SECTION 1. REQUIREMENT TO DISCLOSE TO INSURANCE APPLICANTS CERTAIN MEDICAL TEST RESULTS. (a) In General.--Except as provided in subsections (c) and (d), a life or disability insurer who requires, as a condition for the sale of a covered insurance product, that an applicant for the purchase of the product submit to an examination or test by a physician, health professional, or medical laboratory-- (1) shall require the physician, health professional, or laboratory to provide the results to the insurer in the form of a written report containing the findings of the physician, professional, or laboratory, including the results of all tests, diagnoses, and conclusions made; and (2) shall mail, not later than 30 days after the date on which the insurer receives such report, the report to the applicant at an address provided for this purpose by the applicant. (b) Abnormal Finding.--In any case in which a life or disability insurer mails a report to an applicant under subsection (a) that contains a finding of abnormality or irregularity with respect to the health or condition of the applicant, the insurer shall include with the report a document that-- (1) highlights the abnormal or irregular finding in language that is understandable to a person of average intelligence with no medical training; and (2) advises the applicant to consult with a suitable health professional for further explanation and appropriate follow-up. (c) Election To Receive Results through Physician.--An applicant described in subsection (a) may elect to have the report described in such subsection, and the document described in subsection (b), mailed to a physician of the applicant's choice designated by the applicant for such purpose, in lieu of having the report and document mailed to the applicant. The election shall be effective in any case where the applicant, before the date of the examination or test, submits to the insurer an election form described in subsection (e)(1) that includes-- (1) a check-off box, marked by hand by the applicant, showing the applicant's election to have the report and document mailed to such physician; (2) the applicant's signature; and (3) the date on which the form was completed by the applicant. (d) Waiver by Applicant.--Subsections (a) and (b) shall not apply where the applicant, before the date of the examination or test, declines to receive the results by submitting to the insurer a waiver form described in subsection (e)(1) that includes-- (1) a check-off box, marked by hand by the applicant, showing the applicant's choice to waive the applicant's right to receive any reports under subsection (a); (2) the applicant's signature; and (3) the date on which the form was completed by the applicant. (e) Requirements Relating to Forms.-- (1) Requirement to supply forms.--A life or disability insurer described in subsection (a) shall furnish to an applicant described in such subsection an election form, sufficient for purposes of subsection (c), and a waiver form, sufficient for purposes of subsection (d), at the same time the insurer furnishes to the applicant the application for sale of the covered product. The forms shall be distinct from, and not a part of, such application. (2) Copy.--A life or disability insurer described in subsection (a) shall furnish to an applicant described in such subsection a copy of an election form or a waiver form submitted to the insurer by the applicant upon the insurer's receipt of the form. (3) Revocation.--An election under subsection (c), or a waiver under subsection (d), may be revoked by the applicant at any time, through a written or oral notification to the life or disability insurer. SEC. 2. PROHIBITION ON CERTAIN DISCLOSURES OF EXAMINATION RESULTS. A life or disability insurer who requires, as a condition for the sale of a covered insurance product, that an applicant for the purchase of the product submit to an examination or test by a physician, health professional, or medical laboratory may not disclose to any other person, in any form, the results of such examination or test, except-- (1) as provided in section 1; (2) pursuant to a valid and fully executed written authorization for such disclosure-- (A) during the period specified by the authorization, in the case of an authorization that permits the disclosure to be made only during a period that is shorter than the 2-year period beginning on the date the authorization is executed by the applicant; or (B) during 2-year period beginning on the date the authorization is executed by the applicant, in the case of any other authorization; (3) pursuant to a court order, subpoena, warrant, or search warrant, for use by a law enforcement agency in an official law enforcement investigation or proceeding inquiring into a violation of any civil or criminal law, and where such disclosure is expressly required by an applicable law other than this Act; (4) where the disclosure is made to a public health authority and is expressly required by an applicable law other than this Act. SEC. 3. CIVIL ACTION BY AGGRIEVED PERSON. (a) In General.--Any person who is aggrieved by a violation of this Act by a life or disability insurer may commence a civil action against the insurer in an appropriate State court or district court of the United States. (b) Relief.-- (1) In general.--In an action under this section, if the court finds that the defendant has failed to comply with this Act, the aggrieved person may recover-- (A) statutory damages in an amount equal to $10,000 for each such violation; (B) compensatory damages; and (C) punitive damages. (2) Attorney's fees.--In an action under this section, the court, in its discretion, may allow a prevailing plaintiff, other than the United States, a reasonable attorney's fee (including expert fee) as part of the costs, and the United States shall be liable for costs the same as a private person. SEC. 4. INAPPLICABILITY OF MCCARRAN-FERGUSON ACT. For purposes of section 2(b) of the Act of March 9, 1945 (15 U.S.C. 1012(b); commonly known as the McCarran-Ferguson Act), this Act shall be considered to specifically relate to the business of insurance. SEC. 5. REGULATIONS. The Secretary of Health and Human Services may issue regulations to carry out this Act. SEC. 6. DEFINITIONS. As used in this Act: (1) Applicant.--The term ``applicant'' means an individual whose death or disability will be, or is, the subject of a covered insurance product, upon the acceptance by the life or disability insurer selling the product of the application for the purchase of the product. (2) Covered insurance product.--The term ``covered insurance product'' means-- (A) a life insurance policy or contract, or benefits under such a policy or contract; or (B) a disability insurance policy or contract, or benefits under such a policy or contract. (3) Disclose.--The term ``disclose'', means to release, transfer, provide access to, or otherwise divulge the information to any person other than an individual who is the subject of the information. Such term includes the placement of information into a computerized data base, networked computer system, or any other electronic or magnetic data system, that more than one person may access by any means. (4) Life or disability insurer.--The term ``life or disability insurer'' means-- (A) a person doing business in interstate commerce who is licensed or certified by a State to provide a covered insurance product; or (B) a person who acts as an agent of a person described in subparagraph (A) with respect to the sale of a covered insurance product. SEC. 7. EFFECTIVE DATE. This Act shall take effect on July 1, 1998.

Summary: Requires that a life or disability insurer, if the insurer requires an applicant for life or disability insurance to submit to a medical examination or test, ensure disclosure to the applicant of the test results. Prohibits the insurer from disclosing the results to any other person, except under a written authorization made by the applicant, pursuant to certain legal process, or to a public health authority when expressly required by law. Provides for civil actions for violations of this Act by any aggrieved person, allowing recovery of statutory, compensatory, and punitive damages and attorney's fees. Declares that, for provisions of Federal law commonly known as the McCarran-Ferguson Act prohibiting Federal insurance law from preempting State law unless the Federal law specifically relates to the business of insurance, this Act shall be considered to specifically relate to the business of insurance.


