STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
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STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
(Senate - March 26, 1998)
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S2660-S2683]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Ms. MIKULSKI (for herself, Mrs. Murray and Mr. Wyden):
S. 1864. A bill to amend title XVIII of the Social Security Act to
exclude clinical social worker services from coverage under the
Medicare skilled nursing facility prospective payment system; to the
Committee on Finance.
THE MEDICARE SOCIAL WORK EQUITY ACT OF 1998
Ms. MIKULSKI. Mr. President, I rise today to introduce the ``Medicare
Social Work Equity Act of 1998''. I am proud to sponsor this
legislation which will amend section 4432 in the Balanced Budget Act of
1997 which prevents social workers from directly billing Medicare for
mental health services provided in skilled nursing facilities. I am
honored to be joined by my good friends Senator Murray and Senator
Wyden who care equally about correcting this inequity for social
workers.
Last year's Balanced Budget Act changed the payment method for
skilled nursing facility care. Under current law, reimbursement is made
after services have been delivered for the reasonable costs incurred.
However, this ``cost-based system'' was blamed for inordinate growth in
Medicare spending at skilled nursing facilities.
The Balanced Budget Act of 1997 phases in a prospective payment
system for skilled nursing facilities beginning July 1, 1998. Payments
for Part B services for skilled nursing facility residents will be
consolidated. This means that the provider of the services must bill
the facility instead of directly billing Medicare.
Congress was careful to not include psychologists and psychiatrists
in this new consolidated billing provision. Social workers were
included, I think by mistake. Clinical social workers are the primary
providers of mental health services to residents of nursing homes,
particularly in underserved urban and rural areas. Clinical social
workers are also the most cost effective mental health providers.
This legislation is important for three reasons: First, I am
concerned that section 4432 will inadvertently reduce mental health
services to nursing home residents. Second, I believe that the new
consolidated billing requirement will result in a shift from using
social workers to other mental health professionals who are reimbursed
at a higher cost. This will result in higher costs to Medicare.
Finally, I am concerned that clinical social workers will lose their
jobs in nursing homes or will be inadequately reimbursed.
I like this bill because it will correct an inequity for America's
social workers, it will assure quality of care for nursing home
residents, and will assure cost efficiency for Medicare. I look forward
to the Senate's support of this worthy legislation.
______
By Mr. BAUCUS:
S. 1865. A bill to amend title IV of the Social Security Act to
provide safeguards against the abuse of information reported to the
National Directory of New Hires; to the Committee on Finance.
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the safeguard of new employee information act of 1998
Mr. BAUCUS. Mr. President, today I am introducing the Safeguard of
New Employee Information Act of 1998. This bill will ensure that the
mechanisms created in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (PRWORA) to enhance our child support
enforcement system will not lead to a misuse of personal information. I
believe that my bill will assure that new employee information is kept
confidential without compromising the usefulness of the National
Directory of New Hires. The legislation provides clear safeguards
against the abuse of personal employee information, and makes sure that
the information is erased two years after entry.
As we all know, child support is a critical part of welfare reform. I
strongly support the measures in PRWORA that help states track and
crack down on parents who fail to pay court-ordered child support. In
response to the fact that over 30 percent of child support cases
involve parents who do not live in the same state as their children, a
National Directory of New Hires was created to assist states in
locating parents who reside in other states.
Thus far, the new data base has been very successful in enabling
states to locate delinquent parents, enforcing payment orders and
reducing the number of welfare families. However, many folks are
concerned about the confidentiality of the registry, and the fact that
this information is never deleted.
Last year, for example, the Montana State Legislature passed a child
support bill to comply with the new federal regulations. I must add,
this bill was passed in the final hours of the legislative session and
under the threat of losing $52 million a year in federal funds. At that
time, the legislature was hesitant to pass the bill because of concerns
regarding confidentiality.
Mr. President, the Safeguard of New Employee Information Act of 1998
makes needed changes to the National Directory to alleviate these fears
and ensure the registry's continuation. The bill provides penalties for
misuse of information by federal employees. Specifically, it
establishes a fine of $1,000 for each act of unauthorized access to,
disclosure, or use of information in the National Directory of New
Hires.
The bill also establishes a 24-month limit on retention of New Hire
data. This two year limit gives Child Support Enforcement agencies the
necessary time to determine paternity, establish a child support order
or enforce existing orders. A shorter period of data retention would
impede enforcement activities, and a longer period of retention
increases the potential for abuse.
Mr. President, in my state of Montana, 90 percent of families on
welfare are headed by single parents. That is why it is so important to
require that the absent mothers or fathers provide money to feed,
clothe and care for their children. The National Directory of New Hires
is a good idea--we just need to ensure new employee confidentiality. I
urge my colleagues to protect new hire confidentiality and support this
important legislation.
______
By Mr. DeWINE:
S. 1866. A bill to provide assistance to improve research regarding
the quality and effectiveness of health care for children, to improve
data collection regarding children's health, and to improve the
effectiveness of health care delivery systems for children; to the
Committee on Labor and Human Resources.
the child health care quality research improvement act
Mr. DeWINE. Mr. President, I rise today to introduce the Child Health
Care Quality Research Improvement Act. We have been hearing a great
deal recently about the quality of health care in this country. Most of
the debate, both here in Congress and back home in our States, has been
driven, at least in part, by a fear among consumers that efforts to
control costs and move people into managed care has compromised
quality. This fear has driven legislation such as the bill we passed
just last year to provide for 48-hour maternity stays. This year a
whole host of health care quality bills have been introduced in the
Congress. Even more such legislation has been moving forward at the
State level as well.
As I have learned more and more about the concerns about the quality
of health care, I have tried to focus particular attention on children,
how their health care is delivered and whether its quality has been
compromised. Frankly, I have learned something that I find very
interesting.
While the drive to improve quality and reduce cost has driven a great
deal of new research over the past several years, relatively little has
been done for children in this area. While we are getting better at
measuring quality of health care for adults, we have made little such
progress for our children.
Between 1993 and 1995, only some 5 percent of the health services
research study outcomes focused on our children. This is highly
alarming because I frankly cannot think of anything more critical to
our Nation's future than the quality of our children's health. Clearly
we need to correct this serious lack of good health care quality
measures.
I have spoken with experts in the field of pediatric research and
they agree with this assessment. They tell me that we have to do more
in this field if we expect to improve the care that our children
receive. Many times, frankly, we don't know exactly which treatments
are cost effective or best improve a child's quality of life. We don't
know how to manage children's complicated health problems in ways that
will allow them to lead normal lives
We can answer many of these questions if the patient is an adult, but
we have far fewer answers for our children. Here is one example. One
study recently found that children have three times greater chance of
dying after heart surgery at some hospitals than they have at other
hospitals--three times. We must fix this. That means we have to find
out why, why one hospital loses three times as many children as
another. As both a parent and a grandparent, I can speak from firsthand
experience about the stress and the uncertainty that goes along with
any childhood illness. To think that a parent's choice of a hospital
could actually be harmful to a child is certainly a very scary thought
for a parent.
Another example is asthma. Asthma is the most common chronic health
condition in children, affecting 5 million children in this country,
and that percentage, tragically, is rising. We are not sure why this
has been happening, but we do know that the quality of health care a
child receives can dramatically affect the severity of his or her
asthma. As a result, the better the quality of health care, the less
time that child spends in the hospital, the fewer visits to the
emergency room, and the less time a child has to miss from school. If
we do not even know what kinds of treatment work best for children or
that different treatments work better in different environments, we
cannot help. We certainly can't begin to debate how to improve quality
if we can't even define it or measure it. For that, we need to conduct
research in real world settings.
As a means of getting this research into real world settings and
improving the quality of health care that our children receive, I am
introducing a bill today entitled the Child Health Care Quality
Research Improvement Act. This legislation was developed with the help
of leaders in the pediatric community, child advocates, and health
services researchers. My bill takes a three-pronged approach to address
this issue: One, focusing on training; two, research; and three, data
collection for child health outcomes and effectiveness research.
Let me start with the first one.
In order for us to make advances in the study of pediatric health
outcomes, it is essential that we have researchers who have received
training in this field. This bill I am introducing today promotes
research training programs in child health services research at the
doctoral, post-doctoral, and junior faculty levels. By bringing
professionals into this very important field, we can ensure that issues
that affect the lives of children are receiving the attention they
deserve.
The second component of this bill establishes research centers and
networks. The goal of the centers and networks will be to foster
collaboration among experts in the field of pediatric health care
quality and effectiveness.
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We envision that these centers and networks will bring together
pediatric specialists from children's hospitals, physicians in managed
care plans, statisticians from schools of public health, and other
experts in the field to work together on research projects and to
translate these findings into real-world settings where children are
receiving health care.
Third, and finally, this legislation contains a component that adds
supplements to existing national health surveys that are today
administered by the National Center for Health Statistics and the
Maternal and Child Health Bureau. In addition to not knowing how to
measure health care quality in children, other data, like that
measuring children's use of health care systems and health care
expenditures, are lacking. Adding supplements to existing surveys is a
very sensible measure. This bill does not require yet another survey to
be administered. Rather, it simply adds questions to existing surveys,
to allow us to collect valuable data on children. This is the type of
information that we need if we want to look at trends in children's
health and what we can do to improve their health.
Mr. President, we are all well aware that children have medical
conditions and health care needs that are different from those of
adults. It doesn't make sense to do health services research for adults
and hope that one size fits all--that the things we learn will make
sense for children. Federal support for child health quality and
effectiveness research is vital to ensure that children are receiving
appropriate health care. We owe it to our Nation's children to train
health professionals in this important filed, and to support these very
important research initiatives.
Mr. President, I ask unanimous consent that the bill be printed in
the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1866
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 ``Child Health Care Quality
Research Improvement Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) There is increased emphasis on using evidence of
improved health care outcomes and cost effectiveness to
justify changes in our health care system.
(2) There is a growing movement to use health care quality
measures to ensure that health care services provided are
appropriate and likely to improve health.
(3) Few health care quality measures exist for children,
especially for the treatment of acute and chronic conditions.
(4) A significant number of children in the United States
have health problems, and the percentage of children with
special health care needs is increasing.
(5) Children in the health care marketplace have unique
health attributes, including a child's developmental
vulnerability, differential morbidity, and dependency on
adults, families, and communities.
(6) Children account for less than 15 percent of the
national health care spending, and do not command a large
amount of influence in the health care marketplace.
(7) The Federal government is the major payer of children's
health care in the United States.
(8) Numerous scientifically sound measures exist for
assessing quality of health care for adults, and similar
measures should be developed for assessing the quality of
health care for children.
(9) The delivery structures and systems that provide care
for children are necessarily different than systems caring
for adults, and therefore require appropriate types of
quality measurements and improvement systems.
(10) Improving quality measurement and monitoring will--
(A) assist health care providers in identifying ways to
improve health outcomes for common and rare childhood health
conditions;
(B) assist consumers and purchasers of health care in
determining the value of the health care products and
services they are receiving or buying; and
(C) assist providers in selecting effective treatments and
priorities for service delivery.
(11) Because of the prevalence and patterns of children's
medical conditions, research on improving care for relatively
rare or specific conditions must be conducted across multiple
institutions and practice settings in order to guarantee the
validity and generalizability of research results.
SEC. 3. DEFINITIONS.
In this Act:
(1) High priority areas.--the term ``high priority areas''
means areas of research that are of compelling scientific or
public policy significance, that include high priority areas
of research identified by the Conference on Improving Quality
of Health Care for Children: An Agenda for Research (May,
1997), and that--
(A) are consistent with areas of research as defined in
paragraphs (1)(A) and (2) of section 1142(a) of the Social
Security Act;
(B) are relevant to all children or to specific subgroups
of children; or
(C) are consistent with such other criteria as the
Secretary may require.
(2) Local community.--The term ``local community'' means
city, county, and regional governments, and research
institutes in conjunction with such cities, counties, or
regional governments.
(3) Pediatric quality of care and outcomes research.--The
term ``pediatric quality of care and outcomes research''
means research involving the process of health care delivery
and the outcomes of that delivery in order to improve the
care available for children, including health promotion and
disease prevention, diagnosis, treatment, and rehabilitation
services, including research to--
(A) develop and use better measures of health and
functional status in order to determine more precisely
baseline health status and health outcomes;
(B) evaluate the results of the health care process in
real-life settings, including variations in medical practices
and patterns, as well as functional status, clinical status,
and patient satisfaction;
(C) develop quality improvement tools and evaluate their
implementation in order to establish benchmarks for care for
specific childhood diseases, conditions, impairments, or
populations groups;
(D) develop specific measures of the quality of care to
determine whether a specific health service has been provided
in a technically appropriate and effective manner, that is
responsive to the clinical needs of the patient, and that is
evaluated in terms of the clinical and functional status of
the patient as well as the patient's satisfaction with the
care; or
(E) assess policies, procedures, and methods that can be
used to improve the process and outcomes of the delivery of
care.
(4) Provider-based research networks.--The term ``provider-
based research network'' refers to 1 of the following which
exist for the purpose of conducting research:
(A) A hospital-based research network that is comprised of
a sufficient number of children's hospitals or pediatric
departments of academic health centers.
(B) A physician practice-based research network that is
comprised of a sufficient number of groups of physicians
practices.
(C) A managed care-based research network that is comprised
of a sufficient number of pediatric programs of State-
licensed health maintenance organizations or other State
certified managed care plans.
(D) A combination provider-based research network that is
comprised of all or part of a hospital-based research
network, a physician practice-based research network, and a
managed care-based research network.
(5) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
SEC. 4. EXPANSION OF THE HEALTH SERVICES RESEARCH WORKFORCE.
(a) Grants.--The Secretary shall annually award not less
than 10 grants to eligible entities at geographically diverse
locations throughout the United States to enable such
entities to carry out research training programs that are
dedicated to child health services research training
initiatives at the doctoral, post-doctoral, and junior
faculty levels.
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) be a public or nonprofit private entity; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
(c) Limitation.--A grant awarded under this section shall
be for an amount that does not exceed $500,000.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $5,000,000 for
each of the fiscal years 1999 through 2003.
SEC. 5. DEVELOPMENT OF CHILD HEALTH IMPROVEMENT RESEARCH
CENTERS AND PROVIDER-BASED RESEARCH NETWORKS.
(a) Grants.--In order to address the full continuum of
pediatric quality of care and outcomes research, to link
research to practice improvement, and to speed the
dissemination of research findings to community practice
settings, the Secretary shall award grants to eligible
entities for the establishment of--
(1) not less that 10 national centers for excellence in
child health improvement research at geographically diverse
locations throughout the United States; and
(2) not less than 5 national child health provider quality
improvement research networks at geographically diverse
locations throughout the United States, including at least 1
of each type of network as described in section 3(4).
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) for purposes of--
(A) subsection (a)(1), be a public or nonprofit entity, or
group of entities, including universities, and where
applicable their
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schools of Public Health, research institutions, or
children's hospitals, with multi-disciplinary expertise
including pediatric quality of care and outcomes research and
primary care research; or
(B) subsection (a)(2), be a public or nonprofit institution
that represents children's hospitals, pediatric departments
of academic health centers, physician practices, or managed
care plans; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require, including--
(A) in the case of an application for a grant under
subsection (a)(1), a demonstration that a research center
will conduct 2 or more research projects involving pediatric
quality of care and outcomes research in high priority areas;
or
(B) in the case of an application for a grant under
subsection (a)(2)--
(i) a demonstration that the applicant and its network will
conduct 2 or more projects involving pediatric quality of
care and outcomes research in high priority areas;
(ii) a demonstration of an effective and cost-efficient
data collection infrastructure;
(iii) a demonstration of matching funds equal to the amount
of the grant; and
(iv) a plan for sustaining the financing of the operation
of a provider-based network after the expiration of the 5-
year term of the grant.
(c) Limitations.--A grant awarded under subsection (a)(1)
shall not exceed $1,000,000 per year and be for a term of
more that 5 years and a grant awarded under subsection (a)(2)
shall not exceed $750,000 per year and be for a term of more
than 5 years.
(d) Authorization of Appropriations.--There are authorized
to be appropriated--
(1) to carry out subsection (a)(1), $10,000,000 for each of
the fiscal years 1999 through 2003; and
(2) to carry out subsection (a)(2), $3,750,000 for each of
the fiscal years 1999 through 2003.
SEC. 6. RESEARCH IN SPECIFIC HIGH PRIORITY AREAS.
(a) Additional Funds for Grants.--From amounts appropriated
under subsection (c), the Secretary shall provide support,
through grant programs authorized on the date of enactment of
this Act, to entities determined to have expertise in
pediatric quality of care and outcomes research. Such
additional funds shall be used to improve the quality of
children's health, especially in high priority areas, and
shall be subject to the same conditions and requirements that
apply to funds provided under the existing grant program
through which such additional funds are provided.
(b) Advisory Committee.--
(1) In general.--To evaluate progress made in pediatric
quality of care and outcomes research in high priority areas,
and to identify new high priority areas, the Secretary shall
establish an advisory committee which shall report annually
to the Secretary.
(2) Membership.--The Secretary shall ensure that the
advisory committee established under paragraph (1) includes
individuals who are--
(A) health care consumers;
(B) health care providers;
(C) purchasers of health care;
(D) representative of health plans involved in children's
health care services; and
(E) representatives of Federal agencies including--
(i) the Agency for Health Care Policy and Research;
(ii) the Centers for Disease Control and Prevention;
(iii) the Health Care Financing Administration;
(iv) the Maternal and Child Health Bureau;
(v) the National Institutes of Health; and
(vi) the Substance Abuse and Mental Health Services
Administration.
(3) Evaluation of research.--The advisory committee
established under paragraph (1) shall evaluate research in
high priority areas using criteria that include--
(1) the generation of research that includes both short and
long term studies;
(2) the ability to foster public and private partnerships;
and
(3) the likelihood that findings will be transmitted
rapidly into practice.
(c) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $12,000,000 for
each of the fiscal years 1999 through 2003.
SEC. 7. IMPROVING CHILD HEALTH DATA AND DEVELOPING BETTER
DATA COLLECTION SYSTEMS.
(a) Survey.--The Secretary shall provide assistance to
enable the appropriate Federal agencies to--
(1) conduct ongoing biennial supplements and initiate and
maintain a longitudinal study on children's health that is
linked to the appropriate existing national surveys
(including the National Health Interview Survey and the
Medical Expenditure Panel Survey) to--
(A) provide for reliable national estimates of health care
expenditures, cost, use, access, and satisfaction for
children, including uninsured children, poor and near-poor
children, and children with special health care needs;
(B) enhance the understanding of the determinants of health
outcomes and functional status among children with special
health care needs, as well as an understanding of these
changes over time and their relationship to health care
access and use; and
(C) monitor the overall national impact of Federal and
State policy changes on children's health care; and
(2) develop an ongoing 50-State survey to generate reliable
State estimates of health care expenditures, cost, use,
access, satisfaction, and quality for children, including
uninsured children, poor and near-poor children, and children
with special health care needs.
(b) Grants.--The Secretary shall award grants to public and
nonprofit entities to enable such entities to develop the
capacity of local communities to improve child health
monitoring at the community level.
(c) Eligibility.--To be eligible to receive a grant under
subsection (b), an entity shall--
(1) be a public or nonprofit entity; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $14,000,000 for
each of the fiscal years 1999 through 2003, of which--
(1) $6,000,000 shall be made available in each fiscal year
for grants under subsection (a)(1);
(2) $4,000,000 shall be made available in each fiscal year
for grants under subsection (a)(2);
(3) $4,000,000 shall be made available in each fiscal year
for grants under subsection (b).
SEC. 8. OVERSIGHT.
Not later than ________ after the date of enactment of this
Act, The Secretary shall prepare and submit a report to
Congress on progress made in pediatric quality of care and
outcomes research, including the extent of ongoing research,
programs, and technical needs, and the Department of Health
and Human Services' priorities for funding pediatric quality
of care and outcomes research.
______
By Ms. COLLINS:
S. 1867. A bill to amend chapter 35 of title 44, United States Code,
for the purpose of facilitating compliance by small businesses with
certain Federal paperwork requirements, and to establish a task force
to examine the feasibility of streamlining paperwork requirements
applicable to small businesses; to the Committee on Governmental
Affairs.
the small business paperwork reduction act
Ms. COLLINS. Mr. President, today I am introducing the Small Business
Paperwork Reduction Act Amendments of 1998, a companion bill to
legislation pending in the House of Representatives.
This legislation has five components. First, it requires the Office
of Management and Budget to publish annually in the Federal Register
and on the Internet all of the Federal paperwork requirements imposed
on small business. This will not only serve as a valuable tool for
those who must comply with these mandates, but it will also make it far
easier for policy makers to monitor, and I would hope check, the growth
in the paperwork burden.
Second, under the bill, each agency will have to establish one point
of contact to act as a liaison with small businesses on paperwork
requirements. In an era when serving the customer has become recognized
by the private sector as critical, this is a modest step to ask of our
government.
Third, the legislation provides for the suspension of civil fines
imposed on small enterprises for first-time paperwork violations,
except under certain circumstances, such as when the violation causes
serious harm to the public or presents an imminent danger to the public
health or safety. In dealing with America's entrepreneurs, we need to
move away from a culture that seems to place a higher priority on
imposing punishment than on facilitating compliance.
Fourth, in addition to meeting the mandates of the Paperwork
Reduction Act, agencies will have to make further efforts to reduce the
burden on enterprises with fewer than 25 employees. There must be some
measure of proportionality between the size of a business and its costs
of complying with government regulation.
Fifth, a task force will be established to examine the feasibility of
requiring agencies to consolidate their paperwork mandates in a manner
that will allow small businesses to satisfy those mandates through a
single filing, in a single format, and on the same date. By reducing
the amount of time currently devoted to these tasks, our companies will
have more to spend on the activities for which they were formed.
Mr. President, all too often the relationship between the owners of
small businesses and government is an adversial one. That benefits no
one--not the owners of these enterprises, not the many Americans they
employ, not
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the government they help to support, and not the public at large.
The problem often is not with the goals which underlie our
regulations, but rather in how we seek to achieve those goals. We
should not forget that we are dealing with Americans who make a great
contribution to the prosperity of our nation. In seeking to meet our
regulatory objectives, we should be reaching out to these entrepreneurs
with a helping hand and not a heavy hand. That, Mr. President, is the
purpose of this legislation.
