SECTION 1. SHORT TITLE. This Act may be cited as the ``Beaches Environmental Assessment, Closure, and Health Act of 1999''. SEC. 2. FINDINGS AND PURPOSE. (a) Findings.--Congress finds that-- (1) the Nation's beaches and coastal recreation waters are valuable public resources used for recreation by millions of people annually; (2) the beaches of coastal States are hosts to many out-of- State and international visitors; (3) tourism in the coastal zone generates billions of dollars annually; (4) increased population and urbanization of the watershed have contributed to the decline in the environmental quality of coastal waters; (5) pollution in coastal waters is not restricted by State and other political boundaries; (6) coastal States have different methods of testing, and parameters for evaluating, the quality of coastal recreation waters, providing varying degrees of protection to the public; (7) the adoption of consistent criteria by coastal States for monitoring and evaluating the quality of coastal recreation waters, and the posting of signs at beaches notifying the public during periods when the standards are exceeded, would enhance public health and safety; and (8) while the adoption of such criteria will enhance public health and safety, exceedances of such criteria should be addressed (for example, as part of a watershed approach to effectively identify and eliminate sources of pollution). (b) Purpose.--The purpose of this Act is to require uniform criteria and procedures for testing, monitoring, and notifying users of those coastal recreation waters and beaches open for use by the public in order to protect public safety and improve environmental quality. SEC. 3. BEACH AND COASTAL RECREATION WATER QUALITY. The Federal Water Pollution Control Act (33 U.S.C. 1251 et seq.) is amended by adding at the end the following: ``TITLE VII--BEACH AND COASTAL RECREATION WATER QUALITY ``SEC. 701. DEFINITIONS. ``In this title, the following definitions apply: ``(1) Coastal recreation waters.--The term `coastal recreation waters' means waters adjacent to public beaches of the Great Lakes and other marine coastal waters (including bays, lagoon mouths, and coastal estuaries within the tidal zone) used by the public for swimming, bathing, surfing, or other similar water contact activities. ``(2) Floatable materials.--The term `floatable materials' means any foreign matter that may float or remain suspended in the water column and includes plastic, aluminum cans, wood, bottles, paper products, and fishing gear. ``SEC. 702. ADOPTION OF COASTAL RECREATIONAL WATER QUALITY CRITERIA BY STATES. ``(a) General Rule.--A State shall adopt water quality criteria for coastal recreation waters which, at a minimum, are consistent with the criteria published by the Administrator under section 304(a)(1) not later than 3\1/2\ years following the date of the enactment of this title. Such water quality criteria shall be developed and promulgated in accordance with the requirements of section 303(c). A State shall incorporate such criteria into all appropriate programs into which such State would incorporate other water quality criteria adopted under section 303(c) and revise such criteria not later than 3 years following the date of publication of revisions by the Administrator under section 703(b). ``(b) Failure of States To Adopt.--If a State has not complied with subsection (a) by the last day of the 3\1/2\-year period beginning on the date of the enactment of this title, the water quality criteria issued by the Administrator under section 304(a)(1) shall become applicable as the water quality criteria for coastal recreational waters for the State, and shall be deemed to have been promulgated by the Administrator pursuant to section 303(c)(4). ``SEC. 703. REVISIONS TO WATER QUALITY CRITERIA. ``(a) Studies.--After consultation with appropriate Federal, State, and local officials, including local health officials, and other interested persons, but not later than the last day of the 3-year period beginning on the date of the enactment of this Act, the Administrator shall conduct, in cooperation with the Under Secretary of Commerce for Oceans and Atmosphere, studies to provide additional information to the current base of knowledge for use in developing-- ``(1) a more complete list of potential human health risks from inhalation, ingestion, or body contact with coastal recreation waters, including effects to the upper respiratory system; ``(2) appropriate and effective indicators for improving direct detection of the presence of pathogens that are harmful to human health in coastal recreational waters; ``(3) appropriate, accurate, and expeditious methods (including predictive models) for detecting the presence of pathogens, harmful to human health, found in coastal recreation waters; and ``(4) guidance for the State-to-State application of the criteria to be issued under subsection (b) to account for the diversity of geographic and aquatic conditions nationwide. ``(b) Revised Criteria.--Based on the results of the studies conducted under subsection (a), the Administrator, after consultation with appropriate Federal, State, and local officials, including local health officials, and other interested persons, shall-- ``(1) issue, within 5 years after the date of the enactment of this title, revised water quality criteria for pathogens in coastal recreation waters that are harmful to human health, including a revised list of indicators and testing methods; and ``(2) review and revise such criteria from time to time thereafter, but in no event less than once every 5 years. ``SEC. 704. COASTAL BEACH WATER QUALITY MONITORING. ``(a) Monitoring.--Within 18 months after the date of enactment of this title, the Administrator shall publish regulations requiring monitoring by States of those coastal recreation waters and beaches open for use by the public for compliance with applicable water quality criteria and protection of public safety. Monitoring requirements established pursuant to this subsection shall specify, at a minimum-- ``(1) available monitoring methods to be used by States; ``(2) the frequency and location of monitoring based on-- ``(A) the periods of recreational use of such waters; ``(B) the extent and degree of use during such periods; and ``(C) the proximity of coastal recreation waters to known or identified point and nonpoint sources of pollution and in relation to storm events; ``(3) methods for detecting levels of pathogens that are harmful to human health and for identifying short-term increases in pathogens that are harmful to human health in coastal recreation waters, including in relation to storm events; and ``(4) conditions and procedures under which discrete areas of coastal recreation waters may be exempted by the Administrator from the monitoring requirements of this subsection, if the Administrator determines that an exemption will not impair compliance with the applicable water quality criteria for those waters and protection of public safety. ``(b) Notification.-- ``(1) Requirement.--Regulations published pursuant to subsection (a) shall require States to provide prompt notification to local governments, the public, and the Administrator of an exceedance of applicable water quality criteria for State coastal recreation waters or the immediate likelihood of such an exceedance. ``(2) Contents.--Notification pursuant to this subsection shall include, at a minimum-- ``(A) prompt communication of the occurrence, nature, extent, location, and substances (including pathogens) of such an exceedance, or the immediate likelihood of such an exceedance, to a designated official of a local government having jurisdiction over land adjoining the coastal recreation waters for which an exceedance is identified; and ``(B) posting of signs for the period during which the exceedance continues, sufficient to give notice to the public of an exceedance of applicable water quality criteria for such waters and the potential risks associated with water contact activities in such waters. ``(c) Review and Revision of Regulations.--The Administrator shall review and revise regulations published pursuant to this section periodically, but in no event less than once every 5 years. ``(d) State Implementation.--A State must implement a monitoring and notification program that conforms to the regulations issued pursuant to subsections (a) and (b) not later than 3\1/2\ years after the date of the enactment of this title and revise such program not later than 2 years following the date of publication of revisions by the Administrator under subsection (c). ``(e) Delegation of Responsibility.--Not later than 18 months after the date of the enactment of this title, the Administrator shall issue guidance establishing core performance measures for testing, monitoring, and notification programs and the delegation of such programs under this section to local government authorities. In the case that such responsibilities are delegated by a State to a local government authority, or have been delegated to a local government authority before such date of enactment, in a manner that, at a minimum, is consistent with the guidance issued by the Administrator, State resources, including grants made under section 706, shall be made available to the delegated authority for the purpose of program implementation. ``(f) Floatable Materials Monitoring Procedures.--The Administrator shall provide technical assistance to States for the implementation of uniform assessment and monitoring procedures for floatable materials in coastal recreation waters and specify the conditions under which the presence of floatable material will constitute a threat to public health and safety. ``(g) Occurrence Database.--The Administrator shall establish, maintain, and make available to the public by electronic and other means-- ``(1) a national coastal recreation water pollution occurrence database, using reliable information, including that reported under subsection (b); and ``(2) a listing of those communities complying with the regulations issued under subsections (a) and (b). ``SEC. 705. REPORT TO CONGRESS. ``Not later than 4 years after the date of the enactment of this title, and periodically thereafter, the Administrator shall submit to Congress a report including-- ``(1) recommendations concerning the need for additional water quality criteria and other actions needed to improve the quality of coastal recreation waters; and ``(2) an evaluation of State efforts to implement this title. ``SEC. 706. GRANTS TO STATES. ``(a) Grants.--The Administrator may make grants to States for use in fulfilling requirements established pursuant to sections 702 and 704. ``(b) Cost Sharing.--The total amount of grants to a State under this section for a fiscal year shall not exceed 50 percent of the cost to the State of implementing requirements established pursuant to sections 702 and 704. ``(c) Eligible State.--After the last day of the 3\1/2\-year period beginning on the date of the enactment of this title, the Administrator may make a grant to a State under this section only if the State demonstrates to the satisfaction of the Administrator that it is implementing its monitoring and notification program under section 704. ``SEC. 707. AUTHORIZATION OF APPROPRIATIONS. ``There is authorized to be appropriated to the Administrator-- ``(1) for use in making grants to States under section 706 not more than $9,000,000 for each of fiscal years 2000 through 2004; and ``(2) for carrying out the other provisions of this title not more than $3,000,000 for each of fiscal years 2000 through 2004.''.

