional costs, which may not be
recognized by traditional financial sources. Still others just need
help for the initial environmental feasibility study so they can
identify the most effective path forward.
With these needs in mind, in 1998, I was able to secure $1.3 million
for a grant program for Idaho's small communities. Idaho's program does
not replace other funding sources, but serves as a final resort when
all other means have been exhausted.
The application process was simplified so that any small town mayor,
county commissioner, sewer district chairman, or community leader could
manage it without hiring a professional grant writer. An independent
citizens committee with statewide representation was established to
make the selections and get the funds on the ground as quickly as
possible. No bureaucratic or political intrusions were permitted.
Forty-four communities in Idaho ultimately applied, not including two
that failed to meet the eligibility requirements. Ultimately, twenty-
one communities were awarded grants in several categories, and ranged
in size from $9,000 to $319,000. Communities serving Native Americans
and migrants, as well as several innovative collaborative efforts were
included in the successful applicants. The communities that were not
selected are being given assistance in exploring other funding sources
and other advice.
The response and feedback from all participants has been
overwhelmingly positive. Officials from the state and federal
government who witnessed the process have stated that the process
worked well and was able to accomplish much on a volunteer basis. There
was even extraordinary appreciation from other funding agencies because
some communities they were not able to reach were provided funds for
feasibility studies.
The conclusion of all participants was that Project SEARCH is a
program worthy of being expanded nationally. So many small communities
in so many states can benefit from a program that assists underserved
and often overlooked communities. This legislation provides us the
opportunity to help small communities throughout the United States.
I have been encouraged by statements from regulatory officials at the
Federal, State, and local level that have identified small communities
as particularly in need of assistance in this area. Environmental
organizations have also made favorable remarks about the importance of
assisting small communities with the compliance costs of environmental
regulations. Finally, I should also note that organizations
representing small towns and rural areas recognize this long overlooked
problem.
I invite my colleagues to take this opportunity to assist small
communities in each of their States. Although the grant program
provided for in this bill is not large in comparison to other things
the Federal Government funds, these resources could be put to good and
effective use, as Idaho has proven. Moreover, I will remind everyone
that nowhere does this measure contemplate a change in environmental
regulations or standards. This is simply about relief for small
communities that would not otherwise be able to serve the public
interest or the environment.
______

By Mr. WELLSTONE (for himself, Mr. Helms, Mr. Kohl, Mr. Akaka,
Mr. Feingold, Mr. Inouye, and Mr. Reed):
S. 1467. A bill to amend the Hmong Veterans' Naturalization Act of
2000 to extend the deadlines for application and payment of fees; to
the Committee on the Judiciary.
Mr. WELLSTONE. Mr. President, today I am introducing the Bruce Vento
Hmong Veterans' Naturalization Extension Act. The Act is named after my
late colleague and dear friend, Congressman Bruce Vento. Congressman
Vento dedicated much of his career to working with the Hmong community

[[Page S9877]]

in Minnesota. He worked for a decade to ensure the passage of the Hmong
Veterans Naturalization Act. This bill would make it possible for all
eligible Hmong veterans and their wives to receive the benefits they
are due under this Act by extending the application deadline from
November 26, 2001 to May 26, 2003.
With less than 3 months remaining before the deadline passes for most
of those covered under the Act, only 25 percent of all eligible
applicants have filed for citizenship. Advocates for the Hmong believe
it will be impossible for all those eligible to file by the deadline.
The Hmong community has faced many challenges in getting veterans and
their wives filed. The Department of Justice did not release its
guidelines for 2\1/2\ months and many INS regional offices were
unfamiliar with the guidelines for a period of time after that,
resulting in eligible Hmong applicants being turned away. The language
barrier that created the need for the Hmong Veteran Naturalization Act
in the first place has meant that many Hmong needed assistance from
Hmong community advocates to understand the citizenship process and to
fill out the citizenship application. These advocacy organizations are
vastly under-resourced and are overwhelmed by the demand for help from
Hmong applicants.
I want to make it clear. This bill would not increase the number of
eligible applicants. It in no way would change the other requirements
of the law. It simply would provide a necessary extension for existing
eligible applicants.
As the Senator from Minnesota, I am proud to represent one of the
largest Hmong populations in America. My experience as a Senator has
become much richer as a result of coming to know the history and
culture of the Hmong people in Minnesota. I deeply respect their
extraordinary efforts in support of the American people. I urge my
colleagues' strong support of this legislation. The original Act was
passed because of Hmong veterans' tremendous sacrifice on behalf of the
United States during the Vietnam War and because of the unique literacy
challenges the Hmong community faces. It would be wrong to deny the
benefits of the Act to eligible veterans for reasons that are beyond
their control. Let us fulfill the intent of the Act we passed last year
and ensure that these veterans and their families receive the benefits
they are due.
______

By Mr. KYL:
S. 1468. A bill for the relief of Ilko Vasilev Ivanov, Anelia
Marinova Peneva, Marina Ilkova Ivanova, and Julia Ilkova Ivanova; to
the Committee on the Judiciary.
Mr. KYL. Mr. President, I ask unanimous consent that the text of the
bill be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:

S. 1468

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. PERMANENT RESIDENCE.

In the administration of the Immigration and Nationality
Act (8 U.S.C. 1101 et seq.), Ilko Vasilev Ivanov, Anelia
Marinova Peneva, Marina Ilkova Ivanova, and Julia Ilkova
Ivanova shall be held and considered to have been lawfully
admitted to the United States for permanent residence as of
the date of the enactment of this Act upon payment of the
required visa fees.

