S64 CONGRESSIONAL RECORD — SENATE January 6, 2009 

(2) in subsection (c), in the matter preceding paragraph (1), by inserting ‘‘, or at a 

school that offers a graduate program in professional psychology’’ after ‘‘veterinary medicine’’; and 

(3) in subsection (k)— 

(A) in the matter preceding paragraph (1), 

by striking ‘‘or podiatry’’ and inserting ‘‘podiatry, or professional psychology’’; and 

(B) in paragraph (4), by striking ‘‘or 

podiatric medicine’’ and inserting ‘‘podiatric 

medicine, or professional psychology’’. 

SEC. 3. GENERAL PROVISIONS. 

(a) HEALTH PROFESSIONS DATA.—Section 

792(a) of the Public Health Service Act (42 

U.S.C. 295k(a)) is amended by striking ‘‘clinical’’ and inserting ‘‘professional’’. 

(b) PROHIBITION AGAINST DISCRIMINATION ON

BASIS OF SEX.—Section 794 of the Public 

Health Service Act (42 U.S.C. 295m) is 

amended in the matter preceding paragraph 

(1) by striking ‘‘clinical’’ and inserting ‘‘professional’’. 

(c) DEFINITIONS.—Section 799B(1)(B) of the 

Public Health Service Act (42 U.S.C. 

295p(1)(B)) is amended by striking ‘‘clinical’’ 

each place the term appears and inserting 

‘‘professional’’. 

By Mrs. FEINSTEIN (for herself, 

Mr. SCHUMER, Ms. SNOWE, and 

Mrs. BOXER): 

S. 60. A bill to prohibit the sale and 

counterfeiting of Presidential inaugural tickets; to the Committee on 

Rules and Administration. 

Mrs. FEINSTEIN. Mr. President, I 

am pleased to join Senators SCHUMER, 

SNOWE, and BOXER in introducing legislation to prohibit the selling and counterfeiting of tickets to the Presidential 

inaugural ceremony. 

The inauguration of the President of 

the United States is one of the most 

important rituals of our democracy, 

and the chance to witness this solemn 

event should not be bought and sold 

similar to tickets to a sporting event. 

This is a dignified and critical moment of transition in Government, a 

moment of which Americans have always been justifiably proud. It is, in 

fact, the major symbol of the real 

strength of our democracy—the peaceful transition from one elected President to the next. 

Tickets to the official Presidential 

inaugural ceremony are supposed to be 

free for the people: for the volunteers 

who gave up their weekends, walking 

miles door to door to encourage voters 

to turn out at the polls on election 

day, for members of the African-American community to see one of their own 

take the oath of office for the highest 

office in the land, for schoolchildren to 

witness history, and for the American 

public to watch this affirmation of our 

Constitution, this peaceful transition 

from one administration to another. 

This is going to be the major civic 

event of our time. Excitement is at an 

all time high, and every one of us has 

received more phone calls for tickets 

than we could possibly ever meet. People are desperate to become part of it, 

to touch it, to be around, to feel it, to 

listen to it, and they are coming from 

all over the country. We could have 

more than 1.5 million people descend 

on the Nation’s Capital for this inauguration. 

Before I introduced a similar bill at 

the end of the last Congress, tickets to 

the Presidential inaugural were being 

offered for sale on the Internet for 

$5,000 apiece, with some going as high 

as $40,000 each. To their credit, some 

Internet websites voluntarily agreed to 

refuse to sell these tickets online. I 

want to thank and commend Craigslist, 

eBay, and StubHub for leading the way 

on this issue. 

However, it is clear that relying on 

voluntary industry compliance to prevent the sale of these tickets is simply 

not enough. Today, some Internet sites 

are still offering these tickets for sale 

at prices up to $750 per ticket. 

Let me be clear—these are free tickets that have not yet been distributed 

by congressional and Presidential transition offices. These unscrupulous 

websites who continue to offer these 

tickets for sale do not have any tickets 

to offer for sale. 

These tickets are supposed to be free 

for the people. Once more, these tickets are not yet even available. They 

will not be distributed to congressional 

offices until the end of the week before 

the inauguration. Even then the offices 

will require in-person pickup, with secure identification. But they will be 

free and they should stay that way. 

