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STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
(Senate - April 30, 1998)
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STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. CLELAND:
S. 2009. A bill to require the Secretary of Defense and the Secretary
of Veterans Affairs to carry out joint reviews relating to
interdepartmental cooperation in the delivery of medical care by the
departments; to the Committee on Armed Services.
military health care legislation
Mr. CLELAND. Mr. President, I am particularly honored to serve as the
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ranking Democratic member of the Senate Armed Services Personnel
Subcommittee, a charge I have embraced to its fullest. In the first
session of the 105th Congress, I pledged my commitment to improving
military health care. Today, I am here to discuss proposals to offer
both immediate assistance and a time phased legislative strategy to
fulfill this commitment.
The Fiscal Year 1998 Defense Authorization Act (P.L. 105-85) included
a Sense of the Congress Resolution which provided a finding that ``many
retired military personnel believe that they were promised lifetime
health care in exchange for 20 or more years of service,'' and
expresses the sense of Congress that ``the United States has incurred a
moral obligation'' to provide health care to members and retired
members of the Armed Services and that Congress and the President
should take steps to address ``the problems associated with the
availability of health care for such retirees within two years.'' I
authored that resolution, and today in year one of my two-year
challenge, I stand ready to take the first of many necessary steps to
fulfill this obligation.
I call this obligation ``K-P Duty''--K-P as in KEEPING PROMISES. As a
disabled veteran and retiree, as former head of the Veterans
Administration, and as the Ranking Member on the Personnel
Subcommittee, I am seeking to draft Congress and the entire nation and
put us all on K-P Duty.
Back when I was in the Army, some saw K-P or ``kitchen police'' as
punishment. If a soldier was derelict in his duties, or if he broke the
rules, he went on KP, where he served his fellow soldiers by working in
the messhall.
The K-P Duty I'm talking about is not about punishment, however. Yes,
we as a nation have been derelict in our duties to our military
personnel, active duty and retired. Yes, we have broken our promises.
But the K-P Duty I'm talking about is a sacred honor. It is about a
grateful nation paying respect to those soldiers who made tremendous
sacrifices for our Country. The soldiers who won World War II, who won
the Cold War--the soldiers that have made it possible for the United
States to be the world's only super power. It is our time, indeed it is
past time, to serve these soldiers and fulfill our obligation.
As with any draft in an army, the first order of business is
bootcamp. As long as I have taken the liberty of drafting the entire
Congress, I might as well serve as drill instructor. Let me take this
time to ``drill'' the Senate on the basics of this challenge.
Not only do we have to fulfill our promise, we also have to
reconsider the way in which the military and veterans health care
systems work. It is the change in the demographics of military health
care beneficiaries that necessitates a change in the way that we
administer health care.
When I went on active duty, the military was made up of mostly single
male soldiers. Looking at the all-volunteer, totally-recruited force
today, the picture is much different. Now, 57 percent of all enlisted
members and 73 percent of all officers are married. Not surprisingly,
the number of young dependents has also risen. In terms of recruitment,
quality health care is cited as a major incentive for young men and
women who join the military. It is that same health care for soldiers
and their families that helps retain these soldiers in the military.
Recently, I heard the adage, ``the military recruits a soldier, but
retains a family.''
Since the time I was a U.S. Army Captain 30 years ago, the number of
active duty personnel has undergone a 58 percent reduction.
Concurrently, the number of retirees has more than doubled. The
Government Accounting Office reports that approximately 48 percent of
the beneficiaries of the Department of Defense Military Health System
are active duty members and dependents. The remaining 52 % are retirees
and dependents. 71% of military retirees are under the age of 65, while
29% of military retirees are over the age of 65.
As we consider options for improving the DoD and VA health care
systems, we need to be mindful of some basic facts. About 60% of
retirees under the age 65 live near a military treatment facility but
only about 52% the retirees aged 65 and older live near such a
facility. About two thirds of retirees under age 65 used the military
health system. In comparison, only about a quarter of the retirees aged
65 and older used military medical facilities on a space available
basis primarily for pharmacy services.
According to a 1994-95 survey of DoD beneficiaries, over 40 percent
of military retirees, regardless of age, had private health insurance
coverage. About a third of retirees aged 65 and older also reported
having additional insurance to supplement their Medicare benefits.
Approximately 14% of retirees under age 65 had insurance to supplement
their CHAMPUS coverage.
In this same dynamic environment of the past 30 years, the medical
portion of the DoD budget has increased dramatically from approximately
two percent to six percent. In part, this can be attributed to cost
growth from technology and intensity of treatment in the private and
public sectors. It is interesting to note the converse relationship
between the increase in health care dollars as the number of active
duty personnel decreases and the number of retirees increases.
The Military Health System (MHS) and the Veterans Health
Administration are well established institutions that collectively
manage over 1500 hospitals, clinics, and health care facilities world-
wide, providing services to over 11 million beneficiaries. Overseeing
these systems requires a well-planned and executed effort.
The Veterans Health Administration is a system in transition. In the
past two years, the VA has replaced its structure of four regions, 33
networks, and hundreds of clinics with a new system geared to
decentralizing authority into 22 Veterans Integrated Service Networks.
The purpose of the reorganization was to improve the access, quality
and efficiency of care provided to the Nation's veterans. The hallmark
of the network structure is that the field has been given control over
functions which were previously located in Washington. The majority of
quality-related activities were transferred closer to the site of
patient care.
The Military Health System has also changed. During the Cold War,
that system was designed to support full-scale, extremely violent war
with the Soviet Union and its allies in Europe. The collapse of the
Soviet Union and the end of the Warsaw Pact led to a major reassessment
of the U.S. defense policy. The overall size of the active duty force
has been reduced by one-third since the mid-1980s.
The DoD health care system changes have included the establishment of
a managed care program, numerous facility closures, and significant
downsizing of military medical staff. In the last decade, the number of
military medical personnel has declined by 15 percent and the number of
military hospitals has been reduced by one-third. The National Defense
Authorization Act for Fiscal Year 1994 directed DoD to prescribe and
implement a nationwide managed health care benefit program modeled on
health maintenance organization plans and in 1995, beneficiaries began
enrolling in this new program called TRICARE. With over 8 million
beneficiaries, it is the largest health maintenance organization plan
in the Nation.
One of the problems with TRICARE is what happens to retirees when
they reach the age of 65. They are ineligible to participate in
TRICARE. The law currently provides for transition from military health
care to Medicare for these beneficiaries. This is not the right
solution, especially given the fact that Medicare does not currently
reimburse the DoD for health care services, although Congress recently
authorized a test of this concept. In addition, as the military begins
to close and downsize military treatment facilities, retirees over 65
are unable to seek and obtain treatment on a space available basis. The
retirees over 65 are, in effect, being shut out of the medical
facilities promised to them.
The changing health care environment has created its own set of
unique challenges. To assess these varied and special requirements, I
formed a Military Health Care Reform Working Group of senior officials
in government and the private sector to explore innovative solutions to
improve the military and veterans health care systems. During the past
few months this group analyzed the array of military and veterans
health care issues and recently provided a comprehensive report of
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their findings and recommendations to me.
In March, I hosted a military health care roundtable at Fort Gordon,
Georgia. The positive and supportive working relationship between the
Eisenhower Army Medical Center and the Veterans Administration Medical
Center in Augusta, Georgia was highlighted by the panel speakers and
audience members. These facilities have established a sharing agreement
which allows each to provide certain health care services to the
beneficiaries of the other. This type of joint approach has the
potential to alleviate a significant portion of the accessibility
problem faced by military retirees, especially given the reduction in
DoD medical treatment facilities. In spite of these benchmarked efforts
in cooperative care, beneficiaries who were in the audience still
attested to insufficient accessibility to resources to meet their
needs.
Public Law 97-174, ``The Veterans Administration and Department of
Defense Health Resources Sharing and Emergency Operations Act,'' was
enacted in 1982 specifically to promote cost-effective use of federal
health care resources by minimizing duplication and underuse of health
care resources while benefitting both VA and DoD beneficiaries. Under
this law, VA and DoD pursue programs of cooperation ranging from shared
services to joint venture operations of medical facilities. Sharing
agreements are developed on a local basis, whereas, joint ventures are
developed at the highest levels within an organization or command.
In 1984, there were a combined total of 102 VA and DoD facilities
with sharing agreements. By 1997, that number had grown to 420. In five
years, between FY 1992 and FY 1997, shared services increased from
slightly over 3,000 to more than 6,000 services ranging from major
medical and surgical services, laundry, blood, and laboratory services
to unusual speciality care services. VA and DoD currently have four
joint ventures in operation in New Mexico, Nevada, Texas, Oklahoma, and
four more in planning for Alaska, Florida, Hawaii, California.
In my opening remarks, I suggested that there are things that we can
do immediately and others that can be accomplished through a near term
time phased legislative strategy to fulfill our moral obligation to
active duty and retired service personnel. Let me first discuss some of
the options.
There has been an overwhelming outpouring of support for offering
Federal Employee Health Benefits Program (FEHBP) to military retirees.
Although this program has achieved a successful reputation among
federal employees, it is a costly alternative which necessitates close
scrutiny, along with other health care options. I appreciate the fact
that there are many advantages to FEHBP. Furthermore, I share the view
that health care for military retirees should be at least as good as
the health care we in the Congress afford ourselves. I am committed to
working closely on the FEHBP option.
The Medicare Subvention demonstration project that is scheduled to
begin enrollment in the near future involves TRICARE Prime.
Unfortunately, it will only benefit retirees who live near military
treatment facilities--which is only about half of all retirees. Those
retirees living outside catchment areas won't benefit from subvention.
Additionally, there are ongoing efforts to initiate a Veterans Affairs
Subvention test. The limiting criteria of these tests is that they
require beneficiaries to live near the respective treatment facilities.
To accommodate those beneficiaries that do not live near treatment
facilities or within the catchment area, we must explore other
alternatives, including, as I mentioned, the FEHBP option.
Today, I am announcing two initiatives. The first is a bill to
require the Department of Defense and the Department of Veterans
Affairs to significantly enhance their cooperative efforts in the
delivery of health care to their respective beneficiaries. Several
measures to enhance military health care efficiencies are already being
explored, and the initiative I am proposing would complement these
efforts without any direct impact on current spending. Let me just
highlight some of the elements of my plan.
The first element directs DoD and the VA to conduct a comprehensive
survey to determine the demographics of their beneficiaries, their
geographic distribution, and their preferences for health care. A
second survey would review the range of existing DoD and VA facilities
and resources and the capacity available for cooperative efforts. The
purpose of these reviews is simple. We need to accurately determine who
we are serving, what they want, and what resources we currently have to
provide to them.
The second element directs DoD and the VA to provide to the Congress
a report on any and all impediments which preclude optimal cooperation
and/or integration between DoD and VA in the area of health care
delivery. We need to know what statutory restrictions, regulatory
constraints, and cultural issues stand in the way of full and complete
cooperation between the two departments. They would be directed to
recommend to the Congress what changes should be made in the law.
Furthermore, they would be directed to eliminate any regulatory and
cultural impediments.
The third element addresses several projects that have been
undertaken by the Departments of Defense and Veterans Affairs that can
be accelerated for near term implementation. The Electronic Transfer of
Patient Information, a collaborative effort by DoD and VA which would
provide for immediate transfer of and access to patient records at the
time of treatment is a project which merits Congressional support. The
DoD and VA have also established the DoD/VA Federal Pharmaceutical
Steering Committee. I believe this committee should perform a
comprehensive examination of existing pharmaceutical benefits and
programs, including current management and utilization of mail order
pharmaceuticals. Finally, the initiative directs DoD to review the
extent of VA participation in TRICARE networks and to take steps to
ensure optimal participation by the VA.