SEC. 2. REDUCTION OF NUMBER OF AVAILABLE VISAS.

Upon the granting of permanent residence to Ilko Vasilev
Ivanov, Anelia Marinova Peneva, Marina Ilkova Ivanova, and
Julia Ilkova Ivanova as provided in this Act, the Secretary
of State shall instruct the proper officer to reduce by the
appropriate number during the current fiscal year the total
number of immigrant visas available to natives of the country
of the aliens' birth under subsection (a) of section 203 of
the Immigration and Nationality Act (8 U.S.C. 1153).
______

By Mr. REED (for himself, Mr. Torricelli, Mrs. Carnahan, Mr.
Durbin, Mr. Lieberman, Mr. Wellstone, and Mrs. Clinton):
S. 1469. A bill to amend the Head Start and Early Head Start programs
to ensure that children eligible to participate in those programs are
identified and treated for lead poisoning, and for other purposes; to
the Committee on Health, Education, Labor, and Pensions.
Mr. REED. Mr. President, I rise today along with my colleague,
Senator Torricelli of New Jersey, to introduce two pieces of
legislation we believe are absolutely critical to our ongoing effort to
combat childhood lead poisoning. These two bills, the Early Childhood
Lead Poisoning Prevention Act and the Children's Lead SAFE Act, are
intended to improve our ability to detect and treat children at high
risk of lead poisoning, as well as expand our network of Federal
program sites where children at increased risk of lead poisoning can be
screened.
The Early Childhood Lead Poisoning Prevention Act requires WIC and
Head Start/Early Head Start programs with children under age 3 to
assess whether a child participant has been screened for lead, and
provide and track referrals for any child who has not been
appropriately screened. The bill also calls upon WIC and Head Start/
Early Head Start grantees to ensure that all enrolled children are
screened for lead poisoning and grants these entities the authority to
perform or arrange blood lead screening for program participants.
Lastly, the bill allows WIC clinics and Head Start/Early Head Start
grantees to seek reimbursement through Medicaid or the State Children's
Heath Insurance Program, CHIP, for eligible children who have received
a lead screening test in accordance with CDC recommendations or
Medicaid policy.
The Children's Lead Screening Accountability for Early Intervention
Act, or the Children's Lead SAFE Act, would require Medicaid
contractors to comply with existing requirements to provide screening,
treatment and any necessary follow-up services for Medicaid-eligible
children who test positive for lead poisoning. To be clear, this is not
imposing any new mandate on State Medicaid contractors. It is simply
trying to make current law more effective by explicitly requiring
health care providers to comply with Federal lead screening
requirements that have been in existence since 1992.
This new, stronger mandate has become necessary because 82 percent of
children ages one through five have never been screened for lead
poisoning, even though they were receiving health care benefits or
services through Medicaid, WIC, or the Health Centers program,
according to a recent report from the General Accounting Office, GAO,
despite long standing Federal requirements. This means that of the
estimated 890,000 children in the U.S. with elevated blood lead levels,
over 400,000 have never been identified or treated. Even more
disconcerting is that 50 percent of our States do not have screening
policies that are consistent with Federal requirements.
The reason why our two bills specifically focus on specific Federal
programs stems from the GAO report, which indicated that 77 percent of
U.S. children with high levels of lead in their blood are enrolled in
Federal programs, highlighting the viral role of these programs in
helping to eliminate the preventable tragedy of childhood lead
poisoning. Better involvement by Federal programs in promoting
screening and treatment is also critical to reducing the significant
health care and special education costs associated with the
irreversible effects of lead poisoning, which include the impairment of
mental and physical development.
We need to find the will and the resources to eradicate lead hazards
for millions of at-risk children. We also need to make more Americans
aware of the dangers of lead poisoning. I am committed to addressing
this crisis, and I hope my colleagues will join us in supporting these
bills and other lead poisoning prevention efforts.
I ask consent that the text of the Early Childhood Lead Poisoning
Prevention Act be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:

S. 1469

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Early Childhood Lead
Poisoning Prevention Act of 2001''.

SEC. 2. LEAD POISONING SCREENING FOR THE HEAD START AND EARLY
HEAD START PROGRAMS.

Section 645A of the Head Start Act (42 U.S.C 9840a) is
amended--
(1) in the first sentence of subsection (d), by inserting
before the period the following: ``and shall comply with
subsection (h)''; and

[[Page S9878]]