Summary: Directs the Administrator to conduct studies for use in developing: (1) a more complete list of potential health risks from inhalation, ingestion, or body contact, including effects to the upper respiratory system; (2) appropriate and effective indicators and appropriate, accurate, and expeditious methods for detecting the presence of pathogens in coastal recreational waters; and (3) guidance for State-to-State application of the revised water quality criteria for pathogens required to be issued by the Administrator under this Act that accounts for the diversity of geographic and aquatic conditions nationwide. Directs the Administrator to publish and revise regulations requiring monitoring of, and specifying methods to be used by States to monitor, coastal recreation waters at public beaches for compliance with water quality criteria and protection of public safety. Requires notification of local governments, the public, and the Administrator of exceedances, or the likelihood of exceedances, of water quality criteria for such waters. Requires the Administrator to issue guidance establishing core performance measures for testing, monitoring, and notification programs and for the delegation of such programs to local government authorities. Makes State resources available to such authorities if the programs are so delegated. Directs the Administrator to: (1) provide technical assistance to States for the implementation of uniform assessment and monitoring procedures for floatable materials in such waters; (2) specify the conditions under which the presence of floatable material constitutes a threat to public health and safety; and (3) establish a national coastal recreation water pollution occurrence database and a listing of communities complying with the monitoring and notification regulations published pursuant to this Act. Authorizes the Administrator to make grants to States to fulfill requirements under this Act. Authorizes appropriations.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Prescription Coverage Now Act of 2006''. SEC. 2. EXPEDITING LOW-INCOME SUBSIDIES UNDER THE MEDICARE PRESCRIPTION DRUG PROGRAM. (a) In General.--Section 1860D-14 of the Social Security Act (42 U.S.C. 1395w-114) is amended by adding at the end the following new subsection: ``(e) Expedited Application and Eligibility Process.-- ``(1) Expedited process.-- ``(A) In general.--The Secretary shall provide for an expedited process under this subsection for the qualification for low-income assistance under this section through a request by the Secretary to the Secretary of the Treasury as provided in subparagraphs (B) and (C) for information sufficient to identify whether the individual involved is likely eligible for subsidies under this section based on such information and the amount of premium and cost-sharing subsidies for which they would qualify based on such information. Such process shall be conducted in cooperation with the Commissioner of Social Security. ``(B) Opt in for newly eligible individuals.--Not later than 60 days after the date of the enactment of this subsection, the Secretary shall ensure that, as part of the Medicare enrollment process, enrolling individuals-- ``(i) receive information describing the low-income subsidy provided under this section; and ``(ii) are provided the opportunity to opt- in to the expedited process described in this subsection by giving consent for the Secretary to screen the beneficiary for eligibility for such subsidy through a request to the Secretary of the Treasury under section 6103(l)(7) of the Internal Revenue Code of 1986. ``(C) Transition for currently eligible individuals.--In the case of any part D eligible individual to which subparagraph (B) did not apply at the time of such individual's enrollment, the Secretary shall, as soon as practicable after implementation of subparagraph (B), request in writing that the Secretary of the Treasury disclose, pursuant to section 6103(l)(21) of the Internal Revenue Code of 1986, whether such individual has either filed no income tax return or whether such individual's income tax return indicates likely eligibility for the low-income subsidy provided under this section. ``(2) Notification of potentially eligible individuals.-- Under such process, in the case of each individual identified under paragraph (1) who has not otherwise applied for, or been determined eligible for, benefits under this section (or who has applied for and been determined ineligible for such benefits based only on excess resources), the Secretary shall send them a letter (using basic, uncomplicated language) containing the following: ``(A) Eligibility.--A statement that, based on the information obtained under paragraph (1), the individual is likely eligible for low-income subsidies under this section. ``(B) Amount of subsidies.--A description of the amount of premium and cost-sharing subsidies under this section for which the individual would likely be eligible based on such information. ``(C) Enrollment opportunity.--In case the individual is not enrolled in a prescription drug plan or MA-PD plan-- ``(i) a statement that-- ``(I) the individual has the opportunity to enroll in a prescription drug plan or MA-PD plan for benefits under this part, but is not required to be so enrolled; and ``(II) if the individual has creditable prescription drug coverage, the individual need not so enroll; ``(ii) a list of the prescription drug plans and MA-PD plans in which the individual is eligible to enroll; ``(iii) an enrollment form that may be used to enroll in such a plan by mail and that provides that if the individual wishes to enroll but does not designate a plan, the Secretary is authorized to enroll the individual in such a prescription drug plan selected by the Secretary; and ``(iv) a statement that the individual may also enroll online or by telephone, but, in order to qualify for low-income subsidies, the individual must complete the attestation described in subparagraph (D) or otherwise apply for such subsidies. ``(D) Attestation.--A one-page application form that provides for a signed attestation, under penalty of law, as to the amount of income and assets of the individual and constitutes an application for the low- income subsidies described in subparagraph (B). Such form-- ``(i) shall not require the submittal of additional documentation regarding income or assets; ``(ii) shall permit the appointment of a personal representative described in paragraph (6); and ``(iii) may provide for the specification of a language (other than English) that is preferred for subsequent communications with respect to the individual under this part. ``(E) Information on ship.--Information on how the individual may contact the State Health Insurance Assistance Program (SHIP) for the State in which the individual is located in order to obtain assistance regarding enrollment and benefits under this part. If a State is doing its own outreach to low-income seniors regarding enrollment and low-income subsidies under this part, such process shall be coordinated with the State's outreach effort. ``(3) Follow-up communications.--If the individual does not respond to the letter described in paragraph (2) either by making an enrollment described in paragraph (2)(C), completing an attestation described in paragraph (2)(D), or declining either or both, the Secretary shall make additional attempts to contact the individual to obtain such an affirmative response. ``(4) Hold-harmless.--Under such process, if an individual in good faith and the absence of fraud executes an attestation described in paragraph (2)(D) and is provided low-income subsidies under this section on the basis of such attestation, if the individual is subsequently found not eligible for such subsidies, there shall be no recovery made against the individual because of such subsidies improperly paid. ``(5) Use of authorized representative.--Under such process, with proper authorization (which may be part of the attestation form described in paragraph (2)(D)), an individual may authorize another individual to act as the individual's personal representative with respect to communications under this part and the enrollment of the individual under a prescription drug plan (or MA-PD plan) and for low-income subsidies under this section. ``(6) Use of preferred language in subsequent communications.--In the case an attestation described in paragraph (2)(D) is completed and in which a language other than English is specified under clause (iii) of such paragraph, the Secretary shall provide that subsequent communications to the individual under this part shall be in such language. ``(7) Construction.--Nothing in this subsection shall be construed as precluding the Secretary from taking additional outreach efforts to enroll eligible individuals under this part and to provide low-income subsidies to eligible individuals.''. (b) Transitional Disclosure of Return Information for Purposes of Providing Low-Income Subsidies Under Medicare.-- (1) In general.--Subsection (l) of section 6103 of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph: ``(21) Transitional disclosure of return information for purposes of providing low-income subsidies under medicare.-- ``(A) In general.--The Secretary, upon written request from the Secretary of Health and Human Services under section 1860D-14(e)(1) of the Social Security Act for an individual described in subparagraph (C) of such section, shall disclose to officers and employees of the Department of Health and Human Services and the Social Security Administration with respect to a taxpayer for the applicable year-- ``(i)(I) whether the adjusted gross income, as modified in accordance with specifications of the Secretary of Health and Human Services for purposes of carrying out such section, of such taxpayer and, if applicable, such taxpayer's spouse, for the applicable year, exceeds the amounts specified by the Secretary of Health and Human Services as indicating likely eligibility for the low-income subsidy provided under section 1860D-14 of such Act, ``(II) whether the return was a joint return, and ``(III) the applicable year, or ``(ii) if applicable, the fact that there is no return filed for such taxpayer for the applicable year. ``(B) Definition of applicable year.--For the purposes of this paragraph, the term `applicable year' means the most recent taxable year for which information is available in the Internal Revenue Service's taxpayer data information systems, or, if there is no return filed for such taxpayer for such year, the prior taxable year. ``(C) Restriction on use of disclosed information.--Return information disclosed under this paragraph may be used only for the purposes of identifying eligible individuals for, and administering-- ``(i) low-income subsidies under section 1860D-14 of the Social Security Act, and ``(ii) the Medicare Savings Program implemented under clauses (i), (iii), and (iv) of section 1902(a)(10)(E) of such Act. ``(D) Termination.--Return information may not be disclosed under this paragraph after the date that is one year after the date of the enactment of this paragraph.''. (2) Confidentiality.--Paragraph (3) of section 6103(a) of such Code is amended by striking ``or (20)'' and inserting ``(20), or (21)''. (3) Procedures and recordkeeping related to disclosures.-- Paragraph (4) of section 6103(p) of such Code is amended by striking ``or (20)'' each place it appears and inserting ``(20), or (21)''. (4) Unauthorized disclosure or inspection.--Paragraph (2) of section 7213(a) of such Code is amended by striking ``or (20)'' and inserting ``(20), or (21)''. SEC. 3. INCREASE IN PERMITTED RESOURCES TO OBTAIN LOW-INCOME SUBSIDIES. (a) Increase in Resource Limits.--Subparagraph (E) of section 1860D-14(a)(3) of the Social Security Act (42 U.S.C. 1395ww-114(a)(3)) is amended-- (1) in subclause (I), by striking ``for 2006'' and inserting ``for months in 2006 before the first day of the first month beginning after the date of the enactment of the Prescription Drug Now Act of 2006'' and by striking ``and'' at the end; (2) by redesignating subclause (II) as subclause (III); (3) by inserting after subclause (I) the following new subclause: ``(II) for months in 2006 beginning with the first month that begins after the date of the enactment of the Prescription Drug Now Act of 2006, $50,000 (or $100,000 in the case of the combined value of the individual's assets or resources and the assets or resources of the individual's spouse); and''; and (4) in the last sentence, by striking ``subclause (II)'' and inserting ``subclause (III)''. (b) Not Counting Value of Life Insurance as Resource.--Such section is further amended-- (1) in subparagraphs (D) and (E), by inserting ``, except as provided in subparagraph (G)'' after ``supplemental security income program''; and (2) by adding at the end the following new subparagraph: ``(G) Exclusion of life insurance in resources.-- For purposes of subparagraphs (D) and (E), the value of a life insurance policy shall not be counted as a resource for months beginning after the date of the enactment of this subparagraph.''. SEC. 4. WAIVER OF LATE ENROLLMENT PENALTY FOR SUBSIDY ELIGIBLE INDIVIDUALS FOR FIRST 24 MONTHS OF NON-ENROLLMENT. Section 1860D-13(b)(3)(B) of the Social Security Act (42 U.S.C. 1395w-113(b)(3)(B)) is amended by inserting before the period at the end the following: ``, except that in the case of a subsidy eligible individual (as defined in section 1860D-14(a)(3)(A)) the first 24 uncovered months shall not be counted''.