The second initiative I am announcing today is legislation which is
being crafted to respond to the tremendous outcry to provide health
care for military retirees over 65. Mr. President, as you know, S.
1334, a bill to provide for a test of the FEHBP plan has 60 cosponsors.
It is my plan to work with my friend and colleague Senator Kempthorne
in the Senate Armed Services Committee to include in the National
Defense Authorization bill a proposal that addresses this matter this
year.
I recognize that there is a perception that our military benefits are
eroding but I am here today to say that we can change this perception
if we all do our share on K-P Duty. Greater cooperation among the DoD
and VA will yield greater choices for the beneficiaries of these
systems. Developing a viable health care alternative for our retirees
over 65, a group that has been largely disenfranchised, will ensure
that now all beneficiaries have access to the health care to which they
are entitled because of their service to this Nation.
We made a promise, now let's keep it. It is as simple as that.
Mr. President, I ask unanimous consent that the full text of the bill
be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 2009
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. FINDINGS.
Congress makes the following findings:
(1) The military health care system of the Department of
Defense and the Veterans Health Administration of the
Department of Veterans Affairs are national institutions that
collectively manage more than 1,500 hospitals, clinics, and
health care facilities worldwide to provide services to more
than 11,000,000 beneficiaries.
(2) In the post-Cold War era, these institutions are in a
profound transition that involves challenging opportunities.
(3) During the period from 1988 to 1998, the number of
military medical personnel has declined by 15 percent and the
number of military hospitals has been reduced by one-third.
(4) During the two years since 1996, the Department of
Veterans Affairs has revitalized its structure by
decentralizing authority into 22 Veterans Integrated Service
Networks.
(5) In the face of increasing costs of medical care,
increased demands for health care services, and increasing
budgetary constraints, the Department of Defense and the
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Department of Veterans Affairs have embarked on a variety of
dynamic and innovative cooperative programs ranging from
shared services to joint venture operations of medical
facilities.
(6) In 1984, there was a combined total of 102 Department
of Veterans Affairs and Department of Defense facilities with
sharing agreements. By 1997, that number had grown to 420.
During the six years from fiscal year 1992 through fiscal
year 1997, shared services increased from slightly over 3,000
services to more than 6,000 services ranging from major
medical and surgical services, laundry, blood, and laboratory
services to unusual speciality care services.
(7) The Department of Defense and the Department of
Veterans Affairs are conducting four health care joint
ventures in New Mexico, Nevada, Texas, Oklahoma, and are
planning to conduct four more such ventures in Alaska,
Florida, Hawaii, and California.
SEC. 2. SENSE OF CONGRESS.
It is the sense of Congress that--
(1) the Department of Defense and the Department of
Veterans Affairs are to be commended for the cooperation
between the two departments in the delivery of medical care,
of which the cooperation involved in the establishment and
operation of the Department of Defense and the Department of
Veterans Affairs Executive Council is a praiseworthy example;
(2) the two departments are encouraged to continue to
explore new opportunities to enhance the availability and
delivery of medical care to beneficiaries by further
enhancing the cooperative efforts of the departments; and
(3) enhanced cooperation is encouraged for--
(A) the general areas of access to quality medical care,
identification and elimination of impediments to enhanced
cooperation, and joint research and program development; and
(B) the specific areas in which there is significant
potential to achieve progress in cooperation in a short term,
including computerization of patient records systems,
participation of the Department of Veterans Affairs in the
TRICARE program, pharmaceutical programs, and joint physical
examinations.
SEC. 3. JOINT SURVEY ON POPULATIONS SERVED.
(a) Survey Required.--The Secretary of Defense and the
Secretary of Veterans Affairs shall jointly conduct a survey
of their respective medical care beneficiary populations to
identify, by category of beneficiary (defined as the
Secretaries consider appropriate), the expectations of,
requirements for, and behavior patterns of the beneficiaries
with respect to medical care. The two Secretaries shall
develop the protocol for the survey jointly, but shall obtain
the services of an entity independent of the Department of
Defense and the Department of Veterans Affairs for carrying
out the survey.
(b) Matters To Be Surveyed.--The survey shall include the
following:
(1) Demographic characteristics, economic characteristics,
and geographic location of beneficiary populations with
regard to catchment or service areas.
(2) The types and frequency of care required by veterans,
retirees, and dependents within catchment or service areas of
Department of Defense and Veterans Affairs medical facilities
and outside those areas.
(3) The numbers of, characteristics of, and types of
medical care needed by the veterans, retirees, and dependents
who, though eligible for medical care in Department of
Defense or Department of Veterans Affairs treatment
facilities or other federally funded medical programs, choose
not to seek medical care from those facilities or under those
programs, and the reasons for that choice.
(4) The obstacles or disincentives for seeking medical care
from such facilities or under such programs that veterans,
retirees, and dependents perceive.
(5) Any other matters that the Secretary of Defense and the
Secretary of Veterans Affairs consider appropriate for the
survey.
(c) Report.--The Secretary of Defense and the Secretary of
Veterans Affairs shall submit a report on the results of the
survey to the appropriate committees of Congress. The report
shall contain the matters described in subsection (b) and any
proposals for legislation that the Secretaries recommend for
enhancing Department of Defense and Department of Veterans
Affairs cooperative efforts with respect to the delivery of
medical care.
SEC. 4. REVIEW OF IMPEDIMENTS TO COOPERATION.
(a) Review Required.--The Secretary of Defense and the
Secretary of Veterans Affairs shall jointly conduct a review
to identify impediments to cooperation between the Department
of Defense and the Department of Veterans Affairs regarding
the delivery of medical care. The matters reviewed shall
include the following:
(1) All laws, policies, and regulations, and any attitudes
of beneficiaries of the health care systems of the two
departments, that have the effect of preventing the
establishment, or limiting the effectiveness, of cooperative
health care programs of the departments.
(2) The requirements and practices involved in the
credentialling and licensure of health care providers.
(3) The perceptions of beneficiaries in a variety of
categories (defined as the Secretaries consider appropriate)
regarding the various Federal health care systems available
for their use.
(b) Report.--The Secretaries shall jointly submit a report
on the results of the review to the appropriate committees of
Congress. The report shall include any proposals for
legislation that the Secretaries recommend for eliminating or
reducing impediments to interdepartmental cooperation that
are identified during the review.
SEC. 5. PARTICIPATION OF DEPARTMENT OF VETERANS AFFAIRS IN
TRICARE.
(a) Review Required.--The Secretary of Defense shall review
the TRICARE program to identify opportunities for increased
participation by the Department of Veterans Affairs in that
program. The ongoing collaboration between Department of
Defense officials and Department of Veterans Affairs
officials regarding increasing the participation shall be
included among the matters reviewed.
(b) Semiannual Report.--The Secretary of Defense and the
Secretary of Veterans Affairs shall jointly submit to the
appropriate committees of Congress a semiannual report on the
status of the review and on efforts to increase the
participation of the Department of Veterans Affairs in the
TRICARE program. No report is required under this subsection
after the submission of a semiannual report in which the
Secretaries declare that the Department of Veterans Affairs
is participating in the TRICARE program to the extent that
can reasonably be expected to be attained.
SEC. 6. PHARMACEUTICAL BENEFITS AND PROGRAMS.
(a) Examination Required.--(1) The Federal Pharmaceutical
Steering Committee shall--
(A) undertake a comprehensive examination of existing
pharmaceutical benefits and programs for beneficiaries of
Federal medical care programs, including matters relating to
the purchasing, distribution, and dispensing of
pharmaceuticals and the management of mail order
pharmaceuticals programs; and
(B) review the existing methods for contracting for and
distributing medical supplies and services.
(2) The committee shall submit a report on the results of
the examination to the appropriate committees of Congress.
(b) Report.--The committee shall submit a report on the
results of the examination to the appropriate committees of
Congress.
SEC. 7. STANDARDIZATION OF PHYSICAL EXAMINATIONS FOR
DISABILITIES.
The Secretary of Defense and the Secretary of Veterans
Affairs shall submit to the appropriate committees of
Congress a report on the status of the efforts of the
Department of Defense and the Department of Veterans Affairs
to standardize physical examinations administered by the two
departments for the purpose of determining or rating
disabilities.
SEC. 8. APPROPRIATE COMMITTEES OF CONGRESS DEFINED.
For the purposes of this Act, the appropriate committees of
Congress are as follows:
(1) The Committee on Armed Services and the Committee on
Veterans' Affairs of the Senate.
(2) The Committee on National Security and the Committee on
Veterans' Affairs of the House of Representatives.
SEC. 9. DEADLINES FOR SUBMISSION OF REPORTS.
(a) Report on Joint Survey of Populations Served.--The
report required by section 3(c) shall be submitted not later
than January 1, 2000.
(b) Report on Review of Impediments to Cooperation.--The
report required by section 4(b) shall be submitted not later
than May 1, 1999.
(c) Semiannual Report on Participation of Department of
Veterans Affairs in TRICARE.--The semiannual report required
by section 5(b) shall be submitted not later than January 1
and June 1 of each year.
(d) Report on Examination of Pharmaceutical Benefits and
Programs.--The report on the examination required under
section 6 shall be submitted not later than 60 days after the
completion of the examination.
(e) Report on Standardization of Physical Examinations for
Disabilities.--The report required by section 7 shall be
submitted not later than June 1, 1999.
______
By Mr. CAMPBELL:
S. 2010. A bill to provide for business development and trade
promotion for Native Americans, and for other purposes; to the
Committee on Indian Affairs.
the native american business development, trade promotion, and tourism
act of 1998
Mr. CAMPBELL. Mr. President, today I am pleased to introduce a
measure to help Indians and tribal businesses foster entrepreneurship
and vigorous reservation economies. Indian tribes face many challenges,
but the greatest priority is in building stronger economies and
providing jobs to tribal members. With this bill, I intend to unshackle
Indian entrepreneurship to provide jobs and revenues for reservation
economies.
When the Europeans landed in the New World to explore and build
settlements, they were greeted by Native
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people with a long tradition of inter-tribal and regional trade. The
tribes traded pelts and furs, hand-woven baskets, blankets, virtually
limitless arts and crafts, weapons, and a variety of Native grown and
gathered foods.
Unrestrained by bureaucrats and free to roam their own lands, the
tribes enjoyed a standard of material well-being that, while not ideal,
was a far cry from the Third World conditions most Indian people live
in today.
Over the course of 200 years this tradition has been replaced by
rules and regulations that continue to stifle Indian entrepreneurship
and instead promise cradle-to-grave ``security'' based on federal
transfer payments. The practical results of federal domination is
predictable: lifeless reservation economies and the absence of a
private sector to create wealth and sustain employment for Indian
people.
The current statistical profile of Indian people is poor and shows
little sign of improvement. Despite the popular belief that gaming has
made millionaires of all Indians, the reality is otherwise as most
Indian gaming revenues are more like church bingo than like Las Vegas
or Atlantic City.
In the Great Depression, the national unemployment rate was 20
percent and it was called a ``national crisis.'' Indian country has an
unemployment rate running at 50 percent, and there are no comments, no
sense of urgency and little attention being paid.
There are other reasons job opportunities are needed. In 1996, the
Congress enacted a welfare reform law that provides transition
assistance to welfare recipients and rightly requires able-bodied
Americans to get and keep jobs. In rural areas, particularly on Indian
reservations, the welfare reform will hit hard because employment
opportunities are scarce.
The goal of this and future efforts is to increase value-added
activities on reservations in such fields as manufacturing, energy,
agriculture, livestock and fisheries, high technology, arts and crafts,
and a host of service industries.
The United States has the responsibility to preserve, protect and
maximize tribal assets and resources, and an obligation to improve the
standards of living of Indian people. In this legislation, that
responsibility is primarily in removing the barriers to success the
federal government itself has created over the years.