(2) by adding at the end the following:
``(h) Lead Poisoning Screening.--
``(1) In general.--An entity shall--
``(A) determine whether a child eligible to participate in
the program described in subsection (a)(1) has received a
blood lead screening test using a test that is appropriate
for age and risk factors upon the enrollment of the child in
the program; and
``(B) in the case of a child who has not received a blood
lead screening test, ensure that each enrolled child receives
such a test either by referral or by performing the test
(under contract or otherwise).
``(2) Screenings by entities.--
``(A) In general.--An entity may (under contract or
otherwise) perform a blood lead screening test that is
appropriate for age and risk factors on a child who seeks to
participate in the program.
``(B) Reimbursement.--
``(i) Children enrolled in or eligible for medicaid.--On
the request of an entity that performs or arranges for the
provision of a blood lead screening test under subparagraph
(A) of a child that is eligible for or receiving medical
assistance under a State plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.), the Secretary of
Health and Human Services, notwithstanding any other
provision of, or limitation under, title XIX of the Social
Security Act, shall reimburse the entity, from funds that are
made available under that title, for the Federal medical
assistance percentage (as defined in section 1905(b) of the
Social Security Act (42 U.S.C. 1396d(b)) of the cost of the
test and data reporting. Such costs shall include, if
determined to be desirable by the State agency, the costs of
providing screening through clinical laboratories certified
under section 353 of the Public Health Service Act (42 U.S.C.
263a), or purchasing, for use at sites providing services
under this section, blood lead testing instruments and
associated supplies approved for sale by the Food and Drug
Administration and used in compliance with such section 353.
``(ii) Children enrolled in or eligible for schip.--In the
case of a blood lead screening test performed under
subparagraph (A) (by the entity or under contract with the
entity) on a child who is eligible for or receiving medical
assistance under a State plan under title XXI of the Social
Security Act, the Secretary of Health and Human Services,
notwithstanding any other provision of, or limitation under,
such title XXI, shall reimburse the entity, from funds that
are made available under that title, for the enhanced FMAP
(as defined in section 2105(b) of the Social Security Act (42
U.S.C. 1397ee(b)) of the cost of the test and data reporting.
Such costs shall include the costs described in the second
sentence of clause (i).
``(3) Authorization for early head start.--There is
authorized to be appropriated such sums as may be necessary
to carry out this subsection with respect to blood lead
screening tests performed under this subsection on an infant
or child, and any data reporting with respect to such infant
or child, who is not eligible for coverage under title XIX or
XXI of the Social Security Act, or is not otherwise covered
under a health insurance plan.
``(4) Rule of construction.--Nothing in this subsection
shall be construed as requiring a child eligible to
participate in the program described in subsection (a)(1) to
undergo a blood lead screening test if the child's parent or
guardian objects to the test on the ground that the test is
inconsistent with the parent's or guardian's religious
beliefs.
``(5) Head start.--The provisions of this subsection shall
apply to head start programs that include coverage, directly
or indirectly, for infants and toddlers under the age of 3
years.''.

SEC. 3. LEAD POISONING SCREENING FOR SPECIAL SUPPLEMENTAL
NUTRITION PROGRAM FOR WOMEN, INFANTS, AND
CHILDREN.

Section 17(d) of the Child Nutrition Act of 1966 (42 U.S.C.
1786(d)) is amended by adding at the end the following:
``(4) Lead poisoning screening.--
``(A) In general.--A State agency shall--
``(i) determine whether an infant or child eligible to
participate in the program under this section has received a
blood lead screening test using a test that is appropriate
for age and risk factors upon the enrollment of the infant or
child in the program; and
``(ii) in the case of an infant or child who has not
received a blood lead screening test--

``(I) refer the infant or child for receipt of the test;
and
``(II) determine whether the infant or child receives the
test during a routine visit with a health care provider.

``(B) Screenings by state agencies.--
``(i) In general.--A State agency may (under contract or
otherwise) perform a blood lead screening test that is
appropriate for age and risk factors on an infant or child
who seeks to participate in the program.
``(ii) Reimbursement.--

``(I) Children enrolled in or eligible for medicaid.--On
the request of a State agency that performs or arranges for
the provision of a blood lead screening test under clause (i)
of an infant or child that is eligible for or receiving
medical assistance under a State plan under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.), the Secretary
of Health and Human Services, notwithstanding any other
provision of, or limitation under, title XIX of the Social
Security Act, shall reimburse the State agency, from funds
that are made available under that title, for the Federal
medical assistance percentage (as defined in section 1905(b)
of the Social Security Act (42 U.S.C. 1396d(b)) of the cost
of the test and data reporting. Such costs shall include, if
determined to be desirable by the State agency, the costs of
providing screening through clinical laboratories certified
under section 353 of the Public Health Service Act (42 U.S.C.
263a), or purchasing, for use at sites providing services
under this section, blood lead testing instruments and
associated supplies approved for sale by the Food and Drug
Administration and used in compliance with such section 353.
``(II) Children enrolled in or eligible for schip.--In the
case of a blood lead screening test performed under clause
(i) (by the State agency or under contract with the State
agency) on an infant or child who is eligible for or
receiving medical assistance under a State plan under title
XXI of the Social Security Act, the Secretary of Health and
Human Services, notwithstanding any other provision of, or
limitation under, such title XXI, shall reimburse the State
agency, from funds that are made available under that title,
for the enhanced FMAP (as defined in section 2105(b) of the
Social Security Act (42 U.S.C. 1397ee(b)) of the cost of the
test and data reporting. Such costs shall include the costs
described in the second sentence of subclause (I).

``(C) Authorization of appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this paragraph with respect to blood lead screening tests
performed under this paragraph on an infant or child, and any
data reporting with respect to such infant or child, who is
not eligible for coverage under title XIX or XXI of the
Social Security Act, or is not otherwise covered under a
health insurance plan.
``(D) Rule of construction.--Nothing in this paragraph
shall be construed as requiring a child eligible to
participate in the program under this section to undergo a
blood lead screening test if the child's parent or guardian
objects to the test on the ground that the test is
inconsistent with the parent's or guardian's religious
beliefs.''.

SEC. 4. EFFECTIVE DATE.