SECTION 1. SHORT TITLE; TABLE OF CONTENTS. (a) Short Title.--This Act may be cited as the ``Medicare+Choice Improvement and Stabilization Act of 2001''. (b) Table of Contents.--The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Payment reforms for 2003. Sec. 3. Change in Medicare+Choice reporting deadlines and annual, coordinated election period and delay in lock-in provisions. Sec. 4. Avoiding duplicative State regulation. Sec. 5. Demonstration projects for preferred provider organizations, point-of-service plans, MSA plans, and disease management programs. Sec. 6. Suspension of limitation for program reentry for 2003 and 2004. Sec. 7. Specialized Medicare+Choice plans for special needs beneficiaries. SEC. 2. PAYMENT REFORMS FOR 2003. (a) Payment Based on 100 Percent of Fee-for-Service Costs.-- (1) In general.--Section 1853(c)(1) of the Social Security Act (42 U.S.C. 1395w-23(c)(1)) is amended by adding at the end the following: ``(D) Based on 100 percent of fee-for-service costs for 2003.--For 2003 only, the adjusted average per capita cost for that year, determined under section 1876(a)(4) for the Medicare+Choice payment area for services covered under parts A and B for individuals entitled to benefits under part A and enrolled under part B who are not enrolled in a Medicare+Choice plan under this part for the year, subject to the same adjustment as is provided to the annual per capita rate payment under paragraph (3)(B).''. (2) Conforming amendment.--Such section is further amended in the matter before subparagraph (A), by striking ``or (C)'' and inserting ``(C), or (D)''. (b) Revision of National Average Used in Calculation of Blend.-- Section 1853(c)(4)(B)(i)(II) of such Act (42 U.S.C. 1395w- 23(c)(4)(B)(i)(II)) is amended by inserting ``who (with respect to determinations for 2003) are enrolled in a Medicare+Choice plan'' after ``the average number of medicare beneficiaries''. (c) Elimination of Budget Neutrality.--Section 1853(c) of such Act (42 U.S.C. 1395w-23(c)) is amended-- (1) in paragraph (1)(A), by inserting ``(for a year other than 2003)'' after ``multiplied''; and (2) in paragraph (5), by inserting ``(other than 2003)'' after ``for each year''. SEC. 3. CHANGE IN MEDICARE+CHOICE REPORTING DEADLINES AND ANNUAL, COORDINATED ELECTION PERIOD AND DELAY IN LOCK-IN PROVISIONS. (a) Change in Reporting Deadline.--Section 1854(a)(1) of the Social Security Act (42 U.S.C. 1395w-24(a)(1)) is amended by striking ``July 1'' and inserting ``the third Monday in September''. (b) Delay in Annual, Coordinated Election Period.--Section 1851(e)(3)(B) of such Act (42 U.S.C. 1395w-21(e)(3)(B)) is amended by striking ``(beginning with 2000), the month of November before such year'' and inserting ``, the period beginning on November 15 and ending on December 31 of the year before such year''. (c) 1-Year Delay in Lock-In.--Section 1851(e) of such Act (42 U.S.C. 1395w-21(e)) is amended-- (1) in paragraph (2)(A)-- (A) by striking ``and 2001,'' and inserting ``, 2001, and 2002''; and (B) in the heading, by striking ``2001'' and inserting ``2002''; (2) in paragraph (2)(B)-- (A) in clause (i), by striking ``2002'' each place it appears and inserting ``2003''; and (B) in the heading that precedes clause (i), by striking ``2002'' and inserting ``2003''; (3) in paragraph (2)(C)(i), by striking ``2002'' each place it appears and inserting ``2003''; and (4) in paragraph (4)-- (A) in the matter preceding subparagraph (A), by striking ``2002'' and inserting ``2003''; and (B) in the second sentence, by striking ``2002'' and inserting ``2003''. (d) Effective Date.--The amendments made by this section shall take effect on January 1, 2002. SEC. 4. AVOIDING DUPLICATIVE STATE REGULATION. (a) In General.--Section 1856(b)(3) of the Social Security Act (42 U.S.C. 1395w-26(b)(3)) is amended to read as follows: ``(3) Relation to state laws.--The standards established under this subsection shall supersede any State law or regulation (other than State licensing laws or State laws relating to plan solvency) with respect to Medicare+Choice plans which are offered by Medicare+Choice organizations under this part.''. (b) Effective Date.--The amendment made by subsection (a) shall take effect on the date of the enactment of this Act. SEC. 5. DEMONSTRATION PROJECTS FOR PREFERRED PROVIDER ORGANIZATIONS, POINT-OF-SERVICE PLANS, MSA PLANS, AND DISEASE MANAGEMENT PROGRAMS. (a) In General.--The Secretary of Health and Human Services shall conduct a demonstration program (in this section referred to as the ``demonstration program'') under which payment rules to Medicare+Choice organizations under section 1853 of the Social Security Act are modified in order to promote the offering of Medicare+Choice plans by preferred provider organizations under the Medicare+Choice program, the offering of Medicare+Choice plans that provide point-of-service coverage for other than participating providers, and the offering of MSA plans and to promote the use of disease management programs by Medicare+Choice plans. (b) Projects.--Under the demonstration program, the Secretary shall provide for 10 demonstration projects. Each project shall extend over a period of not to exceed 3 years. Of the demonstration projects conducted under the demonstration, to the extent feasible, at least one such project shall promote the offering of a Medicare+Choice plan by a preferred provider organization, at least one project shall promote the offering of a Medicare+Choice plan that provides point-of-service coverage for other than participating providers, and at least two projects shall promote the offering of a MSA plan. (c) Risk-Sharing Arrangements.--Under the demonstration program, the Secretary may provide for the assumption of portions of the financial risk under a split or partial risk-sharing arrangement. (d) Waiver Authority.--The Secretary is authorized to waive such provisions of section 1853 of the Social Security Act (and related provisions of part C of title XVIII of such Act) as the Secretary determines to be necessary to conduct the demonstration program under this section. (e) Evaluation and Report.-- (1) Evaluation.--The Secretary shall provide for an evaluation of the demonstration program conducted under this section and its impact on enrollment, particularly in areas not previously served by Medicare+Choice plans. (2) Report.--The Secretary shall submit to Congress a report on the demonstration program and its evaluation. Such report shall include an assessment of the costs and savings to the medicare program as a result of the demonstration program and may include such recommendations for changes in the Medicare+Choice program as the Secretary deems appropriate. SEC. 6. SUSPENSION OF LIMITATION FOR PROGRAM REENTRY FOR 2003 AND 2004. Section 1857(c)(4) of the Social Security Act (42 U.S.C. 1395w- 27(c)(4)) is amended-- (1) in subparagraph (A), by striking ``subparagraph (B)'' and inserting ``subparagraphs (B) and (C)''; and (2) by adding at the end the following new subparagraph: ``(C) Applicability in certain years.--Subparagraph (A) shall not apply for contracts entered into for contract year 2003 or 2004.''. SEC. 7. SPECIALIZED MEDICARE+CHOICE PLANS FOR SPECIAL NEEDS BENEFICIARIES. (a) Treatment as Coordinated Care Plan.--Section 1851(a)(2)(A) of the Social Security Act (42 U.S.C. 1395w-21(a)(2)(A)) is amended by adding at the end the following new sentence: ``Specialized Medicare+Choice plans for special needs beneficiaries (as defined in section 1859(b)(4)) may be any type of coordinated care plan.''. (b) Specialized Medicare+Choice Plan for Special Needs Beneficiaries Defined.--Section 1859(b) of such Act (42 U.S.C. 1395w- 29(b)) is amended by adding at the end the following new paragraph: ``(4) Specialized medicare+choice plans for special needs beneficiaries.-- ``(A) In general.--The term `specialized Medicare+Choice plan for special needs beneficiaries' means a Medicare+Choice plan that exclusively serves special needs beneficiaries (as defined in subparagraph (B)). ``(B) Special needs beneficiary.--The term `special needs beneficiary' means a Medicare+Choice eligible individual who-- ``(i) is institutionalized (as defined by the Secretary); ``(ii) is entitled to medical assistance under a State plan under title XIX; or ``(iii) meets such requirements as the Secretary may determine would benefit from enrollment in such a specialized Medicare+Choice plan described in subparagraph (A) for individuals with severe or disabling chronic conditions.''. (c) Restriction on Enrollment Permitted.--Section 1859 of such Act (42 U.S.C. 1395w-29) is amended by adding at the end the following new subsection: ``(f) Restriction on Enrollment for Specialized Medicare+Choice Plans for Special Needs Beneficiaries.--In the case of a specialized Medicare+Choice plan (as defined in subsection (b)(4)), notwithstanding any other provision of this part and in accordance with regulations of the Secretary and for periods before January 1, 2007, the plan may restrict the enrollment of individuals under the plan to individuals who are within one or more classes of special needs beneficiaries.''. (d) Report to Congress.--Not later than December 31, 2005, the Secretary of Health and Human Services shall submit to Congress a report that assesses the impact of specialized Medicare+Choice plans for special needs beneficiaries on the cost and quality of services provided to enrollees. Such report shall include an assessment of the costs and savings to the medicare program as a result of amendments made by subsections (a), (b), and (c). (e) Effective Dates.-- (1) In general.--The amendments made by subsections (a), (b), and (c) shall take effect upon the date of the enactment of this Act. (2) Deadline for issuance of requirements for special needs beneficiaries; transition.--No later than September 1, 2002, the Secretary of Health and Human Services shall issue final regulations to establish requirements for special needs beneficiaries under section 1859(b)(4)(B)(iii) of the Social Security Act, as added by subsection (b). (f) Extension of Municipal Health Service Demonstration Projects.-- The last sentence of section 9215(a) of the Consolidated Omnibus Budget Reconciliation Act of 1985 (42 U.S.C. 1395b-1 note), as previously amended, is amended by striking ``December 31, 2004, but only with respect to'' and all that follows and inserting ``December 31, 2009, but only with respect to individuals who reside in the city in which the project is operated and so long as the total number of individuals participating in the project does not exceed the number of such individuals participating as of January 1, 1996.''.