We are asking people to pick up their 

tickets the day before the inauguration 

in my office. Everyone will submit 

their name, their address, and their 

driver’s license. They will have to 

verify they are the actual person who 

has tickets waiting for them. I believe 

this kind of procedure deters unscrupulous people from selling these tickets 

on the Internet. No websites or other 

ticket outlets have inaugural swearingin tickets to sell, despite what some of 

them claim. 

Congress has the responsibility of 

overseeing this historic event. This bill 

will ensure that these tickets are not 

sold to the highest bidder, and that the 

inauguration has all the respect and 

dignity it deserves. 

This legislation is aimed at stopping 

those who seek to profit by selling 

these tickets. It would also target 

those who seek to dupe the public with 

fraudulent or counterfeit tickets or 

those who merely promise but can’t deliver on tickets that they do not actually have. 

Those who violate the law under this 

legislation would face a class A misdemeanor with a substantial fine, imprisonment of up to 1 year, or both. 

The bill also exempts official Presidential Inaugural Committees, and 

there is good reason for this. Presidential Inaugural Committees are used 

to organize and fund the public inaugural ceremonies. Donations made in 

return for inaugural tickets have long 

been used by both political parts to 

fund the Presidential inaugural festivities. 

Unlike unscrupulous websites and 

ticket scalpers, there is no ‘‘profit’’ 

made by Presidential Inaugural Committees in giving these tickets to people in return for inaugural donations. 

This exemption will allow both parties 

to raise the needed funds to put on 

Presidential inaugurals in the future. 

It is my hope that Congress will pass 

this legislation quickly, before President-elect Obama’s inauguration on 

January 20th. I think it is very important to establish once and for all that 

tickets to the inauguration of the next 

President of the United States are not 

issues of commerce, but rather free 

tickets to be given to the people. 

So I hope that this week this legislation can pass unanimously on a hotline 

by this body. 

Mr. President, I ask unanimous consent that the text of the bill be printed 

in the RECORD. 

There being no objection, the text of 

the bill was ordered to be printed in 

the RECORD, as follows: 

S. 60 

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

Congress assembled, 

SECTION 1. PROHIBITION ON SALE AND COUNTERFEITING OF INAUGURAL TICKETS. 

(a) IN GENERAL.—Chapter 25 of title 18, 

United States Code, is amended by adding at 

the end the following 

‘‘§ 515. Prohibition on sale and counterfeiting 

of inaugural tickets 

‘‘(a) IN GENERAL.—It shall be unlawful for 

any person to— 

‘‘(1) except as provided in subsection (b), 

knowingly and willfully sell for money or 

property, or facilitate the sale for money or 

property of, a ticket to a Presidential inaugural ceremony; 

‘‘(2) with the intent to defraud, falsely 

make, forge, counterfeit, or falsely alter a 

ticket to a Presidential inaugural ceremony; 

or 

‘‘(3) with the intent to defraud, use, unlawfully possess, or exhibit a ticket to a Presidential inaugural ceremony, knowing the 

ticket to be falsely made, forged, counterfeited, or falsely altered. 

‘‘(b) EXCEPTION.—This section shall not 

apply to the sale for money or property, facilitation of such a sale, or attempt of such 

a sale, of a ticket to a Presidential inaugural 

ceremony— 

‘‘(1) that occurs after the date on which the 

Presidential inaugural ceremony for which 

the ticket was issued occurs; or 

‘‘(2) by an official presidential inaugural 

committee established on behalf of a President elect of the United States. 

‘‘(c) PENALTY.—Whoever violates subsection (a) shall be fined under this title, imprisoned not more than 1 year, or both. 

‘‘(d) DEFINITION.—In this section, the term 

‘Presidential inaugural ceremony’ means a 

public inaugural ceremony at which the 

President elect or the Vice President elect 

take the oath or affirmation of office for the 

office of President of the United States or 

the office of Vice President of the United 

States, respectively.’’. 

(b) AMENDMENT TO CHAPTER ANALYSIS.— 

The chapter analysis for chapter 25 of title 

18, United States Code, is amended by inserting at the end the following: 

‘‘515. Prohibition on sale and counterfeiting 

of inaugural tickets.’’. 