______
By Mr. NICKLES (for himself, Mr. Mack, Mr. Lieberman, Mr.
Kempthorne, Mr. Craig, Mr. Hutchinson, and Mr. DeWine):
S. 1868. A bill to express United States foreign policy with respect
to, and to strengthen United States advocacy on behalf of, individuals
persecuted for their faith worldwide; to authorize United States
actions in response to religious persecution worldwide; to establish an
Ambassador at Large on International Religious Freedom within the
Department of State, a Commission on International Religious Freedom
within the Department of State, a Commission on International Religious
Persecution, and a Special Adviser on International Religious Freedom
within the National Security Council; and for other purposes; to the
Committee on Foreign Relations.
the international religious freedom act of 1998
Mr. NICKLES. Mr. President, today I am prompted to speak by both a
tragic reality, and also what I would think is a promising hope. The
tragic reality is that literally millions of religious believers around
the world live gripped by the incessant, terrifying prospect of
persecution, of being tortured, arrested, imprisoned or even killed for
simply practicing their faith. A promising hope, I believe, might
perhaps be found in the bill that I am introducing today with Senator
Lieberman, Senator Mack, Senator Kempthorne, Senator Craig, Senator
Hutchinson and Senator DeWine. It is called the International Religious
Freedom Act. The International Religious Freedom Act will establish a
process to ensure that on an ongoing basis the United States closely
monitors religious persecution worldwide.
It is wrong for a country to persecute, to prosecute, to imprison,
harass individuals for simply practicing their faith, whether that
faith is Jewish or Christian or Muslim or Hindu. It is absolutely wrong
for them to be persecuted for practicing their faith. This act requires
the U.S. Government to take action against all countries engaging in
religious persecution.
What kind of persecution am I talking about? First, three facts
command attention.
One reliable estimate indicates that more Christian martyrs have
perished in this century than all previous centuries combined. That is
a staggering, staggering statement.
A recent book reports that 200 million Christians around the world
live under daily fear and threat of persecution, including
interrogation, imprisonment, torture and in some cases death.
Finally, over half the world's population lives under regimes which
severely restrict if not prohibit their ability to believe in and
practice the religious faith of their choice and conviction.
Of course, religious persecution goes beyond facts and figures. It
happens to real people in real places. Let me point out just four
compelling examples.
At this very moment one of China's leading house church pastors,
Pastor Peter Xu, is languishing in a Chinese prison under a 3-year term
for the so-called ``crime'' of ``disturbing public order.'' Hundreds,
perhaps thousands of other believers in China currently suffer similar
treatment.
Again, at this very moment, 13 courageous Christians are imprisoned
by the Communist authorities in Laos. What was their ``crime''? Simply
that they organized an ``unauthorized'' Bible study in the privacy of a
home.
In Pakistan, just a few months ago, Pastor Noor Alam was brutally
stabbed to death by anti-Christian assailants. Shortly before that,
they had destroyed Pastor Alam's church building. Meanwhile, Christians
and other religious minorities in Pakistan continue to sufferer under
the notorius ``blasphemy laws.''
Or consider Russia, which, as many of my colleagues will remember,
just last summer passed a draconian law that will effectively shut down
the vast majority of independent churches and other religious
organizations and severly curtail the religious freedom of the Russian
people.
I could go on and on. However, I do want to share just a few
highlights of what we humbly but earnestly hope our bill can do to
begin to address the scourge of religious persecution worldwide.
I should also mention that, in 1996, I was honored to sponsor a
Senate resolution on religious persecution, which passed by unanimous
consent. In that resolution, the Senate made a strong recommendation
``that the President expand and invigorate the United States'
international advocacy on behalf of persecuted Christians, and initiate
a thorough examination of all United States' policies that affect
persecuted Christians.''
What was a mere resolution in 1996, I hope it will become a reality
in 1998. While then we acted with words, I hope that this year we can
act with deeds.
In short, this bill seeks to ensure that the U.S. Government
aggressively monitors religious oppression around the world and takes
decisive action against those regimes engaged in persecution, all the
while maintaining the integrity and credibility of the U.S. foreign
policy system.
The International Religious Freedom Act establishes an ``Ambassador-
at-Large for Religious Liberty'' at the State Department. The
Ambassador will be responsible for representing our Government in
vigorous diplomacy with nations guilty of religious persecution. In
addition, the Ambassador will oversee an annual report on religious
persecution which will specify the details on religious persecution
around the world. This report will name names. And those countries
named will be held accountable.
For any country cited in the report, the Act presents a menu of
diplomatic and economic options, and the President is required to
select from at least one of those actions. Silence or passivity are not
options. At the same time, the Act seeks to provide the President
maximum flexibility entailing the most appropriate, effective response
to that particular situation in a particular country. Furthermore,
because we desire good results to follow our good intentions, the Act
requires a consideration of how the action taken by America will affect
American economic and security interests and, most important, how it
will affect the very people that it purports to help.
The International Religious Freedom Act has other provisions--
improved reporting, improved training for immigration and foreign
service officials, a commission on international religious liberty to
provide more attention and expertise on the issue. I invite all my
colleagues, and certainly those who are deeply concerned about the
plight of persecuted religious believers, to join me in supporting this
bill. Not because it might be popular or expedient or convenient to
support this legislation, but because it is the right thing to do and
because I believe it will make a real difference in protecting the
lives of some of the most vulnerable people in the world, those people
who wish to express their religious beliefs and convictions.
Mr. President, I thank my cosponsors, particularly Senator Lieberman,
also Senator Mack, in addition to Senator Hutchinson and Senator Craig
and Senator Kempthorne, for helping us put this legislation together.
Mr. President, I ask unanimous consent that the text of the bill
printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1868
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the
``International Religious Freedom Act of 1998''.
(b) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings; policy.
Sec. 3. Definitions.
TITLE I--DEPARTMENT OF STATE ACTIVITIES
Sec. 101. Office on International Religious Freedom; Ambassador at
Large for International Religious Freedom.
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Sec. 102. Reports.
Sec. 103. Establishment of a religious freedom Internet site.
Sec. 104. Training for Foreign Service officers.
Sec. 105. High-level contacts with NGOs.
Sec. 106. Programs and allocations of funds by United States missions
abroad.
Sec. 107. Equal access to United States missions abroad for conducting
religious activities.
Sec. 108. Prisoner lists and issue briefs on religious persecution
concerns.
TITLE II--COMMISSION ON INTERNATIONAL RELIGIOUS PERSECUTION
Sec. 201. Establishment and composition.
Sec. 202. Duties of the Commission.
Sec. 203. Report of the Commission.
Sec. 204. Termination.
TITLE III--NATIONAL SECURITY COUNCIL
Sec. 301. Special Adviser on Religious Persecution.
TITLE IV--SANCTIONS
Subtitle I--Targeted Responses to Religious Persecution Abroad
Sec. 401. Executive measures and sanctions in response to findings made
in the Annual Report on Religious Persecution.
Sec. 402. Presidential determinations of gross violations of the right
to religious freedom.
Sec. 403. Consultations.
Sec. 404. Report to Congress.
Sec. 405. Description of Executive measures and sanctions.
Sec. 406. Contract sanctity.
Sec. 407. Presidential waiver.
Sec. 408. Publication in Federal Register.
Sec. 409. Congressional review.
Sec. 410. Termination of sanctions.
Subtitle II--Strengthening Existing Law
Sec. 421. United States assistance.
Sec. 422. Multilateral assistance.
Sec. 423. Exports of items relating to religious persecution.
TITLE V--PROMOTION OF RELIGIOUS FREEDOM
Sec. 501. Assistance for promoting religious freedom.
Sec. 502. International broadcasting.
Sec. 503. International exchanges.
Sec. 504. Foreign Service awards.
TITLE VI--REFUGEE, ASYLUM, AND CONSULAR MATTERS
Sec. 601. Use of Annual Report.
Sec. 602. Reform of refugee policy.
Sec. 603. Reform of asylum policy.
Sec. 604. Inadmissibility of foreign government officials who have
engaged in gross violations of the right to religious
freedom.
TITLE VII--MISCELLANEOUS PROVISIONS
Sec. 701. Business codes of conduct.
Sec. 702. International Criminal Court.
SEC. 2. FINDINGS; POLICY.
(a) Findings.--Congress makes the following findings:
(1) Freedom of religious belief and practice is a
fundamental human right articulated in numerous international
agreements and covenants, including the Universal Declaration
of Human Rights, the International Covenant on Civil and
Political Rights, the Helsinki Accords, the Declaration on
the Elimination of All Forms of Intolerance and
Discrimination Based on Religion or Belief, the United
Nations Charter, and the European Convention for the
Protection of Human Rights and Fundamental Freedoms.
(2) The right to freedom of religion undergirds the very
origin and existence of the United States. Many of our
Nation's founders fled religious persecution abroad,
cherishing in their hearts and minds the ideal of religious
freedom. They established in law, as a fundamental right and
as a pillar of our Nation, the right to freedom of religion.
From its birth to this day, the United States has prized this
legacy of religious freedom and honored this heritage by
standing for religious freedom and offering refuge to those
suffering religious persecution.
(3) Article 18 of the Universal Declaration of Human Rights
recognizes that ``Everyone has the right to freedom of
thought, conscience, and religion. This right includes
freedom to change his religion or belief, and freedom, either
alone or in community with others and in public or private,
to manifest his religion or belief in teaching, practice,
worship, and observance.''. Article 18(1) of the
International Covenant on Civil and Political Rights
recognizes that ``Everyone shall have the right to freedom of
thought, conscience, and religion. This right shall include
freedom to have or to adopt a religion or belief of his
choice, and freedom, either individually or in community with
others and in public or private, to manifest his religion or
belief in worship, observance, practice, and teaching''.
Governments have the responsibility to protect the
fundamental rights of their citizens and to pursue justice
for all. Religious freedom is a fundamental right of every
individual, regardless of race, country, creed, or
nationality, and should never be arbitrarily abridged by any
government.
(4) The right to freedom of religion is under renewed and,
in some cases, increasing assault in many countries around
the world. More than one-half of the world's population lives
under regimes that severely restrict or prohibit the freedom
of their citizens to study, believe, observe, and freely
practice the religious faith of their choice. Religious
believers and communities suffer both government-sponsored
and government-tolerated violations of their rights to
religious freedom. Among the many forms of such violations
are state-sponsored slander campaigns, confiscations of
property, surveillance by security police, including by
special divisions of ``religious police'', severe
prohibitions against construction and repair of places of
worship, denial of the right to assemble and relegation of
religious communities to illegal status through arbitrary
registration laws, prohibitions against the pursuit of
education or public office, and prohibitions against
publishing, distributing, or possessing religious literature
and materials.
(5) Even more abhorrent, religious believers in many
countries face such severe and violent forms of religious
persecution as detention, torture, beatings, forced marriage,
rape, imprisonment, enslavement, mass resettlement, and death
merely for the peaceful belief in, change of or practice of
their faith. In many countries, religious believers are
forced to meet secretly, and religious leaders are targeted
by national security forces and hostile mobs.
(6) Though not confined to a particular region or regime,
religious persecution is often particularly widespread,
systematic, and heinous under totalitarian governments and in
countries with militant, politicized religious majorities.
(7) Congress has recognized and denounced acts of religious
persecution through the adoption of the following
resolutions:
(A) House Resolution 515 (104th), expressing the sense of
the House of Representatives with respect to the persecution
of Christians worldwide.
(B) Senate Concurrent Resolution 71 (104th), expressing the
sense of the Senate regarding persecution of Christians
worldwide.
(C) House Concurrent Resolution 102, concerning the
emancipation of the Iranian Baha'i community.
(b) Policy.--It shall be the policy of the United States,
as follows:
(1) To condemn religious persecution, and to promote, and
to assist other governments in the promotion of, the
fundamental right to religious freedom.
(2) To seek to channel United States security and
development assistance to governments other than those found
to be engaged in gross violations of human rights, including
the right to religious freedom, as set forth in the Foreign
Assistance Act of 1961, in the International Financial
Institutions Act of 1977, and in other formulations of United
States human rights policy.
(3) To be vigorous and flexible, reflecting both the
unwavering commitment of the United States to religious
freedom and the desire of the United States for the most
effective and principled response, in light of the range of
violations of religious freedom by a variety of persecuting
regimes, and the status of the relations of the United States
with different nations.
(4) To work with foreign governments that affirm and
protect religious freedom, in order to develop multilateral
documents and initiatives to combat religious persecution and
promote the right to religious freedom abroad.
(5) Standing for liberty and standing with the persecuted,
to use and implement appropriate tools in the United States
foreign policy apparatus, including diplomatic, political,
commercial, charitable, educational, and cultural channels,
to promote respect for religious freedom by all governments
and peoples.
SEC. 3. DEFINITIONS.
In this Act:
(1) Ambassador at large.--The term ``Ambassador at Large''
means the Ambassador at Large on International Religious
Freedom appointed under section 101(b).
(2) Annual report on religious persecution.--The term
``Annual Report on Religious Persecution'' means the report
described in section 102(b).
(3) Appropriate congressional committees.--The term
``appropriate congressional committees'' means the Committee
on Foreign Relations of the Senate and the Committee on
International Relations of the House of Representatives and,
in the case of any determination made with respect to the
imposition of a sanction under paragraphs (9) through (16) of
section 405, the term ``appropriate congressional
committees'' includes those committees, together with the
Committee on Ways and Means and the Committee on Banking and
Financial Services of the House of Representatives and the
Committee on Finance of the Senate.
(4) Commission.--The term ``Commission'' means the United
States Commission on International Religious Persecution
established in section 201(a).
(5) Government or foreign government.--The term
``government'' or ``foreign government'' includes any agency
or instrumentality of the government.
(6) Gross violations of the right to freedom of religion.--
The term ``gross violations of the right to freedom of
religion'' means a consistent pattern of gross violations of
the right to freedom of religion that include torture or
cruel, inhuman, or degrading treatment or punishment,
prolonged detention without charges, causing the
disappearance of persons by the abduction or clandestine
detention of those persons, or other flagrant denial of the
right to life, liberty, or the security of persons, within
the meaning of section 116(a) of the Foreign Assistance Act
of 1961 (22 U.S.C. 2151n(a)).
[[Page
S2666]]
(7) Human rights reports.--The term ``Human Rights
Reports'' means the reports submitted by the Department of
State to Congress under sections 116 and 502B of the Foreign
Assistance Act of 1961.
(8) Office.--The term ``Office'' means the Office on
International Religious Freedom established in section
101(a).
(9) Religious persecution.--The term ``religious
persecution'' means any violation of the internationally
recognized right to freedom of religion, as defined in
Article 18 of the Universal Declaration of Human Rights and
Article 18 of the International Covenant on Civil and
Political Rights, including violations such as--
(A) arbitrary prohibitions on, restrictions of, or
punishment for--
(i) assembling for peaceful religious activities such as
worship, preaching, and prayer, including arbitrary
registration requirements,
(ii) speaking freely about one's religious beliefs,
(iii) changing one's religious beliefs and affiliation,
(iv) possession and distribution of religious literature,
including Bibles, or
(v) raising one's children in the religious teachings and
practices of one's choice,
as well as arbitrary prohibitions or restrictions on the
grounds of religion on holding public office, or pursuing
educational or professional opportunities; and
(B) any of the following acts if committed on account of an
individual's religious belief or practice: detention,
interrogation, harassment, imposition of an onerous financial
penalty, forced labor, forced mass resettlement,
imprisonment, beating, torture, mutilation, rape,
enslavement, murder, and execution.
(10) Special adviser.--The term ``Special Adviser'' means
the Special Adviser to the President on Religious Persecution
established in section 101(i) of the National Security Act of
1947, as added by section 301 of this Act.
TITLE I--DEPARTMENT OF STATE ACTIVITIES
SEC. 101. OFFICE ON INTERNATIONAL RELIGIOUS FREEDOM;
AMBASSADOR AT LARGE FOR INTERNATIONAL RELIGIOUS
FREEDOM.
(a) Establishment of Office.--There is established within
the Department of State an Office on International Religious
Freedom that shall be headed by the Ambassador at Large on
International Religious Freedom appointed under subsection
(b).
(b) Appointment.--The Ambassador at Large shall be
appointed by the President, by and with the advice and
consent of the Senate.
(c) Duties.--The Ambassador at Large shall have the
following responsibilities:
(1) In general.--The primary responsibility of the
Ambassador at Large shall be to advance the right to freedom
of religion abroad, to denounce the violation of that right,
and to recommend appropriate responses by the United States
Government when this right is violated.
(2) Advisory role.--The Ambassador at Large shall be the
principal adviser to the President and the Secretary of State
regarding matters affecting religious freedom abroad and,
with advice from the Commission on International Religious
Persecution, shall make recommendations regarding the
policies of the United States Government toward governments
that violate the freedom of religion or that fail to ensure
the individual's right to religious belief and practice.
(3) Diplomatic representation.--The Ambassador at Large is
authorized to represent the United States in matters and
cases relevant to religious persecution in--
(A) contacts with foreign governments, international
organizations, intergovernmental organizations, and
specialized agencies of the United Nations, the Organization
on Security and Cooperation in Europe, and other
organizations of which the United States is a member; and
(B) multilateral conferences and meetings relevant to
religious persecution.
(4) Reporting responsibilities.--The Ambassador at Large
shall have the reporting responsibilities described in
section 102.
(d) Funding.--The Secretary of State shall provide the
Ambassador at Large with such funds as may be necessary for
the hiring of staff for the Office, for the conduct of
investigations by the Office, and for necessary travel to
carry out the provisions of this section.
SEC. 102. REPORTS.
(a) Portions of Annual Human Rights Reports.--The
Ambassador at Large shall assist the Secretary of State in
preparing those portions of the Human Rights Reports that
relate to freedom of religion and discrimination based on
religion and those portions of other information provided
Congress under sections 116 and 502B of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151m, 2304) that relate to
the right to religious freedom.
(b) Annual Report on Religious Persecution.--
(1) In general.--
(A) Deadline for submission.--Not later than May 1 of each
year, the Ambassador at Large shall submit to the appropriate
congressional committees an Annual Report on Religious
Persecution, expanding upon the most recent Human Rights
Reports. Each Annual Report on Religious Persecution shall
contain the following:
(i) An identification of each foreign country the
government of which engages in or tolerates acts of religious
persecution.
(ii) An assessment and description of the nature and extent
of religious persecution, including persecution of one
religious group by another religious group, religious
persecution by governmental and nongovernmental entities,
persecution targeted at individuals or particular
denominations or entire religions, and the existence of
government policies violating religious freedom.
(iii) A description of United States policies in support of
religious freedom, including a description of the measures
and policies implemented during the preceding 12 months by
the United States under title IV of this Act in opposition to
religious persecution and in support of religious freedom.
(iv) A description of any binding agreement with a foreign
government entered into by the United States under section
402(c).
(B) Classified addendum.--If the Ambassador determines that
it is in the national security interests of the United States
or is necessary for the safety of individuals to be
identified in the Annual Report, any information required by
subparagraph (A), including measures taken by the United
States, may be summarized in the Annual Report and submitted
in more detail in a classified addendum to the Annual Report.
(C) Designation of report.--Each report submitted under
this subsection may be referred to as the ``Annual Report on
Religious Persecution''.
(2) Foreign government input.--Prior to submission of each
report under this subsection, the Secretary of State may
offer the government of any country concerned an opportunity
to respond to the relevant portions of the report. If the
Secretary of State determines that doing so would further the
purposes of this Act, the Secretary shall request the
Ambassador at Large to include the country's response as an
addendum to the Annual Report on Religious Persecution.
(c) Preparation of Reports Regarding Religious
Persecution.--
(1) Standards and investigations.--The Secretary of State
shall ensure that United States missions abroad maintain a
consistent reporting standard and thoroughly investigate
reports of religious persecution.
(2) Contacts with ngos.--In compiling data and assessing
the respect of the right to religious freedom for the Human
Rights Reports and the Annual Report on Religious
Persecution, United States mission personnel shall seek out
and maintain contacts with religious and human rights
nongovernmental organizations, with the consent of those
organizations, including receiving reports and updates from
such organizations and, when appropriate, investigating such
reports.
(d) Amendments to the Foreign Assistance Act.--
(1) Content of human rights reports for countries receiving
economic assistance.--Section 116(d) of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151n(d)) is amended--
(A) by striking ``and'' at the end of paragraph (4);
(B) by striking the period at the end of paragraph (5) and
inserting``; and ''; and
(C) by adding at the end the following:
``(6) wherever applicable, the practice of religious
persecution, including gross violations of the right to
religious freedom.''.
(2) Contents of human rights reports for countries
receiving security assistance.--Section 502B(b) of the
Foreign Assistance Act of 1961 (22 U.S.C. 2304(b)) is
amended--
(A) by inserting ``and with the assistance of the
Ambassador at Large for Religious Freedom'' after ``Labor'';
and
(B) by inserting after the second sentence the following
new sentence: ``Such report shall also include, wherever
applicable, information on religious persecution, including
gross violations of the right to religious freedom.''.
SEC. 103. ESTABLISHMENT OF A RELIGIOUS FREEDOM INTERNET SITE.
In order to facilitate access by nongovernmental
organizations (NGOs) and by the public around the world to
international documents on the protection of religious
freedom, the Ambassador at Large shall establish and maintain
an Internet site containing major international documents
relating to religious freedom, the Annual Report on Religious
Persecution, and any other documentation or references to
other sites as deemed appropriate or relevant by the
Ambassador at Large.
SEC. 104. TRAINING FOR FOREIGN SERVICE OFFICERS.
Chapter 2 of title I of the Foreign Service Act of 1980 is
amended by adding at the end the following new section:
``SEC. 708. TRAINING FOR FOREIGN SERVICE OFFICERS.
``The Secretary of State and the Ambassador at Large on
International Religious Freedom, appointed under section
101(b) of the International Religious Freedom Act of 1998,
acting jointly, shall establish as part of the standard
training for
Major Actions:
All articles in Senate section
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
(Senate - March 26, 1998)
Text of this article available as:
TXT
PDF
[Pages
S2660-S2683]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Ms. MIKULSKI (for herself, Mrs. Murray and Mr. Wyden):
S. 1864. A bill to amend title XVIII of the Social Security Act to
exclude clinical social worker services from coverage under the
Medicare skilled nursing facility prospective payment system; to the
Committee on Finance.