Summary: Prescription Coverage Now Act of 2006 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Service to provide for an expedited process for the qualification for low-income assistance through a request to the Secretary of the Treasury for tax return and other information sufficient to identify: (1) whether the individual involved is likely eligible for subsidies; and (2) the amount of premium and cost-sharing subsidies for which they would qualify based on such information. Increases the maximum permissible resource level for subsidy eligibility. Waives the late enrollment penalty for subsidy-eligible individuals for the first 24 months of non-enrollment.


SECTION 1. SHORT TITLE. This Act may be cited as the ``U.S. Agricultural Sector Relief Act of 2012''. SEC. 2. ENSURING THE AVAILABILITY OF METHYL BROMIDE FOR CRITICAL USES. (a) Critical Use Exemptions and Emergency Events.--Subsection (h) of section 604 of the Clean Air Act (42 U.S.C. 7671c(h)) is amended-- (1) by striking ``Notwithstanding'' and inserting the following: ``(1) In general.--Notwithstanding''; and (2) by adding at the end the following new paragraph: ``(2) Critical use exemptions and emergency events.-- ``(A) Critical use exemptions.-- ``(i) In general.--For each calendar year, beginning with 2013, the Administrator, pursuant to an application submitted by any person, shall take all appropriate actions within the authority of the Environmental Protection Agency to seek a critical use exemption under the Montreal Protocol in order to allow the production, importation, and consumption of methyl bromide-- ``(I) for any use of methyl bromide that-- ``(aa) is an approved critical use; and ``(bb) is determined by the Administrator to be a critical use for the applicant; and ``(II) in the amount necessary for the use described in subclause (I). ``(ii) Applications.--The Administrator shall not deny any application referred to in clause (i), or reduce the amount requested under any such application, unless the Administrator-- ``(I) has substantial evidence to establish that there is a technically and economically feasible alternative available to the applicant for the use of methyl bromide for which the application was submitted; and ``(II) provides such evidence to the applicant in writing. ``(iii) Alternatives.--The Administrator, when evaluating the technical and economic feasibility of any alternative pursuant to clause (ii), shall consider-- ``(I) cost and commercial availability of the alternative to the applicant; ``(II) demonstrated effectiveness of the alternative for the applicant's specific intended use; ``(III) demonstrated effectiveness of the alternative in the geographic region of the applicant's intended use; and ``(IV) State or local regulations that may restrict use of the alternative for the applicant's intended use. ``(B) Emergency events.-- ``(i) In general.--For each calendar year, beginning with 2013, the Administrator, pursuant to an application submitted by any person, shall allow the production, importation, and consumption in the United States of methyl bromide-- ``(I) for any use described in subparagraph (A)(i)(I) in response to an emergency event; and ``(II) in an amount necessary for such use. ``(ii) Limits on use per emergency event.-- The amount of methyl bromide allowed pursuant to clause (i) for use per emergency event at a specific location shall not exceed 20 metric tons. ``(iii) Limit on aggregate amount.--The aggregate amount of methyl bromide allowed pursuant to clause (i) for use in the United States in a calendar year shall not exceed the total amount authorized by the parties to the Montreal Protocol pursuant to the Montreal Protocol process for critical uses in the United States in calendar year 2011. ``(C) International obligations.--The Administrator shall take such actions as may be necessary to carry out this paragraph in accordance with the Montreal Protocol. ``(D) Research.--For each calendar year, beginning with 2013, the Administrator shall take all appropriate actions within the authority of the Environmental Protection Agency to ensure that sufficient quantities of methyl bromide are available for research on methyl bromide alternatives for the agricultural sector. ``(E) Adjustments to critical use nominations.--The Administrator shall review and, as appropriate, take action to adjust any critical use nomination that has been submitted to the Parties to the Montreal Protocol (for production, importation, or consumption of methyl bromide in the United States) if-- ``(i) a methyl bromide alternative is removed from the United States market; and ``(ii) on the basis of the availability of such alternative, the Administrator denied, or reduced the amount requested under, any application for production, importation, or consumption of methyl bromide for the year covered by such nomination. ``(F) Definitions.--In this paragraph: ``(i) The term `approved critical use' means a use that-- ``(I) as of January 1, 2005, was an approved critical use in appendix L to subpart A of part 82 of title 40, Code of Federal Regulations; or ``(II) during the period following such date and ending on the date of enactment of this clause, was added as an approved critical use in such appendix. ``(ii) The term `critical use' means a circumstance in which-- ``(I) there are no technically and economically feasible alternatives or substitutes for methyl bromide available that are acceptable from the standpoint of environment and health and are suitable to the crops and circumstances involved; and ``(II) the lack of availability of methyl bromide for a particular use would result in significant market disruption. ``(iii) The term `emergency event' means a situation-- ``(I) that occurs at a farm, nursery, food processing facility, or commodities storage facility; ``(II) for which there is no critical use exemption in effect for such site, or for which there are not sufficient quantities of methyl bromide available under an existing critical use exemption for such site, as described in subparagraph (A); and ``(III) that requires the use of methyl bromide to control a pest or disease because there is no technically and economically feasible alternative to methyl bromide available for such use.''. (b) Regulations.--Not later than 180 days after the date of enactment of this Act, the Administrator of the Environmental Protection Agency, acting through the Director of the Office of Pesticide Programs, and in consultation with the Secretary of Agriculture, shall-- (1) issue such final regulations as may be necessary to implement the amendment made by subsection (a); and (2) include in such regulations-- (A) criteria for identifying an emergency event, as defined in section 604(h)(2)(D)(iii) of the Clean Air Act, as added by such amendment; and (B) provisions to ensure that each application for use of methyl bromide in response to an emergency event under section 604(h)(2)(B) of the Clean Air Act, as added by such amendment, is approved or disapproved in a timely manner.

Summary: U.S. Agricultural Sector Relief Act of 2012 - Amends the Clean Air Act to require the Administrator of the Environmental Protection Agency (EPA), pursuant to an application submitted by any person, to seek a critical use exemption under the Montreal Protocol to allow the production, importation, and consumption of methyl bromide: (1) for any approved critical use that is determined by the Administrator to be a critical use for the applicant, and (2) in the amount necessary for such use. Prohibits the Administrator from denying such an application or reducing the amount requested unless the Administrator: (1) has substantial evidence that there is a technically and economically feasible alternative available to the applicant for such use of methyl bromide, and (2) provides such evidence to the applicant in writing. Requires the Administrator, when evaluating the technical and economic feasibility of any alternative, to consider: (1) cost and commercial availability of the alternative, (2) demonstrated effectiveness of the alternative for the applicant's specific intended use, (3) demonstrated effectiveness of the alternative in the geographic region of the applicant's intended use, and (4) state or local regulations that may restrict use of the alternative for the applicant's intended use. Requires the Administrator, pursuant to an application, to allow the production, importation, and consumption of methyl bromide for any approved critical use in response to an emergency event, in an amount necessary for such use, not to exceed: (1) per emergency event at a specific location, 20 metric tons, or (2) in the aggregate for emergency use in the United Sates in a year, the total amount authorized pursuant to the Montreal Protocol process for critical uses in the United States in calendar year 2011. Requires the Administrator to ensure that sufficient quantities of methyl bromide are available for research on methyl bromide alternatives for the agricultural sector. Requires the Administrator to review and adjust as appropriate, any critical use nomination for production, importation, or consumption of methyl bromide in the United States that has been submitted to the Parties to the Montreal Protocol if: (1) a methyl bromide alternative is removed from the U.S. market; and (2) on the basis of the availability of such alternative, the Administrator denied, or reduced the amount requested under, any application for production, importation, or consumption of methyl bromide for the year covered by such nomination.