The bill aims to make best use of and streamline existing programs to
provide the necessary tools to enable tribes to attract outside capital
and technical expertise. This model has proven highly successful in the
self governance arena and in the Indian job training program, known as
the ``477'' program. The bill would provide better coordination of
existing business development programs in the Commerce Department and
maximize the resources made available to tribes.
The tribes have a responsibility as well. As a matter of Indian self
determination, the tribes are increasingly administering federal
services, programs, and activities in lieu of the federal government.
This has led to more capable and accountable tribal governments. A
fundamental precept of self-government is a reduction in the dependence
on the federal bureaucracy and federal funds and by assuming a greater
role in funding their own self government.
The Committee on Indian Affairs recently held a hearing on economic
development and one of the findings was that the tribes need to provide
governance infrastructure and friendly business environments if they
want to attract and retain investment. Whether by adopting commercial
codes, or tribal courts that can address business issues, or
regulations that do not repel the private sector, tribal efforts are
critical if this effort is to succeed.
Under the bill, the Native American Business Development Office in
the Commerce Department will coordinate existing programs, including
those for international business and tourism, aimed at development on
Indian lands. This bill does not create any new programs but rather is
intended to achieve more efficiency in those that already exist within
existing budget authority. The bill also prohibits assistance under the
act from being used for gaming on Indian lands.
In addition, the bill directs the Secretary to create a task force on
regulatory reform and business development to analyze existing laws and
regulations that are restraining business and economic development on
Indian lands. Again, the bill is not intended to create a new entity,
but recognizes that there is great need to strip away the layers of
unnecessary rules and regulations that stifle Indian businesses.
I urge those that are critical of Indian gaming to join me in
providing alternatives to build strong and diversified tribal economies
for the benefit of tribes, tribal members, and surrounding communities.
Mr. President, I ask unanimous consent that the provisions of the
bill and an article written by James Gwartney for the Wall Street
Journal dated April 10, 1998, entitled ``Less Government, More Growth''
be printed in the Record.
There being no objection, the items were ordered to be printed in the
Record, as follows:
S. 2010
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Native American Business
Development, Trade Promotion, and Tourism Act of 1998''.
SEC. 2. FINDINGS; PURPOSES.
(a) Findings.--Congress finds that--
(1) clause 3 of section 8 of article I of the United States
Constitution recognizes the special relationship between the
United States and Indian tribes;
(2) beginning in 1970, with the inauguration by the Nixon
Administration, of the Indian self-determination era of the
Federal Government, each President has confirmed the special
government-to-government relationship between Indian tribes
and the United States;
(3) in 1994, President Clinton issued an Executive
memorandum to the heads of departments and agencies that
obligated all Federal departments and agencies, particularly
those that have an impact on economic development, to
evaluate the potential impacts of their actions on Indian
tribes;
(4) consistent with the principles of inherent tribal
sovereignty and the special relationship between Indian
tribes and the United States, tribes retain the right to
enter into contracts and agreements to trade freely, and seek
enforcement of treaty and trade rights;
(5) Congress has carried out the responsibility of the
United States for the protection and preservation of Indian
tribes and the resources of Indian tribes through the
endorsement of treaties, and the enactment of other laws,
including laws that provide for the exercise of
administrative authorities;
(6) the United States has an obligation to guard and
preserve the sovereignty of Indian tribes in order to foster
strong tribal governments, Indian self-determination, and
economic self-sufficiency among Indian tribes;
(7) the capacity of Indian tribes to build strong tribal
governments and vigorous economies is hindered by the
inability of Indian tribes to engage communities that
surround Indian lands and outside investors in economic
activities on Indian lands;
(8) despite the availability of abundant natural resources
on Indian lands and a rich cultural legacy that accords great
value to self-determination, self-reliance, and independence,
American Indians and Alaska Natives suffer higher rates of
unemployment, poverty, poor health, substandard housing, and
associated social ills than those of any other group in the
United States;
(9) the United States has an obligation to assist Indian
tribes with the creation of appropriate economic and
political conditions with respect to Indian lands to--
(A) encourage investment from outside sources that do not
originate with the tribes; and
(B) facilitate economic ventures with outside entities that
are not tribal entities;
(10) the economic success and material well-being of
American Indian and Alaska Native communities depends on the
combined efforts of the Federal Government, tribal
governments, the private sector, and individuals;
(11) the lack of employment and entrepreneurial
opportunities in the communities referred to in paragraph (8)
has resulted in a multigenerational dependence on Federal
assistance that is--
(A) insufficient to address the magnitude of needs; and
(B) unreliable in availability; and
(12) the twin goals of economic self-sufficiency and
political self-determination for American Indians and Alaska
Natives can best be served by making available to address the
challenges faced by those groups--
(A) the resources of the private market;
(B) adequate capital; and
(C) technical expertise.
(b) Purposes.--The purposes of this Act are as follows:
(1) To revitalize economically and physically distressed
Indian reservation economies by--
(A) encouraging the formation of new businesses by eligible
entities, the expansion of existing businesses; and
(B) facilitating the movement of goods to and from Indian
reservations and the provision of services by Indians.
[[Page
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(2) To promote private investment in the economies of
Indian tribes and to encourage the sustainable development of
resources of Indian tribes and tribal and Indian-owned
businesses.
(3) To promote the long-range sustained growth of the
economies of Indian tribes.
(4) To raise incomes of Indians in order to reduce poverty
levels and provide the means for achieving a higher standard
of living on Indian reservations.
(5) To encourage intertribal, regional, and international
trade and business development in order to assist in
increasing productivity and the standard of living of members
of Indian tribes and improving the economic self-sufficiency
of the governing bodies of Indian tribes.
(6) To promote economic self-sufficiency and political
self-determination for Indian tribes and members of Indian
tribes.
SEC. 3. DEFINITIONS.
In this Act:
(1) Board.--The term ``Board'' has the meaning given that
term in the first section of the Act entitled ``To provide
for the establishment, operation, and maintenance of foreign-
trade zones in ports of entry in the United States, to
expedite and encourage foreign commerce, and for other
purposes'', approved June 18, 1934 (19 U.S.C. 81a).
(2) Eligible entity.--The term ``eligible entity'' means an
Indian tribe, tribal organization, Indian arts and crafts
organization, tribal enterprise, tribal marketing
cooperative, or Indian-owned business.
(3) Federal agency.--The term ``Federal agency'' means an
agency, as that term is defined in section 551(1) of title 5,
United States Code.
(4) Foundation.--The term ``Foundation'' means the Rural
Development Foundation.
(5) Indian.--The term ``Indian'' has the meaning given that
term in section 4(d) of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b(d)).
(6) Indian arts and crafts organization.--The term ``Indian
arts and crafts organization'' has the meaning given that
term under section 2 of the Act of August 27, 1935 (49 Stat.
891, chapter 748; 25 U.S.C. 305a).
(7) Indian goods and services.--The term ``Indian goods and
services'' means--
(A) Indian goods, within the meaning of section 2 of the
Act of August 27, 1935 (commonly known as the ``Indian Arts
and Crafts Act'') (49 Stat. 891, chapter 748; 25 U.S.C.
305a);
(B) goods produced or originating within an eligible
entity; and
(C) services provided by eligible entities.
(8) Indian lands.--The term ``Indian lands'' has the
meaning given that term in section 4(4) of the Indian Gaming
Regulatory Act (25 U.S.C. 2703(4)).
(9) Indian-owned business.--The term ``Indian-owned
business'' means an entity organized for the conduct of trade
or commerce with respect to which at least 50 percent of the
property interests of the entity are owned by Indians or
Indian tribes (or a combination thereof).
(10) Indian tribe.--The term ``Indian tribe'' has the
meaning given that term in section 4(e) of the Indian Self-
Determination and Education Assistance Act (25 U.S.C.
450b(e)).
(11) Secretary.--The term ``Secretary'' means the Secretary
of Commerce.
(12) Tribal enterprise.--The term ``tribal enterprise''
means a commercial activity or business managed or controlled
by an Indian tribe.
(13) Tribal marketing cooperative.--The term ``tribal
marketing cooperative'' shall have the meaning given that
term by the Secretary, in consultation with the Secretary of
the Interior.
(14) Tribal organization.--The term ``tribal organization''
has the meaning given that term in section 4(l) of the Indian
Self-Determination and Education Assistance Act (25 U.S.C.
450b(l)).
TITLE I--TASK FORCE ON REGULATORY REFORM AND BUSINESS DEVELOPMENT
SEC. 101. ESTABLISHMENT OF TASK FORCE.
(a) In General.--In order to identify and subsequently
remove obstacles to the business development and the creation
of wealth in the economies of Indian reservations, the
Secretary, in consultation with the Secretary of the Interior
and other officials whom the Secretary determines to be
appropriate, shall, not later than 90 days after the date of
enactment of this Act, establish a task force on regulatory
reform and business development in Indian country (referred
to in this title as the ``task force'').
(b) Membership.--The task force established under this
section shall be composed of 16 members, of which 12 members
shall be representatives of the Indian tribes from the areas
of the Bureau of Indian Affairs and each such area shall be
represented by such a representative.
(c) Initial Meeting.--Not later than 120 days after the
date of enactment of this Act, the task force shall hold its
initial meeting.
(d) Review.--Beginning on the date of the initial meeting
under subsection (b), the task force shall conduct a review
of laws relating to activities occurring on Indian lands
(including regulations under title 25 of the Code of Federal
Regulations).
(e) Meetings.--The task force shall meet at the call of the
chairperson.
(f) Quorum.--A majority of the members of the task force
shall constitute a quorum, but a lesser number of members may
hold hearings.
(g) Chairperson.--The task force shall select a chairperson
from among its members.
SEC. 102. REPORT.
Not later than 1 year after the date of enactment of this
Act, the task force shall prepare and submit to the Committee
on Indian Affairs in the Senate, and the Committee on
Resources in the House of Representatives, and to the
governing body of each Indian tribe a report that includes--
(1) the findings of the task force concerning the review
conducted pursuant to section 101(d); and
(2) such recommendations concerning the proposed revisions
to the regulations under title 25 of the Code of Federal
Regulations and amendments to other laws relating to
activities occurring on Indian lands as the task force
determines to be appropriate.
SEC. 103. POWERS OF THE TASK FORCE.
(a) Hearings.--The task force may hold such hearings, sit
and act at such times and places, take such testimony, and
receive such evidence as the task force considers advisable
to carry out the duties of the task force.
(b) Information From Federal Agencies.--The task force may
secure directly from any Federal department or agency such
information as the task force considers necessary to carry
out the duties of the task force.
(c) Postal Services.--The task force may use the United
States mails in the same manner and under the same conditions
as other departments and agencies of the Federal Government.
(d) Gifts.--The task force may accept, use, and dispose of
gifts or donations of services or property.
SEC. 104. TASK FORCE PERSONNEL MATTERS.
(a) Compensation of Members.--Members of the task force who
are not officers or employees of the Federal Government shall
serve without compensation, except for travel expenses, as
provided under subsection (b). Members of the task force who
are officers or employees of the United States shall serve
without compensation in addition to that received for their
services as officers or employees of the United States.
(b) Travel Expenses.--The members of the task force shall
be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of
business in the performance of services for the task force.
(c) Staff.--
(1) In general.--The chairperson of the task force may,
without regard to the civil service laws, appoint and
terminate such personnel as may be necessary to enable the
task force to perform its duties.
(2) Procurement of temporary and intermittent services.--
The chairperson of the task force may procure temporary and
intermittent service under section 3109(b) of title 5, United
States Code, at rates for individuals that do not exceed the
daily equivalent of the annual rate of basic pay prescribed
under GS-13 of the General Schedule established under section
5332 of title 5, United States Code.