(a) In General.--Except as provided in subsection (b), the
amendments made by this Act take effect on the date that is
18 months after the date of enactment of this Act.
(b) WIC and Early Head Start Waivers.--
(1) In general.--A State agency or contractor administering
the program of assistance under the special supplemental
nutrition program for women, infants and children (WIC) under
section 17 of the Child Nutrition Act of 1966 (42 U.S.C.
1786), or an entity carrying out activities under section
645A of the Head Start Act (42 U.S.C 9840a) may be awarded a
waiver from the amendments made by sections 2 and 3 (as
applicable) if the State where the agency, contractor, or
entity is located establishes to the satisfaction of the
Secretary of Health and Human Services, in accordance with
requirements and procedures recommended in accordance with
paragraph (2) to the Secretary by the Director of the Centers
for Disease Control and Prevention, in consultation with the
Centers for Disease Control and Prevention Advisory Committee
on Childhood Lead Poisoning Prevention, a plan for increasing
the number of blood lead screening tests of children enrolled
in the WIC and the Early Head Start programs in the State.
(2) Development of waiver procedures and requirements.--Not
later than 12 months after the date of enactment of this Act,
the Director of the Centers for Disease Control and
Prevention, in consultation with the Centers for Disease
Control and Prevention Advisory Committee on Childhood Lead
Poisoning Prevention, shall develop and recommend to the
Secretary of Health and Human Services criteria and
procedures (including a timetable for the submission of the
State plan described in paragraph (1)) for the award of
waivers under that paragraph.
______

By Mr. SMITH of Oregon:
S. 1470. A bill to establish a demonstration program for school
dropout prevention; to the Committee on Health, Education, Labor, and
Pensions.
Mr. SMITH of Oregon. Mr. President, I rise today to introduce the
Dropout Reduction Outreach Program Act of 2001 known as DROP. I have
been deeply concerned about the high number of students dropping out of
school in Oregon and around the country. We all know that for children
at risk, having a relationship with a caring adult in school is often
the only reason students choose to stay in school. But many of our
schools, facing tight budgets, have had to cut guidance counselors, the
very people whose top priority is helping our kids manage the difficult
terrain of middle and high school academies and social life.
This bill will provide funds to demonstrate what we know by instinct:
that these guidance counselors can make a significant difference in
reducing our dropout rates. Funding will help districts with
particularly high dropout rates hire more counselors, and train
teachers and administrators in the most effective methods for working
with at-risk students.

[[Page S9879]]

We have spent many hours in this chamber this year debating the way
ahead for education in this country. We discussed and provided funding
for many programs that should allow every child in this country the
opportunity to receive a high quality education. And yet, recent
numbers from my State project that nearly one in five children in
Oregon will drop out of school before graduation.
If you think this statistic is sobering, consider that the dropout
rate for minority students is higher still. Dropout rates among
Hispanic, Native American, and African American children in Oregon are
all in double digits for each year of high school.
We know some of the warning signs for dropping out: getting behind in
coursework, working more than 15 hours each week, dysfunctional home
life, substance abuse, pregnancy, and lack of parental support for
education, but spotting these indicators and keeping students in school
are not the same.
With the economy increasingly dependent on highly trained technical
workers, a high school diploma is now a minimum credential for success
in American society. Keeping students in school is one way we can help
America's young people achieve success in their lives, while
maintaining our status as a world leader.
The DROP Act will establish a multi-state demonstration program that
will fund school counselor positions in middle and high schools with
high dropout rates. it will also offer specialized training to guidance
counselors and teachers who work with ``at risk'' students. The effects
of these demonstration projects will be carefully monitored, and
evaluations reported back to the Secretary of Education, who will then
share them with Congress, states, and educators who wish to address
this problem.
While the DROP Act requires only a small financial commitment, it has
the potential to have far-reaching implications as our society gears up
to lead the world into the 21st century. I encourage my colleagues to
support this legislation as a way to help all our nation's children
achieve their highest potential.
______

By Mr. TORRICELLI (for himself, Mr. Reed, Mrs. Clinton, Mr.
Wellstone, Mr. Durbin, Mrs. Carnahan, and Mr. Lieberman):
S. 1471. A bill to amend titles XIX and XXI of the Social Security
Act to ensure that Children enrolled in the Medicaid and State
children's health insurance program are identified and treated for lead
poisoning; to the committee on Finance.
Mr. TORRICELLI. Mr. President, I rise today along with my colleague,
Senator Reed of Rhode Island, to introduce the Children's Lead
Screening Accountability for Early-Intervention Act of 2001 and the
Early Childhood Lead Poisoning Prevention Act of 2001.
Lead poisoning is one of the dangerous environmental health hazards
for young children. It is estimated that 890,000 children nationally
suffer from elevated blood lead levels. Lead poisoning causes damage to
the brain and nervous system, loss in IQ, impaired physical development
and behavioral problems. High levels of exposure to lead can result in
comas, convulsions and death. Poor and minority children are most at-
risk of lead poisoning because of inadequate diets and exposure to
environmental hazards such as old housing.
In an effort to alleviate this problem, in 1992, Congress instructed
the Health Care Financing Administration to require States to lead
screen Medicaid children under the age of two. The screening would have
enabled the highest-risk children to be tested and treated before lead
poisoning impaired their development. Despite the Federal law, however,
a study from the General Accounting Office indicates that currently
two-thirds of all Medicaid children remain unscreened and that only
half the States have screening policies consistent with the law. In New
Jersey, only 30% of children covered by Medicaid are tested.
The Children's Lead Screening Accountability for Early-Intervention
Act or Children's Lead SAFE Act will create a lead screening safety net
that will, though the Medicaid and State Children's Health Insurance,
SCHIP, programs, ensure that children enrolled in these programs
receive blood lead screenings and appropriate follow-up care.
Specifically, this legislation will require state Medicaid contracts to
explicitly require health management organizations to comply with
federal rules related to lead screening and treatment. The bill will
expand Medicaid coverage to include lead treatment services and
environmental investigations to determine the source of the poisoning.
The Early Childhood Lead Poisoning Prevention Act of 2001 requires
the Head Start, Early Head Start and Women, Infants and Children, WIC,
programs to determine if enrolled children under age three have
received a blood lead screening test appropriate for their age and risk
factors. This legislation also requires that these programs provide and
track referrals for any child who has not been screened for lead
poisoning. Importantly, this legislation authorizes WIC, Head Start and
Early Head Start programs to seek reimbursement through Medicaid or the
SCHIP program for eligible children who have received a lead screening
test.
The health and safety of our children would be greatly enhanced with
the passage of these important measures. Childhood lead poisoning is
easily preventable and I hope my colleagues will join us in support of
this legislation.
At this time, I ask that the text of the Children's Lead Screening
Accountability for Early-Intervention Act of 2001 be printed in the
Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:

S. 1471

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Children's Lead Screening
Accountability For Early-Intervention Act of 2001'' or the
``Children's Lead SAFE Act''.

SEC. 2. FINDINGS AND PURPOSES.

(a) Findings.--Congress finds that--
(1) lead poisoning remains a serious environmental risk,
especially to the health of young children;
(2) childhood lead poisoning can cause reductions in IQ,
attention span, reading, and learning disabilities, and other
growth and behavior problems;
(3) children under the age of 6 are at the greatest risk of
suffering the effects of lead poisoning because of the
sensitivity of their developing brains and nervous systems,
while children under the age of 3 are especially at risk due
to their stage of development and hand-to-mouth activities;
(4) poor children and minority children are at
substantially higher risk of lead poisoning;
(5) three-fourths of all children ages 1 through 5 found to
have an elevated blood lead level in a Centers for Disease
Control and Prevention nationally representative sample were
enrolled in or targeted by Federal health care programs,
specifically the medicaid program, the special supplemental
nutrition program for women, infants, and children (WIC), and
the community health centers programs under section 330 of
the Public Health Service Act, equating to an estimated
688,000 children nationwide;
(6) the General Accounting Office estimates that \2/3\ of
the 688,000 children who have elevated blood lead levels and
are enrolled in or targeted by Federal health care programs
have never been screened for lead;
(7) although the Health Care Financing Administration has
required mandatory blood lead screenings for children
enrolled in the medicaid program who are not less than 1 nor
more than 5 years of age, less than 20 percent of these
children have received such screenings;
(8) the Health Care Financing Administration mandatory
screening policy has not been effective, or sufficient, to
properly identify and screen children enrolled in the
medicaid program who are at risk;
(9) only about \1/2\ of State programs have screening
policies consistent with Federal policy; and
(10) adequate treatment services are not uniformly
available for children with elevated blood lead levels.
(b) Purpose.--The purpose of this Act is to create a lead
screening safety net that will, through the medicaid and
State children's health insurance program, ensure that
children enrolled in those programs receive blood lead
screenings and appropriate followup care.

SEC. 3. INCREASED LEAD POISONING SCREENINGS AND TREATMENTS
UNDER THE MEDICAID PROGRAM.

(a) Reporting Requirement.--Section 1902(a)(43)(D) of the
Social Security Act (42 U.S.C. 1396a(a)(43)(D)) is amended--
(1) in clause (iii), by striking ``and'' at the end;
(2) in clause (iv), by striking the semicolon and inserting
``, and''; and
(3) by adding at the end the following new clause:
``(v) the number of children who are under the age of 3 and
enrolled in the State plan

[[Page S9880]]

under this title and the number of those children who have
received a blood lead screening test;''.
(b) Mandatory Screening Requirements.--Section 1902(a) of
the Social Security Act (42 U.S.C. 1396a(a)) is amended--
(1) in paragraph (64), by striking ``and'' at the end;
(2) in paragraph (65), by striking the period and inserting
``; and''; and
(3) by inserting after paragraph (65) the following new
paragraph:
``(66) provide that each contract entered into between the
State and an entity (including a health insuring organization
and a medicaid managed care organization) that is responsible
for the provision (directly or through arrangements with
providers of services) of medical assistance under the State
plan shall provide for--
``(A) compliance with mandatory blood lead screening
requirements that are consistent with prevailing guidelines
of the Centers for Disease Control and Prevention for such
screening; and
``(B) coverage of qualified lead treatment services
described in section 1905(x) including diagnosis, treatment,
and follow-up furnished for children with elevated blood lead
levels in accordance with prevailing guidelines of the
Centers for Disease Control and Prevention.''.
(c) Reimbursement for Treatment of Children With Elevated
Blood Lead Levels.--Section 1905 of the Social Security Act
(42 U.S.C. 1396d) is amended--
(1) in subsection (a)--
(A) in paragraph (26), by striking ``and'' at the end;
(B) by redesignating paragraph (27) as paragraph (28); and
(C) by inserting after paragraph (26) the following new
paragraph:
``(27) qualified lead treatment services (as defined in
subsection (x)); and''; and
(2) by adding at the end the following new subsection:
``(x)(1) In this subsection:
``(A) The term `qualified lead treatment services' means
the following:
``(i) Lead-related medical management, as defined in
subparagraph (B).
``(ii) Lead-related case management, as defined in
subparagraph (C), for a child described in paragraph (2).
``(iii) Lead-related anticipatory guidance, as defined in
subparagraph (D), provided as part of--
``(I) prenatal services;
``(II) early and periodic screening, diagnostic, and
treatment services (EPSDT) described in subsection (r) and
available under subsection (a)(4)(B) (including as described
and available under implementing regulations and guidelines)
to individuals enrolled in the State plan under this title
who have not attained age 21; and
``(III) routine pediatric preventive services.
``(B) The term `lead-related medical management' means the
provision and coordination of the diagnostic, treatment, and
follow-up services provided for a child diagnosed with an
elevated blood lead level (EBLL) that includes--
``(i) a clinical assessment, including a physical
examination and medically indicated tests (in addition to
diagnostic blood lead level tests) and other diagnostic
procedures to determine the child's developmental,
neurological, nutritional, and hearing status, and the
extent, duration, and possible source of the child's exposure
to lead;
``(ii) repeat blood lead level tests furnished when
medically indicated for purposes of monitoring the blood lead
concentrations in the child;
``(iii) pharmaceutical services, including chelation agents
and other drugs, vitamins, and minerals prescribed for
treatment of an EBLL;
``(iv) medically indicated inpatient services including
pediatric intensive care and emergency services;
``(v) medical nutrition therapy when medically indicated by
a nutritional assessment, that shall be furnished by a
dietitian or other nutrition specialist who is authorized to
provide such services under State law;
``(vi) referral--
``(I) when indicated by a nutritional assessment, to the
State agency or contractor administering the program of
assistance under the special supplemental nutrition program
for women, infants and children (WIC) under section 17 of the
Child Nutrition Act of 1966 (42 U.S.C. 1786) and coordination
of clinical management with that program; and
``(II) when indicated by a clinical or developmental
assessment, to the State agency responsible for early
intervention and special education programs under the
Individuals with Disabilities Education Act (20 U.S.C. 1400
et seq.); and
``(vii) environmental investigation, as defined in
subparagraph (E).
``(C) The term `lead-related case management' means the
coordination, provision, and oversight of the nonmedical
services for a child with an EBLL necessary to achieve
reductions in the child's blood lead levels, improve the
child's nutrition, and secure needed resources and services
to protect the child by a case manager trained to develop and
oversee a multi-disciplinary plan for a child with an EBLL or
by a childhood lead poisoning prevention program, as defined
by the Secretary. Such services include--
``(i) assessing the child's environmental, nutritional,
housing, family, and insurance status and identifying the
family's immediate needs to reduce lead exposure through an
initial home visit;
``(ii) developing a multidisciplinary case management plan
of action that addresses the provision and coordination of
each of the following items as appropriate--
``(I) determination of whether or not such services are
covered under the State plan under this title;
``(II) lead-related medical management of an EBLL
(including environmental investigation);
``(III) nutrition services;
``(IV) family lead education;
``(V) housing;
``(VI) early intervention services;
``(VII) social services; and
``(VIII) other services or programs that are indicated by
the child's clinical status and environmental, social,
educational, housing, and other needs;
``(iii) assisting the child (and the child's family) in
gaining access to covered and non-covered services in the
case management plan developed under clause (ii);
``(iv) providing technical assistance to the provider that
is furnishing lead-related medical management for the child;
and
``(v) implementation and coordination of the case
management plan developed under clause (ii) through home
visits, family lead education, and referrals.
``(D) The term `lead-related anticipatory guidance' means
education and information for families of children and
pregnant women enrolled in the State plan under this title
about prevention of childhood lead poisoning that addresses
the following topics:
``(i) The importance of lead screening tests and where and
how to obtain such tests.
``(ii) Identifying lead hazards in the home.
``(iii) Specialized cleaning, home maintenance,
nutritional, and other measures to minimize the risk of
childhood lead poisoning.
``(iv) The rights of families under the Residential Lead-
Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et
seq.).
``(E) The term `environmental investigation' means the
process of determining the source of a child's exposure to
lead by an individual that is certified or registered to
perform such investigations under State or local law,
including the collection and analysis of information and
environmental samples from a child's living environment. For
purposes of this subparagraph, a child's living environment
includes the child's residence or residences, residences of
frequently visited caretakers, relatives, and playmates, and
the child's day care site. Such investigations shall be
conducted in accordance with the standards of the Department
of Housing and Urban Development for the evaluation and
control of lead-based paint hazards in housing and in
compliance with State and local health agency standards for
environmental investigation and reporting.
``(2) For purposes of paragraph (1)(A)(ii), a child
described in this paragraph is a child who--
``(A) has attained 6 months but has not attained 6 years of
age; and
``(B) has been identified as having a blood lead level that
equals or exceeds 20 micrograms per deciliter (or after 2
consecutive tests, equals or exceeds 15 micrograms per
deciliter, or the applicable number of micrograms designated
for such tests under prevailing guidelines of the Centers for
Disease Control and Prevention).''.
(d) Enhanced Match for Data Communications System.--Section
1903(a)(3) of the Social Security Act (42 U.S.C. 1396b(a)(3))
is amended--
(1) in subparagraph (D), by striking ``plus'' at the end
and inserting ``and''; and
(2) by inserting after subparagraph (D), the following new
subparagraph:
``(E)(i) 90 percent of so much of the sums expended during
such quarter as are attributable to the design, development,
or installation of an information retrieval system that may
be easily accessed and used by other federally-funded means-
tested public benefit programs to determine whether a child
is enrolled in the State plan under this title and whether an
enrolled child has received mandatory early and periodic
screening, diagnostic, and treatment services, as described
in section 1905(r); and
``(ii) 75 percent of so much of the sums expended during
such quarter as are attributable to the operation of a system
(whether such system is operated directly by the State or by
another person under a contract with the State) of the type
described in clause (i); plus''.
(e) Report.--The Secretary of Health and Human Services,
acting through the Administrator of the Health Care Financing
Administration, annually shall report to Congress on the
number of children enrolled in the medicaid program under
title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
who have received a blood lead screening test during the
prior fiscal year, noting the percentage that such children
represent as compared to all children enrolled in that
program.
(f) Emergency Measures.--
(1) In general.--Subject to paragraph (2), the Secretary of
Health and Human Services or the State agency administering
the State plan under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.) shall use funds provided under title XIX
of that Act to reimburse a State or entity for expenditures
for medically necessary activities in the home of a lead-
poisoned child with an EBLL of at least 20, or a pregnant
woman with an EBLL of at least 20, to prevent additional
exposure to lead, including specialized cleaning of