of September 29, 1969 (Public Law 1, 2 42 U.S.C. 2461 91-76)........................................... National Aeronautics and Space Administration 6 42 U.S.C. 2463 Authorization Act, 1978 (Public Law 95-76)....... National Aeronautics and Space Administration 106(a) 42 U.S.C. 2464 Authorization Act, 1983 (Public Law 97-324)...... National Aeronautics and Space Administration 201 42 U.S.C. 2466 Authorization Act of 1986 (Public Law 99-170).... 202 42 U.S.C. 2466a 203 42 U.S.C. 2466b 204 42 U.S.C. 2466c National Space Grant College and Fellowship Act 202 42 U.S.C. 2486 (Title II of Public Law 100-147)................. 203 42 U.S.C. 2486a 204 42 U.S.C. 2486b 205 42 U.S.C. 2486c 206 42 U.S.C. 2486d 207 42 U.S.C. 2486e 208 42 U.S.C. 2486f 209 42 U.S.C. 2486g 210 42 U.S.C. 2486h 211 42 U.S.C. 2486i 213 42 U.S.C. 2486k 214 42 U.S.C. 2486l Department of Housing and Urban Development-- (par. under heading 42 U.S.C. 2467 Independent Agencies Appropriations Act, 1989 ``Science, Space, and (Public Law 100-404)............................. Technology Education Trust Fund'', at 102 Stat. 1028) Departments of Veterans Affairs and Housing and (pars. under heading ``Small 42 U.S.C. 2473b Urban Development, and Independent Agencies and Disadvantaged Business'', Appropriations Act, 1990 (Public Law 101-144).... at 103 Stat. 863) National Aeronautics and Space Administration 112 42 U.S.C. 2465a Authorization Act, Fiscal Year 1991 (Public Law 101-611)......................................... 123 (not previously classified) 203 42 U.S.C. 2465c 206 42 U.S.C. 2465f Departments of Veterans Affairs and Housing and (1st par. under heading 42 U.S.C. 2459d Urban Development, and Independent Agencies ``Administrative Appropriations Act, 1992 (Public Law 102-139).... Provisions'', at 105 Stat. 771) National Aeronautics and Space Administration 19 42 U.S.C. 2459e Authorization Act, Fiscal Year 1992 (Public Law 102-195)......................................... 20 42 U.S.C. 2467a 21 42 U.S.C. 2473c Land Remote Sensing Policy Act of 1992 (Public Law 2 15 U.S.C. 5601 102-555)......................................... 3 15 U.S.C. 5602 101 15 U.S.C. 5611 102 15 U.S.C. 5612 103 15 U.S.C. 5613 104 15 U.S.C. 5614 105 15 U.S.C. 5615 201 15 U.S.C. 5621 202 15 U.S.C. 5622 203 15 U.S.C. 5623 204 15 U.S.C. 5624 205 15 U.S.C. 5625 301 15 U.S.C. 5631 302 15 U.S.C. 5632 303 15 U.S.C. 5633 401 15 U.S.C. 5641 501 15 U.S.C. 5651 502 15 U.S.C. 5652 503 15 U.S.C. 5653 504 15 U.S.C. 5654 505 15 U.S.C. 5655 506 15 U.S.C. 5656 507 15 U.S.C. 5657 508 15 U.S.C. 5658 601 15 U.S.C. 5671 602 15 U.S.C. 5672 National Aeronautics and Space Administration 304 42 U.S.C. 2467b Authorization Act, Fiscal Year 1993 (Public Law 102-588)......................................... 501 15 U.S.C. 5801 502 15 U.S.C. 5802 504 15 U.S.C. 5803 506 15 U.S.C. 5805 507 15 U.S.C. 5806 508 15 U.S.C. 5807 510 15 U.S.C. 5808 601 42 U.S.C. 2487 602 42 U.S.C. 2487a 603 42 U.S.C. 2487b 604 42 U.S.C. 2487c 606 42 U.S.C. 2487e 607 42 U.S.C. 2487f 608 42 U.S.C. 2487g Commercial Space Act of 1998 (Public Law 105-303). 2 42 U.S.C. 14701 101 42 U.S.C. 14711 104 42 U.S.C. 14712 105 42 U.S.C. 14713 106 42 U.S.C. 14714 107 42 U.S.C. 14715, 15 U.S.C. 5621, 5622 201 42 U.S.C. 14731 202 42 U.S.C. 14732 204 42 U.S.C. 14733 205 42 U.S.C. 14734 206 42 U.S.C. 14735 National Aeronautics and Space Administration 126 42 U.S.C. 2475a Authorization Act of 2000 (Public Law 106-391)... 301 42 U.S.C. 2459g 304 42 U.S.C. 2459h 305 42 U.S.C. 2475b 325 42 U.S.C. 2473d Commercial Reusable In-Space Transportation Act of 902 42 U.S.C. 14751 2002 (Title IX of Public Law 107-248)............ 903 42 U.S.C. 14752 904 42 U.S.C. 14753 Departments of Veterans Affairs and Housing and (last par. under heading 42 U.S.C. 2459i Urban Development, and Independent Agencies ``Administrative Appropriations Act, 2003 (Division K of Public Provisions'', at 117 Stat. Law 108-7)....................................... 520) National Aeronautics and Space Administration 101(a) 42 U.S.C. 16611(a) Authorization Act of 2005 (Public Law 109-155)... 101(b) 42 U.S.C. 16611(b) 101(h)(1) 42 U.S.C. 16611(h)(1) 101(i) 42 U.S.C. 16611(i) 103 42 U.S.C. 16613 105 42 U.S.C. 16614 107 42 U.S.C. 16615 110 42 U.S.C. 16618 202 42 U.S.C. 16631 203 42 U.S.C. 16632 204 42 U.S.C. 16633 205 42 U.S.C. 16634 301 42 U.S.C. 16651 304(a) (matter before par. 42 U.S.C. 16654(a) (matter (1)) before par. (1)) 304(a)(2) 42 U.S.C. 16654(a)(2) 305 42 U.S.C. 16655 306 42 U.S.C. 16656 311 42 U.S.C. 16671 312 42 U.S.C. 16672 313 42 U.S.C. 16673 314 42 U.S.C. 16674 315 42 U.S.C. 16675 316 42 U.S.C. 16676 401 42 U.S.C. 16701 411 42 U.S.C. 16711 421 42 U.S.C. 16721 422 42 U.S.C. 16722 423 42 U.S.C. 16723 424 42 U.S.C. 16724 425 42 U.S.C. 16725 426 42 U.S.C. 16726 427 42 U.S.C. 16727 431 42 U.S.C. 16741 441 42 U.S.C. 16751 501 42 U.S.C. 16761 503 42 U.S.C. 16763 504 42 U.S.C. 16764 505 42 U.S.C. 16765 506 42 U.S.C. 16766 507 42 U.S.C. 16767 601 42 U.S.C. 16781 612 42 U.S.C. 16791 613 42 U.S.C. 16792 615 42 U.S.C. 16794 616 42 U.S.C. 16795 618 42 U.S.C. 16797 619(b) 42 U.S.C. 16798(b) 621 42 U.S.C. 16811 707 42 U.S.C. 16821 708 42 U.S.C. 16822 709 42 U.S.C. 16823 821 42 U.S.C. 16841 822 42 U.S.C. 16842 823 42 U.S.C. 16843 824 42 U.S.C. 16844 825 42 U.S.C. 16845 826 42 U.S.C. 16846 827 42 U.S.C. 16847 828 42 U.S.C. 16848 829 42 U.S.C. 16849 830 42 U.S.C. 16850 ----------------------------------------------------------------------------------------------------------------

Summary: Enacts title 51 of the United States Code into positive law to be entitled "National and Commercial Space Programs." Makes conforming changes to existing law and repeals specified provisions of specified laws.


SECTION 1. SPECIAL RULES FOR EXECUTIVE PERKS AND RETIREMENT BENEFITS. (a) In General.--Part I of subchapter D of chapter 1 of the Internal Revenue Code of 1986 (relating to pension, profit-sharing, stock bonus plans, etc.) is amended by adding at the end the following new subpart: ``subpart f--special rules for executive perks and retirement benefits ``Sec. 420A. Holding period requirement for stock acquired through exercise of option. ``Sec. 420B. Additional tax on nondisclosed retirement perks. ``Sec. 420C. Inclusion in gross income of funded deferred compensation of corporate insiders. ``Sec. 420D. Definitions and special rule. ``SEC. 420A. HOLDING PERIOD REQUIREMENT FOR STOCK ACQUIRED THROUGH EXERCISE OF OPTION. ``(a) In General.--In the case of a corporate insider with respect to a corporation, the tax imposed by this chapter on a corporate insider for any taxable year shall be increased by 50 percent of the amount realized by such insider from the disqualified disposition during such year of stock acquired by the corporate insider upon the exercise of a stock option granted by the corporation with respect to which such individual is a corporate insider. ``(b) Disqualified Disposition of Stock.-- ``(1) In general.--For purposes of subsection (a), the term `disqualified disposition of stock' means any sale, exchange, or other disposition of stock which, if such stock were employer securities held in a qualified cash or deferred arrangement (as defined in section 401(k)(2)), would violate any restriction imposed on the sale or other disposition of such securities by the plan of which such arrangement is a part. ``(2) Special rule for 2 or more cash or deferred arrangements.--If a corporation has more than 1 qualified cash or deferred arrangement (as so defined), the restrictions which apply for purposes of paragraph (1) shall be the most restrictive provisions relating to the disposition of employer securities held pursuant to any such arrangements. ``SEC. 420B. ADDITIONAL TAX ON NONDISCLOSED RETIREMENT PERKS. ``(a) In General.--In the case of a publicly traded corporation, the tax imposed by this chapter for the taxable year shall be increased by 50 percent of the net cost to the corporation for the taxable year of personal perks provided to a retired executive of the corporation. ``(b) Waiver If Perks Provided Pursuant to Shareholder Approval.-- Subsection (a) shall not apply with respect to any personal perks provided pursuant to a contract if-- ``(1) all of the material terms of such contract (including a description of the benefits to be provided to the executive and the extent of such benefits) are disclosed to shareholders, and ``(2) such contract is approved by a majority of the vote in a separate shareholder vote before any benefits are provided under the contract. ``(c) Net Cost of Personal Perks.-- ``(1) In general.--For purposes of subsection (a), the net cost of personal perks provided to a retired executive is the excess of-- ``(A) the cost to the corporation of such perks, over ``(B) the amount paid in cash during the taxable year by the executive to reimburse the corporation for the cost of such perks. ``(2) Personal perks.--For purposes of paragraph (1), the term `personal perks' means-- ``(A) the use of corporate-owned property, ``(B) travel expenses, including meals and lodging, unless such expenses are directly related to the performance of services by the executive for the corporation and the business relationship of such expenses is substantiated under the requirements of section 274, ``(C) tickets to sporting or other entertainment events, ``(D) amounts paid or incurred for membership in any club organized for business, pleasure, recreation, or other social purpose, and ``(E) other personal services, including services related to maintenance or protection of any personal residence of the executive. ``(3) Cost relating to use of corporate-owned property.-- For purposes of this subsection-- ``(A) In general.--The cost taken into account with respect to the use of corporate-owned property shall be the allocable portion of the total cost of operating such property. ``(B) Allocable portion.--For purposes of subparagraph (A), the allocable portion of total cost is-- ``(i) the portion of the total cost (including depreciation) incurred by the corporation for operating and maintaining such property during the corporation's taxable year in which such use occurred, ``(ii) which is allocable to the use (determined on the basis of the relationship of such use to the total use of the property during the taxable year). ``SEC. 420C. INCLUSION IN GROSS INCOME OF FUNDED DEFERRED COMPENSATION OF CORPORATE INSIDERS. ``(a) In General.--If an employer maintains a funded deferred compensation plan-- ``(1) compensation of any corporate insider which is deferred under such funded deferred compensation plan shall be included in the gross income of the corporate insider or beneficiary for the 1st taxable year in which there is no substantial risk of forfeiture of the rights to such compensation, and ``(2) the tax treatment of any amount made available under the plan to a corporate insider or beneficiary shall be determined under section 72 (relating to annuities, etc.). ``(b) Funded Deferred Compensation Plan.--For purposes of this section-- ``(1) In general.--The term `funded deferred compensation plan' means any plan providing for the deferral of compensation unless-- ``(A) the employee's rights to the compensation deferred under the plan are no greater than the rights of a general creditor of the employer, and ``(B) all amounts set aside (directly or indirectly) for purposes of paying the deferred compensation, and all income attributable to such amounts, remain (until made available to the participant or other beneficiary) solely the property of the employer (without being restricted to the provision of benefits under the plan), and ``(C) the amounts referred to in subparagraph (B) are available to satisfy the claims of the employer's general creditors at all times (not merely after bankruptcy or insolvency). Such term shall not include a qualified employer plan. ``(2) Special rules.-- ``(A) Employee's rights.--A plan shall be treated as failing to meet the requirements of paragraph (1)(A) unless-- ``(i) the compensation deferred under the plan is payable only upon separation from service, death, disability, or at a specified time (or pursuant to a fixed schedule), and ``(ii) the plan does not permit the acceleration of the time such deferred compensation is payable by reason of any event. If the employer and employee agree to a modification of the plan that accelerates the time for payment of any deferred compensation, then all compensation previously deferred under the plan shall be includible in gross income for the taxable year during which such modification takes effect and the taxpayer shall pay interest at the underpayment rate on the underpayments that would have occurred had the deferred compensation been includible in gross income on the earliest date that there is no substantial risk of forfeiture of the rights to such compensation. ``(B) Creditor's rights.--A plan shall be treated as failing to meet the requirements of paragraph (1)(B) with respect to amounts set aside in a trust unless-- ``(i) the employee has no beneficial interest in the trust, ``(ii) assets in the trust are available to satisfy claims of general creditors at all times (not merely after bankruptcy or insolvency), and ``(iii) there is no factor that would make it more difficult for general creditors to reach the assets in the trust than it would be if the trust assets were held directly by the employer in the United States. Except as provided in regulations prescribed by the Secretary, such a factor shall include the location of the trust outside the United States. ``(c) Other Definitions and Special Rules.--For purposes of this section-- ``(1) Qualified employer plan.--The term `qualified employer plan' means-- ``(A) any plan, contract, pension, account, or trust described in subparagraph (A) or (B) of section 219(g)(5), and ``(B) any other plan of an organization exempt from tax under subtitle A. ``(2) Plan includes arrangements, etc.--The term `plan' includes any agreement or arrangement. ``(3) Substantial risk of forfeiture.--The rights of a person to compensation are subject to a substantial risk of forfeiture if such person's rights to such compensation are conditioned upon the future performance of substantial services by any individual. ``(4) Treatment of earnings.--Except for purposes of subsection (a)(1) and the last sentence of (b)(2)(A), references to deferred compensation shall be treated as including references to income attributable to such compensation or such income. ``SEC. 420D. DEFINITIONS AND SPECIAL RULE. ``(a) Definitions.--For purposes of this subpart-- ``(1) Corporate insider.--The term `corporate insider' means, with respect to a corporation, any individual-- ``(A) who is subject to the requirements of section 16(a) of the Securities Exchange Act of 1934 with respect to such corporation, or ``(B) who would be subject to such requirements if such corporation were an issuer of equity securities referred to in such section. ``(2) Retired executive.--The term `retired executive' means any corporate insider who is no longer performing services on a substantially full time basis in the capacity that resulted in being subject to the requirements of section 16(a) of the Securities Exchange Act of 1934. ``(3) Publicly traded corporation.--The term `publicly traded corporation' means any corporation issuing any class of securities required to be registered under section 12 of the Securities Exchange Act of 1934. ``(4) Corporate-owned property.-- ``(A) In general.--Except as provided in subparagraph (B), the term `corporate-owned property' means any of the following property owned by a corporation-- ``(i) planes, ``(ii) apartments or other residences, ``(iii) vacation, sports, and entertainment facilities, and ``(iv) cars. Such term includes any such property which is leased or chartered by the corporation. ``(B) Exceptions.--Such term does not include any property used directly by the corporation in providing transportation, lodging, or entertainment services to the general public. ``(b) Additions to Tax Not Treated As Tax for Certain Purposes.-- The tax imposed by sections 420A and 420B shall not be treated as a tax imposed by this chapter for purposes of determining-- ``(1) the amount of any credit allowable under this chapter, or ``(2) the amount of the minimum tax imposed by section 55.''. (b) Clerical Amendment.--The table of subparts for part I of subchapter D of chapter 1 of such Code is amended by adding at the end the following new item: ``Subpart F. Special Rules for Executive Perks and Retirement Benefits.''. (c) Effective Date.--The amendments made by this section shall take effect as follows: (1) Section 420A of the Internal Revenue Code of 1986 (as added by this section) shall apply to stock acquired pursuant to the exercise of an option after the date of the enactment of this Act. (2)(A) Except as provided by subparagraph (B), section 420B of such Code (as so added) shall apply to perks provided after the date of the enactment of this Act. (B) In the case of perks provided pursuant to a contract in existence on the date of the enactment of this Act, such section 420B shall apply to such perks after the date of the first annual shareholders meeting after the date of the enactment of this Act. (3) Section 420C of such Code (as so added) shall apply to amounts deferred after the date of the enactment of this Act.