SEC. 105. TERMINATION OF TASK FORCE.
The task force shall terminate 90 days after the date on
which the task force has submitted, to the committees of
Congress specified in section 102, and to the governing body
of each Indian tribe, a copy of the report prepared under
that section.
SEC. 106. EXEMPTION FROM FEDERAL ADVISORY COMMITTEE ACT.
All of the activities of the task force conducted under
this title shall be exempt from the Federal Advisory
Committee Act (5 U.S.C. App.).
TITLE II--NATIVE AMERICAN BUSINESS DEVELOPMENT
SEC. 201. OFFICE OF NATIVE AMERICAN BUSINESS DEVELOPMENT.
(a) In General.--
(1) Establishment.--There is established within the
Department of Commerce an office known as the Office of
Native American Business Development (referred to in this
title as the ``Office'').
(2) Director.--The Office shall be headed by a Director,
appointed by the Secretary, whose title shall be the Director
of Native American Business Development (referred to in this
title as the ``Director''). The Director shall be compensated
at a rate not to exceed level V of the Executive Schedule
under section 5316 of title 5, United States Code.
(b) Duties of the Secretary.--
(1) In general.--The Secretary, acting through the
Director, shall ensure the coordination of Federal programs
that provide assistance, including financial and technical
assistance, to eligible entities for increased business, the
expansion of trade by eligible entities, and economic
development on Indian lands.
(2) Activities.--In carrying out the duties described in
paragraph (1), the Secretary, acting through the Director,
shall ensure the coordination of, or, as appropriate, carry
out--
(A) Federal programs designed to provide legal, accounting,
or financial assistance to eligible entities;
(B) market surveys;
(C) the development of promotional materials;
(D) the financing of business development seminars;
(E) the facilitation of marketing;
[[Page
S3925]]
(F) the participation of appropriate Federal agencies or
eligible entities in trade fairs;
(G) any activity that is not described in subparagraphs (A)
through (F) that is related to the development of appropriate
markets; and
(H) any other activity that the Secretary, in consultation
with the Director, determines to be appropriate to carry out
this section.
(3) Assistance.--In conjunction with the activities
described in paragraph (2), the Secretary, acting through the
Director, shall provide--
(A) financial assistance, technical assistance, and
administrative services to eligible entities to assist those
entities with--
(i) identifying and taking advantage of business
development opportunities; and
(ii) compliance with appropriate laws and regulatory
practices; and
(B) such other assistance as the Secretary, in consultation
with the Director, determines to be necessary for the
development of business opportunities for eligible entities
to enhance the economies of Indian tribes.
(4) Priorities.--In carrying out the duties and activities
described in paragraphs (2) and (3), the Secretary, acting
through the Director, shall give priority to activities
that--
(A) provide the greatest degree of economic benefits to
Indians; and
(B) foster long-term stable economies of Indian tribes.
(5) Prohibition.--The Secretary may not provide under this
section assistance for any activity related to the operation
of a gaming activity on Indian lands pursuant to the Indian
Gaming Regulatory Act (25 U.S.C. 2710 et seq.).
SEC. 202. NATIVE AMERICAN TRADE AND EXPORT PROMOTION.
(a) In General.--The Secretary, acting through the
Director, shall carry out a Native American export and trade
promotion program (referred to in this section as the
``program'').
(b) Coordination of Federal Programs and Services.--In
carrying out the program, the Secretary, acting through the
Director, and in cooperation with the heads of appropriate
Federal agencies, shall ensure the coordination of Federal
programs and services designed to--
(1) develop the economies of Indian tribes; and
(2) stimulate the demand for Indian goods and services that
are available to eligible entities.
(c) Activities.--In carrying out the duties described in
subsection (b), the Secretary, acting through the Director,
shall ensure the coordination of, or, as appropriate, carry
out--
(1) Federal programs designed to provide technical or
financial assistance to eligible entities;
(2) the development of promotional materials;
(3) the financing of appropriate trade missions;
(4) the marketing of Indian goods and services;
(5) the participation of appropriate Federal agencies or
eligible entities in international trade fairs; and
(6) any other activity related to the development of
markets for Indian goods and services.
(d) Technical Assistance.--In conjunction with the
activities described in subsection (c), the Secretary, acting
through the Director, shall provide technical assistance and
administrative services to eligible entities to assist those
entities with--
(1) the identification of appropriate markets for Indian
goods and services;
(2) entering the markets referred to in paragraph (1);
(3) compliance with foreign or domestic laws and practices
with respect to financial institutions with respect to the
export and import of Indian goods and services; and
(4) entering into financial arrangements to provide for the
export and import of Indian goods and services.
(e) Priorities.--In carrying out the duties and activities
described in subsections (b) and (c), the Secretary, acting
through the Director, shall give priority to activities
that--
(1) provide the greatest degree of economic benefits to
Indians; and
(2) foster long-term stable international markets for
Indian goods and services.
SEC. 203. INTERTRIBAL TOURISM DEMONSTRATION PROJECTS.
(a) In General.--
(1) Demonstration projects.--The Secretary, acting through
the Director, shall conduct a Native American tourism program
to facilitate the development and conduct of tourism
demonstration projects by Indian tribes, on a tribal,
intertribal, or regional basis.
(2) Projects.--
(A) In general.--Under the program established under this
section, in order to assist in the development and promotion
of tourism on and in the vicinity of Indian lands, the
Secretary, acting through the Director, shall, in
coordination with the Foundation, assist eligible entities in
the planning, development, and implementation of tourism
development demonstration projects that meet the criteria
described in subparagraph (B).
(B) Projects described.--In selecting tourism development
demonstration projects under this section, the Secretary,
acting through the Director, shall select projects that have
the potential to increase travel and tourism revenues by
attracting visitors to Indian lands and in the vicinity of
Indian lands, including projects that provide for--
(i) the development and distribution of educational and
promotional materials pertaining to attractions located on
and near Indian lands;
(ii) the development of educational resources to assist in
private and public tourism development on and in the vicinity
of Indian lands; and
(iii) the coordination of tourism-related joint ventures
and cooperative efforts between eligible entities and
appropriate State and local governments that have
jurisdiction over areas in the vicinity of Indian lands.
(3) Grants.--To carry out the program under this section,
the Secretary, acting through the Director, may award grants
or enter into other appropriate arrangements with Indian
tribes, tribal organizations, intertribal consortia, or other
tribal entities that the Secretary, in consultation with the
Director, determines to be appropriate.
(4) Locations.--In providing for tourism development
demonstration projects under the program under this section,
the Secretary, acting through the Director, shall provide for
a demonstration project to be conducted--
(A) for Indians of the Four Corners area located in the
area adjacent to the border between Arizona, Utah, Colorado,
and New Mexico;
(B) for Indians of the northwestern area that is commonly
known as the Great Northwest (as determined by the
Secretary);
(C) for the Oklahoma Indians in Oklahoma; and
(D) for the Indians of the Great Plains area (as determined
by the Secretary).
(b) Studies.--The Secretary, acting through the Director,
shall provide financial assistance, technical assistance, and
administrative services to participants that the Secretary,
acting through the Director, selects to carry out a tourism
development project under this section, with respect to--
(1) feasibility studies conducted as part of that project;
(2) market analyses;
(3) participation in tourism and trade missions; and
(4) any other activity that the Secretary, in consultation
with the Director, determines to be appropriate to carry out
this section.
(c) Infrastructure Development.--The demonstration projects
conducted under this section shall include provisions to
facilitate the development and financing of infrastructure,
including the development of Indian reservation roads in a
manner consistent with title 23, United States Code.
SEC. 204. REPORT TO CONGRESS.
(a) In General.--Not later than 1 year after the date of
enactment of this Act, and annually thereafter, the
Secretary, in consultation with the Director, shall prepare
and submit to the Committee on Indian Affairs of the Senate a
report on the operation of the Office.
(b) Contents of Report.--Each report prepared under
subsection (a) shall include--
(1) for the period covered by the report, a summary of the
activities conducted by the Secretary, acting through the
Director, in carrying out this title; and
(2) any recommendations for legislation that the Secretary,
in consultation with the Director, determines to be necessary
to carry out this title.
SEC. 205. FOREIGN-TRADE ZONE PREFERENCES.
(a) Preference in Establishment of Foreign-Trade Zones in
Indian Enterprise Zones.--In processing applications for the
establishment of foreign-trade zones pursuant to the Act
entitled ``To provide for the establishment, operation, and
maintenance of foreign-trade zones in ports of entry of the
United States, to expedite and encourage foreign commerce,
and for other purposes'', approved June 18, 1934 (19 U.S.C.
81a et seq.), the Board shall consider, on a priority basis,
and expedite, to the maximum extent practicable, the
processing of any application involving the establishment of
a foreign-trade zone on Indian lands, including any Indian
lands designated as an empowerment zone or enterprise
community pursuant to section 1391 of the Internal Revenue
Code of 1986.
(b) Application Procedure.--In processing applications for
the establishment of ports of entry pursuant to the Act
entitled ``An Act making appropriations for sundry civil
expenses of the Government for the fiscal year ending June
thirtieth, nineteen hundred and fifteen, and for other
purposes'', approved August 1, 1914 (19 U.S.C. 2), the
Secretary of the Treasury shall, with respect to any
application involving the establishment of a port of entry
that is necessary to permit the establishment of a foreign-
trade zone on Indian lands--
(1) consider on a priority basis; and
(2) expedite, to the maximum extent practicable, the
processing of that application.
(c) Application Evaluation.--In evaluating applications for
the establishment of foreign-trade zones and ports of entry
in connection with Indian lands, to the maximum extent
practicable and consistent with applicable law, the Board and
Secretary of the Treasury shall approve the applications.
[From the Wall Street Journal, Apr. 10, 1998]
Less Government, More Growth
(By James Gwartney)
Propelled by a confidence that politicians could solve
problems, government spending has soared in the U.S. and
other Western
[[Page
S3926]]
countries since 1960. Has wise ``government planning''
improved economic performance? Quite the opposite. Robert
Lawson, Randall Holcombe and I recently completed a study on
the size and functions of government for Congress's Joint
Economic Committee. Here are some of our findings:
As the size of government has expanded in the U.S., growth
of real gross domestic product has steadily fallen. Even
though the U.S. economy is now moving into the eighth year of
an expansion, the growth of real GDP during the 1990s is only
about half what it was during the 1960s and well below even
that of the turbulent 1970s. Likewise, as the size of
government in other nations has increased, economic growth
has declined. On average, government expenditures in the
Organization for Economic Cooperation and Development'
s 23
long-standing members rose to 48% of GDP in 1996 from 27% in
1960. The average economic growth rate fell from 5.5% in the
1960s to 1.9% in the 1990s.
As the chart nearby shows, there has is a striking
relationship between the size of government and economic
growth. When government spending was less than 25% of GDP,
OECD countries achieved an average real growth rate of 6.6%.
As the size of government rose, growth steadily declined,
plunging to 1.6% when government spending exceeded 60% of
GDP.
While growth has declined in all of the OECD countries,
those countries with the least growth of government have
suffered the least. Between 1960 and 1996, the size of
government as a share of GDP increased by less than 15
percentage points in the U.S., Britain, Iceland, Ireland
and New Zealand. The average growth rate for these five
countries was 1.6 percentage points lower in the 1990s
than in the 1960s. In contrast, the size of government
increased by 25 percentage points or more in Denmark,
Finland, Greece, Portugal, Spain and Sweden. The growth
rate of these six countries fell by 5.2 percentage points.