By Mr. DURBIN (for himself, 

Mrs. BOXER, Mrs. FEINSTEIN, 

Mr. HARKIN, Mr. SCHUMER, and 

Mr. WHITEHOUSE): 


wwoods2 on PRODPC68 with SENATE
January 6, 2009 CONGRESSIONAL RECORD — SENATE S65 

S. 61. A bill to amend title 11 of the 

United States Code with respect to 

modification of certain mortgages on 

principal residences, and for other purposes; to the Committee on the Judiciary. 

Mr. DURBIN. Mr. President, as the 

111th Congress begins, the most important item on our agenda is to help end 

the worst economic crisis America has 

faced since the Great Depression. 

I look forward to working with my 

colleagues in the Senate to develop and 

approve an economic turnaround package as quickly as possible. 

But even if Congress authorizes as 

much as $1 trillion in new Government 

spending over the next 2 years to stimulate the economy, if we don’t address 

the origins of this crisis, I fear the impact of any recovery package will be 

dampened. 

This economic crisis began with the 

bubble that burst in the housing market. So we have to address that, first 

and foremost. Families need to be able 

to stay in their homes, and communities need to be stabilized before the 

economy can start to grow again. 

That’s why, as my first bill in the 

new Congress, I am reintroducing the 

Helping Families Save Their Homes in 

Bankruptcy Act. 

When I first began working on this 

bill almost two years ago, the Center 

for Responsible Lending, Credit Suisse, 

and others estimated that 2 million 

homes were at risk of foreclosure. 

The Mortgage Bankers Association 

and the rest of the mortgage industry 

scoffed at such a number. 

Last month, Credit Suisse estimated 

that 8.1 million homes are likely to be 

lost to foreclosure by 2012. If the economy continues to worsen, they believe 

foreclosures will exceed 10 million 

homes. 

If over 8 million families—representing 16 percent of all mortgages— 

are losing their homes, our economy is 

not going to recover. 

I first introduced this bill in September of 2007. I have chaired three 

hearings on the subject and tried three 

times to pass this legislation last year. 

A large coalition supports this bill— 

including the AARP, the Consumer 

Federation of America, the Leadership 

Conference on Civil Rights, the AFLCIO, the Center for Responsible Lending, the National Association of Consumer Bankruptcy Attorneys, and 

many others. But the Mortgage Bankers Association and the rest of the 

mortgage industry have successfully 

opposed it so far. 

Three things have fundamentally 

changed, and I am back, pressing even 

harder that we make this bill law. 

First, the banks that brought us the 

reckless lending, dense securitization, 

and risky investing practices that created the boom and bust in the housing 

market have now happily accepted a 

$700 billion handout from the American 

taxpayers . . . even as most of them 

refuse to help the homeowners who are 

suffering most acutely from their irresponsible business practices. Frankly, I 

think that the credibility of the opposition to my bill has slipped just a bit. 

Second, it is painfully clear that 

foreclosure mitigation efforts to date 

have failed. Professor Alan White of 

the Valparaiso School of Law analyzed 

a large sample of the mortgage modifications made voluntarily by the industry-led Hope Now Alliance. He 

found that almost half of these socalled foreclosure prevention plans actually increased the monthly payments 

of homeowners. How does that help 

families save their homes? 

Third, America soon will have a 

President who understands the enormity of this problem and supports this 

change to the bankruptcy code. 

So what does this bill do? This bill 

would allow mortgages on primary 

residences to be modified in bankruptcy just like other debts—including 

vacation homes, family farms, and 

yachts. 

Only families living in the home 

would qualify—no speculators are allowed. 

The bill would allow judges to cut 

through all of the constraints that 

have doomed foreclosure prevention 

plans from being successful for even 

the most proactive and well-intentioned mortgage servicers. 

There are very real constraints on 

some of the current efforts to prevent 

foreclosure today because most mortgages are sliced and sold to different 

investors, servicers sometimes have a 

hard time locating all of the owners of 

the mortgages to get their consent for 

modifications. 

Servicers that modify mortgages 

without the consent of all the investors 

fear that they could be sued. 

Some investors refuse to approve sensible restructurings, because there is 

little incentive for the owner of a second mortgage to approve a modification of a first mortgage that will see 

the second mortgage wiped out. 