Summary: Medicare+Choice Improvement and Stabilization Act of 2001 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA) to make each annual Medicare+Choice capitation rate for a Medicare+Choice payment area for a contract year equal to the largest of the amounts specified under current law or, for 2003, 100 percent of the fee-for-service costs for the Medicare+Choice payment area for services covered under Medicare parts A (Hospital Insurance) or B (Supplementary Medical Insurance) for individuals entitled to benefits under part A and enrolled under part B who are not enrolled in a Medicare+Choice plan under this part for the year.Revises the calculation of the national standardized annual Medicare+Choice capitation rate used in determining the input-price-adjusted annual national Medicare+Choice capitation rate for a Medicare+Choice payment area for calculation of annual Medicare+Choice capitation rates for 2003.Eliminates budget neutrality in such calculation for a year other than 2003. Modifies requirements for establishment of standards (other than solvency standards) for provider-sponsored organizations for Medicare+Choice organizations and plans in relation to State laws to avoid duplicative State regulation.Directs the Secretary of Health and Human Services to conduct a demonstration program under which payment rules for Medicare+Choice organizations are modified in order to promote: (1) the offering of Medicare+Choice plans by preferred provider organizations, of Medicare+Choice plans that provide point-of-sale coverage for other than participating providers, and of MSA plans: and (2) the use of disease management programs by Medicare+Choice plans.Amends SSA title XVII part C to: (1) suspend the limitation for program reentry for Medicare+Choice organizations for 2003 and 2004; and (2) set forth rules governing specialized Medicare+Choice plans for special needs beneficiaries.Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to provide for extension of municipal health service demonstration projects.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Stepping Up to STEM Act of 2013''. SEC. 2. FINDINGS. Congress finds the following: (1) Technology and the Internet have transformed nearly every aspect of both the global economy and our daily lives. In a technology-rich world, no amount of memorizing information will make a student competitive in the global labor market. America needs an education system that supports students from all walks of life in becoming inquisitive, resourceful thinkers who use technology to pursue knowledge, collaborate across geographic and cultural boundaries, acquire new skills, and solve complex problems. (2) Equality and equity of access is more than access to the same hardware, software, and broadband connections. It includes access to the best digital learning resources and access to teachers who know how to orchestrate the use of these resources in ways that inspire students and produce better learning outcomes. (3) Technology by itself will not improve student outcomes. What is needed are carefully designed innovations that include not just technology but also good learning content, effective instructional strategies, supports for teachers and school systems figuring out how to use the new approach, and the capacity to collect, analyze and reflect on data that will show whether or not the innovation is having the intended effects. (4) Effective learning technology implementations addressing the challenging aspects of language arts, mathematics and science that all students are expected to master. This will require partnerships among education agencies, education researchers, and technology developers with the common goal of harnessing technology to provide opportunities for deeper learning to students who would not otherwise experience them. SEC. 3. OFFICE OF SCIENCE, TECHNOLOGY, ENGINEERING, AND MATHEMATICS EDUCATION WITHIN THE DEPARTMENT OF EDUCATION. (a) Assistant Secretary.--Section 202 of the Department of Education Organization Act (20 U.S.C. 3412) is amended in subsection (b)(1)-- (1) in subparagraph (E) by striking ``and'' at the end; (2) by redesignating subparagraph (F) as (G); and (3) by inserting after subparagraph (E) the following: ``(F) an Assistant Secretary for Science, Technology, Engineering, and Mathematics Education (in this Act referred to as the `Assistant Secretary for STEM Education'); and''. (b) Office.--Title II of the Department of Education Organization Act (20 U.S.C. 3411 et seq.) is amended by adding at the end the following: ``SEC. 221. OFFICE OF SCIENCE, TECHNOLOGY, ENGINEERING, AND MATHEMATICS EDUCATION. ``(a) In General.--There shall be in the Department of Education an Office of Science, Technology, Engineering, and Mathematics Education (in this section referred to as the `Office of STEM Education'), to be administered by the Assistant Secretary for STEM Education appointed under section 202(b). ``(b) Responsibilities.--The Assistant Secretary of STEM Education, acting through the Office, shall serve as the principal advisor to the Secretary on matters affecting science, technology, engineering, and math education, and shall administer such functions representing STEM education, including the coordination of STEM activities and programs across Federal agencies. ``(c) Evaluation and Report.--The Assistant Secretary for STEM Education shall conduct an independent evaluation, through grant or by contract, of the STEM education programs administered by the Department, at least every 5 years, which shall include-- ``(1) conducting an assessment of STEM education activities within the Department by using the evaluations and reports of these programs to determine these programs' impact on-- ``(A) the quantity of students taking advanced placement in STEM areas and seeking STEM degrees; ``(B) the quantity of students exposed to STEM content in the hours outside of the regular school day; ``(C) student academic achievement in mathematics and science; and ``(D) the increased number of highly qualified STEM teachers, STEM content coaches, and STEM master educators; and ``(2) the preparation and submission of a report on the results of the evaluation described in paragraph (1) to the Committee on Health, Education, Labor, and Pensions and the Committee on Commerce, Science, and Transportation of the Senate, the Committee on Education and the Workforce and the Committee on Science, Space, and Technology of the House of Representatives, and the Committees on Appropriations of the Senate and the House of Representatives. ``(d) Authorization of Appropriations.--There are authorized to be appropriated $1,500,000 to carry out this section for fiscal year 2014 and such sums as may be necessary for each fiscal year thereafter.''. SEC. 4. ADVANCED RESEARCH PROJECTS AGENCY FOR EDUCATION. Title II of the Department of Education Organization Act (20 U.S.C. 3411 et seq.), as amended by section 2 of this Act, is further amended by adding at the end the following: ``SEC. 222. ADVANCED RESEARCH PROJECTS AGENCY FOR EDUCATION. ``(a) Establishment.--There shall be in the Department an Advanced Research Projects Agency for Education (referred to in this section as `ARPA-ED'). ``(b) Purposes.--ARPA-ED is established under this section for the purposes of pursuing breakthrough research and development in educational technology and providing the effective use of the technology to improve achievement for all students, by-- ``(1) integrating STEM related content areas including science, technology, computer science, engineering design, mathematics and computational thinking; ``(2) identifying and promoting revolutionary advances in fundamental and applied sciences and engineering that could be translated into new learning technologies; ``(3) developing novel learning technologies, and the enabling processes and contexts for effective use of those technologies; ``(4) developing, testing, and evaluating the impact and efficacy of those technologies; ``(5) developing educational technology innovations including data analytic tools that help State educational agencies and local educational agencies with reporting required under Federal accountability mandates; ``(6) accelerating transformational technological advances in areas in which the private sector, by itself, is not likely to accelerate such advances because of difficulties in implementation or adoption, or technical and market uncertainty; ``(7) coordinating activities with nongovernmental entities to demonstrate technologies and research applications to facilitate technology transfer; and ``(8) encouraging educational research using new technologies and the data produced by the technologies. ``(c) Coordination.-- ``(1) The Agency shall work closely and collaboratively between agencies in order to maximize the Federal effort and investment to the Project. ``(2) The Agency shall work with the National Science Foundation's Cyber Learning Program. ``(d) Authorities of Secretary.--The Secretary is authorized to-- ``(1) appoint a Director, who shall be responsible for carrying out the purposes of ARPA-ED, as described in subsection (b), and such additional functions as the Secretary may prescribe; ``(2) establish processes for the development and execution of projects and the solicitation of entities to carry out the projects in a manner that is-- ``(A) tailored to the purposes of ARPA-ED and not constrained by other Department-wide administrative requirements that could detract from achieving program results; and ``(B) designed to heighten transparency, and public- and private-sector involvement, to ensure that investments are made in the most promising areas; ``(3) award grants, contracts, cooperative agreements, and cash prizes, and enter into other transactions (in accordance with such regulations as the Secretary may establish regarding other transactions); ``(4) obtain independent, periodic, rigorous evaluations, as appropriate, of-- ``(A) the effectiveness of the processes ARPA-ED is using to achieve its purposes; and ``(B) the effectiveness of individual projects assisted by ARPA-ED, using evidence standards developed in consultation with the Institute of Education Sciences, and the suitability of ongoing projects assisted by ARPA-ED for further investment or increased scale; and ``(5) disseminate, through the comprehensive centers established under section 203 of the Educational Technical Assistance Act of 2002 (20 U.S.C. 9602), the regional educational laboratories system established under section 174 of the Education Sciences Reform Act of 2002 (20 U.S.C. 9564), or such other means as the Secretary determines to be appropriate, information on effective practices and technologies developed with ARPA-ED support. ``(e) Evaluation Funds.--The Secretary may use funds made available for ARPA-ED to pay the cost of the evaluations under subsection (c)(6). ``(f) Federal Advisory Committee Act.--Notwithstanding any other provision of law, any advisory committee convened by the Secretary to provide advice with respect to this section shall be exempt from the requirements of the Federal Advisory Committee Act (5 U.S.C. App.) and the definition of `employee' in section 2105 of title 5, United States Code, shall not be considered to include any appointee to such a committee. ``(g) Nonduplication.--To the maximum extent practicable, the Secretary shall ensure that grants, contracts, cooperative agreements, cash prizes, or other assistance or arrangements awarded or entered into pursuant to this section that are designed to carry out the purposes of ARPA-ED do not duplicate activities under programs carried out under Federal law other than this section by the Department or other Federal agencies.''. SEC. 5. STATE NETWORKS AND CONSORTIA ON SCIENCE, TECHNOLOGY, ENGINEERING, AND MATHEMATICS EDUCATION. (a) In General.--From amounts made available to carry out this section, the Secretary of Education shall make grants to eligible networks to expand STEM education. (b) Eligible Network Defined.--In this section, the term ``eligible network'' means a State-based STEM network or similar organization, which-- (1) may include the participation of State officials, educators, administrators, afterschool providers, out of school time educators, parents, industry leaders, philanthropists, and representatives from the STEM communities; (2) aims to increase student achievement and experiences in the STEM disciplines at the elementary schools and secondary schools in its State, and out of school programs and particularly for students with a high concentration of historically under represented students and at rural schools (within the meaning of part B of title VI of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6201 et seq.)); and (3) aims to increase the number of quality afterschool programs offering STEM learning opportunities, particularly for students from populations traditionally under-represented in the STEM fields. (c) Eligible Network Application.-- (1) In general.--An eligible network seeking a grant under this section shall submit an application at such time, in such manner, and containing such information as the Secretary may reasonably require. (2) Matching requirement.--In order to receive a grant under this section, an eligible network shall agree to provide, either directly or through private contributions, non-Federal matching funds equal to not less than 30 percent of the amount of the grant. (d) Uses of Funds.--Each eligible network receiving a grant under this section shall use the funds to carry out one or more of the following: (1) Testing, validating, sharing, and scaling up STEM education research, promising practices, and exemplary programs among members of the network and with other eligible networks receiving grants under this section. (2) Identifying points of weakness and strength among State STEM education efforts, prioritizing strategies for addressing problem areas, and communicating State needs to the Secretary. (3) Assisting in the implementation of rigorous career and college ready standards in STEM education for grades prekindergarten through grade 12 that reflect and take into consideration-- (A) career and college ready standards in STEM disciplines; (B) established international standards and 21st century skills that include critical thinking, problem solving, communication, collaboration, creativity, and innovation; (C) the needs of English language learners and special education students; and (D) the need to increase STEM literacy of prekindergarten through grade 12 students. (4) Assisting the development of innovative STEM assessments that measure interest, engagement, and content proficiency. (5) Supporting the implementation of STEM assessments that measure career and college ready standards. (6) Promoting and developing rigorous undergraduate pre- service teacher programs in institutions of higher education that emphasize STEM content with emphasis on the elementary educator. (7) Promoting and developing curriculum tools and professional development for STEM educators both in school and out of school. (8) Developing STEM career pathways that reflect the projected STEM workforce needs of the 21st century that may include mentoring programs and STEM professional outreach. (9) Developing STEM-related education and workforce training programs in secondary schools and community colleges to reflect the needs of the local community. (10) Developing systems for the implementation of expanded learning opportunities on school sites to enhance STEM education inside and outside of the classroom. (11) Promoting, supporting, and designing programs that develop STEM content coaches and master educators in order to strengthen core competencies of the classroom practitioner. (e) Evaluation and Report.--Not later than 2 years after receiving a grant under this section, each eligible network receiving such a grant shall-- (1) conduct periodic independent evaluations, by grant or by contract, of the eligible network's effectiveness at accomplishing the activities described in this section, which shall include an assessment of the impact of such activities on STEM teaching and learning; and (2) prepare and submit a report on the results of each evaluation described in paragraph (1) to the Secretary and make for dissemination to other STEM Networks. (f) Prohibitions.--In implementing this section, the Secretary may not-- (1) endorse, approve, or sanction any STEM curriculum designed for use in any elementary school, secondary school, or institution of higher education; or (2) engage in oversight, technical assistance, or activities that will require the adoption of a specific STEM program or instructional materials by a State, local educational agency, or school. (g) Total Amount of Grants.--The total amount of grants made under this section in any fiscal year may not exceed $20,000,000. (h) Definitions.--In this section: (1) The terms ``elementary school'', ``local educational agency'', ``secondary school'', and ``State educational agency'' have the meanings given such terms in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801). (2) The term ``high concentration of low-income students'' has the meaning given such term in section 1707 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 6537). (3) The term ``institution of higher education'' has the meaning given such term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001). (4) The term ``Secretary'' means the Secretary of Education. (5) The term ``State'' means each of the several States of the United States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the Commonwealth of Northern Mariana Islands, American Samoa, and the United States Virgin Islands. (6) The term ``STEM'' means science, technology, engineering, and mathematics. (7) The term ``21st century readiness initiative'' means any initiative that-- (A) embeds core academic subjects with critical skills; and (B) is focused on ensuring that students are prepared for postsecondary education and careers, upon graduation from secondary school.

Summary: Stepping Up to STEM Act of 2013 - Amends the Department of Education Organization Act to establish the Office of Science, Technology, Engineering, and Mathematics (STEM) Education within the Department of Education to administer STEM education. Directs the Office of STEM Education to conduct an independent evaluation of the Department's STEM Education programs at least once every five years. Establishes an Advanced Research Projects Agency for Education (ARPA-ED) within the Department to pursue breakthrough research and development in educational technology and to facilitate the effective use of that technology to improve student achievement. Directs the Secretary of Education to award matching grants to state-based STEM networks or similar organizations of STEM stakeholders to increase students' achievement in the STEM disciplines in elementary and secondary schools and in out of school and afterschool programs. Includes among grant uses: testing, sharing, and scaling up STEM education research, promising practices, and exemplary programs; identifying state STEM education weaknesses and prioritizing strategies to address them; implementing rigorous career and college ready standards in STEM education; developing and implementing innovative STEM assessments that measure student progress toward those career and college ready standards; promoting and developing pre- and in-service STEM teacher training; developing STEM career pathways and workforce education and training programs that reflect 21st century workforce needs; facilitating the implementation of expanded STEM learning opportunities on school sites; and promoting, supporting, and designing programs that develop STEM content coaches and master educators in order to strengthen core competencies of the classroom practitioner. Requires grantees to conduct periodic independent evaluations of their effectiveness in accomplishing those activities. Prohibits the Secretary from: (1) endorsing or approving any STEM curriculum designed for use in an elementary school, secondary school, or institution of higher education; or (2) requiring a state, local educational agency, or school to adopt a specific STEM program or instructional materials.


.-- (1) In general.--Section 233(e) of such Act (42 U.S.C. 433(e)) is amended by striking paragraph (2) and inserting the following new paragraphs: ``(2)(A) Except as provided in paragraph (4) or (5), the agreement transmitted to the Congress pursuant to paragraph (1) may enter into force according to its terms or upon the expiration of the period of 60 calendar days following the date of its transmittal to each House of the Congress (excluding Saturdays, Sundays, holidays, and days on which either House of Congress is not in session), whichever is later. ``(B) Whenever a document setting forth an agreement entered into under this section and the President's report in support of the agreement is transmitted to the Congress pursuant to paragraph (1), copies of such document shall be delivered to both Houses of Congress on the same day and shall be delivered to the Clerk of the House of Representatives if the House is not in session and to the Secretary of the Senate if the Senate is not in session. ``(3)(A) Any document setting forth an agreement entered into under this section and transmitted to each House of the Congress pursuant to paragraph (1) shall set forth a determination of the Chief Actuary of the Social Security Administration as to whether there is expected, over the 75-year period following the date of the entry into force of the agreement, a net reduction in any positive actuarial balance for such period of the social security system established by this title (or a net increase in any negative actuarial balance for such period for such system) attributable to the operation of such agreement equal to at least 0.005 percent of the present value of taxable payroll for such period. ``(B) For purposes of this paragraph-- ``(i) The term `actuarial balance' means, with respect to a period, the difference between the adjusted summarized income rate over such period and the adjusted summarized cost rate over such period. ``(ii) The term `taxable payroll' means, for a period, the total wages (as defined in section 209) to be paid, and self- employment income (as defined in section 211(b)) to be derived, during such period. ``(iii) The term `adjusted summarized income rate' means, over a period, the ratio (expressed as a percentage) of the sum of the trust fund balance at the beginning of the period plus the present value of the total income from taxes during such period, to the present value of the taxable payroll for such period. ``(iv) The term `adjusted summarized cost rate' means, over a period, the ratio (expressed as a percentage) of the sum of the present value of the cost during such period plus the present value of the targeted trust fund balance, to the present value of the taxable payroll for the years for such period. ``(v) The term `trust fund balance' means the combined balance of the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund (hereinafter in this subparagraph referred to as the `Trust Funds'). ``(vi) The term `income from taxes' means, during a period, the amounts deposited in the Trust Funds as appropriations during the period based on taxes under chapters 2 and 21 and section 86 of the Internal Revenue Code of 1986. ``(vii) The term `cost' means, during a period, disbursements from the Trust Funds during such period, including scheduled benefit payments, special monthly payments to certain uninsured persons who have 3 or more quarters of coverage (and whose payments are therefore not reimbursable from the general fund of the Treasury), administrative expenses, net transfers from the Trust Funds to the Railroad Retirement program under financial-interchange provisions, and payments for vocational rehabilitation services for disabled beneficiaries, and excluding special monthly payments to certain uninsured persons whose payments are reimbursable from the general fund of the Treasury, and transfers under the interfund borrowing provisions of section 201(l). ``(viii) The term `target trust fund balance' means the trust fund balance, as of the end of the 75-year period described in subparagraph (A), necessary to support an OASDI trust fund ratio (as defined in section 201(l)(3)(B)(iii)) of 100 percent for the year following the last year of such period. ``(C) In making determinations under this paragraph, the Chief Actuary shall employ the intermediate assumptions of the Board of Trustees of the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund in its most recent annual report issued pursuant to section 201. ``(4) An agreement entered into under this section shall not enter into force if there is enacted into law, during the period of 60 calendar days specified in paragraph (2)(A), a bill or joint resolution disapproving such agreement. ``(5) In any case in which the determination of the Chief Actuary described in subparagraph (A) of paragraph (3) in connection with an agreement entered into under this section is that, with respect to the 75-year period described in such subparagraph, there is expected a net reduction, in the actuarial balance for such period of the social security system established by this title, which-- ``(A) is attributable to the operation of such agreement, and ``(B) is equal to at least 0.005 percent of the present value of taxable payroll for such period, such agreement shall not enter into force unless, during the period of 60 calendar days specified in paragraph (2)(A), there is enacted into law a bill or joint resolution approving such agreement. ``(6)(A) The provisions of this paragraph are enacted by the Congress-- ``(i) as an exercise of the rulemaking power of the House of Representatives and the Senate, respectively, and as such they are deemed a part of the rules of each House, respectively, but applicable only with respect to the procedure to be followed in that House in the case of disapproval resolutions and approval resolutions, and they supersede other rules only to the extent that they are inconsistent therewith; and ``(ii) with full recognition of the constitutional right of either House to change the rules (so far as relating to the procedure of that House) at any time, in the same manner and to the same extent as in the case of any other rule of that House. ``(B) During the period of 60 calendar days specified in paragraph (2)(A), it shall be in order as a matter of highest privilege in each House of the Congress to consider a bill or joint resolution described in paragraph (4) or (5) providing solely for the disapproval or approval of an agreement entered into under this section, if offered by the majority leader or minority leader of such House (or a designee). ``(C) For purposes of consideration of a bill or joint resolution described in paragraph (4) or (5) providing solely for approval or disapproval of an agreement under this section, the agreement shall not be subject to amendment after the transmittal to each House of the Congress pursuant to paragraph (1).''. (2) Effective date.--The amendment made by this subsection shall apply with respect to agreements, establishing totalization arrangements pursuant to section 233 of the Social Security Act, which are transmitted to the Congress on or after the date of the enactment of this Act. (3) Special rule.--Notwithstanding subsection (e) of section 233 of the Social Security Act (as in effect prior to the amendments made by this section), any agreement entered into pursuant to such section 233, establishing totalization arrangements between the social security system established by title II of such Act and the social security system of another country, which-- (A) was signed by the Commissioner of Social Security in June 2004, and (B) was transmitted to the Congress pursuant to such subsection (e) on or after September 1, 2007, and before the date of the enactment of this Act, shall be deemed not to have entered into force as of the date of the enactment of this Act and shall be deemed to enter into force after such date only as provided in section 233(e) of such Act (as amended by this section) as if such agreement had been transmitted to the Congress on the date on which the President transmits to the Congress on or after such date, pursuant to section 233(e)(1) of such Act (as amended by this section), a report in support of such agreement meeting the requirements of such section 233(e)(1) (as so amended). (c) Biennial Reports to the Congress Regarding Ongoing Operation of Totalization Agreements.-- (1) In general.--Section 233 of such Act (42 U.S.C. 433) is amended by adding at the end the following new subsection: ``Biennial Oversight Reports ``(f) The Commissioner of Social Security shall submit biennially to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report evaluating the operation, during the preceding 2-year period covered by the report, of each agreement entered into pursuant to this section. Such report shall include-- ``(1) if the report is submitted during the 10-year period following the date on which the agreement enters into force, the change in benefit costs under the social security system established by this title which is attributable to the agreement, as estimated as of the date of the report, and the change in contributions under such system which is attributable to such agreement, as so estimated, ``(2) information relating to actual, or perceived potential, fraudulent receipt of benefits attributable to the operation of the agreement under the social security system established by this title, ``(3) information relating to perceived problems with the integrity of the other country's data and records used in determining eligibility for benefits or benefit amounts, and ``(4) if the report is submitted during the 10-year period following the date on which the agreement enters into force, information relating to demographic or other trends that may cause future deviations from the original estimates of costs to each social security system which are attributable to the agreement.''. (2) Initial report.--The Commissioner of Social Security shall submit the initial report pursuant to section 233(f) of the Social Security Act (added by this subsection) not later than December 31, 2008. SEC. 203. SUSPENSION OF BENEFITS FOR INDIVIDUALS REMOVED FROM THE UNITED STATES. (a) In General.--Section 202(n)(1) of the Social Security Act (42 U.S.C. 402(n)(1)) is amended-- (1) in subparagraph (A), by striking ``, on the basis of his wages and self-employment income,''; (2) in subparagraph (B), by striking ``and'' at the end; (3) in subparagraph (C), by striking the period and inserting ``, and''; and (4) by adding at the end the following new subparagraph: ``(D) no lump sum death payment shall be made to such individual after the Commissioner of Social Security is notified by the Attorney General or the Secretary of Homeland Security that such individual has been so removed.''. (b) Effective Date.--The amendments made by this section shall apply to any individual with respect to whose removal from the United States the Commissioner of Social Security receives notification from the Attorney General or the Secretary of Homeland Security after the twelfth month that begins after the date of the enactment of this Act.

Summary: New Employee Verification Act of 2008 - Amends the Immigration and Nationality Act (INA) to require employers to verify employee identification and employment eligibility under the Electronic Employment Verification System (EEVS) or the Secure Employment Eligibility Verification System (SEEVS) (as established by this Act). Permits employers subject to employee verification requirements to do so under EEVS or SEEVS. Sets forth provisions respecting: (1) voluntary and expedited participation; (2) employer penalties for failure to participate in EEVS or SEEVS; (3) employer and employee information and document requirements; (4) employer liability protection; (5) attestation; and (6) consequences of EEVS determinations. States that nothing in this Act shall be construed to require a national identification card. Repeals the employment eligibility pilot programs under the Illegal Immigration Reform and Immigrant Responsibility Act of 1996. Amends title II (Old Age, Survivor's and Disability Insurance) of the Social Security Act (SSA) to direct the Commissioner of Social Security to establish EEVS utilizing information in the National Directory of New Hires. States that EEVS shall have the capacity to determine whether: (1) employer-submitted information is consistent with information maintained by the Commissioner with respect to U.S. citizens and nationals and by the Secretary of Homeland Security with respect to aliens; and (2) the individual is a citizen or national or is not an unauthorized alien. Sets forth provisions respecting: (1) submission for confirmation of an individual's identification and employment eligibility and related EEVs determinations; (2) administrative and judicial review of employment disapproval; (3) EEVS implementation; and (4) data use by EEVS. Directs the Commissioner to establish SEEVS to provide, through government certified private entities, for verification of identity and employment eligibility respecting new employees Permits an employer to opt out of SEEVS after one year's participation. Sets forth provisions respecting: (1) certification of entities; (2) database management, including limitations on accessibility and the use and storage of biometric data; (3) employer responsibilities; (4) employee protections; and (5) information security and confidentiality, including penalties for violations. Directs the Commissioner to establish the Employment Verification Advisory Council, which shall terminate five years after enactment of this Act. Amends INA to: (1) apply certain antidiscrimination provisions to EEVS and SEEVS; (2) increase civil money penalties for unfair employment practice violations; (3) increase civil money penalties for certain hiring, recruiting, and referral violations (reduces certain penalties for small employers, exempts certain good faith, first-time violations, and provides a safe harbor for certain contractors); and (4) increase criminal penalties for pattern or practice violations. Amends SSA to: (1) provide for disclosure to the Secretary of Homeland Security of certain National Directory of New Hires information about employees with the greatest number or percentage of mismatched social security information; (2) deny credit toward earnings benefits from unauthorized work; (3) revise totalization agreement provisions; and (4) prohibit survivor's lump sum death payments to individuals who have been removed from the United States under INA.


SECTION 1. SHORT TITLE. This Act may be cited as the ``Rural Health Quality Advisory Commission Act of 2007''. SEC. 2. RURAL HEALTH QUALITY ADVISORY COMMISSION AND DEMONSTRATION PROJECTS. (a) Rural Health Quality Advisory Commission.-- (1) Establishment.--Not later than 6 months after the date of the enactment of this section, the Secretary of Health and Human Services (in this section referred to as the ``Secretary'') shall establish a commission to be known as the Rural Health Quality Advisory Commission (in this section referred to as the ``Commission''). (2) Duties of commission.-- (A) National plan.--The Commission shall develop, coordinate, and facilitate implementation of a national plan for rural health quality improvement. The national plan shall-- (i) identify objectives for rural health quality improvement; (ii) identify strategies to eliminate known gaps in rural health system capacity and improve rural health quality; and (iii) provide for Federal programs to identify opportunities for strengthening and aligning policies and programs to improve rural health quality. (B) Demonstration projects.--The Commission shall design demonstration projects to test alternative models for rural health quality improvement, including with respect to both personal and population health. (C) Monitoring.--The Commission shall monitor progress toward the objectives identified pursuant to paragraph (1)(A). (3) Membership.-- (A) Number.--The Commission shall be composed of 11 members appointed by the Secretary. (B) Selection.--The Secretary shall select the members of the Commission from among individuals with significant rural health care and health care quality expertise, including expertise in clinical health care, health care quality research, population or public health, or purchaser organizations. (4) Contracting authority.--Subject to the availability of funds, the Commission may enter into contracts and make other arrangements, as may be necessary to carry out the duties described in paragraph (2). (5) Staff.--Upon the request of the Commission, the Secretary may detail, on a reimbursable basis, any of the personnel of the Office of Rural Health Policy of the Health Resources and Services Administration, the Agency for Health Care Quality and Research, or the Centers for Medicare & Medicaid Services to the Commission to assist in carrying out this subsection. (6) Reports to congress.--Not later than 1 year after the establishment of the Commission, and annually thereafter, the Commission shall submit a report to the Congress on rural health quality. Each such report shall include the following: (A) An inventory of relevant programs and recommendations for improved coordination and integration of policy and programs. (B) An assessment of achievement of the objectives identified in the national plan developed under paragraph (2) and recommendations for realizing such objectives. (C) Recommendations on Federal legislation, regulations, or administrative policies to enhance rural health quality and outcomes. (b) Rural Health Quality Demonstration Projects.-- (1) In general.--Not later than 270 days after the date of the enactment of this section, the Secretary, in consultation with the Rural Health Quality Advisory Commission, the Office of Rural Health Policy of the Health Resources and Services Administration, the Agency for Healthcare Research and Quality, and the Centers for Medicare & Medicaid Services, shall make grants to eligible entities for 5 demonstration projects to implement and evaluate methods for improving the quality of health care in rural communities. Each such demonstration project shall include-- (A) alternative community models that-- (i) will achieve greater integration of personal and population health services; and (ii) address safety, effectiveness, patient- or community-centeredness, timeliness, efficiency, and equity (the six aims identified by the Institute of Medicine of the National Academies in its report entitled ``Crossing the Quality Chasm: A New Health System for the 21st Century'' released on March 1, 2001); (B) innovative approaches to the financing and delivery of health services to achieve rural health quality goals; and (C) development of quality improvement support structures to assist rural health systems and professionals (such as workforce support structures, quality monitoring and reporting, clinical care protocols, and information technology applications). (2) Eligible entities.--In this subsection, the term ``eligible entity'' means a consortium that-- (A) shall include-- (i) at least one health care provider or health care delivery system located in a rural area; and (ii) at least one organization representing multiple community stakeholders; and (B) may include other partners such as rural research centers. (3) Consultation.--In developing the program for awarding grants under this subsection, the Secretary shall consult with the Administrator of the Agency for Healthcare Research and Quality, rural health care providers, rural health care researchers, and private and non-profit groups (including national associations) which are undertaking similar efforts. (4) Expedited waivers.--The Secretary shall expedite the processing of any waiver that-- (A) is authorized under title XVIII or XIX of the Social Security Act (42 U.S.C. 1395 et seq.); and (B) is necessary to carry out a demonstration project under this subsection. (5) Demonstration project sites.--The Secretary shall ensure that the 5 demonstration projects funded under this subsection are conducted at a variety of sites representing the diversity of rural communities in the Nation. (6) Duration.--Each demonstration project under this subsection shall be for a period of 4 years. (7) Independent evaluation.--The Secretary shall enter into an arrangement with an entity that has experience working directly with rural health systems for the conduct of an independent evaluation of the program carried out under this subsection. (8) Report.--Not later than one year after the conclusion of all of the demonstration projects funded under this subsection, the Secretary shall submit a report to the Congress on the results of such projects. The report shall include-- (A) an evaluation of patient access to care, patient outcomes, and an analysis of the cost effectiveness of each such project; and (B) recommendations on Federal legislation, regulations, or administrative policies to enhance rural health quality and outcomes. (c) Appropriation.-- (1) In general.--Out of funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary to carry out this section $30,000,000 for the period of fiscal years 2008 through 2012. (2) Availability.-- (A) In general.--Funds appropriated under paragraph (1) shall remain available for expenditure through fiscal year 2012. (B) Report.--For purposes of carrying out subsection (b)(8), funds appropriated under paragraph (1) shall remain available for expenditure through fiscal year 2013. (3) Reservation.--Of the amount appropriated under paragraph (1), the Secretary shall reserve-- (A) $5,000,000 to carry out subsection (a); and (B) $25,000,000 to carry out subsection (b), of which-- (i) 2 percent shall be for the provision of technical assistance to grant recipients; and (ii) 5 percent shall be for independent evaluation under subsection (b)(7).

Summary: Rural Health Quality Advisory Commission Act of 2007 - Directs the Secretary of Health and Human Services to establish the Rural Health Quality Advisory Commission to develop, coordinate, and facilitate implementation of a national plan for rural health quality improvements. Requires that such plan: (1) identify objectives for rural health quality improvement; (2) identify strategies to eliminate known gaps in rural health system capacity and improve rural health quality; and (3) provide for federal programs to identify opportunities for strengthening and aligning policies and programs to improve rural health quality. Directs the Commission to: (1) design demonstration projects to test alternative models for rural health quality improvement, including with respect to both personal and population health; and (2) monitor progress towards identified objectives. Requires the Secretary to make grants for demonstration projects to implement and evaluate methods for improving the quality of health care in rural communities that include: (1) alternative community models; (2) innovative approaches to the financing and delivery of health services; and (3) the development of quality improvement support structures to assist rural health systems and professionals. Directs the Secretary to: (1) expedite Medicaid and Medicare waivers as necessary to carry out such demonstration projects; and (2) provide for an independent evaluation of such projects.


SECTION 1. FINDINGS. The Congress finds as follows: (1) The over reliance of the United States on imported petroleum creates a major strategic vulnerability for the Nation, with nearly half of the energy supply of the United States dependent on foreign sources. (2) From the economically damaging Arab oil embargoes of 1973-74 and 1979 to the recession precipitated by rising oil prices which began in 1999, to the stock market's instability in early 2005 due to the cost of imported oil at near record highs of $55 per barrel, the economic stability of the United States has too often been shaken by economic forces outside its borders. (3) Increasing fuel prices have been a particular hardship on small, independent businesses particularly truckers and farmers, who have no choice but to pay ever-increasing fuel bills while absorbing these higher costs in today's economic environment. (4) This Act would help shift America's dependence away from foreign petroleum as an energy source toward alternative, renewable, domestic agricultural sources. Its aim is to convert the current petroleum trade deficit to a trade balance by replacing foreign sources of supply with steady increases of biobased fuels through domestic production. (5) Today, there are nearly 140,000,000 cars and 85,000,000 trucks on our highways. Of this amount, approximately 3,300,000 cars and trucks already on our highways will run on 85 percent ethanol (E-85), and this number is increasing. For the 2005 model year, there are 20 different models of vehicles capable of running on E-85. Yet given this market, the alternative fuel is used less than 1 percent of the time given that of the more than 187,000 retail locations selling motor fuel in the United States, only 400 stations across 38 States sell E-85. (6) Biodiesel production is also dramatically increasing, going from 5,000,000 gallons in 2001 to nearly 25,000,000 gallons in 2003. Daimler-Chrysler has also announced its intentions to initially fuel the Diesel Jeep Liberty with a 5 percent biodiesel blend, the first time a vehicle has been explicitly fueled with an alternative fuel as it rolls off the production line. (7) Currently the United States annually consumes about 7,171,885,000 barrels of petroleum. (164,000,000,000 gallons of vehicle fuels and 5,600,00,000 gallons of heating oil.) In 2002, 62 percent of these fuels were imported, part of a total $358,200,000,000 trade deficit with the rest of the world. Since 1983, the United States importation of petroleum and its derivatives has more than tripled, rising from 1,215,225,000 barrels in 1983 to 4,476,501,000 barrels in 2003. (8) Further Strategic Petroleum Reserve policy should encourage domestic production to the greatest extent possible. Currently, the Strategic Petroleum Reserve holds 670,700,000 barrels (out of a potential 727,000,000 barrels), sufficient to cushion the United States from wild price swings for a period of 53 days. None of the fuel in this Reserve is bio-based. In fact, 92.2 percent of the Strategic Petroleum Reserve has been purchased from foreign sources--41.9 percent from Mexico, 24 percent from the United Kingdom, and over 20 percent from OPEC nations. (9) Strategic Petroleum Reserve policy also should encourage the development of alternatives to the Nation's reliance on petroleum such as biomass fuels. (10) As a first step in diversification, the Strategic Petroleum Reserve should exchange 2,100,000 barrels from our current reserves for 32,000,000 gallons of ethanol and biodiesel, which could comprise less than 2 percent of the United States market, but yield a doubling of ethanol products. (11) The benefits of biofuels are as follows: (A) Energy security.-- (i) Biofuels hold potential to address our dependence on foreign energy sources immediately. With agricultural surpluses, commodity prices have reached record lows; concurrently world petroleum prices have reached record highs and are expected to continue rising as global petroleum reserves are drawn down over the next 25 years. It also is clear that economic conditions are favorable to utilize domestic surpluses of biobased oils to enhance the Nation's energy security. (ii) In the short term, biofuels can supply at least one-fifth of current United States fuel demand using existing technologies and capabilities. Additional plant research, newer processing and distribution technologies, and placing additional acres under cultivation can yield even greater results. (iii) Biofuels can be used with existing petroleum infrastructure and conventional equipment. (B) Economic security.-- (i) Continued dependence upon imported sources of oil means our Nation is strategically vulnerable to disruptions in our oil supply. (ii) Renewable biofuels domestically produced directly replace imported oil. (iii) Increased use of renewable biofuels would result in significant economic benefits to rural and urban areas and also reduce the trade deficit. (iv) According to the Department of Agriculture, a sustained annual market of 100,000,000 gallons of biodiesel alone would result in $170,000,000 in increased income to farmers. (v) Farmer-owned biofuels production has already resulted in improved income for farmers, as evidenced by the experience with State-supported rural development efforts in Minnesota where prices to corn producers have been increased by $1.00 per bushel. With the Department of Agriculture having forecast prices of $2.10 per bushel of corn for the 2004-2005 marketing year, the portion of the corn crop that goes for ethanol has a farm value of $2,100,000,000. (C) Environmental security.-- (i) The use of grain-based ethanol reduces greenhouse gas emissions from 35 to 46 percent compared with conventional gasoline. Biomass ethanol provides an even greater reduction. (ii) The American Lung Association of Metropolitan Chicago credits ethanol-blended reformulated gasoline with reducing smog- forming emissions by 25 percent since 1990. (iii) Ethanol reduces tailpipe carbon monoxide emissions by as much as 30 percent. (iv) Ethanol reduces exhaust volatile organic compounds emissions by 12 percent. (v) Ethanol reduces toxic emissions by 30 percent. (vi) Ethanol reduces particulate emissions, especially fine-particulates that pose a health threat to children, senior citizens, and those with respiratory ailments. (vii) Biodiesel contains no sulfur or aromatics associated with air pollution. (viii) The use of biodiesel provides a 78.5 percent reduction in CO<INF>2</INF> emissions compared to petroleum diesel and when burned in a conventional engine provides a substantial reduction of unburned hydrocarbons, carbon monoxide, and particulate matter. SEC. 2. ETHANOL AND BIODIESEL FUEL REQUIREMENTS. Section 211 of the Clean Air Act (42 U.S.C. 7545) is amended as follows: (1) By redesignating subsection (o) as subsection (q). (2) By inserting after subsection (n) the following: ``(o) Renewable Fuel Program-- ``(1) Definitions.--In this section: ``(A) Ethanol.--The term `ethanol' means ethanol derived from any lignocellulosic or hemicellulosic matter that is available on a renewable or recurring basis, including dedicated energy crops and trees, wood and wood residues, plants, grasses, agricultural residues, and fibers. The term includes ethanol derived from animal wastes, including poultry fats and poultry wastes, and other waste materials, or municipal solid waste. ``(B) Biodiesel.--The term `biodiesel'has the same meaning as when used in section 312(f) of the Energy Policy Act of 1992 (42 U.S.C. 13220(f)). ``(2) Renewable fuel program.--Not later than 1 year after the enactment of this subsection, the Administrator shall promulgate regulations ensuring that, after December 31, 2010, all gasoline or diesel motor vehicle fuel sold or dispensed to consumers in the contiguous United States, on an annual average basis, contains not less than 10 percent ethanol, in the case of gasoline, and not less than 5 percent biodiesel, in the case of diesel fuel.''.

Summary: Amends the Clean Air Act to require the Administrator of the Environmental Protection Agency (EPA) to promulgate regulations ensuring that after December 31, 2010, all gasoline or diesel motor vehicle fuel sold or dispensed in the contiguous United States contains not less than ten percent ethanol (in the case of gasoline) and not less than five percent biodiesel (in the case of diesel fuel).


SECTION 1. SHORT TITLE. This Act may be cited as the ``Southern Prairie Potholes National Wildlife Refuge Act''. SEC. 2. FINDINGS. Congress finds that-- (1) the area of the State of Iowa known as the Southern Prairie Potholes and consisting primarily of the Willow Creek watershed in Greene County offers exceptional potential for restoration into a bountiful native wildlife habitat area; (2) ongoing restoration and preservation of this wildlife habitat area will significantly enhance opportunities for outdoor recreation in this region, including waterfowl and upland hunting, wildlife viewing, and hiking; (3) the Southern Prairie Potholes area is located at the southwestern edge of the Des Moines Lobe left by glaciers 12,000 years ago; (4) the sloughs and grassland offer a substantial oasis of both wetland and grassland habitat at the southwestern boundary of the most heavily cropped region in Iowa; (5) because of the location of the Southern Prairie Potholes at the edge of the multistate and international region known as the Prairie Potholes Region, and along important migratory flyways, the restoration and preservation of the area is critical to providing wildlife habitat across the full extent of the Prairie Potholes Region; (6) this 23,500-acre area has for years been designated by the Prairie Pothole Joint Venture as a priority area for restoration and preservation because of the importance of the area to wildlife, facilitating gradual public land acquisition for habitat restoration; (7) the area already includes the 2,134-acre Dunbar Slough wetland complex of Federal and State land managed as popular wildlife and hunting areas serving Carroll, Greene, and Guthrie Counties and beyond; (8) national wildlife refuges increasingly follow a mosaic pattern with a core of publicly held land surrounded by privately held land also located within the refuge boundary; (9) private ownership and uses are not affected for private land within the designated boundaries of the refuge, but private landowners may be provided increased opportunities for partnering on conservation or restoration practices; (10) restoration and preservation of the Southern Prairie Potholes area will benefit hundreds of birds, mammals, butterflies, reptiles, and amphibians that have been classified as species of greatest conservation need, including the endangered Blanding's turtle; (11) restoration of grassland and wetland in the area will contribute to improved flood control and water quality downstream, as the Middle Raccoon River is the major water source for the Des Moines metropolitan region and other communities; (12) the Southern Prairie Potholes area offers unique recreational appeal because the area is adjacent to the existing Whiterock Conservancy, a 4,300-acre land trust dedicated to conserving and protecting the natural resources of Iowa and engaging the public with the landscape; (13) Whiterock Conservancy offers outdoor recreation and education and includes a major new Backcountry Trail complex; (14) the proximity of the Southern Prairie Potholes to the largest metropolitan area in Iowa adds to the ability of the area to provide natural resource experiences to a broad community; and (15) the area is already attracting cyclists, and that appeal will grow with ongoing development of the cross-country American Discovery Trail transecting the area. SEC. 3. DEFINITIONS. In this Act: (1) Refuge.--The term ``Refuge'' means the Southern Prairie Potholes National Wildlife Refuge established under section 4. (2) Secretary.--The term ``Secretary'' means the Secretary of the Interior. SEC. 4. ESTABLISHMENT AND PURPOSE OF REFUGE. (a) Establishment.-- (1) In general.--The Secretary shall establish the Southern Prairie Potholes National Wildlife Refuge, consisting of approximately 23,500 acres of Federal land, water, and interests in land and water within the boundaries depicted on the map entitled ``Southern Prairie Potholes Project Area'' and dated August 26, 2014. (2) Boundary revisions.--The Secretary shall make such minor revisions of the boundaries of the Refuge as may be appropriate to carry out the purposes of the Refuge or to facilitate the acquisition of property within the Refuge. (3) Availability of map.--The Secretary shall keep the map referred to in paragraph (1) available for inspection in appropriate offices of the United States Fish and Wildlife Service. (b) Purposes.--The purposes of the Refuge are-- (1) to enhance opportunities for outdoor recreation, including waterfowl and upland hunting, hiking, native habitat exploration, and wildlife viewing; (2) to provide for the restoration or preservation of Refuge land to native wetland and grassland habitats and landscapes; (3) to provide for the restoration and conservation of native plants and animal communities on suitable sites in the Southern Prairie Potholes area, including the protection of threatened and endangered species and the restoration of extirpated species; (4) to provide critical travel and nesting habitat for migratory birds; (5) to provide opportunities to private landowners to access technical or financial assistance for the voluntary restoration of the land of the private landowners for the benefit of fish and wildlife; (6) to provide for outdoor recreation, including hunting, hiking, paddling, and wildlife viewing to the public; and (7) to facilitate the education of the public, especially young people, about nature, the environment, and the conservation of the natural resources. (c) Effective Date.-- (1) In general.--The establishment of the Refuge shall take effect on the date on which the Secretary publishes a notice that sufficient property has been acquired by the United States within the boundaries described in subsection (a)(1) to constitute an area that can be efficiently managed as a National Wildlife Refuge. (2) Publication.--The Secretary shall publish the notice described in paragraph (1) in the Federal Register and publications of local circulation in the vicinity of the area within the boundaries described in subsection (a)(1). SEC. 5. ADMINISTRATION OF REFUGE. (a) In General.--Subject to the purposes described in section 4(b), the Secretary shall administer all land, water, and interests in land and water acquired under this Act in accordance with the National Wildlife Refuge System Administration Act of 1966 (16 U.S.C. 668dd et seq.). (b) Additional Authority.--The Secretary may use such additional statutory authority as may be available for the conservation of fish and wildlife, and the provision of fish- and wildlife-oriented recreational opportunities, as the Secretary considers appropriate to carry out the purposes of this Act. (c) Priority Uses.--In providing opportunities for compatible fish- and wildlife-oriented recreation, the Secretary, in accordance with paragraphs (3) and (4) of section 4(a) of the National Wildlife Refuge System Administration Act of 1996 (16 U.S.C. 668dd(a)), shall ensure that hunting, fishing, wildlife observation and photography, and environmental education and interpretation are the priority public uses of the Refuge. (d) Volunteers and Partnerships.--The Secretary shall encourage the use of volunteers and facilitate partnerships among the United States Fish and Wildlife Service, local communities, conservation organizations, and other non-Federal entities to promote public awareness, conservation, and priority uses of the resources of the Refuge. SEC. 6. ACQUISITION OF LAND AND WATER. (a) In General.--Subject to subsection (c) and the availability of appropriations, the Secretary may acquire up to 23,500 acres of land and water, or interests in land and water, within the boundaries of the Refuge as described in section 4(a)(1). (b) Inclusion in Refuge.--Any land, water, or interests acquired by the Secretary under this section shall be part of the Refuge. (c) Manner of Acquisition.--All acquisition of land or water under this section shall be made in a voluntary manner from willing sellers only. SEC. 7. AUTHORIZATION OF APPROPRIATIONS. There are authorized to be appropriated such sums as are necessary to carry out this Act.