In the world's fastest-growing economies, furthermore, the
size of government is small, and there is no trend toward
bigger governme
Major Actions:
All articles in Senate section
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
(Senate - April 30, 1998)
Text of this article available as:
TXT
PDF
[Pages
S3919-S3940]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. CLELAND:
S. 2009. A bill to require the Secretary of Defense and the Secretary
of Veterans Affairs to carry out joint reviews relating to
interdepartmental cooperation in the delivery of medical care by the
departments; to the Committee on Armed Services.
military health care legislation
Mr. CLELAND. Mr. President, I am particularly honored to serve as the
[[Page
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ranking Democratic member of the Senate Armed Services Personnel
Subcommittee, a charge I have embraced to its fullest. In the first
session of the 105th Congress, I pledged my commitment to improving
military health care. Today, I am here to discuss proposals to offer
both immediate assistance and a time phased legislative strategy to
fulfill this commitment.
The Fiscal Year 1998 Defense Authorization Act (P.L. 105-85) included
a Sense of the Congress Resolution which provided a finding that ``many
retired military personnel believe that they were promised lifetime
health care in exchange for 20 or more years of service,'' and
expresses the sense of Congress that ``the United States has incurred a
moral obligation'' to provide health care to members and retired
members of the Armed Services and that Congress and the President
should take steps to address ``the problems associated with the
availability of health care for such retirees within two years.'' I
authored that resolution, and today in year one of my two-year
challenge, I stand ready to take the first of many necessary steps to
fulfill this obligation.
I call this obligation ``K-P Duty''--K-P as in KEEPING PROMISES. As a
disabled veteran and retiree, as former head of the Veterans
Administration, and as the Ranking Member on the Personnel
Subcommittee, I am seeking to draft Congress and the entire nation and
put us all on K-P Duty.
Back when I was in the Army, some saw K-P or ``kitchen police'' as
punishment. If a soldier was derelict in his duties, or if he broke the
rules, he went on KP, where he served his fellow soldiers by working in
the messhall.
The K-P Duty I'm talking about is not about punishment, however. Yes,
we as a nation have been derelict in our duties to our military
personnel, active duty and retired. Yes, we have broken our promises.
But the K-P Duty I'm talking about is a sacred honor. It is about a
grateful nation paying respect to those soldiers who made tremendous
sacrifices for our Country. The soldiers who won World War II, who won
the Cold War--the soldiers that have made it possible for the United
States to be the world's only super power. It is our time, indeed it is
past time, to serve these soldiers and fulfill our obligation.
As with any draft in an army, the first order of business is
bootcamp. As long as I have taken the liberty of drafting the entire
Congress, I might as well serve as drill instructor. Let me take this
time to ``drill'' the Senate on the basics of this challenge.
Not only do we have to fulfill our promise, we also have to
reconsider the way in which the military and veterans health care
systems work. It is the change in the demographics of military health
care beneficiaries that necessitates a change in the way that we
administer health care.
When I went on active duty, the military was made up of mostly single
male soldiers. Looking at the all-volunteer, totally-recruited force
today, the picture is much different. Now, 57 percent of all enlisted
members and 73 percent of all officers are married. Not surprisingly,
the number of young dependents has also risen. In terms of recruitment,
quality health care is cited as a major incentive for young men and
women who join the military. It is that same health care for soldiers
and their families that helps retain these soldiers in the military.
Recently, I heard the adage, ``the military recruits a soldier, but
retains a family.''
Since the time I was a U.S. Army Captain 30 years ago, the number of
active duty personnel has undergone a 58 percent reduction.
Concurrently, the number of retirees has more than doubled. The
Government Accounting Office reports that approximately 48 percent of
the beneficiaries of the Department of Defense Military Health System
are active duty members and dependents. The remaining 52 % are retirees
and dependents. 71% of military retirees are under the age of 65, while
29% of military retirees are over the age of 65.
As we consider options for improving the DoD and VA health care
systems, we need to be mindful of some basic facts. About 60% of
retirees under the age 65 live near a military treatment facility but
only about 52% the retirees aged 65 and older live near such a
facility. About two thirds of retirees under age 65 used the military
health system. In comparison, only about a quarter of the retirees aged
65 and older used military medical facilities on a space available
basis primarily for pharmacy services.
According to a 1994-95 survey of DoD beneficiaries, over 40 percent
of military retirees, regardless of age, had private health insurance
coverage. About a third of retirees aged 65 and older also reported
having additional insurance to supplement their Medicare benefits.
Approximately 14% of retirees under age 65 had insurance to supplement
their CHAMPUS coverage.
In this same dynamic environment of the past 30 years, the medical
portion of the DoD budget has increased dramatically from approximately
two percent to six percent. In part, this can be attributed to cost
growth from technology and intensity of treatment in the private and
public sectors. It is interesting to note the converse relationship
between the increase in health care dollars as the number of active
duty personnel decreases and the number of retirees increases.
The Military Health System (MHS) and the Veterans Health
Administration are well established institutions that collectively
manage over 1500 hospitals, clinics, and health care facilities world-
wide, providing services to over 11 million beneficiaries. Overseeing
these systems requires a well-planned and executed effort.
The Veterans Health Administration is a system in transition. In the
past two years, the VA has replaced its structure of four regions, 33
networks, and hundreds of clinics with a new system geared to
decentralizing authority into 22 Veterans Integrated Service Networks.
The purpose of the reorganization was to improve the access, quality
and efficiency of care provided to the Nation's veterans. The hallmark
of the network structure is that the field has been given control over
functions which were previously located in Washington. The majority of
quality-related activities were transferred closer to the site of
patient care.
The Military Health System has also changed. During the Cold War,
that system was designed to support full-scale, extremely violent war
with the Soviet Union and its allies in Europe. The collapse of the
Soviet Union and the end of the Warsaw Pact led to a major reassessment
of the U.S. defense policy. The overall size of the active duty force
has been reduced by one-third since the mid-1980s.
The DoD health care system changes have included the establishment of
a managed care program, numerous facility closures, and significant
downsizing of military medical staff. In the last decade, the number of
military medical personnel has declined by 15 percent and the number of
military hospitals has been reduced by one-third. The National Defense
Authorization Act for Fiscal Year 1994 directed DoD to prescribe and
implement a nationwide managed health care benefit program modeled on
health maintenance organization plans and in 1995, beneficiaries began
enrolling in this new program called TRICARE. With over 8 million
beneficiaries, it is the largest health maintenance organization plan
in the Nation.
One of the problems with TRICARE is what happens to retirees when
they reach the age of 65. They are ineligible to participate in
TRICARE. The law currently provides for transition from military health
care to Medicare for these beneficiaries. This is not the right
solution, especially given the fact that Medicare does not currently
reimburse the DoD for health care services, although Congress recently
authorized a test of this concept. In addition, as the military begins
to close and downsize military treatment facilities, retirees over 65
are unable to seek and obtain treatment on a space available basis. The
retirees over 65 are, in effect, being shut out of the medical
facilities promised to them.
The changing health care environment has created its own set of
unique challenges. To assess these varied and special requirements, I
formed a Military Health Care Reform Working Group of senior officials
in government and the private sector to explore innovative solutions to
improve the military and veterans health care systems. During the past
few months this group analyzed the array of military and veterans
health care issues and recently provided a comprehensive report of
[[Page
S3921]]
their findings and recommendations to me.
In March, I hosted a military health care roundtable at Fort Gordon,
Georgia. The positive and supportive working relationship between the
Eisenhower Army Medical Center and the Veterans Administration Medical
Center in Augusta, Georgia was highlighted by the panel speakers and
audience members. These facilities have established a sharing agreement
which allows each to provide certain health care services to the
beneficiaries of the other. This type of joint approach has the
potential to alleviate a significant portion of the accessibility
problem faced by military retirees, especially given the reduction in
DoD medical treatment facilities. In spite of these benchmarked efforts
in cooperative care, beneficiaries who were in the audience still
attested to insufficient accessibility to resources to meet their
needs.
Public Law 97-174, ``The Veterans Administration and Department of
Defense Health Resources Sharing and Emergency Operations Act,'' was
enacted in 1982 specifically to promote cost-effective use of federal
health care resources by minimizing duplication and underuse of health
care resources while benefitting both VA and DoD beneficiaries. Under
this law, VA and DoD pursue programs of cooperation ranging from shared
services to joint venture operations of medical facilities. Sharing
agreements are developed on a local basis, whereas, joint ventures are
developed at the highest levels within an organization or command.
In 1984, there were a combined total of 102 VA and DoD facilities
with sharing agreements. By 1997, that number had grown to 420. In five
years, between FY 1992 and FY 1997, shared services increased from
slightly over 3,000 to more than 6,000 services ranging from major
medical and surgical services, laundry, blood, and laboratory services
to unusual speciality care services. VA and DoD currently have four
joint ventures in operation in New Mexico, Nevada, Texas, Oklahoma, and
four more in planning for Alaska, Florida, Hawaii, California.
In my opening remarks, I suggested that there are things that we can
do immediately and others that can be accomplished through a near term
time phased legislative strategy to fulfill our moral obligation to
active duty and retired service personnel. Let me first discuss some of
the options.
There has been an overwhelming outpouring of support for offering
Federal Employee Health Benefits Program (FEHBP) to military retirees.
Although this program has achieved a successful reputation among
federal employees, it is a costly alternative which necessitates close
scrutiny, along with other health care options. I appreciate the fact
that there are many advantages to FEHBP. Furthermore, I share the view
that health care for military retirees should be at least as good as
the health care we in the Congress afford ourselves. I am committed to
working closely on the FEHBP option.
The Medicare Subvention demonstration project that is scheduled to
begin enrollment in the near future involves TRICARE Prime.
Unfortunately, it will only benefit retirees who live near military
treatment facilities--which is only about half of all retirees. Those
retirees living outside catchment areas won't benefit from subvention.
Additionally, there are ongoing efforts to initiate a Veterans Affairs
Subvention test. The limiting criteria of these tests is that they
require beneficiaries to live near the respective treatment facilities.
To accommodate those beneficiaries that do not live near treatment
facilities or within the catchment area, we must explore other
alternatives, including, as I mentioned, the FEHBP option.
Today, I am announcing two initiatives. The first is a bill to
require the Department of Defense and the Department of Veterans
Affairs to significantly enhance their cooperative efforts in the
delivery of health care to their respective beneficiaries. Several
measures to enhance military health care efficiencies are already being
explored, and the initiative I am proposing would complement these
efforts without any direct impact on current spending. Let me just
highlight some of the elements of my plan.
The first element directs DoD and the VA to conduct a comprehensive
survey to determine the demographics of their beneficiaries, their
geographic distribution, and their preferences for health care. A
second survey would review the range of existing DoD and VA facilities
and resources and the capacity available for cooperative efforts. The
purpose of these reviews is simple. We need to accurately determine who
we are serving, what they want, and what resources we currently have to
provide to them.
The second element directs DoD and the VA to provide to the Congress
a report on any and all impediments which preclude optimal cooperation
and/or integration between DoD and VA in the area of health care
delivery. We need to know what statutory restrictions, regulatory
constraints, and cultural issues stand in the way of full and complete
cooperation between the two departments. They would be directed to
recommend to the Congress what changes should be made in the law.
Furthermore, they would be directed to eliminate any regulatory and
cultural impediments.
The third element addresses several projects that have been
undertaken by the Departments of Defense and Veterans Affairs that can
be accelerated for near term implementation. The Electronic Transfer of
Patient Information, a collaborative effort by DoD and VA which would
provide for immediate transfer of and access to patient records at the
time of treatment is a project which merits Congressional support. The
DoD and VA have also established the DoD/VA Federal Pharmaceutical
Steering Committee. I believe this committee should perform a
comprehensive examination of existing pharmaceutical benefits and
programs, including current management and utilization of mail order
pharmaceuticals. Finally, the initiative directs DoD to review the
extent of VA participation in TRICARE networks and to take steps to
ensure optimal participation by the VA.
The second initiative I am announcing today is legislation which is
being crafted to respond to the tremendous outcry to provide health
care for military retirees over 65. Mr. President, as you know, S.
1334, a bill to provide for a test of the FEHBP plan has 60 cosponsors.
It is my plan to work with my friend and colleague Senator Kempthorne
in the Senate Armed Services Committee to include in the National
Defense Authorization bill a proposal that addresses this matter this
year.
I recognize that there is a perception that our military benefits are
eroding but I am here today to say that we can change this perception
if we all do our share on K-P Duty. Greater cooperation among the DoD
and VA will yield greater choices for the beneficiaries of these
systems. Developing a viable health care alternative for our retirees
over 65, a group that has been largely disenfranchised, will ensure
that now all beneficiaries have access to the health care to which they
are entitled because of their service to this Nation.
We made a promise, now let's keep it. It is as simple as that.
Mr. President, I ask unanimous consent that the full text of the bill
be printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 2009
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. FINDINGS.
Congress makes the following findings:
(1) The military health care system of the Department of
Defense and the Veterans Health Administration of the
Department of Veterans Affairs are national institutions that
collectively manage more than 1,500 hospitals, clinics, and
health care facilities worldwide to provide services to more
than 11,000,000 beneficiaries.
(2) In the post-Cold War era, these institutions are in a
profound transition that involves challenging opportunities.
(3) During the period from 1988 to 1998, the number of
military medical personnel has declined by 15 percent and the
number of military hospitals has been reduced by one-third.
(4) During the two years since 1996, the Department of
Veterans Affairs has revitalized its structure by
decentralizing authority into 22 Veterans Integrated Service
Networks.
(5) In the face of increasing costs of medical care,
increased demands for health care services, and increasing
budgetary constraints, the Department of Defense and the
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Department of Veterans Affairs have embarked on a variety of
dynamic and innovative cooperative programs ranging from
shared services to joint venture operations of medical
facilities.
(6) In 1984, there was a combined total of 102 Department
of Veterans Affairs and Department of Defense facilities with
sharing agreements. By 1997, that number had grown to 420.
During the six years from fiscal year 1992 through fiscal
year 1997, shared services increased from slightly over 3,000
services to more than 6,000 services ranging from major
medical and surgical services, laundry, blood, and laboratory
services to unusual speciality care services.
(7) The Department of Defense and the Department of
Veterans Affairs are conducting four health care joint
ventures in New Mexico, Nevada, Texas, Oklahoma, and are
planning to conduct four more such ventures in Alaska,
Florida, Hawaii, and California.
SEC. 2. SENSE OF CONGRESS.
It is the sense of Congress that--
(1) the Department of Defense and the Department of
Veterans Affairs are to be commended for the cooperation
between the two departments in the delivery of medical care,
of which the cooperation involved in the establishment and
operation of the Department of Defense and the Department of
Veterans Affairs Executive Council is a praiseworthy example;
(2) the two departments are encouraged to continue to
explore new opportunities to enhance the availability and
delivery of medical care to beneficiaries by further
enhancing the cooperative efforts of the departments; and
(3) enhanced cooperation is encouraged for--
(A) the general areas of access to quality medical care,
identification and elimination of impediments to enhanced
cooperation, and joint research and program development; and
(B) the specific areas in which there is significant
potential to achieve progress in cooperation in a short term,
including computerization of patient records systems,
participation of the Department of Veterans Affairs in the
TRICARE program, pharmaceutical programs, and joint physical
examinations.
SEC. 3. JOINT SURVEY ON POPULATIONS SERVED.
(a) Survey Required.--The Secretary of Defense and the
Secretary of Veterans Affairs shall jointly conduct a survey
of their respective medical care beneficiary populations to
identify, by category of beneficiary (defined as the
Secretaries consider appropriate), the expectations of,
requirements for, and behavior patterns of the beneficiaries
with respect to medical care. The two Secretaries shall
develop the protocol for the survey jointly, but shall obtain
the services of an entity independent of the Department of
Defense and the Department of Veterans Affairs for carrying
out the survey.
(b) Matters To Be Surveyed.--The survey shall include the
following:
(1) Demographic characteristics, economic characteristics,
and geographic location of beneficiary populations with
regard to catchment or service areas.
(2) The types and frequency of care required by veterans,
retirees, and dependents within catchment or service areas of
Department of Defense and Veterans Affairs medical facilities
and outside those areas.
(3) The numbers of, characteristics of, and types of
medical care needed by the veterans, retirees, and dependents
who, though eligible for medical care in Department of
Defense or Department of Veterans Affairs treatment
facilities or other federally funded medical programs, choose
not to seek medical care from those facilities or under those
programs, and the reasons for that choice.
(4) The obstacles or disincentives for seeking medical care
from such facilities or under such programs that veterans,
retirees, and dependents perceive.
(5) Any other matters that the Secretary of Defense and the
Secretary of Veterans Affairs consider appropriate for the
survey.
(c) Report.--The Secretary of Defense and the Secretary of
Veterans Affairs shall submit a report on the results of the
survey to the appropriate committees of Congress. The report
shall contain the matters described in subsection (b) and any
proposals for legislation that the Secretaries recommend for
enhancing Department of Defense and Department of Veterans
Affairs cooperative efforts with respect to the delivery of
medical care.
SEC. 4. REVIEW OF IMPEDIMENTS TO COOPERATION.
(a) Review Required.--The Secretary of Defense and the
Secretary of Veterans Affairs shall jointly conduct a review
to identify impediments to cooperation between the Department
of Defense and the Department of Veterans Affairs regarding
the delivery of medical care. The matters reviewed shall
include the following:
(1) All laws, policies, and regulations, and any attitudes
of beneficiaries of the health care systems of the two
departments, that have the effect of preventing the
establishment, or limiting the effectiveness, of cooperative
health care programs of the departments.
(2) The requirements and practices involved in the
credentialling and licensure of health care providers.
(3) The perceptions of beneficiaries in a variety of
categories (defined as the Secretaries consider appropriate)
regarding the various Federal health care systems available
for their use.
(b) Report.--The Secretaries shall jointly submit a report
on the results of the review to the appropriate committees of
Congress. The report shall include any proposals for
legislation that the Secretaries recommend for eliminating or
reducing impediments to interdepartmental cooperation that
are identified during the review.
SEC. 5. PARTICIPATION OF DEPARTMENT OF VETERANS AFFAIRS IN
TRICARE.
(a) Review Required.--The Secretary of Defense shall review
the TRICARE program to identify opportunities for increased
participation by the Department of Veterans Affairs in that
program. The ongoing collaboration between Department of
Defense officials and Department of Veterans Affairs
officials regarding increasing the participation shall be
included among the matters reviewed.
(b) Semiannual Report.--The Secretary of Defense and the
Secretary of Veterans Affairs shall jointly submit to the
appropriate committees of Congress a semiannual report on the
status of the review and on efforts to increase the
participation of the Department of Veterans Affairs in the
TRICARE program. No report is required under this subsection
after the submission of a semiannual report in which the
Secretaries declare that the Department of Veterans Affairs
is participating in the TRICARE program to the extent that
can reasonably be expected to be attained.
SEC. 6. PHARMACEUTICAL BENEFITS AND PROGRAMS.
(a) Examination Required.--(1) The Federal Pharmaceutical
Steering Committee shall--
(A) undertake a comprehensive examination of existing
pharmaceutical benefits and programs for beneficiaries of
Federal medical care programs, including matters relating to
the purchasing, distribution, and dispensing of
pharmaceuticals and the management of mail order
pharmaceuticals programs; and
(B) review the existing methods for contracting for and
distributing medical supplies and services.
(2) The committee shall submit a report on the results of
the examination to the appropriate committees of Congress.
(b) Report.--The committee shall submit a report on the
results of the examination to the appropriate committees of
Congress.
SEC. 7. STANDARDIZATION OF PHYSICAL EXAMINATIONS FOR
DISABILITIES.
The Secretary of Defense and the Secretary of Veterans
Affairs shall submit to the appropriate committees of
Congress a report on the status of the efforts of the
Department of Defense and the Department of Veterans Affairs
to standardize physical examinations administered by the two
departments for the purpose of determining or rating
disabilities.
SEC. 8. APPROPRIATE COMMITTEES OF CONGRESS DEFINED.
For the purposes of this Act, the appropriate committees of
Congress are as follows:
(1) The Committee on Armed Services and the Committee on
Veterans' Affairs of the Senate.
(2) The Committee on National Security and the Committee on
Veterans' Affairs of the House of Representatives.
SEC. 9. DEADLINES FOR SUBMISSION OF REPORTS.
(a) Report on Joint Survey of Populations Served.--The
report required by section 3(c) shall be submitted not later
than January 1, 2000.
(b) Report on Review of Impediments to Cooperation.--The
report required by section 4(b) shall be submitted not later
than May 1, 1999.
(c) Semiannual Report on Participation of Department of
Veterans Affairs in TRICARE.--The semiannual report required
by section 5(b) shall be submitted not later than January 1
and June 1 of each year.
(d) Report on Examination of Pharmaceutical Benefits and
Programs.--The report on the examination required under
section 6 shall be submitted not later than 60 days after the
completion of the examination.
(e) Report on Standardization of Physical Examinations for
Disabilities.--The report required by section 7 shall be
submitted not later than June 1, 1999.
______
By Mr. CAMPBELL:
S. 2010. A bill to provide for business development and trade
promotion for Native Americans, and for other purposes; to the
Committee on Indian Affairs.
the native american business development, trade promotion, and tourism
act of 1998
Mr. CAMPBELL. Mr. President, today I am pleased to introduce a
measure to help Indians and tribal businesses foster entrepreneurship
and vigorous reservation economies. Indian tribes face many challenges,
but the greatest priority is in building stronger economies and
providing jobs to tribal members. With this bill, I intend to unshackle
Indian entrepreneurship to provide jobs and revenues for reservation
economies.
When the Europeans landed in the New World to explore and build
settlements, they were greeted by Native
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people with a long tradition of inter-tribal and regional trade. The
tribes traded pelts and furs, hand-woven baskets, blankets, virtually
limitless arts and crafts, weapons, and a variety of Native grown and
gathered foods.
Unrestrained by bureaucrats and free to roam their own lands, the
tribes enjoyed a standard of material well-being that, while not ideal,
was a far cry from the Third World conditions most Indian people live
in today.
Over the course of 200 years this tradition has been replaced by
rules and regulations that continue to stifle Indian entrepreneurship
and instead promise cradle-to-grave ``security'' based on federal
transfer payments. The practical results of federal domination is
predictable: lifeless reservation economies and the absence of a
private sector to create wealth and sustain employment for Indian
people.
The current statistical profile of Indian people is poor and shows
little sign of improvement. Despite the popular belief that gaming has
made millionaires of all Indians, the reality is otherwise as most
Indian gaming revenues are more like church bingo than like Las Vegas
or Atlantic City.
In the Great Depression, the national unemployment rate was 20
percent and it was called a ``national crisis.'' Indian country has an
unemployment rate running at 50 percent, and there are no comments, no
sense of urgency and little attention being paid.
There are other reasons job opportunities are needed. In 1996, the
Congress enacted a welfare reform law that provides transition
assistance to welfare recipients and rightly requires able-bodied
Americans to get and keep jobs. In rural areas, particularly on Indian
reservations, the welfare reform will hit hard because employment
opportunities are scarce.
The goal of this and future efforts is to increase value-added
activities on reservations in such fields as manufacturing, energy,
agriculture, livestock and fisheries, high technology, arts and crafts,
and a host of service industries.