Mortgage modifications that ignore 

the other pile of debt a household is 

facing is a set-up for failure. That’s a 

leading reason why we see so many redefaults on newly modified mortgages 

through the current programs. 

Finally, servicers who are on the 

front lines answering the phone calls 

from homeowners and processing the 

paperwork often are compensated more 

for foreclosures than modifications. 

My proposal would allow judges to 

cut through these complicating factors 

to rework the underlying loans. 

The mortgages that are modified in 

bankruptcy will provide far more value 

to the lenders and the investors than 

foreclosure. 

The bill would provide borrowers who 

are frustrated with their mortgage 

servicers some desperately needed leverage to get their banker’s full attention. It provides an incentive for banks 

to modify loans before the judges in 

bankruptcy do it for them. 

Best of all, this program would cost 

the taxpayers nothing. Given the staggering amounts that taxpayers have 

been asked to give to the mortgage industry lately, the taxpayers are ready 

for a plan that doesn’t cost them anything and that will actually work. 

Since the Mortgage Bankers Association still opposes this plan, after taking all of that taxpayer money and 

after failing to do anything meaningful 

on their own to address this crisis, I 

want to address their primary remaining objection to this plan as clearly as 

possible so that everyone listening 

fully understands why the industry is 

wrong, once and for all. 

A few weeks ago, the Chairman of the 

Mortgage Bankers Association testified in the Senate Judiciary Committee that my bill would create a tax 

of $295, per month, for every homeowner in America, forever. I asked in 

the hearing, and my staff asked three 

times after the hearing, for some shred 

of evidence to support such a ridiculous 

claim. The response finally came just 

before the holidays, and it is laughable. 

The Mortgage Bankers Association 

claims that changing the bankruptcy 

code will create new costs for lenders 

that must then be passed on to all borrowers. They have concocted a list of 

individual costs that add up to the full 

‘‘tax,’’ as they call it. But they don’t 

provide a single shred of evidence to 

support any of these cost estimates. 

Not one. They just made them all up. 

On the other hand, a study conducted 

by Adam Levitin of the Georgetown 

Law School uses actual statistical data 

to show that there is virtually no impact on mortgage interest rates just 

because mortgages can be modified by 

judges in bankruptcy. 

The main problem with the argument 

that my bill will increase future mortgage rates is this: 

The choice for mortgage lenders and 

investors is not full payment of the 

original mortgage versus a lower payment from a judicially modified mortgage. 

The choice is between a lower payment from a judicially modified mortgage and mortgage failure. 

Valparaiso’s Professor White reports 

that in his large study sample, mortgage servicers and their investors lost 

an average of 55 percent of the value of 

the mortgages that failed through foreclosure, or about $145,000 per loan. 

If those loans would have been modified in bankruptcy, the servicers and 

investors would have been given ownership of a sustainable mortgage worth 

at least the fair market value of the 

home plus an interest rate that included a premium for risk. These modified mortgages would on average have 

created far better results than the foreclosures that actually occurred. 

Therefore, when the Mortgage Bankers Association claims with no evidence whatsoever that my bill would 

raise mortgage interest rates, we 

should all ask them this: Why would 

mortgage bankers charge future borrowers higher interest rates tomorrow 

because of a change in the law that 


wwoods2 on PRODPC68 with SENATE
S66 CONGRESSIONAL RECORD — SENATE January 6, 2009 

helps the bankers reduce their losses 

today? 

I urge the Senate to move swiftly to 

enact the economic recovery package 

that America desperately needs. And as 

part of that effort I urge my colleagues 

to support the remedy to the foreclosure crisis that will provide the 

most help to the 8.1 million families 

across the country who are at risk of 

losing their homes. 

If we don’t address the core of the 

crisis, I fear that the stimulus may not 

work as well as it should. I look forward to working with Chairman DODD, 

Senator SCHUMER, all of the other Senators who have supported this provision, and President-elect Obama to see 

that it is signed into law quickly. 

Mr. President, I ask unanimous consent that the text of the bill be printed 

in the RECORD. 

There being no objection, the text of 

the bill was ordered to be printed in 

the RECORD, as follows: 

S. 61 

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 ‘‘Helping 

Families Save Their Homes in Bankruptcy 

Act of 2009’’. 

SEC. 2. ELIGIBILITY FOR RELIEF. 