THE MEDICARE SOCIAL WORK EQUITY ACT OF 1998
Ms. MIKULSKI. Mr. President, I rise today to introduce the ``Medicare
Social Work Equity Act of 1998''. I am proud to sponsor this
legislation which will amend section 4432 in the Balanced Budget Act of
1997 which prevents social workers from directly billing Medicare for
mental health services provided in skilled nursing facilities. I am
honored to be joined by my good friends Senator Murray and Senator
Wyden who care equally about correcting this inequity for social
workers.
Last year's Balanced Budget Act changed the payment method for
skilled nursing facility care. Under current law, reimbursement is made
after services have been delivered for the reasonable costs incurred.
However, this ``cost-based system'' was blamed for inordinate growth in
Medicare spending at skilled nursing facilities.
The Balanced Budget Act of 1997 phases in a prospective payment
system for skilled nursing facilities beginning July 1, 1998. Payments
for Part B services for skilled nursing facility residents will be
consolidated. This means that the provider of the services must bill
the facility instead of directly billing Medicare.
Congress was careful to not include psychologists and psychiatrists
in this new consolidated billing provision. Social workers were
included, I think by mistake. Clinical social workers are the primary
providers of mental health services to residents of nursing homes,
particularly in underserved urban and rural areas. Clinical social
workers are also the most cost effective mental health providers.
This legislation is important for three reasons: First, I am
concerned that section 4432 will inadvertently reduce mental health
services to nursing home residents. Second, I believe that the new
consolidated billing requirement will result in a shift from using
social workers to other mental health professionals who are reimbursed
at a higher cost. This will result in higher costs to Medicare.
Finally, I am concerned that clinical social workers will lose their
jobs in nursing homes or will be inadequately reimbursed.
I like this bill because it will correct an inequity for America's
social workers, it will assure quality of care for nursing home
residents, and will assure cost efficiency for Medicare. I look forward
to the Senate's support of this worthy legislation.
______
By Mr. BAUCUS:
S. 1865. A bill to amend title IV of the Social Security Act to
provide safeguards against the abuse of information reported to the
National Directory of New Hires; to the Committee on Finance.
[[Page
S2661]]
the safeguard of new employee information act of 1998
Mr. BAUCUS. Mr. President, today I am introducing the Safeguard of
New Employee Information Act of 1998. This bill will ensure that the
mechanisms created in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (PRWORA) to enhance our child support
enforcement system will not lead to a misuse of personal information. I
believe that my bill will assure that new employee information is kept
confidential without compromising the usefulness of the National
Directory of New Hires. The legislation provides clear safeguards
against the abuse of personal employee information, and makes sure that
the information is erased two years after entry.
As we all know, child support is a critical part of welfare reform. I
strongly support the measures in PRWORA that help states track and
crack down on parents who fail to pay court-ordered child support. In
response to the fact that over 30 percent of child support cases
involve parents who do not live in the same state as their children, a
National Directory of New Hires was created to assist states in
locating parents who reside in other states.
Thus far, the new data base has been very successful in enabling
states to locate delinquent parents, enforcing payment orders and
reducing the number of welfare families. However, many folks are
concerned about the confidentiality of the registry, and the fact that
this information is never deleted.
Last year, for example, the Montana State Legislature passed a child
support bill to comply with the new federal regulations. I must add,
this bill was passed in the final hours of the legislative session and
under the threat of losing $52 million a year in federal funds. At that
time, the legislature was hesitant to pass the bill because of concerns
regarding confidentiality.
Mr. President, the Safeguard of New Employee Information Act of 1998
makes needed changes to the National Directory to alleviate these fears
and ensure the registry's continuation. The bill provides penalties for
misuse of information by federal employees. Specifically, it
establishes a fine of $1,000 for each act of unauthorized access to,
disclosure, or use of information in the National Directory of New
Hires.
The bill also establishes a 24-month limit on retention of New Hire
data. This two year limit gives Child Support Enforcement agencies the
necessary time to determine paternity, establish a child support order
or enforce existing orders. A shorter period of data retention would
impede enforcement activities, and a longer period of retention
increases the potential for abuse.
Mr. President, in my state of Montana, 90 percent of families on
welfare are headed by single parents. That is why it is so important to
require that the absent mothers or fathers provide money to feed,
clothe and care for their children. The National Directory of New Hires
is a good idea--we just need to ensure new employee confidentiality. I
urge my colleagues to protect new hire confidentiality and support this
important legislation.
______
By Mr. DeWINE:
S. 1866. A bill to provide assistance to improve research regarding
the quality and effectiveness of health care for children, to improve
data collection regarding children's health, and to improve the
effectiveness of health care delivery systems for children; to the
Committee on Labor and Human Resources.
the child health care quality research improvement act
Mr. DeWINE. Mr. President, I rise today to introduce the Child Health
Care Quality Research Improvement Act. We have been hearing a great
deal recently about the quality of health care in this country. Most of
the debate, both here in Congress and back home in our States, has been
driven, at least in part, by a fear among consumers that efforts to
control costs and move people into managed care has compromised
quality. This fear has driven legislation such as the bill we passed
just last year to provide for 48-hour maternity stays. This year a
whole host of health care quality bills have been introduced in the
Congress. Even more such legislation has been moving forward at the
State level as well.
As I have learned more and more about the concerns about the quality
of health care, I have tried to focus particular attention on children,
how their health care is delivered and whether its quality has been
compromised. Frankly, I have learned something that I find very
interesting.
While the drive to improve quality and reduce cost has driven a great
deal of new research over the past several years, relatively little has
been done for children in this area. While we are getting better at
measuring quality of health care for adults, we have made little such
progress for our children.
Between 1993 and 1995, only some 5 percent of the health services
research study outcomes focused on our children. This is highly
alarming because I frankly cannot think of anything more critical to
our Nation's future than the quality of our children's health. Clearly
we need to correct this serious lack of good health care quality
measures.
I have spoken with experts in the field of pediatric research and
they agree with this assessment. They tell me that we have to do more
in this field if we expect to improve the care that our children
receive. Many times, frankly, we don't know exactly which treatments
are cost effective or best improve a child's quality of life. We don't
know how to manage children's complicated health problems in ways that
will allow them to lead normal lives
We can answer many of these questions if the patient is an adult, but
we have far fewer answers for our children. Here is one example. One
study recently found that children have three times greater chance of
dying after heart surgery at some hospitals than they have at other
hospitals--three times. We must fix this. That means we have to find
out why, why one hospital loses three times as many children as
another. As both a parent and a grandparent, I can speak from firsthand
experience about the stress and the uncertainty that goes along with
any childhood illness. To think that a parent's choice of a hospital
could actually be harmful to a child is certainly a very scary thought
for a parent.
Another example is asthma. Asthma is the most common chronic health
condition in children, affecting 5 million children in this country,
and that percentage, tragically, is rising. We are not sure why this
has been happening, but we do know that the quality of health care a
child receives can dramatically affect the severity of his or her
asthma. As a result, the better the quality of health care, the less
time that child spends in the hospital, the fewer visits to the
emergency room, and the less time a child has to miss from school. If
we do not even know what kinds of treatment work best for children or
that different treatments work better in different environments, we
cannot help. We certainly can't begin to debate how to improve quality
if we can't even define it or measure it. For that, we need to conduct
research in real world settings.
As a means of getting this research into real world settings and
improving the quality of health care that our children receive, I am
introducing a bill today entitled the Child Health Care Quality
Research Improvement Act. This legislation was developed with the help
of leaders in the pediatric community, child advocates, and health
services researchers. My bill takes a three-pronged approach to address
this issue: One, focusing on training; two, research; and three, data
collection for child health outcomes and effectiveness research.
Let me start with the first one.
In order for us to make advances in the study of pediatric health
outcomes, it is essential that we have researchers who have received
training in this field. This bill I am introducing today promotes
research training programs in child health services research at the
doctoral, post-doctoral, and junior faculty levels. By bringing
professionals into this very important field, we can ensure that issues
that affect the lives of children are receiving the attention they
deserve.
The second component of this bill establishes research centers and
networks. The goal of the centers and networks will be to foster
collaboration among experts in the field of pediatric health care
quality and effectiveness.
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We envision that these centers and networks will bring together
pediatric specialists from children's hospitals, physicians in managed
care plans, statisticians from schools of public health, and other
experts in the field to work together on research projects and to
translate these findings into real-world settings where children are
receiving health care.
Third, and finally, this legislation contains a component that adds
supplements to existing national health surveys that are today
administered by the National Center for Health Statistics and the
Maternal and Child Health Bureau. In addition to not knowing how to
measure health care quality in children, other data, like that
measuring children's use of health care systems and health care
expenditures, are lacking. Adding supplements to existing surveys is a
very sensible measure. This bill does not require yet another survey to
be administered. Rather, it simply adds questions to existing surveys,
to allow us to collect valuable data on children. This is the type of
information that we need if we want to look at trends in children's
health and what we can do to improve their health.
Mr. President, we are all well aware that children have medical
conditions and health care needs that are different from those of
adults. It doesn't make sense to do health services research for adults
and hope that one size fits all--that the things we learn will make
sense for children. Federal support for child health quality and
effectiveness research is vital to ensure that children are receiving
appropriate health care. We owe it to our Nation's children to train
health professionals in this important filed, and to support these very
important research initiatives.
Mr. President, I ask unanimous consent that the bill be printed in
the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1866
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 ``Child Health Care Quality
Research Improvement Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) There is increased emphasis on using evidence of
improved health care outcomes and cost effectiveness to
justify changes in our health care system.
(2) There is a growing movement to use health care quality
measures to ensure that health care services provided are
appropriate and likely to improve health.
(3) Few health care quality measures exist for children,
especially for the treatment of acute and chronic conditions.
(4) A significant number of children in the United States
have health problems, and the percentage of children with
special health care needs is increasing.
(5) Children in the health care marketplace have unique
health attributes, including a child's developmental
vulnerability, differential morbidity, and dependency on
adults, families, and communities.
(6) Children account for less than 15 percent of the
national health care spending, and do not command a large
amount of influence in the health care marketplace.
(7) The Federal government is the major payer of children's
health care in the United States.
(8) Numerous scientifically sound measures exist for
assessing quality of health care for adults, and similar
measures should be developed for assessing the quality of
health care for children.
(9) The delivery structures and systems that provide care
for children are necessarily different than systems caring
for adults, and therefore require appropriate types of
quality measurements and improvement systems.
(10) Improving quality measurement and monitoring will--
(A) assist health care providers in identifying ways to
improve health outcomes for common and rare childhood health
conditions;
(B) assist consumers and purchasers of health care in
determining the value of the health care products and
services they are receiving or buying; and
(C) assist providers in selecting effective treatments and
priorities for service delivery.
(11) Because of the prevalence and patterns of children's
medical conditions, research on improving care for relatively
rare or specific conditions must be conducted across multiple
institutions and practice settings in order to guarantee the
validity and generalizability of research results.
SEC. 3. DEFINITIONS.
In this Act:
(1) High priority areas.--the term ``high priority areas''
means areas of research that are of compelling scientific or
public policy significance, that include high priority areas
of research identified by the Conference on Improving Quality
of Health Care for Children: An Agenda for Research (May,
1997), and that--
(A) are consistent with areas of research as defined in
paragraphs (1)(A) and (2) of section 1142(a) of the Social
Security Act;
(B) are relevant to all children or to specific subgroups
of children; or
(C) are consistent with such other criteria as the
Secretary may require.
(2) Local community.--The term ``local community'' means
city, county, and regional governments, and research
institutes in conjunction with such cities, counties, or
regional governments.
(3) Pediatric quality of care and outcomes research.--The
term ``pediatric quality of care and outcomes research''
means research involving the process of health care delivery
and the outcomes of that delivery in order to improve the
care available for children, including health promotion and
disease prevention, diagnosis, treatment, and rehabilitation
services, including research to--
(A) develop and use better measures of health and
functional status in order to determine more precisely
baseline health status and health outcomes;
(B) evaluate the results of the health care process in
real-life settings, including variations in medical practices
and patterns, as well as functional status, clinical status,
and patient satisfaction;
(C) develop quality improvement tools and evaluate their
implementation in order to establish benchmarks for care for
specific childhood diseases, conditions, impairments, or
populations groups;
(D) develop specific measures of the quality of care to
determine whether a specific health service has been provided
in a technically appropriate and effective manner, that is
responsive to the clinical needs of the patient, and that is
evaluated in terms of the clinical and functional status of
the patient as well as the patient's satisfaction with the
care; or
(E) assess policies, procedures, and methods that can be
used to improve the process and outcomes of the delivery of
care.
(4) Provider-based research networks.--The term ``provider-
based research network'' refers to 1 of the following which
exist for the purpose of conducting research:
(A) A hospital-based research network that is comprised of
a sufficient number of children's hospitals or pediatric
departments of academic health centers.
(B) A physician practice-based research network that is
comprised of a sufficient number of groups of physicians
practices.
(C) A managed care-based research network that is comprised
of a sufficient number of pediatric programs of State-
licensed health maintenance organizations or other State
certified managed care plans.
(D) A combination provider-based research network that is
comprised of all or part of a hospital-based research
network, a physician practice-based research network, and a
managed care-based research network.
(5) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
SEC. 4. EXPANSION OF THE HEALTH SERVICES RESEARCH WORKFORCE.
(a) Grants.--The Secretary shall annually award not less
than 10 grants to eligible entities at geographically diverse
locations throughout the United States to enable such
entities to carry out research training programs that are
dedicated to child health services research training
initiatives at the doctoral, post-doctoral, and junior
faculty levels.
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) be a public or nonprofit private entity; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
(c) Limitation.--A grant awarded under this section shall
be for an amount that does not exceed $500,000.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $5,000,000 for
each of the fiscal years 1999 through 2003.
SEC. 5. DEVELOPMENT OF CHILD HEALTH IMPROVEMENT RESEARCH
CENTERS AND PROVIDER-BASED RESEARCH NETWORKS.
(a) Grants.--In order to address the full continuum of
pediatric quality of care and outcomes research, to link
research to practice improvement, and to speed the
dissemination of research findings to community practice
settings, the Secretary shall award grants to eligible
entities for the establishment of--
(1) not less that 10 national centers for excellence in
child health improvement research at geographically diverse
locations throughout the United States; and
(2) not less than 5 national child health provider quality
improvement research networks at geographically diverse
locations throughout the United States, including at least 1
of each type of network as described in section 3(4).
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) for purposes of--
(A) subsection (a)(1), be a public or nonprofit entity, or
group of entities, including universities, and where
applicable their
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schools of Public Health, research institutions, or
children's hospitals, with multi-disciplinary expertise
including pediatric quality of care and outcomes research and
primary care research; or
(B) subsection (a)(2), be a public or nonprofit institution
that represents children's hospitals, pediatric departments
of academic health centers, physician practices, or managed
care plans; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require, including--
(A) in the case of an application for a grant under
subsection (a)(1), a demonstration that a research center
will conduct 2 or more research projects involving pediatric
quality of care and outcomes research in high priority areas;
or
(B) in the case of an application for a grant under
subsection (a)(2)--
(i) a demonstration that the applicant and its network will
conduct 2 or more projects involving pediatric quality of
care and outcomes research in high priority areas;
(ii) a demonstration of an effective and cost-efficient
data collection infrastructure;
(iii) a demonstration of matching funds equal to the amount
of the grant; and
(iv) a plan for sustaining the financing of the operation
of a provider-based network after the expiration of the 5-
year term of the grant.
(c) Limitations.--A grant awarded under subsection (a)(1)
shall not exceed $1,000,000 per year and be for a term of
more that 5 years and a grant awarded under subsection (a)(2)
shall not exceed $750,000 per year and be for a term of more
than 5 years.
(d) Authorization of Appropriations.--There are authorized
to be appropriated--
(1) to carry out subsection (a)(1), $10,000,000 for each of
the fiscal years 1999 through 2003; and
(2) to carry out subsection (a)(2), $3,750,000 for each of
the fiscal years 1999 through 2003.
SEC. 6. RESEARCH IN SPECIFIC HIGH PRIORITY AREAS.
(a) Additional Funds for Grants.--From amounts appropriated
under subsection (c), the Secretary shall provide support,
through grant programs authorized on the date of enactment of
this Act, to entities determined to have expertise in
pediatric quality of care and outcomes research. Such
additional funds shall be used to improve the quality of
children's health, especially in high priority areas, and
shall be subject to the same conditions and requirements that
apply to funds provided under the existing grant program
through which such additional funds are provided.
(b) Advisory Committee.--
(1) In general.--To evaluate progress made in pediatric
quality of care and outcomes research in high priority areas,
and to identify new high priority areas, the Secretary shall
establish an advisory committee which shall report annually
to the Secretary.
(2) Membership.--The Secretary shall ensure that the
advisory committee established under paragraph (1) includes
individuals who are--
(A) health care consumers;
(B) health care providers;
(C) purchasers of health care;
(D) representative of health plans involved in children's
health care services; and
(E) representatives of Federal agencies including--
(i) the Agency for Health Care Policy and Research;
(ii) the Centers for Disease Control and Prevention;
(iii) the Health Care Financing Administration;
(iv) the Maternal and Child Health Bureau;
(v) the National Institutes of Health; and
(vi) the Substance Abuse and Mental Health Services
Administration.
(3) Evaluation of research.--The advisory committee
established under paragraph (1) shall evaluate research in
high priority areas using criteria that include--
(1) the generation of research that includes both short and
long term studies;
(2) the ability to foster public and private partnerships;
and
(3) the likelihood that findings will be transmitted
rapidly into practice.
(c) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $12,000,000 for
each of the fiscal years 1999 through 2003.
SEC. 7. IMPROVING CHILD HEALTH DATA AND DEVELOPING BETTER
DATA COLLECTION SYSTEMS.
(a) Survey.--The Secretary shall provide assistance to
enable the appropriate Federal agencies to--
(1) conduct ongoing biennial supplements and initiate and
maintain a longitudinal study on children's health that is
linked to the appropriate existing national surveys
(including the National Health Interview Survey and the
Medical Expenditure Panel Survey) to--
(A) provide for reliable national estimates of health care
expenditures, cost, use, access, and satisfaction for
children, including uninsured children, poor and near-poor
children, and children with special health care needs;
(B) enhance the understanding of the determinants of health
outcomes and functional status among children with special
health care needs, as well as an understanding of these
changes over time and their relationship to health care
access and use; and
(C) monitor the overall national impact of Federal and
State policy changes on children's health care; and
(2) develop an ongoing 50-State survey to generate reliable
State estimates of health care expenditures, cost, use,
access, satisfaction, and quality for children, including
uninsured children, poor and near-poor children, and children
with special health care needs.
(b) Grants.--The Secretary shall award grants to public and
nonprofit entities to enable such entities to develop the
capacity of local communities to improve child health
monitoring at the community level.
(c) Eligibility.--To be eligible to receive a grant under
subsection (b), an entity shall--
(1) be a public or nonprofit entity; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $14,000,000 for
each of the fiscal years 1999 through 2003, of which--
(1) $6,000,000 shall be made available in each fiscal year
for grants under subsection (a)(1);
(2) $4,000,000 shall be made available in each fiscal year
for grants under subsection (a)(2);
(3) $4,000,000 shall be made available in each fiscal year
for grants under subsection (b).
SEC. 8. OVERSIGHT.
Not later than ________ after the date of enactment of this
Act, The Secretary shall prepare and submit a report to
Congress on progress made in pediatric quality of care and
outcomes research, including the extent of ongoing research,
programs, and technical needs, and the Department of Health
and Human Services' priorities for funding pediatric quality
of care and outcomes research.
______
By Ms. COLLINS:
S. 1867. A bill to amend chapter 35 of title 44, United States Code,
for the purpose of facilitating compliance by small businesses with
certain Federal paperwork requirements, and to establish a task force
to examine the feasibility of streamlining paperwork requirements
applicable to small businesses; to the Committee on Governmental
Affairs.
the small business paperwork reduction act
Ms. COLLINS. Mr. President, today I am introducing the Small Business
Paperwork Reduction Act Amendments of 1998, a companion bill to
legislation pending in the House of Representatives.
This legislation has five components. First, it requires the Office
of Management and Budget to publish annually in the Federal Register
and on the Internet all of the Federal paperwork requirements imposed
on small business. This will not only serve as a valuable tool for
those who must comply with these mandates, but it will also make it far
easier for policy makers to monitor, and I would hope check, the growth
in the paperwork burden.
Second, under the bill, each agency will have to establish one point
of contact to act as a liaison with small businesses on paperwork
requirements. In an era when serving the customer has become recognized
by the private sector as critical, this is a modest step to ask of our
government.
Third, the legislation provides for the suspension of civil fines
imposed on small enterprises for first-time paperwork violations,
except under certain circumstances, such as when the violation causes
serious harm to the public or presents an imminent danger to the public
health or safety. In dealing with America's entrepreneurs, we need to
move away from a culture that seems to place a higher priority on
imposing punishment than on facilitating compliance.
Fourth, in addition to meeting the mandates of the Paperwork
Reduction Act, agencies will have to make further efforts to reduce the
burden on enterprises with fewer than 25 employees. There must be some
measure of proportionality between the size of a business and its costs
of complying with government regulation.
Fifth, a task force will be established to examine the feasibility of
requiring agencies to consolidate their paperwork mandates in a manner
that will allow small businesses to satisfy those mandates through a
single filing, in a single format, and on the same date. By reducing
the amount of time currently devoted to these tasks, our companies will
have more to spend on the activities for which they were formed.
Mr. President, all too often the relationship between the owners of
small businesses and government is an adversial one. That benefits no
one--not the owners of these enterprises, not the many Americans they
employ, not
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the government they help to support, and not the public at large.
The problem often is not with the goals which underlie our
regulations, but rather in how we seek to achieve those goals. We
should not forget that we are dealing with Americans who make a great
contribution to the prosperity of our nation. In seeking to meet our
regulatory objectives, we should be reaching out to these entrepreneurs
with a helping hand and not a heavy hand. That, Mr. President, is the
purpose of this legislation.