Summary: Southern Prairie Potholes National Wildlife Refuge Act - Directs the Secretary of the Interior to establish the approximately 23,500-acre Southern Prairie Potholes National Wildlife Refuge in Iowa. Authorizes the Secretary to acquire land and water within the boundaries of the Refuge from willing sellers. Lists as purposes of the Refuge to: (1) enhance opportunities for outdoor recreation; (2) provide for the restoration or preservation of Refuge land to native wetland and grassland habitats and landscapes; (3) provide for the restoration and conservation of native plants and animal communities; (4) provide critical travel and nesting habitat for migratory birds; (5) provide opportunities to private landowners to access assistance for the voluntary restoration of land for the benefit of fish and wildlife; and (6) facilitate the education of the public about nature, the environment, and the conservation of the natural resources. Directs the Secretary to: (1) administer all land, water, and interests therein acquired under this Act in accordance with the National Wildlife Refuge System Administration Act of 1966; (2) ensure that hunting, fishing, wildlife observation and photography, and environmental education and interpretation are the priority public uses of the Refuge; and (3) encourage the use of volunteers and facilitate partnerships to promote public awareness, conservation, and priority uses of Refuge resources. .


SECTION 1. SHORT TITLE. This Act may be cited as the ``Military Sexual Assault Victims Empowerment Act'' or the ``Military SAVE Act''. SEC. 2. PILOT PROGRAM FOR PRIVATE HEALTH CARE FOR VETERANS WHO ARE SURVIVORS OF MILITARY SEXUAL TRAUMA. (a) Establishment.--The Secretary of Veterans Affairs shall carry out a pilot program to furnish hospital care and medical services to eligible veterans through non-Department health care providers to treat injuries or illnesses which, in the judgment of a professional employed by the Department, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the veteran was serving on active duty, active duty for training, or inactive duty training. (b) Duration.--The Secretary shall carry out the pilot program under subsection (a) for a 3-year period. If at the completion of the pilot program an eligible veteran is receiving hospital care and medical services from a non-Department health care provider under the pilot program, the Secretary may approve, on a case-by-case basis, the continuation of such hospital care and medical services from that non- Department health care provider until the completion of the episode of care. (c) Eligible Veterans.--A veteran is eligible to participate in the pilot program under subsection (a) if the veteran-- (1) is eligible to receive counseling and appropriate care and services under section 1720D of title 38, United States Code; and (2) resides in a site selected under subsection (d). (d) Sites.-- (1) Selection.--The Secretary shall select not more than five sites in which to carry out the pilot program under subsection (a). Each site shall meet each of the following criteria: (A) Except as provided by paragraph (2), the site consists of a city with a population between 200,000 and 500,000, as determined by the Bureau of the Census as of the first day of the pilot program. (B) The site is in a State in which the National Violence Against Women Prevention Research Center or the Centers for Disease Control and Prevention, or both, has determined the rate of sexual assault to be a substantial problem. (C) The site is in a State that, as of the first day of the pilot program, has a weighted percentage of reported rape of not less than 20 percent but not more than 30 percent of sexual assault cases, in accordance with the finding of the Centers for Disease Control and Prevention contained in the ```Lifetime Prevalence of Sexual Violence by any Perpetrator'' (NISVS 2010). (2) Rural site.--Not fewer than one site selected under paragraph (1) shall be rural, as determined by the Secretary. (e) Participation.-- (1) Election.--Subject to paragraph (2), an eligible veteran may elect to participate in the pilot program under subsection (a). Such election shall not affect the ability of the veteran to receive health care furnished by Department providers. (2) Number.--Not more than 75 veterans may participate in the pilot program under subsection (a) at each site selected under subsection (d). (3) Choice of non-department health care providers.--An eligible veteran who participates in the pilot program under subsection (a) may freely choose from which non-Department health care provider the veteran receives hospital care or medical services under the pilot program, except that the Secretary shall-- (A) ensure that each such non-Department health care provider maintains at least the same or similar credentials and licenses as those credentials and licenses that are required of health care providers of the Department, as determined by the Secretary for the purposes of this section; and (B) make a reasonable effort to ensure that such non-Department health care provider is familiar with the conditions and concerns that affect members of the Armed Forces and veterans and is trained in evidence- based psychotherapy. (4) Provision of information.--The Secretary shall-- (A) notify eligible veterans of the ability to make an election under paragraph (1); and (B) provide to such veterans educational referral materials, including through pamphlets and internet websites, on the non-Department providers in the sites selected under subsection (d). (f) Authorization and Monitoring of Care.--In accordance with subsection (e), the Secretary shall ensure that the Department of Veterans Affairs authorizes and monitors the hospital care and medical services furnished under the pilot program for appropriateness and necessity. In authorizing and monitoring such care, the Secretary shall-- (1) treat a non-Department health care provider that furnishes to such a veteran hospital care or medical services under the pilot program as an authorized recipient of records of such veteran for purposes of section 7332(b) of title 38, United States Code; and (2) ensure that such non-Department health care provider transmits to the Department such records as the Secretary determines appropriate. (g) Payments.-- (1) Current providers.--If a non-Department health care provider has entered into a contract, agreement, or other arrangement with the Secretary pursuant to another provision of law to furnish hospital care or medical services to veterans, the Secretary shall pay the health care provider for hospital care or medical services furnished under this section using the same rates and payment schedules as provided for in such contract, agreement, or other arrangement. (2) New providers.--If a non-Department health care provider has not entered into a contract, agreement, or other arrangement with the Secretary pursuant to another provision of law to furnish hospital care or medical services to veterans, the Secretary shall pay the health care provider for hospital care or medical services furnished under this section using the same rates and payment schedule as if such care and services was furnished pursuant to section 1703 of title 38, United States Code. (3) New contracts and agreements.--The Secretary shall take reasonable efforts to enter into a contract, agreement, or other arrangement with a non-Department health care provider described in subsection (a) to ensure that future care and services authorized by the Secretary and furnished by the provider are subject to such a contract, agreement, or other arrangement. (h) Surveys.--The Secretary shall conduct a survey of a sample of eligible veterans to assess the hospital care and medical services furnished to such veterans either pursuant to this section or section 1720D of title 38, United States Code, as the case may be. (i) Report.--Not later than 60 days before the completion of the pilot program under subsection (a), the Secretary shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a report on the pilot program. The report shall include the following: (1) The results of the pilot program, including, to the extent possible, an assessment of the health outcomes of veterans who participated in the pilot program. (2) The recommendation of the Secretary with respect to extending or making permanent the pilot program. (j) Definitions.--In this section: (1) The term ``non-Department health care provider'' means an entity specified in section 101(a)(1)(B) of section 101 of the Veterans Access, Choice, and Accountability Act of 2015 (Public Law 113-146; 38 U.S.C. 1701) or any other health care provider that has entered into a contract, agreement, or other arrangement with the Secretary pursuant to another provision of law to furnish hospital care or medical services to veterans. (2) The term ``sexual harassment'' has the meaning given that term in section 1720D of title 38, United States Code. (3) The term ``State'' has the meaning given that term in section 101(20) of title 38, United States Code. SEC. 3. NO ADDITIONAL FUNDS AUTHORIZED. No additional funds are authorized to be appropriated to carry out the requirements of this Act. Such requirements shall be carried out using amounts otherwise authorized to be appropriated. Passed the House of Representatives May 21, 2018. Attest: KAREN L. HAAS, Clerk.

Summary: Military Sexual Assault Victims Empowerment Act or the Military SAVE Act (Sec. 2) This bill directs the Department of Veterans Affairs (VA) to carry out a three-year pilot program of hospital care and medical services for eligible veterans at non-VA health care providers to treat injuries or illnesses resulting from sexual assault, battery, or harassment while the veteran was on active duty, active duty for training, or inactive duty training. Program participation shall not affect a veteran's ability to receive VA health care. An eligible veteran may elect to participate in the program and choose his or her provider as long as the provider meets VA requirements. The program shall be carried out at not more than five sites that meet criteria of city size and rates of sexual assault and rape. At least one site shall be a rural site and not more than 75 veterans may participate at any one site. The bill sets forth payment provisions for current and new non-VA providers.