Summary: Amends the Internal Revenue Code to: (1) increase, for a corporate insider, the applicable tax by 50 percent of the amount realized by such insider from the disqualified disposition of stock (a sale violating specified restrictions) acquired by such corporate insider upon the exercise of a stock option granted by the corporation; (2) increase, for a publicly traded corporation, the applicable tax by 50 percent of the net cost to the corporation of personal perks provided to a retired executive of the corporation; and (3) include in the gross income of a corporate insider funded deferred compensation.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Working Families' Access to Health Innovations Act of 2013''. SEC. 2. AMENDMENT OF SMALL BUSINESS ACT. The Small Business Act is amended by redesignating section 45 as section 46 and by inserting after section 44 the following: ``SEC. 45. LOAN GUARANTEES FOR HEALTH INFORMATION TECHNOLOGY. ``(a) Definitions.--As used in this section: ``(1) The term `health information technology' means computer hardware, software, and related technology (including electronic medical record technology) that-- ``(A) supports the compliance with the meaningful EHR use requirements set forth in section 1848(o)(2)(A) of the Social Security Act (42 U.S.C. 1395w- 4(o)(2)(A)); ``(B) is purchased by an eligible professional to aid in the provision of health care in a health care setting; and ``(C) provides for-- ``(i) enhancement of continuity of care for patients through electronic storage, transmission, and exchange of relevant personal health data and information, such that this information is accessible at the times and places where clinical decisions will be or are likely to be made; ``(ii) enhancement of communication between patients and health care providers; ``(iii) improvement of quality measurement by eligible professionals enabling them to collect, store, measure, and report on the processes and outcomes of individual and population performance and quality of care; ``(iv) improvement of evidence-based decision support; or ``(v) enhancement of consumer and patient empowerment. Such term does not include information technology the sole use of which is financial management, maintenance of inventory of basic supplies, or appointment scheduling. ``(2) The term `eligible professional' means any of the following: ``(A) A physician (as defined in section 1861(r) of the Social Security Act (42 U.S.C. 1395x(r))). ``(B) A practitioner described in section 1842(b)(18)(C) of such Act (42 U.S.C. 1395u(b)(18)(C)). ``(C) A physical or occupational therapist or a qualified speech-language pathologist. ``(D) A qualified audiologist (as defined in section 1861(ll)(4)(B) of such Act (42 U.S.C. 1395x(ll)(4)(B))). ``(E) A State-licensed pharmacist. ``(F) A State-licensed supplier of durable medical equipment, prosthetics, orthotics, or supplies. ``(G) A State-licensed, a State-certified, or a nationally accredited home health care provider. ``(3) The term `qualified eligible professional' means an eligible professional whose practice-- ``(A) is a small business concern; and ``(B)(i) is in a medically underserved community (as defined in section 799B(6) of the Public Health Service Act (42 U.S.C. 295p(6))); ``(ii) serves individuals at least 50 percent of whom are entitled to benefits or enrolled under title XVIII of the Social Security Act; or ``(iii) serves an area that consists predominantly of low-income families (as defined in section 3 of the United States Housing Act of 1937 (42 U.S.C. 1437a)). ``(b) Loan Guarantees for Qualified Eligible Professionals.-- ``(1) Guarantee percentage.--Subject to paragraph (2), the Administrator may guarantee up to 90 percent of the amount of the loan made to a qualified eligible professional for the acquisition of health information technology for use in such eligible professional's medical practice and for the costs associated with the installation of such technology. ``(2) Limitations on guarantee amounts.--The maximum amount of loan principal guaranteed under this subsection may not exceed-- ``(A) $350,000 with respect to any single qualified eligible professional; and ``(B) $2,000,000 with respect to a single group of affiliated qualified eligible professionals. ``(c) Fees.--(1) The Administrator may impose a guarantee fee on the borrower in an amount not to exceed 2 percent of the total guaranteed portion of any loan guaranteed under this section. The Administrator may also impose annual servicing fees on lenders not to exceed 0.5 percent of the outstanding balance of the guarantees on lenders' books. ``(2) No service fees, processing fees, origination fees, application fees, points, brokerage fees, bonus points, or other fees may be charged to a loan applicant or recipient by a lender in the case of a loan guaranteed under this section. ``(d) Interest Rates.--The interest rate charged on a loan guaranteed under this section shall not be greater than 25 basis points below the rate provided for a loan under the program under section 7(a). ``(e) Deferral Period.--Loans guaranteed under this section shall carry a deferral period of not more than 3 years. ``(f) Terms and Conditions for Loan Guarantees.--The loans guaranteed under this section shall be subject to the terms and conditions that apply to the program under section 7(a) or other such terms and conditions as are prescribed by the Administrator.''. SEC. 3. SMALL BUSINESS DEVELOPMENT CENTER DUTIES. Section 21(c)(3) of the Small Business Act (15 U.S.C. 648(c)(3)) is amended-- (1) by striking ``and'' at the end of subparagraph (S); (2) by striking the period at the end of subparagraph (T) and inserting a semicolon; and (3) by adding at the end the following: ``(U) facilitating the training of medical professionals in health information technology systems; and ``(V) establishing and providing a network of small health information technology companies available to medical professionals in low-income and underserved areas, as defined by the Secretary of Health and Human Services, for the purpose of aiding medical professionals in such areas to purchase, utilize, and maintain such technology.''.