______
By Mr. NICKLES (for himself, Mr. Mack, Mr. Lieberman, Mr.
Kempthorne, Mr. Craig, Mr. Hutchinson, and Mr. DeWine):
S. 1868. A bill to express United States foreign policy with respect
to, and to strengthen United States advocacy on behalf of, individuals
persecuted for their faith worldwide; to authorize United States
actions in response to religious persecution worldwide; to establish an
Ambassador at Large on International Religious Freedom within the
Department of State, a Commission on International Religious Freedom
within the Department of State, a Commission on International Religious
Persecution, and a Special Adviser on International Religious Freedom
within the National Security Council; and for other purposes; to the
Committee on Foreign Relations.
the international religious freedom act of 1998
Mr. NICKLES. Mr. President, today I am prompted to speak by both a
tragic reality, and also what I would think is a promising hope. The
tragic reality is that literally millions of religious believers around
the world live gripped by the incessant, terrifying prospect of
persecution, of being tortured, arrested, imprisoned or even killed for
simply practicing their faith. A promising hope, I believe, might
perhaps be found in the bill that I am introducing today with Senator
Lieberman, Senator Mack, Senator Kempthorne, Senator Craig, Senator
Hutchinson and Senator DeWine. It is called the International Religious
Freedom Act. The International Religious Freedom Act will establish a
process to ensure that on an ongoing basis the United States closely
monitors religious persecution worldwide.
It is wrong for a country to persecute, to prosecute, to imprison,
harass individuals for simply practicing their faith, whether that
faith is Jewish or Christian or Muslim or Hindu. It is absolutely wrong
for them to be persecuted for practicing their faith. This act requires
the U.S. Government to take action against all countries engaging in
religious persecution.
What kind of persecution am I talking about? First, three facts
command attention.
One reliable estimate indicates that more Christian martyrs have
perished in this century than all previous centuries combined. That is
a staggering, staggering statement.
A recent book reports that 200 million Christians around the world
live under daily fear and threat of persecution, including
interrogation, imprisonment, torture and in some cases death.
Finally, over half the world's population lives under regimes which
severely restrict if not prohibit their ability to believe in and
practice the religious faith of their choice and conviction.
Of course, religious persecution goes beyond facts and figures. It
happens to real people in real places. Let me point out just four
compelling examples.
At this very moment one of China's leading house church pastors,
Pastor Peter Xu, is languishing in a Chinese prison under a 3-year term
for the so-called ``crime'' of ``disturbing public order.'' Hundreds,
perhaps thousands of other believers in China currently suffer similar
treatment.
Again, at this very moment, 13 courageous Christians are imprisoned
by the Communist authorities in Laos. What was their ``crime''? Simply
that they organized an ``unauthorized'' Bible study in the privacy of a
home.
In Pakistan, just a few months ago, Pastor Noor Alam was brutally
stabbed to death by anti-Christian assailants. Shortly before that,
they had destroyed Pastor Alam's church building. Meanwhile, Christians
and other religious minorities in Pakistan continue to sufferer under
the notorius ``blasphemy laws.''
Or consider Russia, which, as many of my colleagues will remember,
just last summer passed a draconian law that will effectively shut down
the vast majority of independent churches and other religious
organizations and severly curtail the religious freedom of the Russian
people.
I could go on and on. However, I do want to share just a few
highlights of what we humbly but earnestly hope our bill can do to
begin to address the scourge of religious persecution worldwide.
I should also mention that, in 1996, I was honored to sponsor a
Senate resolution on religious persecution, which passed by unanimous
consent. In that resolution, the Senate made a strong recommendation
``that the President expand and invigorate the United States'
international advocacy on behalf of persecuted Christians, and initiate
a thorough examination of all United States' policies that affect
persecuted Christians.''
What was a mere resolution in 1996, I hope it will become a reality
in 1998. While then we acted with words, I hope that this year we can
act with deeds.
In short, this bill seeks to ensure that the U.S. Government
aggressively monitors religious oppression around the world and takes
decisive action against those regimes engaged in persecution, all the
while maintaining the integrity and credibility of the U.S. foreign
policy system.
The International Religious Freedom Act establishes an ``Ambassador-
at-Large for Religious Liberty'' at the State Department. The
Ambassador will be responsible for representing our Government in
vigorous diplomacy with nations guilty of religious persecution. In
addition, the Ambassador will oversee an annual report on religious
persecution which will specify the details on religious persecution
around the world. This report will name names. And those countries
named will be held accountable.
For any country cited in the report, the Act presents a menu of
diplomatic and economic options, and the President is required to
select from at least one of those actions. Silence or passivity are not
options. At the same time, the Act seeks to provide the President
maximum flexibility entailing the most appropriate, effective response
to that particular situation in a particular country. Furthermore,
because we desire good results to follow our good intentions, the Act
requires a consideration of how the action taken by America will affect
American economic and security interests and, most important, how it
will affect the very people that it purports to help.
The International Religious Freedom Act has other provisions--
improved reporting, improved training for immigration and foreign
service officials, a commission on international religious liberty to
provide more attention and expertise on the issue. I invite all my
colleagues, and certainly those who are deeply concerned about the
plight of persecuted religious believers, to join me in supporting this
bill. Not because it might be popular or expedient or convenient to
support this legislation, but because it is the right thing to do and
because I believe it will make a real difference in protecting the
lives of some of the most vulnerable people in the world, those people
who wish to express their religious beliefs and convictions.
Mr. President, I thank my cosponsors, particularly Senator Lieberman,
also Senator Mack, in addition to Senator Hutchinson and Senator Craig
and Senator Kempthorne, for helping us put this legislation together.
Mr. President, I ask unanimous consent that the text of the bill
printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1868
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the
``International Religious Freedom Act of 1998''.
(b) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings; policy.
Sec. 3. Definitions.
TITLE I--DEPARTMENT OF STATE ACTIVITIES
Sec. 101. Office on International Religious Freedom; Ambassador at
Large for International Religious Freedom.
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Sec. 102. Reports.
Sec. 103. Establishment of a religious freedom Internet site.
Sec. 104. Training for Foreign Service officers.
Sec. 105. High-level contacts with NGOs.
Sec. 106. Programs and allocations of funds by United States missions
abroad.
Sec. 107. Equal access to United States missions abroad for conducting
religious activities.
Sec. 108. Prisoner lists and issue briefs on religious persecution
concerns.
TITLE II--COMMISSION ON INTERNATIONAL RELIGIOUS PERSECUTION
Sec. 201. Establishment and composition.
Sec. 202. Duties of the Commission.
Sec. 203. Report of the Commission.
Sec. 204. Termination.
TITLE III--NATIONAL SECURITY COUNCIL
Sec. 301. Special Adviser on Religious Persecution.
TITLE IV--SANCTIONS
Subtitle I--Targeted Responses to Religious Persecution Abroad
Sec. 401. Executive measures and sanctions in response to findings made
in the Annual Report on Religious Persecution.
Sec. 402. Presidential determinations of gross violations of the right
to religious freedom.
Sec. 403. Consultations.
Sec. 404. Report to Congress.
Sec. 405. Description of Executive measures and sanctions.
Sec. 406. Contract sanctity.
Sec. 407. Presidential waiver.
Sec. 408. Publication in Federal Register.
Sec. 409. Congressional review.
Sec. 410. Termination of sanctions.
Subtitle II--Strengthening Existing Law
Sec. 421. United States assistance.
Sec. 422. Multilateral assistance.
Sec. 423. Exports of items relating to religious persecution.
TITLE V--PROMOTION OF RELIGIOUS FREEDOM
Sec. 501. Assistance for promoting religious freedom.
Sec. 502. International broadcasting.
Sec. 503. International exchanges.
Sec. 504. Foreign Service awards.
TITLE VI--REFUGEE, ASYLUM, AND CONSULAR MATTERS
Sec. 601. Use of Annual Report.
Sec. 602. Reform of refugee policy.
Sec. 603. Reform of asylum policy.
Sec. 604. Inadmissibility of foreign government officials who have
engaged in gross violations of the right to religious
freedom.
TITLE VII--MISCELLANEOUS PROVISIONS
Sec. 701. Business codes of conduct.
Sec. 702. International Criminal Court.
SEC. 2. FINDINGS; POLICY.
(a) Findings.--Congress makes the following findings:
(1) Freedom of religious belief and practice is a
fundamental human right articulated in numerous international
agreements and covenants, including the Universal Declaration
of Human Rights, the International Covenant on Civil and
Political Rights, the Helsinki Accords, the Declaration on
the Elimination of All Forms of Intolerance and
Discrimination Based on Religion or Belief, the United
Nations Charter, and the European Convention for the
Protection of Human Rights and Fundamental Freedoms.
(2) The right to freedom of religion undergirds the very
origin and existence of the United States. Many of our
Nation's founders fled religious persecution abroad,
cherishing in their hearts and minds the ideal of religious
freedom. They established in law, as a fundamental right and
as a pillar of our Nation, the right to freedom of religion.
From its birth to this day, the United States has prized this
legacy of religious freedom and honored this heritage by
standing for religious freedom and offering refuge to those
suffering religious persecution.
(3) Article 18 of the Universal Declaration of Human Rights
recognizes that ``Everyone has the right to freedom of
thought, conscience, and religion. This right includes
freedom to change his religion or belief, and freedom, either
alone or in community with others and in public or private,
to manifest his religion or belief in teaching, practice,
worship, and observance.''. Article 18(1) of the
International Covenant on Civil and Political Rights
recognizes that ``Everyone shall have the right to freedom of
thought, conscience, and religion. This right shall include
freedom to have or to adopt a religion or belief of his
choice, and freedom, either individually or in community with
others and in public or private, to manifest his religion or
belief in worship, observance, practice, and teaching''.
Governments have the responsibility to protect the
fundamental rights of their citizens and to pursue justice
for all. Religious freedom is a fundamental right of every
individual, regardless of race, country, creed, or
nationality, and should never be arbitrarily abridged by any
government.
(4) The right to freedom of religion is under renewed and,
in some cases, increasing assault in many countries around
the world. More than one-half of the world's population lives
under regimes that severely restrict or prohibit the freedom
of their citizens to study, believe, observe, and freely
practice the religious faith of their choice. Religious
believers and communities suffer both government-sponsored
and government-tolerated violations of their rights to
religious freedom. Among the many forms of such violations
are state-sponsored slander campaigns, confiscations of
property, surveillance by security police, including by
special divisions of ``religious police'', severe
prohibitions against construction and repair of places of
worship, denial of the right to assemble and relegation of
religious communities to illegal status through arbitrary
registration laws, prohibitions against the pursuit of
education or public office, and prohibitions against
publishing, distributing, or possessing religious literature
and materials.
(5) Even more abhorrent, religious believers in many
countries face such severe and violent forms of religious
persecution as detention, torture, beatings, forced marriage,
rape, imprisonment, enslavement, mass resettlement, and death
merely for the peaceful belief in, change of or practice of
their faith. In many countries, religious believers are
forced to meet secretly, and religious leaders are targeted
by national security forces and hostile mobs.
(6) Though not confined to a particular region or regime,
religious persecution is often particularly widespread,
systematic, and heinous under totalitarian governments and in
countries with militant, politicized religious majorities.
(7) Congress has recognized and denounced acts of religious
persecution through the adoption of the following
resolutions:
(A) House Resolution 515 (104th), expressing the sense of
the House of Representatives with respect to the persecution
of Christians worldwide.
(B) Senate Concurrent Resolution 71 (104th), expressing the
sense of the Senate regarding persecution of Christians
worldwide.
(C) House Concurrent Resolution 102, concerning the
emancipation of the Iranian Baha'i community.
(b) Policy.--It shall be the policy of the United States,
as follows:
(1) To condemn religious persecution, and to promote, and
to assist other governments in the promotion of, the
fundamental right to religious freedom.
(2) To seek to channel United States security and
development assistance to governments other than those found
to be engaged in gross violations of human rights, including
the right to religious freedom, as set forth in the Foreign
Assistance Act of 1961, in the International Financial
Institutions Act of 1977, and in other formulations of United
States human rights policy.
(3) To be vigorous and flexible, reflecting both the
unwavering commitment of the United States to religious
freedom and the desire of the United States for the most
effective and principled response, in light of the range of
violations of religious freedom by a variety of persecuting
regimes, and the status of the relations of the United States
with different nations.
(4) To work with foreign governments that affirm and
protect religious freedom, in order to develop multilateral
documents and initiatives to combat religious persecution and
promote the right to religious freedom abroad.
(5) Standing for liberty and standing with the persecuted,
to use and implement appropriate tools in the United States
foreign policy apparatus, including diplomatic, political,
commercial, charitable, educational, and cultural channels,
to promote respect for religious freedom by all governments
and peoples.
SEC. 3. DEFINITIONS.
In this Act:
(1) Ambassador at large.--The term ``Ambassador at Large''
means the Ambassador at Large on International Religious
Freedom appointed under section 101(b).
(2) Annual report on religious persecution.--The term
``Annual Report on Religious Persecution'' means the report
described in section 102(b).
(3) Appropriate congressional committees.--The term
``appropriate congressional committees'' means the Committee
on Foreign Relations of the Senate and the Committee on
International Relations of the House of Representatives and,
in the case of any determination made with respect to the
imposition of a sanction under paragraphs (9) through (16) of
section 405, the term ``appropriate congressional
committees'' includes those committees, together with the
Committee on Ways and Means and the Committee on Banking and
Financial Services of the House of Representatives and the
Committee on Finance of the Senate.
(4) Commission.--The term ``Commission'' means the United
States Commission on International Religious Persecution
established in section 201(a).
(5) Government or foreign government.--The term
``government'' or ``foreign government'' includes any agency
or instrumentality of the government.
(6) Gross violations of the right to freedom of religion.--
The term ``gross violations of the right to freedom of
religion'' means a consistent pattern of gross violations of
the right to freedom of religion that include torture or
cruel, inhuman, or degrading treatment or punishment,
prolonged detention without charges, causing the
disappearance of persons by the abduction or clandestine
detention of those persons, or other flagrant denial of the
right to life, liberty, or the security of persons, within
the meaning of section 116(a) of the Foreign Assistance Act
of 1961 (22 U.S.C. 2151n(a)).
[[Page
S2666]]
(7) Human rights reports.--The term ``Human Rights
Reports'' means the reports submitted by the Department of
State to Congress under sections 116 and 502B of the Foreign
Assistance Act of 1961.
(8) Office.--The term ``Office'' means the Office on
International Religious Freedom established in section
101(a).
(9) Religious persecution.--The term ``religious
persecution'' means any violation of the internationally
recognized right to freedom of religion, as defined in
Article 18 of the Universal Declaration of Human Rights and
Article 18 of the International Covenant on Civil and
Political Rights, including violations such as--
(A) arbitrary prohibitions on, restrictions of, or
punishment for--
(i) assembling for peaceful religious activities such as
worship, preaching, and prayer, including arbitrary
registration requirements,
(ii) speaking freely about one's religious beliefs,
(iii) changing one's religious beliefs and affiliation,
(iv) possession and distribution of religious literature,
including Bibles, or
(v) raising one's children in the religious teachings and
practices of one's choice,
as well as arbitrary prohibitions or restrictions on the
grounds of religion on holding public office, or pursuing
educational or professional opportunities; and
(B) any of the following acts if committed on account of an
individual's religious belief or practice: detention,
interrogation, harassment, imposition of an onerous financial
penalty, forced labor, forced mass resettlement,
imprisonment, beating, torture, mutilation, rape,
enslavement, murder, and execution.
(10) Special adviser.--The term ``Special Adviser'' means
the Special Adviser to the President on Religious Persecution
established in section 101(i) of the National Security Act of
1947, as added by section 301 of this Act.
TITLE I--DEPARTMENT OF STATE ACTIVITIES
SEC. 101. OFFICE ON INTERNATIONAL RELIGIOUS FREEDOM;
AMBASSADOR AT LARGE FOR INTERNATIONAL RELIGIOUS
FREEDOM.
(a) Establishment of Office.--There is established within
the Department of State an Office on International Religious
Freedom that shall be headed by the Ambassador at Large on
International Religious Freedom appointed under subsection
(b).
(b) Appointment.--The Ambassador at Large shall be
appointed by the President, by and with the advice and
consent of the Senate.
(c) Duties.--The Ambassador at Large shall have the
following responsibilities:
(1) In general.--The primary responsibility of the
Ambassador at Large shall be to advance the right to freedom
of religion abroad, to denounce the violation of that right,
and to recommend appropriate responses by the United States
Government when this right is violated.
(2) Advisory role.--The Ambassador at Large shall be the
principal adviser to the President and the Secretary of State
regarding matters affecting religious freedom abroad and,
with advice from the Commission on International Religious
Persecution, shall make recommendations regarding the
policies of the United States Government toward governments
that violate the freedom of religion or that fail to ensure
the individual's right to religious belief and practice.
(3) Diplomatic representation.--The Ambassador at Large is
authorized to represent the United States in matters and
cases relevant to religious persecution in--
(A) contacts with foreign governments, international
organizations, intergovernmental organizations, and
specialized agencies of the United Nations, the Organization
on Security and Cooperation in Europe, and other
organizations of which the United States is a member; and
(B) multilateral conferences and meetings relevant to
religious persecution.
(4) Reporting responsibilities.--The Ambassador at Large
shall have the reporting responsibilities described in
section 102.
(d) Funding.--The Secretary of State shall provide the
Ambassador at Large with such funds as may be necessary for
the hiring of staff for the Office, for the conduct of
investigations by the Office, and for necessary travel to
carry out the provisions of this section.
SEC. 102. REPORTS.
(a) Portions of Annual Human Rights Reports.--The
Ambassador at Large shall assist the Secretary of State in
preparing those portions of the Human Rights Reports that
relate to freedom of religion and discrimination based on
religion and those portions of other information provided
Congress under sections 116 and 502B of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151m, 2304) that relate to
the right to religious freedom.
(b) Annual Report on Religious Persecution.--
(1) In general.--
(A) Deadline for submission.--Not later than May 1 of each
year, the Ambassador at Large shall submit to the appropriate
congressional committees an Annual Report on Religious
Persecution, expanding upon the most recent Human Rights
Reports. Each Annual Report on Religious Persecution shall
contain the following:
(i) An identification of each foreign country the
government of which engages in or tolerates acts of religious
persecution.
(ii) An assessment and description of the nature and extent
of religious persecution, including persecution of one
religious group by another religious group, religious
persecution by governmental and nongovernmental entities,
persecution targeted at individuals or particular
denominations or entire religions, and the existence of
government policies violating religious freedom.
(iii) A description of United States policies in support of
religious freedom, including a description of the measures
and policies implemented during the preceding 12 months by
the United States under title IV of this Act in opposition to
religious persecution and in support of religious freedom.
(iv) A description of any binding agreement with a foreign
government entered into by the United States under section
402(c).
(B) Classified addendum.--If the Ambassador determines that
it is in the national security interests of the United States
or is necessary for the safety of individuals to be
identified in the Annual Report, any information required by
subparagraph (A), including measures taken by the United
States, may be summarized in the Annual Report and submitted
in more detail in a classified addendum to the Annual Report.
(C) Designation of report.--Each report submitted under
this subsection may be referred to as the ``Annual Report on
Religious Persecution''.
(2) Foreign government input.--Prior to submission of each
report under this subsection, the Secretary of State may
offer the government of any country concerned an opportunity
to respond to the relevant portions of the report. If the
Secretary of State determines that doing so would further the
purposes of this Act, the Secretary shall request the
Ambassador at Large to include the country's response as an
addendum to the Annual Report on Religious Persecution.
(c) Preparation of Reports Regarding Religious
Persecution.--
(1) Standards and investigations.--The Secretary of State
shall ensure that United States missions abroad maintain a
consistent reporting standard and thoroughly investigate
reports of religious persecution.
(2) Contacts with ngos.--In compiling data and assessing
the respect of the right to religious freedom for the Human
Rights Reports and the Annual Report on Religious
Persecution, United States mission personnel shall seek out
and maintain contacts with religious and human rights
nongovernmental organizations, with the consent of those
organizations, including receiving reports and updates from
such organizations and, when appropriate, investigating such
reports.
(d) Amendments to the Foreign Assistance Act.--
(1) Content of human rights reports for countries receiving
economic assistance.--Section 116(d) of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151n(d)) is amended--
(A) by striking ``and'' at the end of paragraph (4);
(B) by striking the period at the end of paragraph (5) and
inserting``; and ''; and
(C) by adding at the end the following:
``(6) wherever applicable, the practice of religious
persecution, including gross violations of the right to
religious freedom.''.
(2) Contents of human rights reports for countries
receiving security assistance.--Section 502B(b) of the
Foreign Assistance Act of 1961 (22 U.S.C. 2304(b)) is
amended--
(A) by inserting ``and with the assistance of the
Ambassador at Large for Religious Freedom'' after ``Labor'';
and
(B) by inserting after the second sentence the following
new sentence: ``Such report shall also include, wherever
applicable, information on religious persecution, including
gross violations of the right to religious freedom.''.
SEC. 103. ESTABLISHMENT OF A RELIGIOUS FREEDOM INTERNET SITE.
In order to facilitate access by nongovernmental
organizations (NGOs) and by the public around the world to
international documents on the protection of religious
freedom, the Ambassador at Large shall establish and maintain
an Internet site containing major international documents
relating to religious freedom, the Annual Report on Religious
Persecution, and any other documentation or references to
other sites as deemed appropriate or relevant by the
Ambassador at Large.
SEC. 104. TRAINING FOR FOREIGN SERVICE OFFICERS.
Chapter 2 of title I of the Foreign Service Act of 1980 is
amended by adding at the end the following new section:
``SEC. 708. TRAINING FOR FOREIGN SERVICE OFFICERS.
``The Secretary of State and the Ambassador at Large on
International Religious Freedom, appointed under section
101(b) of the International Religious Freedom Act of 1998,
acting jointly, shall establish as part of the standard
tr
Amendments:
Cosponsors:
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
Sponsor:
Summary:
All articles in Senate section
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
(Senate - March 26, 1998)
Text of this article available as:
TXT
PDF
[Pages
S2660-S2683]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Ms. MIKULSKI (for herself, Mrs. Murray and Mr. Wyden):
S. 1864. A bill to amend title XVIII of the Social Security Act to
exclude clinical social worker services from coverage under the
Medicare skilled nursing facility prospective payment system; to the
Committee on Finance.