Section 109 of title 11, United States Code, 

is amended— 

(1) by adding at the end of subsection (e) 

the following: ‘‘For purposes of this subsection, the computation of debts shall not 

include the secured or unsecured portions 

of— 

‘‘(1) debts secured by the debtor’s principal 

residence if the current value of that residence is less than the secured debt limit; or 

‘‘(2) debts secured or formerly secured by 

real property that was the debtor’s principal 

residence that was sold in foreclosure or that 

the debtor surrendered to the creditor if the 

current value of such real property is less 

than the secured debt limit.’’; and 

(2) by adding at the end of subsection (h) 

the following: 

‘‘(5) The requirements of paragraph (1) 

shall not apply in a case under chapter 13 

with respect to a debtor who submits to the 

court a certification that the debtor has received notice that the holder of a claim secured by the debtor’s principal residence 

may commence a foreclosure on the debtor’s 

principal residence.’’. 

SEC. 3. PROHIBITING CLAIMS ARISING FROM VIOLATIONS OF CONSUMER PROTECTION LAWS. 

Section 502(b) of title 11, United States 

Code, is amended— 

(1) in paragraph (8) by striking ‘‘or’’ at the 

end, 

(2) in paragraph (9) by striking the period 

at the end and inserting ‘‘; or’’, and 

(3) by adding at the end the following: 

‘‘(10) the claim is subject to any remedy for 

damages or rescission due to failure to comply with any applicable requirement under 

the Truth in Lending Act, or any other provision of applicable State or Federal consumer protection law that was in force when 

the noncompliance took place, notwithstanding the prior entry of a foreclosure 

judgment.’’. 

SEC. 4. AUTHORITY TO MODIFY CERTAIN MORTGAGES. 

Section 1322(b) of title 11, United States 

Code, is amended— 

(1) by redesignating paragraph (11) as paragraph (12), 

(2) in paragraph (10) by striking ‘‘and’’ at 

the end, and 

(3) by inserting after paragraph (10) the following: 

‘‘(11) notwithstanding paragraph (2) and 

otherwise applicable nonbankruptcy law, 

with respect to a claim for a loan secured by 

a security interest in the debtor’s principal 

residence that is the subject of a notice that 

a foreclosure may be commenced, modify the 

rights of the holder of such claim— 

‘‘(A) by providing for payment of the 

amount of the allowed secured claim as determined under section 506(a)(1); 

‘‘(B) if any applicable rate of interest is adjustable under the terms of such security interest by prohibiting, reducing, or delaying 

adjustments to such rate of interest applicable on and after the date of filing of the plan; 

‘‘(C) by modifying the terms and conditions of such loan— 

‘‘(i) to extend the repayment period for a 

period that is no longer than the longer of 40 

years (reduced by the period for which such 

loan has been outstanding) or the remaining 

term of such loan, beginning on the date of 

the order for relief under this chapter; and 

‘‘(ii) to provide for the payment of interest 

accruing after the date of the order for relief 

under this chapter at an annual percentage 

rate calculated at a fixed annual percentage 

rate, in an amount equal to the then most 

recently published annual yield on conventional mortgages published by the Board of 

Governors of the Federal Reserve System, as 

of the applicable time set forth in the rules 

of the Board, plus a reasonable premium for 

risk; and 

‘‘(D) by providing for payments of such 

modified loan directly to the holder of the 

claim; and’’. 

SEC. 5. COMBATING EXCESSIVE FEES. 

Section 1322(c) of title 11, the United 

States Code, is amended— 

(1) in paragraph (1) by striking ‘‘and’’ at 

the end, 

(2) in paragraph (2) by striking the period 

at the end and inserting a semicolon, and 

(3) by adding at the end the following: 

‘‘(3) the debtor, the debtor’s property, and 

property of the estate are not liable for a fee, 

cost, or charge that is incurred while the 

case is pending and arises from a debt that is 

secured by the debtor’s principal residence 

except to the extent that— 

‘‘(A) the holder of the claim for such debt 

files with the court (annually or, in order to 

permit filing consistent with clause (ii), at 

such more frequent periodicity as the court 

determines necessary) notice of such fee, 

cost, or charge before the earlier of— 

‘‘(i) 1 year after such fee, cost, or charge is 

incurred; or 

‘‘(ii) 60 days before the closing of the case; 

and 

‘‘(B) such fee, cost, or charge— 

‘‘(i) is lawful under applicable nonbankruptcy law, reasonable, and provided for in 

the applicable security agreement; and 

‘‘(ii) is secured by property the value of 

which is greater than the amount of such 

claim, including such fee, cost, or charge; 