The United States has the responsibility to preserve, protect and
maximize tribal assets and resources, and an obligation to improve the
standards of living of Indian people. In this legislation, that
responsibility is primarily in removing the barriers to success the
federal government itself has created over the years.
The bill aims to make best use of and streamline existing programs to
provide the necessary tools to enable tribes to attract outside capital
and technical expertise. This model has proven highly successful in the
self governance arena and in the Indian job training program, known as
the ``477'' program. The bill would provide better coordination of
existing business development programs in the Commerce Department and
maximize the resources made available to tribes.
The tribes have a responsibility as well. As a matter of Indian self
determination, the tribes are increasingly administering federal
services, programs, and activities in lieu of the federal government.
This has led to more capable and accountable tribal governments. A
fundamental precept of self-government is a reduction in the dependence
on the federal bureaucracy and federal funds and by assuming a greater
role in funding their own self government.
The Committee on Indian Affairs recently held a hearing on economic
development and one of the findings was that the tribes need to provide
governance infrastructure and friendly business environments if they
want to attract and retain investment. Whether by adopting commercial
codes, or tribal courts that can address business issues, or
regulations that do not repel the private sector, tribal efforts are
critical if this effort is to succeed.
Under the bill, the Native American Business Development Office in
the Commerce Department will coordinate existing programs, including
those for international business and tourism, aimed at development on
Indian lands. This bill does not create any new programs but rather is
intended to achieve more efficiency in those that already exist within
existing budget authority. The bill also prohibits assistance under the
act from being used for gaming on Indian lands.
In addition, the bill directs the Secretary to create a task force on
regulatory reform and business development to analyze existing laws and
regulations that are restraining business and economic development on
Indian lands. Again, the bill is not intended to create a new entity,
but recognizes that there is great need to strip away the layers of
unnecessary rules and regulations that stifle Indian businesses.
I urge those that are critical of Indian gaming to join me in
providing alternatives to build strong and diversified tribal economies
for the benefit of tribes, tribal members, and surrounding communities.
Mr. President, I ask unanimous consent that the provisions of the
bill and an article written by James Gwartney for the Wall Street
Journal dated April 10, 1998, entitled ``Less Government, More Growth''
be printed in the Record.
There being no objection, the items were ordered to be printed in the
Record, as follows:
S. 2010
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Native American Business
Development, Trade Promotion, and Tourism Act of 1998''.
SEC. 2. FINDINGS; PURPOSES.
(a) Findings.--Congress finds that--
(1) clause 3 of section 8 of article I of the United States
Constitution recognizes the special relationship between the
United States and Indian tribes;
(2) beginning in 1970, with the inauguration by the Nixon
Administration, of the Indian self-determination era of the
Federal Government, each President has confirmed the special
government-to-government relationship between Indian tribes
and the United States;
(3) in 1994, President Clinton issued an Executive
memorandum to the heads of departments and agencies that
obligated all Federal departments and agencies, particularly
those that have an impact on economic development, to
evaluate the potential impacts of their actions on Indian
tribes;
(4) consistent with the principles of inherent tribal
sovereignty and the special relationship between Indian
tribes and the United States, tribes retain the right to
enter into contracts and agreements to trade freely, and seek
enforcement of treaty and trade rights;
(5) Congress has carried out the responsibility of the
United States for the protection and preservation of Indian
tribes and the resources of Indian tribes through the
endorsement of treaties, and the enactment of other laws,
including laws that provide for the exercise of
administrative authorities;
(6) the United States has an obligation to guard and
preserve the sovereignty of Indian tribes in order to foster
strong tribal governments, Indian self-determination, and
economic self-sufficiency among Indian tribes;
(7) the capacity of Indian tribes to build strong tribal
governments and vigorous economies is hindered by the
inability of Indian tribes to engage communities that
surround Indian lands and outside investors in economic
activities on Indian lands;
(8) despite the availability of abundant natural resources
on Indian lands and a rich cultural legacy that accords great
value to self-determination, self-reliance, and independence,
American Indians and Alaska Natives suffer higher rates of
unemployment, poverty, poor health, substandard housing, and
associated social ills than those of any other group in the
United States;
(9) the United States has an obligation to assist Indian
tribes with the creation of appropriate economic and
political conditions with respect to Indian lands to--
(A) encourage investment from outside sources that do not
originate with the tribes; and
(B) facilitate economic ventures with outside entities that
are not tribal entities;
(10) the economic success and material well-being of
American Indian and Alaska Native communities depends on the
combined efforts of the Federal Government, tribal
governments, the private sector, and individuals;
(11) the lack of employment and entrepreneurial
opportunities in the communities referred to in paragraph (8)
has resulted in a multigenerational dependence on Federal
assistance that is--
(A) insufficient to address the magnitude of needs; and
(B) unreliable in availability; and
(12) the twin goals of economic self-sufficiency and
political self-determination for American Indians and Alaska
Natives can best be served by making available to address the
challenges faced by those groups--
(A) the resources of the private market;
(B) adequate capital; and
(C) technical expertise.
(b) Purposes.--The purposes of this Act are as follows:
(1) To revitalize economically and physically distressed
Indian reservation economies by--
(A) encouraging the formation of new businesses by eligible
entities, the expansion of existing businesses; and
(B) facilitating the movement of goods to and from Indian
reservations and the provision of services by Indians.
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(2) To promote private investment in the economies of
Indian tribes and to encourage the sustainable development of
resources of Indian tribes and tribal and Indian-owned
businesses.
(3) To promote the long-range sustained growth of the
economies of Indian tribes.
(4) To raise incomes of Indians in order to reduce poverty
levels and provide the means for achieving a higher standard
of living on Indian reservations.
(5) To encourage intertribal, regional, and international
trade and business development in order to assist in
increasing productivity and the standard of living of members
of Indian tribes and improving the economic self-sufficiency
of the governing bodies of Indian tribes.
(6) To promote economic self-sufficiency and political
self-determination for Indian tribes and members of Indian
tribes.
SEC. 3. DEFINITIONS.
In this Act:
(1) Board.--The term ``Board'' has the meaning given that
term in the first section of the Act entitled ``To provide
for the establishment, operation, and maintenance of foreign-
trade zones in ports of entry in the United States, to
expedite and encourage foreign commerce, and for other
purposes'', approved June 18, 1934 (19 U.S.C. 81a).
(2) Eligible entity.--The term ``eligible entity'' means an
Indian tribe, tribal organization, Indian arts and crafts
organization, tribal enterprise, tribal marketing
cooperative, or Indian-owned business.
(3) Federal agency.--The term ``Federal agency'' means an
agency, as that term is defined in section 551(1) of title 5,
United States Code.
(4) Foundation.--The term ``Foundation'' means the Rural
Development Foundation.
(5) Indian.--The term ``Indian'' has the meaning given that
term in section 4(d) of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b(d)).
(6) Indian arts and crafts organization.--The term ``Indian
arts and crafts organization'' has the meaning given that
term under section 2 of the Act of August 27, 1935 (49 Stat.
891, chapter 748; 25 U.S.C. 305a).
(7) Indian goods and services.--The term ``Indian goods and
services'' means--
(A) Indian goods, within the meaning of section 2 of the
Act of August 27, 1935 (commonly known as the ``Indian Arts
and Crafts Act'') (49 Stat. 891, chapter 748; 25 U.S.C.
305a);
(B) goods produced or originating within an eligible
entity; and
(C) services provided by eligible entities.
(8) Indian lands.--The term ``Indian lands'' has the
meaning given that term in section 4(4) of the Indian Gaming
Regulatory Act (25 U.S.C. 2703(4)).
(9) Indian-owned business.--The term ``Indian-owned
business'' means an entity organized for the conduct of trade
or commerce with respect to which at least 50 percent of the
property interests of the entity are owned by Indians or
Indian tribes (or a combination thereof).
(10) Indian tribe.--The term ``Indian tribe'' has the
meaning given that term in section 4(e) of the Indian Self-
Determination and Education Assistance Act (25 U.S.C.
450b(e)).
(11) Secretary.--The term ``Secretary'' means the Secretary
of Commerce.
(12) Tribal enterprise.--The term ``tribal enterprise''
means a commercial activity or business managed or controlled
by an Indian tribe.
(13) Tribal marketing cooperative.--The term ``tribal
marketing cooperative'' shall have the meaning given that
term by the Secretary, in consultation with the Secretary of
the Interior.
(14) Tribal organization.--The term ``tribal organization''
has the meaning given that term in section 4(l) of the Indian
Self-Determination and Education Assistance Act (25 U.S.C.
450b(l)).
TITLE I--TASK FORCE ON REGULATORY REFORM AND BUSINESS DEVELOPMENT
SEC. 101. ESTABLISHMENT OF TASK FORCE.
(a) In General.--In order to identify and subsequently
remove obstacles to the business development and the creation
of wealth in the economies of Indian reservations, the
Secretary, in consultation with the Secretary of the Interior
and other officials whom the Secretary determines to be
appropriate, shall, not later than 90 days after the date of
enactment of this Act, establish a task force on regulatory
reform and business development in Indian country (referred
to in this title as the ``task force'').
(b) Membership.--The task force established under this
section shall be composed of 16 members, of which 12 members
shall be representatives of the Indian tribes from the areas
of the Bureau of Indian Affairs and each such area shall be
represented by such a representative.
(c) Initial Meeting.--Not later than 120 days after the
date of enactment of this Act, the task force shall hold its
initial meeting.
(d) Review.--Beginning on the date of the initial meeting
under subsection (b), the task force shall conduct a review
of laws relating to activities occurring on Indian lands
(including regulations under title 25 of the Code of Federal
Regulations).
(e) Meetings.--The task force shall meet at the call of the
chairperson.
(f) Quorum.--A majority of the members of the task force
shall constitute a quorum, but a lesser number of members may
hold hearings.
(g) Chairperson.--The task force shall select a chairperson
from among its members.
SEC. 102. REPORT.
Not later than 1 year after the date of enactment of this
Act, the task force shall prepare and submit to the Committee
on Indian Affairs in the Senate, and the Committee on
Resources in the House of Representatives, and to the
governing body of each Indian tribe a report that includes--
(1) the findings of the task force concerning the review
conducted pursuant to section 101(d); and
(2) such recommendations concerning the proposed revisions
to the regulations under title 25 of the Code of Federal
Regulations and amendments to other laws relating to
activities occurring on Indian lands as the task force
determines to be appropriate.
SEC. 103. POWERS OF THE TASK FORCE.
(a) Hearings.--The task force may hold such hearings, sit
and act at such times and places, take such testimony, and
receive such evidence as the task force considers advisable
to carry out the duties of the task force.
(b) Information From Federal Agencies.--The task force may
secure directly from any Federal department or agency such
information as the task force considers necessary to carry
out the duties of the task force.
(c) Postal Services.--The task force may use the United
States mails in the same manner and under the same conditions
as other departments and agencies of the Federal Government.
(d) Gifts.--The task force may accept, use, and dispose of
gifts or donations of services or property.
SEC. 104. TASK FORCE PERSONNEL MATTERS.
(a) Compensation of Members.--Members of the task force who
are not officers or employees of the Federal Government shall
serve without compensation, except for travel expenses, as
provided under subsection (b). Members of the task force who
are officers or employees of the United States shall serve
without compensation in addition to that received for their
services as officers or employees of the United States.
(b) Travel Expenses.--The members of the task force shall
be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of
business in the performance of services for the task force.
(c) Staff.--
(1) In general.--The chairperson of the task force may,
without regard to the civil service laws, appoint and
terminate such personnel as may be necessary to enable the
task force to perform its duties.
(2) Procurement of temporary and intermittent services.--
The chairperson of the task force may procure temporary and
intermittent service under section 3109(b) of title 5, United
States Code, at rates for individuals that do not exceed the
daily equivalent of the annual rate of basic pay prescribed
under GS-13 of the General Schedule established under section
5332 of title 5, United States Code.
SEC. 105. TERMINATION OF TASK FORCE.
The task force shall terminate 90 days after the date on
which the task force has submitted, to the committees of
Congress specified in section 102, and to the governing body
of each Indian tribe, a copy of the report prepared under
that section.
SEC. 106. EXEMPTION FROM FEDERAL ADVISORY COMMITTEE ACT.
All of the activities of the task force conducted under
this title shall be exempt from the Federal Advisory
Committee Act (5 U.S.C. App.).
TITLE II--NATIVE AMERICAN BUSINESS DEVELOPMENT
SEC. 201. OFFICE OF NATIVE AMERICAN BUSINESS DEVELOPMENT.
(a) In General.--
(1) Establishment.--There is established within the
Department of Commerce an office known as the Office of
Native American Business Development (referred to in this
title as the ``Office'').
(2) Director.--The Office shall be headed by a Director,
appointed by the Secretary, whose title shall be the Director
of Native American Business Development (referred to in this
title as the ``Director''). The Director shall be compensated
at a rate not to exceed level V of the Executive Schedule
under section 5316 of title 5, United States Code.
(b) Duties of the Secretary.--
(1) In general.--The Secretary, acting through the
Director, shall ensure the coordination of Federal programs
that provide assistance, including financial and technical
assistance, to eligible entities for increased business, the
expansion of trade by eligible entities, and economic
development on Indian lands.
(2) Activities.--In carrying out the duties described in
paragraph (1), the Secretary, acting through the Director,
shall ensure the coordination of, or, as appropriate, carry
out--
(A) Federal programs designed to provide legal, accounting,
or financial assistance to eligible entities;
(B) market surveys;
(C) the development of promotional materials;
(D) the financing of business development seminars;
(E) the facilitation of marketing;
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(F) the participation of appropriate Federal agencies or
eligible entities in trade fairs;
(G) any activity that is not described in subparagraphs (A)
through (F) that is related to the development of appropriate
markets; and
(H) any other activity that the Secretary, in consultation
with the Director, determines to be appropriate to carry out
this section.
(3) Assistance.--In conjunction with the activities
described in paragraph (2), the Secretary, acting through the
Director, shall provide--
(A) financial assistance, technical assistance, and
administrative services to eligible entities to assist those
entities with--
(i) identifying and taking advantage of business
development opportunities; and
(ii) compliance with appropriate laws and regulatory
practices; and
(B) such other assistance as the Secretary, in consultation
with the Director, determines to be necessary for the
development of business opportunities for eligible entities
to enhance the economies of Indian tribes.
(4) Priorities.--In carrying out the duties and activities
described in paragraphs (2) and (3), the Secretary, acting
through the Director, shall give priority to activities
that--
(A) provide the greatest degree of economic benefits to
Indians; and
(B) foster long-term stable economies of Indian tribes.
(5) Prohibition.--The Secretary may not provide under this
section assistance for any activity related to the operation
of a gaming activity on Indian lands pursuant to the Indian
Gaming Regulatory Act (25 U.S.C. 2710 et seq.).
SEC. 202. NATIVE AMERICAN TRADE AND EXPORT PROMOTION.
(a) In General.--The Secretary, acting through the
Director, shall carry out a Native American export and trade
promotion program (referred to in this section as the
``program'').
(b) Coordination of Federal Programs and Services.--In
carrying out the program, the Secretary, acting through the
Director, and in cooperation with the heads of appropriate
Federal agencies, shall ensure the coordination of Federal
programs and services designed to--
(1) develop the economies of Indian tribes; and
(2) stimulate the demand for Indian goods and services that
are available to eligible entities.
(c) Activities.--In carrying out the duties described in
subsection (b), the Secretary, acting through the Director,
shall ensure the coordination of, or, as appropriate, carry
out--
(1) Federal programs designed to provide technical or
financial assistance to eligible entities;
(2) the development of promotional materials;
(3) the financing of appropriate trade missions;
(4) the marketing of Indian goods and services;
(5) the participation of appropriate Federal agencies or
eligible entities in international trade fairs; and
(6) any other activity related to the development of
markets for Indian goods and services.
(d) Technical Assistance.--In conjunction with the
activities described in subsection (c), the Secretary, acting
through the Director, shall provide technical assistance and
administrative services to eligible entities to assist those
entities with--
(1) the identification of appropriate markets for Indian
goods and services;
(2) entering the markets referred to in paragraph (1);
(3) compliance with foreign or domestic laws and practices
with respect to financial institutions with respect to the
export and import of Indian goods and services; and
(4) entering into financial arrangements to provide for the
export and import of Indian goods and services.
(e) Priorities.--In carrying out the duties and activities
described in subsections (b) and (c), the Secretary, acting
through the Director, shall give priority to activities
that--
(1) provide the greatest degree of economic benefits to
Indians; and
(2) foster long-term stable international markets for
Indian goods and services.
SEC. 203. INTERTRIBAL TOURISM DEMONSTRATION PROJECTS.
(a) In General.--
(1) Demonstration projects.--The Secretary, acting through
the Director, shall conduct a Native American tourism program
to facilitate the development and conduct of tourism
demonstration projects by Indian tribes, on a tribal,
intertribal, or regional basis.
(2) Projects.--
(A) In general.--Under the program established under this
section, in order to assist in the development and promotion
of tourism on and in the vicinity of Indian lands, the
Secretary, acting through the Director, shall, in
coordination with the Foundation, assist eligible entities in
the planning, development, and implementation of tourism
development demonstration projects that meet the criteria
described in subparagraph (B).
(B) Projects described.--In selecting tourism development
demonstration projects under this section, the Secretary,
acting through the Director, shall select projects that have
the potential to increase travel and tourism revenues by
attracting visitors to Indian lands and in the vicinity of
Indian lands, including projects that provide for--
(i) the development and distribution of educational and
promotional materials pertaining to attractions located on
and near Indian lands;
(ii) the development of educational resources to assist in
private and public tourism development on and in the vicinity
of Indian lands; and
(iii) the coordination of tourism-related joint ventures
and cooperative efforts between eligible entities and
appropriate State and local governments that have
jurisdiction over areas in the vicinity of Indian lands.
(3) Grants.--To carry out the program under this section,
the Secretary, acting through the Director, may award grants
or enter into other appropriate arrangements with Indian
tribes, tribal organizations, intertribal consortia, or other
tribal entities that the Secretary, in consultation with the
Director, determines to be appropriate.
(4) Locations.--In providing for tourism development
demonstration projects under the program under this section,
the Secretary, acting through the Director, shall provide for
a demonstration project to be conducted--
(A) for Indians of the Four Corners area located in the
area adjacent to the border between Arizona, Utah, Colorado,
and New Mexico;
(B) for Indians of the northwestern area that is commonly
known as the Great Northwest (as determined by the
Secretary);
(C) for the Oklahoma Indians in Oklahoma; and
(D) for the Indians of the Great Plains area (as determined
by the Secretary).
(b) Studies.--The Secretary, acting through the Director,
shall provide financial assistance, technical assistance, and
administrative services to participants that the Secretary,
acting through the Director, selects to carry out a tourism
development project under this section, with respect to--
(1) feasibility studies conducted as part of that project;
(2) market analyses;
(3) participation in tourism and trade missions; and
(4) any other activity that the Secretary, in consultation
with the Director, determines to be appropriate to carry out
this section.
(c) Infrastructure Development.--The demonstration projects
conducted under this section shall include provisions to
facilitate the development and financing of infrastructure,
including the development of Indian reservation roads in a
manner consistent with title 23, United States Code.
SEC. 204. REPORT TO CONGRESS.
(a) In General.--Not later than 1 year after the date of
enactment of this Act, and annually thereafter, the
Secretary, in consultation with the Director, shall prepare
and submit to the Committee on Indian Affairs of the Senate a
report on the operation of the Office.
(b) Contents of Report.--Each report prepared under
subsection (a) shall include--
(1) for the period covered by the report, a summary of the
activities conducted by the Secretary, acting through the
Director, in carrying out this title; and
(2) any recommendations for legislation that the Secretary,
in consultation with the Director, determines to be necessary
to carry out this title.
SEC. 205. FOREIGN-TRADE ZONE PREFERENCES.
(a) Preference in Establishment of Foreign-Trade Zones in
Indian Enterprise Zones.--In processing applications for the
establishment of foreign-trade zones pursuant to the Act
entitled ``To provide for the establishment, operation, and
maintenance of foreign-trade zones in ports of entry of the
United States, to expedite and encourage foreign commerce,
and for other purposes'', approved June 18, 1934 (19 U.S.C.
81a et seq.), the Board shall consider, on a priority basis,
and expedite, to the maximum extent practicable, the
processing of any application involving the establishment of
a foreign-trade zone on Indian lands, including any Indian
lands designated as an empowerment zone or enterprise
community pursuant to section 1391 of the Internal Revenue
Code of 1986.
(b) Application Procedure.--In processing applications for
the establishment of ports of entry pursuant to the Act
entitled ``An Act making appropriations for sundry civil
expenses of the Government for the fiscal year ending June
thirtieth, nineteen hundred and fifteen, and for other
purposes'', approved August 1, 1914 (19 U.S.C. 2), the
Secretary of the Treasury shall, with respect to any
application involving the establishment of a port of entry
that is necessary to permit the establishment of a foreign-
trade zone on Indian lands--
(1) consider on a priority basis; and
(2) expedite, to the maximum extent practicable, the
processing of that application.
(c) Application Evaluation.--In evaluating applications for
the establishment of foreign-trade zones and ports of entry
in connection with Indian lands, to the maximum extent
practicable and consistent with applicable law, the Board and
Secretary of the Treasury shall approve the applications.
[From the Wall Street Journal, Apr. 10, 1998]
Less Government, More Growth
(By James Gwartney)
Propelled by a confidence that politicians could solve
problems, government spending has soared in the U.S. and
other Western
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countries since 1960. Has wise ``government planning''
improved economic performance? Quite the opposite. Robert
Lawson, Randall Holcombe and I recently completed a study on
the size and functions of government for Congress's Joint
Economic Committee. Here are some of our findings:
As the size of government has expanded in the U.S., growth
of real gross domestic product has steadily fallen. Even
though the U.S. economy is now moving into the eighth year of
an expansion, the growth of real GDP during the 1990s is only
about half what it was during the 1960s and well below even
that of the turbulent 1970s. Likewise, as the size of
government in other nations has increased, economic growth
has declined. On average, government expenditures in the
Organization for Economic Cooperation and Development'
s 23
long-standing members rose to 48% of GDP in 1996 from 27% in
1960. The average economic growth rate fell from 5.5% in the
1960s to 1.9% in the 1990s.
As the chart nearby shows, there has is a striking
relationship between the size of government and economic
growth. When government spending was less than 25% of GDP,
OECD countries achieved an average real growth rate of 6.6%.
As the size of government rose, growth steadily declined,
plunging to 1.6% when government spending exceeded 60% of
GDP.
While growth has declined in all of the OECD countries,
those countries with the least growth of government have
suffered the least. Between 1960 and 1996, the size of
government as a share of GDP increased by less than 15
percentage points in the U.S., Britain, Iceland, Ireland
and New Zealand. The average growth rate for these five
countries was 1.6 percentage points lower in the 1990s
than in the 1960s. In contrast, the size of government
increased by 25 percentage points or more in Denmark,
Finland, Greece, Portugal, Spain and Sweden. The growth
rate of these six countries fell by 5.2 percentage points.
In the world's fastest-growing economies, furthermore, the
size of government is small, and there is no trend toward
bigger government. On average, government expen