THE MEDICARE SOCIAL WORK EQUITY ACT OF 1998
Ms. MIKULSKI. Mr. President, I rise today to introduce the ``Medicare
Social Work Equity Act of 1998''. I am proud to sponsor this
legislation which will amend section 4432 in the Balanced Budget Act of
1997 which prevents social workers from directly billing Medicare for
mental health services provided in skilled nursing facilities. I am
honored to be joined by my good friends Senator Murray and Senator
Wyden who care equally about correcting this inequity for social
workers.
Last year's Balanced Budget Act changed the payment method for
skilled nursing facility care. Under current law, reimbursement is made
after services have been delivered for the reasonable costs incurred.
However, this ``cost-based system'' was blamed for inordinate growth in
Medicare spending at skilled nursing facilities.
The Balanced Budget Act of 1997 phases in a prospective payment
system for skilled nursing facilities beginning July 1, 1998. Payments
for Part B services for skilled nursing facility residents will be
consolidated. This means that the provider of the services must bill
the facility instead of directly billing Medicare.
Congress was careful to not include psychologists and psychiatrists
in this new consolidated billing provision. Social workers were
included, I think by mistake. Clinical social workers are the primary
providers of mental health services to residents of nursing homes,
particularly in underserved urban and rural areas. Clinical social
workers are also the most cost effective mental health providers.
This legislation is important for three reasons: First, I am
concerned that section 4432 will inadvertently reduce mental health
services to nursing home residents. Second, I believe that the new
consolidated billing requirement will result in a shift from using
social workers to other mental health professionals who are reimbursed
at a higher cost. This will result in higher costs to Medicare.
Finally, I am concerned that clinical social workers will lose their
jobs in nursing homes or will be inadequately reimbursed.
I like this bill because it will correct an inequity for America's
social workers, it will assure quality of care for nursing home
residents, and will assure cost efficiency for Medicare. I look forward
to the Senate's support of this worthy legislation.
______
By Mr. BAUCUS:
S. 1865. A bill to amend title IV of the Social Security Act to
provide safeguards against the abuse of information reported to the
National Directory of New Hires; to the Committee on Finance.
[[Page
S2661]]
the safeguard of new employee information act of 1998
Mr. BAUCUS. Mr. President, today I am introducing the Safeguard of
New Employee Information Act of 1998. This bill will ensure that the
mechanisms created in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (PRWORA) to enhance our child support
enforcement system will not lead to a misuse of personal information. I
believe that my bill will assure that new employee information is kept
confidential without compromising the usefulness of the National
Directory of New Hires. The legislation provides clear safeguards
against the abuse of personal employee information, and makes sure that
the information is erased two years after entry.
As we all know, child support is a critical part of welfare reform. I
strongly support the measures in PRWORA that help states track and
crack down on parents who fail to pay court-ordered child support. In
response to the fact that over 30 percent of child support cases
involve parents who do not live in the same state as their children, a
National Directory of New Hires was created to assist states in
locating parents who reside in other states.
Thus far, the new data base has been very successful in enabling
states to locate delinquent parents, enforcing payment orders and
reducing the number of welfare families. However, many folks are
concerned about the confidentiality of the registry, and the fact that
this information is never deleted.
Last year, for example, the Montana State Legislature passed a child
support bill to comply with the new federal regulations. I must add,
this bill was passed in the final hours of the legislative session and
under the threat of losing $52 million a year in federal funds. At that
time, the legislature was hesitant to pass the bill because of concerns
regarding confidentiality.
Mr. President, the Safeguard of New Employee Information Act of 1998
makes needed changes to the National Directory to alleviate these fears
and ensure the registry's continuation. The bill provides penalties for
misuse of information by federal employees. Specifically, it
establishes a fine of $1,000 for each act of unauthorized access to,
disclosure, or use of information in the National Directory of New
Hires.
The bill also establishes a 24-month limit on retention of New Hire
data. This two year limit gives Child Support Enforcement agencies the
necessary time to determine paternity, establish a child support order
or enforce existing orders. A shorter period of data retention would
impede enforcement activities, and a longer period of retention
increases the potential for abuse.
Mr. President, in my state of Montana, 90 percent of families on
welfare are headed by single parents. That is why it is so important to
require that the absent mothers or fathers provide money to feed,
clothe and care for their children. The National Directory of New Hires
is a good idea--we just need to ensure new employee confidentiality. I
urge my colleagues to protect new hire confidentiality and support this
important legislation.
______
By Mr. DeWINE:
S. 1866. A bill to provide assistance to improve research regarding
the quality and effectiveness of health care for children, to improve
data collection regarding children's health, and to improve the
effectiveness of health care delivery systems for children; to the
Committee on Labor and Human Resources.
the child health care quality research improvement act
Mr. DeWINE. Mr. President, I rise today to introduce the Child Health
Care Quality Research Improvement Act. We have been hearing a great
deal recently about the quality of health care in this country. Most of
the debate, both here in Congress and back home in our States, has been
driven, at least in part, by a fear among consumers that efforts to
control costs and move people into managed care has compromised
quality. This fear has driven legislation such as the bill we passed
just last year to provide for 48-hour maternity stays. This year a
whole host of health care quality bills have been introduced in the
Congress. Even more such legislation has been moving forward at the
State level as well.
As I have learned more and more about the concerns about the quality
of health care, I have tried to focus particular attention on children,
how their health care is delivered and whether its quality has been
compromised. Frankly, I have learned something that I find very
interesting.
While the drive to improve quality and reduce cost has driven a great
deal of new research over the past several years, relatively little has
been done for children in this area. While we are getting better at
measuring quality of health care for adults, we have made little such
progress for our children.
Between 1993 and 1995, only some 5 percent of the health services
research study outcomes focused on our children. This is highly
alarming because I frankly cannot think of anything more critical to
our Nation's future than the quality of our children's health. Clearly
we need to correct this serious lack of good health care quality
measures.
I have spoken with experts in the field of pediatric research and
they agree with this assessment. They tell me that we have to do more
in this field if we expect to improve the care that our children
receive. Many times, frankly, we don't know exactly which treatments
are cost effective or best improve a child's quality of life. We don't
know how to manage children's complicated health problems in ways that
will allow them to lead normal lives
We can answer many of these questions if the patient is an adult, but
we have far fewer answers for our children. Here is one example. One
study recently found that children have three times greater chance of
dying after heart surgery at some hospitals than they have at other
hospitals--three times. We must fix this. That means we have to find
out why, why one hospital loses three times as many children as
another. As both a parent and a grandparent, I can speak from firsthand
experience about the stress and the uncertainty that goes along with
any childhood illness. To think that a parent's choice of a hospital
could actually be harmful to a child is certainly a very scary thought
for a parent.
Another example is asthma. Asthma is the most common chronic health
condition in children, affecting 5 million children in this country,
and that percentage, tragically, is rising. We are not sure why this
has been happening, but we do know that the quality of health care a
child receives can dramatically affect the severity of his or her
asthma. As a result, the better the quality of health care, the less
time that child spends in the hospital, the fewer visits to the
emergency room, and the less time a child has to miss from school. If
we do not even know what kinds of treatment work best for children or
that different treatments work better in different environments, we
cannot help. We certainly can't begin to debate how to improve quality
if we can't even define it or measure it. For that, we need to conduct
research in real world settings.
As a means of getting this research into real world settings and
improving the quality of health care that our children receive, I am
introducing a bill today entitled the Child Health Care Quality
Research Improvement Act. This legislation was developed with the help
of leaders in the pediatric community, child advocates, and health
services researchers. My bill takes a three-pronged approach to address
this issue: One, focusing on training; two, research; and three, data
collection for child health outcomes and effectiveness research.
Let me start with the first one.
In order for us to make advances in the study of pediatric health
outcomes, it is essential that we have researchers who have received
training in this field. This bill I am introducing today promotes
research training programs in child health services research at the
doctoral, post-doctoral, and junior faculty levels. By bringing
professionals into this very important field, we can ensure that issues
that affect the lives of children are receiving the attention they
deserve.
The second component of this bill establishes research centers and
networks. The goal of the centers and networks will be to foster
collaboration among experts in the field of pediatric health care
quality and effectiveness.
[[Page
S2662]]
We envision that these centers and networks will bring together
pediatric specialists from children's hospitals, physicians in managed
care plans, statisticians from schools of public health, and other
experts in the field to work together on research projects and to
translate these findings into real-world settings where children are
receiving health care.
Third, and finally, this legislation contains a component that adds
supplements to existing national health surveys that are today
administered by the National Center for Health Statistics and the
Maternal and Child Health Bureau. In addition to not knowing how to
measure health care quality in children, other data, like that
measuring children's use of health care systems and health care
expenditures, are lacking. Adding supplements to existing surveys is a
very sensible measure. This bill does not require yet another survey to
be administered. Rather, it simply adds questions to existing surveys,
to allow us to collect valuable data on children. This is the type of
information that we need if we want to look at trends in children's
health and what we can do to improve their health.
Mr. President, we are all well aware that children have medical
conditions and health care needs that are different from those of
adults. It doesn't make sense to do health services research for adults
and hope that one size fits all--that the things we learn will make
sense for children. Federal support for child health quality and
effectiveness research is vital to ensure that children are receiving
appropriate health care. We owe it to our Nation's children to train
health professionals in this important filed, and to support these very
important research initiatives.
Mr. President, I ask unanimous consent that the bill be printed in
the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1866
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 ``Child Health Care Quality
Research Improvement Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) There is increased emphasis on using evidence of
improved health care outcomes and cost effectiveness to
justify changes in our health care system.
(2) There is a growing movement to use health care quality
measures to ensure that health care services provided are
appropriate and likely to improve health.
(3) Few health care quality measures exist for children,
especially for the treatment of acute and chronic conditions.
(4) A significant number of children in the United States
have health problems, and the percentage of children with
special health care needs is increasing.
(5) Children in the health care marketplace have unique
health attributes, including a child's developmental
vulnerability, differential morbidity, and dependency on
adults, families, and communities.
(6) Children account for less than 15 percent of the
national health care spending, and do not command a large
amount of influence in the health care marketplace.
(7) The Federal government is the major payer of children's
health care in the United States.
(8) Numerous scientifically sound measures exist for
assessing quality of health care for adults, and similar
measures should be developed for assessing the quality of
health care for children.
(9) The delivery structures and systems that provide care
for children are necessarily different than systems caring
for adults, and therefore require appropriate types of
quality measurements and improvement systems.
(10) Improving quality measurement and monitoring will--
(A) assist health care providers in identifying ways to
improve health outcomes for common and rare childhood health
conditions;
(B) assist consumers and purchasers of health care in
determining the value of the health care products and
services they are receiving or buying; and
(C) assist providers in selecting effective treatments and
priorities for service delivery.
(11) Because of the prevalence and patterns of children's
medical conditions, research on improving care for relatively
rare or specific conditions must be conducted across multiple
institutions and practice settings in order to guarantee the
validity and generalizability of research results.
SEC. 3. DEFINITIONS.
In this Act:
(1) High priority areas.--the term ``high priority areas''
means areas of research that are of compelling scientific or
public policy significance, that include high priority areas
of research identified by the Conference on Improving Quality
of Health Care for Children: An Agenda for Research (May,
1997), and that--
(A) are consistent with areas of research as defined in
paragraphs (1)(A) and (2) of section 1142(a) of the Social
Security Act;
(B) are relevant to all children or to specific subgroups
of children; or
(C) are consistent with such other criteria as the
Secretary may require.
(2) Local community.--The term ``local community'' means
city, county, and regional governments, and research
institutes in conjunction with such cities, counties, or
regional governments.
(3) Pediatric quality of care and outcomes research.--The
term ``pediatric quality of care and outcomes research''
means research involving the process of health care delivery
and the outcomes of that delivery in order to improve the
care available for children, including health promotion and
disease prevention, diagnosis, treatment, and rehabilitation
services, including research to--
(A) develop and use better measures of health and
functional status in order to determine more precisely
baseline health status and health outcomes;
(B) evaluate the results of the health care process in
real-life settings, including variations in medical practices
and patterns, as well as functional status, clinical status,
and patient satisfaction;
(C) develop quality improvement tools and evaluate their
implementation in order to establish benchmarks for care for
specific childhood diseases, conditions, impairments, or
populations groups;
(D) develop specific measures of the quality of care to
determine whether a specific health service has been provided
in a technically appropriate and effective manner, that is
responsive to the clinical needs of the patient, and that is
evaluated in terms of the clinical and functional status of
the patient as well as the patient's satisfaction with the
care; or
(E) assess policies, procedures, and methods that can be
used to improve the process and outcomes of the delivery of
care.
(4) Provider-based research networks.--The term ``provider-
based research network'' refers to 1 of the following which
exist for the purpose of conducting research:
(A) A hospital-based research network that is comprised of
a sufficient number of children's hospitals or pediatric
departments of academic health centers.
(B) A physician practice-based research network that is
comprised of a sufficient number of groups of physicians
practices.
(C) A managed care-based research network that is comprised
of a sufficient number of pediatric programs of State-
licensed health maintenance organizations or other State
certified managed care plans.
(D) A combination provider-based research network that is
comprised of all or part of a hospital-based research
network, a physician practice-based research network, and a
managed care-based research network.
(5) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
SEC. 4. EXPANSION OF THE HEALTH SERVICES RESEARCH WORKFORCE.
(a) Grants.--The Secretary shall annually award not less
than 10 grants to eligible entities at geographically diverse
locations throughout the United States to enable such
entities to carry out research training programs that are
dedicated to child health services research training
initiatives at the doctoral, post-doctoral, and junior
faculty levels.
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) be a public or nonprofit private entity; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
(c) Limitation.--A grant awarded under this section shall
be for an amount that does not exceed $500,000.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $5,000,000 for
each of the fiscal years 1999 through 2003.
SEC. 5. DEVELOPMENT OF CHILD HEALTH IMPROVEMENT RESEARCH
CENTERS AND PROVIDER-BASED RESEARCH NETWORKS.
(a) Grants.--In order to address the full continuum of
pediatric quality of care and outcomes research, to link
research to practice improvement, and to speed the
dissemination of research findings to community practice
settings, the Secretary shall award grants to eligible
entities for the establishment of--
(1) not less that 10 national centers for excellence in
child health improvement research at geographically diverse
locations throughout the United States; and
(2) not less than 5 national child health provider quality
improvement research networks at geographically diverse
locations throughout the United States, including at least 1
of each type of network as described in section 3(4).
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) for purposes of--
(A) subsection (a)(1), be a public or nonprofit entity, or
group of entities, including universities, and where
applicable their
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schools of Public Health, research institutions, or
children's hospitals, with multi-disciplinary expertise
including pediatric quality of care and outcomes research and
primary care research; or
(B) subsection (a)(2), be a public or nonprofit institution
that represents children's hospitals, pediatric departments
of academic health centers, physician practices, or managed
care plans; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require, including--
(A) in the case of an application for a grant under
subsection (a)(1), a demonstration that a research center
will conduct 2 or more research projects involving pediatric
quality of care and outcomes research in high priority areas;
or
(B) in the case of an application for a grant under
subsection (a)(2)--
(i) a demonstration that the applicant and its network will
conduct 2 or more projects involving pediatric quality of
care and outcomes research in high priority areas;
(ii) a demonstration of an effective and cost-efficient
data collection infrastructure;
(iii) a demonstration of matching funds equal to the amount
of the grant; and
(iv) a plan for sustaining the financing of the operation
of a provider-based network after the expiration of the 5-
year term of the grant.
(c) Limitations.--A grant awarded under subsection (a)(1)
shall not exceed $1,000,000 per year and be for a term of
more that 5 years and a grant awarded under subsection (a)(2)
shall not exceed $750,000 per year and be for a term of more
than 5 years.
(d) Authorization of Appropriations.--There are authorized
to be appropriated--
(1) to carry out subsection (a)(1), $10,000,000 for each of
the fiscal years 1999 through 2003; and
(2) to carry out subsection (a)(2), $3,750,000 for each of
the fiscal years 1999 through 2003.
SEC. 6. RESEARCH IN SPECIFIC HIGH PRIORITY AREAS.
(a) Additional Funds for Grants.--From amounts appropriated
under subsection (c), the Secretary shall provide support,
through grant programs authorized on the date of enactment of
this Act, to entities determined to have expertise in
pediatric quality of care and outcomes research. Such
additional funds shall be used to improve the quality of
children's health, especially in high priority areas, and
shall be subject to the same conditions and requirements that
apply to funds provided under the existing grant program
through which such additional funds are provided.
(b) Advisory Committee.--
(1) In general.--To evaluate progress made in pediatric
quality of care and outcomes research in high priority areas,
and to identify new high priority areas, the Secretary shall
establish an advisory committee which shall report annually
to the Secretary.
(2) Membership.--The Secretary shall ensure that the
advisory committee established under paragraph (1) includes
individuals who are--
(A) health care consumers;
(B) health care providers;
(C) purchasers of health care;
(D) representative of health plans involved in children's
health care services; and
(E) representatives of Federal agencies including--
(i) the Agency for Health Care Policy and Research;
(ii) the Centers for Disease Control and Prevention;
(iii) the Health Care Financing Administration;
(iv) the Maternal and Child Health Bureau;
(v) the National Institutes of Health; and
(vi) the Substance Abuse and Mental Health Services
Administration.
(3) Evaluation of research.--The advisory committee
established under paragraph (1) shall evaluate research in
high priority areas using criteria that include--
(1) the generation of research that includes both short and
long term studies;
(2) the ability to foster public and private partnerships;
and
(3) the likelihood that findings will be transmitted
rapidly into practice.
(c) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $12,000,000 for
each of the fiscal years 1999 through 2003.
SEC. 7. IMPROVING CHILD HEALTH DATA AND DEVELOPING BETTER
DATA COLLECTION SYSTEMS.
(a) Survey.--The Secretary shall provide assistance to
enable the appropriate Federal agencies to--
(1) conduct ongoing biennial supplements and initiate and
maintain a longitudinal study on children's health that is
linked to the appropriate existing national surveys
(including the National Health Interview Survey and the
Medical Expenditure Panel Survey) to--
(A) provide for reliable national estimates of health care
expenditures, cost, use, access, and satisfaction for
children, including uninsured children, poor and near-poor
children, and children with special health care needs;
(B) enhance the understanding of the determinants of health
outcomes and functional status among children with special
health care needs, as well as an understanding of these
changes over time and their relationship to health care
access and use; and
(C) monitor the overall national impact of Federal and
State policy changes on children's health care; and
(2) develop an ongoing 50-State survey to generate reliable
State estimates of health care expenditures, cost, use,
access, satisfaction, and quality for children, including
uninsured children, poor and near-poor children, and children
with special health care needs.
(b) Grants.--The Secretary shall award grants to public and
nonprofit entities to enable such entities to develop the
capacity of local communities to improve child health
monitoring at the community level.
(c) Eligibility.--To be eligible to receive a grant under
subsection (b), an entity shall--
(1) be a public or nonprofit entity; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $14,000,000 for
each of the fiscal years 1999 through 2003, of which--
(1) $6,000,000 shall be made available in each fiscal year
for grants under subsection (a)(1);
(2) $4,000,000 shall be made available in each fiscal year
for grants under subsection (a)(2);
(3) $4,000,000 shall be made available in each fiscal year
for grants under subsection (b).
SEC. 8. OVERSIGHT.
Not later than ________ after the date of enactment of this
Act, The Secretary shall prepare and submit a report to
Congress on progress made in pediatric quality of care and
outcomes research, including the extent of ongoing research,
programs, and technical needs, and the Department of Health
and Human Services' priorities for funding pediatric quality
of care and outcomes research.
______
By Ms. COLLINS:
S. 1867. A bill to amend chapter 35 of title 44, United States Code,
for the purpose of facilitating compliance by small businesses with
certain Federal paperwork requirements, and to establish a task force
to examine the feasibility of streamlining paperwork requirements
applicable to small businesses; to the Committee on Governmental
Affairs.
the small business paperwork reduction act
Ms. COLLINS. Mr. President, today I am introducing the Small Business
Paperwork Reduction Act Amendments of 1998, a companion bill to
legislation pending in the House of Representatives.
This legislation has five components. First, it requires the Office
of Management and Budget to publish annually in the Federal Register
and on the Internet all of the Federal paperwork requirements imposed
on small business. This will not only serve as a valuable tool for
those who must comply with these mandates, but it will also make it far
easier for policy makers to monitor, and I would hope check, the growth
in the paperwork burden.
Second, under the bill, each agency will have to establish one point
of contact to act as a liaison with small businesses on paperwork
requirements. In an era when serving the customer has become recognized
by the private sector as critical, this is a modest step to ask of our
government.
Third, the legislation provides for the suspension of civil fines
imposed on small enterprises for first-time paperwork violations,
except under certain circumstances, such as when the violation causes
serious harm to the public or presents an imminent danger to the public
health or safety. In dealing with America's entrepreneurs, we need to
move away from a culture that seems to place a higher priority on
imposing punishment than on facilitating compliance.
Fourth, in addition to meeting the mandates of the Paperwork
Reduction Act, agencies will have to make further efforts to reduce the
burden on enterprises with fewer than 25 employees. There must be some
measure of proportionality between the size of a business and its costs
of complying with government regulation.
Fifth, a task force will be established to examine the feasibility of
requiring agencies to consolidate their paperwork mandates in a manner
that will allow small businesses to satisfy those mandates through a
single filing, in a single format, and on the same date. By reducing
the amount of time currently devoted to these tasks, our companies will
have more to spend on the activities for which they were formed.
Mr. President, all too often the relationship between the owners of
small businesses and government is an adversial one. That benefits no
one--not the owners of these enterprises, not the many Americans they
employ, not
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the government they help to support, and not the public at large.
The problem often is not with the goals which underlie our
regulations, but rather in how we seek to achieve those goals. We
should not forget that we are dealing with Americans who make a great
contribution to the prosperity of our nation. In seeking to meet our
regulatory objectives, we should be reaching out to these entrepreneurs
with a helping hand and not a heavy hand. That, Mr. President, is the
purpose of this legislation.