Summary: Working Families' Access to Health Innovations Act of 2013 - Amends the Small Business Act to authorize the Administrator of the Small Business Administration (SBA) to guarantee up to 90% of a loan made to a health care professional for the acquisition of health information technology for use in such professional's medical practice and for the costs associated with its installation. Provides loan guarantee limits, and authorizes the Administrator to impose a loan guarantee fee. Requires services provided by a small business development center to include: (1) facilitating the training of medical professionals in health information technology systems; and (2) establishing and providing a network of small health information technology companies available to such professionals in low-income and underserved areas for assistance in purchasing, utilizing, and maintaining such technology.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Superfund Site Public Health Improvement Act''. SEC. 2. PUBLIC HEALTH AT NPL FACILITIES. Section 104(i)(6) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9604(i)(6)) is amended as follows: (1) By amending subparagraph (A) to read as follows: ``(A) The Administrator of ATSDR shall perform a health assessment for each facility, including those facilities owned by any department, agency, or instrumentality of the United States, on the National Priorities List established under section 105. The health assessment shall be commenced as soon as practicable after each facility is proposed for inclusion on the National Priorities List and shall be completed not later than the date of issuance of a remedial investigation and feasibility study for the facility to allow full consideration in selecting the remedial action of the public health implications of any release.''. (2) By amending subparagraph (D) to read as follows: ``(D)(i) The Administrator and the Administrator of ATSDR shall develop strategies to obtain relevant on-site and off-site characterization data for use in a health assessment. The Administrator shall, to the maximum extent practicable, provide the Administrator of ATSDR with the data and information necessary to make health assessments sufficiently prior to the initiation of remedial actions to allow ATSDR to complete these assessments. Where deemed appropriate, the Administrator of ATSDR shall provide to the Administrator as soon as practicable after site discovery, recommendations for sampling environmental media for hazardous substances of public health concern. To the extent feasible, the Administrator shall incorporate such recommendations into its site investigation activities. ``(ii) In order to improve community involvement in health assessments, the Administrator of ATSDR shall carry out each of the following duties: ``(I) The Administrator of ATSDR shall actively collect data from residents of affected communities and from other sources in communities affected or potentially affected by releases of hazardous substances, pollutants, or contaminants regarding exposure, relevant human activities, and other factors. ``(II) The Administrator of ATSDR shall design health assessments that take into account the needs and conditions of the affected community. Community-based research models, building links to local expertise, and local health resources should be used. Each affected community shall be permitted to play an active and early role in reviewing health assessment designs. In preparing such designs, emphasis shall be placed on collection of actual exposure data and sources of multiple exposure shall be considered.''. SEC. 3. HEALTH STUDIES. Subparagraph (A) of section 104(i)(7) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9604(i)(7)) is amended to read as follows: ``(A) Whenever in the judgment of the Administrator of ATSDR it is appropriate on the basis of the results of a health assessment or on the basis of other appropriate information, the Administrator of ATSDR shall conduct a human health study of exposure or other health effects for selected groups or individuals in order to determine the desirability of conducting full scale epidemiologic or other health studies of the entire exposed population.''. SEC. 4. DISTRIBUTION OF MATERIALS TO HEALTH PROFESSIONALS AND MEDICAL CENTERS. Paragraph (14) of section 104(i) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9604(i)) is amended to read as follows: ``(14) In implementing this subsection and other health-related provisions of this Act in cooperation with the States, the Administrator of ATSDR shall-- ``(A) assemble, develop as necessary, and distribute to the States, medical colleges, physicians, nursing institutions, nurses, and other health professionals and medical centers, appropriate educational materials (including short courses) on the medical surveillance, screening, and methods of prevention, diagnosis, and treatment of injury or disease related to exposure to hazardous substances (giving priority to those listed in paragraph (2)), through means the Administrator of ATSDR considers appropriate; and ``(B) assemble, develop as necessary, and distribute to the general public and to at-risk populations appropriate educational materials and other information on human health effects of hazardous substances.''. SEC. 5. GRANT AWARDS, CONTRACTS, AND COMMUNITY ASSISTANCE ACTIVITIES. Section 104(i)(15) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 6904(i)(15)) is amended as follows: (1) By inserting ``(A)'' before ``The activities''. (2) In the first sentence, by striking ``cooperative agreements with States (or political subdivisions thereof)'' and inserting ``grants, cooperative agreements, or contracts with States (or political subdivisions thereof), other appropriate public authorities, public or private institutions, colleges, universities, and professional associations giving consideration to those colleges and universities that are historically black colleges and universities and to other educational institutions that primarily serve minorities or represent the interests of affected communities''. (3) By adding at the end the following new subparagraphs: ``(B) When a health assessment is conducted at a facility on the National Priorities List, or a release is being evaluated for inclusion on the National Priorities List, the Administrator of ATSDR may provide the assistance specified in this paragraph to public or private nonprofit entities, individuals, and community-based groups that may be affected by the release or threatened release of hazardous substances in the environment. ``(C) The Administrator of the Agency for Toxic Substances and Disease Registry, pursuant to the grants, cooperative agreements and contracts referred to in this paragraph, is authorized and directed to provide, where appropriate, health services to communities affected by the release of hazardous substances. Such health services may include diagnostic services, specialized treatment, health data registries and preventative public health education.''. SEC. 6. PUBLIC HEALTH RECOMMENDATIONS IN REMEDIAL ACTIONS. Section 121(c) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9621(c)) is amended in the first sentence by inserting after ``remedial action'' the second time it appears the following: ``, including public health recommendations and decisions resulting from activities under section 104(i),''.

Summary: Superfund Site Public Health Improvement Act - Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 to include U.S. Government facilities on the National Priorities List (NPL) among those requiring a health assessment by the Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR). Requires all health assessments to be commenced as soon as practicable after proposal for inclusion on the NPL and to be completed no later than the date of issuance of a remedial investigation and feasibility study. Directs the Administrator of the Environmental Protection Agency (EPA) and the ATSDR Administrator to develop strategies to obtain characterization data for use in health assessments. Requires the EPA Administrator to provide data sufficiently prior to initiation of remedial actions to allow ATSDR to complete its assessments and requires the ATSDR Administrator, where appropriate, to provide EPA as soon as practicable after site discovery with recommendations for sampling environmental media for hazardous substances of public health concern. Directs the ATSDR Administrator to improve community involvement in health assessments by: (1) collecting data from residents of affected communities and other sources in communities affected or potentially affected by hazardous substances, pollutants, or contaminants; and (2) designing assessments that take into account the needs and conditions of the community and permitting affected communities to play an active and early role in reviewing assessment designs. Directs the ATSDR Administrator to include other appropriate information (in addition to health assessment results) as a basis for conducting human health studies of exposure or other health effects in order to determine whether to conduct full-scale epidemiological or other health studies of the exposed population. Revises provisions regarding distribution by ATSDR of educational materials concerning hazardous substance exposure to health professionals and medical centers to: (1) include nursing institutions and nurses as recipients of such materials; (2) add materials on methods of prevention; and (3) require distribution to the general public and at-risk populations of such materials and other information. Authorizes the ATSDR Administrator, in addition to using cooperative agreements, to carry out activities through grants to or contracts with States and political subdivisions, other public authorities, institutions, colleges, universities, and professional associations, giving consideration to historically black colleges and other educational institutions that primarily serve minorities or represent the interests of affected communities. Authorizes assistance, when a health assessment is conducted at a facility on the NPL or a release is being evaluated for inclusion on such list, to public and nonprofit entities, individuals, and community-based groups that may be affected by the release or threatened release. Authorizes and directs the provision of health services to affected communities. Requires the President to add to the review at least every five years of remedial actions that result in a site remaining contaminated a review of public health recommendations and decisions resulting from ATSDR activities.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Community Mental Health and Addiction Safety Net Equity Act of 2010''. SEC. 2. FEDERALLY QUALIFIED BEHAVIORAL HEALTH CENTERS. Section 1913 of the Public Health Service Act (42 U.S.C. 300x-3) is amended-- (1) in subsection (a)(2)(A), by striking ``community mental health services'' and inserting ``behavioral health services (of the type offered by federally qualified behavioral health centers consistent with subsection (c)(3))''; (2) in subsection (b)-- (A) by striking paragraph (1) and inserting the following: ``(1) services under the plan will be provided only through appropriate, qualified community programs (which may include federally qualified behavioral health centers, child mental health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental health primary consumer-directed programs); and''; and (B) in paragraph (2), by striking ``community mental health centers'' and inserting ``federally qualified behavioral health centers''; and (3) by striking subsection (c) and inserting the following: ``(c) Criteria for Federally Qualified Behavioral Health Centers.-- ``(1) In general.--The Administrator shall certify, and recertify at least every 5 years, federally qualified behavioral health centers as meeting the criteria specified in this subsection. ``(2) Regulations.--Not later than 18 months after the date of the enactment of the Community Mental Health and Addiction Safety Net Equity Act of 2010, the Administrator shall issue final regulations for certifying non-profit or local government centers as centers under paragraph (1). ``(3) Criteria.--The criteria referred to in subsection (b)(2) are that the center performs each of the following: ``(A) Provide services in locations that ensure services will be available and accessible promptly and in a manner which preserves human dignity and assures continuity of care. ``(B) Provide services in a mode of service delivery appropriate for the target population. ``(C) Provide individuals with a choice of service options where there is more than one efficacious treatment. ``(D) Employ a core staff of clinical staff that is multidisciplinary and culturally and linguistically competent. ``(E) Provide services, within the limits of the capacities of the center, to any individual residing or employed in the service area of the center, regardless of the ability of the individual to pay. ``(F) Provide, directly or through contract, to the extent covered for adults in the State Medicaid plan under title XIX of the Social Security Act and for children in accordance with section 1905(r) of such Act regarding early and periodic screening, diagnosis, and treatment, each of the following services: ``(i) Screening, assessment, and diagnosis, including risk assessment. ``(ii) Person-centered treatment planning or similar processes, including risk assessment and crisis planning. ``(iii) Outpatient clinic mental health services, including screening, assessment, diagnosis, psychotherapy, substance abuse counseling, medication management, and integrated treatment for mental illness and substance abuse which shall be evidence-based (including cognitive behavioral therapy and other such therapies which are evidence-based). ``(iv) Outpatient clinic primary care services, including screening and monitoring of key health indicators and health risk (including screening for diabetes, hypertension, and cardiovascular disease and monitoring of weight, height, body mass index (BMI), blood pressure, blood glucose or HbA1C, and lipid profile). ``(v) Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention services, and crisis stabilization. ``(vi) Targeted case management (services to assist individuals gaining access to needed medical, social, educational, and other services and applying for income security and other benefits to which they may be entitled). ``(vii) Psychiatric rehabilitation services including skills training, assertive community treatment, family psychoeducation, disability self-management, supported employment, supported housing services, therapeutic foster care services, and such other evidence-based practices as the Secretary may require. ``(viii) Peer support and counselor services and family supports. ``(G) Maintain linkages, and where possible enter into formal contracts with the following: ``(i) Inpatient psychiatric facilities and substance abuse detoxification and residential programs. ``(ii) Adult and youth peer support and counselor services. ``(iii) Family support services for families of children with serious mental disorders. ``(iv) Other community or regional services, supports, and providers, including schools, child welfare agencies, juvenile and criminal justice agencies and facilities, housing agencies and programs, employers, and other social services. ``(v) Onsite or offsite access to primary care services. ``(vi) Enabling services, including outreach, transportation, and translation. ``(vii) Health and wellness services, including services for tobacco cessation.''. SEC. 3. MEDICAID COVERAGE AND PAYMENT FOR FEDERALLY QUALIFIED BEHAVIORAL HEALTH CENTER SERVICES. (a) Payment for Services Provided by Federally Qualified Behavioral Health Centers.--Section 1902(bb) of the Social Security Act (42 U.S.C. 1396a(bb)) is amended-- (1) in the heading, by striking ``and Rural Health Clinics'' and inserting ``, Federally Qualified Behavioral Health Centers, and Rural Health Clinics''; (2) in paragraph (1), by inserting ``(and beginning with fiscal year 2011 with respect to services furnished on or after January 1, 2011, and each succeeding fiscal year, for services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center)'' after ``by a rural health clinic''; (3) in paragraph (2)-- (A) by striking the heading and inserting ``Initial fiscal year''; (B) by inserting ``(or, in the case of services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center, for services furnished on and after January 1, 2011, during fiscal year 2011)'' after ``January 1, 2001, during fiscal year 2001''; (C) by inserting ``(or, in the case of services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center, during fiscal years 2009 and 2010)'' after ``1999 and 2000''; and (D) by inserting ``(or, in the case of services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center, during fiscal year 2011)'' before the period; (4) in paragraph (3)-- (A) in the heading, by striking ``Fiscal year 2002 and succeeding'' and inserting ``Succeeding''; and (B) by inserting ``(or, in the case of services described in section 1905(a)(2)(D) furnished by a federally qualified behavioral health center, for services furnished during fiscal year 2012 or a succeeding fiscal year)'' after ``2002 or a succeeding fiscal year''; (5) in paragraph (4)-- (A) by inserting ``(or as a federally qualified behavioral health center after fiscal year 2010)'' after ``or rural health clinic after fiscal year 2000''; (B) by striking ``furnished by the center or'' and inserting ``furnished by the federally qualified health center, services described in section 1905(a)(2)(D) furnished by the federally qualified behavioral health center, or''; (C) in the second sentence, by striking ``or rural health clinic'' and inserting ``, federally qualified behavioral health center, or rural health clinic''; (6) in paragraph (5), in each of subparagraphs (A) and (B), by striking ``or rural health clinic'' and inserting ``, federally qualified behavioral health center, or rural health clinic''; and (7) in paragraph (6), by striking ``or to a rural health clinic'' and inserting ``, to a federally qualified behavioral health center for services described in section 1905(a)(2)(D), or to a rural health clinic''. (b) Inclusion of Federally Qualified Behavioral Health Center Services in the Term Medical Assistance.--Section 1905(a)(2) of the Social Security Act (42 U.S.C. 1396d(a)(2)) is amended-- (1) by striking ``and'' before ``(C)''; and (2) by inserting before the semicolon at the end the following: ``, and (D) federally qualified behavioral health center services (as defined in subsection (l)(4))''. (c) Definition of Federally Qualified Behavioral Health Center Services.--Section 1905(l) of the Social Security Act (42 U.S.C. 1396d(l)) is amended by adding at the end the following paragraph: ``(4)(A) The term `federally qualified behavioral health center services' means services furnished to an individual at a federally qualified behavioral health center (as defined by subparagraph (B). ``(B) The term `federally qualified behavioral health center' means an entity that is certified under section 1913(c) of the Public Health Service Act as meeting the criteria described in paragraph (3) of such section.''. SEC. 4. MENTAL HEALTH AND ADDICTION SAFETY NET STUDIES. (a) Paperwork Reduction Study.-- (1) In general.--Not later than 12 months after the date of the enactment of this Act, the Institute of Medicine shall submit to the appropriate committees of Congress a report that evaluates the combined paperwork burden of federally qualified behavioral health centers certified section 1913(c) of the Public Health Service Act, as inserted by section 2. (2) Scope.--In preparing the report under paragraph (1), the Institute of Medicine shall examine licensing, certification, service definitions, claims payment, billing codes, and financial auditing requirements utilized by the Office of Management and Budget, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Office of the Inspector General, State Medicaid agencies, State departments of health, State departments of education, and State and local juvenile justice and social services agencies to-- (A) establish an estimate of the combined nationwide cost of complying with the requirements described in this paragraph, in terms of both administrative funding and staff time; (B) establish an estimate of the per capita cost to each federally qualified behavioral health center certified under section 1913(c) of the Public Health Service Act to comply with the requirements described in this paragraph, in terms of both administrative funding and staff time; and (C) make administrative and statutory recommendations to Congress, which may include a uniform methodology, to reduce the paperwork burden experienced by such federally qualified behavioral health centers. (3) Authorization of appropriations.--There are authorized to be appropriated to carry out this subsection $550,000 for each of the fiscal years 2012 and 2013. (b) Wage Study.-- (1) In general.--Not later than 12 months after the date of the enactment of this Act, the Institute of Medicine shall conduct a nationwide analysis, and submit a report to the appropriate committees of Congress, concerning the compensation structure of professional and paraprofessional personnel employed by federally qualified behavioral health centers certified under section 1913(c) of the Public Health Service Act, as inserted by section 2, as compared with the compensation structure of comparable health safety net providers and relevant private sector health care employers. (2) Scope.--In preparing the report under paragraph (1), the Institute of Medicine shall examine compensation disparities, if such disparities are determined to exist, by type of personnel, type of provider or private sector employer, and by geographic region. (3) Authorization of appropriations.--There are authorized to be appropriated to carry out this subsection, $550,000 for each of the fiscal years 2012 and 2013.

Summary: Community Mental Health and Addiction Safety Net Equity Act of 2010 - Amends the Public Health Service Act to replace community mental health centers with federally qualified behavioral health centers which treat substance abuse in addition to mental illness and other conditions. Amends title XIX (Medicaid) of the Social Security Act to extend Medicaid coverage to federally qualified behavioral health center services. Directs the Institute of Medicine to: (1) evaluate for Congress the combined paperwork burden of federally qualified behavioral health centers; and (2) analyze and report to Congress on the compensation structure of professional and paraprofessional personnel employed by federally qualified behavioral health centers nationwide as compared with the compensation structure of comparable health safety net providers and relevant private sector health care employers.