‘‘(4) the failure of a party to give notice described in paragraph (3) shall be deemed a 

waiver of any claim for fees, costs, or 

charges described in paragraph (3) for all 

purposes, and any attempt to collect such 

fees, costs, or charges shall constitute a violation of section 524(a)(2) or, if the violation 

occurs before the date of discharge, of section 362(a); and 

‘‘(5) a plan may provide for the waiver of 

any prepayment penalty on a claim secured 

by the debtor’s principal residence.’’. 

SEC. 6. CONFIRMATION OF PLAN. 

Section 1325(a) of title 11, the United 

States Code, is amended— 

(1) in paragraph (8) by striking ‘‘and’’ at 

the end, 

(2) in paragraph (9) by striking the period 

at the end and inserting a semicolon, and 

(3) by inserting after paragraph (9) the following: 

‘‘(10) notwithstanding subclause (I) of paragraph (5)(B)(i), the plan provides that the 

holder of a claim whose rights are modified 

pursuant to section 1322(b)(11) retain the lien 

until the later of— 

‘‘(A) the payment of such holder’s allowed 

secured claim; or 

‘‘(B) discharge under section 1328; and 

‘‘(11) the plan modifies a claim in accordance with section 1322(b)(11), and the court 

finds that such modification is in good 

faith.’’. 

SEC. 7. DISCHARGE. 

Section 1328 of title 11, the United States 

Code, is amended— 

(1) in subsection (a)— 

(A) by inserting ‘‘(other than payments to 

holders of claims whose rights are modified 

under section 1322(b)(11)’’ after ‘‘paid’’ the 

1st place it appears, and 

(B) in paragraph (1) by inserting ‘‘or, to the 

extent of the unpaid portion of an allowed 

secured claim, provided for in section 

1322(b)(11)’’ after ‘‘1322(b)(5)’’, and 

(2) in subsection (c)(1) by inserting ‘‘or, to 

the extent of the unpaid portion of an allowed secured claim, provided for in section 

1322(b)(11)’’ after ‘‘1322(b)(5)’’. 

SEC. 8. EFFECTIVE DATE; APPLICATION OF 

AMENDMENTS. 

(a) EFFECTIVE DATE.—Except as provided in 

subsection (b), this Act and the amendments 

made by this Act shall take effect on the 

date of the enactment of this Act. 

(b) APPLICATION OF AMENDMENTS.—The 

amendments made by this Act shall apply 

with respect to cases commenced under title 

11 of the United States Code before, on, or 

after the date of the enactment of this Act. 

By Mr. INOUYE: 

S. 63. A bill to amend title XIX of the 

Social Security Act to improve access 

to advanced practice nurses and physicians assistants under the Medicaid 

Program; to the Committee on Finance. 

Mr. INOUYE. Mr. President, today, I, 

again, introduce the Medicaid Advanced Practice Nurse and Physician 

Assistants Access Act of 2009. This legislation would change the Federal law 

to expand fee-for-service Medicaid to 

include direct payment for services 

provided by all nurse practitioners, 

clinical nurse specialists, and physician assistants. It would ensure all 

nurse practitioners, certified nurse 

midwives, and physician assistants are 

recognized as primary care case managers, and require Medicaid panels to 

include advanced practice nurses on 

their managed care panels. 

Advanced practice nurses are registered nurses who have attained additional expertise in the clinical management of health conditions. Typically, 

an advanced practice nurse holds a 

master’s degree with didactic and clinical preparation beyond that of the registered nurse. They are employed in 

clinics, hospitals, and private practices. While there are many titles 

given to these advanced practice 


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January 6, 2009 CONGRESSIONAL RECORD — SENATE S67 

nurses, such as pediatric nurse practitioners, family nurse practitioners, 

certified nurse midwives, certified registered nurse anesthetists, and clinical 

nurse specialists, our current Medicaid 

law has not kept up with the multiple 

specialties and titles of these advanced 

practitioners, nor has it recognized the 

critical role physician assistants play 

in the delivery of primary care. 

I have been a long-time advocate of 

advanced practice nurses and their 

ability to extend health care services 

to our most rural and underserved 

communities. They have improved access to health care in Hawaii and 

throughout the United States by their 

willingness to practice in what some 

providers might see as undesirable locations—extremely rural, frontier, or 

urban areas. This legislation ensures 

they are recognized and reimbursed for 

providing the necessary health care 

services patients need, and it gives 

those patients the choice of selecting 

advanced practice nurses and physician 

assistants as their primary care providers. 

Mr. President, I ask unanimous consent that the text of the bill be printed 

in the RECORD. 

There being no objection, the text of 

the bill was ordered to be printed in 

the RECORD, as follows: 

S. 63 

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 ‘‘Medicaid 

Advanced Practice Nurses and Physician Assistants Access Act of 2009’’. 

SEC. 2. IMPROVED ACCESS TO SERVICES OF ADVANCED PRACTICE NURSES AND 

PHYSICIAN ASSISTANTS UNDER 

STATE MEDICAID PROGRAMS. 

(a) PRIMARY CARE CASE MANAGEMENT.— 

Section 1905(t)(2) of the Social Security Act 

(42 U.S.C. 1396d(t)(2)) is amended by striking 

subparagraph (B) and inserting the following: 

‘‘(B) A nurse practitioner (as defined in 

section 1861(aa)(5)(A)). 

‘‘(C) A certified nurse-midwife (as defined 

in section 1861(gg)). 

‘‘(D) A physician assistant (as defined in 

section 1861(aa)(5)(A)).’’. 

(b) FEE-FOR-SERVICE PROGRAM.—Section 

1905(a)(21) of such Act (42 U.S.C. 1396d(a)(21)) 

is amended— 

(1) by inserting ‘‘(A)’’ after ‘‘(21)’’; 

(2) by striking ‘‘services furnished by a certified pediatric nurse practitioner or certified family nurse practitioner (as defined 

by the Secretary) which the certified pediatric nurse practitioner or certified family 

nurse practitioner’’ and inserting ‘‘services 

furnished by a nurse practitioner (as defined 

in section 1861(aa)(5)(A)) or by a clinical 

nurse specialist (as defined in section 

1861(aa)(5)(B)) which the nurse practitioner 

or clinical nurse specialist’’; 

(3) by striking ‘‘the certified pediatric 

nurse practitioner or certified family nurse 

practitioner’’ and inserting ‘‘the nurse practitioner or clinical nurse specialist’’; and 

(4) by inserting before the semicolon at the 

end the following: ‘‘and (B) services furnished by a physician assistant (as defined in 

section 1861(aa)(5)) with the supervision of a 

physician which the physician assistant is 

legally authorized to perform under State 

law’’. 

(c) INCLUDING IN MIX OF SERVICE PROVIDERS

UNDER MEDICAID MANAGED CARE ORGANIZATIONS.—Section 1932(b)(5)(B) of such Act (42 

U.S.C. 1396u–2(b)(5)(B)) is amended by inserting ‘‘, with such mix including nurse practitioners, clinical nurse specialists, physician 

assistants, certified nurse midwives, and certified registered nurse anesthetists (as defined in section 1861(bb)(2))’’ after ‘‘services’’. 

(d) EFFECTIVE DATE.—The amendments 

made by this section shall apply to items 

and services furnished in calendar quarters 

beginning on or after 90 days after the date 

of the enactment of this Act, without regard 

to whether or not final regulations to carry 

out such amendments have been promulgated by such date. 

By Mr. INOUYE: 

S. 65. A bill to provide relief to the 

Pottawatomi Nation in Canada for settlement of certain claims against the 

United States; to the Committee on 

the Judiciary. 

Mr. INOUYE. Mr. President, almost 

14 years ago, I stood before you to introduce a bill ‘‘to provide an opportunity for the Pottawatomi Nation in 

Canada to have the merits of their 

claims against the United States determined by the United States Court of 

Federal Claims.’’ 

That bill was introduced as Senate 

Resolution 223, which referred the 

Pottawatomi’s claim to the Chief 

Judge of the U.S. Court of Federal 

Claims and required the Chief Judge to 

report back to the Senate and provide 

sufficient findings of fact and conclusions of law to enable the Congress to 

determine whether the claim of the 

Pottawatomi Nation in Canada is legal 

or equitable in nature, and the amount 

of damages, if any, which may be legally or equitably due from the United 

States. 

Nine years ago, the Chief Judge of 

the Court of Federal Claims reported 

back that the Pottawatomi Nation in 

Canada has a legitimate and credible 

legal claim. By settlement stipulation, 

the United States has taken the position that it would be ‘‘fair, just and equitable’’ to settle the claims of the 

Pottawatomi Nation in Canada for the 

sum of $1,830,000. This settlement 

amount was reached by the parties 

after 7 years of extensive, fact-intensive litigation. Independently, the 

Court of Federal Claims concluded that 

the settlement amount is ‘‘not a gratuity’’ and that the ‘‘settlement was 

predicated on a credible legal claim.’’ 

Pottawatomi Nation in Canada, et al. 

v. United States, Cong. Ref. 94–1037X at 

28 (Ct. Fed. Cl., September 15, 2000) (Report of Hearing Officer). 

The bill I introduce today is to authorize the payment of those funds 

that the United States has concluded 

would be ‘‘fair, just and equitable’’ to 

satisfy this legal claim from amounts 

appropriated under section 1304 of title 

31 of the United States Code. If enacted, this bill will finally achieve a 

measure of justice for a tribal nation 

that has for far too long been denied. 

For the information of our colleagues, this is the historical background that informs the underlying 

legal claim of the Canadian 

Pottawatomi. 

The members of the Pottawatomi Nation in Canada are one of the descendant groups—successors-in-interest—of 

the historical Pottawatomi Nation and 

their claim originates in the latter 

part of the 18th century. The historical 

Pottawatomi Nation was aboriginal to 

the United States. They occupied and 

possessed a vast expanse in what is now 

the States of Ohio, Michigan, Indiana, 

Illinois, and Wisconsin. From 1795 to 

1833, the United States annexed most of 

the traditional land of the 

Pottawatomi Nation through a series 

of treaties of cession—many of these 

cessions were made under extreme duress and the threat of military action. 

In exchange, the Pottawatomis were 

repeatedly made promises that the remainder of their lands would be secure 

and, in addition, that the United 

States would pay certain annuities to 

the Pottawatomi. 

In 1829, the United States formally 

adopted a Federal policy of removal— 

an effort to remove all Indian tribes 

from their traditional lands east of the 

Mississippi River to the west. As part 

of that effort, the government increasingly pressured the Pottawatomis to 

cede the remainder of their traditional 

lands—some 5 million acres in and 

around the city of Chicago and remove 

themselves west. For years, the 

Pottawatomis steadfastly refused to 

cede the remainder of their tribal territory. Then in 1833, the United States, 

pressed by settlers seeking more land, 

sent a Treaty Commission to the 

Pottawatomi with orders to extract a 

cession of the remaining lands. The 

Treaty Commissioners spent 2 weeks 

using extraordinarily coercive tactics—including threats of war—in an 

attempt to get the Pottawatomis to 

agree to cede their territory. Finally, 

those Pottawatomis who were present 

relented and on September 26, 1933, 

they ceded their remaining tribal estate through what would be known as 

the Treaty of Chicago. Seventy-seven 

members of the Pottawatomi Nation 

signed the Treaty of Chicago. Members 

of the ‘‘Wisconsin Band’’ were not 

present and did not assent to the cession. 

In exchange for their land, the Treaty of Chicago provided that the United 

States would give to the Pottawatomis 

5 million acres of comparable land in 

what is now Missouri. The 

Pottawatomi were familiar with the 

Missouri land, aware that it was similar to their homeland. But the Senate 

refused to ratify that negotiated agreement and unilaterally switched the 

land to 5 million acres in Iowa. The 

Treaty Commissioners were sent back 

to acquire Pottawatomi assent to the 

Iowa land. All but seven of the original 

77 signatories refused to accept the 

change even with promises that if they 

were dissatisfied ‘‘justice would be 

done.’’ Treaty of Chicago, as amended, 

Article 4. Nevertheless, the Treaty of 

Chicago was ratified as amended by the 


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