______
By Mr. NICKLES (for himself, Mr. Mack, Mr. Lieberman, Mr.
Kempthorne, Mr. Craig, Mr. Hutchinson, and Mr. DeWine):
S. 1868. A bill to express United States foreign policy with respect
to, and to strengthen United States advocacy on behalf of, individuals
persecuted for their faith worldwide; to authorize United States
actions in response to religious persecution worldwide; to establish an
Ambassador at Large on International Religious Freedom within the
Department of State, a Commission on International Religious Freedom
within the Department of State, a Commission on International Religious
Persecution, and a Special Adviser on International Religious Freedom
within the National Security Council; and for other purposes; to the
Committee on Foreign Relations.
the international religious freedom act of 1998
Mr. NICKLES. Mr. President, today I am prompted to speak by both a
tragic reality, and also what I would think is a promising hope. The
tragic reality is that literally millions of religious believers around
the world live gripped by the incessant, terrifying prospect of
persecution, of being tortured, arrested, imprisoned or even killed for
simply practicing their faith. A promising hope, I believe, might
perhaps be found in the bill that I am introducing today with Senator
Lieberman, Senator Mack, Senator Kempthorne, Senator Craig, Senator
Hutchinson and Senator DeWine. It is called the International Religious
Freedom Act. The International Religious Freedom Act will establish a
process to ensure that on an ongoing basis the United States closely
monitors religious persecution worldwide.
It is wrong for a country to persecute, to prosecute, to imprison,
harass individuals for simply practicing their faith, whether that
faith is Jewish or Christian or Muslim or Hindu. It is absolutely wrong
for them to be persecuted for practicing their faith. This act requires
the U.S. Government to take action against all countries engaging in
religious persecution.
What kind of persecution am I talking about? First, three facts
command attention.
One reliable estimate indicates that more Christian martyrs have
perished in this century than all previous centuries combined. That is
a staggering, staggering statement.
A recent book reports that 200 million Christians around the world
live under daily fear and threat of persecution, including
interrogation, imprisonment, torture and in some cases death.
Finally, over half the world's population lives under regimes which
severely restrict if not prohibit their ability to believe in and
practice the religious faith of their choice and conviction.
Of course, religious persecution goes beyond facts and figures. It
happens to real people in real places. Let me point out just four
compelling examples.
At this very moment one of China's leading house church pastors,
Pastor Peter Xu, is languishing in a Chinese prison under a 3-year term
for the so-called ``crime'' of ``disturbing public order.'' Hundreds,
perhaps thousands of other believers in China currently suffer similar
treatment.
Again, at this very moment, 13 courageous Christians are imprisoned
by the Communist authorities in Laos. What was their ``crime''? Simply
that they organized an ``unauthorized'' Bible study in the privacy of a
home.
In Pakistan, just a few months ago, Pastor Noor Alam was brutally
stabbed to death by anti-Christian assailants. Shortly before that,
they had destroyed Pastor Alam's church building. Meanwhile, Christians
and other religious minorities in Pakistan continue to sufferer under
the notorius ``blasphemy laws.''
Or consider Russia, which, as many of my colleagues will remember,
just last summer passed a draconian law that will effectively shut down
the vast majority of independent churches and other religious
organizations and severly curtail the religious freedom of the Russian
people.
I could go on and on. However, I do want to share just a few
highlights of what we humbly but earnestly hope our bill can do to
begin to address the scourge of religious persecution worldwide.
I should also mention that, in 1996, I was honored to sponsor a
Senate resolution on religious persecution, which passed by unanimous
consent. In that resolution, the Senate made a strong recommendation
``that the President expand and invigorate the United States'
international advocacy on behalf of persecuted Christians, and initiate
a thorough examination of all United States' policies that affect
persecuted Christians.''
What was a mere resolution in 1996, I hope it will become a reality
in 1998. While then we acted with words, I hope that this year we can
act with deeds.
In short, this bill seeks to ensure that the U.S. Government
aggressively monitors religious oppression around the world and takes
decisive action against those regimes engaged in persecution, all the
while maintaining the integrity and credibility of the U.S. foreign
policy system.
The International Religious Freedom Act establishes an ``Ambassador-
at-Large for Religious Liberty'' at the State Department. The
Ambassador will be responsible for representing our Government in
vigorous diplomacy with nations guilty of religious persecution. In
addition, the Ambassador will oversee an annual report on religious
persecution which will specify the details on religious persecution
around the world. This report will name names. And those countries
named will be held accountable.
For any country cited in the report, the Act presents a menu of
diplomatic and economic options, and the President is required to
select from at least one of those actions. Silence or passivity are not
options. At the same time, the Act seeks to provide the President
maximum flexibility entailing the most appropriate, effective response
to that particular situation in a particular country. Furthermore,
because we desire good results to follow our good intentions, the Act
requires a consideration of how the action taken by America will affect
American economic and security interests and, most important, how it
will affect the very people that it purports to help.
The International Religious Freedom Act has other provisions--
improved reporting, improved training for immigration and foreign
service officials, a commission on international religious liberty to
provide more attention and expertise on the issue. I invite all my
colleagues, and certainly those who are deeply concerned about the
plight of persecuted religious believers, to join me in supporting this
bill. Not because it might be popular or expedient or convenient to
support this legislation, but because it is the right thing to do and
because I believe it will make a real difference in protecting the
lives of some of the most vulnerable people in the world, those people
who wish to express their religious beliefs and convictions.
Mr. President, I thank my cosponsors, particularly Senator Lieberman,
also Senator Mack, in addition to Senator Hutchinson and Senator Craig
and Senator Kempthorne, for helping us put this legislation together.
Mr. President, I ask unanimous consent that the text of the bill
printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1868
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the
``International Religious Freedom Act of 1998''.
(b) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings; policy.
Sec. 3. Definitions.
TITLE I--DEPARTMENT OF STATE ACTIVITIES
Sec. 101. Office on International Religious Freedom; Ambassador at
Large for International Religious Freedom.
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Sec. 102. Reports.
Sec. 103. Establishment of a religious freedom Internet site.
Sec. 104. Training for Foreign Service officers.
Sec. 105. High-level contacts with NGOs.
Sec. 106. Programs and allocations of funds by United States missions
abroad.
Sec. 107. Equal access to United States missions abroad for conducting
religious activities.
Sec. 108. Prisoner lists and issue briefs on religious persecution
concerns.
TITLE II--COMMISSION ON INTERNATIONAL RELIGIOUS PERSECUTION
Sec. 201. Establishment and composition.
Sec. 202. Duties of the Commission.
Sec. 203. Report of the Commission.
Sec. 204. Termination.
TITLE III--NATIONAL SECURITY COUNCIL
Sec. 301. Special Adviser on Religious Persecution.
TITLE IV--SANCTIONS
Subtitle I--Targeted Responses to Religious Persecution Abroad
Sec. 401. Executive measures and sanctions in response to findings made
in the Annual Report on Religious Persecution.
Sec. 402. Presidential determinations of gross violations of the right
to religious freedom.
Sec. 403. Consultations.
Sec. 404. Report to Congress.
Sec. 405. Description of Executive measures and sanctions.
Sec. 406. Contract sanctity.
Sec. 407. Presidential waiver.
Sec. 408. Publication in Federal Register.
Sec. 409. Congressional review.
Sec. 410. Termination of sanctions.
Subtitle II--Strengthening Existing Law
Sec. 421. United States assistance.
Sec. 422. Multilateral assistance.
Sec. 423. Exports of items relating to religious persecution.
TITLE V--PROMOTION OF RELIGIOUS FREEDOM
Sec. 501. Assistance for promoting religious freedom.
Sec. 502. International broadcasting.
Sec. 503. International exchanges.
Sec. 504. Foreign Service awards.
TITLE VI--REFUGEE, ASYLUM, AND CONSULAR MATTERS
Sec. 601. Use of Annual Report.
Sec. 602. Reform of refugee policy.
Sec. 603. Reform of asylum policy.
Sec. 604. Inadmissibility of foreign government officials who have
engaged in gross violations of the right to religious
freedom.
TITLE VII--MISCELLANEOUS PROVISIONS
Sec. 701. Business codes of conduct.
Sec. 702. International Criminal Court.
SEC. 2. FINDINGS; POLICY.
(a) Findings.--Congress makes the following findings:
(1) Freedom of religious belief and practice is a
fundamental human right articulated in numerous international
agreements and covenants, including the Universal Declaration
of Human Rights, the International Covenant on Civil and
Political Rights, the Helsinki Accords, the Declaration on
the Elimination of All Forms of Intolerance and
Discrimination Based on Religion or Belief, the United
Nations Charter, and the European Convention for the
Protection of Human Rights and Fundamental Freedoms.
(2) The right to freedom of religion undergirds the very
origin and existence of the United States. Many of our
Nation's founders fled religious persecution abroad,
cherishing in their hearts and minds the ideal of religious
freedom. They established in law, as a fundamental right and
as a pillar of our Nation, the right to freedom of religion.
From its birth to this day, the United States has prized this
legacy of religious freedom and honored this heritage by
standing for religious freedom and offering refuge to those
suffering religious persecution.
(3) Article 18 of the Universal Declaration of Human Rights
recognizes that ``Everyone has the right to freedom of
thought, conscience, and religion. This right includes
freedom to change his religion or belief, and freedom, either
alone or in community with others and in public or private,
to manifest his religion or belief in teaching, practice,
worship, and observance.''. Article 18(1) of the
International Covenant on Civil and Political Rights
recognizes that ``Everyone shall have the right to freedom of
thought, conscience, and religion. This right shall include
freedom to have or to adopt a religion or belief of his
choice, and freedom, either individually or in community with
others and in public or private, to manifest his religion or
belief in worship, observance, practice, and teaching''.
Governments have the responsibility to protect the
fundamental rights of their citizens and to pursue justice
for all. Religious freedom is a fundamental right of every
individual, regardless of race, country, creed, or
nationality, and should never be arbitrarily abridged by any
government.
(4) The right to freedom of religion is under renewed and,
in some cases, increasing assault in many countries around
the world. More than one-half of the world's population lives
under regimes that severely restrict or prohibit the freedom
of their citizens to study, believe, observe, and freely
practice the religious faith of their choice. Religious
believers and communities suffer both government-sponsored
and government-tolerated violations of their rights to
religious freedom. Among the many forms of such violations
are state-sponsored slander campaigns, confiscations of
property, surveillance by security police, including by
special divisions of ``religious police'', severe
prohibitions against construction and repair of places of
worship, denial of the right to assemble and relegation of
religious communities to illegal status through arbitrary
registration laws, prohibitions against the pursuit of
education or public office, and prohibitions against
publishing, distributing, or possessing religious literature
and materials.
(5) Even more abhorrent, religious believers in many
countries face such severe and violent forms of religious
persecution as detention, torture, beatings, forced marriage,
rape, imprisonment, enslavement, mass resettlement, and death
merely for the peaceful belief in, change of or practice of
their faith. In many countries, religious believers are
forced to meet secretly, and religious leaders are targeted
by national security forces and hostile mobs.
(6) Though not confined to a particular region or regime,
religious persecution is often particularly widespread,
systematic, and heinous under totalitarian governments and in
countries with militant, politicized religious majorities.
(7) Congress has recognized and denounced acts of religious
persecution through the adoption of the following
resolutions:
(A) House Resolution 515 (104th), expressing the sense of
the House of Representatives with respect to the persecution
of Christians worldwide.
(B) Senate Concurrent Resolution 71 (104th), expressing the
sense of the Senate regarding persecution of Christians
worldwide.
(C) House Concurrent Resolution 102, concerning the
emancipation of the Iranian Baha'i community.
(b) Policy.--It shall be the policy of the United States,
as follows:
(1) To condemn religious persecution, and to promote, and
to assist other governments in the promotion of, the
fundamental right to religious freedom.
(2) To seek to channel United States security and
development assistance to governments other than those found
to be engaged in gross violations of human rights, including
the right to religious freedom, as set forth in the Foreign
Assistance Act of 1961, in the International Financial
Institutions Act of 1977, and in other formulations of United
States human rights policy.
(3) To be vigorous and flexible, reflecting both the
unwavering commitment of the United States to religious
freedom and the desire of the United States for the most
effective and principled response, in light of the range of
violations of religious freedom by a variety of persecuting
regimes, and the status of the relations of the United States
with different nations.
(4) To work with foreign governments that affirm and
protect religious freedom, in order to develop multilateral
documents and initiatives to combat religious persecution and
promote the right to religious freedom abroad.
(5) Standing for liberty and standing with the persecuted,
to use and implement appropriate tools in the United States
foreign policy apparatus, including diplomatic, political,
commercial, charitable, educational, and cultural channels,
to promote respect for religious freedom by all governments
and peoples.
SEC. 3. DEFINITIONS.
In this Act:
(1) Ambassador at large.--The term ``Ambassador at Large''
means the Ambassador at Large on International Religious
Freedom appointed under section 101(b).
(2) Annual report on religious persecution.--The term
``Annual Report on Religious Persecution'' means the report
described in section 102(b).
(3) Appropriate congressional committees.--The term
``appropriate congressional committees'' means the Committee
on Foreign Relations of the Senate and the Committee on
International Relations of the House of Representatives and,
in the case of any determination made with respect to the
imposition of a sanction under paragraphs (9) through (16) of
section 405, the term ``appropriate congressional
committees'' includes those committees, together with the
Committee on Ways and Means and the Committee on Banking and
Financial Services of the House of Representatives and the
Committee on Finance of the Senate.
(4) Commission.--The term ``Commission'' means the United
States Commission on International Religious Persecution
established in section 201(a).
(5) Government or foreign government.--The term
``government'' or ``foreign government'' includes any agency
or instrumentality of the government.
(6) Gross violations of the right to freedom of religion.--
The term ``gross violations of the right to freedom of
religion'' means a consistent pattern of gross violations of
the right to freedom of religion that include torture or
cruel, inhuman, or degrading treatment or punishment,
prolonged detention without charges, causing the
disappearance of persons by the abduction or clandestine
detention of those persons, or other flagrant denial of the
right to life, liberty, or the security of persons, within
the meaning of section 116(a) of the Foreign Assistance Act
of 1961 (22 U.S.C. 2151n(a)).
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(7) Human rights reports.--The term ``Human Rights
Reports'' means the reports submitted by the Department of
State to Congress under sections 116 and 502B of the Foreign
Assistance Act of 1961.
(8) Office.--The term ``Office'' means the Office on
International Religious Freedom established in section
101(a).
(9) Religious persecution.--The term ``religious
persecution'' means any violation of the internationally
recognized right to freedom of religion, as defined in
Article 18 of the Universal Declaration of Human Rights and
Article 18 of the International Covenant on Civil and
Political Rights, including violations such as--
(A) arbitrary prohibitions on, restrictions of, or
punishment for--
(i) assembling for peaceful religious activities such as
worship, preaching, and prayer, including arbitrary
registration requirements,
(ii) speaking freely about one's religious beliefs,
(iii) changing one's religious beliefs and affiliation,
(iv) possession and distribution of religious literature,
including Bibles, or
(v) raising one's children in the religious teachings and
practices of one's choice,
as well as arbitrary prohibitions or restrictions on the
grounds of religion on holding public office, or pursuing
educational or professional opportunities; and
(B) any of the following acts if committed on account of an
individual's religious belief or practice: detention,
interrogation, harassment, imposition of an onerous financial
penalty, forced labor, forced mass resettlement,
imprisonment, beating, torture, mutilation, rape,
enslavement, murder, and execution.
(10) Special adviser.--The term ``Special Adviser'' means
the Special Adviser to the President on Religious Persecution
established in section 101(i) of the National Security Act of
1947, as added by section 301 of this Act.
TITLE I--DEPARTMENT OF STATE ACTIVITIES
SEC. 101. OFFICE ON INTERNATIONAL RELIGIOUS FREEDOM;
AMBASSADOR AT LARGE FOR INTERNATIONAL RELIGIOUS
FREEDOM.
(a) Establishment of Office.--There is established within
the Department of State an Office on International Religious
Freedom that shall be headed by the Ambassador at Large on
International Religious Freedom appointed under subsection
(b).
(b) Appointment.--The Ambassador at Large shall be
appointed by the President, by and with the advice and
consent of the Senate.
(c) Duties.--The Ambassador at Large shall have the
following responsibilities:
(1) In general.--The primary responsibility of the
Ambassador at Large shall be to advance the right to freedom
of religion abroad, to denounce the violation of that right,
and to recommend appropriate responses by the United States
Government when this right is violated.
(2) Advisory role.--The Ambassador at Large shall be the
principal adviser to the President and the Secretary of State
regarding matters affecting religious freedom abroad and,
with advice from the Commission on International Religious
Persecution, shall make recommendations regarding the
policies of the United States Government toward governments
that violate the freedom of religion or that fail to ensure
the individual's right to religious belief and practice.
(3) Diplomatic representation.--The Ambassador at Large is
authorized to represent the United States in matters and
cases relevant to religious persecution in--
(A) contacts with foreign governments, international
organizations, intergovernmental organizations, and
specialized agencies of the United Nations, the Organization
on Security and Cooperation in Europe, and other
organizations of which the United States is a member; and
(B) multilateral conferences and meetings relevant to
religious persecution.
(4) Reporting responsibilities.--The Ambassador at Large
shall have the reporting responsibilities described in
section 102.
(d) Funding.--The Secretary of State shall provide the
Ambassador at Large with such funds as may be necessary for
the hiring of staff for the Office, for the conduct of
investigations by the Office, and for necessary travel to
carry out the provisions of this section.
SEC. 102. REPORTS.
(a) Portions of Annual Human Rights Reports.--The
Ambassador at Large shall assist the Secretary of State in
preparing those portions of the Human Rights Reports that
relate to freedom of religion and discrimination based on
religion and those portions of other information provided
Congress under sections 116 and 502B of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151m, 2304) that relate to
the right to religious freedom.
(b) Annual Report on Religious Persecution.--
(1) In general.--
(A) Deadline for submission.--Not later than May 1 of each
year, the Ambassador at Large shall submit to the appropriate
congressional committees an Annual Report on Religious
Persecution, expanding upon the most recent Human Rights
Reports. Each Annual Report on Religious Persecution shall
contain the following:
(i) An identification of each foreign country the
government of which engages in or tolerates acts of religious
persecution.
(ii) An assessment and description of the nature and extent
of religious persecution, including persecution of one
religious group by another religious group, religious
persecution by governmental and nongovernmental entities,
persecution targeted at individuals or particular
denominations or entire religions, and the existence of
government policies violating religious freedom.
(iii) A description of United States policies in support of
religious freedom, including a description of the measures
and policies implemented during the preceding 12 months by
the United States under title IV of this Act in opposition to
religious persecution and in support of religious freedom.
(iv) A description of any binding agreement with a foreign
government entered into by the United States under section
402(c).
(B) Classified addendum.--If the Ambassador determines that
it is in the national security interests of the United States
or is necessary for the safety of individuals to be
identified in the Annual Report, any information required by
subparagraph (A), including measures taken by the United
States, may be summarized in the Annual Report and submitted
in more detail in a classified addendum to the Annual Report.
(C) Designation of report.--Each report submitted under
this subsection may be referred to as the ``Annual Report on
Religious Persecution''.
(2) Foreign government input.--Prior to submission of each
report under this subsection, the Secretary of State may
offer the government of any country concerned an opportunity
to respond to the relevant portions of the report. If the
Secretary of State determines that doing so would further the
purposes of this Act, the Secretary shall request the
Ambassador at Large to include the country's response as an
addendum to the Annual Report on Religious Persecution.
(c) Preparation of Reports Regarding Religious
Persecution.--
(1) Standards and investigations.--The Secretary of State
shall ensure that United States missions abroad maintain a
consistent reporting standard and thoroughly investigate
reports of religious persecution.
(2) Contacts with ngos.--In compiling data and assessing
the respect of the right to religious freedom for the Human
Rights Reports and the Annual Report on Religious
Persecution, United States mission personnel shall seek out
and maintain contacts with religious and human rights
nongovernmental organizations, with the consent of those
organizations, including receiving reports and updates from
such organizations and, when appropriate, investigating such
reports.
(d) Amendments to the Foreign Assistance Act.--
(1) Content of human rights reports for countries receiving
economic assistance.--Section 116(d) of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151n(d)) is amended--
(A) by striking ``and'' at the end of paragraph (4);
(B) by striking the period at the end of paragraph (5) and
inserting``; and ''; and
(C) by adding at the end the following:
``(6) wherever applicable, the practice of religious
persecution, including gross violations of the right to
religious freedom.''.
(2) Contents of human rights reports for countries
receiving security assistance.--Section 502B(b) of the
Foreign Assistance Act of 1961 (22 U.S.C. 2304(b)) is
amended--
(A) by inserting ``and with the assistance of the
Ambassador at Large for Religious Freedom'' after ``Labor'';
and
(B) by inserting after the second sentence the following
new sentence: ``Such report shall also include, wherever
applicable, information on religious persecution, including
gross violations of the right to religious freedom.''.
SEC. 103. ESTABLISHMENT OF A RELIGIOUS FREEDOM INTERNET SITE.
In order to facilitate access by nongovernmental
organizations (NGOs) and by the public around the world to
international documents on the protection of religious
freedom, the Ambassador at Large shall establish and maintain
an Internet site containing major international documents
relating to religious freedom, the Annual Report on Religious
Persecution, and any other documentation or references to
other sites as deemed appropriate or relevant by the
Ambassador at Large.
SEC. 104. TRAINING FOR FOREIGN SERVICE OFFICERS.
Chapter 2 of title I of the Foreign Service Act of 1980 is
amended by adding at the end the following new section:
``SEC. 708. TRAINING FOR FOREIGN SERVICE OFFICERS.
``The Secretary of State and the Ambassador at Large on
International Religious Freedom, appointed under section
101(b) of the International Religious Freedom Act of 1998,
acting jointly, shall establish as part of the standard
training for
Major Actions:
All articles in Senate section
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
(Senate - March 26, 1998)
Text of this article available as:
TXT
PDF
[Pages
S2660-S2683]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Ms. MIKULSKI (for herself, Mrs. Murray and Mr. Wyden):
S. 1864. A bill to amend title XVIII of the Social Security Act to
exclude clinical social worker services from coverage under the
Medicare skilled nursing facility prospective payment system; to the
Committee on Finance.
