I

106TH CONGRESS

2D SESSION S. 1515

IN THE HOUSE OF REPRESENTATIVES

JANUARY 27, 2000

Referred to the Committee on the Judiciary

AN ACT

To amend the Radiation Exposure Compensation Act, and

for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Radiation Exposure

5 Compensation Act Amendments of 1999’’.
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1 SEC. 2. FINDINGS.

2 Congress finds that—

3 (1) the Radiation Exposure Compensation Act

4 (42 U.S.C. 2210 note) recognized the responsibility

5 of the Federal Government to compensate individ6 uals who were harmed by the mining of radioactive

7 materials or fallout from nuclear arms testing;

8 (2) a congressional oversight hearing conducted

9 by the Committee on Labor and Human Resources

10 of the Senate demonstrated that since enactment of

11 the Radiation Exposure Compensation Act (42

12 U.S.C. 2210 note), regulatory burdens have made it

13 too difficult for some deserving individuals to be

14 fairly and efficiently compensated;

15 (3) reports of the Atomic Energy Commission

16 and the National Institute for Occupational Safety

17 and Health testify to the need to extend eligibility

18 to States in which the Federal Government spon19 sored uranium mining and milling from 1941

20 through 1971;

21 (4) scientific data resulting from the enactment

22 of the Radiation Exposed Veterans Compensation

23 Act of 1988 (38 U.S.C. 101 note), and obtained

24 from the Committee on the Biological Effects of Ion25 izing Radiations, and the President’s Advisory Com26 mittee on Human Radiation Experiments provide
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1 medical validation for the extension of compensable

2 radiogenic pathologies;

3 (5) above-ground uranium miners, millers and

4 individuals who transported ore should be fairly

5 compensated, in a manner similar to that provided

6 for underground uranium miners, in cases in which

7 those individuals suffered disease or resultant death,

8 associated with radiation exposure, due to the failure

9 of the Federal Government to warn and otherwise

10 help protect citizens from the health hazards ad11 dressed by the Radiation Exposure Compensation

12 Act of 1990 (42 U.S.C. 2210 note); and

13 (6) it should be the responsibility of the Federal

14 Government in partnership with State and local gov15 ernments and appropriate healthcare organizations,

16 to initiate and support programs designed for the

17 early detection, prevention and education on

18 radiogenic diseases in approved States to aid the

19 thousands of individuals adversely affected by the

20 mining of uranium and the testing of nuclear weap21 ons for the Nation’s weapons arsenal.

22 SEC. 3. AMENDMENTS TO THE RADIATION EXPOSURE COM23 PENSATION ACT.

24 (a) CLAIMS RELATING TO ATMOSPHERIC NUCLEAR

25 TESTING.—Section 4(a)(1) of the Radiation Exposure
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1 Compensation Act (42 U.S.C. 2210 note) is amended to

2 read as follows:

3 ‘‘(1) CLAIMS RELATING TO LEUKEMIA.—

4 ‘‘(A) IN GENERAL.—An individual de5 scribed in this subparagraph shall receive an

6 amount specified in subparagraph (B) if the

7 conditions described in subparagraph (C) are

8 met. An individual referred to in the preceding

9 sentence is an individual who—

10 ‘‘(i)(I) was physically present in an af11 fected area for a period of at least 1 year

12 during the period beginning on January

13 21, 1951, and ending on October 31, 1958;

14 ‘‘(II) was physically present in the af15 fected area for the period beginning on

16 June 30, 1962, and ending on July 31,

17 1962; or

18 ‘‘(III) participated onsite in a test in19 volving the atmospheric detonation of a

20 nuclear device; and

21 ‘‘(ii) submits written documentation

22 that such individual developed leukemia—

23 ‘‘(I) after the applicable period of

24 physical presence described in sub25 clause (I) or (II) of clause (i) or on-
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1 site participation described in clause

2 (i)(III) (as the case may be); and

3 ‘‘(II) more that 2 years after

4 first exposure to fallout.

5 ‘‘(B) AMOUNTS.—If the conditions de6 scribed in subparagraph (C) are met, an

7 individual—

8 ‘‘(i) who is described in subclause (I)

9 or (II) of subparagraph (A)(i) shall receive

10 $50,000; or

11 ‘‘(ii) who is described in subclause

12 (III) of subparagraph (A)(i) shall receive

13 $75,000.

14 ‘‘(C) CONDITIONS.—The conditions de15 scribed in this subparagraph are as follows:

16 ‘‘(i) Initial exposure occurred prior to

17 age 21.

18 ‘‘(ii) The claim for a payment under

19 subparagraph (B) is filed with the Attor20 ney General by or on behalf of the indi21 vidual.

22 ‘‘(iii) The Attorney General deter23 mines, in accordance with section 6, that

24 the claim meets the requirements of this

25 Act.’’.
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1 (b) DEFINITIONS.—Section 4(b) of the Radiation Ex2 posure Compensation Act (42 U.S.C. 2210 note) is

3 amended—

4 (1) in paragraph (1)—

5 (A) in subparagraph (A) by inserting

6 ‘‘Wayne, San Juan,’’ after ‘‘Millard,’’; and

7 (B) by amending subparagraph (C) to read

8 as follows:

9 ‘‘(C) in the State of Arizona, the counties

10 of Coconino, Yavapai, Navajo, Apache, and

11 Gila; and’’; and

12 (2) in paragraph (2)—

13 (A) by striking ‘‘the onset of the disease

14 was between 2 and 30 years of first exposure,’’

15 and inserting ‘‘the onset of the disease was at

16 least 2 years after first exposure, lung cancer

17 (other than in situ lung cancer that is discov18 ered during or after a post-mortem exam),’’;

19 (B) by striking ‘‘(provided initial exposure

20 occurred by the age of 20)’’ after ‘‘thyroid’’;

21 (C) by inserting ‘‘male or’’ before ‘‘female

22 breast’’;

23 (D) by striking ‘‘(provided initial exposure

24 occurred prior to age 40)’’ after ‘‘female

25 breast’’;
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1 (E) by striking ‘‘(provided low alcohol con2 sumption and not a heavy smoker)’’ after

3 ‘‘esophagus’’;

4 (F) by striking ‘‘(provided initial exposure

5 occurred before age 30)’’ after ‘‘stomach’’;

6 (G) by striking ‘‘(provided not a heavy

7 smoker)’’ after ‘‘pharynx’’;

8 (H) by striking ‘‘(provided not a heavy

9 smoker and low coffee consumption)’’ after

10 ‘‘pancreas’’; and

11 (I) by inserting ‘‘salivary gland, urinary

12 bladder, brain, colon, ovary,’’ after ‘‘gall blad13 der,’’.

14 (c) CLAIMS RELATING TO URANIUM MINING.—

15 (1) IN GENERAL.—Section 5(a) of the Radi16 ation Exposure Compensation Act (42 U.S.C. 2210

17 note) is amended to read as follows:

18 ‘‘(a) ELIGIBILITY OF INDIVIDUALS.—

19 ‘‘(1) IN GENERAL.—An individual shall receive

20 $100,000 for a claim made under this Act if—

21 ‘‘(A) that individual—

22 ‘‘(i) was employed in a uranium mine

23 or uranium mill (including any individual

24 who was employed in the transport of ura25 nium ore or vanadium-uranium ore from
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1 such mine or mill) located in Colorado,

2 New Mexico, Arizona, Wyoming, South

3 Dakota, Washington, Utah, Idaho, North

4 Dakota, Oregon, and Texas at any time

5 during the period beginning on January 1,

6 1942, and ending on December 31, 1971;

7 and

8 ‘‘(ii)(I) was a miner exposed to 40 or

9 more working level months of radiation

10 and submits written medical documenta11 tion that the individual, after that expo12 sure, developed lung cancer or a nonmalig13 nant respiratory disease; or

14 ‘‘(II) was a miller or ore transporter

15 who worked for at least 1 year during the

16 period described under clause (i) and sub17 mits written medical documentation that

18 the individual, after that exposure, devel19 oped lung cancer or a nonmalignant res20 piratory disease or renal cancers and other

21 chronic renal disease including nephritis

22 and kidney tubal tissue injury;

23 ‘‘(B) the claim for that payment is filed

24 with the Attorney General by or on behalf of

25 that individual; and
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1 ‘‘(C) the Attorney General determines, in

2 accordance with section 6, that the claim meets

3 the requirements of this Act.

4 ‘‘(2) INCLUSION OF ADDITIONAL STATES.—

5 Paragraph (1)(A)(i) shall apply to a State, in addi6 tion to the States named under such clause, if—

7 ‘‘(A) an Atomic Energy Commission ura8 nium mine was operated in such State at any

9 time during the period beginning on January 1,

10 1942, and ending on December 31, 1971;

11 ‘‘(B) the State submits an application to

12 the Department of Justice to include such

13 State; and

14 ‘‘(C) the Attorney General makes a deter15 mination to include such State.

16 ‘‘(3) PAYMENT REQUIREMENT.—Each payment

17 under this section may be made only in accordance

18 with section 6.’’.

19 (2) DEFINITIONS.—Section 5(b) of the Radi20 ation Exposure Compensation Act (42 U.S.C. 2210

21 note) is amended—

22 (A) in paragraph (3)—

23 (i) by striking ‘‘and’’ before

24 ‘‘corpulmonale’’;
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1 (ii) by striking ‘‘; and if the claim2 ant,’’ and all that follows through the end

3 of the paragraph and inserting ‘‘, silicosis,

4 and pneumoconiosis’’; and

5 (iii) by striking ‘‘and’’ at the end of

6 the paragraph;

7 (B) by striking the period at the end of

8 paragraph (4) and inserting a semicolon; and

9 (C) by adding at the end the following:

10 ‘‘(5) the term ‘written medical documentation’

11 for purposes of proving a nonmalignant respiratory

12 disease or lung cancer means, in any case in which

13 the claimant is living—

14 ‘‘(A)(i) an arterial blood gas study; or

15 ‘‘(ii) a written diagnosis by a physician

16 meeting the requirements of subsection (c)(1);

17 and

18 ‘‘(B)(i) a chest x-ray administered in ac19 cordance with standard techniques and the in20 terpretive reports of a maximum of 2 National

21 Institute of Occupational Health and Safety

22 certified ‘B’ readers classifying the existence of

23 the nonmalignant respiratory disease of cat24 egory 1/0 or higher according to a 1989 report
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1 of the International Labor Office (known as the

2 ‘ILO’), or subsequent revisions;

3 ‘‘(ii) high resolution computed tomography

4 scans (commonly known as ‘HRCT scans’) (in5 cluding computer assisted tomography scans

6 (commonly known as ‘CAT scans’), magnetic

7 resonance imaging scans (commonly known as

8 ‘MRI scans’), and positron emission tomog9 raphy scans (commonly known as ‘PET scans’))

10 and interpretive reports of such scans;

11 ‘‘(iii) pathology reports of tissue biopsies;

12 or

13 ‘‘(iv) pulmonary function tests indicating

14 restrictive lung function, as defined by the

15 American Thoracic Society;

16 ‘‘(6) the term ‘lung cancer’—

17 ‘‘(A) means any physiological condition of

18 the lung, trachea, or bronchus that is recog19 nized as lung cancer by the National Cancer In20 stitute; and

21 ‘‘(B) includes in situ lung cancers;

22 ‘‘(7) the term ‘uranium mine’ means any under23 ground excavation, including ‘dog holes’, as well as

24 open pit, strip, rim, surface, or other aboveground
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1 mines, where uranium ore or vanadium-uranium ore

2 was mined or otherwise extracted; and

3 ‘‘(8) the term ‘uranium mill’ includes milling

4 operations involving the processing of uranium ore

5 or vanadium-uranium ore, including both carbonate

6 and acid leach plants.’’.

7 (3) WRITTEN DOCUMENTATION.—Section 5 of

8 the Radiation Exposure Compensation Act (42

9 U.S.C. 2210 note) is amended by adding at the end

10 the following:

11 ‘‘(c) WRITTEN DOCUMENTATION.—

12 ‘‘(1) DIAGNOSIS ALTERNATIVE TO ARTERIAL

13 BLOOD GAS STUDY.—

14 ‘‘(A) IN GENERAL.—For purposes of this

15 Act, the written diagnosis and the accom16 panying interpretive reports described in sub17 section (b)(5)(A) shall—

18 ‘‘(i) be considered to be conclusive;

19 and

20 ‘‘(ii) be subject to a fair and random

21 audit procedure established by the Attor22 ney General.

23 ‘‘(B) CERTAIN WRITTEN DIAGNOSES.—

24 ‘‘(i) IN GENERAL.—For purposes of

25 this Act, a written diagnosis made by a
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1 physician described under clause (ii) of a

2 nonmalignant pulmonary disease or lung

3 cancer of a claimant that is accompanied

4 by written documentation shall be consid5 ered to be conclusive evidence of that dis6 ease.

7 ‘‘(ii) DESCRIPTION OF PHYSICIANS.—

8 A physician referred to under clause (i) is

9 a physician who—

10 ‘‘(I) is employed by the Indian

11 Health Service or the Department of

12 Veterans Affairs; or

13 ‘‘(II) is a board certified physi14 cian; and

15 ‘‘(III) has a documented ongoing

16 physician patient relationship with the

17 claimant.

18 ‘‘(2) CHEST X-RAYS.—

19 ‘‘(A) IN GENERAL.—For purposes of this

20 Act, a chest x-ray and the accompanying inter21 pretive reports described in subsection

22 (b)(5)(B) shall—

23 ‘‘(i) be considered to be conclusive;

24 and
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1 ‘‘(ii) be subject to a fair and random

2 audit procedure established by the Attor3 ney General.

4 ‘‘(B) CERTAIN WRITTEN DIAGNOSES.—

5 ‘‘(i) IN GENERAL.—For purposes of

6 this Act, a written diagnosis made by a

7 physician described in clause (ii) of a non8 malignant pulmonary disease or lung can9 cer of a claimant that is accompanied by

10 written documentation that meets the defi11 nition of that term under subsection (b)(5)

12 shall be considered to be conclusive evi13 dence of that disease.

14 ‘‘(ii) DESCRIPTION OF PHYSICIANS.—

15 A physician referred to under clause (i) is

16 a physician who—

17 ‘‘(I) is employed by—

18 ‘‘(aa) the Indian Health

19 Service; or

20 ‘‘(bb) the Department of

21 Veterans Affairs; and

22 ‘‘(II) has a documented ongoing

23 physician patient relationship with the

24 claimant.’’.

25 (d) DETERMINATION AND PAYMENT OF CLAIMS.—
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1 (1) FILING PROCEDURES.—Section 6(a) of the

2 Radiation Exposure Compensation Act (42 U.S.C.

3 2210 note) is amended by adding at the end the fol4 lowing: ‘‘In establishing procedures under this sub5 section, the Attorney General shall take into account

6 and make allowances for the law, tradition, and cus7 toms of Indian tribes (as that term is defined in sec8 tion 5(b)) and members of Indian tribes, to the max9 imum extent practicable.’’.

10 (2) DETERMINATION AND PAYMENT OF CLAIMS,

11 GENERALLY.—Section 6(b)(1) of the Radiation Ex12 posure Compensation Act (42 U.S.C. 2210 note) is

13 amended by adding at the end the following: ‘‘All

14 reasonable doubt with regard to whether a claim

15 meets the requirements of this Act shall be resolved

16 in favor of the claimant.’’.

17 (3) OFFSET FOR CERTAIN PAYMENTS.—Section

18 6(c)(2)(B) of the Radiation Exposure Compensation

19 Act (42 U.S.C. 2210 note) is amended—

20 (A) in clause (i), by inserting ‘‘(other than

21 a claim for workers’ compensation)’’ after

22 ‘‘claim’’; and

23 (B) in clause (ii), by striking ‘‘Federal

24 Government’’ and inserting ‘‘Department of

25 Veterans Affairs’’.
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1 (4) APPLICATION OF NATIVE AMERICAN LAW TO

2 CLAIMS.—Section 6(c)(4) of the Radiation Exposure

3 Compensation Act (42 U.S.C. 2210 note) is amend4 ed by adding at the end the following:

5 ‘‘(D) APPLICATION OF NATIVE AMERICAN

6 LAW.—In determining those individuals eligible

7 to receive compensation by virtue of marriage,

8 relationship, or survivorship, such determina9 tion shall take into consideration and give effect

10 to established law, tradition, and custom of the

11 particular affected Indian tribe.’’.

12 (5) ACTION ON CLAIMS.—Section 6(d) of the

13 Radiation Exposure Compensation Act (42 U.S.C.

14 2210 note) is amended—

15 (A) by inserting ‘‘(1) IN GENERAL.—’’ be16 fore ‘‘The Attorney General’’;

17 (B) by inserting at the end the following:

18 ‘‘For purposes of determining when the 12-

19 month period ends, a claim under this Act shall

20 be deemed filed as of the date of its receipt by

21 the Attorney General. In the event of the denial

22 of a claim, the claimant shall be permitted a

23 reasonable period in which to seek administra24 tive review of the denial by the Attorney Gen25 eral. The Attorney General shall make a final
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1 determination with respect to any administra2 tive review within 90 days after the receipt of

3 the claimant’s request for such review. In the

4 event the Attorney General fails to render a de5 termination within 12 months after the date of

6 the receipt of such request, the claim shall be

7 deemed awarded as a matter of law and paid.’’;

8 and

9 (C) by adding at the end the following:

10 ‘‘(2) ADDITIONAL INFORMATION.—The Attor11 ney General may request from any claimant under

12 this Act, or from any individual or entity on behalf

13 of any such claimant, any reasonable additional in14 formation or documentation necessary to complete

15 the determination on the claim in accordance with

16 the procedures established under subsection (a).

17 ‘‘(3) TREATMENT OF PERIOD ASSOCIATED WITH

18 REQUEST.—

19 ‘‘(A) IN GENERAL.—The period described

20 in subparagraph (B) shall not apply to the 12-

21 month limitation under paragraph (1).

22 ‘‘(B) PERIOD.—The period described in

23 this subparagraph is the period—

24 ‘‘(i) beginning on the date on which

25 the Attorney General makes a request for
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1 additional information or documentation

2 under paragraph (2); and

3 ‘‘(ii) ending on the date on which the

4 claimant or individual or entity acting on

5 behalf of that claimant submits that infor6 mation or documentation or informs the

7 Attorney General that it is not possible to

8 provide that information or that the claim9 ant or individual or entity will not provide

10 that information.

11 ‘‘(4) PAYMENT WITHIN 6 WEEKS.—The Attor12 ney General shall ensure that an approved claim is

13 paid not later than 6 weeks after the date on which

14 such claim is approved.

15 ‘‘(5) NATIVE AMERICAN CONSIDERATIONS.—

16 Any procedures under this subsection shall take into

17 consideration and incorporate, to the fullest extent

18 feasible, Native American law, tradition, and custom

19 with respect to the submission and processing of

20 claims by Native Americans.’’.

21 (e) REGULATIONS.—

22 (1) IN GENERAL.—Section 6(i) of the Radiation

23 Exposure Compensation Act (42 U.S.C. 2210 note)

24 is amended by adding at the end the following: ‘‘Not

25 later than 180 days after the date of enactment of
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1 the Radiation Exposure Compensation Act Amend2 ments of 1999, the Attorney General shall issue re3 vised regulations to carry out this Act.’’.

4 (2) AFFIDAVITS.—

5 (A) IN GENERAL.—The Attorney General

6 shall take such action as may be necessary to

7 ensure that the procedures established by the

8 Attorney General under section 6 of the Radi9 ation Exposure Compensation Act (42 U.S.C.

10 2210 note) provide that, in addition to any

11 other material that may be used to substantiate

12 employment history for purposes of determining

13 working level months, an individual filing a

14 claim under those procedures may make such a

15 substantiation by means of an affidavit de16 scribed in subparagraph (B).

17 (B) AFFIDAVITS.—An affidavit referred to

18 under subparagraph (A) is an affidavit—

19 (i) that meets such requirements as

20 the Attorney General may establish; and

21 (ii) is made by a person other than

22 the individual filing the claim that attests

23 to the employment history of the claimant.
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1 (f) LIMITATIONS ON CLAIMS.—Section 8 of the Radi2 ation Exposure Compensation Act (42 U.S.C. 2210 note)

3 is amended—

4 (1) by inserting ‘‘(a) IN GENERAL.—’’ before

5 ‘‘A claim’’; and

6 (2) by adding at the end the following:

7 ‘‘(b) RESUBMITTAL OF CLAIMS.—After the date of

8 enactment of the Radiation Exposure Compensation Act

9 Amendments of 1999, any claimant who has been denied

10 compensation under this Act may resubmit a claim for

11 consideration by the Attorney General in accordance with

12 this Act not more than 3 times. Any resubmittal made

13 before the date of enactment of the Radiation Exposure

14 Compensation Act Amendments of 1999 shall not be ap15 plied to the limitation under the preceding sentence.’’.

16 (g) EXTENSION OF CLAIMS AND FUND.—

17 (1) EXTENSION OF CLAIMS.—Section 8 of the

18 Radiation Exposure Compensation Act (42 U.S.C.

19 2210 note) is amended by striking ‘‘20 years after

20 the date of the enactment of this Act’’ and inserting

21 ‘‘22 years after the date of enactment of the Radi22 ation Exposure Compensation Act Amendments of

23 1999’’.

24 (2) EXTENSION OF FUND.—Section 3(d) of the

25 Radiation Exposure Compensation Act (42 U.S.C.
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1 2210 note) is amended in the first sentence by strik2 ing ‘‘date of the enactment of this Act’’ and insert3 ing ‘‘date of enactment of the Radiation Exposure

4 Compensation Act Amendments of 1999’’.

5 (h) ATTORNEY FEES LIMITATIONS.—Section 9 of the

6 Radiation Exposure Compensation Act (42 U.S.C. 2210

7 note) is amended in the first sentence by striking ‘‘10 per

8 centum’’ and inserting ‘‘2 percent’’.

9 (i) GAO REPORTS.—

10 (1) IN GENERAL.—Not later than 18 months

11 after the date of enactment of this Act, and every

12 18 months thereafter, the General Accounting Office

13 shall submit a report to Congress containing a de14 tailed accounting of the administration of the Radi15 ation Exposure Compensation Act (42 U.S.C. 2210

16 note) by the Department of Justice.

17 (2) CONTENTS.—Each report submitted under

18 this subsection shall include an analysis of—

19 (A) claims, awards, and administrative

20 costs under the Radiation Exposure Compensa21 tion Act (42 U.S.C. 2210 note); and

22 (B) the budget of the Department of Jus23 tice relating to such Act.
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1 SEC. 4. ESTABLISHMENT OF PROGRAM OF GRANTS TO

2 STATES FOR EDUCATION, PREVENTION, AND

3 EARLY DETECTION OF RADIOGENIC CAN4 CERS AND DISEASES.

5 Subpart I of part C of title IV of the Public Health

6 Service Act (42 U.S.C. 285 et seq.) is amended by adding

7 at the end the following:

8 ‘‘SEC. 417C. GRANTS FOR EDUCATION, PREVENTION, AND

9 EARLY DETECTION OF RADIOGENIC CAN10 CERS AND DISEASES.

11 ‘‘(a) DEFINITION.—In this section the term ‘entity’

12 means any—

13 ‘‘(1) National Cancer Institute-designated can14 cer center;

15 ‘‘(2) Department of Veterans Affairs hospital or

16 medical center;

17 ‘‘(3) Federally Qualified Health Center, com18 munity health center, or hospital;

19 ‘‘(4) agency of any State or local government,

20 including any State department of health; or

21 ‘‘(5) nonprofit organization.

22 ‘‘(b) IN GENERAL.—The Secretary, acting through

23 the Administrator of the Health Resources and Services

24 Administration in consultation with the Director of the

25 National Institutes of Health and the Director of the In-
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1 dian Health Service, may make competitive grants to any

2 entity for the purpose of carrying out programs to—

3 ‘‘(1) screen individuals described under section

4 4(a)(1)(A)(i) or 5(a)(1)(A) of the Radiation Expo5 sure Compensation Act (42 U.S.C. 2210 note) for

6 cancer as a preventative health measure;

7 ‘‘(2) provide appropriate referrals for medical

8 treatment of individuals screened under paragraph

9 (1) and to ensure, to the extent practicable, the pro10 vision of appropriate follow-up services;

11 ‘‘(3) develop and disseminate public information

12 and education programs for the detection, preven13 tion, and treatment of radiogenic cancers and dis14 eases; and

15 ‘‘(4) facilitate putative applicants in the docu16 mentation of claims as described in section 5(a) of

17 the Radiation Exposure Compensation Act (42

18 U.S.C. 2210 note).

19 ‘‘(c) INDIAN HEALTH SERVICE.—The programs

20 under subsection (a) shall include programs provided

21 through the Indian Health Service or through tribal con22 tracts, compacts, grants, or cooperative agreements with

23 the Indian Health Service and which are determined ap24 propriate to raising the health status of Indians.
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1 ‘‘(d) GRANT AND CONTRACT AUTHORITY.—Entities

2 receiving a grant under subsection (b) may expend the

3 grant to carry out the purpose described in such sub4 section.

5 ‘‘(e) HEALTH COVERAGE UNAFFECTED.—Nothing in

6 this section shall be construed to affect any coverage obli7 gation of a governmental or private health plan or pro8 gram relating to an individual referred to under subsection

9 (b)(1).

10 ‘‘(f) REPORT TO CONGRESS.—Beginning on October

11 1 of the year following the date on which amounts are

12 first appropriated to carry out this section and annually

13 on each October 1 thereafter, the Secretary shall submit

14 a report to the Committee on the Judiciary and the Com15 mittee on Health, Education, Labor, and Pensions of the

16 Senate and to the Committee on the Judiciary and the

17 Committee on Commerce of the House of Representatives.

18 Each report shall summarize the expenditures and pro19 grams funded under this section as the Secretary deter20 mines to be appropriate.

21 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There

22 are authorized to be appropriated for the purpose of car23 rying out this section $20,000,000 for fiscal year 1999
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1 and such sums as may be necessary for each of the fiscal

2 years 2000 through 2009.’’.

Passed the Senate November 19, 1999.

Attest: GARY SISCO,

Secretary.