AND ENFORCEMENT ``Section 7.1. Good Faith Implementation. ``Each of the Parties pledges to support implementation of all provisions of this Compact, and covenants that its officers and agencies shall not hinder, impair, or prevent any other Party carrying out any provision of this Compact. ``Section 7.2. Alternative Dispute Resolution. ``1. Desiring that this Compact be carried out in full, the Parties agree that disputes between the Parties regarding interpretation, application and implementation of this Compact shall be settled by alternative dispute resolution. ``2. The Council, in consultation with the Provinces, shall provide by rule procedures for the resolution of disputes pursuant to this section. ``Section 7.3. Enforcement. ``1. Any Person aggrieved by any action taken by the Council pursuant to the authorities contained in this Compact shall be entitled to a hearing before the Council. Any Person aggrieved by a Party action shall be entitled to a hearing pursuant to the relevant Party's administrative procedures and laws. After exhaustion of such administrative remedies, (i) any aggrieved Person shall have the right to judicial review of a Council action in the United States District Courts for the District of Columbia or the District Court in which the Council maintains offices, provided such action is commenced within 90 days; and, (ii) any aggrieved Person shall have the right to judicial review of a Party's action in the relevant Party's court of competent jurisdiction, provided that an action or proceeding for such review is commenced within the time frames provided for by the Party's law. For the purposes of this paragraph, a State or Province is deemed to be an aggrieved Person with respect to any Party action pursuant to this Compact. ``2. a. Any Party or the Council may initiate actions to compel compliance with the provisions of this Compact, and the rules and regulations promulgated hereunder by the Council. Jurisdiction over such actions is granted to the court of the relevant Party, as well as the United States District Courts for the District of Columbia and the District Court in which the Council maintains offices. The remedies available to any such court shall include, but not be limited to, equitable relief and civil penalties. ``b. Each Party may issue orders within its respective jurisdiction and may initiate actions to compel compliance with the provisions of its respective statutes and regulations adopted to implement the authorities contemplated by this Compact in accordance with the provisions of the laws adopted in each Party's jurisdiction. ``3. Any aggrieved Person, Party or the Council may commence a civil action in the relevant Party's courts and administrative systems to compel any Person to comply with this Compact should any such Person, without approval having been given, undertake a New or Increased Withdrawal, Consumptive Use or Diversion that is prohibited or subject to approval pursuant to this Compact. ``a. No action under this subsection may be commenced if: ``i. The Originating Party or Council approval for the New or Increased Withdrawal, Consumptive Use or Diversion has been granted; or, ``ii. The Originating Party or Council has found that the New or Increased Withdrawal, Consumptive Use or Diversion is not subject to approval pursuant to this Compact. ``b. No action under this subsection may be commenced unless: ``i. A Person commencing such action has first given 60 days prior notice to the Originating Party, the Council and Person alleged to be in noncompliance; and, ``ii. Neither the Originating Party nor the Council has commenced and is diligently prosecuting appropriate enforcement actions to compel compliance with this Compact. The available remedies shall include equitable relief, and the prevailing or substantially prevailing party may recover the costs of litigation, including reasonable attorney and expert witness fees, whenever the court determines that such an award is appropriate. ``4. Each of the Parties may adopt provisions providing additional enforcement mechanisms and remedies including equitable relief and civil penalties applicable within its jurisdiction to assist in the implementation of this Compact. ``ARTICLE 8 ``ADDITIONAL PROVISIONS ``Section 8.1. Effect on Existing Rights. ``1. Nothing in this Compact shall be construed to affect, limit, diminish or impair any rights validly established and existing as of the effective date of this Compact under State or federal law governing the Withdrawal of Waters of the Basin. ``2. Nothing contained in this Compact shall be construed as affecting or intending to affect or in any way to interfere with the law of the respective Parties relating to common law Water rights. ``3. Nothing in this Compact is intended to abrogate or derogate from treaty rights or rights held by any Tribe recognized by the federal government of the United States based upon its status as a Tribe recognized by the federal government of the United States. ``4. An approval by a Party or the Council under this Compact does not give any property rights, nor any exclusive privileges, nor shall it be construed to grant or confer any right, title, easement, or interest in, to or over any land belonging to or held in trust by a Party; neither does it authorize any injury to private property or invasion of private rights, nor infringement of federal, State or local laws or regulations; nor does it obviate the necessity of obtaining federal assent when necessary. ``Section 8.2. Relationship to Agreements Concluded by the United States of America. ``1. Nothing in this Compact is intended to provide nor shall be construed to provide, directly or indirectly, to any Person any right, claim or remedy under any treaty or international agreement nor is it intended to derogate any right, claim, or remedy that already exists under any treaty or international agreement. ``2. Nothing in this Compact is intended to infringe nor shall be construed to infringe upon the treaty power of the United States of America, nor shall any term hereof be construed to alter or amend any treaty or term thereof that has been or may hereafter be executed by the United States of America. ``3. Nothing in this Compact is intended to affect nor shall be construed to affect the application of the Boundary Waters Treaty of 1909 whose requirements continue to apply in addition to the requirements of this Compact. ``Section 8.3. Confidentiality. ``1. Nothing in this Compact requires a Party to breach confidentiality obligations or requirements prohibiting disclosure, or to compromise security of commercially sensitive or proprietary information. ``2. A Party may take measures, including but not limited to deletion and redaction, deemed necessary to protect any confidential, proprietary or commercially sensitive information when distributing information to other Parties. The Party shall summarize or paraphrase any such information in a manner sufficient for the Council to exercise its authorities contained in this Compact. ``Section 8.4. Additional Laws. ``Nothing in this Compact shall be construed to repeal, modify or qualify the authority of any Party to enact any legislation or enforce any additional conditions and restrictions regarding the management and regulation of Waters within its jurisdiction. ``Section 8.5. Amendments and Supplements. ``The provisions of this Compact shall remain in full force and effect until amended by action of the governing bodies of the Parties and consented to and approved by any other necessary authority in the same manner as this Compact is required to be ratified to become effective. ``Section 8.6. Severability. ``Should a court of competent jurisdiction hold any part of this Compact to be void or unenforceable, it shall be considered severable from those portions of the Compact capable of continued implementation in the absence of the voided provisions. All other provisions capable of continued implementation shall continue in full force and effect. ``Section 8.7. Duration of Compact and Termination. ``Once effective, the Compact shall continue in force and remain binding upon each and every Party unless terminated. ``This Compact may be terminated at any time by a majority vote of the Parties. In the event of such termination, all rights established under it shall continue unimpaired. ``ARTICLE 9 ``EFFECTUATION ``Section 9.1. Repealer. ``All acts and parts of acts inconsistent with this act are to the extent of such inconsistency hereby repealed. ``Section 9.2. Effectuation by Chief Executive. ``The Governor is authorized to take such action as may be necessary and proper in his or her discretion to effectuate the Compact and the initial organization and operation thereunder. ``Section 9.3. Entire Agreement. ``The Parties consider this Compact to be complete and an integral whole. Each provision of this Compact is considered material to the entire Compact, and failure to implement or adhere to any provision may be considered a material breach. Unless otherwise noted in this Compact, any change or amendment made to the Compact by any Party in its implementing legislation or by the U.S. Congress when giving its consent to this Compact is not considered effective unless concurred in by all Parties. ``Section 9.4. Effective Date and Execution. ``This Compact shall become binding and effective when ratified through concurring legislation by the states of Illinois, Indiana, Michigan, Minnesota, New York, Ohio and Wisconsin and the Commonwealth of Pennsylvania and consented to by the Congress of the United States. This Compact shall be signed and sealed in nine identical original copies by the respective chief executives of the signatory Parties. One such copy shall be filed with the Secretary of State of each of the signatory Parties or in accordance with the laws of the state in which the filing is made, and one copy shall be filed and retained in the archives of the Council upon its organization. The signatures shall be affixed and attested under the following form: ``In Witness Whereof, and in evidence of the adoption and enactment into law of this Compact by the legislatures of the signatory parties and consent by the Congress of the United States, the respective Governors do hereby, in accordance with the authority conferred by law, sign this Compact in nine duplicate original copies, attested by the respective Secretaries of State, and have caused the seals of the respective states to be hereunto affixed this ____ day of (month), (year).''. SEC. 2. RIGHT TO ALTER, AMEND, OR APPEAL. Congress expressly reserves the right to alter, amend, or repeal this Act.

Summary: Grants congressional consent to and approval of the Great Lakes-St. Lawrence River Basin Water Resources Compact entered into between the states of Illinois, Indiana, Michigan, Minnesota, New York, Ohio, and Wisconsin, and the Commonwealth of Pennsylvania. Reserves the right to alter, amend, or repeal this Act.


SECTION 1. SHORT TITLE. This Act may be cited as the ``EMTALA Regulatory Improvement Act of 2003''. SEC. 2. EMTALA IMPROVEMENTS. (a) Notification of Providers When EMTALA Investigation Closed.-- Section 1867(d) of the Social Security Act (42 U.S.C. 42 U.S.C. 1395dd(d)) is amended by adding at the end the following new paragraph: ``(4) Notice upon closing an investigation.--The Secretary shall establish a procedure to notify hospitals and physicians when an investigation under this section is closed.''. (b) Prior Review by Peer Review Organizations in EMTALA Cases Involving Termination of Participation.-- (1) In general.--Section 1867(d)(3) of such Act (42 U.S.C. 1395dd(d)(3)) is amended-- (A) in the first sentence, by inserting ``or in terminating a hospital's participation under this title'' after ``in imposing sanctions under paragraph (1)''; and (B) by adding at the end the following new sentences: ``Except in the case in which a delay would jeopardize the health or safety of individuals, the Secretary shall also request such a review before making a compliance determination as part of the process of terminating a hospital's participation under this title for violations related to the appropriateness of a medical screening examination, stabilizing treatment, or an appropriate transfer as required by this section, and shall provide a period of 5 days for such review. The Secretary shall provide a copy of the organization's report to the hospital or physician consistent with confidentiality requirements imposed on the organization under such part B.''. (2) Effective date.--The amendments made by paragraph (1) shall apply to terminations of participation initiated on or after the date of the enactment of this Act. SEC. 3. EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA) TECHNICAL ADVISORY GROUP. (a) Establishment.--The Secretary shall establish a Technical Advisory Group (in this section referred to as the ``Advisory Group'') to review issues related to the Emergency Medical Treatment and Labor Act (EMTALA) and its implementation. In this section, the term ``EMTALA'' refers to the provisions of section 1867 of the Social Security Act (42 U.S.C. 1395dd). (b) Membership.--The Advisory Group shall be composed of 19 members, including the Administrator of the Centers for Medicare & Medicaid Services and the Inspector General of the Department of Health and Human Services and of which-- (1) 4 shall be representatives of hospitals, including at least one public hospital, that have experience with the application of EMTALA and at least 2 of which have not been cited for EMTALA violations; (2) 7 shall be practicing physicians drawn from the fields of emergency medicine, cardiology or cardiothoracic surgery, orthopedic surgery, neurosurgery, pediatrics or a pediatric subspecialty, obstetrics-gynecology, and psychiatry, with not more than one physician from any particular field; (3) 2 shall represent patients; (4) 2 shall be staff involved in EMTALA investigations from different regional offices of the Centers for Medicare & Medicaid Services; and (5) 1 shall be from a State survey office involved in EMTALA investigations and 1 shall be from a peer review organization, both of whom shall be from areas other than the regions represented under paragraph (4). In selecting members described in paragraphs (1) through (3), the Secretary shall consider qualified individuals nominated by organizations representing providers and patients. (c) General Responsibilities.--The Advisory Group-- (1) shall review EMTALA regulations; (2) may provide advice and recommendations to the Secretary with respect to those regulations and their application to hospitals and physicians; (3) shall solicit comments and recommendations from hospitals, physicians, and the public regarding the implementation of such regulations; and (4) may disseminate information on the application of such regulations to hospitals, physicians, and the public. (d) Administrative Matters.-- (1) Chairperson.--The members of the Advisory Group shall elect a member to serve as chairperson of the Advisory Group for the life of the Advisory Group. (2) Meetings.--The Advisory Group shall first meet at the direction of the Secretary. The Advisory Group shall then meet twice per year and at such other times as the Advisory Group may provide. (e) Termination.--The Advisory Group shall terminate 30 months after the date of its first meeting. (f) Waiver of Administrative Limitation.--The Secretary shall establish the Advisory Group notwithstanding any limitation that may apply to the number of advisory committees that may be established (within the Department of Health and Human Services or otherwise).

Summary: EMTALA Regulatory Improvement Act of 2003 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to require the Secretary of Health and Human Services to establish a procedure to notify hospitals and physicians when an investigation under the Emergency Medical Treatment and Labor Act (EMTALA) is closed.Directs the Secretary to establish a Technical Advisory Group to review issues related to EMTALA and its implementation.