THE MEDICARE SOCIAL WORK EQUITY ACT OF 1998
Ms. MIKULSKI. Mr. President, I rise today to introduce the ``Medicare
Social Work Equity Act of 1998''. I am proud to sponsor this
legislation which will amend section 4432 in the Balanced Budget Act of
1997 which prevents social workers from directly billing Medicare for
mental health services provided in skilled nursing facilities. I am
honored to be joined by my good friends Senator Murray and Senator
Wyden who care equally about correcting this inequity for social
workers.
Last year's Balanced Budget Act changed the payment method for
skilled nursing facility care. Under current law, reimbursement is made
after services have been delivered for the reasonable costs incurred.
However, this ``cost-based system'' was blamed for inordinate growth in
Medicare spending at skilled nursing facilities.
The Balanced Budget Act of 1997 phases in a prospective payment
system for skilled nursing facilities beginning July 1, 1998. Payments
for Part B services for skilled nursing facility residents will be
consolidated. This means that the provider of the services must bill
the facility instead of directly billing Medicare.
Congress was careful to not include psychologists and psychiatrists
in this new consolidated billing provision. Social workers were
included, I think by mistake. Clinical social workers are the primary
providers of mental health services to residents of nursing homes,
particularly in underserved urban and rural areas. Clinical social
workers are also the most cost effective mental health providers.
This legislation is important for three reasons: First, I am
concerned that section 4432 will inadvertently reduce mental health
services to nursing home residents. Second, I believe that the new
consolidated billing requirement will result in a shift from using
social workers to other mental health professionals who are reimbursed
at a higher cost. This will result in higher costs to Medicare.
Finally, I am concerned that clinical social workers will lose their
jobs in nursing homes or will be inadequately reimbursed.
I like this bill because it will correct an inequity for America's
social workers, it will assure quality of care for nursing home
residents, and will assure cost efficiency for Medicare. I look forward
to the Senate's support of this worthy legislation.
______
By Mr. BAUCUS:
S. 1865. A bill to amend title IV of the Social Security Act to
provide safeguards against the abuse of information reported to the
National Directory of New Hires; to the Committee on Finance.
[[Page
S2661]]
the safeguard of new employee information act of 1998
Mr. BAUCUS. Mr. President, today I am introducing the Safeguard of
New Employee Information Act of 1998. This bill will ensure that the
mechanisms created in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (PRWORA) to enhance our child support
enforcement system will not lead to a misuse of personal information. I
believe that my bill will assure that new employee information is kept
confidential without compromising the usefulness of the National
Directory of New Hires. The legislation provides clear safeguards
against the abuse of personal employee information, and makes sure that
the information is erased two years after entry.
As we all know, child support is a critical part of welfare reform. I
strongly support the measures in PRWORA that help states track and
crack down on parents who fail to pay court-ordered child support. In
response to the fact that over 30 percent of child support cases
involve parents who do not live in the same state as their children, a
National Directory of New Hires was created to assist states in
locating parents who reside in other states.
Thus far, the new data base has been very successful in enabling
states to locate delinquent parents, enforcing payment orders and
reducing the number of welfare families. However, many folks are
concerned about the confidentiality of the registry, and the fact that
this information is never deleted.
Last year, for example, the Montana State Legislature passed a child
support bill to comply with the new federal regulations. I must add,
this bill was passed in the final hours of the legislative session and
under the threat of losing $52 million a year in federal funds. At that
time, the legislature was hesitant to pass the bill because of concerns
regarding confidentiality.
Mr. President, the Safeguard of New Employee Information Act of 1998
makes needed changes to the National Directory to alleviate these fears
and ensure the registry's continuation. The bill provides penalties for
misuse of information by federal employees. Specifically, it
establishes a fine of $1,000 for each act of unauthorized access to,
disclosure, or use of information in the National Directory of New
Hires.
The bill also establishes a 24-month limit on retention of New Hire
data. This two year limit gives Child Support Enforcement agencies the
necessary time to determine paternity, establish a child support order
or enforce existing orders. A shorter period of data retention would
impede enforcement activities, and a longer period of retention
increases the potential for abuse.
Mr. President, in my state of Montana, 90 percent of families on
welfare are headed by single parents. That is why it is so important to
require that the absent mothers or fathers provide money to feed,
clothe and care for their children. The National Directory of New Hires
is a good idea--we just need to ensure new employee confidentiality. I
urge my colleagues to protect new hire confidentiality and support this
important legislation.
______
By Mr. DeWINE:
S. 1866. A bill to provide assistance to improve research regarding
the quality and effectiveness of health care for children, to improve
data collection regarding children's health, and to improve the
effectiveness of health care delivery systems for children; to the
Committee on Labor and Human Resources.
the child health care quality research improvement act
Mr. DeWINE. Mr. President, I rise today to introduce the Child Health
Care Quality Research Improvement Act. We have been hearing a great
deal recently about the quality of health care in this country. Most of
the debate, both here in Congress and back home in our States, has been
driven, at least in part, by a fear among consumers that efforts to
control costs and move people into managed care has compromised
quality. This fear has driven legislation such as the bill we passed
just last year to provide for 48-hour maternity stays. This year a
whole host of health care quality bills have been introduced in the
Congress. Even more such legislation has been moving forward at the
State level as well.
As I have learned more and more about the concerns about the quality
of health care, I have tried to focus particular attention on children,
how their health care is delivered and whether its quality has been
compromised. Frankly, I have learned something that I find very
interesting.
While the drive to improve quality and reduce cost has driven a great
deal of new research over the past several years, relatively little has
been done for children in this area. While we are getting better at
measuring quality of health care for adults, we have made little such
progress for our children.
Between 1993 and 1995, only some 5 percent of the health services
research study outcomes focused on our children. This is highly
alarming because I frankly cannot think of anything more critical to
our Nation's future than the quality of our children's health. Clearly
we need to correct this serious lack of good health care quality
measures.
I have spoken with experts in the field of pediatric research and
they agree with this assessment. They tell me that we have to do more
in this field if we expect to improve the care that our children
receive. Many times, frankly, we don't know exactly which treatments
are cost effective or best improve a child's quality of life. We don't
know how to manage children's complicated health problems in ways that
will allow them to lead normal lives
We can answer many of these questions if the patient is an adult, but
we have far fewer answers for our children. Here is one example. One
study recently found that children have three times greater chance of
dying after heart surgery at some hospitals than they have at other
hospitals--three times. We must fix this. That means we have to find
out why, why one hospital loses three times as many children as
another. As both a parent and a grandparent, I can speak from firsthand
experience about the stress and the uncertainty that goes along with
any childhood illness. To think that a parent's choice of a hospital
could actually be harmful to a child is certainly a very scary thought
for a parent.
Another example is asthma. Asthma is the most common chronic health
condition in children, affecting 5 million children in this country,
and that percentage, tragically, is rising. We are not sure why this
has been happening, but we do know that the quality of health care a
child receives can dramatically affect the severity of his or her
asthma. As a result, the better the quality of health care, the less
time that child spends in the hospital, the fewer visits to the
emergency room, and the less time a child has to miss from school. If
we do not even know what kinds of treatment work best for children or
that different treatments work better in different environments, we
cannot help. We certainly can't begin to debate how to improve quality
if we can't even define it or measure it. For that, we need to conduct
research in real world settings.
As a means of getting this research into real world settings and
improving the quality of health care that our children receive, I am
introducing a bill today entitled the Child Health Care Quality
Research Improvement Act. This legislation was developed with the help
of leaders in the pediatric community, child advocates, and health
services researchers. My bill takes a three-pronged approach to address
this issue: One, focusing on training; two, research; and three, data
collection for child health outcomes and effectiveness research.
Let me start with the first one.
In order for us to make advances in the study of pediatric health
outcomes, it is essential that we have researchers who have received
training in this field. This bill I am introducing today promotes
research training programs in child health services research at the
doctoral, post-doctoral, and junior faculty levels. By bringing
professionals into this very important field, we can ensure that issues
that affect the lives of children are receiving the attention they
deserve.
The second component of this bill establishes research centers and
networks. The goal of the centers and networks will be to foster
collaboration among experts in the field of pediatric health care
quality and effectiveness.
[[Page
S2662]]
We envision that these centers and networks will bring together
pediatric specialists from children's hospitals, physicians in managed
care plans, statisticians from schools of public health, and other
experts in the field to work together on research projects and to
translate these findings into real-world settings where children are
receiving health care.
Third, and finally, this legislation contains a component that adds
supplements to existing national health surveys that are today
administered by the National Center for Health Statistics and the
Maternal and Child Health Bureau. In addition to not knowing how to
measure health care quality in children, other data, like that
measuring children's use of health care systems and health care
expenditures, are lacking. Adding supplements to existing surveys is a
very sensible measure. This bill does not require yet another survey to
be administered. Rather, it simply adds questions to existing surveys,
to allow us to collect valuable data on children. This is the type of
information that we need if we want to look at trends in children's
health and what we can do to improve their health.
Mr. President, we are all well aware that children have medical
conditions and health care needs that are different from those of
adults. It doesn't make sense to do health services research for adults
and hope that one size fits all--that the things we learn will make
sense for children. Federal support for child health quality and
effectiveness research is vital to ensure that children are receiving
appropriate health care. We owe it to our Nation's children to train
health professionals in this important filed, and to support these very
important research initiatives.
Mr. President, I ask unanimous consent that the bill be printed in
the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1866
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 ``Child Health Care Quality
Research Improvement Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) There is increased emphasis on using evidence of
improved health care outcomes and cost effectiveness to
justify changes in our health care system.
(2) There is a growing movement to use health care quality
measures to ensure that health care services provided are
appropriate and likely to improve health.
(3) Few health care quality measures exist for children,
especially for the treatment of acute and chronic conditions.
(4) A significant number of children in the United States
have health problems, and the percentage of children with
special health care needs is increasing.
(5) Children in the health care marketplace have unique
health attributes, including a child's developmental
vulnerability, differential morbidity, and dependency on
adults, families, and communities.
(6) Children account for less than 15 percent of the
national health care spending, and do not command a large
amount of influence in the health care marketplace.
(7) The Federal government is the major payer of children's
health care in the United States.
(8) Numerous scientifically sound measures exist for
assessing quality of health care for adults, and similar
measures should be developed for assessing the quality of
health care for children.
(9) The delivery structures and systems that provide care
for children are necessarily different than systems caring
for adults, and therefore require appropriate types of
quality measurements and improvement systems.
(10) Improving quality measurement and monitoring will--
(A) assist health care providers in identifying ways to
improve health outcomes for common and rare childhood health
conditions;
(B) assist consumers and purchasers of health care in
determining the value of the health care products and
services they are receiving or buying; and
(C) assist providers in selecting effective treatments and
priorities for service delivery.
(11) Because of the prevalence and patterns of children's
medical conditions, research on improving care for relatively
rare or specific conditions must be conducted across multiple
institutions and practice settings in order to guarantee the
validity and generalizability of research results.
SEC. 3. DEFINITIONS.
In this Act:
(1) High priority areas.--the term ``high priority areas''
means areas of research that are of compelling scientific or
public policy significance, that include high priority areas
of research identified by the Conference on Improving Quality
of Health Care for Children: An Agenda for Research (May,
1997), and that--
(A) are consistent with areas of research as defined in
paragraphs (1)(A) and (2) of section 1142(a) of the Social
Security Act;
(B) are relevant to all children or to specific subgroups
of children; or
(C) are consistent with such other criteria as the
Secretary may require.
(2) Local community.--The term ``local community'' means
city, county, and regional governments, and research
institutes in conjunction with such cities, counties, or
regional governments.
(3) Pediatric quality of care and outcomes research.--The
term ``pediatric quality of care and outcomes research''
means research involving the process of health care delivery
and the outcomes of that delivery in order to improve the
care available for children, including health promotion and
disease prevention, diagnosis, treatment, and rehabilitation
services, including research to--
(A) develop and use better measures of health and
functional status in order to determine more precisely
baseline health status and health outcomes;
(B) evaluate the results of the health care process in
real-life settings, including variations in medical practices
and patterns, as well as functional status, clinical status,
and patient satisfaction;
(C) develop quality improvement tools and evaluate their
implementation in order to establish benchmarks for care for
specific childhood diseases, conditions, impairments, or
populations groups;
(D) develop specific measures of the quality of care to
determine whether a specific health service has been provided
in a technically appropriate and effective manner, that is
responsive to the clinical needs of the patient, and that is
evaluated in terms of the clinical and functional status of
the patient as well as the patient's satisfaction with the
care; or
(E) assess policies, procedures, and methods that can be
used to improve the process and outcomes of the delivery of
care.
(4) Provider-based research networks.--The term ``provider-
based research network'' refers to 1 of the following which
exist for the purpose of conducting research:
(A) A hospital-based research network that is comprised of
a sufficient number of children's hospitals or pediatric
departments of academic health centers.
(B) A physician practice-based research network that is
comprised of a sufficient number of groups of physicians
practices.
(C) A managed care-based research network that is comprised
of a sufficient number of pediatric programs of State-
licensed health maintenance organizations or other State
certified managed care plans.
(D) A combination provider-based research network that is
comprised of all or part of a hospital-based research
network, a physician practice-based research network, and a
managed care-based research network.
(5) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
SEC. 4. EXPANSION OF THE HEALTH SERVICES RESEARCH WORKFORCE.
(a) Grants.--The Secretary shall annually award not less
than 10 grants to eligible entities at geographically diverse
locations throughout the United States to enable such
entities to carry out research training programs that are
dedicated to child health services research training
initiatives at the doctoral, post-doctoral, and junior
faculty levels.
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) be a public or nonprofit private entity; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
(c) Limitation.--A grant awarded under this section shall
be for an amount that does not exceed $500,000.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $5,000,000 for
each of the fiscal years 1999 through 2003.
SEC. 5. DEVELOPMENT OF CHILD HEALTH IMPROVEMENT RESEARCH
CENTERS AND PROVIDER-BASED RESEARCH NETWORKS.
(a) Grants.--In order to address the full continuum of
pediatric quality of care and outcomes research, to link
research to practice improvement, and to speed the
dissemination of research findings to community practice
settings, the Secretary shall award grants to eligible
entities for the establishment of--
(1) not less that 10 national centers for excellence in
child health improvement research at geographically diverse
locations throughout the United States; and
(2) not less than 5 national child health provider quality
improvement research networks at geographically diverse
locations throughout the United States, including at least 1
of each type of network as described in section 3(4).
(b) Eligibility.--To be eligible to receive a grant under
subsection (a), an entity shall--
(1) for purposes of--
(A) subsection (a)(1), be a public or nonprofit entity, or
group of entities, including universities, and where
applicable their
[[Page
S2663]]
schools of Public Health, research institutions, or
children's hospitals, with multi-disciplinary expertise
including pediatric quality of care and outcomes research and
primary care research; or
(B) subsection (a)(2), be a public or nonprofit institution
that represents children's hospitals, pediatric departments
of academic health centers, physician practices, or managed
care plans; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require, including--
(A) in the case of an application for a grant under
subsection (a)(1), a demonstration that a research center
will conduct 2 or more research projects involving pediatric
quality of care and outcomes research in high priority areas;
or
(B) in the case of an application for a grant under
subsection (a)(2)--
(i) a demonstration that the applicant and its network will
conduct 2 or more projects involving pediatric quality of
care and outcomes research in high priority areas;
(ii) a demonstration of an effective and cost-efficient
data collection infrastructure;
(iii) a demonstration of matching funds equal to the amount
of the grant; and
(iv) a plan for sustaining the financing of the operation
of a provider-based network after the expiration of the 5-
year term of the grant.
(c) Limitations.--A grant awarded under subsection (a)(1)
shall not exceed $1,000,000 per year and be for a term of
more that 5 years and a grant awarded under subsection (a)(2)
shall not exceed $750,000 per year and be for a term of more
than 5 years.
(d) Authorization of Appropriations.--There are authorized
to be appropriated--
(1) to carry out subsection (a)(1), $10,000,000 for each of
the fiscal years 1999 through 2003; and
(2) to carry out subsection (a)(2), $3,750,000 for each of
the fiscal years 1999 through 2003.
SEC. 6. RESEARCH IN SPECIFIC HIGH PRIORITY AREAS.
(a) Additional Funds for Grants.--From amounts appropriated
under subsection (c), the Secretary shall provide support,
through grant programs authorized on the date of enactment of
this Act, to entities determined to have expertise in
pediatric quality of care and outcomes research. Such
additional funds shall be used to improve the quality of
children's health, especially in high priority areas, and
shall be subject to the same conditions and requirements that
apply to funds provided under the existing grant program
through which such additional funds are provided.
(b) Advisory Committee.--
(1) In general.--To evaluate progress made in pediatric
quality of care and outcomes research in high priority areas,
and to identify new high priority areas, the Secretary shall
establish an advisory committee which shall report annually
to the Secretary.
(2) Membership.--The Secretary shall ensure that the
advisory committee established under paragraph (1) includes
individuals who are--
(A) health care consumers;
(B) health care providers;
(C) purchasers of health care;
(D) representative of health plans involved in children's
health care services; and
(E) representatives of Federal agencies including--
(i) the Agency for Health Care Policy and Research;
(ii) the Centers for Disease Control and Prevention;
(iii) the Health Care Financing Administration;
(iv) the Maternal and Child Health Bureau;
(v) the National Institutes of Health; and
(vi) the Substance Abuse and Mental Health Services
Administration.
(3) Evaluation of research.--The advisory committee
established under paragraph (1) shall evaluate research in
high priority areas using criteria that include--
(1) the generation of research that includes both short and
long term studies;
(2) the ability to foster public and private partnerships;
and
(3) the likelihood that findings will be transmitted
rapidly into practice.
(c) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $12,000,000 for
each of the fiscal years 1999 through 2003.
SEC. 7. IMPROVING CHILD HEALTH DATA AND DEVELOPING BETTER
DATA COLLECTION SYSTEMS.
(a) Survey.--The Secretary shall provide assistance to
enable the appropriate Federal agencies to--
(1) conduct ongoing biennial supplements and initiate and
maintain a longitudinal study on children's health that is
linked to the appropriate existing national surveys
(including the National Health Interview Survey and the
Medical Expenditure Panel Survey) to--
(A) provide for reliable national estimates of health care
expenditures, cost, use, access, and satisfaction for
children, including uninsured children, poor and near-poor
children, and children with special health care needs;
(B) enhance the understanding of the determinants of health
outcomes and functional status among children with special
health care needs, as well as an understanding of these
changes over time and their relationship to health care
access and use; and
(C) monitor the overall national impact of Federal and
State policy changes on children's health care; and
(2) develop an ongoing 50-State survey to generate reliable
State estimates of health care expenditures, cost, use,
access, satisfaction, and quality for children, including
uninsured children, poor and near-poor children, and children
with special health care needs.
(b) Grants.--The Secretary shall award grants to public and
nonprofit entities to enable such entities to develop the
capacity of local communities to improve child health
monitoring at the community level.
(c) Eligibility.--To be eligible to receive a grant under
subsection (b), an entity shall--
(1) be a public or nonprofit entity; and
(2) prepare and submit to the Secretary an application, at
such time, in such manner, and containing such information as
the Secretary may require.
(d) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section, $14,000,000 for
each of the fiscal years 1999 through 2003, of which--
(1) $6,000,000 shall be made available in each fiscal year
for grants under subsection (a)(1);
(2) $4,000,000 shall be made available in each fiscal year
for grants under subsection (a)(2);
(3) $4,000,000 shall be made available in each fiscal year
for grants under subsection (b).
SEC. 8. OVERSIGHT.
Not later than ________ after the date of enactment of this
Act, The Secretary shall prepare and submit a report to
Congress on progress made in pediatric quality of care and
outcomes research, including the extent of ongoing research,
programs, and technical needs, and the Department of Health
and Human Services' priorities for funding pediatric quality
of care and outcomes research.
______
By Ms. COLLINS:
S. 1867. A bill to amend chapter 35 of title 44, United States Code,
for the purpose of facilitating compliance by small businesses with
certain Federal paperwork requirements, and to establish a task force
to examine the feasibility of streamlining paperwork requirements
applicable to small businesses; to the Committee on Governmental
Affairs.
the small business paperwork reduction act
Ms. COLLINS. Mr. President, today I am introducing the Small Business
Paperwork Reduction Act Amendments of 1998, a companion bill to
legislation pending in the House of Representatives.
This legislation has five components. First, it requires the Office
of Management and Budget to publish annually in the Federal Register
and on the Internet all of the Federal paperwork requirements imposed
on small business. This will not only serve as a valuable tool for
those who must comply with these mandates, but it will also make it far
easier for policy makers to monitor, and I would hope check, the growth
in the paperwork burden.
Second, under the bill, each agency will have to establish one point
of contact to act as a liaison with small businesses on paperwork
requirements. In an era when serving the customer has become recognized
by the private sector as critical, this is a modest step to ask of our
government.
Third, the legislation provides for the suspension of civil fines
imposed on small enterprises for first-time paperwork violations,
except under certain circumstances, such as when the violation causes
serious harm to the public or presents an imminent danger to the public
health or safety. In dealing with America's entrepreneurs, we need to
move away from a culture that seems to place a higher priority on
imposing punishment than on facilitating compliance.
Fourth, in addition to meeting the mandates of the Paperwork
Reduction Act, agencies will have to make further efforts to reduce the
burden on enterprises with fewer than 25 employees. There must be some
measure of proportionality between the size of a business and its costs
of complying with government regulation.
Fifth, a task force will be established to examine the feasibility of
requiring agencies to consolidate their paperwork mandates in a manner
that will allow small businesses to satisfy those mandates through a
single filing, in a single format, and on the same date. By reducing
the amount of time currently devoted to these tasks, our companies will
have more to spend on the activities for which they were formed.
Mr. President, all too often the relationship between the owners of
small businesses and government is an adversial one. That benefits no
one--not the owners of these enterprises, not the many Americans they
employ, not
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the government they help to support, and not the public at large.
The problem often is not with the goals which underlie our
regulations, but rather in how we seek to achieve those goals. We
should not forget that we are dealing with Americans who make a great
contribution to the prosperity of our nation. In seeking to meet our
regulatory objectives, we should be reaching out to these entrepreneurs
with a helping hand and not a heavy hand. That, Mr. President, is the
purpose of this legislation.