[[Page S9881]]

lead-contaminated dust, emergency relocation, safe repair of
peeling paint, dust control, and other activities that reduce
lead exposure. Such reimbursement, when provided by the State
agency administering the State plan under title XIX of the
Social Security Act, shall be considered medical assistance
for purposes of section 1903(a) of such Act.
(2) Limitation.--Not more than $1,000 in expenditures for
the emergency measures described in paragraph (1) may be
incurred on behalf of a child or pregnant woman to which that
paragraph applies.
(g) Rule of Construction.--Nothing in this Act or any
amendment made by this Act shall be construed as requiring a
child enrolled in the State medicaid program under title XIX
of the Social Security Act to undergo a lead blood screening
test if the child's parent or guardian objects to the test on
the ground that the test is inconsistent with the parent's or
guardian's religious beliefs.

SEC. 4. BONUS PROGRAM FOR IMPROVEMENT OF CHILDHOOD LEAD
SCREENING RATES.

(a) In General.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary'') may
establish a program to improve the blood lead screening rates
of States for children under the age of 3 enrolled in the
medicaid program.
(b) Payments.--If the Secretary establishes a program under
subsection (a), the Secretary, using State-specific blood
lead screening data, shall, subject to the availability of
appropriations, annually pay a State an amount determined as
follows:
(1) $25 per each 2 year-old child enrolled in the medicaid
program in the State who has received the minimum required
(for that age) screening blood lead level tests (capillary or
venous samples) to determine the presence of elevated blood
lead levels, as established by the Centers for Disease
Control and Prevention, if the State rate for such screenings
exceeds 65 but does not exceed 75 percent of all 2 year-old
children in the State.
(2) $50 per each such child who has received such minimum
required tests if the State rate for such screenings exceeds
75 but does not exceed 85 percent of all 2 year-old children
in the State.
(3) $75 per each such child who has received such minimum
required tests if the State rate for such screenings exceeds
85 percent of all 2 year-old children in the State.
(c) Use of Bonus Funds.--Funds awarded to a State under
subsection (b) shall only be used--
(1) by the State department of health in the case of a
child with an elevated blood lead level who is enrolled in
medicaid or another Federal means-tested program designed to
reduce the source of the child's exposure to lead; or
(2) in accordance with guidelines for the use of such funds
developed by the Secretary in collaboration with the
Secretary of Housing and Urban Development.
(d) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section, $30,000,000 for
each of fiscal years 2002 through 2006.

SEC. 5. AUTHORIZATION TO USE SCHIP FUNDS FOR BLOOD LEAD
SCREENING.

(a) Optional Application To SCHIP.--
(1) In general.--Section 2107(e)(1) of the Social Security
Act (42 U.S.C. 1397gg(e)(1)) is amended by adding at the end
the following new subparagraph:
``(E) At State option, section 1902(a)(66) (relating to
blood lead screening and coverage of qualified lead treatment
services defined in section 1905(x)).''.
(2) Conforming amendment.--Section 2110(a) of the Social
Security Act (42 U.S.C. 1397jj(a)) is amended--
(A) by redesignating paragraph (28) as paragraph (29); and
(B) by inserting after paragraph (27) the following new
paragraph:
``(28) qualified lead treatment services (as defined in
section 1905(x)), but only if the State has elected under
section 2107(e)(1)(E) to apply section 1902(a)(66) to the
State child health plan under this title.''.
(b) Inclusion in Medicaid Reporting Requirement.--
(1) In general.--Section 1902(a)(43)(D)(v) of the Social
Security Act (42 U.S.C. 1396a(a)(43)(D)(v)), as added by
section 3(a)(3), is amended by inserting ``or, if the State
has elected under section 2107(e)(1)(E) to apply paragraph
(66) to the State child health plan under title XXI, in the
State plan under title XXI,'' after ``this title''.
(2) Report to congress.--Section 3(e) of this Act is
amended--
(A) by inserting ``or in the State children's health
insurance program under title XXI of that Act (42 U.S.C
1397aa et seq.)'' after ``(42 U.S.C. 1396 et seq.)''; and
(B) by striking ``that program'' and inserting ``those
programs''.

SEC. 6. EFFECTIVE DATE.

This Act and the amendments made by this Act take effect on
the date that is 18 months after the date of enactment of
this Act.
______

By Mr. HARKIN (for himself and Mr. Lugar):
S. 1474. A bill to amend the Federal Insecticide, Fungicide, and
Rodenticide Act to extend and improve the collection of maintenance
fees, and for other purposes; to the Committee on Agriculture,
Nutrition, and Forestry.
Mr. HARKIN. Mr. President, I rise today to introduce the Pesticide
Maintenance Fees Reauthorization Act of 2001 on behalf of myself and my
friend, Senator Lugar. This legislation reauthorizes several existing
legislative provisions addressing pesticide fees.
As Senator Lugar and my colleagues know, the legal authorization for
the collection of so-called maintenance fees for the reregistration of
pesticides expires at the end of this month. This expiration means that
EPA will face a significant funding shortfall as it continues its
implementation of FQPA.
This legislation has been negotiated between the Senate and House
Agriculture Committees and representatives of the environmental and
agri-chemical industry. It would require industry to pay $20 million a
year to reevaluate pesticides approved by EPA prior to 1984. In return,
a controversial proposal by the Environmental Protection Agency to more
than quadruple the amount of fees paid by the pesticide industry will
be shelved.
The $20 million per year represents an increase over the previous fee
schedule that had ranged from $14 to $17.6 million a year. $20 million
reflects the amount of money that EPA says is necessary to pay the
salaries and expenses of the 200 employees that review older
pesticides.
If this reauthorization were not provided, EPA would have to make up
the money from elsewhere in its budget or layoff some of those
employees. If that were to happen there is widespread concern that
EPA's review of pesticides would slow down significantly. EPA has been
charged with reviewing all pesticides to make sure they are safe for
the environment and safe for kids. The last we need is for EPA to lose
the workers vital to accomplishing that.
I hope that the Senate will be able to move quickly on this
legislation, and I thank Senator Lugar for working with me to get it
introduced.
______

By Mr. BREAUX (for himself and Mr. Hatch):
S. 1475. A bill to amend the Internal Revenue Code of 1986 to provide
an appropriate and permanent tax structure for investments in the
Commonwealth of Puerto Rico and the possessions of the United States,
and for other purposes; to the Committee on Finance.
Mr. BREAUX. Mr. President, I am proud to be an original co-sponsor of
the Economic Revitalization Tax Act of 2001. This legislation is
designed to revitalize one of America's most important economic
partners. As we discuss economic stimulus measures for our Nation
during these difficult times, it is important the we do not leave
behind the 3.9 million U.S. citizens of the Commonwealth of Puerto
Rico.
Puerto Rico purchases over $16 billion a year in goods and services
from the rest of the United States. This is more than much larger
nations such as Russia, China, Italy and Brazil. A strong economy in
Puerto Rico helps generate over 320,000 jobs in the U.S. mainland. It
is important that we maintain this economic partnership as strong as
ever.
The economy of Puerto Rico was weak even before the current national
crisis. Since the beginning of the year, plant closures have been
announced affecting over 7 percent of the manufacturing workforce.
Since Congress repealed tax incentives for investment in Puerto Rico in
October 1996, manufacturing employment has declined by over 15
percent--more than any state in the U.S. mainland. Employment in other
sectors of the economy has not increased enough to offset the loss in
manufacturing jobs. Consequently, total employment in Puerto Rico has
declined over the last five years. By contrast, during the same period,
jobs increased by over 10 percent in the average state, and no state
experienced a net job loss.
The negative economic impacts of the current state of national alert
will be felt most in those regions of the country that are dependent on
tourism and air transportation. As a small island, Puerto Rico is four
times more dependent on external trade as a share of GDP than the U.S.
mainland, and 45 percent of Puerto Rico's trade is transported by air,
compared to only 5 percent for the U.S. American Airlines which employs
thousands at its major hub in Puerto Rico will be dramatically affected
by the reduction in air travel.
Tourist expenditures are an essential component of Puerto Rico's
economy.

[[Page S9882]]

Occupancy rates at Puerto Rico hotels have already been cut in half,
with more losses expected as convention cancellations mount. Absent a
turnaround, a significant portion of Puerto Rico's economy is directly
at risk, with ripple effects beyond the tourism sector.
Puerto Rico's economy is closely linked to the U.S. economy. When the
United States goes into recession, the impact is immediately felt on
the Island where the rate of unemployment currently is running at about
13 percent. Retail sales are down over 30 percent since the terrorist
acts.
It is essential to adopt measures to help Puerto Rico, like the rest
of the country, recover economically and financially. Proposed national
economic recovery legislation will not, without special provisions,
help Puerto Rico. For example, because Puerto Rico is considered a
separate taxing jurisdiction, investment tax credits and other business
incentives do not apply to investments in Puerto Rico.
``The Economic Revitalization Tax Act of 2001,'' will materially
assist in mitigating the impact of the expected economic losses in
Puerto Rico as a result of the tragic recent events, as well as halt
the continuing loss of manufacturing jobs due to the 1996 repeal of
U.S. tax incentives. This legislation would provide a new tax regime to
encourage American companies to retain their Puerto Rico operations and
to re-invest profits earned in Puerto Rico and the U.S. possessions in
the United States on a tax preferred basis. This will not only help
Puerto Rico directly, but it will also help the American economy by
returning profits to the U.S. where they can be invested in other job
creating activities.
Puerto Rico is a vital partner in the American family. The new
administration of Governor Sila Maria Calderon, is bringing a renewed
vision of a prosperous Puerto Rico and is implementing a coherent
development plan that will make that vision a reality. Governor
Calderon understands that reform of the Commonwealth government and its
economic development policies are necessary for Puerto Rico's economic
development. She is doing this in close collaboration with business and
community leaders in Puerto Rico.
This proposal is a win-win situation for Puerto Rico and for the
American worker and taxpayer. We help create jobs in Puerto Rico, and
those jobs will help create jobs in the U.S. mainland.
Please join me in supporting this legislation.

____________________