______
By Mr. NICKLES (for himself, Mr. Mack, Mr. Lieberman, Mr.
Kempthorne, Mr. Craig, Mr. Hutchinson, and Mr. DeWine):
S. 1868. A bill to express United States foreign policy with respect
to, and to strengthen United States advocacy on behalf of, individuals
persecuted for their faith worldwide; to authorize United States
actions in response to religious persecution worldwide; to establish an
Ambassador at Large on International Religious Freedom within the
Department of State, a Commission on International Religious Freedom
within the Department of State, a Commission on International Religious
Persecution, and a Special Adviser on International Religious Freedom
within the National Security Council; and for other purposes; to the
Committee on Foreign Relations.
the international religious freedom act of 1998
Mr. NICKLES. Mr. President, today I am prompted to speak by both a
tragic reality, and also what I would think is a promising hope. The
tragic reality is that literally millions of religious believers around
the world live gripped by the incessant, terrifying prospect of
persecution, of being tortured, arrested, imprisoned or even killed for
simply practicing their faith. A promising hope, I believe, might
perhaps be found in the bill that I am introducing today with Senator
Lieberman, Senator Mack, Senator Kempthorne, Senator Craig, Senator
Hutchinson and Senator DeWine. It is called the International Religious
Freedom Act. The International Religious Freedom Act will establish a
process to ensure that on an ongoing basis the United States closely
monitors religious persecution worldwide.
It is wrong for a country to persecute, to prosecute, to imprison,
harass individuals for simply practicing their faith, whether that
faith is Jewish or Christian or Muslim or Hindu. It is absolutely wrong
for them to be persecuted for practicing their faith. This act requires
the U.S. Government to take action against all countries engaging in
religious persecution.
What kind of persecution am I talking about? First, three facts
command attention.
One reliable estimate indicates that more Christian martyrs have
perished in this century than all previous centuries combined. That is
a staggering, staggering statement.
A recent book reports that 200 million Christians around the world
live under daily fear and threat of persecution, including
interrogation, imprisonment, torture and in some cases death.
Finally, over half the world's population lives under regimes which
severely restrict if not prohibit their ability to believe in and
practice the religious faith of their choice and conviction.
Of course, religious persecution goes beyond facts and figures. It
happens to real people in real places. Let me point out just four
compelling examples.
At this very moment one of China's leading house church pastors,
Pastor Peter Xu, is languishing in a Chinese prison under a 3-year term
for the so-called ``crime'' of ``disturbing public order.'' Hundreds,
perhaps thousands of other believers in China currently suffer similar
treatment.
Again, at this very moment, 13 courageous Christians are imprisoned
by the Communist authorities in Laos. What was their ``crime''? Simply
that they organized an ``unauthorized'' Bible study in the privacy of a
home.
In Pakistan, just a few months ago, Pastor Noor Alam was brutally
stabbed to death by anti-Christian assailants. Shortly before that,
they had destroyed Pastor Alam's church building. Meanwhile, Christians
and other religious minorities in Pakistan continue to sufferer under
the notorius ``blasphemy laws.''
Or consider Russia, which, as many of my colleagues will remember,
just last summer passed a draconian law that will effectively shut down
the vast majority of independent churches and other religious
organizations and severly curtail the religious freedom of the Russian
people.
I could go on and on. However, I do want to share just a few
highlights of what we humbly but earnestly hope our bill can do to
begin to address the scourge of religious persecution worldwide.
I should also mention that, in 1996, I was honored to sponsor a
Senate resolution on religious persecution, which passed by unanimous
consent. In that resolution, the Senate made a strong recommendation
``that the President expand and invigorate the United States'
international advocacy on behalf of persecuted Christians, and initiate
a thorough examination of all United States' policies that affect
persecuted Christians.''
What was a mere resolution in 1996, I hope it will become a reality
in 1998. While then we acted with words, I hope that this year we can
act with deeds.
In short, this bill seeks to ensure that the U.S. Government
aggressively monitors religious oppression around the world and takes
decisive action against those regimes engaged in persecution, all the
while maintaining the integrity and credibility of the U.S. foreign
policy system.
The International Religious Freedom Act establishes an ``Ambassador-
at-Large for Religious Liberty'' at the State Department. The
Ambassador will be responsible for representing our Government in
vigorous diplomacy with nations guilty of religious persecution. In
addition, the Ambassador will oversee an annual report on religious
persecution which will specify the details on religious persecution
around the world. This report will name names. And those countries
named will be held accountable.
For any country cited in the report, the Act presents a menu of
diplomatic and economic options, and the President is required to
select from at least one of those actions. Silence or passivity are not
options. At the same time, the Act seeks to provide the President
maximum flexibility entailing the most appropriate, effective response
to that particular situation in a particular country. Furthermore,
because we desire good results to follow our good intentions, the Act
requires a consideration of how the action taken by America will affect
American economic and security interests and, most important, how it
will affect the very people that it purports to help.
The International Religious Freedom Act has other provisions--
improved reporting, improved training for immigration and foreign
service officials, a commission on international religious liberty to
provide more attention and expertise on the issue. I invite all my
colleagues, and certainly those who are deeply concerned about the
plight of persecuted religious believers, to join me in supporting this
bill. Not because it might be popular or expedient or convenient to
support this legislation, but because it is the right thing to do and
because I believe it will make a real difference in protecting the
lives of some of the most vulnerable people in the world, those people
who wish to express their religious beliefs and convictions.
Mr. President, I thank my cosponsors, particularly Senator Lieberman,
also Senator Mack, in addition to Senator Hutchinson and Senator Craig
and Senator Kempthorne, for helping us put this legislation together.
Mr. President, I ask unanimous consent that the text of the bill
printed in the Record.
There being no objection, the bill was ordered to be printed in the
Record, as follows:
S. 1868
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the
``International Religious Freedom Act of 1998''.
(b) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings; policy.
Sec. 3. Definitions.
TITLE I--DEPARTMENT OF STATE ACTIVITIES
Sec. 101. Office on International Religious Freedom; Ambassador at
Large for International Religious Freedom.
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Sec. 102. Reports.
Sec. 103. Establishment of a religious freedom Internet site.
Sec. 104. Training for Foreign Service officers.
Sec. 105. High-level contacts with NGOs.
Sec. 106. Programs and allocations of funds by United States missions
abroad.
Sec. 107. Equal access to United States missions abroad for conducting
religious activities.
Sec. 108. Prisoner lists and issue briefs on religious persecution
concerns.
TITLE II--COMMISSION ON INTERNATIONAL RELIGIOUS PERSECUTION
Sec. 201. Establishment and composition.
Sec. 202. Duties of the Commission.
Sec. 203. Report of the Commission.
Sec. 204. Termination.
TITLE III--NATIONAL SECURITY COUNCIL
Sec. 301. Special Adviser on Religious Persecution.
TITLE IV--SANCTIONS
Subtitle I--Targeted Responses to Religious Persecution Abroad
Sec. 401. Executive measures and sanctions in response to findings made
in the Annual Report on Religious Persecution.
Sec. 402. Presidential determinations of gross violations of the right
to religious freedom.
Sec. 403. Consultations.
Sec. 404. Report to Congress.
Sec. 405. Description of Executive measures and sanctions.
Sec. 406. Contract sanctity.
Sec. 407. Presidential waiver.
Sec. 408. Publication in Federal Register.
Sec. 409. Congressional review.
Sec. 410. Termination of sanctions.
Subtitle II--Strengthening Existing Law
Sec. 421. United States assistance.
Sec. 422. Multilateral assistance.
Sec. 423. Exports of items relating to religious persecution.
TITLE V--PROMOTION OF RELIGIOUS FREEDOM
Sec. 501. Assistance for promoting religious freedom.
Sec. 502. International broadcasting.
Sec. 503. International exchanges.
Sec. 504. Foreign Service awards.
TITLE VI--REFUGEE, ASYLUM, AND CONSULAR MATTERS
Sec. 601. Use of Annual Report.
Sec. 602. Reform of refugee policy.
Sec. 603. Reform of asylum policy.
Sec. 604. Inadmissibility of foreign government officials who have
engaged in gross violations of the right to religious
freedom.
TITLE VII--MISCELLANEOUS PROVISIONS
Sec. 701. Business codes of conduct.
Sec. 702. International Criminal Court.
SEC. 2. FINDINGS; POLICY.
(a) Findings.--Congress makes the following findings:
(1) Freedom of religious belief and practice is a
fundamental human right articulated in numerous international
agreements and covenants, including the Universal Declaration
of Human Rights, the International Covenant on Civil and
Political Rights, the Helsinki Accords, the Declaration on
the Elimination of All Forms of Intolerance and
Discrimination Based on Religion or Belief, the United
Nations Charter, and the European Convention for the
Protection of Human Rights and Fundamental Freedoms.
(2) The right to freedom of religion undergirds the very
origin and existence of the United States. Many of our
Nation's founders fled religious persecution abroad,
cherishing in their hearts and minds the ideal of religious
freedom. They established in law, as a fundamental right and
as a pillar of our Nation, the right to freedom of religion.
From its birth to this day, the United States has prized this
legacy of religious freedom and honored this heritage by
standing for religious freedom and offering refuge to those
suffering religious persecution.
(3) Article 18 of the Universal Declaration of Human Rights
recognizes that ``Everyone has the right to freedom of
thought, conscience, and religion. This right includes
freedom to change his religion or belief, and freedom, either
alone or in community with others and in public or private,
to manifest his religion or belief in teaching, practice,
worship, and observance.''. Article 18(1) of the
International Covenant on Civil and Political Rights
recognizes that ``Everyone shall have the right to freedom of
thought, conscience, and religion. This right shall include
freedom to have or to adopt a religion or belief of his
choice, and freedom, either individually or in community with
others and in public or private, to manifest his religion or
belief in worship, observance, practice, and teaching''.
Governments have the responsibility to protect the
fundamental rights of their citizens and to pursue justice
for all. Religious freedom is a fundamental right of every
individual, regardless of race, country, creed, or
nationality, and should never be arbitrarily abridged by any
government.
(4) The right to freedom of religion is under renewed and,
in some cases, increasing assault in many countries around
the world. More than one-half of the world's population lives
under regimes that severely restrict or prohibit the freedom
of their citizens to study, believe, observe, and freely
practice the religious faith of their choice. Religious
believers and communities suffer both government-sponsored
and government-tolerated violations of their rights to
religious freedom. Among the many forms of such violations
are state-sponsored slander campaigns, confiscations of
property, surveillance by security police, including by
special divisions of ``religious police'', severe
prohibitions against construction and repair of places of
worship, denial of the right to assemble and relegation of
religious communities to illegal status through arbitrary
registration laws, prohibitions against the pursuit of
education or public office, and prohibitions against
publishing, distributing, or possessing religious literature
and materials.
(5) Even more abhorrent, religious believers in many
countries face such severe and violent forms of religious
persecution as detention, torture, beatings, forced marriage,
rape, imprisonment, enslavement, mass resettlement, and death
merely for the peaceful belief in, change of or practice of
their faith. In many countries, religious believers are
forced to meet secretly, and religious leaders are targeted
by national security forces and hostile mobs.
(6) Though not confined to a particular region or regime,
religious persecution is often particularly widespread,
systematic, and heinous under totalitarian governments and in
countries with militant, politicized religious majorities.
(7) Congress has recognized and denounced acts of religious
persecution through the adoption of the following
resolutions:
(A) House Resolution 515 (104th), expressing the sense of
the House of Representatives with respect to the persecution
of Christians worldwide.
(B) Senate Concurrent Resolution 71 (104th), expressing the
sense of the Senate regarding persecution of Christians
worldwide.
(C) House Concurrent Resolution 102, concerning the
emancipation of the Iranian Baha'i community.
(b) Policy.--It shall be the policy of the United States,
as follows:
(1) To condemn religious persecution, and to promote, and
to assist other governments in the promotion of, the
fundamental right to religious freedom.
(2) To seek to channel United States security and
development assistance to governments other than those found
to be engaged in gross violations of human rights, including
the right to religious freedom, as set forth in the Foreign
Assistance Act of 1961, in the International Financial
Institutions Act of 1977, and in other formulations of United
States human rights policy.
(3) To be vigorous and flexible, reflecting both the
unwavering commitment of the United States to religious
freedom and the desire of the United States for the most
effective and principled response, in light of the range of
violations of religious freedom by a variety of persecuting
regimes, and the status of the relations of the United States
with different nations.
(4) To work with foreign governments that affirm and
protect religious freedom, in order to develop multilateral
documents and initiatives to combat religious persecution and
promote the right to religious freedom abroad.
(5) Standing for liberty and standing with the persecuted,
to use and implement appropriate tools in the United States
foreign policy apparatus, including diplomatic, political,
commercial, charitable, educational, and cultural channels,
to promote respect for religious freedom by all governments
and peoples.
SEC. 3. DEFINITIONS.
In this Act:
(1) Ambassador at large.--The term ``Ambassador at Large''
means the Ambassador at Large on International Religious
Freedom appointed under section 101(b).
(2) Annual report on religious persecution.--The term
``Annual Report on Religious Persecution'' means the report
described in section 102(b).
(3) Appropriate congressional committees.--The term
``appropriate congressional committees'' means the Committee
on Foreign Relations of the Senate and the Committee on
International Relations of the House of Representatives and,
in the case of any determination made with respect to the
imposition of a sanction under paragraphs (9) through (16) of
section 405, the term ``appropriate congressional
committees'' includes those committees, together with the
Committee on Ways and Means and the Committee on Banking and
Financial Services of the House of Representatives and the
Committee on Finance of the Senate.
(4) Commission.--The term ``Commission'' means the United
States Commission on International Religious Persecution
established in section 201(a).
(5) Government or foreign government.--The term
``government'' or ``foreign government'' includes any agency
or instrumentality of the government.
(6) Gross violations of the right to freedom of religion.--
The term ``gross violations of the right to freedom of
religion'' means a consistent pattern of gross violations of
the right to freedom of religion that include torture or
cruel, inhuman, or degrading treatment or punishment,
prolonged detention without charges, causing the
disappearance of persons by the abduction or clandestine
detention of those persons, or other flagrant denial of the
right to life, liberty, or the security of persons, within
the meaning of section 116(a) of the Foreign Assistance Act
of 1961 (22 U.S.C. 2151n(a)).
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(7) Human rights reports.--The term ``Human Rights
Reports'' means the reports submitted by the Department of
State to Congress under sections 116 and 502B of the Foreign
Assistance Act of 1961.
(8) Office.--The term ``Office'' means the Office on
International Religious Freedom established in section
101(a).
(9) Religious persecution.--The term ``religious
persecution'' means any violation of the internationally
recognized right to freedom of religion, as defined in
Article 18 of the Universal Declaration of Human Rights and
Article 18 of the International Covenant on Civil and
Political Rights, including violations such as--
(A) arbitrary prohibitions on, restrictions of, or
punishment for--
(i) assembling for peaceful religious activities such as
worship, preaching, and prayer, including arbitrary
registration requirements,
(ii) speaking freely about one's religious beliefs,
(iii) changing one's religious beliefs and affiliation,
(iv) possession and distribution of religious literature,
including Bibles, or
(v) raising one's children in the religious teachings and
practices of one's choice,
as well as arbitrary prohibitions or restrictions on the
grounds of religion on holding public office, or pursuing
educational or professional opportunities; and
(B) any of the following acts if committed on account of an
individual's religious belief or practice: detention,
interrogation, harassment, imposition of an onerous financial
penalty, forced labor, forced mass resettlement,
imprisonment, beating, torture, mutilation, rape,
enslavement, murder, and execution.
(10) Special adviser.--The term ``Special Adviser'' means
the Special Adviser to the President on Religious Persecution
established in section 101(i) of the National Security Act of
1947, as added by section 301 of this Act.
TITLE I--DEPARTMENT OF STATE ACTIVITIES
SEC. 101. OFFICE ON INTERNATIONAL RELIGIOUS FREEDOM;
AMBASSADOR AT LARGE FOR INTERNATIONAL RELIGIOUS
FREEDOM.
(a) Establishment of Office.--There is established within
the Department of State an Office on International Religious
Freedom that shall be headed by the Ambassador at Large on
International Religious Freedom appointed under subsection
(b).
(b) Appointment.--The Ambassador at Large shall be
appointed by the President, by and with the advice and
consent of the Senate.
(c) Duties.--The Ambassador at Large shall have the
following responsibilities:
(1) In general.--The primary responsibility of the
Ambassador at Large shall be to advance the right to freedom
of religion abroad, to denounce the violation of that right,
and to recommend appropriate responses by the United States
Government when this right is violated.
(2) Advisory role.--The Ambassador at Large shall be the
principal adviser to the President and the Secretary of State
regarding matters affecting religious freedom abroad and,
with advice from the Commission on International Religious
Persecution, shall make recommendations regarding the
policies of the United States Government toward governments
that violate the freedom of religion or that fail to ensure
the individual's right to religious belief and practice.
(3) Diplomatic representation.--The Ambassador at Large is
authorized to represent the United States in matters and
cases relevant to religious persecution in--
(A) contacts with foreign governments, international
organizations, intergovernmental organizations, and
specialized agencies of the United Nations, the Organization
on Security and Cooperation in Europe, and other
organizations of which the United States is a member; and
(B) multilateral conferences and meetings relevant to
religious persecution.
(4) Reporting responsibilities.--The Ambassador at Large
shall have the reporting responsibilities described in
section 102.
(d) Funding.--The Secretary of State shall provide the
Ambassador at Large with such funds as may be necessary for
the hiring of staff for the Office, for the conduct of
investigations by the Office, and for necessary travel to
carry out the provisions of this section.
SEC. 102. REPORTS.
(a) Portions of Annual Human Rights Reports.--The
Ambassador at Large shall assist the Secretary of State in
preparing those portions of the Human Rights Reports that
relate to freedom of religion and discrimination based on
religion and those portions of other information provided
Congress under sections 116 and 502B of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151m, 2304) that relate to
the right to religious freedom.
(b) Annual Report on Religious Persecution.--
(1) In general.--
(A) Deadline for submission.--Not later than May 1 of each
year, the Ambassador at Large shall submit to the appropriate
congressional committees an Annual Report on Religious
Persecution, expanding upon the most recent Human Rights
Reports. Each Annual Report on Religious Persecution shall
contain the following:
(i) An identification of each foreign country the
government of which engages in or tolerates acts of religious
persecution.
(ii) An assessment and description of the nature and extent
of religious persecution, including persecution of one
religious group by another religious group, religious
persecution by governmental and nongovernmental entities,
persecution targeted at individuals or particular
denominations or entire religions, and the existence of
government policies violating religious freedom.
(iii) A description of United States policies in support of
religious freedom, including a description of the measures
and policies implemented during the preceding 12 months by
the United States under title IV of this Act in opposition to
religious persecution and in support of religious freedom.
(iv) A description of any binding agreement with a foreign
government entered into by the United States under section
402(c).
(B) Classified addendum.--If the Ambassador determines that
it is in the national security interests of the United States
or is necessary for the safety of individuals to be
identified in the Annual Report, any information required by
subparagraph (A), including measures taken by the United
States, may be summarized in the Annual Report and submitted
in more detail in a classified addendum to the Annual Report.
(C) Designation of report.--Each report submitted under
this subsection may be referred to as the ``Annual Report on
Religious Persecution''.
(2) Foreign government input.--Prior to submission of each
report under this subsection, the Secretary of State may
offer the government of any country concerned an opportunity
to respond to the relevant portions of the report. If the
Secretary of State determines that doing so would further the
purposes of this Act, the Secretary shall request the
Ambassador at Large to include the country's response as an
addendum to the Annual Report on Religious Persecution.
(c) Preparation of Reports Regarding Religious
Persecution.--
(1) Standards and investigations.--The Secretary of State
shall ensure that United States missions abroad maintain a
consistent reporting standard and thoroughly investigate
reports of religious persecution.
(2) Contacts with ngos.--In compiling data and assessing
the respect of the right to religious freedom for the Human
Rights Reports and the Annual Report on Religious
Persecution, United States mission personnel shall seek out
and maintain contacts with religious and human rights
nongovernmental organizations, with the consent of those
organizations, including receiving reports and updates from
such organizations and, when appropriate, investigating such
reports.
(d) Amendments to the Foreign Assistance Act.--
(1) Content of human rights reports for countries receiving
economic assistance.--Section 116(d) of the Foreign
Assistance Act of 1961 (22 U.S.C. 2151n(d)) is amended--
(A) by striking ``and'' at the end of paragraph (4);
(B) by striking the period at the end of paragraph (5) and
inserting``; and ''; and
(C) by adding at the end the following:
``(6) wherever applicable, the practice of religious
persecution, including gross violations of the right to
religious freedom.''.
(2) Contents of human rights reports for countries
receiving security assistance.--Section 502B(b) of the
Foreign Assistance Act of 1961 (22 U.S.C. 2304(b)) is
amended--
(A) by inserting ``and with the assistance of the
Ambassador at Large for Religious Freedom'' after ``Labor'';
and
(B) by inserting after the second sentence the following
new sentence: ``Such report shall also include, wherever
applicable, information on religious persecution, including
gross violations of the right to religious freedom.''.
SEC. 103. ESTABLISHMENT OF A RELIGIOUS FREEDOM INTERNET SITE.
In order to facilitate access by nongovernmental
organizations (NGOs) and by the public around the world to
international documents on the protection of religious
freedom, the Ambassador at Large shall establish and maintain
an Internet site containing major international documents
relating to religious freedom, the Annual Report on Religious
Persecution, and any other documentation or references to
other sites as deemed appropriate or relevant by the
Ambassador at Large.
SEC. 104. TRAINING FOR FOREIGN SERVICE OFFICERS.
Chapter 2 of title I of the Foreign Service Act of 1980 is
amended by adding at the end the following new section:
``SEC. 708. TRAINING FOR FOREIGN SERVICE OFFICERS.
``The Secretary of State and the Ambassador at Large on
International Religious Freedom, appointed under section
101(b) of the International Religious Freedom Act of 1998,
acting jointly, shall establish as part of the standard
tr
Amendments:
Cosponsors:
